“It Feels Like Somebody Cut my Legs off”: Public Transportation and the Politics of Health in Saskatchewan
Date
2021-05-17
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
ORCID
0000-0002-5370-0612
Type
Thesis
Degree Level
Doctoral
Abstract
Background: In May 2017, the Government of Saskatchewan closed the Saskatchewan Transportation Company (STC), a 70-year-old bus company in Saskatchewan, Canada, through an austerity budget that saw many cuts to programs and services. The government justified its decision on budgetary grounds ignoring opponents who cited the possibility of negative impacts of the decision on population health. Little research evidence exists to interrogate the closure and its implications for the health system, population health, health equity and the politics of health.
Methodology: A qualitative case study was conducted to explore the politics, health and health equity implications of the closure of STC. The study drew on 47 days of Parliamentary Hansards, 751 newspaper articles, archival material, six focus group discussions (with activists, Indigenous, health system and social services stakeholders) and 100 interviews (with former STC users). A discourse analysis was conducted on two focus groups, newspaper articles and Parliamentary Hansards. The rest of the data were subjected to a thematic analysis. The study maintained rigour through crystallisation and member checking.
Findings: The closure of STC was facilitated by a neoliberal economic policy paradigm that ignored counter-discourses of resistance from activists and advocates who argued that the bus should be maintained on human rights, climate change and other grounds. The closure of STC has had deleterious impacts on health and this is best understood through a web of
dispossession whereby the closure affects individual former bus users through missed hospital appointments and other psychosocial impacts, their family members through financial burdens and strained relationships, communities through reduced access to the commons, and the whole of society through inefficiencies in the health system and stress on health and other workers. The closure has had inequitable impacts and has exacerbated the vulnerability of women, low-income populations, Indigenous populations, seniors, newcomers, young adults, people with disabilities and rural and northern populations.
Conclusion: Austerity is bad for health. This transportation case study reveals how it affects health in the Saskatchewan context. New approaches to public policy that prioritise health in all policies (HiAP) are needed to pay attention to the negative impacts of austerity on health and health equity globally and in Saskatchewan.
Description
Keywords
Politics, Health in All Policies, Austerity, Transportation, Intersectionality, Political Economy, Health Equity, Saskatchewan, Buses, Human Rights, Democracy, Neoliberalism
Citation
Degree
Doctor of Philosophy (Ph.D.)
Department
Community Health and Epidemiology
Program
Community and Population Health Science