Dr Catherine Conlon: Standing up for middle Ireland leaves the most vulnerable behind

Segregating the poor from the well-off has dramatic and negative impacts on the mental and physical wellbeing of the less well-off, writes Dr Catherine Conlon

Housing, health, education, childcare, and a living wage are as essential to the health and wellbeing of every citizen and should be the priority of every TD in Government. File photo

In May 2017, at the official launch of his campaign to become leader of Fine Gael, Minister for Social Protection Leo Varadkar said he wanted to lead a party for "people who get up early in the morning".

In the ensuing battle to the be next Fine Gael leader, TD Simon Coveney said he wanted to represent everyone and create a more compassionate society for all.

"I’m trying to unite people not divide them and that kind of language is separating the public sector from the private sector, separating the achievers from the non-achievers," Mr Coveney said.

"In my view, this is what has damaged politics over the last 10 years, the has and the has-nots, the people who are now benefiting from the growing economy and those who have not.

"Its been about the protest politics, the people who go to the streets with politics because they feel they are not part of the sustainable growth story that we are trying to build. I want to kick back against that."

Six years later, Taoiseach Leo Varadkar is again soundly unapologetic in his views about the haves versus the have-nots. He is "very clear…that we want income taxes reduced," he said in an interview with the Irish Times.

"We were very clear that our basis for participation in this Government is that middle Ireland gets looked after, and that’s looking after working people, it’s looking after business, it’s promoting things like home ownership.

The Taoiseach appears to be a solid advocate of the model of free market fundamentalism that believes in the ability of the market to resolve almost all social, economic, and political problems with low taxation and minimal state regulation — a model that is now showing itself to be at the core of widening socioeconomic determinants of health and wellbeing. File picture: Niall Carson/PA

"Is it part of Fine Gael’s identity to be the party that stands up for middle Ireland, that promotes business, that wants to make sure there’s more money in your pocket? That is a big part of who we are."

The Taoiseach appears to be a solid advocate of the model of free market fundamentalism that believes in the ability of the market to resolve almost all social, economic, and political problems with low taxation and minimal state regulation — a model that is now showing itself to be at the core of widening socioeconomic determinants of health and wellbeing.

The pandemic and the planetary health crisis that is hurtling toward us have shown up the neoliberal market economy as fundamentally flawed in that it ignores the impact of economic growth on social inequalities, planetary health, and physical and mental health.

In real terms, that means housing, health, education, childcare, and a living wage are prioritised as essential to the health and wellbeing of every citizen. Surely that should be basis of every TD’s participation in Government.

Pulitzer prize-winner Matthew Desmond in Poverty by America (2023) states that tax cuts are the main engines of private opulence and public squalor.

"In many corners of America, a pricey mortgage doesn’t just buy a home; it also buys a good education; a well-run soccer league and public safety so thick and expected it feels natural, instead of the product of social design.

"Most Americans want the country to build more public housing for low-income families, but they do not want that public housing (or any sort of multi-family housing) in their neighbourhood. Maybe above a certain income level we are all segregationists."

Nimbyism

Similar scenes have been playing out across the country in recent months as citizens in towns and cities protest against the influx of asylum seekers being housed in their communities. Comparable protests have occurred with the threat of new housing developments. 

Nimbyism voiced by people living in comfortable homes is a constant challenge to the ability to provide affordable housing (and social housing as part of that development) to young people both working in key jobs in the public and private sector as well as people in low-income groups that struggle to survive on the minimum wage.

People want more housing and social housing – just not in my backyard, please.

One study found that growing up in a severely disadvantaged neighbourhood is equivalent to missing a year of school when it comes to verbal ability. Another found that achievement gaps between rich and poor children form and harden before kindergarten.

The tenet of Desmond’s book is that there is so much poverty in the US "not in spite of our wealth but because of it. Which is to say, it’s not about them, it’s about us."

Tolstoy said something similar when he said, "If I want to aid the poor, that is to help the poor not to be poor, I ought not to make them poor."

Desmond suggests that we make people poor by exploiting them. "We constrain their choice in the labour market, the housing market and the financial market, driving down wages while forcing the poor to overpay for housing and access to cash and credit."

One study found that growing up in a severely disadvantaged neighbourhood is equivalent to missing a year of school when it comes to verbal ability. Another found that achievement gaps between rich and poor children form and harden before kindergarten. File photo

Desmond is describing the US, but he could equally be describing how people on the minimum wage are treated in Ireland. People who are not poor benefit from these arrangements. Corporations benefit from worker exploitation, but so do consumers who buy the cheap goods and services the working poor produce. 

Landlords benefit from housing exploitation but so also do homeowners – their property values propped up by the collective efforts (nimbyism) to make housing scarce and expensive.

Another way we make people poor, Desmond suggests, is by creating prosperous and exclusive communities. "We not only create neighbourhoods with concentrated riches but also neighbourhoods with concentrated despair — the externality of stockpiled opportunity.

"The concentration of affluence breeds more affluence and the concentration of poverty, more poverty. To be poor is miserable but to be poor and surrounded by poverty on all sides is a much deeper cut."

'Tear down the walls'

Sir Michael Marmot, Professor of Epidemiology and Public Health at University College London, writing in his seminal book The Health Gap, says that the main cause of health inequalities reside in the circumstances in which people are born, grow, live, work and age — the social determinants of health. This implies that action to reduce health inequalities must confront those circumstances.

The social gradient affects parenting, which in turn affects cognitive, social, emotional as well as physical development of children, which in turn is related to inequities in mental and physical health in adulthood. If we want to address inequality and poverty, Desmond says we need to "tear down the walls". 

By deconcentrating poverty in schools and communities, without doing anything to increase their incomes, improves their lives tremendously. Even if they stay below the poverty line, they become less ‘poor’ in that their exposure to crime drops, their mental health improves, and their children flourish in schools.

Studies have found that each year that poor children spend in a high-opportunity neighbourhood increases their income in adulthood — so much so that younger siblings experience bigger gains than their older brothers and sisters because of the additional years spent in a safer and more prosperous place.

Integration works. That’s the resounding conclusion from a half-century of research. The rich have less to fear and more to gain by getting to know and trust and learn from their low-income neighbours. Surely, that should be not just "a big part" but the essence of what we stand for and who we are.

• Dr Catherine Conlon is a public health doctor in Cork and former director of human health and nutrition, safefood.