Dependency denied: Health inequalities in the neo-liberal era

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Date: Oct. 2014
From: Social Science & Medicine(Vol. 118)
Publisher: Elsevier Science Publishers
Document Type: Article
Length: 344 words

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Abstract :

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.socscimed.2014.08.006 Byline: Marian Peacock, Paul Bissell, Jenny Owen Abstract: The ways in which inequality generates particular population health outcomes remains a major source of dispute within social epidemiology and medical sociology. Wilkinson and Pickett's The Spirit Level (2009), undoubtedly galvanised thinking across the disciplines, with its emphasis on how income inequality shapes the distribution of health and social problems. In this paper, we argue that their focus on income inequality, whilst important, understates the role of neoliberal discourses and practises in making sense of contemporary inequality and its health-related consequences. Many quantitative studies have demonstrated that more neoliberal countries have poorer health compared to less neoliberal countries, but there are few qualitative studies which explore how neoliberal discourses shape accounts and experiences and what protections and resources might be available to people. This article uses findings from a qualitative psycho-social study employing biographical-narrative interviews with women in Salford (England) to understand experiences of inequality as posited in The Spirit Level. We found evidence for the sorts of damages resulting from inequality as proposed in The Spirit Level. However, in addition to these, the most striking finding was the repeated articulation of a discourse which we have termed "no legitimate dependency". This was something both painful and damaging, where dependency of almost any sort was disavowed and responsibility was assumed by the self or "othered" in various ways. No legitimate dependency, we propose, is a partial (and problematic) internalisation of neoliberal discourses which becomes naturalised and unquestioned at the individual level. We speculate that these sorts of discourses in conjunction with a destruction of protective resources (both material and discursive), lead to an increase in strain and account in part for well-known damages consequent on life in an unequal society. We conclude that integrating understandings of neoliberalism into theorising about inequality enriches sociological perspectives in this area. Author Affiliation: School of Health and Related Research (ScHARR), University of Sheffield, UK Article History: Received 20 February 2014; Revised 4 August 2014; Accepted 7 August 2014

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Gale Document Number: GALE|A382900251