A Bourdieusian approach to class-related inequalities: the role of capitals and capital structure in the utilisation of health care services in later life

This paper draws on Bourdieu’s theory of economic, social and cultural capital to understand the relative effect of the volume and the composition of these capitals on health care service use in later life. Based on data from the fifth wave of the Survey of Health, Aging, and Retirement in Europe (n=64,840), we first look at the contribution of each capital in the use of three health care services (general practitioner, dentist and hospital). Using cluster analysis, we then mobilise Bourdieu’s concept of habitus to explain how the unequal distribution of material and non-material capitals acquired in childhood lead to different levels of health and hospital care utilisation in later life.
After controlling for demographic and health insurance variables, our results show that economic capital has the strongest individual association among the three capitals. However, the results of a cluster analysis used to distinguish between capital structures shows that those with high non-material capital and low material capital have higher levels of primary health care utilisation, and in turn lower levels of hospital use. Bourdieu’s approach sheds light on class-related mechanisms that contribute to the production of practices related to use of health and hospital services in later life.