Adding Insult to Injury: How Neoliberal Ideology Convinces the Disadvantaged to Blame Themselves for Poor Health
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Abstract
Health outcomes are strongly tied to social class. Childhood environment, level of education, income, and even neighborhood characteristics are strongly correlated with negative health outcomes such as obesity, diabetes, hypertension, stress, and others. Despite extensive research chronicling these structural factors, federal, state, and community initiatives to combat these issues target individuals as actors responsible for enacting change through their personal choices, ignoring the systemic barriers that many people face to make healthy decisions. Tying Bourdieu’s theory of class distinction, system justification, and neoliberal theory, I conducted and analyzed 11 qualitative, semi-structured interviews with Americans of varied class backgrounds. These were analyzed to understand whether individuals perceive health outcomes as the result of neoliberal choice or of structural conditions of socioeconomic positioning, which for the purposes of this study is measured primarily as a combination of income and education. The results suggest that individuals with lower income and education characterize obstacles to health as a result of their personal choices, reflecting a subscription to neoliberal ideology which mandates rational choice and personal responsibility. Individuals with lower socioeconomic status were also more likely to state positive attitudes of doctors and medical professionals despite negative experiences with them, reflecting the structural limitations of low capital. In contrast, those with higher income and education tend to characterize obstacles to health as a result of deficiencies in the health care system, class advantages, and the economic cost of a healthy lifestyle, as well as hold more negative views of doctors, reflecting the high capital that allows them mitigate poor medical care. This study did not find race, gender, or age to have a meaningful systemic effect on either individuals’ subscription to neoliberal ideology or their trust in doctors, but these variables may have effects that could be observed in a larger sample.
Table of Contents
Introduction -- Review of literature -- Methodology -- Results -- Discussion -- Conclusion -- Appendix A. Recruitment Flier -- Appendix B.Interview Guide -- Appendix C. Code Book -- Appendix D. IRB
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M.A. ( Master of Arts)