Faraz Vahid Shahidi has responded to our paper, suggesting that we are 
class apologists and giving us an introductory lesson on class and 
Marxism. In so doing he has rather missed the nuance of the argument 
being made.

There is no suggestion in our paper that class does not 'set limits' on 
what people may achieve. Obviously a person's class position affects her 
opportunities in life.

What we do argue, however, is that class has fractured considerably in 
the almost 150 years since Marx published Capital. To understand health 
behaviours and their differences among different groups we need to 
consider that class is more complicated than the dichotomy of workers 
and capitalists, or the sliding scales of income quintile or education 
level. There are many many structural influences that set limits on the 
opportunities a person enjoys and privileging one measure over all 
others is to the detriment of our ability to accurately describe the 
ways people behave.

Public health can continue to treat some abstract concept of class as 
the complete explanation for all differences in health behaviour. It has 
taken this position consistently in the 40 years since the first 
Whitehall study. In that time, we have been spectacularly unsuccessful 
at describing why people choose the health behaviours they do, or why 
some of these behaviours are associated with certain class positions. If 
we are to advance at all it might be worth engaging instead with all of 
the useful sociology and social theory that has occurred in the last 
century.

-- 
Brad Crammond BA LLB LLM PhD
Adjunct Research Fellow
Michael Kirby Centre for Public Health and Human Rights

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