Cars, corporations, and commodities: Consequences for the social determinants of health

In this paper, we explain how thinking about social forms and social processes can develop epidemiological theory about the social determinants of health. We present the case of the car, the related social forms of the commodity and corporation, and the social processes of motorisation and capital accumulation. These concepts help to elucidate the car's role in production and consumption, and how this impacts on health. Our focus on these social forms and social processes introduces an area missing from social epidemiological work with implications for theoretical and empirical work. We discuss these implications for debates on psychosocial versus material pathways and the impact of place on health, before offering suggestions on how to progress the research agenda and identify major anti-health forces.Health inequalities and the social determinants of health have become part of mainstream health discourse. In March 2005, the World Health Organization (WHO) set up a Commission on Social Determinants of Health [1] involving some leading global social epidemiologists.Social epidemiologists have drawn attention to health inequalities as avoidable, unfair and inequitable, challenging the individual risk factor approach and medical solutions dominating much of 20th century research. Developments include using the concept of embodiment to understand health outcomes as the manifestation of social inequalities [2] and the re-emergence of life course approaches investigating long-term and cumulative health effects of exposures [3]. Theoretical schemas combine ecological and social perspectives, including the eco-social model of Krieger [2], the eco-epidemiological model of Susser [4], and the social-ecologic systems perspective of McMichael [5]. The earlier social production perspective, which in Doyal with Pennell's [6] classic text interrogated relationships between commodity production, profit, and health, is explicitly included in Krieger's models. We intend this article