The School Form of the Hospital: How Does Social Class Affect Post-Stroke Patients in Rehabilitation Units?

This paper wishes to explain, using qualitative sociology, an epidemiological finding: that the extent of recovery following stroke is class-based and that patients from the working classes and lower socioeconomic groups are more vulnerable to functional impairments following stroke than those from higher socioeconomic groups. Based on a 15-month ethnographic study of neurology and rehabilitation units, the paper shows that hospital rehabilitation after stroke is shaped by a “school form,” and that it therefore proves far more efficient with patients who have scholastic dispositions, more frequently associated with people from the middle and upper classes with considerable cultural capital. “What is lost” during a stroke and “what is regained” after is not only a question of location in the brain and how serious the neurological incident was, but also correlates with class-based dispositions and attitudes towards practice, as well as language and learning situations. The notion of “school form” can be useful outside the school context per se when it comes to understanding social inequalities, since it can, in this case, explain the class-based processes through which health inequalities arise.