Dependency denied: Health inequalities in the neoliberal era

It is now well established that unequal societies have higher rates of health and social problems than more equal ones. Shame and invidious social comparison have been proposed as one means by which inequality impacts the body, and the social body (Wilkinson & Pickett 2009). Social epidemiology supports this, but has been critiqued for theoretical ‘thinness’ and marginalising of agency. For example, people are not passive recipients of inequality, they resist and endeavour to protect themselves, and there are debates about the place of political discourses such as neoliberalism.

In this paper we explore the findings from a study of women in the north of England which used Free Association Narrative Interviews (FANI) to explore the experience of life in an unequal, neoliberal society.

Shame and social comparison were present but not in the ways anticipated. Shame avoidance focused on protecting children from the stigmatising impacts of living with a lack of appropriate goods and was in relation to the women's bodies and homes. But most striking was a discourse of no legitimate dependency - an often painful discourse, where all aspects of dependence were disavowed and self-reliance valorised, leading to considerable strain and distress.

We argue that this discourse represents a partial internalisation of neoliberalism; often expressed colloquially, using the language of therapy. It is manifested by the holding of the self to impossible standards of non-dependence, and through the ‘othering’ of those considered insufficiently responsible. It is an unstable and unhappy discourse, but one which seemed unavoidable in the absence of available, alternative explanations for inequalities