Doctoral Dissertation Research: Healthcare Austerity and the Mobilization of Social Networks

University Of California-Davis, Davis CA

Investigators

Abstract

Reductions in state-sponsored forms of healthcare are an increasingly common response to economic crisis. When public programs and private financial resources both recede, what kinds of social resources do chronically ill people, who need stable access to pharmaceuticals, mobilize in order to survive? Social scientific accounts of unmet healthcare needs associated with economic crises have largely focused on the developing world. Less is known about the relationship between austerity and healthcare resources in contexts such as the U.S. or Europe. This research addresses pharmaceutical access under austerity in a context with a previously robust universal healthcare system. Deepening financial and healthcare inequalities associated with economic crisis have given way to newly disenfranchised people that must seek pharmaceuticals in a therapeutic economy characterized by frequent crisis-driven reformulations. This research, which is centered on training a graduate student in rigorous methods of scientific data collection and analysis, seeks to understand the kinds of social resources people mobilize in order to address unmet pharmaceutical needs, when public healthcare is no longer dependable and financial resources and pharmaceuticals are unevenly distributed. In addition to providing funding for the training of a graduate student, the project would improve scientific understanding through broadly disseminating its findings to governmental and non-governmental organizations charged with improving public health access, as they mediate the differential impacts of austerity on healthcare outcomes. Taylor Bell, under the supervision of Dr. Cristiana Giordano of the University of California at Davis, will explore what forms of social networks replace public infrastructures under conditions of austerity in healthcare access. This research takes place in Athens, Greece, which has instituted the most stringent austerity measures targeting public healthcare across Europe. Athens has the highest concentration of state-sponsored healthcare resources in Greece, and so, will best highlight how people adjust pharmaceutical-seeking practices when public resources disappear. In order to learn how pharmaceuticals are exchanged and the relationships that facilitate these exchanges, the co-PI will conduct participant observation in emergent grassroots solidarity clinics and pharmacies, which many people turned to after austerity measures eroded the universal healthcare system, cutting its budget by more than 50%. The co-PI will also track, map, and analyze pharmaceutical networks and therapeutic economies through a range of observational and archival methods on extended social networks, as well as interviews (through both the McGill Illness Narrative Interview, and well as targeted semi-structured follow-ups) with a representative sample of pharmaceutical seekers. The findings will contribute to debates in medical, political, and economic anthropology about inequality, specifically in the differential distribution of healthcare burdens under conditions of economic austerity. This research offers insight to policymakers concerned with the kinds of social resources that disenfranchised, chronically ill people build in order to establish access to needed pharmaceuticals, as state-funded healthcare retracts. This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.