Privilege and status in an unequal society: shifting the focus of health promotion research to include the maintenance of advantage.

There has been a great deal of social policy and health promotion practice directed toward the inclusion of underprivileged groups with the aim of improving their health. This focus on disadvantaged people and poor communities, to help them empower themselves and improve their lot, often fails because it ignores the role of the broader society. We neglect to note the crucial part that the advantaged play in perpetuating inequalities. Theory and empirical work from sociology and anthropology points to the everyday ways in which privileged people are able to maintain their advantage and even hi-jack the benefits of public health programmes designed to improve the health of the poor. Some examples from these other disciplines suggest ways in which a social psychological perspective can contribute to an understanding of how inequalities and poverty are perpetuated in everyday life. These understandings will inform the effectiveness of social programmes to reduce inequalities.