Urban Poverty and Health Inequalities

A Relational Approach

Darrin Hodgetts, Ottilie Stolte

• Publisher: Routledge
• Year: 2017
• ISBN:
  9781317300304
• Edition: 1
• Topic: Psicología
• Subtopic: Historia y teoría en psicología

When discussing health, we talk about ailments and afflictions, the potential of modern medicine and the behaviours that affect our health. Yet although these relationships exist, they undermine a more socio-economic understanding of health. This timely book takes a critical perspective to argue that urban poverty and health inequalities are intimately interconnected, and that the increasing disparity between rich and poor will necessarily exacerbate health issues within urban communities.

Urban Poverty and Health Inequalities documents how life has become increasingly insecure and stressful for growing numbers of people due to increased insecurities in employment, income and housing, rising living costs, and the retrenchment of welfare and social services. The book explores the role of history and media depictions of poverty and health inequalities in influencing the current situation. A central objective is to advance ways to understand and respond to urban poverty as a key social determinant of health. The authors pay particular attention to the ways in which punitive responses to urban poverty are further exacerbating the hardships faced by people living in urban poverty.

Looking at issues of class, age, gender, ethnic and disability-based inequalities, the book offers both critical theory and grounded solutions to enable those living in poverty to live healthier lives. The collateral damage resulting from current socio-economic arrangements reflects political choices regarding the distribution of resources in societies that needs to be challenged and changed. The authors attend to initiatives for change, offering practical responses to address urban poverty, including efforts to address wealth distribution, the potential of living wage and Universal Basic Income initiatives, social housing and anti-oppressive welfare systems.

CONTENTS

Series editor preface

Foreword

1 Introduction to urban poverty and health inequalities

2 Greed versus need

3 Mediating urban poverty

4 Experiences of poverty and ill health

5 Homelessness as the sharp edge of poverty

6 Responses, resistance, and reforms

References

Index

SERIES EDITOR PREFACE

Critical Approaches to Health

Health is a major issue for people all around the world, and is fundamental to individual well-being, personal achievements, and satisfaction, as well as to families, communities, and societies. It is also embedded in social notions of participation and citizenship. Much has been written about health, from a variety of perspectives and disciplines, but a lot of this writing takes a biomedical and causally positivist approach to health matters, neglecting the historical, social, and cultural contexts and environments within which health is experienced, understood, and practised. It is an appropriate time to introduce a new series of books that offer critical, social science perspectives on important health topics.

The Critical Approaches to Health series aims to provide new critical writing on health by presenting critical, interdisciplinary, and theoretical writing about health, where matters of health are framed quite broadly. The series will include books that range across important health matters, including general health-related issues (such as gender and media), major social issues for health (such as medicalization, obesity, and palliative care), particular health concerns (such as pain, doctor–patient interaction, health services, and health technologies), particular health problems (such as diabetes, autoimmune disease, and medically unexplained illness), or health for specific groups of people (such as the health of migrants, the homeless, and the aged), or combinations of these.

The series seeks above all to promote critical thought about health matters. By critical, we mean going beyond the critique of the topic and work in the field, to more general considerations of power and benefit, and in particular, to addressing concerns about whose understandings and interests are upheld and whose are marginalized by the approaches, findings, and practices in these various domains of health. Such critical agendas involve reflections on what constitutes knowledge, how it is created, and how it is used. Accordingly, critical approaches consider epistemological and theoretical positioning, as well as issues of methodology and practice, and seek to examine how health is enmeshed within broader social relations and structures. Books within this series take up this challenge and seek to provide new insights and understandings by applying a critical agenda to their topics.

In this book, Darrin Hodgetts and Ottilie Stolte offer a wide-ranging and critical discussion of urban poverty and socio-economic inequalities, and their implications for health and well-being. The book documents the changing conditions of inequality and the recent increase in people living precarious lives in Western societies due to a range of factors, including inadequate income, unemployment, working conditions, lack of shelter, and social involvement. Hodgetts and Stolte provide a brief historical analysis to demonstrate how understandings and responses to poverty have changed over time. They argue that we are currently experiencing a return to forms of penal welfare, with a focus on individual responsibility, imposed sanctions, and marginalized citizenship. Drawing on current social and political framings of poverty and disadvantage, the authors discuss contemporary neoliberal responses to urban poverty, how welfare systems have altered, and how impoverished people are regarded and treated by these systems.

Through this framework, Hodgetts and Stolte examine a number of key issues of poverty. Their consideration of media representations of the ‘urban poor’, welfare systems, and health inequalities demonstrates how these form a symbolic landscape that marginalizes and ignores the experiences of people living in impoverished circumstances, constituting them as undeserving while simultaneously rendering invisible the structural factors that impact on poverty. The lived realities of people living impoverished lives are also considered, demonstrating the hardship, the health implications, as well as the resilience that appears in these difficult circumstances. Homelessness is viewed as the ‘sharp edge of poverty’, with a range of health implications, and the authors argue that this requires a relational and societal approach to be addressed successfully.

This is a significant and timely contribution to the Critical Approaches to Health series, offering a strong critique of current responses to urban poverty, and of the structural arrangements that produce and sustain it within contemporary urban societies. As Hodgetts and Stolte argue, relational aspects of life have been essentially ignored or marginalized in responses to urban poverty. Solutions must take account of the interconnected nature of people’s lives, as these inform participation and citizenship, and ultimately offer alternative ways of addressing urban poverty more constructively.

Kerry Chamberlain and Antonia Lyons

May 2017

FOREWORD

Urban poverty is not an isolated phenomenon. It stems from broader structural inequalities in society. Current societal arrangements are increasingly serving the interests of people with economic and political power, while impoverishing and harming the health of people lower down the socio-economic ladder. The wealth of the 1 per cent of most affluent people now far exceeds that of the poorest half of the global population. Relatedly, as the health and social costs of present socio-economic arrangements become harder to ignore, issues of inequality, poverty, and ill health are again on the political agenda.

While we acknowledge the importance of issues of rural poverty, the urbanization of populations has led to an intensification of issues of urban poverty. This book offers a synthesis of current thought on urban poverty and health inequalities. Our focus is on how the rise of socio-economic inequalities, and corresponding increasingly punitive responses to human need, further exacerbate the hardships faced by people. In doing so, we consider key trends across so-called ‘developed’ or ‘minority world’ ¹ countries, including the United States, Canada, the United Kingdom, Australia, and New Zealand. An advantage of looking for common threads that emerge across these countries is that this enables us to consider the broader influences at play in perpetuating inequalities and urban poverty on an increasingly global scale. These broader influences are associated with market fundamentalism (read neoliberalism) and the corresponding concentration of wealth in the hands of a few at the expense of the many.

Life has become increasingly insecure and stressful for growing numbers of people due to heightened competition for jobs, rising living costs, inadequate incomes, and the retrenchment of health and social services. As hardship has increased in many countries, social safety nets have been undermined. This means that becoming sick, elderly, or losing one’s livelihood now poses much greater risks for one’s health. Current political–economic frameworks advocate the self-responsible individual pitted against others in a competitive battle for resources and survival. Charles Darwin is often a misquoted source of justification for such arrangements. Proponents of so-called ‘Social Darwinism’ often chant the mantra of ‘survival of the fittest’. Darwin actually never used this phrase. What Darwin stated was that species ‘who learned to collaborate and improvise most effectively have prevailed’. Today, the significance of collaboration and cooperation in human societies is frequently overlooked due to the adherence to a narrow caricature of what it means to be human that fetishizes individualism and competition over interconnectivity and cooperation. This misrepresentation of human nature is costing lives, and is obstructing human flourishing. We have known for some time that adversarial social arrangements that are associated with distorted notions of survival of the fittest have serious health and social implications. These arrangements can adversely affect all of us, but those of more modest means carry the greatest burden.

People lower down the socio-economic ladder are more likely to get sick and die quicker than more affluent people. This does not have to be the case. We do not accept the assertion that is often made by conservative commentators that inequalities, and the resulting poverty, are inevitable and that ‘the poor will always be with us’. Socio-economic inequalities are the product of human relations and are thus avoidable. At a collective level, we have the resources to improve population health. The world is now wealthier than ever before in human history. However, instead of being investe...