Developed countries

Widows’ deprivation in developed countries has been widely overlooked in research and awareness is low. In part this may be because any comparison between the West and the Third World reduces the significance of the western findings. Many of the deprivations suffered by widows in Africa and Asia are however shared by their western counterparts, though rarely to the same degree.

Poverty, sexual exploitation, exclusion from healthcare and from social acceptance: the stigma of widowhood exists as in parts of the developing world just as elsewhere. And in the developed world too, it is mostly below the radar of governments and the media.

Where developed countries differ as a group is in lacking the discriminatory widow-specific social norms that in many developing countries act as a driver of material deprivation. There is no serious link in developed countries between stigma and material deprivation.


 

Incomplete welfare states: lack of free healthcare and pensions

Such research as exists is mainly concentrated on the older, especially the elderly age groups, with particular focus on the psychology of bereavement in widowhood. A recent study on widowhood in the UK reveals this tendency (Chambers 2005; see also Bennett 1997). Another focus is on pension shortfalls, not without reason – in 2005, around two-thirds of Britain’s poorest pensioners were reported to be female’ (Osborne 2005). Help the Aged, a UK NGO, stated that ‘The existing contributory pension system is unfair because it penalises women who take time out from their careers to care for family or who work part-time, reducing their overall pension pot in retirement’ (ibid). Deaths of elderly UK widows have been documented from lack of winter heating due to “fuel poverty”. Whether young or old, widows from low-skill, low-income backgrounds risk significant deterioration in their standard of living in several developed countries through loss of their husband or partner’s income. The areas of severest deprivation are housing and healthcare.

The United States is of particular interest for the study of widows’ deprivation in developed countries, due to its higher than average incidence of a range of deprivations – from infant mortality and functional illiteracy to mass lack of access to healthcare (OECD 2000 and 2005). However, the  research on widows living in poverty in the USA – beyond some work on older women as widows – is limited, and we therefore have to extrapolate widows’ outcomes from general accounts of similar younger women from low-income, low-skill and low-education backgrounds. The research on older widows indicates that there is a poverty issue among this group:

‘For the past 30 or more years, the poverty rate for elderly widows has persistently been three to four times higher than that for elderly married women. Although policy makers have repeatedly expressed concern about these high rates, successful policy prescriptions have yet to be adopted’. (McGarry and Schoeni 2005: 58)

It was noted that poverty of elderly widows in the United States is linked to ‘the potential for couples to spend substantial portions of their resources on the healthcare of a sick or dying spouse, leaving the surviving spouse in a precarious financial situation.’ (ibid.)  This is in no small part due to the severe limitations of the healthcare system, not in terms of quality of care, but in terms of who can obtain health insurance to avoid otherwise catastrophic medical costs. Women dependent on the husband’s employer-provided health insurance risk losing this when he dies (Weir and Willis 2002).

Some 47 million US citizens are said to be without medical insurance. In the absence of a state system accessible to all, catastrophic medical expenses or death and disability are inevitable. Even when people do have medical insurance, it often does not cover required treatment, or insurance companies seek to avoid having to pay for treatment. The example of President Barack Obama’s mother having to negotiate her cancer treatment with the insurance company is well known.

Research shows that medical expenses are a significant social problem in the US due to the lack of free or substantially subsidised healthcare, and the common requirement even for those who are insured to pay first and be reimbursed later (ibid.). The US spends a ‘…greater proportion of national income … on healthcare, [yet] manifests poorer health than many other developed nations’ (Kubzansky et al 2001: 105). Catastrophic medical expenses are a standard feature of the widow experience in developing countries. Costs often accrue in the period leading up to the death of the husband. Remote Area Medical, a US-based health NGO originally established to provide aid in developing countries, now operates a mobile field hospital across the United States, providing free medical care for a few days in each location. The similarity with developing countries is striking. Government-provided healthcare for those in poverty is not uniform across the country; instead ‘Medicaid’ programmes are set up at state level, with coverage therefore varying from state to state. The system lacks its own medical staff. Medical service providers’ costs are capped irrespective of need, so creating a barrier against participation by providers (Clarke with Fox Piven 2009: 30, citing Starr 1982).

Healthcare is an ongoing cause of concern for people in poorer countries, or those, such as Russia, which have seen a sharp fall in state health expenditure and scrapping of free provision. Ambulances in at least one part of Russia do not respond to calls from the elderly.

A 2002 World Bank poverty study found that Bosnians considered lack of healthcare insurance as a key poverty characteristic and it is notable that in this way, the US healthcare system draws parallels with Balkan countries recovering from war. US researchers point out that ‘healthcare ranked first among the issues Americans believe the government should address, and third among the most critical issues facing the country today’ (Narayan et al 2002: 8; Murray et al 2000). One commented:

‘…it is impossible to estimate how many women turn to welfare simply because they have no health insurance for their children. Generally no records are kept that would provide that kind of information, although one study estimated that the welfare caseload would drop by 16 percent if all working women had health coverage.’
(Berrick 1997: 43)

The parallels with developing countries are clear.

The Obama administration has sought to address the healthcare issue with the introduction of the 2010 Patient Protection and Affordable Care Act (popularly referred to as ‘Obamacare’). In the face of determined opposition by the insurance lobby and the Republican Party many of its provisions have been watered down and problems certainly persist. It is too early to assess what impact Obamacare may have on widows’ poverty in coming years.

Poverty and deprived social groups: ethnic minorities and low skilled workers

The combination of incomplete welfare states with other poverty risks – e.g. belonging to ethnic minority or low-skill groups – produces further striking parallels with developing countries.

The high poverty rate among US widows has been observed in various studies (Hurd and Wise 1998; Hurd 1991; Weir 1998). There is also evidence – although at lesser magnitude than in developing countries – of widows taking on the primary care role for grandchildren when parents die of HIV/AIDS (Draimin and Reich 2005).
One significant group of widows known to be at risk of severe poverty in the United States are African Americans:

‘The effects of race, class, and gender proscriptions have placed the black female in one of the most vulnerable positions in American society, black women are more likely to be overrepresented at the bottom of the economic and social hierarchy. While married, these effects are somewhat mitigated by the emotional and economic supports of the spouse. However, the death or loss of a spouse may be among the most devastating events for a black woman. For, in many instances, the husband provided a major source of economic support.’ (McDonald 1987: 141)

Poverty data for 2005 using the official US government poverty line showed that of all those below the poverty line, 24.9 percent were African American, and female-headed households represented 28.7 percent. White Americans accounted for 8 percent of the total (United States Census Bureau, 2006).
The development economist Amartya Sen highlights the plight of African Americans:

‘…[with respect to income] African Americans are decidedly poorer than American whites. This is very often seen as an example of relative deprivation of African Americans within the nation, but not compared with poorer people in the rest of the world. Indeed, in comparison with the population of third world countries, African Americans may well be a great many times richer in terms of income, even after taking note of price differences. Seen this way, the deprivation of the American blacks seems to pale to insignificance in the international perspective.

‘But is income the right space [metric] in which to make such comparisons? What about the basic capability to live to a mature age, without succumbing to premature mortality? In terms of that criterion the African American men fall well behind the immensely poorer men of China, or the Indian state of Kerala, and also of Sri Lanka, Costa Rica, Jamaica and many other poor economies. [American] black women too fall not only behind white women in the United States but also behind Indian women in Kerala, and come very close to falling behind Chinese women as well. American black men continue to lose ground vis-à-vis the Chinese and Indians over the years – well past the younger ages when death from violence is common.’
(Eitzen and Eitzen-Smith 2009: 121)

Two US poverty specialists report key facts for the United States, which has consistently shown the worst performance among developed countries on a broad range of human development indicators:

‘Two out of three impoverished adults in the United States are women, a consequence of the prevailing institutional sexism in society. With few exceptions, US society provides poor job and earnings opportunities for women. 28.7 percent of female-headed families with no husband present were below the poverty line in 2005, compared to 5.1 percent of married couples living in poverty. Women with children with no husband present, on average, were in 2005, $8,610 below the poverty threshold. In short, the highest risk of poverty results from being a woman and having children…’ (ibid.)

American women on low incomes with dependent children often find it is better to accept government income support, because income support includes free state-funded healthcare for children. Childcare – essential if they are to work – is also neither universal nor affordable (ibid.: 144-150).

Since US state benefits do not cover living costs for a single adult with children, the adult – typically a woman – must find other ways of making up the shortfall, sometimes resorting to extreme steps, as recounted by one poor female family head from Chicago:

‘They ought to build [create] jobs, build houses or buildings where people can live. You got three of four families staying together because they can’t find nowhere to stay or they can’t afford where this rent is at. So everybody that can, they huddle up together. Then you have to fix it, and give an address somewhere else in order to get your cheque [state support]. They don’t understand that the rent is so high that the only thing you can do is live with somebody. ‘[Interviewee assumes the tone of a government official making accusation of fraudulent benefit claims]: Well all you all living in the same house together, you all just trying to get all the money you can.’ They don’t realise how things is.’ (Wilson 1996: 82)

US writer Barbara Ehrenreich spent months living in America’s low-wage economy to see how difficult it was to survive. She worked waitressing, in a care home, marketing and cleaning. At times, she had to take two jobs to make ends meet. Finding affordable accommodation is an heroic undertaking, even trailers and rented rooms proving beyond the means of the low paid. Having paid rent, essential energy can eat up most of what remains after the purchase of the minimum food basket. Following labyrinthine inquiries, Ehrenreich learns that food vouchers are available for the working poor.

‘My dinner choices… are limited to any two of the following: one box spaghetti noodles, one jar spaghetti sauce, one can of vegetables, once can of baked beans, one pound of hamburger [raw minced beef], a box of Hamburger Helper [seasoning mix], or a box of Tuna Helper. No fresh fruit or vegetables, no chicken or cheese, and oddly, no tuna to help out with. For breakfast I can have cereal and milk or juice… Bottom line: $7.02 worth of food acquired in 70 minutes of calling and driving, minus $2.80 for the phone calls.’ (Seabrook 2003: 14)

Poverty also remains an issue in the UK, with children among the worst affected. In 2003, Save the Children UK published an in-depth report on child poverty in the UK, showing:

‘…eight percent of British children – approximately one million children – were severely poor and 37 percent non-severely poor. Children were defined as being in severe poverty if they were poor on three measures:

‘the child’s own deprivation – the child going without one or more ‘necessities’ because they could not be afforded;

‘the deprivation of the parents – parents going without two or more ‘necessities’ because they couldn’t be afforded;

‘the income poverty of their household – the household having an income of below 40 percent of median income.’ (Adelman, Middleton and Ashworth 2003)

Child poverty is the result of adult poverty. Single parents on low incomes in the UK often face long term poverty due to the lack of state-provided free childcare which leaves them able only to work part-time or not at all. Single parents who are widows may fall into the low-income single parent category. Government plans to reduce or end dependence on welfare state benefits undermine efforts to move low-skilled people into employment, which may well require more benefits, such as free or subsidised childcare, to succeed. In 2001, it was observed that: ‘provision of publicly funded childcare in the UK remains derisory, (covering) only two percent of children up to age three, and (is) one of the lowest rates in Europe’ (Hearn 2001: 92; see also Heymann 2006).

In Eastern Europe and Central Asia the situation for impoverished widows and their children remains bleak, with a review of a series of World Bank poverty assessments from the 1990s indicating that female-headed households have a greater probability of being in poverty than other household types (composition of households was shown to make a difference) (Lampietti and Stalker 2000: 24-25).

In Russia, the scaling back of state provision has been especially severely felt in rural areas. Migration to cities following the 1991 demise of the Soviet Union has left rural local government with few resources, resulting in the systematic closure of local government offices and reduction in welfare provision. The remaining inhabitants are mainly elderly and predominantly widows, living in villages and on former farmland. Widespread male alcoholism is partly to blame through increased male mortality – so much so that alcoholism is to segments of Russian society what HIV/AIDS is to whole Sub-Saharan African countries. A Russian woman is making a significant statement when she says, ‘I am lucky my husband does not drink’ (Levinson et al 2002: 301).

A recent account of the dire state of rural Russian public services, and the isolated elderly widows who once depended on them, was given in a report by The Guardian newspaper,  which adds to the picture of developing poverty traced through a series of studies (Harding and Robertson 2008). One shows a widespread drop in the real public health spending in Russia over the period 1994-2000 (Ivaschenko 2006: 265-272; Shkolnikov, Field and Andreev 2001: 151). This is corroborated by more recent evidence:

‘...according to the results of the INTAS funded project, Health, Health Policy and Poverty in Russia, ‘the poorest strata of the population showing the lowest levels of health find it hardest to obtain access to good quality healthcare, since free medical services are being gradually phased out.’ (Davidova and Manning 2008: 205, citing Davidova 2007)

The decline of the high pay, low skills manufacturing sector has increased the poverty risk for current and future widows from low-income, low-skills backgrounds in advanced OECD countries. A 1991 study noted that middle or lower-income US households were getting poorer in real terms:

‘Families have come increasingly to rely on the dual income of husband and wife to meet ongoing expenses in light of erosion of the family wage. Since the wife’s earnings were once thought of as ‘extra money’, such reliance may reduce both the effect of married women’s earnings on family savings for retirement and their replacement potential when a marriage ends through death [hence, in widowhood] or divorce.’ (Morgan 1991: 275, citing Smith 1984; Treas 1981; Morgan 1981)

This decline has been extensively documented in ‘When Work Disappears: The World of the New Urban Poor’ (Wilson 1996) and ‘The Collapse in Demand for the Unskilled and Unemployment Across the OECD’ (Nickell and Bell 1995) among other research. By 1990, widows entering older age groups were characterised as having limited previous employment experience, often placing them in competition for jobs with younger low-skilled workers (Morgan 1991: 277). Very few of these widows have built private sector pensions of their own. The position is likely to worsen as the baby-boom generation ages, particularly in light of increasing life expectancy. A form of discrimination against widows in the US indirectly suggested by a US economist, who suggested that since women live longer than men, employers will have to pay pensions longer too. This justified reducing women’s wages during their employment (ibid., citing Moore 1997)

In America, low-skilled but well-paid manufacturing work allowed large numbers of men and women with minimal levels of education to rise to relative affluence after the end of the Second World War. Other western countries followed and the period to 1970 has been referred to as the ‘golden era’ in western economic history. This was followed by the steady decline of manufacturing industry in the west in the face of competition from Japan and the so-called Asian Tiger economies, a group of East Asian countries that invested aggressively in human and physical capital and in research and development.

China’s entry into this arena in the last 15 to 20 years has added further challenging manufacturing competition for developed countries. In the USA, poor business planning and incentives from poorly designed economic policy has had the effect of transferring manufacturing capacity to such lower cost countries. Together with declining quality of state education and the lack of universal healthcare coverage, this has resulted in increasing poverty for the low-skilled and those from low-income backgrounds. The implications for widows and women who have lost partners are clear.

Research has noted that women still face labour market discrimination in developed economies. A study on family and employment in the OECD notes: ‘the persistence of powerful gender norms in relation to care work means that women have different kinds of external constraints, and therefore a lack of equity, in comparison to men’ (Crompton 2006: 90). Another study observes that, ‘the structural causes of female poverty are to be found in the interaction of economic disadvantages and risk factors in domestic circumstances, labour markets and welfare systems’ (Ruspini 2001: 107). It is clear that widows will feel the effects on their living standards and those of their children.

The economic impact of caring for dependent children is another factor. Nancy Folbre and M. V. Lee Badgett’s observation about the US can be applied widely:

‘No matter who performs it, caring labour is expensive. A parent who devotes time and energy to ‘family-specific’ activities typically experiences a significant reduction in lifetime earnings. The human capital that housewives and/or househusbands acquire is less transportable than that of a partner who specializes in market work, leaving them in a weaker bargaining position in the family and economically vulnerable to separation or divorce [to this, add: or being widowed].’ (Badgett and Folbre 2001)

US research has conclusively shown that older widows who have had a break in employment, seen little employment over their lives, or come from low-skilled backgrounds in continuous employment, end up in poverty in old age: ‘those poor beyond age sixty-five remain disproportionately female, with an overrepresentation of widows’ (Morgan 1991: 275, citing Boskin and Shoven 1986; Holden, Burkhauser and Myers 1986; Holden 1988; Walick 1985). And:

‘of all the factors associated with poverty in old age, the most critical is to be a woman without a husband… those most likely to be widowed have lower incomes than intact couples even before they lose their husbands. Their lower incomes reflect less education on the part of both husband and wife and poorer health on the part of the husband than couples that remain intact.’ (Karamcheva and Munnell 2007: 1)

With similar effects, but different causes, the pre-1989 gains in living standards in Eastern Europe, Central Asia and Russia were seriously reversed with the collapse of the communist system. Russia faced ten years of crisis during which social policy received no serious consideration, with far-reaching consequences for low-income groups, widows among them. Older widows living alone are most at risk from this trend. This has been drawing some attention from researchers, for example: ‘Older women in Europe: East follows west in the feminization of poverty?’ (Ginn 1998).

Among developed countries – OECD, Eastern Europe, Russia and East Asian countries such Japan, Malaysia, Singapore and Taiwan – the different causes of widows’ deprivation are determined by whether or not, or to what degree, countries have relatively comprehensive welfare states and strong pro-women labour market legislation. Such differences can often be traced to prevailing social norms, and in some cases to strong vested interests that have grown from them and that reinforce them.

By this measure, developed countries fall into two groups: those with incomplete means testing or minimal welfare states and labour market legislation, including Australia, the United Kingdom, Canada, New Zealand, the United States, Eastern Europe and Russia; and those with comprehensive systems: the six original members of the European Economic Community (now the European Union) and the Scandinavian countries. Comprehensive welfare is also provided in the advanced East Asian countries of Japan, Taiwan and South Korea (Haggard and Kaufman 2008: 227-229; Uzuhashi 2009: 210-230).

This distinction is illustrated with clear implications for widows in this observation:

‘In a number of respects, British labour market and welfare policies are closer to those of the US than the rest of Europe. For example, a comparative policy analysis of dual-earner family policies and their outcomes consistently ranks Britain, along with the US and Canada, as making the least generous provisions and having the most negative outcomes for families.’ (Gornick and Meyers 2003: 92)

State provision still exists in Eastern Europe and Russia, but it has become inconsistent and, since those who rely on it most heavily require a broad range of support, has therefore become less effective. A woman in her thirties from the Kyrgyz Republic in Central Asia exclaims ‘…now it is as if the government didn’t exist!’ (Kuehnast 2003: 38). Some changes have resulted from regressive attitudes, such as in Hungary, where childrace was withdrawn in the face of calls for women to return to the home-based role.

Overall, the crucial determinant of poverty, deprivation and destitution for widows and their children is the extent to which they must rely on private means versus the availability of government support.

Globally the distribution of poor widows facing multiple deprivations can be distinguished with on the one hand countries that have effective government welfare provision, and on the other, those that do not. We have seen that this does not neatly fall into rich and poor countries with the examples of the USA, where there is no universal free healthcare, and many of the former communist states of Eastern Europe, Russia, and Central Asia, where state social protection has declined since the end of Communism (Kandiyoti 1999: 500; see also Haggard and Kaufman 2008). This global correlation between poverty and state welfare is broadly confirmed for both developed and developing countries. Poverty remains the common denominator in the deprivations faced by widows and their children across the world.