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Professor Clare Bambra
Newcastle University 
Research Leadership Award

Local health inequalities in an age of austerity: the Stockton-on-Tees study

Town Hall and Shambes Market Hall, Stockton-on-Tees
Town Hall and Shambes Market Hall, Stockton-on-Tees. Image: Petegal-half CC BY-SA 3.0

The overarching objective of the study is to examine localised patterns of health inequality in an age of austerity. I aim to provide a contemporary and innovative, theoretically informed, comprehensive, interdisciplinary, mixed methods intensive case study of the aetiology and experience of health inequalities in England at a local level. As well as to examine whether these health inequalities and their determinants change during the current period of economic downturn and an age of austerity.

Biographies of health and place

This study examines the recent history of Stockton-on-Tees, using oral history interviews, visual focus groups and archival research to look at the legacies of deindustrialisation on place identities, social inequalities, and health and well-being:

  • It argues that to understand the health and social inequalities evident in Stockton today, it is not only essential to understand the contemporary place, but also how these historic processes and forces shape it
  • It examines the health legacies of Stockton’s (post) industrial past and how these contribute to its present situation including its experience of austerity, and its future prospects in light of Brexit

Placing health and austerity

Examining the debate whether the health and well-being of an individual is determined by their own attributes (the compositional theory) and/or the political economy and environmental attributes of the area where the person lives (contextual approach):

  • By analysing longitudinal household survey data conducted in the most and least deprived neighbourhoods of Stockton-on-Tees, which indicates that there is a significant gap in general and physical health in Stockton-on-Tees and that compositional level material factors, contextual factors and their interaction appear to be the major explanations of the health gap
  • Findings are discussed in relation to geographical theories of health inequalities and the context of austerity

How the other half live

An examination of how people living in two socially contrasting areas of Stockton-on-Tees experience, explain, and understand the stark health inequalities in their town:

  • Drawing on extensive ethnographic observations and over 100 qualitative interviews, documentary research, and photographic data with people living in one of the most and one of the least deprived neighbourhoods, this study emphasises the importance of stigma, place and, perception in peoples’ everyday lives at a time of austerity
  • It focuses on three key themes: lay perspectives on inequalities, place and its meaning(s), and the relationship between austerity, family life and health

Minding the gap

Engages with key debates around the causes of socio-economic inequalities in health by examining the extent and underpinning determinants of the gap in mental health and well-being between the most and least deprived neighbourhoods of Stockton-on-Tees:

  • Using data from the longitudinal household survey, it establishes the extent of inequalities in mental health and well-being in Stockton-on-Tees and examines the explanatory role of behavioural, psychosocial and material factors in explaining this gap
  • Results indicate that there is a significant gap in mental health and well-being between the most and least deprived neighbourhoods of Stockton-on-Tees and it is material and psychosocial factors that are the major explanations of the health gap, with implications of the findings discussed

Divided lives

A consideration of how inequalities in mental health are affected by austerity, providing a qualitative account of the human price of government policy:

  • Engaging with debates around inequalities in mental health, it will use interview data from people experiencing mental health problems in the most and the least deprived neighbourhoods alongside interviews with key stakeholders and local service providers, to show how people experience austerity and inequality in their everyday lives
  • This study will show how it is those on the lowest incomes and living in the most deprived communities who are paying the highest price and carrying the heaviest burden

Mothers in austerity

Using the results of qualitative longitudinal research with mothers to understand the impact that austerity and welfare reform are having on mothers, families and their communities:

  • Three key themes are explored: firstly, the effects of austerity and what the continuation of it might mean for respondents’ families, communities and livelihoods; secondly, the increasing devaluation of women’s roles as mothers and carers; and thirdly, that gender should be central to our reading of austerity
  • Findings show that mothers play a crucial role within families in insulating against many of the negative effects of austerity and challenge articulations of austerity which ignore its’ gendered structure and argues that ongoing austerity measures are exacerbating the deeply gendered dynamics of the politics of inequality and austerity in the UK

Austerity then and now

An examination of the political, economic and social determinants of health and health inequality during the 1930s within the historical perspective of Stockton-on-Tees:

  • This study will outline the effects of government spending cutbacks on unemployment, housing provision, and health care in 1930s Stockton-on-Tees during the period of the Great Depression, charting the detrimental consequences for health and health inequalities between neighbourhoods and social classes
  • The parallels, consistencies, continuities and discontinuities between 1930s Stockton and Stockton today are also examined: austerity then and now. It thereby engages with contemporary debates about health and austerity as well as a long-running debate within historical research about the effects of the Great Depression on health and social inequalities

Magazine Cover for Health Divides  Magazine Cover for Hunger Pains  

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