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Rapid Responses: Rapid Responses published:
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R-E-S-P-E-C-T Autonomic Poverty
- Andrew J Ashworth (6 July 2008)
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Respect Checklist
- Hugh Mann (9 July 2008)
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Poverty, Homicides and Respect
- Niyi Awofeso (10 July 2008)
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Andrew J Ashworth, GP Davidson's Mains Medical Centre, 5 Quality Street, EDINBURGH, EH4 5BP
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Heath addresses the association between poverty and violence in the young, looking at the association between a lack of economic wellbeing (“low income, inadequate education, unemployment, poor housing, social isolation, and even the carrying of knives”) and the emotional consequences on the victims/perpetrators of poverty/crime (the attrition of hope, opportunity, dignity, and respect.). All but the most totalitarian communist systems economies have relative affluence, relative poverty is inevitable but it is not inevitably associated with crime; other factors are influential and it is these that we in the health professions may be able to address to the benefit of the economically poor and affluent. In its post White Colonial Christian phase, Britain has addressed the diversity of its society by imagining and legislating for a homogenous ideal that suits society but fails to provide an attractive role model for the testosterone fuelled young black men from the inner city who engage in public violence (private violence, for example in the home is, according to the British Crime Survey (1), hardly affected by gender, social class or race). The homogenous ideal is increasingly supported by a Government that developed its success using focus groups to refine the ideal and has changed services to appeal to the middle-aged, middle-England, middle of the road voters who elected them. The homogenous ideal wants CHOICE and so it is to be delivered. My experience of young men in the Royal Navy and as prisoners in Scotland is that they are at their happiest when they have clear direction and tight parameters for behavioural acceptability to give them a sense of belonging. In the absence of direction and positive belonging messages from polite society (increasingly they can’t even rely on having the same GP who treated their sore ear as a child!), they have turned to gangs who offer NO CHOICE on issues such as carrying knives and who to speak to. Gang membership has become the only refuge for young men who do not fit the homogenous ideal and cannot cope with lack of direction that providing choice for others implies for them. No amount of organisational change can do away with relative financial poverty without causing economic collapse: a shift in our definition of poverty to one based on reduced individual autonomy (restricted among eg. those with chronic illness, cultural constraints and in late adolescence) might help us as professionals best to direct our resources to those most in need, in other words, RESPECT not CHOICE should be our watchword but the evidence should be based not on easily measurable economic parameters but on more nebulous factors that require professionals to provide individual solutions. Lord Darzi and his co-conspirators should beware that when they increase choice for the median, they will reduce it for the outliers: the predictable outcome is poorer health for a disrespected minority and increased dissent by the disrespectful disaffected. 1. Domestic Violence and Stalking: Findings from 2004/5 British Crime Survey, Andrea Finney, Home Office Online report 12/06 http://www.homeoffice.gov.uk/rds/pdfs06/rdsolr1206.pdf Competing interests: Former Naval Medical Officer, Prison Doctor and Tory Parliamentary Candidate |
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Hugh Mann, Physician Eagle Rock, MO 65641 USA
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Respect is a recognition of human dignity. Respect is a key factor in all interactions between people of different backgrounds. Despite its importance, respect is subjective and difficult to evaluate. A good way to objectively evaluate and promote respect is to use my respect checklist:
R - Race, Religion, Ethnicity, and Gender Competing interests: None declared |
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Niyi Awofeso, Associate Professor School of Public Health, University of New South Wales, Australia
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The first paragraph of Dr Heath’s article raises a controversial issue - that homicides perpetrated by children and young adults from poor UK families are due largely to lack of respect and a need to exact revenge. I am not aware of any well-regarded study that concurs with this perspective. To take just one example, a 2007 US Justice Department report on homicides (http://www.ojp.usdoj.gov/bjs/pub/press/bvvcpr.htm) determined that American blacks, undoubtedly among the poorest groups un the United States, account for 13% of the US population but are victims of 15% of all non-fatal violent attacks and nearly half of all homicides. Also, 93% of all black victims were murdered by black offenders. Do these trends imply that the blacks perpetrating homicides in America perceive fellow (poor) blacks as disrespectful, and are killing them in order to exact revenge? Most studies1,2 concede that the manner in which economic inequality generates variations in homicide rates is influenced by scores of factors, of which poverty or lack of respect are is not necessarily the most frequent. Chamlin and Cochran1 posit that ascribed economic inequalities (e.g.. those based on unfair advantages and ‘accidents of birth’) rather than achieved inequalities (i.e. based on merit) are widely perceived as illegitimate by the disadvantaged and may explain increased likelihood among those who feel ‘illegitimately’ disadvantaged. The United Kingdom remains more egalitarian than most nations, and the British social system still has high legitimacy and strong capacity to control its members within the dictates of established democratic laws. Thus, the links between poverty and homicides are unlikely to be strong in the United Kingdom. References 1) Chamlin MB, Cochran JK. Economic inequality, legitimacy and cross- national homicide rates. Homicide Studies, 2006; 10: 231-252. 2) Messner, SF. Societal development, social equality, and homicide: A cross-national test of a Durkheimian model. Social Forces, 1982; 61: 225- 240. Competing interests: None declared |
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