The impact of poverty and deprivation at the end of life: a critical review

This critical review interrogates what we know about how poverty and deprivation impact people at the end of life and what more we need to uncover. While we know that people in economically resource-rich countries who experience poverty and deprivation over the life course are likely to die younger,...

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Main Authors: Jane Rowley, Naomi Richards, Emma Carduff, Merryn Gott
Format: Article
Language:English
Published: SAGE Publishing 2021-08-01
Series:Palliative Care and Social Practice
Online Access:https://doi.org/10.1177/26323524211033873
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author Jane Rowley
Naomi Richards
Emma Carduff
Merryn Gott
author_facet Jane Rowley
Naomi Richards
Emma Carduff
Merryn Gott
author_sort Jane Rowley
collection DOAJ
description This critical review interrogates what we know about how poverty and deprivation impact people at the end of life and what more we need to uncover. While we know that people in economically resource-rich countries who experience poverty and deprivation over the life course are likely to die younger, with increased co-morbidities, palliative care researchers are beginning to establish a full picture of the disproportionate impact of poverty on how, when and where we die. This is something the Covid-19 pandemic has further illustrated. Our article uses a critical social science lens to investigate an eclectic range of literature addressing health inequities and is focused on poverty and deprivation at the end of life. Our aim was to see if we could shed new light on the myriad ways in which experiences of poverty shape the end of people’s lives. We start by exploring the definitions and language of poverty while acknowledging the multiple intersecting identities that produce privilege. We then discuss poverty and deprivation as a context for the nature of palliative care need and overall end-of-life circumstances. In particular, we explore: total pain; choice at the end of life; access to palliative care; and family caregiving. Overall, we argue that in addressing the effects of poverty and deprivation on end-of-life experiences, there is a need to recognise not just socio-economic injustice but also cultural and symbolic injustice. Too often, a deficit-based approach is adopted which both ‘Others’ those living with poverty and renders invisible the strategies and resilience they develop to support themselves, their families and communities. We conclude with some recommendations for future research, highlighting in particular the need to amplify the voices of people with lived experience of poverty regarding palliative and end-of-life care.
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spelling doaj.art-0122efc7c27442f5a740697d5062c7872023-06-30T05:03:19ZengSAGE PublishingPalliative Care and Social Practice2632-35242021-08-011510.1177/26323524211033873The impact of poverty and deprivation at the end of life: a critical reviewJane RowleyNaomi RichardsEmma CarduffMerryn GottThis critical review interrogates what we know about how poverty and deprivation impact people at the end of life and what more we need to uncover. While we know that people in economically resource-rich countries who experience poverty and deprivation over the life course are likely to die younger, with increased co-morbidities, palliative care researchers are beginning to establish a full picture of the disproportionate impact of poverty on how, when and where we die. This is something the Covid-19 pandemic has further illustrated. Our article uses a critical social science lens to investigate an eclectic range of literature addressing health inequities and is focused on poverty and deprivation at the end of life. Our aim was to see if we could shed new light on the myriad ways in which experiences of poverty shape the end of people’s lives. We start by exploring the definitions and language of poverty while acknowledging the multiple intersecting identities that produce privilege. We then discuss poverty and deprivation as a context for the nature of palliative care need and overall end-of-life circumstances. In particular, we explore: total pain; choice at the end of life; access to palliative care; and family caregiving. Overall, we argue that in addressing the effects of poverty and deprivation on end-of-life experiences, there is a need to recognise not just socio-economic injustice but also cultural and symbolic injustice. Too often, a deficit-based approach is adopted which both ‘Others’ those living with poverty and renders invisible the strategies and resilience they develop to support themselves, their families and communities. We conclude with some recommendations for future research, highlighting in particular the need to amplify the voices of people with lived experience of poverty regarding palliative and end-of-life care.https://doi.org/10.1177/26323524211033873
spellingShingle Jane Rowley
Naomi Richards
Emma Carduff
Merryn Gott
The impact of poverty and deprivation at the end of life: a critical review
Palliative Care and Social Practice
title The impact of poverty and deprivation at the end of life: a critical review
title_full The impact of poverty and deprivation at the end of life: a critical review
title_fullStr The impact of poverty and deprivation at the end of life: a critical review
title_full_unstemmed The impact of poverty and deprivation at the end of life: a critical review
title_short The impact of poverty and deprivation at the end of life: a critical review
title_sort impact of poverty and deprivation at the end of life a critical review
url https://doi.org/10.1177/26323524211033873
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