低收入社区的紧缩、健康和公共安全:对英格兰东南部地方服务下降的基层反应。

IF 4.3 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Journal of Urban Health-Bulletin of the New York Academy of Medicine Pub Date : 2023-12-01 DOI:10.1007/s11524-023-00807-x
David M Smith
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引用次数: 0

摘要

本文使用人种学和定性研究来探讨英格兰东南部一个低收入社区的健康影响和社会反应,十多年来的紧缩政策和不断下降的制度和福利支持。调查结果考察了公共服务和福利项目的削减以及该地区社会结构的变化如何影响居民对健康风险和威胁的看法。居民们指出,由于经济不安全、社区设施关闭以及难以获得支持和专业帮助,心理健康状况恶化。该地区社会构成的变化和社区警务的减少是导致该地区社会混乱和危机感增加的另一个原因,这也是居民焦虑的原因。许多人认为,他们的社区在法律和秩序、保健服务和旨在解决其社会环境中的健康问题和风险和危险的其他服务方面受到不公平对待。这一体制真空产生了未得到满足的卫生需求,促进了管理卫生的非正式做法和方法,例如通过自我提供或使用替代的和更容易获得的医疗咨询和治疗来源。旧形式的社会控制和监视的消亡与该地区公共空间的关闭同时发生,社交媒体的使用在一定程度上弥补了这一点,而非正式的治安方式在该社区越来越多地出现,以应对日益严重的无法无天以及警察和地方当局的无能。
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Austerity, Health and Public Safety in Low-Income Neighborhoods: Grassroots Responses to the Decline of Local Services in Southeast England.

This article uses ethnographic and qualitative research to explore the health implications and social responses of a low-income neighborhood in Southeast England, to more than a decade of austerity policies and declining institutional and welfare support. Findings examine how cuts to public services and welfare programs alongside changes to the area's social structure shape resident's perceptions of health risks and threats. Residents pointed to poor levels of mental health that were exacerbated by financial insecurity, the closure of community facilities and difficulties accessing support and professional help. An increase in social disorder and sense of danger within the vicinity were attributed to changes in the area's social composition and a reduction of policing in the neighborhood, which were an additional cause of anxiety for residents. Many people felt their neighborhood was treated inequitably with regard to law-and-order, health provision and other services designed to address health problems and risks and dangers in their social environment. This institutional vacuum generates unmet health needs facilitating informal practices and methods for managing health, such as through self-provision or using alternative, and more readily available, sources of medical advice and treatment. The demise of older forms of social control and surveillance that ran parallel with closure of the area's communal spaces had been partly compensated by social media usage, while informal methods of policing were a growing presence in the neighborhood in reaction to rising lawlessness and the ineffectiveness of police and local authorities.

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来源期刊
Journal of Urban Health-Bulletin of the New York Academy of Medicine
Journal of Urban Health-Bulletin of the New York Academy of Medicine 医学-公共卫生、环境卫生与职业卫生
CiteScore
9.10
自引率
3.00%
发文量
105
审稿时长
6-12 weeks
期刊介绍: The Journal of Urban Health is the premier and authoritative source of rigorous analyses to advance the health and well-being of people in cities. The Journal provides a platform for interdisciplinary exploration of the evidence base for the broader determinants of health and health inequities needed to strengthen policies, programs, and governance for urban health. The Journal publishes original data, case studies, commentaries, book reviews, executive summaries of selected reports, and proceedings from important global meetings. It welcomes submissions presenting new analytic methods, including systems science approaches to urban problem solving. Finally, the Journal provides a forum linking scholars, practitioners, civil society, and policy makers from the multiple sectors that can influence the health of urban populations.
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