by Amy Greer Murphy, Durham University
My PhD is part of a five year research project entitled ‘Local Health Inequalities in an Age of Austerity: The Stockton-on-Tees study’. It’s a mixed method case study exploring the localised impacts of austerity on health. My role is examining the experiences of women living in Stockton using qualitative research.
A few key terms
Austerity refers to attempts to reduce government deficits through spending cuts and sometimes tax increases. Across Europe, austerity was implemented in many countries, such as Greece and Ireland, as a precondition of receiving bailouts in the wake of the financial crisis of 2008. In the UK, a major restructuring of the public sector and welfare system has been undertaken since 2010.
Neoliberalism refers to the application of free market principles to public policy. It has been enacted in the UK since Thatcher’s Conservative government came to power in the 1980s and has comprised of deregulation (e.g. of the banking and financial system), privatisation (e.g. of bus and rail services) and, more recently, austerity (e.g. extensive welfare reforms).
‘Health inequalities’ refer to disparities in life expectancy and years of health life (‘mortality’ and ‘morbidity’) within and across nations. There is a gradient in all countries – those with more socio-economic resources also have better health (Marmot, 2010). In the UK, health inequalities are widening since austerity began. Schrecker and Bambra (2015) have referred to the process of widening health inequalities and liberalised economic and social policies as a ‘neoliberal epidemic’.
Austerity and inequality in the UK
The UK is a large country, and one of great social contrasts. The contrasts that are relevant to my research are related to inequality of opportunity, resources, health, and the government policies, political decisions and historical legacies that bring these about. The North East has experienced a huge restructuring of its’ social landscape in recent decades. Mining, heavy industry and manufacturing have all but ceased to operate there. The jobs that once provided decent incomes and rooted people to their communities, providing clear routes through the lifecourse and class allegiances, have slipped away. In their place are zero hour contracts in care homes and nurseries, seasonal work in factories and as agency staff providing security in shopping centres.
Through this research process I have tried to understand what neoliberalism and austerity feel like if you’re not on the winning side of them, focussing on gender and class. I’ve then tried to see the wider connection to globalised economies and deregulated financial markets.
One of the ways austerity is affecting places and people differently is through health. In Stockton-on-Tees, the gap in life expectancy for men is the largest in all of England, at 17.3 years, and one of the widest for women, at 11.4 (Public Health England, 2015). If you are a man born in one of the wealthier, typically less urbanised parts of Stockton you can expect, on average, to live 17.3 years longer, and more of those years in good health, than a man born just a short walk away, in a more built-up and less well-off part of town. You are also at a higher risk of cardio-vascular disease, obesity, cancer, mental health issues, suicide, alcoholism, to be more socially isolated, have a worse paying, precarious job or no job at all, and to be at the mercy of an increasingly retrenched welfare state for your income and livelihood. The picture for women is similar, but different in crucial ways I will explore later.
This, of course, isn’t the picture for everyone in Stockton; I don’t want to paint a doomsday caricature (Benefits Street, the Channel 4 show, made a noble attempt at that in 2014 with their ‘poverty porn’ foray into life on Kingston Road). Stockton is steeped in a proud industrial legacy, is surrounded by beautiful dales and hills, has a vibrant town centre, and is home to thousands of people of all kinds who are creating thriving and enduring communities. Undeniably, however, government policy is making the lives of an increasing number of its residents tougher.
The research topic
Women face a distinct set of risks under austerity, as their lives, choices and opportunities often play out differently. This led me to develop my research project, to be carried out with mothers from across the borough. I wanted to understand what the experiences are of being a woman living in a place like Stockton – what can they tell us about other similar places that have experienced stark deindustrialisation and withdrawal of resources and traditional routes to employment and social stability? What does it feel like to live through welfare reform, as a mother, with enough money or very little, in an area with lots of different inequalities?
The research design was informed by the work of Sociologists who have used their skills to bring to the academic and policy world narratives that are otherwise silenced – quite often the voices of women. Berverley Skeggs (1997), wrote about class and gender and respectability in an area of England not so far from Stockton, Ann Oakley (1979; 1993) spent years with mothers asking them what they thought about housework, women’s health and becoming a mother, and Arlie Hochschild (1989) delved into the lives of women trapped in the double- or triple-bind of work, caring for children and elderly relatives. The methods I used are similar to theirs, and ‘qualitative’, meaning they are designed to explore diverse social worlds and understand why certain groups of people or individuals make choices or live in certain ways, or why their lives are presented in a certain light. I had a methodology (system of methods) and sampling strategy (idea of why I wanted to contact, and why). Unlike some quantitative social research or scientific experiment, or the research wasn’t designed with representativeness or generalisability in mind.
I used ethnography, or participant observation; I spent 16 months at a women’s group where I gained friends and mentors and learned about being woman living on a low income in Stockton. I also interviewed 15 women, 14 of whom are mothers, from a wide variety of socio-economic backgrounds and from many different walks of life. I recruited participants through the local Sure Start centres, Twitter, Thrive, the anti-poverty charity I spent a lot of time at, and through snowball sampling (asking people I met if they could recommend someone, or pass on my details). I offered a voucher as a thank-you and recorded my interviews.
Continuing austerity and the decline of opportunities: For respondents and their wider networks, there is a huge concern about the likely continuation of austerity and what that might mean for families and communities. We spoke about diminishing opportunity and prospects, the long-term decline of services, the quality and availability of housing and work in the area.
The desire to ‘just be a mam’: Respondents found their roles as mothers and carers increasingly devalued, with the expectation that caring work should be provided by the market and that they should seek formal work as a primary source of income. However, quality work is unavailable, childcare unaffordable, and an important source of identity formation, their role as carers and mothers, diminished under austerity.
Mental health: It became increasingly obvious as I spent more time in the field that the deterioration of participants’ mental health and sense of wellbeing was stark. Discussions of everyday struggles with depression, anxiety and serious bouts of post-natal depression were worryingly frequent. Furthermore, long-term physical health and chronic pain issues were part and parcel of life for many of the women I spent time with, symptoms of a lifetime of stress, poor quality housing and other inequalities (Mattheys et al. 2015).
Underpinning my research is the understanding that women, particularly mothers, face a set of distinct risks under austerity, through labour market changes, reliance on the welfare system and the public sector. They are employed in higher numbers in the public sector, and so more vulnerable to job losses there, and more likely to be underemployed or in low-paid work in ‘feminised’ sectors. They may also face maternity discrimination in their workplace, experience a large gender pay gap and are absent from the labour market for extended periods while they take care of young children. Women also make use of public sector services in high numbers, the very services being cut back during austerity. They rely on the welfare state for many reasons to a much larger extent than men. Welfare reforms like the benefit cap, bedroom tax and sanctions, closures of community centres and privatisation of Sure Starts and lone parent conditionality hit not just women in large numbers, but children and families too. This research is trying to illustrate how austerity is regressive and contributing to growing inequality, and how this group, like many all around the UK, are finding it a challenging time to live through.
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