Honors College Thesis
 

Social Determinants to Real FreedomsAn Empirical Development of the Capabilities Approach

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  • In the Capabilities Approach literature “capabilities” are the real freedoms individuals possess to achieve certain “functionings,” which are the doings and beings that constitute a good life. I argue that this approach requires, or at least can benefit from, an account of the psychosocial mechanisms involved in capability limitation. The three mechanisms, or pathways, I consider include the cognitive resources perspective, the stress process model, and cumulative advantage and disadvantage theory. Each of these pathways begins with an individual’s social characteristics and results in health outcomes with direct and indirect capability relations. Since these capability relations are distributed unequally according to individuals’ social characteristics they are an issue of social justice and require policy attention. I highlight some policy recommendations made in the WHO Commission on Social Determinants of Health report and recommend policies to address the experiences of direct discrimination that report overlooks. I also explain some ways in which the pathways considered here can address two difficulties in the practical application of the capabilities approach, viz., measuring and selecting capabilities.
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