How politics makes us sick : neoliberal epidemics PDF
Preview How politics makes us sick : neoliberal epidemics
How Politics Makes Us Sick This page intentionally left blank How Politics Makes Us Sick Neoliberal Epidemics Ted Schrecker and Clare Bambra DurhamUniversity,UK ©TedSchreckerandClareBambra2015 Softcover reprint of the hardcover 1st edition 2015 978-1-137-46306-7 Allrightsreserved.Noreproduction,copyortransmissionofthis publicationmaybemadewithoutwrittenpermission. Noportionofthispublicationmaybereproduced,copiedortransmitted savewithwrittenpermissionorinaccordancewiththeprovisionsofthe Copyright,DesignsandPatentsAct1988,orunderthetermsofanylicence permittinglimitedcopyingissuedbytheCopyrightLicensingAgency, SaffronHouse,6–10KirbyStreet,LondonEC1N8TS. Anypersonwhodoesanyunauthorizedactinrelationtothispublication maybeliabletocriminalprosecutionandcivilclaimsfordamages. Theauthorshaveassertedtheirrightstobeidentifiedastheauthorsofthis workinaccordancewiththeCopyright,DesignsandPatentsAct1988. Firstpublished2015by PALGRAVEMACMILLAN PalgraveMacmillanintheUKisanimprintofMacmillanPublishersLimited, registeredinEngland,companynumber785998,ofHoundmills,Basingstoke, HampshireRG216XS. PalgraveMacmillanintheUSisadivisionofStMartin’sPressLLC, 175FifthAvenue,NewYork,NY10010. PalgraveMacmillanistheglobalacademicimprintoftheabovecompanies andhascompaniesandrepresentativesthroughouttheworld. Palgrave®andMacmillan®areregisteredtrademarksintheUnitedStates, theUnitedKingdom,Europeandothercountries. ISBN 978-1-349-49917-5 ISBN 978-1-137-46307-4 (eBook) DOI 10.1057/9781137463074 Thisbookisprintedonpapersuitableforrecyclingandmadefromfully managedandsustainedforestsources.Logging,pulpingandmanufacturing processesareexpectedtoconformtotheenvironmentalregulationsofthe countryoforigin. AcataloguerecordforthisbookisavailablefromtheBritishLibrary. LibraryofCongressCataloging-in-PublicationData Schrecker,Ted. Howpoliticsmakesussick:neoliberalepidemics/TedSchreckerand ClareBambra. pages cm 1. Politicalsociology. 2. Neoliberalism—Socialaspects. 3. Internationaleconomicrelations—Socialaspects. 4. Welfarestate. I. Bambra,C.(Clare) II. Title. JA76.S3572015 306.20973—dc23 2015002382 Contents ListofFigures,TablesandBoxes vi Preface viii Acknowledgements xi 1 Introduction:PoliticsandHealth 1 2 Obesity:HowPoliticsMakesUsFat 23 3 Insecurity:HowPoliticsGetsUnderOurSkin 42 4 Austerity:HowPoliticsHasPulledAwayOurSafetyNet 67 5 Inequality:HowPoliticsDividesandRulesUs 87 6 Conclusion:TheirScarcityandOurPoliticalCure 112 Notes 126 References 128 Index 156 v Figures, Tables and Boxes Figures 1.1 Under-5mortalityrates,sixlow-andmiddle-income countries 6 1.2 Theriseofneoliberalism,1980–2010,bywelfarestate regime 16 2.1 Percentageofthepopulationthatisoverweightand obese,1980–2008,in21countries 25 2.2 Percentageofwomenoverweightand/orobese, 1980–2008,bywelfarestateregime 27 2.3 Percentageofmenoverweightand/orobese,1980–2008, bywelfarestateregime 28 2.4 Associationofpackagedfoodvolume(percapita)with sugarconsumptionandobesityprevalence,2005 36 3.1 Trendsintradeuniondensityasapercentageofpaid workforce,1980–2010,inselectedliberalandsocial democraticcountries 48 3.2 Riseinanti-depressantmedicationbetween2000and 2011intheOECDcountries 54 3.3 VisualrepresentationofKarasek’smodelofjobstrain 55 3.4 Standardizedillnessratiosofincapacitybenefitclaimsby localauthority,EnglandandWales 62 3.5 Percentageofwomenunemployed,worklessduetoill healthordisabilityorinpoorhealth,UK,1978–2004 63 3.6 Percentageofmenunemployed,worklessduetoillhealth ordisabilityorinpoorhealth,UK,1978–2004 64 4.1 MapofcutstolocalauthoritybudgetsinEngland, 2010–2015 77 4.2 Mapoftheprojectedfinanciallossesduetowelfare reformbyEnglishlocalauthority,2010–2015 78 5.1 Lifeexpectancyanddisability-freelifeexpectancyat birth,personsbyneighbourhoodincomelevel,England, 1999–2003 88 5.2 MapoflifeexpectancyformeninEngland,2011 94 5.3 MapoflifeexpectancyforwomeninEngland,2011 95 vi ListofFigures,TablesandBoxes vii 5.4 Mapshowingpercentageofhouseholdsexperiencingfuel povertybylocalauthorityinEngland,2012 97 5.5 Lifeexpectancyisrelatedtoinequalityinrichcountries 108 5.6 Infantmortalityisrelatedtoinequalityinrichcountries 109 5.7 Healthandsocialproblemsarecloselyrelatedto inequalityamongrichcountries 110 6.1 Povertyrates(percent)beforeandaftertaxesand transfers,2011(unlessotherwisenoted),inselected OECDcountries 120 Tables 1.1 Internationalrankingsforlifeexpectancy(nyearsatbirth formenandwomen),1960–2010 2 1.2 Internationalrankingsforinfantmortality(deathsper 1000livebirths),1960–2010 4 1.3 Welfarestateregimes 10 1.4 Averagelifeexpectancyinyears(men)byoccupationin England,1840sand2010s 19 2.1 Annualgrowthrateinpercapitaretailsalesofselected products,1998–2012 38 4.1 Summaryofwelfarereformssince2010 75 Boxes 2.1 Definitionsofobesityandoverweight 26 3.1 TheWhitehallstudies 55 Preface Since the early 1980s, neoliberalism has dominated discussions about politicsandeconomicsacrosstheglobe.Thepoliciesofneoliberalism– whichplacemarketsatthecentreofalleconomicandsociallife–have been implemented across many countries and have usually been pre- sented as the only alternative. In this book, we consider the effects of over three decades of these policies with particular reference to the US and the UK. We focus on four areas: obesity, stress, austerity and inequality. We argue that they represent four ‘neoliberal epidemics’: neoliberal because, as we will show, they are associated with or exac- erbated by the rise of neoliberal politics; epidemics because they are on such an international scale and have been transmitted so quickly across populations that if they were a biological contagion they would beseenasbeingofepidemicproportions.Wealsouseepidemicbecause our focus is largely on the health effects of these phenomena, now and in the future. We will show that, during the neoliberal era, obe- sity has emerged as a new and immensely damaging threat to public health across the world; that insecurity likewise is a common condi- tion for vast swathes of the population, with many negative impacts on health; that austerity – a neoliberal response to the 2008 financial crisis – has caused increases in mortality and morbidity; and that eco- nomic, social and health inequalities – once in decline across rich industrializedcountries–haveincreasedrapidlyasaresultoftheunhin- dered neoliberal pursuit of profit. All of these epidemics are associated with neoliberalism, and we argue that alternative political and eco- nomic choices would have prevented them – or at least reduced their scale–resultinginahealthier21stcentury.Neoliberalpoliticshasmade ussick. In Chapter 1, we examine how health varies internationally among rich countries and the social, economic and political reasons for these differences. We also introduce the concept of welfare state regimes. We then outline the rise of neoliberal economics and politics, par- ticularly in the US and the UK, defining their key aspects and draw- ing parallels with earlier forms of liberal economics in the 19th century. viii Preface ix In Chapter 2, we start with an overview of our first neoliberal epidemic – obesity. Over the last 30 years, obesity rates have doubled in countries such as the UK and the US, with over 20 and 30 per cent (respectively)ofadults nowconsideredobese – an epidemic which has beentransmittedtoourchildren,aswell.Weoutlinethecontoursofthe epidemic, the serious health effects of obesity and the influence of neoliberaleconomicpoliciesinshapingthedevelopmentandspreadof thedisease,anduseinternationalcomparisonstoshowhowthingsare– or could be – different in countries that have made different political choices. Chapter 3 focuses on the neoliberal epidemic of insecurity. Here we argue that neoliberalism has made the labour market and the world of work far less secure and, consequently, more stressful and health dam- aging. This insecurity manifests itself through reductions in workplace rights, job security, pay levels and welfare rights (so-called flexibility). We argue that this has led to large increases in chronic stress across the populations of many countries (and particularly in the most vul- nerable groups), resulting in a myriad of chronic diseases, including musculoskeletal pain and cardiovascular disease. International com- parisons are made with countries that have taken a less neoliberal politicalpath. Chapter 4 examines austerity as a neoliberal epidemic, a particular political and ideological response to the financial crisis of 2008. We describe the politics of this and draw historical comparisons with ear- lierperiodsofcutsinsocialprotection.Weoutlinetheeconomic,social and health effects, with a particular focus on the US and the UK, con- trastingtheexperiencesinthese–twoofthemostneoliberalcountries in the world – with other international experiences where countries have responded to the crisis with state spending rather than public sectorcuts. Chapter 5 examines how neoliberalism has led to an increase in inequalities – economic inequalities, social inequalities and, particu- larly, health inequalities. We explore trends in inequality at macro, national levels and also draw on three case studies that show differ- entfacetsofinequalityintheUKandtheUStoday:howneoliberalism has exacerbated spatial inequalities in health within England; how neoliberalism has fuelled incarceration rates in the US; and how neoliberal approaches to public services have been played out through theprivatizationoftheEnglishNationalHealthService(NHS).Wealso draw on research showing the importance of equality for public health.
The list of books you might like
