“I feel like the worst mother in the world”: Neoliberal subjectivity in Indigenous Australian oral health

Abstract

Neoliberalism gained popularity during the post-Cold War period as a set of dominating ideologies, practices and policies that underpinned the movement towards globalisation. Neoliberalism champions competitive private markets, deregulation that facilitates economic activity, personal responsibility, and reduced public expenditure on infrastructure. A decade after the initial rise of neoliberalism, health inequities became concerns on the global stage. Oral health inequities aptly reflect social injustices due to the unique relation between material circumstances, access to health services and structural inequities. In Australia, Indigenous children experience early childhood caries at alarmingly higher rates than non-Indigenous children. Recently, neoliberalism has been suggested as an overwhelming contributor to Indigenous oral health disparities. This qualitative research is an extension of a single-blind parallel-arm randomised control trial that aimed to identify factors related to the increased occurrence of dental caries in Indigenous children. The objective of this constructivist grounded theory study was to generate an understanding of how neoliberal subjectivity exists for Indigenous peoples in the context of oral health in Australia. Experiences of ownership, guilt, failure, embarrassment, shame, and judgment were key in participants’ experiences of neoliberal subjectivity; these feelings were exacerbated by experiences of bullying, financial limitations, and institutional racism. We argue that individual responsibility for health, as a tenet of neoliberal ideologies, furthers Indigenous oral health inequities and that neoliberalism as a societal discourse perpetuates colonial values by benefitting the privileged and further oppressing the disadvantaged. Trial registration: Australian New Zealand Clinical Trial Registry ACTRN12611000111976; registered February 01, 2011.

Keywords

• Indigenous
• Neoliberalism
• Oral health
• Globalisation
• Neoliberal subjectivity
• Grounded theory