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

Rowley, J., Richards, N. , Carduff, E. and Gott, M. (2021) The impact of poverty and deprivation at the end of life: a critical review. Palliative Care and Social Practice, 15, p. 26323524211033873. (doi: 10.1177/26323524211033873)

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Abstract

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.

Item Type:Articles
Keywords:Review, deprivation, end of life, inequalities, inequity, palliative care, poverty, social determinants of health, social gradient.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Carduff, Dr Emma and Richards, Dr Naomi and Rowley, Dr Jane
Authors: Rowley, J., Richards, N., Carduff, E., and Gott, M.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Nursing and Health Care
College of Social Sciences > School of Interdisciplinary Studies
Journal Name:Palliative Care and Social Practice
Publisher:SAGE Publications
ISSN:2632-3524
ISSN (Online):2632-3524
Published Online:12 September 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in Palliative Care and Social Practice 15: 26323524211033873
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
304429Dying at the Margins: uncovering the reasons for unequal access to home dying for the socio-economically deprivedNaomi RichardsEconomic and Social Research Council (ESRC)ES/S014373/1IS - Interdisciplinary Studies