2 - Discourse, capital, intersectionality and precarity

Summary

Introduction

This chapter outlines the theoretical lenses used to frame and discuss the book's themes. Framing discussion using theory is important because it lifts analysis beyond a descriptive account to a more critical examination of how societal structures and discursive developments have impacted institutions. For example, neoliberal and austerity discourse has shaped health and social care structures and institutions, such as the NHS, which have changed the experiences of individuals, such as older people and health or social care workers. Furthermore, it is important to discuss theoretical concepts such as neoliberalism, capital and precarity, in order to illustrate how broad discursive and structural change has influenced levels of security and stability for older people and staff in health and social care. For example, neoliberal discourse, which supports austerity measures and public funding cuts, impacts the resources or capital available to service users and those working in the public sector by making their lives more precarious. The extent to which older people are affected relates to their level of capital (economic, physical, social and cultural [Bourdieu, 1984; Dumas and Turner, 2006]); for example, being more educated or wealthy mediates an older person's access to health and social care systems. Family and friends (social and cultural capital) are particularly important in helping older people traverse and negotiate the complexities of fragmented health and social care services. However, class is not the only identity that can impact older people's access to health care resources. Social class intersects with other identities such as age, gender, disability and ethnicity (Corus and Saatcioglu, 2015). These identity combinations influence access to health and social care, either by layering disadvantages or advantages through one's lifecourse. This chapter will draw on ideas from Michel Foucault (1972) to demonstrate how these identity combinations have shaped older people's access to necessary health resources. Foucauldian theory is being used here to provide a critical lens through which to analyse how and why particular arguments about desired health behaviours have been constructed. Foucault was interested in how language, practice and perceptions shape the world; for instance, he was interested in how some groups, but not others, are enabled to exercise the power to produce knowledge (Foucault, 1972).