Austerity and the embodiment of neoliberalism as ill-health: Towards a theory of biological sub-citizenship

Sparke, Matthew

doi:10.1016/j.socscimed.2016.12.027

Cited by 75 publications

(90 citation statements)

References 61 publications

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“…Taken together, these consequences amount to what has previously been argued is a differential disenfranchisement from fully realized citizenship (Brown, 2015; Ong, 2006; Sparke, 2017). That is, our participants' narratives identify them as a population structurally excluded from (1) the benefits of economic growth and capital accumulation made possible by neoliberalism (Ong, 2006), (2) the rights of protection and security historically afforded to political subjects of liberal democracy (Brown, 2015), and (3) the capacity for active health management and expectations of health and wellbeing that are collectively referred to as ‘biological citizenship’ (Sparke, 2017).…”

Section: Discussionmentioning

confidence: 54%

“…That is, our participants' narratives identify them as a population structurally excluded from (1) the benefits of economic growth and capital accumulation made possible by neoliberalism (Ong, 2006), (2) the rights of protection and security historically afforded to political subjects of liberal democracy (Brown, 2015), and (3) the capacity for active health management and expectations of health and wellbeing that are collectively referred to as ‘biological citizenship’ (Sparke, 2017). Moreover, the central role of government bureaucracy in the findings underlines that these exclusions occur not simply through the workings of the free market, but via sovereign political decisions made by representatives of the US state (Ong, 2006).…”

Section: Discussionmentioning

confidence: 99%

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“The land of the sick and the land of the healthy”: Disability, bureaucracy, and stigma among people living with poverty and chronic illness in the United States

Whittle

Palar

Ranadive

et al. 2017

Social Science & Medicine

102

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Disability benefits have become an increasingly prominent source of cash assistance for impoverished American citizens over the past two decades. This development coincided with cuts and market-oriented reforms to state and federal welfare programs, characteristic of the wider political-economic trends collectively referred to as neoliberalism. Recent research has argued that contemporary discourses on ‘disability fraudsters’ and ‘malingerers’ associated with this shift represent the latest manifestation of age-old stigmatization of the ‘undeserving poor’. Few studies, however, have investigated how the system of disability benefits, as well as these stigmatizing discourses, shapes the lived experience of disabling physical illness in today's United States. Here we present qualitative data from 64 semi-structured interviews with low-income individuals living with HIV and/or type 2 diabetes mellitus to explore the experience of long-term, work-limiting disability in the San Francisco Bay Area. Interviews were conducted between April and December 2014. Participants explained how they had encountered what they perceived to be excessive, obstructive, and penalizing bureaucracy from social institutions, leading to destitution and poor mental health. They also described being stigmatized as disabled for living with chronic ill health, and simultaneously stigmatized as shirking and malingering for claiming disability benefits as a result. Notably, this latter form of stigma appeared to be exacerbated by the bureaucracy of the administrating institutions. Participants also described intersections of health-related stigma with stigmas of poverty, gender, sexual orientation, and race. The data reveal a complex picture of poverty and intersectional stigma in this population, potentiated by a convoluted and inflexible bureaucracy governing the system of disability benefits. We discuss how these findings reflect the historical context of neoliberal cuts and reforms to social institutions, and add to ongoing debate around the future of public social provision for impoverished and chronically ill citizens under neoliberalism.

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

“The land of the sick and the land of the healthy”: Disability, bureaucracy, and stigma among people living with poverty and chronic illness in the United States

Whittle

Palar

Ranadive

et al. 2017

Social Science & Medicine

102

View full text Add to dashboard Cite

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“…Neoliberal ideology guides the global health field and has transformed healthcare systems in low‐income countries. Global health initiatives, financing and programmes follow an economistic logic that prioritises solutions that are cost‐effective and emphasises the role of the market, rather than the state, as the distributor of social goods (Keshavjee , Sparke ). Structural adjustment policies in the 1980s and 90s, for instance, cut government spending on primary health care and promoted the privatisation of health services (Pfeiffer , Pfeiffer and Chapman ).…”

Section: From Therapeutic Citizenship To Clientship Of Global Healthmentioning

confidence: 99%

Therapeutic citizens and clients: diverging healthcare practices in Malawi's prenatal clinics

Zhou

2019

Sociology Health & Illness

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This article examines how HIV policies and the funding priorities of global institutions affect practices in prenatal clinics and the quality of healthcare women receive. Data consist of observations at health centres in Lilongwe, Malawi and interviews with providers (N = 37). I argue that neoliberal ideology, which structures the global health field, produces a fragmented healthcare system on the ground. Findings show two kinds of healthcare practices within the same clinic: donor‐funded NGOs took on HIV services while government providers focused on prenatal care. NGO practices were defined by surveillance, where providers targeted pregnant HIV‐positive women and intensively monitored their adherence to drug treatment. In contrast, state‐led practices were defined by rationing. Government providers worked with all pregnant women, but with staff and resource shortages, they limited time and services for each patient in order to serve everyone. This paper builds on concepts of therapeutic citizenship and clientship by exploring how global health priorities produce different conditions, practices and outcomes of NGO and state‐led care.

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“…But, as global health slowly gains traction within geography (for examples of some of the most recent contributions to the field, see Brown ; Brown et al . ; Herrick and Reubi ; Mitchell and Sparke ; Reid‐Henry ; Sparke ; Taylor ), it is crucial to be cognisant of the extent to which this ‘obscure object’ (Fassin ) of analysis has been constructed by particular disciplinary tropes and traits. Of these, arguably one of the most powerful has been the medical anthropological commitment to the ‘suffering subject’.…”

Section: Introductionmentioning

confidence: 99%

When places come first: suffering, archetypal space and the problematic production of global health

Herrick

2017

Trans Inst British Geog

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The rise of global health as a field of study and site of intervention has animated significant critical social science engagements. Of these, medical anthropology has arguably emerged as the ascendant in the field with its growing corpus of writing and advocacy largely animated by the discipline's 'suffering slot'. This paper thus applies a geographical critique to anthropology's moral, humanitarian impulse to give voice to suffering by exploring the spatial consequences of this mode of scholarship. It argues that the suffering slot inevitably leads global health researchers to certain archetypal spaces and that, in turn, these places: (i) are overwhelmingly biomedical; (ii) come to function as 'truth spots' in the production and circulation of global health knowledge and (iii) perpetuate a global health riddled with 'ignorance spots'. Given this, the paper asks what happens if we look beyond suffering to consider the hidden geographies of global health that might then be revealed. It argues that in order to develop a richer topography of global health knowledge and critique, we must also consider those spaces where pleasure and suffering intersect in ways that challenge the humanitarian impulse and crisis-led readings of health. These other archetypal spaces of global health -gyms, bars, supermarkets and more -are not flippant distractions from the grave reality of human suffering, but rather spaces that condition the genesis of suffering and where affliction is put aside in favour of pleasure. In arguing that we need to be far more attuned to the non-medical spaces where global health is produced, experienced and challenged, the paper also articulates how geography might productively meet anthropology in critical studies of global health.

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Austerity and the embodiment of neoliberalism as ill-health: Towards a theory of biological sub-citizenship

Cited by 75 publications

References 61 publications

“The land of the sick and the land of the healthy”: Disability, bureaucracy, and stigma among people living with poverty and chronic illness in the United States

“The land of the sick and the land of the healthy”: Disability, bureaucracy, and stigma among people living with poverty and chronic illness in the United States

Therapeutic citizens and clients: diverging healthcare practices in Malawi's prenatal clinics

When places come first: suffering, archetypal space and the problematic production of global health

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