The Politics of Tackling Inequalities: The Rise of Psychological Fundamentalism in Public Health and Welfare Reform

This chapter is concerned with the growing influence of non-material explanations for inequalities and a corresponding emphasis on psychological interventions, which aim to modify cognitive function or emotional disposition/affect (Friedli 2013, 2014). These developments intersect with and are reinforced by the parallel rise in brain science, which correlates a range of outcomes (crime, addiction, health behaviour, educational attainment) with brain structure (Katz 2013; Rose 2013). As a recent editorial in the British Medical Journal observes:

There is great interest in whether the structure and function of brain circuits can be changed to optimise the operation of the executive control system (Marteau and Hall 2013, p. 6750)

In public health, the psychological attributes and dispositions of individuals and communities (the ostensible presence or absence of optimism, aspiration, self-efficacy, conscientiousness, sense of coherence, etc.) are being used to explain patterns of health and health behaviour and to account for the impact of material deprivation, in a twin process of psychologizing and biologizing poverty (Edwards et al 2014). Deprivation is understood less and less in relation to issues of equity, power, and justice and more and more in terms of the impact of the ‘environment’ on brain function.