Social capital, economic capital and power: further issues for a public health agenda

Lynch et al offer a rejoinder to my editorial and argue for “a neo-material basis for health in the 21st century”.1 In their article they claim that my editorial rejected a materialist view of health inequities and promoted instead a psychosocial perspective on health inequities. While I find myself in agreement with much of the thrust of the argument of Lynchet al concerning the importance of material factors to health, I think their critiques of my piece are largely unsubstantiated. In the following reply I dispute some of their claims about my editorial, offer support to much of their argument and suggest that both my original editorial and their rejoinder failed to pay attention to the role of power in producing and continuing economic, social and health inequities.

I am glad that my editorial has sparked the interest of thoughtful public health researchers. That was my intention in writing it. Social capital literature is growing apace. Winter2 reports that before 1981 the number of journal articles listing social capital as an identifier totalled 20. Between 1991 and 1995 there were 109 listings and from 1996 to March 1999 there were 1003 listings. The term is being used in a range of policy settings including by local, state and national governments and by international organisations such as the World Bank. In this context it is vitally important that public health enters the theoretical debate more rigorously than it has to date. My editorial was a short piece (in fact about half the length of the rejoinder) in which I sought to offer some warnings to the public health community about an unquestioning acceptance of the notion of social capital and, in particular a view of social capital that did not consider its interaction with economic factors and that …