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Challenging categorical thinking: a mixed methods approach to explaining health inequalities

Sochas, Laura (2021) Challenging categorical thinking: a mixed methods approach to explaining health inequalities. Social Science & Medicine, 283. ISSN 0277-9536

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Identification Number: 10.1016/j.socscimed.2021.114192


“Categorical thinking” in social science research has been widely criticised by feminist scholars for conceptualising social categories as natural, de-contextualised, and internally homogeneous. This paper develops and applies a mixed-methods approach to the study of health inequalities, using social categories meaningfully in order to challenge categorical thinking. The approach is demonstrated through a case study of socio-economic (SES) inequalities in maternal healthcare access in Zambia. This paper’s approach responds to the research agenda set by intersectional social epidemiologists by considering potential heterogeneity within categories, but also by exploring the context-specific meaning of categories, examining explanations at multiple levels, and interpreting results according to mutually constitutive social processes. The study finds that meso-level institutions, “health service environments”, explain a large share of SES inequalities in maternal healthcare access. Women’s work, marital status, and levels of “autonomy” have heterogeneous implications for healthcare access across SES categories. Disadvantaged categories and their reproductive behaviours are stigmatised as 'backwards', in contrast to advantaged categories and their behaviours, which are associated with 'modernity' and 'development'. Challenging categorical thinking has important implications for social justice and health, by rejecting framings of a specific category as problematic or non-compliant, highlighting the possibility of change, and emphasising the political and structural nature of progress.

Item Type: Article
Official URL:
Additional Information: © 2021 Elsevier Ltd
Divisions: LSE Health
Subjects: R Medicine > RA Public aspects of medicine
H Social Sciences > HN Social history and conditions. Social problems. Social reform
Date Deposited: 05 Jul 2021 11:39
Last Modified: 20 Oct 2021 03:35

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