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Egalitarianism in Scandinavia pp 181–200Cite as

Palgrave Macmillan

Social Differences in Health as a Challenge to the Danish Welfare State

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Part of the book series: Approaches to Social Inequality and Difference ((ATSIAD))

Abstract

In Denmark, as in most other parts of the world, socially deprived people most often lead shorter and more illness-ridden lives than people living in more affluent social situations. In the context of an egalitarian welfare state where ideals of equality, solidarity, and universality dominate, this may seem somewhat paradoxical. The central argument in this chapter is that differences in morbidity and mortality across the population in a very definite way reveal fundamental structures of inequality in the Danish egalitarian welfare state. These differences are most often overlooked or ignored, given the egalitarian ideology of imagined sameness. This implies that ideologies of egalitarianism in the Nordic welfare states may sometimes blind us to the consequences that existing social hierarchies have for the lives of people from lower social classes.

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Notes

  1. 1.

    Kjærsgård ascribes these differences to the divergent attitudes, media content, and the legacy of the political economies of Denmark and Sweden (Kjærsgård 2015, 40).

  2. 2.

    This aversion to sticking out may also be understood by reference to Janteloven (the Law of Jante), which was described and conceptualized by the Norwegian novelist Aksel Sandemose (1992 [1972)). In his novel En flygtning krydser sit spor [A Fugitive Crosses His Tracks], he describes the Danish imperative of the need to fit in, not think of oneself as better than anyone else. Although the point of departure for describing Janteloven was rural Denmark in the early nineteenth century, the concept remains central to Danish self-understanding and outlook and is still referred to when describing “typical” Danish character traits or tendencies.

  3. 3.

    The lower classes include what is termed the “underclass” and the “working class”, and the higher social classes are described as the “upper class” and the “higher middle class”. Olsen and colleagues define the middle class as independent business men, senior executives or people with short-range or middle-range education who earn less than twice the average income in Denmark . The lower social classes are defined as skilled and unskilled workers and people who are out of the workforce for 4/5ths of the year. The higher social classes are defined as independent business men, senior executives and people with a higher education who earn more than twice the average Danish income, as well as all university graduates, independent of income (Olsen et al. 2012, 37). The average income in Denmark was 403,500 Danish Kroner in 2012 (Sabiers and Larsen 2014).

  4. 4.

    An exception is the work of ethnologist Thomas Højrup , who carried out pioneering work on different lifeforms (livsformer) in Denmark in the early 1980s. He analyzed how different social groups of people practiced their everyday lives, and highlighted significant social differences within Danish society (Højrup 1983).

  5. 5.

    See Chap. 13 by Monica Aarset in this volume, where Aarset discusses the challenges of transgressing social and cultural boundaries between social classes.

  6. 6.

    See Linnet (2011) for a similar point regarding stereotypical descriptions of social classes.

  7. 7.

    The geographical division of Danish society, especially in rural vs. urban areas, adds to social segregation, and expressions such as the “rotten banana” (den rådne banan) and “outskirts Denmark” (udkants-Danmark) are commonly used to underline the social and economic hierarchy of the urban-rural division of the country.

  8. 8.

    See the Introduction, Chap. 1 of this volume for further discussion of the egalitarian paradox.

  9. 9.

    See Chap. 9 by Ida Erstad in this volume for a similar point raised in a Norwegian context.

  10. 10.

    Elin Pausewang (2001, 171) makes an interesting point regarding how in the very process of measuring and categorizing, differences in disease prevalence and survival through socio-economic variables (such as economy, education, or employment status differences) are drawn up and explicated, paradoxically, in the attempt to eradicate them.

  11. 11.

    Some scholars have analyzed the ways in which the moral landscape and organizational or social structures influence health practices, looking at, for example, the availability and accessibility of healthy food (Cummins et al. 2014), social and material circumstances (Farmer 1999), and the organization of the health care system (Andersen et al. 2014).

  12. 12.

    Halvard Vike’s point is that people with low social positions are often described as lacking personal competences if they fail to live up to the standards of the universal welfare system (Vike 2001).

  13. 13.

    Such neo-liberal transformations of the very idea and the character of the welfare state have also been traced in recent writings on the Danish welfare state (Bruun et al. 2015). The chapters in the volume edited by Bruun, Krøijer, and Rytter analyze the various ways in which the Danish welfare state has changed its expectations of its citizens, indicating a move away from a welfare ideal of imagined sameness.

  14. 14.

    See Offersen , Vedsted , and Andersen for an analysis of the ways in which notions of morality are embedded in perceptions of bodily sensations by their Danish middle-class informants, and thereby create possibilities for interpretations and actions regarding the body, health, and illness. Offersen argues that these possibilities include concerns about the common good of the Danish welfare state, which may legitimize decisions regarding whether or not to seek health care; this is particularly salient among Danish middle-class citizens (Offersen et al. 2017).

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Acknowledgements

I would like to extend my profound thanks to Rikke Sand Andersen for taking the time to read through this chapter and for offering insightful and critical constructive comments. I would also like to thank the members of CAP anthropology at The Research Unit for General Practice for their valuable comments and input.

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  1. The Research Unit for General Practice, Department of Public Health, Aarhus University, Århus, Denmark

    Camilla Hoffmann Merrild

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Editors and Affiliations

  1. Dept of Social Anthropology, University of Bergen, Bergen, Norway

    Synnøve Bendixsen

  2. University of Bergen, Bergen, Norway

    Mary Bente Bringslid

  3. University College Southeast Norway, Skien, Norway

    Halvard Vike

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Merrild, C.H. (2018). Social Differences in Health as a Challenge to the Danish Welfare State. In: Bendixsen, S., Bringslid, M., Vike, H. (eds) Egalitarianism in Scandinavia. Approaches to Social Inequality and Difference. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-59791-1_8

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  • DOI: https://doi.org/10.1007/978-3-319-59791-1_8

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