Rapid urbanization globally threatens to increase the risk to mental health and requires a rethinking of the relationship between urban poverty and mental health. The aim of this article is to reveal the cyclic nature of this relationship: Concentrated urban poverty cultivates mental illness, while the resulting mental illness reinforces poverty. The authors used theories about social disorganization and crime to explore the mechanisms through which the urban environment can contribute to mental health problems. They present some data on crime, substance abuse, and social control to support their claim that mental illness reinforces poverty. The authors argue that, to interrupt this cycle and improve outcomes, social workers and policymakers must work together to implement a comprehensive mental health care system that emphasizes prevention, reaches young people, crosses traditional health care provision boundaries, and involves the entire community to break this cycle and improve the outcomes of those living in urban poverty.
Based on in-depth interviews with 70 hospital support workers in Vancouver, Canada, this article describes how the contracting out of their jobs to multinational corporations has had deleterious consequences for these workers, their families, and the health care system. Privatization and outsourcing resulted in a steep initial wage reduction for hospital support staff, decreasing by up to 50% from approximately $18 to $20 per hour to between $9 and $12 per hour—with much weaker job benefits. Despite recent wage increases as a result of Hospital Employees’ Union—led contract negotiations, workers still earn lower hourly wages than they did before contracting out and report challenges making ends meet. The concluding discussion presents the implications of these findings for the sociology of work and health and proposes some policy reforms for mitigating the negative consequences of privatization. The article also describes the beginning of a living-wage movement in Vancouver that has emerged in part as a result of this decision to outsource these hospital support jobs.
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