Eleven - Policy, practice and obstacles

Summary

Every time a person in the Global South displaced by climate catastrophe or armed conflict migrates in search of shelter and a means of subsistence, every time someone in a high- income country such as the USA or the UK cannot access health care in an emergency, and every time foodbank users try to do so clandestinely for fear of the stigma weaponised against ‘losers like them’, then no sociological explanation for what is happening to them is complete without a micro- to- meso- to- macro- account of why they find themselves in such unnecessary and intolerable predicaments. We live in the UK in a fractured society, and one which is located in an increasingly fractured or shattered world. In his comprehensive review of the empirical literature, Danny Dorling (2023) refers to our ‘shattered nation’ and describes the UK as a ‘failing state’. ‘The UK’, he writes,

has been speeding in the wrong direction for over forty years and that has resulted in growing disillusion, despair and apathy. … What may be helpful at this point is to realise that if there is no planned progressive change – change of the kind that last began in 1942 during the Second World War – then in each year from here on there will be more crises. (Dorling, 2023: 242– 243)

Given the emphasis throughout this volume on the sheer causal power of prevailing social structures and cultural recipes in general, and of the ruling class or current hegemonic bloc in particular, this seems like a council of despair. But despair is not an option. This chapter visits general and specific policy options.

The ambitions of this contribution already extend well beyond typical considerations of sociology and health inequalities in fractured communities in the UK and across the globe. Having said that, they are nevertheless constrained, both by what it is possible to cover in a short volume like this and by my own limited expertise. I have addressed global inequalities of health and living and touched on climate change and the omnipresent threat of warfare in a rapidly changing world.