[Book Review of] Bambra, C. (ed) Health in Hard Times: Austerity and Health Inequalities, Bristol: Policy Press. 2019. 288pp. ISBN 978-1-4473-4485-8

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