Book Re iew
Bamb a, C. (ed) Heal h in Ha d Times: Aus e i y
and Heal h Inequali ies, B is ol: Policy P ess.
2019. 288pp. ISBN 978-1-4473-4485-8
Following he financial c ises o 2007-2008, Eu o-
pean coun ies ha e been o ced o implemen aus-
e i y measu es as a means o educe hei defici
and inc ease hei economic g ow h. In England,
aus e i y has led o an inc ease in heal h dispa i-
ies, pa icula ly among he mos ulne able such
as he unemployed, low-income women, in pa ic-
ula mo he s, olde people and hose wi h men al
heal h condi ions. Al hough he e ec s o aus e i y
measu es on he social de e minan s o heal h a a
na ional le el has been widely acknowledged, li le
is known abou how aus e i y has a ec ed he
heal h o ce ain communi ies a specific a eas
wi hin he coun y. The book edi ed by Cla e
Bamb a b oke new g ound as ins ead o using he
adi ional app oach o quan i a i e esea ch i
d ew on a mixed me hod case s udy app oach o
s udying he geog aphical inequali ies in heal h.
Th ough he use o a longi udinal household su -
ey, ex ensi e a chi al esea ch, e hnog aphic
obse a ions, quali a i e in e iews, documen a y
esea ch and pho og aphic da a he book sheds
ligh on he eali y o he inhabi an s o S ock on-
on-Tees in an Age o Aus e i y. The book also
makes an impo an con ibu ion o Heal h and
Social Science fields by showing how di e en
disciplines such as Sociology, Social Policy, His-
o y, Geog aphy and Epidemiology a e use ul o
unde s anding local heal h inequali ies.
In seeking o unde s and he ae iology o heal h
inequali ies, his case s udy makes explici how
gende in e ac s wi h socioeconomic s a us and
locali y. The impo ance o in e sec ionali y o
unde s anding heal h inequali ies is pa icula ly
e iden in chap e se en by Amy G ee Mu phy.
Ve y ew au ho s so a ha e employed an in e -
sec ional analysis o unde s anding he geog aphi-
cal inequali ies in heal h. D awing upon he
accoun s o mo he s li ing in S ock on-on-Tees,
Mu phy shows ha women and hei child en a e
placed in a mo e disad an aged posi ion han men
in he con ex o financial insecu i y leading o a
poo men al heal h expe ience. The impo an ole
o mo he s a a ime o aus e i y has also been
highligh ed by Rebecca O’Connell, Abigail Knigh
and Julia B annen in hei book Li ing Hand o
Mou h (2019). By ocusing on ood and ea ing in
e e yday li e, O’Connell, Knigh and B annen
show how amily p ac ices ha e been a ec ed by
aus e i y measu es. The way aus e i y impac s
upon amily li e is b illian ly elucida ed in chap e
ou by Kayleigh Ga hwai e. Ga hwai e ad ances
esea ch on heal h inequali ies by paying a en ion
o s igma, place and pe cep ion in he e e yday
li e o he inhabi an s o wo con as ing a eas in
S ock on-on-Tees. Place-based s igma is cen al in
he e e yday li e o hese people, which no only
leads o a loss o hei sense o iden i y and social
in e ac ions bu also limi s hei access o o he
communi ies. The way in which aus e i y pa icu-
la ly impac s upon ulne able amilies and com-
muni ies is well demons a ed in chap e h ee by
Ramjee Bhanda i. Bhanda i no es ha ma e ial ac-
o s ela ed o he income and employmen s a us
o he household a e key o unde s anding he
heal h gap. The heal h o membe s om ulne a-
ble amilies in S ock on-on-Tees, ha is, ‘wi h low
incomes, wi h membe s on ou o wo k benefi s,
and/o who a e long- e m sick and disabled’
(pp.96), a e mo e likely o su e om wha has
been e med as dep i a ion amplifica ion.
The impo ance o ma e ial ac o s as an
explana o y elemen o heal h inequali ies is also
explo ed in chap e six by Akh e , Ma heys, Wa -
en and Kasim when hey analyse he gap in men-
al heal h and wellbeing be ween he mos and
leas dep i ed neighbou hoods o S ock on-on-
Tees. The au ho s make an impo an con ibu ion
by ein o cing he idea ha poli ical in e en ions
on men al heal h should no ocus only on beha-
iou al aspec s, bu also on he influence o psy-
chosocial and ma e ial ac o s. The impac ha
aus e i y measu es can ha e on men al heal h in
S ock on-on-Tees is discussed by Ka e Ma heys in
©2020 Founda ion o he Sociology o Heal h & Illness
Published by John Wiley & Sons L d., 9600 Ga sing on Road, Ox o d OX4 2DQ, UK and 350 Main S ee , Malden, MA 02148, USA
Sociology o Heal h & Illness Vol. xx No. xx 2020 ISSN 0141-9889, pp. 1–2
doi: 10.1111/1467-9566.13096
chap e fi e. Aspec s such as unemploymen and
unde employmen , low income and he high le els
o dep i a ion o he a ea o esidence had a nega-
i e impac on he men al heal h o he inhabi an s
o S ock on-on-Tees, con ibu ing o wo sening o
he li ing condi ions o his popula ion. The com-
pa a i e and his o ical analysis de eloped by Mike
Lang ho ne in chap e wo explo es heal h inequal-
i ies in S ock on-on-Tees o e wo dis inc pe iods,
hus o e ing he eade he possibili y o ge ing
o know he case s udy in di e en con ex s and
ci cums ances. The au ho explo es wo majo
ecessions, in pa icula elemen s o con inui y and
change ha cha ac e ise hem. Th ough he analy-
sis o opics such as unemploymen , housing,
heal h and heal hca e, Lang ho ne shows how aus-
e i y –in wo di e en pe iods o his o y –had
p o ound impac s on he o ganisa ional and ela-
ional dynamics ha cha ac e ise S ock on-on-
Tees.
The case s udy is suppo ed by a solid, clea
and comp ehensi e heo e ical amewo k. The
a gumen s a e explo ed logically h oughou he
a ious chap e s wi hou becoming oo ob ious o
epe i i e. To his cohesi e heo e ical basis is
added an inno a i e and ambi ious me hodological
a chi ec u e, wi hou losing sigh o he objec i es
and ocus o he s udy. The book clea ly demon-
s a es he impo ance o con inuing o in es iga e
geog aphical inequali ies in heal h. The place
whe e indi iduals li e has s ong implica ions on
hei li es and condi ions hem. Ano he impo an
con ibu ion is ela ed o he impo ance o paying
a en ion o he s uc u al aspec s o minimise
heal h inequali ies. In addi ion, i is c ucial o
ecognise ha du ing an Age o Aus e i y he
impac s a e no homogeneous, a ec ing he popu-
la ion di e en ly. Thus, he wel a e s a e should
play an impo an ole by ensu ing ha he popula-
ion, in pa icula he mos ulne able, has a s ong
suppo ne wo k h ough he a ailabili y o e fi-
cien social policies. The book ep esen s a alu-
able ool o hose who seek o in e ene
poli ically, bu also o hose who wan o unde -
s and he impac ha aus e i y can ha e in accen u-
a ing heal h inequali ies.
Ana Pa 
ıcia Hil
a io, F
abio Ra ael Augus o
Ins i u o de Ci^
encias Sociais Uni e sidade de
Lisboa, Lisbon, Po ugal
Re e ence
O’Connell, R., Knigh , A. and B annen, J. (2019)
Li ing hand o mou h: Child en and ood in
low-income amilies. London: Child Po e y
Ac ion G oup.
©2020 Founda ion o he Sociology o Heal h & Illness
2 Book Re iew