Edward Hall

Moving beyond walkability: on the potential of health geography.

In the context of the substantial volume of research focused in recent years on the walkability of the built environment, this report presents some initial thoughts on what the sub-discipline of health geography might be able to contribute, beyond what it currently does, to existing debates. It is posited that at one level this contribution could be critical yet constructive, focussing on the limitations of current epistemological and methodological approaches but offering ideas on how they and others might be developed. At another level, given the limited scope of existing walkability research, a further contribution could be to pay attention to different forms of embodiment, movement activities, their relationships to health, and the places, experiences, agency and cultures involved.

Alternative spaces of ‘work’ and inclusion for disabled people

Western governments have emphasized paid work as a key route to social inclusion for disabled people. Although the proportion of disabled people in ‘mainstream’ employment has increased in recent decades, rates remain significantly below those for non-disabled people. Moreover, disabled workers continue to face discrimination and a lack of workplace accommodation. This paper critically examines the potential of three alternatives to the current situation. First, how might stronger ties between disabled workers and the labour movement allow for greater control over the nature of mainstream work? Second, can more enabling work opportunities be created beyond the ‘mainstream’ in social economy organizations? Finally, how might other forms of unpaid and creative work usefully challenge the dominance of paid employment as a route to social inclusion?

Shopping for support: personalisation and the new spaces and relations of commodified care for people with learning disabilities

The ‘suitable’ spaces of care for people with bodies and minds of difference have been rescaled from the socio-spatial exclusion of the asylum, to collective spaces within mainstream communities, and most recently to the normalised spaces of the home, employment and public space. The mechanism facilitating the latest spatial reconfiguration in the UK is ‘Personal Budgets’, part of a broader ‘personalisation’ of neoliberal state care provision, whereby disabled people and older people take on responsibility for the management of their care within a new ‘care marketplace’. The paper examines the new forms, spaces and relations of care produced within this commodified system of welfare, focusing on people with learning disabilities. In doing so, the paper argues that the new care marketplace both transforms existing relations of care and constrains collective and interdependent forms of care that many people with learning disabilities (and many others) value. In conclusion, the paper contends that the ‘lack of fit’ between the needs of many disabled and older people and personalised care provision demands a reconceptualisation of the dominant notion of ‘active citizenship’.

Making and Gifting Belonging: Creative Arts and People with Learning Disabilities:

Creative arts are understood to be a mediator between positions of social exclusion and of inclusion for marginalised people and places, building self-confidence and strengthening social networks. Although there are undoubted benefits from involvement in creative arts, the author critiques the assumed shift from excluded to included positions. Instead, he adopts the nuanced notion of ‘belonging’ to reflect the experiences of attachment and desire or yearning for recognition, of one marginal group—people with learning disabilities. Drawing on case studies of two creative arts organisations in Edinburgh, Scotland, it is argued that: first, the making of arts objects and performances provides opportunities for embodied and emotional expression, and belonging; second, the act of ‘gifting’ objects and performances to people in wider society transmits emotions and creativity into nondisabled spaces, with possible outcomes of connection and recognition; and third, the intimate communities and safe spaces where creative art is made provide bases for ventures into public spaces for gifting, and the generation of senses of belonging. The author concludes hopefully, arguing that through the doing of creative arts, people with learning disabilities can transcend the exclusionary landscape (albeit temporarily) and begin to reimagine and transform understandings of learning disability and difference in society.

Progressive localism for an ethics of care: Local Area Co-ordination with people with learning disabilities

In the UK devolution to ‘new’ nations and localities is generating differences in the tone and substance of social care. In Scotland there is an apparent rejection of the ‘personalisation’ model dominant in England and other neoliberal welfare states; in its place, there is an emphasis on locally based co-produced care provision, involving local organisations, practitioners and individuals. The paper argues that this is an outcome of the open and deliberative nature of policy-making, and the further devolution of social care provision to local authorities in Scotland. Local scale networks and spaces of provision are generating a ‘progressive localism’, contesting the association between the local scale and financial austerity, drawing on a relational understanding of place. Non-commodified and locally-based provision expands the discourse of care from ‘caring for’ individuals to ‘caring about’ people and places, in what is termed an ‘ethics of care’. The paper uses the example of people with learning disabilities to examine a more broadly conceived ‘caring’ within local communities, offering possibilities for inclusion and belonging. The paper draws on interviews with key policy makers and place-based care practitioners, known as ‘Local Area Co-ordinators’.

Spaces of Wellbeing for People with Learning Disabilities

Abstract There is a growing interest in the geography of health in the concept of ‘wellbeing’, as it provides a fuller understanding of health, builds in embodied experiences, and accounts for the socio-spatial relations and contexts that shape health. The paper sets out the case for using ‘wellbeing’ to rethink the poor health outcomes experienced by people with learning disabilities, which conventional tools of healthcare and health promotion have failed to address. Shifting the focus of concern from the individualised objective ill-health of people with learning disabilities to a broader sense of emotional and social wellbeing and happiness, the paper argues that there is potential within learning disability spaces and networks for wellbeing to flourish, through greater self-determination and presence in and attachment to local places. The outcome is people with learning disabilities being able to find stability and build resilience in difficult bodily and social circumstances.

Towards a relational geography of disability

In this paper we develop linkages between non-representational theory and emerging work by disability scholars in geography. We argue that non-representational thinking has the potential to advance our understanding of the complex and emergent geographies of dis/ability. We first outline key dimensions of non-representational thinking within geography. We then explore how this perspective has begun to, and might further inform, geographical scholarship on disability. Next, we extend our thinking to consider how NRT might provide the basis for a critical geography of the ‘able-body’. We conclude by reflecting on the conceptual, political, methodological and empirical implications of our argument.

Peer advocacy in a personalized landscape The role of peer support in a context of individualized support and austerity

Whilst personalization offers the promise of more choice and control and wider participation in the community, the reality in the United Kingdom has been hampered by local council cuts and a decline in formal services. This has left many people with intellectual disabilities feeling dislocated from collective forms of support (Needham, 2015). What fills this gap and does peer advocacy have a role to play? Drawing on a co-researched study undertaken with and by persons with intellectual disabilities, we examined what role peer advocacy can play in a context of reduced day services, austerity and individualized support. The findings reveal that peer advocacy can help people reconnect in the face of declining services, problem-solve issues and informally learn knowledge and skills needed to participate in the community. We argue that peer advocacy thus offers a vital role in enabling people to take up many of the opportunities afforded by personalization.

Being in Control: Personal Budgets and the New Landscape of Care for People with Learning Disabilities

A central element in the shift to a ‘personalised’ care system in the UK is the opportunity for disabled people to hold and manage budgets for the purchase of care and support, to replace local authority services. The delivery mechanisms of ‘Direct Payments’ and ‘Individual Budgets’ have allowed many disabled people to control their care and support better, and have promoted their social inclusion. However, the particular contexts and issues for people with learning disabilities in holding personal funding have been little considered. The paper sets out the broad themes of the introduction of personalised care, and examines the limited use by people with learning disabilities of Direct Payments and the subsequent development of Individual Budgets. The paper considers the challenges to the nature, spaces and relations of care commonly used by people with learning disabilities that personal budgets present, in particular for those with more severe disabilities. The paper concludes by suggesting ways in which people with learning disabilities can use personal budgets, whilst maintaining the collective relations and spaces of caring desired by many.

Placing care in times of austerity

Abstract The concept of care and its associated practices remain a key subject of debate in human geography, as they continue to evolve in response to changing norms and expections of who does and should provide care, how, and where care takes place. With the growing politics of austerity shaping welfare and support provision across the Global North, these norms and expectations are once again being reviewed and reconfigured. New spaces and relationships of care are unfolding, as austerity intensifies many debates over the role of the state vis-a-vis the private, informal and third sectors. This paper examines the changing geographies of care that are unfolding within this context of austerity and frames a collection of papers on this subject. It offers a short review of the concept of care in the discipline of geography before examining the shifting landscapes of care provision overtime. It considers where these new spaces of care are unfolding. After identifying the boundaries of this scholarship, it then outlines the key themes within and across the four papers in this special issue.