A comment on Kerry Chamberlain paper: Poverty, health, and health psychology. A critical perspective

Titolo Rivista PSICOLOGIA DELLA SALUTE
Autori/Curatori Simona Beretta
Anno di pubblicazione 2018 Fascicolo 2018/2
Lingua Inglese Numero pagine 8 P. 9-16 Dimensione file 175 KB
DOI 10.3280/PDS2018-002003
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Chamberlain’s proposition that individualistic perspectives in mainstream health psychology cannot adequately address those forms of health deprivations that reflect poverty and exclusion also challenges individualistic perspectives in Economics. Beyond the individualistic rationality of homo economicus, behavioural economics suggests policy actions such as nudging people in making better decisions, using priming and framing instruments that especially target macro-social constructs and contexts, that are likely to induce desirable individual behaviours. However, we need to consider other inner drivers of personal agency (perceptions, beliefs and hopes), that develop within micro-social relations. Health-related personal decisions, for example, can be affected by experience and exposure to personalised, durable care relations. Community care, and accompaniment, for example, are both cost-effective and restorative of a dignified sense of self. Empirical evidence of the transformative impact of micro- social relations, both on vulnerable individuals and people in charge of policymaking, requires both quantitative and qualitative tools in a multi-disciplinary, multi-instrument setting.

Secondo Chamberlain, le prospettive individualistiche tipiche dell’approccio mainstream di Psicologia della Salute non sono adatte a mettere adeguatamente in luce la questione di come affrontare le forme di deprivazione sanitaria associate a condizioni di povertà ed esclusione sociale. Questa affermazione sfida anche l’approccio individualistico in Economia. Superando l’ipotesi di razionalità dell’homo economicus, l’economia comportamentale suggerisce politiche di nudging per spingere individui non perfettamente razionali verso scelte migliori, utilizzando forme di priming e di framing che riformulino i costrutti e contesti macro- sociali in cui le scelte individuali avvengono, inducendo comportamenti maggiormente desiderabili. Tuttavia, l’agire individuale risponde ad altre determinanti profonde (percezioni, convinzioni, speranze) che si sviluppano nelle relazioni micro-sociali. Le decisioni personali relative alla salute, per esempio, dipendono anche dalla esposizione ed esperienza di relazioni personalizzate e durevoli di cura. La community care e l’accompagnamento, per esempio, sono forme di intervento efficaci sia in termini di costo, sia nel rigenerare il senso di dignità personale. L’analisi empirica del possibile impatto trasformativo delle relazioni micro-sociali, sia sui soggetti vulnerabili sia sui decisori della politica sanitaria, richiede approcci multidisciplinari e multi-strumenti, con l’uso di metodi sia qualitativi, sia quantitativi.

Keywords:Economia comportamentale, relazioni micro sociali, tubercolosi, agency, processo politico

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Simona Beretta, A comment on Kerry Chamberlain paper: Poverty, health, and health psychology. A critical perspective in "PSICOLOGIA DELLA SALUTE" 2/2018, pp 9-16, DOI: 10.3280/PDS2018-002003