Progressive municipalities and health inequalities - a Swiss paradox?
To the researchers' surprise, inequalities in health based on social status are greater in economically progressive locations in Switzerland. Indeed, people of low status in economically progressive locations report significantly lower subjective health and life satisfaction than people of the same status in conservative locations. Two LIVES Centre researchers, Katy Morris (University of Lausanne) and Dimitrios Lampropoulos (University of Vincennes, Paris 8), interpret this unexpected result as evidence of the impact of the ideological climate. They speculate that the repeated national rejection of ballot initiatives that sought to change the economic status quo may play a role in explaining why status-based health inequalities are larger in economically progressive municipalities.
Research on social status and health has consistently shown that people with lower socio-economic status have worse health and lower subjective wellbeing. Using MOSAiCH (Measurement and Observation of Social Attitudes in Switzerland) data from 2015 to 2020, Katy Morris and Dimitrios Lampropoulos propose and test the idea that local ideological climates – shared local norms and ways of thinking – may impact the relationship between social status and health. From existing studies, the researchers expected that low status people would report higher levels of subjective health and life satisfaction if they lived in economically progressive municipalities. However, the results obtained run counter to their hypothesis.
On average, respondents with low subjective status report life satisfaction of 60 on a 100 point scale in the most economically progressive municipalities, whereas this score is 72 in the most economically conservative locations. Among low income respondents, average life satisfaction is 65 in the most economically progressive municipalities but 76 in the most conservative places.
Consequences of the structural climate on individual health
While the results do not corroborate the initial hypothesis, the negative association between economic progressivity and the health and wellbeing of low status individuals merits consideration. The LIVES researchers measured the economic progressivity or conservatism of Swiss municipalities on the basis of the results of three popular ballot initiatives that sought to change the economic status quo in Switzerland. In this framework, economically progressive places are places where a higher proportion of residents voted in favour of these initiatives:
- executive pay (2013)
- the national minimum wage (2014)
- 99% - Lower taxes on wages, tax capital fairly (2021)
These votes were rejected by 65.3%, 76.3% and 64.9% of the Swiss electorate respectively. Morris and Lampropoulos argue that the wholesale national rejection of the three ballot initiatives used to measure the ideological climate is likely to be core to understanding. They propose that the contrast between local norms and aspirations in places that were more favourably disposed to these ballot initiatives and national voting patterns may be such that low status individuals in economically progressive places have internalised a sense of anger, frustration and/or hopelessness about the impossibility of structural change in Switzerland that materially affects their health and wellbeing.
Contact and full article
- Dr Katy Morris, Junior lecturer, Institut des Sciences sociales, Faculté des Sciences sociales et politiques (SSP), Université de Lausanne - katy.morris@unil.ch
- Dr Dimitrios Lampropoulos, Senior lecturer, Laboratoire parisien de psychologie sociale, Université Paris 8 - dimitrios.lampropoulos@univ-paris8.fr
Katy Morris and Dimitrios Lampropoulos (2024) The progressive place paradox: Status-based health inequalities are magnified in more economically progressive Swiss localities Health & Place, 86, 103215. doi:10.1016/j.healthplace.2024.103215
Since 2011, the LIVES Centre (Swiss Centre of Competence in Life Course and Vulnerability Research) has been studying the effects of the economy and society on the development of situations of vulnerability through longitudinal and comparative studies. Its aim is to gain a better understanding of the emergence and evolution of vulnerability, as well as the ways in which it can be overcome, in order to encourage the emergence of innovative socio-political measures. The LIVES Centre is hosted by the universities of Lausanne and Geneva. It comprises a network of some 200 researchers from a variety of disciplines throughout Switzerland and abroad.