Health inequalities researchers have long advocated for governments to adopt policy instruments that address structural determinants of health rather than targeting individual behaviours. The assumption behind this position is that such instruments might challenge a core neoliberal principle of individualism embedded in the prevailing health policy paradigm. We critique this assumption by highlighting the discursive construction of policy instruments, and their discursive effects. Using the UK’s Tackling Obesity policy as a case study, we demonstrate how instruments designed to target structural determinants of health (such as food advertisement regulation) can actively sustain – rather than challenge, the dominant policy paradigm. We call this phenomenon ‘upstream individualism’, exploring how it relates to tensions in the research-policy relationship, and its relevance beyond health policy. We argue that instruments can shape policy change and continuity, including at a paradigm level, and that ‘upstream individualism’ provides a useful basis for theorising these power dynamics. This article contributes to the constructivist public policy literature by noting how policy instruments meant to challenge the discursive construction of individualism within public health can ultimately reinforce it.
Background:
The advent of the COVID-19 pandemic in South Africa and across the globe posed special challenges and implications for low-income families with children. In this study we explored the experiences of primary caregivers of children receiving a South African social assistance programme, the Child Support Grant (CSG), during lockdown in Cape Town, South Africa, and sought to understand whether and to what extent the underlying logic of cash transfers such as the CSG speaks to the pitfalls of the social protection paradigm and the potential for moving closer to a transformative social policy approach.
Methods:
We conducted 26 telephonic qualitative interviews with primary caregivers of recipients of South Africa’s CSG that were part of a longitudinal cohort study assessing the impact of the CSG on child nutritional status and food security.
Results:
Even though primary caregivers of the CSG and their children and households were already living in precarity before the pandemic, COVID-19, and particularly the hard lockdown, worsened their social, economic and living conditions, especially as regards hunger and food insecurity.
Conclusion:
Low-income women bore the brunt of the pandemic in their roles as mothers, providers and homemakers. The pandemic has highlighted the inadequacies of the social protection paradigm that underlies the design of cash transfers such as the CSG, which has a narrowed focus on chronic poverty and vulnerability. It has also highlighted opportunities to shift to a transformative social policy framework that incorporates production, redistribution, social cohesion, adequacy and protection.
The Village Savings and Loan Association (VSLA) model is currently being employed in Uganda for deepening financial inclusion and poverty reduction. Despite its focus on women’s empowerment, concerns have arisen of an under-representation of women on VSLA leadership committees. Human rights-based, economic, and social justice arguments support active participation of women on VSLA leadership committees. The study sought to identify, explicate and characterise the barriers and facilitators to women in VSLA leadership. An exploratory study design using qualitative methods was selected to address the research objectives. Forty-nine focus group discussions were undertaken, featuring both VSLA members and non-members. VSLAs for inclusion in the study were randomly selected from within four regions of Uganda, stratified by: mature (>2 years old) versus new (<2 years old). The study exposed a diverse array of barriers and facilitators to women in VSLA leadership positions, revealing the influence of individual, material, institutional and social factors, in addition to social norms and gender characteristics, on women in VSLA leadership. The findings revealed that the design of interventions to achieve fair representation of women in leadership positions should be informed by an understanding of the different types, relative strengths, support for/against, and intersectionality of the factors impacting women in VSLA leadership.
This commentary discusses the ways in which the welfare system has responded to the financial and housing needs of Ukrainian citizens coming to the UK since the Russian invasion of Ukraine on 24 February 2022. The focus is on two key areas of policy: social security and housing. The article considers the revised eligibility criteria for welfare benefits and two policies which can provide accommodation: the Ukraine Family Scheme, which allows applicants to join family members in the UK, and the Ukrainian Sponsorship Scheme (known as ‘Homes for Ukraine’) which allows Ukrainian nationals to come to the UK if they have a sponsor who can provide accommodation for at least six months. It provides a comparison of the provision for Ukrainian refugees and the standard asylum system in the UK.
This article concludes that although the UK government quickly introduced emergency provisions for newly arrived Ukrainians which go beyond the scope of support for many other groups moving to the UK, significant areas of concern are evident, with risks that these will increase in future months and years. These concerns centre on discrepancies between the two policies which provide accommodation, risk of exploitation, homelessness caused by the breakdown in provision, and complexity in the welfare benefit system.
In recent decades the study of emotions in the daily lives and geographies of migrants has received growing attention. In this chapter, I discuss the emotional attachments expressed by young male migrants in relation to public spaces in Cork, Ireland. This chapter interrogates the interrelation of affect and emotion and ‘spatial belonging’ from a migrant perspective, and is based on a recent study of homemaking practices of two subgroups of young male migrants in Ireland: international students and refugees. The data collected through walking interviews and photo elicitation interviews show interesting similarities between these two different groups. This chapter focuses on public spaces as homes and thus offers a novel analysis of emotions within the context of migration of single young male migrants in Europe and their ways of creating a meaningful sense of spatial belonging within public spaces.
This chapter examines the experiences and life-worlds of young migrant women in Thembisa, a sprawling township on the outskirts of the city of Johannesburg, South Africa. Based on conversations and interviews in small hairdressing salons where the young women congregate, the chapter explores how they form relationships and build networks around what we refer to as ‘private-public’ spaces. ‘Private-public’ spaces describe the ways in which a space like a hair salon can be open to anyone on a busy, open street but also be a space for creating (sometimes temporary) friendships, networks and threads of trust among girls and young women looking for better futures in a different country. Exploring how the teenage girls, many of whom have become mothers themselves at a young age, do not fit the stereotypical picture of a vulnerable child migrant, the chapter argues for a greater focus on the realities and needs of migrant youth and especially girls as they move across borders, and base their survival on spaces which simultaneously expose and provide protection from the precarious experiences of everyday life in South Africa.
Esatis is an engaged slam poet from the Central African Republic. Nathan-2K is a Congolese gospel music guitarist. Both young men left their respective home towns and made their way to a foreign African megapolis in search of greener pastures. Based on two biographical trajectories, this chapter (1) problematises South–North migration and concentrates on trajectories within Africa; (2) questions the artificial migrant–refugee divide and; (3) challenges images of the vulnerable refugee/migrant and underlines self-affirmation, personal success and dignity instead. The biographic approach helps to contextualise important moments of decision in these young men’s biographical trajectories. Exploring these details leads to a deeper understanding of how lives of youth in urban Africa can unfold in a constant interplay between structure and agency (through music).
The city – rather than the state – plays an important role in refugee youth’s everyday experiences. In this chapter, we draw upon participatory research among young refugees and asylum seekers in Amsterdam to illustrate the lived experiences of these youngsters in public spaces in the urban fabric of Amsterdam. We illustrate their favourite places, the use and meaning of these spaces, and how these spaces impact their sense of belonging in both the Netherlands and Amsterdam. The findings show that it is not self-evident for refugee youth who are new to the city to immediately exploit the potential of public space. Semi-public spaces can fill an important role in providing a safe and meaningful space for refugees’ integration and participation in society. At the same time it is not self-evident to transmit these encounters beyond these semi-public places, which illustrates that conviviality is spatially bound to specific places.
A vision for social justice in the built environment suggests that urban planning is a political process that can and should enable the conditions for all city inhabitants to influence the spatial and material character of the urban public space. This chapter examines theoretical dimensions of the inclusive city, urban planning and the public space and connects these debates to findings from interviews conducted with refugee youth living in the city of Amman. These interviews reveal insight surrounding the everyday experiences of refugee youth and shed light on the challenges and transformative potential of inclusive planning. Building on this analysis, this chapter emphasises the criticality and necessity for inclusive urban planning processes as a means to encourage alternative and innovative ways to rethink urban politics, engage the urban political will of refugee youth and re-envision public space for a more socially just city.
