On the morning of 25 August 2014 a young New Jersey woman, Maria Fernandes, died from inhaling gasoline fumes as she slept in her 13-year-old car. She often slept in the car while shuttling between her three, low-wage jobs in food service; she kept a can of gasoline in the car because she often slept with the engine running, and was worried about running out of gasoline. Apparently, the can accidentally tipped over and the vapours from spilled gasoline cost her life.
Ms Fernandes was one of the more obvious casualties of the zero-hours culture of stress and insecurity that pervades the contemporary labour market under neoliberalism. Since the early 1980s, neoliberalism or "market fundamentalism" has dominated politics and economics across much of the globe. In our new book Neoliberal Epidemics: How Politics Makes Us Sick (published this month by Palgrave Macmillan) we consider the health effects of over three decades of neoliberal policies with particular reference to the US and the UK. We argue that there are four 'neoliberal epidemics': austerity, obesity, stress, and inequality.
They are neoliberal because they are associated with or exacerbated by the rise of neoliberal politics. They are epidemics because they are on such an international scale and have been transmitted so quickly across time and space that if they were a biological contagion they would be seen as of epidemic proportions. All of these epidemics are associated with neoliberalism and we argue that alternative political and economic choices would have prevented them - or at least reduced their scale - resulting in a healthier 21st Century.
A key element of neoliberalism has been the drive to make labour markets more 'flexible', through such measures as liberalizing trade and attacking trade unions. The full time, secure, skilled, pensionable jobs that characterised the early post-war period are increasingly rare, replaced by flexible or precarious employment: more and more people are working on either temporary contracts or no contracts, with limited or no employment or welfare rights. In this new economy working hours, contracts, conditions, pay and location are all more precarious. The expansion of this "precariat" is exemplified by zero hours contracts, under which workers have no set hours of work and are not guaranteed even minimum hours from week to week. There are 1.4million workers in the UK on such contracts - extensively used by large multi-national companies such as Amazon, which have also been criticized for paying very little UK corporation tax.
Neoliberalism operates through labour markets to undermine health not only by way of the financial consequences of unemployment, inadequate employment, or low wages, as important as these are, but also through chronic exposure to stress that 'gets under your skin' by way of multiple mechanisms. Quite simply, the effects of chronic insecurity wear people out over the life course in biologically measurable ways. In our book, we summarize a growing body of scientific evidence that the results include increased likelihood of obesity (another one of the neoliberal epidemics); cardiovascular disease; and anxiety and depression.
In countries that have gone farthest down the neoliberal road, particularly the US and the UK, stress has a worse effect on health than in those countries that are less neoliberal. The health penalty of unemployment, and the unemployment penalty of ill health, is also higher in more neoliberal countries. This is because countries that have not been as affected by the politics and economics of neoliberalism have a more regulatory state which provides a better context within which to work as well as a stronger social safety net for those out of work.
We argue that neoliberalism has created an epidemic of stress and insecurity - one that could have been avoided if different political choices had been made. Stress is a neoliberal epidemic and an example of how politics makes us sick.
Neoliberal Epidemics: How Politics Makes Us Sick, Palgrave Macmillan is available here
Clare Bambra PhD is Professor of Public Health Geography and Director of the Centre for Health and Inequalities Research, Durham University. She is a member of the Labour Party and can be followed on Twitter @ProfBambra
Ted Schrecker is Professor of Global Health Policy, Centre for Public Policy and Health, Durham University. He can be followed on Twitter at @ProfGlobHealthSuggest a correction