title: Living on the edge: precariousness and why it matters for health.
abstract: The post-war period in Europe, between the late 1940s and the 1970s, was characterised by an expansion of the role of by the state, protecting its citizens from risks of unemployment, poverty, homelessness, and food insecurity. This security began to erode in the 1980s as a result of privatisation and deregulation. The withdrawal of the state further accelerated after the 2008 financial crisis, as countries began pursuing deep austerity. The result has been a rise in what has been termed 'precariousness'. Here we review the development of the concept of precariousness and related phenomena of vulnerability and resilience, before reviewing evidence of growing precariousness in European countries. It describes a series of studies of the impact on precariousness on health in domains of employment, housing, and food, as well as natural experiments of policies that either alleviate or worsen these impacts. It concludes with a warning, drawn from the history of the 1930s, of the political consequences of increasing precariousness in Europe and North America.
authors.affiliation: ECOHOST, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH UK.
authors.forename: Martin
authors.identifier: 0000-0002-0121-9683
authors.initials: M
authors.lastname: McKee
authors.affiliation: London School of Economics and Political Science, London, UK.
authors.forename: Aaron
authors.initials: A
authors.lastname: Reeves
authors.affiliation: Department of Sociology, University of Oxford, Oxford, UK.
authors.forename: Amy
authors.initials: A
authors.lastname: Clair
authors.affiliation: Department of Sociology, University of Oxford, Oxford, UK.
authors.forename: David
authors.initials: D
authors.lastname: Stuckler
keywords: Health policy; Precariousness; Social determinants of health