Inequality Utilitarian and Capabilities Perspectives (and what they may imply for public health) 1
Utilitarian Perspectives on Inequality 2
Inequalities matter most in terms of their impact onthelivesthatpeopleseektoliveandthethings, relationshipsandpracticeswhichtheyvalue. 3
Agent sovereignty What is good for each person is entirely determined by that very person s evaluative perspective. 4
Ultimately the quality of life must be in the eye of the beholder [ and therefore] it is there is there that weseek ways to evaluate it (Campbell 1972) 5
Happiness of children aged 12-15 (N= 2145) (DJI- Youth Survey) Total Percent Very happy 921 42,9% Rather happy 1173 54,7% Rather not happy 48 2,2% Not happy at all 3 0,1% 6
A variety of social programs that reduced social expectations among the disadvantaged might be hedonically beneficial as well. The key empirical findings here are that increasing the social isolation of subordinated groups often seems to make them happier by leading individuals to compare themselves to a narrower, less prosperous cohort in evaluating their circumstances. 7
Thus, women reported themselves to be more satisfied with their incomes when they did not have much chance of getting traditionally male jobs at male pay. Black children in segregated schools have substantially higher self-esteem than blacks in integrated settings [ ], while high-status blacks who interact with more whites and expect to have lives more like theirs were reported by some researchers to have low and falling rates of happiness. 8
The trouble comes when social or health policy is driven by people s actual preferences. If what people in oppressed circumstances want is conditioned by their presently-feasible options, no social action would seem to be called for to improve the lot of such oppressed people who do not express dissatisfaction with their circumstances. 9
Capability Perspectives on Inequality 10
We ask not only about the person s satisfaction with what she does, but about what she does, and what she is in a position to do (what her opportunities and liberties are). And we ask not just about the resources that are sitting around, but about how those do or do not go to work, enabling [this person] to function in a fully human way (Nussbaum 2000: 71) 11
Functionings vs. Capabilities 12
Das konventionelle Grundmodell der Wirkungen von Interventionen Verhaltensund Daseins- Intervention zustand A Verhaltens- und Daseinszustand C (= unwirksame Maßnahme) Verhaltens- und Daseinszustand B Verhaltens- und Daseinszustand D (= unwirksame Maßnahme) 13
Das CA Grundmodell der Wirkungen von Interventionen Functionings Capabilities Handlungs- und Daseinszustand B Handlungs- und Daseinszustand A Intervention X unter Bedingung Y bei AkteurIn Z Realer Handlungs- und Entscheidungsspielraum Agency- Freedom Handlungs- und Daseinszustand C Ressourcen Konvertierungsfaktoren Handlungs- und Daseinszustand D 14