Tag: Deprivation

Dying from inequality: socioeconomic disadvantage and suicidal behaviour – report from Samaritans

cn_fairchange_comp1

As Samaritans release a report ahead of Wednesday’s Budget linking inequality with a higher risk of suicide, the charity is calling on the government, businesses, industry and sector leaders to be aware of the risks of suicide and to direct support to those with unstable employment, insecure housing, low income or in areas of socioeconomic deprivation.

The report, Dying from Inequality, produced in conjunction with leading researchers and academics, is far-reaching and highlights clear areas of risk to communities and individuals, including the closure and downsizing of businesses, those in manual, low-skilled employment, those facing unmanageable debt and those with poor housing conditions.

In today’s press release, Samaritans’ CEO Ruth Sutherland says, “Suicide is an inequality issue that we have known about for some time, this report says that’s not right, it’s not fair and it’s got to change. Most importantly this report sets out, for the first time, what needs to happen to save lives. Addressing inequality would remove the barriers to help and support where they are needed most and reduce the need for that support in the first place. Government, public services, employers, service providers, communities, family and friends all have a role in making sure help is relevant and accessible when it matters most.

“Everyone can feel overwhelmed at times in their life. People at risk of suicide may have employers, or they may seek help at job centres, or go to their GP. They may come into contact with national and local government agencies, perhaps on a daily basis. So, in the light of this report we are asking key people and organisations from across society, for example those working in housing, in businesses, medical staff, job centre managers, to all take action to make sure their service, their organisation, their community is doing all it can to promote mental health and prevent the tragedy of suicide. 

Samaritans has already started addressing the inequalities driving people to suicide, by making its helpline number free to call, by calling on Government for more frontline staff to be trained in suicide prevention in England and by campaigning for local authorities to have effective suicide prevention plans in place. Now, in response to the findings of this report, the next steps will involve instigating working groups, in different sectors, bringing together businesses and charities who can influence in the areas highlighted, in order to tackle this issue in a collaborative, systematic and effective way to ensure that fewer people die by suicide.”

Sutherland continues: “Each suicide statistic is a person. The employee on a zero hour’s contract is somebody’s parent or child. A person at risk of losing their home may be a sibling or a friend. And each one of them will leave others devastated, and potentially more disadvantaged too, if they take their own life. This is a call for us as individuals to care more and for organisations that can make a difference, to do so.”

She went on to say: “Living in poverty shouldn’t mean losing your life. Going through difficult times like losing your job or being in debt shouldn’t mean not wanting to live. But that is what’s happening in the UK and Ireland today. Suicide is killing the most disadvantaged and vulnerable people, devastating families and communities.”

Some key points from the report summary:

There is no single reason why people take their own lives. Suicide is a complex and multi-faceted behaviour, resulting from a wide range of psychological, social, economic and cultural risk factors which interact and increase an individual’s level of risk.

Socioeconomic disadvantage is a key risk factor for suicidal behaviour.

Socioeconomic disadvantage or living in an area of socioeconomic deprivation increases the risk of suicidal behaviour.

The research evidence was considered at three levels: societal, community and individual: 

Societal: political, economic and social policies related to, for example, economic change, employment, social support and the labour market; stigmatised attitudes towards people on the basis of their socioeconomic standing or their suicidal behaviour.

Community: the local economic, social, cultural and physical environment, including, for example, geographical location, job opportunities, service availability and accessibility, and home ownership.

Individual: demographic characteristics, such as gender and age; socioeconomic position, including occupational social class and type of employment; mental health; and health-related behaviours.

Suicide risk increases during periods of economic recession, particularly when recessions are associated with a steep rise in unemployment, and this risk remains high when crises end, especially for individuals whose economic circumstances do not improve. Countries with higher levels of per capita spending on active labour market programmes, and which have more generous unemployment benefits, experience lower recession-related rises in suicides.

During the most recent recession (2008-09), there was a 0.54% increase in suicides for every 1% increase in indebtedness across 20 EU countries, including the UK and Ireland. Social and employment protection for the most vulnerable in society, and labour market programmes to help unemployed people find work, can reduce suicidal behaviour by reducing both the real and perceived risks of job insecurity and by increasing protective factors, such as social contact. In order to be effective, however, programmes must be meaningful to participants and felt to be non-stigmatising.

There is a strong association between area-level deprivation and suicidal behaviour: as area-level deprivation increases, so does suicidal behaviour. Suicide rates are two to three times higher in the most deprived neighbourhoods compared to the most affluent.

Admissions to hospital following self-harm are two times higher in the most deprived neighbourhoods compared to the most affluent. Multiple and large employer closures resulting in unemployment can increase stress in a local community, break down social connections and increase feelings of hopelessness and depression, all of which are recognised risk factors for suicidal behaviour.  

While the economic situation and policy approaches vary across the nations in which Samaritans operates, the link between socioeconomic disadvantage and increased risk of suicide is evident in all these nations. It is therefore essential that we understand why this link exists. We all need to address this inequality issue which is resulting in the tragic loss of lives.

Features of socioeconomic disadvantage include low income, unmanageable debt, poor housing conditions, lack of educational qualifications, unemployment and living in a socioeconomically deprived area. Individual Individuals experiencing socioeconomic disadvantage and adverse experiences, such as unemployment and unmanageable debt, are at increased risk of suicidal behaviour, particularly during periods of economic recession.

The risk of suicidal behaviour is increased among those experiencing job insecurity and downsizing or those engaged in non-traditional work situations, such as part-time, irregular and short-term contracts with various employers. The experience of being declared bankrupt, losing one’s home or not being able to repay debts to family and friends is not only stressful but can also feel humiliating. This can lead to an increased risk of suicidal behaviour.

The risk of suicidal behaviour increases when an individual faces negative life events, such as adversity, relationship breakdown, social isolation, or experiences stigma, emotional distress or poor mental health.

Socioeconomically disadvantaged individuals are more likely to experience ongoing stress and negative life events, thus increasing their risk of suicidal behaviour. In the UK, socioeconomically disadvantaged individuals are less likely to seek help for mental health problems than the more affluent, and are less likely to be referred to specialist mental health services following self-harm by GPs located in deprived areas.

Different welfare states have been shown to have different effects on social and health inequalities. High quality public service provision leads to a more cohesive society than policies based on means-testing which may generate social divisions. Given the link between inequalities and suicidal behaviour, labour market policy design can help improve wellbeing and reduce the risk of suicide.

Employment

Evidence on the association between working conditions, debt and suicide suggests that increased, involuntary part-time work, job insecurity and workplace downsizing are important risk factors for suicidal behaviour. It is not only unemployed people who are at increased risk. Employees who keep their jobs during a workplace downsizing may experience job insecurity and negative relationships with their peers, as well as stress from an increased workload. People who are self-employed can also be affected if demand for their business decreases. 

Unemployment benefits

Generous unemployment benefits and other types of social protection can reduce the risk of suicidal behaviour. Suicide rates tend to increase in countries which implement significant budget cuts, which was evident during the 2008-09 recession in some EU countries (Karanikolos et al., 2013). Unemployment benefits compensate for some of the income loss experienced from involuntary unemployment. Depending on the level of benefits, they should help ease financial worries that may lead to suicidal behaviour. However, means-tested benefits may actually contribute to suicidal behaviour, if recipients feel stigmatised, leading to feelings of shame, worthlessness, a loss of status, and a deterioration of mental health.

Employment protection

Strong employment protection should reduce real and perceived risks around job insecurity and unemployment, resulting in a positive impact on mental health. In contrast, weak employment protection is likely to increase real and perceived insecurity, and could lead to precarious forms of employment, such as temporary or zero-hours contracts, with adverse effects on mental health.

Inexperienced workers with low skills are particularly vulnerable in such contexts, since they are most likely to be on contracts which are less well protected and more precarious. The risk of mental health problems is increased among those engaged in non-traditional work situations, such as part-time, irregular and short-term contracts with various employers, especially where there is little or no choice, as well as for those experiencing job insecurity and downsizing. Suicidal behaviour can be reduced amongst the most vulnerable in society through social and employment protection and labour market programmes. This will reduce the real and perceived risks of job insecurity and reduce stigma of unemployment.

Recommendations:

Individuals, communities and wider society can all play a part in reducing the risk of suicidal behaviour. Governments need to take a lead by placing a stronger emphasis on suicide prevention as an inequality issue.

National suicide prevention strategies need to target efforts towards the most vulnerable people and places, in order to reduce geographical inequalities in suicide. Effective cross-governmental approaches are required, with mental health services improved and protected.

Suicide prevention needs to be a government priority in welfare, education, housing and employment policies. Workplaces should have in place a suicide prevention plan, and provide better psychological support to all employees, especially those experiencing job insecurity or those affected by downsizing.

Poverty and debt need to be destigmatised so that individuals feel valued and able to access support without fear of being judged. Every local area should have a suicide prevention plan in place. This should include the development and maintenance of services that provide support to individuals experiencing socioeconomic disadvantage.

Staff and volunteers in services accessed by socioeconomically disadvantaged individuals or groups should receive specialist training in recognising, understanding and responding to individuals who are in distress and may be suicidal (even if they do not say they are feeling suicidal). People bereaved or affected by suicidal behaviour, and therefore at higher risk of suicide themselves, should be offered tailored psychological, practical and financial support particularly in disadvantaged communities.

It is well understood that adverse individual or family circumstances, such as relationship breakdown, unemployment or debt, can result in a higher risk of suicidal behaviour (Gunnell & Chang 2016). What is less well known is the potential impact of the place where people live (neighbourhood, city, region) on the likelihood of suicidal behaviour.

The public health evidence is clear: as area-level deprivation increases, so does suicidal behaviour. For both men and women, those living in the most deprived neighbourhoods are more likely to engage in suicidal behaviour; and every increase in area-level affluence results in a reduction in the risk of suicidal behaviour.

The health of people in a neighbourhood, town, region or country is the product of the demographic, behavioural, socioeconomic and other characteristics of the people who live there. Compositional factors that are likely to increase the risk of suicidal behaviour in areas of socioeconomic deprivation include (O’Reilly et al., 2008; Lorant et al., 2005): experiencing multiple negative life events, such as poor health, unemployment, poor living conditions feeling powerless, stigmatised, disrespected, social disconnectedness, such as social isolation, poor social support other features of social exclusion, such as poverty, and poor educational attainment.

People living in the most deprived areas are more likely to engage in suicidal behaviour. Suicide rates are two to three times higher in the most deprived neighbourhoods compared to the most affluent, and rates of hospitalised self-harm are also twice as high. Neighbourhoods that are the most deprived have worse health than those that are less deprived and this association follows a gradient: for each increase in deprivation, there is a decrease in health. Additional support for those living in deprived areas is needed to reduce geographical inequalities in health and the risk of suicidal behaviour.

Experiences of childhood adversity, negative life events, and the cumulative effects of stress are associated with feelings of entrapment and hopelessness and increase the risk of suicidal behaviour, especially among those who are socioeconomically disadvantaged.

Stressful life events and childhood adversity

Exposure to negative life events, particularly those involving loss, such as bereavement or a relationship breakdown, heightens the risk of suicidal behaviour. Socioeconomically disadvantaged individuals are more likely to experience such negative life events, and therefore more likely to engage in suicidal behaviour. Experiencing childhood adversity increases the likelihood that individuals will become socioeconomically disadvantaged in later life.

For example, unemployment is more likely among those who have adverse childhood experiences, particularly men who have experienced childhood sexual abuse. Stress response and allostatic load Ongoing exposure to stress and adversity may gradually reduce an individual’s biological stress regulation resources, leading to a cumulative physiological toll known as “allostatic load” (Seeman et al., 2010).

Socioeconomic disadvantage itself is a stressor linked to increased allostatic load, but it may also influence allostatic load indirectly by increasing the likelihood of individuals experiencing childhood adversity and other stressful life events. Increased allostatic load brought about by the chronic and acute stresses associated with socioeconomic disadvantage may contribute to suicidal behaviour.

Socioeconomic disadvantage, from a psychological perspective, makes a major contribution to the occurrence of suicidal behaviour.

 

You can read the full summary report here

The full version of the report will be available on 10th March

 


 

I don’t make any money from my work. I am disabled because of illness and have a very limited income. But you can help by making a donation to help me continue to research and write informative, insightful and independent articles, and to provide support to others. The smallest amount is much appreciated – thank you. 

DonatenowButton cards

The poverty of responsibility and the politics of blame. Part 3 – the Tories want to repeal the 2010 Child Poverty Act

demcracy

Political theories of poverty vary across the political spectrum, with those on the right tending to individualise social problems more generally, and those on the left tending to socialise them. Very different policy implications stem from each perspective.

Since the Thatcher era, the New Right have developed a distinctive behaviourist approach to poverty, founded on the idea that poor people are poor because they lack certain qualities and traits.

In 2013, Iain Duncan Smith worked on developingbetter measures of child povertyto provide a “more accurate reflection of the reality of child poverty.” According to the Conservatives, poverty isn’t caused by a lack of income.

The Coalition conducted a weighted and biased consultation at the time that did little more than provide a Conservative ideological framework in the form of leading questions, to catch carefully calculated, led and subliminally shaped public responses.

Iain Duncan Smith has indicated he will repeal the 2010 Child Poverty Act, which committed the government to a target of eradicating child poverty in the UK by 2020. He has dispensed with the current relative definition of poverty (anyone in a household beneath 60% of median income), abandoned the targets and introduced a new (although rather unclear) definition: the child poverty target is to be replaced with a new duty to report levels of educational attainment, “worklessness” and addiction, rather than relative material deprivation and disadvantage.

Duncan Smith argues that the measures set originally by Tony Blair are a “poor measure of poverty”, and he claims that families can fall or go above the relative poverty line for reasons that have little to do with their material wealth.

Using the Centre for Social Justice’s 2012 report Rethinking Child Poverty, (set up by none other than Iain Duncan Smith in 2004) to support his ideological perspective, Duncan Smith’s account of UK poverty is defined by bad parenting, by alcohol dependency and drug-addiction.

There is of course very little focus on accounts of parents who are poor because they are unemployed or in low-paid work. Or because of government policies that are directed at rewarding wealthy people and punishing poor people. (See also: We are raising more money for the rich.) Duncan Smith said:

“We know in households with unstable relationships, where debt and addiction destabilise families, where parents lack employment skills, where children just aren’t ready to start school, these children don’t have the same chances in life as others. It is self evident.”

Of course it’s also “self-evident” that debt, addiction and unstable relationships happen to wealthy people as well, so as far as causal explanations of poverty go, this one certainly lacks credibility and coherence.

Furthermore, I propose that a lack of opportunities and life chances arise from the cumulative effects of discriminatory economic and social structures and policies. Iain Duncan Smith went on to say:

“They cannot break out of that cycle of disadvantage. We are currently developing these measures right now – family breakdown, problem debt and drug and alcohol dependency – and we will report each year on these life chances as well.”

The Conservatives are claiming that poverty arises because of the “faulty” lifestyle choices of people with personal deficits and aim to reconstruct the identities of poor people via psychopolitical interventions, but it is only through a wholesale commitment to eliminating poverty by addressing unemployment, underemployment, job insecurity, low paid work, inadequate welfare support and institutionalised inequalities that any meaningful social progress can be made.

Over the last five years, the UK has become the most unequal country in Europe, on the basis of income distribution and wages. If that increase in inequality arose because of individual failings, as the Conservatives are claiming, why have those personal failings only become apparent so suddenly within the past five years? The Child Poverty Action Group voiced concerns :

“The statement isn’t about strengthening efforts to end child poverty, but about burying the failure of the government’s child poverty approach. And with more cuts coming down the line, child poverty is set to rise.”

The Bell Swerve

Iain Duncan Smith draws on a framework of ideas that was shaped to a large extent by the white male supremacist musings of Charles Murray, the controversial ultra-conservative American sociologist that exhumed social Darwinism and gave the bones of it originally to Bush and Thatcher to re-cast.

Murray’s New Right culture of poverty theory popularised notions that poverty is caused by an individual’s personal deficits and character flaws; that the poor have earned their position in society; the poor deserve to be poor because this is a reflection of their lack of qualities and level of abilities. Murray’s very controversial work The Bell Curve was a novel of racist pseudoscience and manipulated, misleading statistics which he used to propose that social inequality is caused by the genetic inferiority of the black and Latino communities, women and the poor.

According to Murray, disadvantaged groups are disadvantaged because, on average, they cannot compete with white men, who are intellectually, psychologically and morally superior. Murray advocates the total elimination of the welfare state, arguing that public policy cannot overcome the “innate deficiencies” that cause unequal social and educational outcomes.

Many critics, including myself, regard Murray as a white supremacist, a nationalist that has a long history of advocating discredited ideas that are rooted in eugenics. Nonetheless, Murray has had a significant influence on Conservative thinking about welfare in particular, both here in the UK and across the Atlantic.

“Unless the government sets out a clear target for improving the life chances of the poorest families, its agenda for healing social division in our country will lack both ambition and credibility.”

The Children’s Commissioner issued a statement regarding the repeal of the Child Poverty Act:

“The Child Poverty Act targets were not just about relative poverty – which is a measure of inequality, important in itself – but also included a measure of material deprivation. Critically, the new measures proposed today would not include any tangible measure of poverty, hunger, cold, or deprivation of any kind. Poverty is a financial measure. Unemployment statistics and statistics on educational attainment are already collected.

“The majority of children living in poverty have at least one parent who is working. Employment is important but if wages do not rise substantially in relation to living costs it will not provide a route out of poverty alone. The Joseph Rowntree Foundation has today published a report stating that families with children working full-time on the National Minimum Wage are now 15% short of the Minimum Income Standard that people believe offers an acceptable standard of living.  Today’s announcement will effectively confine to history any figures on the millions of children being raised in families who experience in-work poverty denying them necessities such as adequate food, clothing and heating.”

Last year, the Children’s Commissioner said that the increasing inequality which has resulted from the cuts, and in particular, the welfare reforms, means that Britain is now in breach of the United Nations Convention on the Rights of the Child, which protects children from the adverse effects of government economic measures.

Austerity cuts are disproportionately targeted at the poorest. It’s particularly shameful that absolute poverty has returned to Britain since 2010, given that we are the 5th wealthiest nation in the world. That indicates clearly just how much inequality has increased under the Conservatives since 2010.

Poverty and inequality are a consequence of the way that society is organised, political decision-making and how resources are allocated through discriminatory government policies.

Poverty arises because of the behaviour of the powerful and wealthy, not the poor.

___

See also:

The Poverty of Responsibility and the Politics of Blame

The poverty of responsibility and the politics of blame – part 2

The just world fallacy

The right-wing moral hobby horse: thrift and self-help, but only for the poor

The New New Poor Law

UK Wealth Divide widens, with inequality heading for “most unequal country in the developed world”

Poor people are poor because they don’t know how to get something from nothing

1957929_293215800829475_303676825_oPictures courtesy of  Robert Livingstone