Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-27T23:22:15.007Z Has data issue: false hasContentIssue false
  • English
  • Français

Shifting the Goalposts: A Longitudinal Mixed-Methods Study of the Health of Long-Term Incapacity Benefit Recipients during a Period of Substantial Change to the UK Social Security System

Published online by Cambridge University Press:  04 February 2014

KAYLEIGH GARTHWAITE ,
CLARE BAMBRA ,
JONATHAN WARREN ,
ADETAYO KASIM  and
GRAEME GREIG
KAYLEIGH GARTHWAITE
Affiliation:
Department of Geography and Wolfson Research Institute for Health and Wellbeing, Durham University email: [email protected]
CLARE BAMBRA
Affiliation:
Department of Geography and Wolfson Research Institute for Health and Wellbeing, Durham University
JONATHAN WARREN
Affiliation:
Department of Geography and Wolfson Research Institute for Health and Wellbeing, Durham University
ADETAYO KASIM
Affiliation:
Wolfson Research Institute for Health and Wellbeing, Durham University
GRAEME GREIG
Affiliation:
Public Health Team, Durham County Council
Get access Rights & Permissions [Opens in a new window]

Abstract

The UK social security safety net for those who are out of work due to ill health or disability has experienced significant change, most notably the abolition of Incapacity Benefit (IB) and the introduction of Employment and Support Allowance (ESA). These changes have been underpinned by the assumption that many recipients are not sufficiently sick or disabled to ‘deserve’ welfare benefits – claims that have been made in the absence of empirical data on the health of recipients. Employing a unique longitudinal and mixed-methods approach, this paper explores the health of a cohort of 229 long-term IB recipients in the North East of England over an eighteen-month period, during a time of significant changes to the UK welfare state. In-depth interviews with twenty-five of the survey cohort are also presented to illustrate the lived experiences of recipients. Contributing to debates surrounding the conceptualisation of work-readiness for sick and disabled people, findings indicate IB recipients had significantly worse health than the general population, with little change in their health state over the eighteen-month study period. Qualitative data reinforced the constancy of ill health for IB recipients. Finally, the paper discusses the implications for social policy, noting how the changing nature of administrative definitions and redefinitions of illness and capacity to work can impact upon the lives of sick and disabled people.

Type
Articles
Information
Journal of Social Policy , Volume 43 , Issue 2 , April 2014 , pp. 311 - 330
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bambra, C. (2008), ‘In sickness or in health? Incapacity Benefit reform and the politics of ill health’, British Medical Journal, 337: 1452.Google Scholar
Bambra, C. (2011), Work, Worklessness and the Political Economy of Health, Oxford: Oxford University Press.Google Scholar
Bambra, C. and Smith, K. E. (2010), ‘No longer deserving? Sickness benefit reform and the politics of (ill) health’, Critical Public Health, 20: 1, 71–83.Google Scholar
Beatty, C., Fothergill, S. and Macmillan, R. (2000), ‘A theory of employment, unemployment and sickness’, Regional Studies, 34: 7, 617–30.CrossRefGoogle Scholar
Bendelow, G. (1993), ‘Using visual imagery to explore gendered notions of pain’, in Renzetti, C. M. and Lee, R. M. (eds.), Researching Sensitive Topics, Newbury Park, CA: SAGE, pp. 212–28.Google Scholar
Burns, T., Catty, J., Becker, T., Drake, R. E., Fioritti, A., Knapp, M., Lauber, C., Rössler, W., Tomov, T., van Busschbach, J., White, S. and Wiersma, D. (2007), ‘The effectiveness of supported employment for people with severe mental illness: a randomised controlled trial’, Lancet, 370: 1146–52.Google Scholar
Charmaz, K. (1991), Good Days, Bad Days: The Self in Chronic Illness and Time, New Brunswick, NJ: Rutgers University Press.Google Scholar
Crawford, J. R., Henry, J. D., Crombie, C. and Taylor, E. P. (2001), ‘Normative data for the HADS from a large non-clinical sample’, British Journal of Clinical Psychology, 40: 429–34.Google Scholar
Deacon, A. (1978), ‘The scrounging controversy: public attitudes towards the unemployed in contemporary Britain’, Social and Economic Administration, 12: 2, 120–35.Google Scholar
Dean, H. (forthcoming), ‘“Life first” welfare, the need/right to work and the scope for a “eudaimonic ethic” of social security’, in Keune, M. and Serrano Pascual, A. (eds.), Deconstructing Flexicurity and Constructing Alternative Perspectives, London: Routledge.Google Scholar
Dean, H. (2003), ‘Re-conceptualising welfare-to-work for people with multiple problems and needs’, Journal of Social Policy, 32: 3, 441–59.CrossRefGoogle Scholar
Dean, H. and Taylor-Gooby, P. (1992), Dependency Culture the Explosion of a Myth, Hemel Hempstead: Harvester Wheatsheaf.Google Scholar
Department for Work and Pensions (DWP) (2011), Employment and Support Allowance: Work Capability Assessment by Health Condition and Functional Impairment – Official Statistics, London: TSO.Google Scholar
Finkelstein, V. (1980), Attitudes and Disabled People: Issues for Discussion, New York: World Rehabilitation Monograph.Google Scholar
Gandek, B., Ware, J. E., Aaronson, N. K., Apolone, G., Bjorner, J. B., Brazier, J. E., Bullinger, M., Kaasa, S., Leplege, A., Prieto, L. and Sullivan, M. (1998), ‘Cross-validation of item selection and scoring for the SF-12 health survey in nine countries: results from the IQOLA Project’, Journal of Clinical Epidemiology, 51: 11, 1171–8. Google Scholar
Garthwaite, K. (2011), ‘The language of shirkers and scroungers? Talking about illness, disability and coalition welfare reform’, Disability and Society, 26: 3, 369–72.CrossRefGoogle Scholar
Grover, C. and Piggott, L. (2010), ‘From incapacity benefit to employment and support allowance: social sorting, sickness and impairment, and social security’, Policy Studies, 31: 2, 265–82.Google Scholar
Guba, E. G. and Lincoln, Y. S. (1994), ‘Competing paradigms in qualitative research’, in Denzin, N. K. and Lincoln, Y. S. (eds.), Handbook of Qualitative Research, New York: Sage, pp. 105–17.Google Scholar
Haverkamp, B. E., Morrow, S. L. and Ponterotto, J. G. (2005), ‘A time and place for qualitative and mixed methods in counseling psychology research’, Journal of Counseling Psychology, 52: 123–5. Google Scholar
Kellett, S., Bickerstaffe, D., Purdie, F., Dyke, A., Filer, S., Lomax, V. and Tomlinson, H. (2011), ‘The clinical and occupational effectiveness of condition management for Incapacity Benefit recipients’, British Journal of Clinical Psychology, 50: 164–77.CrossRefGoogle ScholarPubMed
Kemp, P. and Davidson, J. (2010), ‘Employability trajectories among new claimants of incapacity benefit’, Policy Studies, 31: 2, 203–21.CrossRefGoogle Scholar
Kind, P., Hardman, G. and Macran, S. (1999), UK Population Norms for EQ-5D, Vol. 172, Centre for Health Economics, University of York.Google Scholar
McKendrick, J., Sinclair, S., Irwin, A., O’Donnell, H., Scott, G. and Dobbie, L. (2008), The Media, Poverty and Public Opinion in the UK, York: Joseph Rowntree Foundation.Google Scholar
NICE (National Institute for Health and Clinical Excellence) (2009), Public Health Guidance 19: Managing Long-Term Sickness Absence and Incapacity for Work, London: NICE.Google Scholar
Norman, P. and Bambra, C. (2007), ‘Incapacity or unemployment? The utility of an administrative data source as an updatable indicator of population health’, Population, Space and Place, 13: 333–52.CrossRefGoogle Scholar
Norris, M. (1978), ‘Those we like to help’, New Society, 45: 822, 18–25. Google Scholar
Plano-Clark, V., Huddleston-Casas, C., Churchill, S., O’Neil Green, D., and Garrett, A. (2008), Mixed Methods Approaches in Family Science Research , Journal of Family Issues, 29: 11, 1543–1566.Google Scholar
Sainsbury, R. and Davidson, J. (2006), Routes onto Incapacity Benefits: Findings from Qualitative Research, DWP Research Report 350, London: The Stationery Office.Google Scholar
Shildrick, T., MacDonald, R., Webster, C. and Garthwaite, K. (2012), Poverty and Insecurity: Life in ‘Low-Pay, No-Pay’ Britain, Bristol: Policy Press.Google Scholar
Skivington, K., McCartney, G., Thomson, H. and Bond, L. (2010), ‘Challenges in evaluating welfare to work policy interventions: would an RCT design have been the answer to all our problems?’, BMC Public Health, 10: 254.Google Scholar
Strauss, A. (1969), Mirrors and Masks, Mill Valley, CA: Sociology Press.Google Scholar
Stone, D. A. (1986), The Disabled State, Basingstoke: Macmillan.Google Scholar
Taylor-Gooby, P. (1983), ‘Moralism, self-interest and attitudes to welfare’, Policy and Politics, 11: 2, 145–60.Google Scholar
Taylor-Gooby, P. (1985), Public Opinion, Ideology and State Welfare, London: Routledge & Kegan Paul.Google Scholar
Warren, J. (2005), ‘Disabled people the state and employment’, in Roulstone, A. and Barnes, C. (eds.), Working Futures: Disabled People, Employment Policy and Social Inclusion, Bristol: Policy Press.Google Scholar
Warren, J., Bambra, C., Kasim, A., Garthwaite, K., Mason, J. and Booth, M. (2013), ‘Prospective pilot evaluation of the effectiveness and cost-utility of a “health first” case management service for long-term Incapacity Benefit recipients’, Journal of Public Health, 1–9.Google Scholar