The authors argue that Wilkinson's model omits important variables (social
class) that make it vulnerable to biases due to model mis-specification. Fu
rthermore, the culture of inequality hypothesis unnecessarily "psychopathol
ogizes" the relatively deprived while omitting social determinants of disea
se related to production (environmental and occupational hazards) and the c
apacity of the relatively deprived for collective action. In addition, the
hypothesis that being "disrespected" is a fundamental determinant of violen
ce has already been refuted. Shying away from social mechanisms such as exp
loitation, workplace domination, or classist ideology might avoid conflict
but reduce the income inequality model to a set of useful, but simple and w
anting associations. Using a nonrecursive structural equation model that te
sts for reciprocal effects, the authors show that working-class position is
negatively associated with social cohesion but positively associated with
union membership. Thus, current indicators of social cohesion use middle-cl
ass standards for collective action that working-class communities are unli
kely to meet. An erroneous characterization of working-class communities as
noncohesive could be used to justify paternalistic or punitive social poli
cies. These criticisms should not detract from an acknowledgment of Wilkins
on's investigations as a leading empirical contribution to reviving social
epidemiology at the end of the century.