Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 20
Filter
1.
Proc Natl Acad Sci U S A ; 119(39): e2207487119, 2022 09 27.
Article in English | MEDLINE | ID: mdl-36122235

ABSTRACT

Protracted droughts lasting years to decades constitute severe threats to human welfare across the Indian subcontinent. Such events are, however, rare during the instrumental period (ca. since 1871 CE). In contrast, the historic documentary evidence indicates the repeated occurrences of protracted droughts in the region during the preinstrumental period implying that either the instrumental observations underestimate the full spectrum of monsoon variability or the historic accounts overestimate the severity and duration of the past droughts. Here we present a temporally precise speleothem-based oxygen isotope reconstruction of the Indian summer monsoon precipitation variability from Mawmluh cave located in northeast India. Our data reveal that protracted droughts, embedded within multidecadal intervals of reduced monsoon rainfall, frequently occurred over the past millennium. These extreme events are in striking temporal synchrony with the historically documented droughts, famines, mass mortality events, and geopolitical changes in the Indian subcontinent. Our findings necessitate reconsideration of the region's current water resources, sustainability, and mitigation policies that discount the possibility of protracted droughts in the future.


Subject(s)
Cyclonic Storms , Droughts , Social Conditions , Humans , India , Oxygen Isotopes , Rain , Seasons
2.
J Urban Health ; 100(6): 1224-1233, 2023 12.
Article in English | MEDLINE | ID: mdl-38038818

ABSTRACT

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.


Subject(s)
Poverty , Residence Characteristics , Humans , England , Mental Health , Anxiety Disorders
3.
Demography ; 59(2): 607-628, 2022 04 01.
Article in English | MEDLINE | ID: mdl-35195250

ABSTRACT

The decline of manufacturing employment is frequently invoked as a key cause of worsening U.S. population health trends, including rising mortality due to "deaths of despair." Increasing automation-the use of industrial robots to perform tasks previously done by human workers-is one structural force driving the decline of manufacturing jobs and wages. In this study, we examine the impact of automation on age- and sex-specific mortality. Using exogenous variation in automation to support causal inference, we find that increases in automation over the period 1993-2007 led to substantive increases in all-cause mortality for both men and women aged 45-54. Disaggregating by cause, we find evidence that automation is associated with increases in drug overdose deaths, suicide, homicide, and cardiovascular mortality, although patterns differ by age and sex. We further examine heterogeneity in effects by safety net program generosity, labor market policies, and the supply of prescription opioids.


Subject(s)
Drug Overdose , Robotics , Automation , Employment , Female , Homicide , Humans , Male , Middle Aged , United States/epidemiology
4.
Soc Sci Res ; 104: 102686, 2022 05.
Article in English | MEDLINE | ID: mdl-35400391

ABSTRACT

This article examines how the automation of jobs has shaped spatial patterns of intergenerational income mobility in the United States over the past three decades. Using data on the spread of industrial robots across 722 local labor markets, we find significantly lower rates of upward mobility in areas more exposed to automation. The erosion of mobility chances is rooted in childhood environments and is particularly evident among males growing up in low-income households. These findings reveal how recent technological advances have contributed to the unequal patterns of economic opportunity in the United States today.


Subject(s)
Income , Social Mobility , Automation , Family Characteristics , Humans , Intergenerational Relations , Male , Socioeconomic Factors , United States
5.
Br J Sociol ; 73(1): 220-236, 2022 Jan.
Article in English | MEDLINE | ID: mdl-34967449

ABSTRACT

This article theorizes a link between contemporary masculinity in post-industrial spaces and 'hardcore' gym culture. Over the last three decades the health and fitness industry has grown exponentially, with bodily modification and the proliferation of gymnasia, health supplements and wearable fitness trackers now a dominant means by which many construct their identities. Simultaneously, the onset of wholesale neoliberalism, which has caused large-scale de-industrialization and the global outsourcing of labor, has resulted in a macro-economic shift from production to consumption in the West. Set against this backdrop, this article draws upon two ethnographic studies in 'hardcore' gyms to examine the significance of bodywork in the lives of men in two working-class, post-industrial locales in England. First, gym work is conceptualized as a form of both graft and craft within our samples, and the role of the male body as a post-industrial project is considered. Following this, the gym is presented as a site of fraternity which, following the loss of collectivizing industry in both areas, allows men to bond over a shared endeavor and build genuine kinship. Ultimately, we conclude that the gym is a space of production within consumption, furnishing our sample with a means of performing their embodied masculinity and repurposing formative notions of graft, craft, and fraternity in a new adaptive space.


Subject(s)
Exercise , Masculinity , Anthropology, Cultural , England , Humans , Industry , Male
6.
Br J Sociol ; 72(4): 1062-1076, 2021 Sep.
Article in English | MEDLINE | ID: mdl-33641171

ABSTRACT

Despite frequent associations, deindustrialization features rarely in studies of organized crime, and organized crime is at best a spectral presence in studies of deindustrialization. By developing an original application of Linkon's concept of the "half-life," we present an empirical case for the symbiotic relationship between former sites of industry and the emergence of criminal markets. Based on a detailed case-study in the west of Scotland, an area long associated with both industry and crime, the paper interrogates the environmental, social, and cultural after-effects of deindustrialization at a community level. Drawing on 55 interviews with residents and service-providers in Tunbrooke, an urban community where an enduring criminal market grew in the ruins of industry, the paper elaborates the complex landscapes of identity, vulnerability, and harm that are embedded in the symbiosis of crime and deindustrialization. Building on recent scholarship, the paper argues that organized crime in Tunbrooke is best understood as an instance of "residual culture" grafted onto a fragmented, volatile criminal marketplace where the stable props of territorial identity are unsettled. The analysis allows for an extension of both the study of deindustrialization and organized crime, appreciating the "enduring legacies" of closure on young people, communal identity, and social relations in the twenty-first century.


Subject(s)
Crime , Industry , Adolescent , Half-Life , Humans , Scotland
7.
Br J Sociol ; 70(2): 610-626, 2019 Mar.
Article in English | MEDLINE | ID: mdl-29638002

ABSTRACT

Deindustrialization is a complex and multifaceted series of processes and transitions, reflecting the equally complicated web of social relationships and interdependencies that constitute(d) an industrial society. Contemporary scholars have looked beyond just the economic impact of industrial loss, to the cultural, temporal and spatial legacies and impacts wrought by the mass closures of the 1980s, as well as the continuing presence of an industrial identity in struggles over representation and regeneration. However, deindustrialization has a history that precedes the volatility and culmination of that period, and has impacted upon a more geographically diverse range of former industrial locations than are commonly represented. The narratives that surround some sites are complicated by their displacement in time, place and discourse; they lack the political capital of an 'industrial' identity through this disassociation. In this article I aim to go beyond what we might consider the industrial 'heartlands' of the UK to a place that has felt the impact of deindustrialization, but which falls outside of the usual representations of the UK's industrial past. I explore how the industrial identity and memory of a place can be naturalized and selectively reworked for the needs of the hour, the very meaning of 'industrial' altered in the process. I argue that for sites unable to access or utilize the imagery of modern, heavy industry for community or promotional aims, deindustrialization becomes a process of rewriting an historic identity - one that sheds new light on industrial loss in diverse situations, and at an ever-increasing distance from closure.


Subject(s)
Industry , Social Change , Urban Renewal , Humans , Industry/economics , Interpersonal Relations , Interviews as Topic , Rural Population , United Kingdom , Urban Population
8.
Br J Sociol ; 70(5): 2116-2132, 2019 Dec.
Article in English | MEDLINE | ID: mdl-31465116

ABSTRACT

In the seemingly routine and the everyday, lie layers of cultural and social symbolism. So it is with dirt. This article examines the social and cultural roles of dirt within socialization practices in working-class industrial and ex-industrial communities. Drawn from oral history accounts with 46 former and current engineering apprentices, the discussion demonstrates dirt as a concept and a practicality, and how the idea of 'getting dirty' provided a cultural imagery used to renegotiate moral boundaries that devalue working class, masculine experiences and identities. Building on from the work of Skeggs (1997, 2004, 2011), it demonstrates the lived experience of value within the industrial workplace past and present. Through dirt, the role of cultural artefacts and iconography within working-class experience and workplace training is explored. Additionally, the role of a cultural icon like dirt in the intergenerational dialogues of workplace communities is given new attention. In doing so the article argues that while after decades of underinvestment in apprenticeships as a model for training in the UK, a recent resurgence in interest can go some way in overcoming the long-term effects of the loss of large-scale industrial work. However, the cultures of work attached to the apprenticeships of the past are, within deindustrialization, much more complicated to develop or recreate.


Subject(s)
Culture , Industry/education , Social Identification , Work/psychology , Adult , Humans , Industry/statistics & numerical data , Male , Residence Characteristics , Social Class
9.
J Transp Geogr ; 66: 200-212, 2018 Jan.
Article in English | MEDLINE | ID: mdl-32288376

ABSTRACT

Transportation investment continues to grow in aid of economic competitiveness and environmental sustainability worldwide, but limited empirical research has been conducted on the changing value of highway investment in deindustrializing economies. This study examines the influences of highway proximity and traffic on office values in Hong Kong using hedonic price analysis on 13,670 transactions around highway interchanges for 2002-2013. Our hedonic regressions, controlling for unobservable district effects and incorporating instrumental variables, reveal that the associations of highway proximity and traffic with office prices appear to exhibit mixed results across Hong Kong's three territorial divisions. The negative externalities generated by excess traffic cancel out the accessibility benefits of highway proximity on Hong Kong Island, where densely built-up office districts are suited for amenity-sensitive knowledge businesses that tend to create value-added services through face-to-face communications. By contrast, highway proximity uplifts the value of office properties with lower transportation costs and higher market accessibility in Kowloon and the New Territories, where spacious workplaces near hub-port and logistics facilities are advantageous for mobility-driven trade and transportation businesses that tend to increase value-added throughput in cross-border relations with mainland China. These territorial findings are of particular importance for progressive policymakers to deploy the strategic applications of underground bypasses, greenway creation, interchange improvement, congestion charges, and smart technology to manage mobility and alleviate disamenity, accompanied by supportive public transit services and adaptive land-use rezoning, in the dynamic and complex process of deindustrialization.

10.
SSM Popul Health ; 27: 101706, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39246452

ABSTRACT

Background: - Coal mining areas in the UK continue to suffer worse health outcomes despite the industry disappearing by the early 1990s. Unemployment and deprivation are cited as key explanations. However, as the health effects of hazardous working environments continue after the industry's closure, it is unclear to what extent this ongoing health deficit is due to the legacy health effect of coal mining versus socioeconomic factors, including unemployment and deprivation. Methods: - I isolate the legacy health effect of coal mining using a matching research design. Coal mining areas are paired with non-mining areas using propensity score matching. This creates a sample of socioeconomically similar local authority districts in England and Wales. I estimate the effect of coal mining on male and female age-standardised period mortality rates for 1981-2019, analysing temporal dynamics and testing for convergence. Results: - I find an initial coal mining effect in 1981 on male (female) mortality rates of 122.6 (66.5) deaths per 100,000. This effect decreases by 91% (70%) during this period, indicating convergence in mortality rates. The timing of this convergence is consistent with that of the industry's closure, with higher convergence rates observed during the 1990s. Conclusions: - These results provide evidence for a legacy health effect on mortality from coal mining and convergence in mortality rates between 1981 and 2019. This effect is important when explaining the health deficit experienced by coal mining areas. Furthermore, as coal mining areas tend to be more deprived, these results also shed light on relevant mechanisms driving recent health inequality in the UK.

11.
Struct Chang Econ Dyn ; 61: 278-293, 2022 Jun.
Article in English | MEDLINE | ID: mdl-36247207

ABSTRACT

The COVID-19 crisis represents a turning point to rethink industrial policy spaces and countries' productive autonomy, especially for developing economies, such as Brazil, that call for new ways of thinking about manufacturing within societal purposes. Using an input-output model, the paper explores the pandemic-crisis-effects in the case of the Brazilian manufacturing sector. We find that the pandemic-crisis has harmful effects on the Brazilian productive structure, revealing the dependence on imports of the Brazilian Health System. Reductions in manufacturing gross output and value-added are mainly seen in knowledge-intensive subsectors, followed by job losses and tax revenue reduction. We suggest that the pandemic points to some roads to reindustrialization and resilience, given the reorganization of international production networks and the growing dependence on imports in key manufacturing sectors. Thus, the potential role of the manufacturing sector to achieve inclusive and sustainable growth reveals the importance of building productive capacity beyond the pandemic.

12.
J Chin Sociol ; 8(1): 9, 2021.
Article in English | MEDLINE | ID: mdl-35822197

ABSTRACT

At the end of the twentieth century, two historical turns of economic inequality happened. Among the developed countries of the Global North, the secular trend of decreasing intra-national inequality turned into its opposite. At about the same time, the long period of global inequality began to bend down, among households as well as among nations, a turn less noticed but more significant than the reduction of extreme poverty in the South. The foundation of the former turn was the beginning of de-industrialization in the North, and the coming of a post-industrial society, very different from the one predicted. The paper analyzes the trigger of the turn and the central dynamics of the new inequality in the rich North, financialization, and the digital revolution. It then tries to answer two questions about the global turn: Was the decline of global inequality causally connected to the increase of Northern intra-national inequality? Will there be a development of industrial societies in the South? The answer to both is no. What lies ahead is more likely a global convergence of intra-national unequalization, albeit with both different and similar dynamics, as the decline of extreme poverty in the South is leading to inequality increases comparable to those of the North. Post-industrialism has no egalitarian dialectic like that of industrial capitalism, but the dynamics of the twenty-first century inequality are likely to be confronted not only with popular protest movements but also with an emergent scholarly and intellectual Egalitarian Enlightenment.

13.
J Prev Med Hyg ; 62(3): E709-E717, 2021 Sep.
Article in English | MEDLINE | ID: mdl-34909499

ABSTRACT

AIMS: Genoa is a city hit by a strong economic, demographic and social involution. The changes in the demographic and socio-economic (SE) situation were analysed and the capacity of two Socio-Economic and Health Deprivation Indices (SEHDI) in describing the evolutions of the recent period were verified. MATERIAL AND METHODS: The data about the evolution of demographic and SE situation in Genoa came from publications of Statistics Offices of Genoa Municipality and Liguria Region and from published analyses of Bank of Italy. The two SEHDIs, referring to 2001 and 2011 population, were computed at census tract level by linear regression, factor and clusters analyses and had been already validated and published. RESULTS: Wide transformations in aging and population composition by age groups and gender occurred in Genoa between 1951 and 2016. Internal (from other Italian regions) and external (from other countries) migrations concurred to change the profile of Genoese population. These changes followed the industrial history of city and its deindustrialization occurred since 2001. A progressive SE involution, worsened by the Italian and international crises, carried out the recent impoverishment of the city. Between 2001 and 2011 the population at medium-high deprivation increased and the SEHDIs 2001 and 2011 contributed to describe the population distribution by deprivation groups, either geographically, and by groups of citizenships (Italians and Foreigners). The first identified in 2001 some aspects of a well-off society regarding education, labour market and characteristics of the family and housing structure. The second depicted in 2011 an impoverished society in aging, lack of family support and of property of the main house, diminishing of educational level. DISCUSSION: Genoa city demonstrated an its own specific decline. Starting from the deindustrialization, a worsening of welfare, independently from the national and international economic troubles, was evident. The aging and the changed equilibria among age groups testified the growing difficulties of society in keeping up with the deep social and economic changes. The results demonstrated that specific deprivation indices aid to better define the populations under analysis, because they identify the subpopulations that could have the maximum benefit from investments of resources targeted to the correction of inequalities.


Subject(s)
Census Tract , Economic Recession , Aging , Demography , Humans , Social Class , Socioeconomic Factors
14.
J Prev Interv Community ; 49(2): 136-151, 2021.
Article in English | MEDLINE | ID: mdl-33998397

ABSTRACT

Opioid related drug overdose deaths are a leading cause of death and injury in the United States. While research demonstrates that where people live has a major impact on drug use and abuse, most work looks at social dynamics at the county level or under the rubric of the urban/rural divide. Only recently, scholarship has become attuned to the post-industrialized areas located on the fringes of urban cores. Data presented in here are from field research conducted in McKeesport, Pennsylvania, a small river town located east of Pittsburgh. Once a thriving industrial city, it is now deteriorated and has documented high levels of overdose experience. Preliminary results suggest that McKeesport residents, even before the emergence of SARS-CoV-2 (COVID-19), practice social and physical distancing as a way of life; data indicate how the pandemic potentially exacerbates the risk of accidental opioid overdose among a population defined by both geographic and social isolation.


Subject(s)
COVID-19 , Drug Overdose/prevention & control , Law Enforcement , Pandemics , Drug Overdose/mortality , Health Policy , Humans , Interviews as Topic , Pennsylvania , Physical Distancing , Poverty Areas , Risk Factors , Rural Population , Social Isolation , United States/epidemiology
15.
Front Sociol ; 5: 541490, 2020.
Article in English | MEDLINE | ID: mdl-33869492

ABSTRACT

This paper reflects upon issues of class and identity in the UK over the last 50 years. 1969 is a useful starting point, economically and technologically it can be regarded as the high tide of the vision of a Britain remade in what the then Prime Minister Harold Wilson had termed "the white heat of technology." That technology had produced Concord the world's first supersonic airliner which made its debut that year. This successful Anglo French collaboration also showed how Britain was rapidly moving into a different relationship with Europe a process that culminated in the UK's entry into the EEC or the "common market" as it was more usually referred to on January 1st 1973. Sociologically, it marked the publication of Goldthorpe et al. Affluent worker studies, which examined the idea that increasing affluence was breaking down established class structures, roles and attitudes. This debate about whether the changing nature of work brought with it a fundamental change in class structure and identity has been going on ever since. It has subtly changed and this is to be expected, 50 years is a long time. However, it is generally accepted that the change to economic and social policy that had followed the second world, social mobility was increasingly evident by the late sixties and continued into the seventies. Over the years issues of not only social class but de-industrialization, social mobility, regional decline, globalization, and its impact on policy have been added to the mix. Furthermore, "Brexit" is part of this debate and partly a product of it, however this paper doesn't have the space required to examine this. The title of this paper relates to Dick Clement and Ian La Frenais sitcom "Whatever happened to the Likely Lads" (WHTTLL) which was first broadcast by the BBC in 1973. It focusses on the relationship between 2 young men in their late 20's Bob and Terry. They come from the same place, have similar backgrounds and have been friends since childhood. But their lives are now at a crossroads. Whilst Bob is attempting to grasp new opportunities, Terry is skeptical and to some degree baffled by the change going on around him. The future of class in an era of social mobility also raised questions about aspiration and identity. These are questions which are now less prominent within discourse on class. The debate around class today is arguably less concerned with the mainstream and has become focussed on extremes looking at either poverty, criminality, dispossession or sometimes the lifestyles of a superrich elite. In summary then this paper will look at the changing ideas, and narratives that have surrounded social class and social mobility over the past half century within the context of the UK, it will do that by reflecting on my own personal biography and the themes raised in "Whatever happened to the Likely Lads" (WHTTLL).

16.
Front Sociol ; 5: 38, 2020.
Article in English | MEDLINE | ID: mdl-33869445

ABSTRACT

This article advances conceptualizations of belonging and alienation among deindustrializing people toward (i) pluralistic temporal and (ii) affective processes. The focus is on belonging and alienation among a deindustrialized generation in the Nottinghamshire coalfield, UK, exploring how various affective-temporal processes mediate capacities, claims, and senses of belonging and alienation. Extant studies suggest that multiple temporal processes constitute deindustrialized places, particularly intergenerational transmissions, declarative memory, and place-histories. Recent work has explored the affective, emotional, and embodied dynamics of these temporal processes. While these literatures are insightful in locating affective and temporal processes of belonging, studies do not have much to say on the relational dynamics of affective-temporal processes in everyday becoming lives and experiences of deindustrializing places. The significance of foregrounding multiple affective-temporal processes of belonging and alienation is because of their relational nature. Advancing understandings of belonging is critical as a coherent sense of belonging is fundamental for individual and social well-being, and the loss of belonging, namely, alienation, informs how former industrial places are lived. Based on autoethnographic, interview and Observant Participation research with participants born between 1984 and 1994, I use ethnographic vignettes to delineate multiple relating affective-temporal processes of belonging and alienation of a generation that came after coal. The first vignette concerns the embodied and affective relationalities of intergenerational transmission and becoming in a deindustrialized world through the lens of masculinity, place and belonging. The second vignette examines nostalgic and traumatic shared declarative memories contingent of living through and with deindustrialization. The third vignette looks at intersections of place histories, silenced memory and local pride and shame, drawing out the significance of space and place to class-based experiences. Weaved through the stories are thematic threads of class, place, alienation, belonging, and temporality. Bringing these threads together, the paper then discusses the relationalities between issues covered, emphasizing the mutual contingencies between affective-temporal processes of belonging and alienation. I end by calling for shared affective-temporal processes of belonging and alienation to form the basis of a renewed solidarity, attenuation of alienation and a means to belong.

17.
SSM Popul Health ; 12: 100679, 2020 Dec.
Article in English | MEDLINE | ID: mdl-33319025

ABSTRACT

U.S. labor markets have experienced transformative change over the past half century. Spurred on by global economic change, robotization, and the decline of labor unions, state labor markets have shifted away from an occupational regime dominated by the production of goods to one characterized by the provision of services. Prior studies have proposed that the deterioration of employment opportunities may be associated with the rise of substance use disorders and drug overdose deaths, yet no clear link between changes in labor market dynamics in the U.S. manufacturing sector and drug overdose deaths has been established. Using restricted-use vital registration records between 1999 and 2017 that comprise over 700,000 drug deaths, I test two questions: First, what is the association between manufacturing decline and drug and opioid overdose mortality rates? Second, how much of the increase in these drug-related outcomes can be predicted by manufacturing decline? The findings provide strong evidence that the restructuring of the U.S. labor market has played an important upstream role in the current drug crisis. Up to 92,000 overdose deaths for men and up to 44,000 overdose deaths for women are predicted by the decline of state-level manufacturing over this nearly two-decade period. These results persist in models that adjust for other social, economic, and policy trends changing at the same time. Critically, the findings signal the value of policy interventions that aim to reduce persistent economic precarity experienced by individuals and communities, especially the economic strain placed upon the middle class.

18.
Int J Epidemiol ; 47(3): 720-730, 2018 Jun 01.
Article in English | MEDLINE | ID: mdl-29182726

ABSTRACT

BACKGROUND: The health gap between the top and the bottom of the income distribution is widening rapidly in the USA, but the lifespan of America's poor depends substantially on where they live. We ask whether two major developments in American society, deindustrialization and incarceration, can explain variation among states in life expectancy of those in the lowest income quartile. METHODS: Life expectancy estimates at age 40 of those in the bottom income quartile were used to fit panel data models examining the relationship with deindustrialization and incarceration between 2001 and 2014 for all US states. RESULTS: A one standard deviation (s.d.) increase in deindustrialization (mean = 11.2, s.d. = 3.5) reduces life expectancy for the poor by 0.255 years [95% confidence interval (CI): 0.090-0.419] and each additional prisoner per 1000 residents (mean = 4.0, s.d. = 1.5) is associated with a loss of 0.468 years (95% CI: 0.213-0.723). Our predictors explain over 20% of the state-level variation in life expectancy among the poor and virtually the entire increase in the life expectancy gap between the top and the bottom income quartiles since the turn of the century. CONCLUSIONS: In the USA between 2001 and 2014, deindustrialization and incarceration subtracted roughly 2.5 years from the lifespan of the poor, pointing to their role as major health determinants. Future research must remain conscious of the upstream determinants and the political economy of public health. If public policy responses to growing health inequalities are to be effective, they must consider strengthening industrial policy and ending hyper-incarceration.

19.
Int J Drug Policy ; 29: 19-26, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26868674

ABSTRACT

BACKGROUND: Applying the "risk environment" approach proposed by Rhodes (2002, 2009), this study considers the diverse contextual factors contributing to drug overdose in a deindustrialized region of the United States. The Monongahela Valley of Pennsylvania, once a global center of steel production, has suffered a mass exodus of jobs, residents, and businesses since a national manufacturing crisis erupted in the early 1980s; more recently, it has seen a dramatic uptick in accidental drug poisoning deaths. Where recent local and national media attention to overdose has focused on suburban areas and middle class victims, this study concentrates instead on the deteriorating mill city of McKeesport, Pennsylvania. METHODS: Eighteen clients of the city's sole drug treatment facility participated in in-depth interviews concerning their direct experience with accidental overdose. Specifically, participants were asked to describe their own most recent overdose event and/or the last overdose they had personally witnessed. They were also asked to speculate upon the roots of the local overdose epidemic, while venturing possible remedies. RESULTS: In relating their overdose experiences, participants characterized a micro-level risk environment that was hidden behind closed doors, and populated by unprepared, ambivalent overdose "assistants." Tasked with explaining a geographic concentration of overdose in and around McKeesport, interviewees referenced the hopelessness of the area and its lack of opportunity as driving the use of heroin, with many explicitly suggesting the need for jobs and community reinvestment to reduce fatalities. CONCLUSION: While state and county efforts to ameliorate overdose mortality have focused upon creating an open market in naloxone, this study suggests the need for interventions that address the poverty and social isolation of opiate users in the post-industrial periphery.


Subject(s)
Drug Overdose/economics , Drug Overdose/psychology , Employment/economics , Industry/economics , Opioid-Related Disorders/epidemiology , Opioid-Related Disorders/psychology , Urban Health/statistics & numerical data , Adult , Drug Overdose/mortality , Drug Overdose/prevention & control , Female , Hope , Humans , Male , Middle Aged , Opioid-Related Disorders/mortality , Opioid-Related Disorders/prevention & control , Pennsylvania/epidemiology , Risk Factors , Socioeconomic Factors , Urban Health/economics
SELECTION OF CITATIONS
SEARCH DETAIL