A sociological approach to resilience in health and illness

Work on resilience in health and illness has been approached from a number of perspectives. These are the biological and psychosocial with a focus on the individual's responses to cope and adapt to changing circumstances wrought by changing physical health states. This we argue has a place but is far too narrow emphasizing the neoliberal view that the sick or imperfect individual is ultimately responsible for their own health outcomes. In this perspective, the individual's failure to cope or adapt may be seen as a personal failure to interact with the health system on offer. A broader sociological approach focuses on the overarching sociopolitical system within which health and illness occur and looks at the role of concepts such as growing social and economic inequity and the process by which neoliberalism establishes the framework of unequal opportunity and life chances. At this broader level, resilience relates to interplay between the sociopolitical and health systems and the individual. It is the role of the health system to provide opportunities, and supports and to reduce inequities to promote healthy lifestyle and beneficial coping approaches. We aim to understand and describe the mechanisms and opportunities afforded to individuals by their place in the social structure and to argue for health reform that makes a health system that assists all individuals be resilient. Longitudinal data from the Australian Epilepsy Longitudinal Survey are used to understand how income, inequity, and social isolation affect resilience over time.