Neoliberal Governance and Health : Duties, Risks, and Vulnerabilities PDF
Preview Neoliberal Governance and Health : Duties, Risks, and Vulnerabilities
NEOLIBERAL GOVERNANCE AND HEALTH NEOLIBERAL GOVERNANCE AND HEALTH Duties, Risks, and Vulnerabilities Edited by Jessica Polzer and Elaine Power © McGill-Queen’s University Press 2016 ISBN 978-0-7735-4782-7 (cloth) ISBN 978-0-7735-4783-4 (paper) ISBN 978-0-7735-9954-3 (ePDF) ISBN 978-0-7735-9955-0 (ePUB) Legal deposit second quarter 2016 Bibliothèque nationale du Québec Printed in Canada on acid-free paper that is 100% ancient forest free (100% post-consumer recycled), processed chlorine free This book has been published with the help of a grant from the Canadian Federation for the Humanities and Social Sciences, through the Awards to Scholarly Publications Program, using funds provided by the Social Sciences and Humanities Research Council of Canada. McGill-Queen’s University Press acknowledges the support of the Canada Council for the Arts for our publishing program. We also acknowledge the financial support of the Government of Canada through the Canada Book Fund for our publishing activities. LIBRARY AND ARCHIVES CANADA CATALOGUING IN PUBLICATION Neoliberal governance and health : duties, risks, and vulnerabilities / edited by Jessica Polzer and Elaine Power. Includes bibliographical references and index. Issued in print and electronic formats. ISBN 978-0-7735-4782-7 (cloth). – ISBN 978-0-7735-4783-4 (paper). – ISBN 978-0-7735-9954-3 (ePDF). – ISBN 978-0- 7735-9955-0 (ePUB) 1. Medical care – Canada – Case studies. 2. Medical policy – Canada – Case studies. 3. Public health – Canada – Case studies. 4. Neoliberalism – Canada – Case studies. I. Polzer, Jessica, 1969–, author, editor II. Power, Elaine M., 1961–, author, editor RA395.C3N45 2016 362.10971 C2016-901775-3 C2016-901776-1 Set in 10.5/14 Calluna with Gotham Book design and typesetting by Garet Markvoort, zijn digital CONTENTS Acknowledgments Introduction: The Governance of Health in Neoliberal Societies Jessica Polzer and Elaine Power 1 Fat Children, Failed (Future) Consumer-Citizens, and Mothers’ Duties in Neoliberal Consumer Society Elaine Power 2 Environment-as-Risk and Green Consumerism in Neoliberal Public Health Practices Rebecca Hasdell 3 Tween Girls, Human Papillomavirus (HPV), and the Deployment of Female Sexuality in English Canadian Magazines Laura Cayen, Jessica Polzer, and Susan Knabe 4 Risk, Retirement, and the “Duty to Age Well”: Shaping Productive Aging Citizens in Canadian Newsprint Media Debbie Laliberte-Rudman 5 The Political Is Personal: Breast Cancer Risk, Genetic(optim)ization, and the Proactive Subject as Neoliberal Biological Citizen Jessica Polzer 6 Global Biopolitics and Pandemic Influenza Preparedness: Securitization and the Regulation of Viral Uncertainty and Mutual Vulnerability Sarah Sanford 7 Risk and Resistance: Citizenship and Self-Determination through Health Governance in Nunavut, Canada Sara Tedford 8 “So It’s Always a Dance”: The Politics of Gifts and Governance at a Drop-In Centre for Vulnerable Women in Southern Ontario Treena Orchard 9 “You Are Free to Set Your Own Hours”: Governing Worker Productivity and Health through Flexibility and Resilience Ellen MacEachen, Jessica Polzer, and Judy Clarke 10 Active Citizenship and the Management of Stigma in Contingent Work Marcia Facey 11 Self-Management and the Government of Disability: Reinforcing Normalcy through the Construction of Able-Disabled Subjectivities Erika Katzman Contributors Index ACKNOWLEDGMENTS We acknowledge the faculty and staff of the former Department of Behavioural Science and Social Science and Health Graduate Program, University of Toronto, who worked against the institutional grain to create a space within which graduate training in critical social science perspectives on health could flourish, with special thanks extended to Robin Badgley, David Coburn, Joan Eakin, Blake Poland, Ann Robertson, and Harvey Skinner. In particular we would like to acknowledge Ann Robertson whose supervision helped us craft our own distinct critical sensibilities and bring them together fruitfully in this volume. We express our thanks to Jonathan Crago at McGill-Queen’s University Press for his guidance throughout the process of bringing this manuscript to publishable form and the anonymous reviewers for their thoughtful feedback on previous versions of the manuscript. Thank you as well to Joanne Muzak for her fine editorial care and attention and to Ryan Van Huijstee for his assistance with the cover design. NEOLIBERAL GOVERNANCE AND HEALTH INTRODUCTION The Governance of Health in Neoliberal Societies Jessica Polzer and Elaine Power Discourses on health come into and go out of fashion, but not arbitrarily. Rather, they emerge and gain widespread acceptance primarily because they are more or less congruent with the prevailing social, political and economic context within which they are produced, maintained and reproduced. In addition, because they are always attached to other interests and agendas – professional, economic, political, cultural, ideological – the ways in which we conceptualize and speak and write about health are never just about health; they also function as repositories and mirrors of our ideas and beliefs about human nature and the nature of reality, as well as about the kind of society we can imagine creating and how best to achieve it. Robertson, “Shifting Discourses in Health Promotion” Since the stormy development of Medicare in Canada, the relationship between health, governance, and citizenship has been thrown into sharp relief. The provision of publicly funded, universal health insurance, conceived by Tommy Douglas as an inalienable right of citizenship (Redden 2002), has become a cornerstone of Canadian identity and a tireless target of political deliberation. Beginning in the mid-1970s, the right to health care, with its emphasis on the collective pooling of risks and government responsibility for health, has been increasingly displaced by a discourse of individual responsibility for health and the prevention of disease through the identification and management of risk. This shift has in part stemmed from efforts to broaden policy frameworks concerning the determinants of health beyond curative biomedicine, which focus on the treatment of disease, to consider the various personal, environmental, and social determinants of health, which focus on the prevention of disease (see, for example, the Lalonde Report [Lalonde 1974], the Epp Report [HWC 1986], and the Ottawa Charter for Heath Promotion [WHO 1986]). However, the tendency in public and professional discourse to privilege individual behaviours and biological processes as explanations of health over social determinants and social well-being is symptomatic of a political shift that began in earnest in the 1980s. With this shift from welfare state to neoliberal approaches, the legitimacy of free market rationalities has become entrenched in social policy, emphasizing the principles of individualism, privatization, and de-centralization over those of universal social rights and collective welfare (Broad and Antony 1999; McGregor 2001). In health care, this has transformed the way in which patients in publicly funded health care systems are increasingly understood and represented as consumers of health services rather than recipients of care and social entitlements. More generally, neoliberal approaches to social policy favour a model of citizenship in which individuals are expected to demonstrate their duties to maintain their health through their own “free choices” and “informed decisions.” In this collection, we present a range of case studies that explore how neoliberal styles of governance idealize particular notions of health and citizenship and the implications for human
The list of books you might like
