There are large amounts of literature which refers to the identification, support and management of ‘vulnerable groups’, but who is referred to within this category varies widely. How ‘vulnerability’ is constructed within this arena is difficult to summarise as its employment as a term is highly disparate. Rather than a
comprehensive overview, this section is designed to provide a flavour of the variety of ways in which vulnerability is used to highlight the needs of specific populations for special attention. Particular attention is given to ‘vulnerable groups’ of children and young people, as information about which young people were deemed as vulnerable informed part of the sampling strategy for the present study (see 4.4.2).
Most often, when authors refer to vulnerable populations or groups, who they mean by this is not clearly defined. Occasionally, research and official reports or policy guidance give more precise indications of which categories they mean by the term ‘vulnerable groups’. As one example, writing about the social exclusion and
vulnerability of children and young people, Bynner (2001) argues that particular groups of children are the ‘most vulnerable’ to exclusion. For Bynner, these groups include: those who experience weak or absent ‘family relations’, those who grow up in care, children with absent parents, those whose parents have drug and alcohol problems and/or criminal records, and disabled children (particularly disabled children who grow up in poverty) (p. 293). Such attention to ‘vulnerable’
groups of children and young people tends to draw on ‘human development’
understandings of childhood.
A sample of specified and defined vulnerable groups is provided in Table 2.1. This sample shows that although the list of vulnerable groups varies, there are some commonly occurring groups, (like children in care and young offenders for example) indicating a certain tacit level of consensus of understandings at both practice and policy level. There is overlap here with the literature on research methods which focuses on how to conduct research with ‘vulnerable groups’ (see Liamputtong, 2006; Taylor, 2009; Yates, 2009 for examples). The way in which researchers are often deemed to have certain ethical responsibilities when engaged in direct work with ‘vulnerable’ groups has received significant attention in the research methods literature and this is explored further in Chapter 4.
Table 2.1: Examples of ‘vulnerable groups’ of children and young people in official and academic literature
Document Vulnerable groups of children/young people (CYP) identified Comments Every Child Matters
(Department for Education and Skills, 2005)
‘Most vulnerable’ children are those most at risk of significant harm and
‘vulnerable’ children are those at risk from poor outcomes.
Vulnerability is associated with all children, but groups needing extra attention are listed according to factors associated with poor outcomes.
Think Research (Social Exclusion Task Force, 2008)
‘Most vulnerable’ and ‘disadvantaged’ are discussed throughout. Targets
‘families at risk’ and ‘vulnerable families’.
Uses evidence base to argue that ‘vulnerable families’ are the same population caught at different points in their lives.
Goulden and Sondhi (2001) School truants and those excluded from school, young offenders, homeless young people and runaways, young people living in drug using families
Research on drug use. Talks of vulnerable groups generally, but seems to be referring to groups vulnerable to substance misuse.
NICE (2007) Those whose family members misuse substances, CYP with behavioural or mental health problems, excludees and truants, young offenders, ‘looked after’ CYP, those who are homeless, those involved in sex work, those from some minority ethnic groups
Document on drugs interventions, identifies ‘vulnerable and disadvantaged children and young people aged under-25 who are at risk of using substances’.
Home Office Vulnerable Groups Research Programme (cited in Cusick et al, 2003)
Young people involved in sex work, young people leaving care (including runaways), homeless young people, young drug users in touch with Youth Offending Services
Programme investigating patterns of drug use among vulnerable young people. Like Think Family report, alerts reader to same population caught at different points in their lives.
Operating Framework, City Council Vulnerable Groups Commissioning Partnership Board (2009)10
Young people who offend, children who misuse substances and alcohol, teenage parents and those at risk of conceiving, children with mental health problems and ‘behavioural difficulties’, disabled children and those with complex needs, ‘looked after’ children and those ‘on the edge of care’
Local document from the city in which the empirical case study was carried out (Chapters 5─8) showing practice interpretation of policy and more tacit local understandings and priorities.
National Institute for Health Research (2001)
Notes the term means different things to each of us. Lists 28 groups as example vulnerable groups (p. 2): ‘children in general’, children in care, young carers, asylum seekers and refugees, people whose ‘voices cannot be heard’, people who cannot read or write English, people who need (but are not receiving) health or social care services.
Document aimed at promoting research in public health and social care. Document refers to vulnerable groups more generally, not specifically children and young people. This list includes a positioning of people in line with their (in)adequate use of services (cf Watts and Bohle, 2003)
Bynner (2001) Children most vulnerable to exclusion: CYP who experience weak or absent
‘family relations’, who grow up in care, whose parents have drug and alcohol problems and/or criminal records, and disabled children
Research paper examining ‘risks’ and ‘protective’ factors in social exclusion. Example of more ‘developmental’ approach.
10 This was a local document used in the city of the empirical case study. A full reference is not given in the bibliography for reasons of anonymity.
The phrase ‘the most vulnerable’ appears to be used widely across official and academic writing. The opening of the Executive Summary of ECM (Department for Education and Skills, 2003: 5) describes ‘shameful failings in our ability to protect the most vulnerable children’, which is a reference to the death of Victoria Climbié.
The use of this phrase in child protection arenas imagines children’s risk of harm from adverse circumstances as a spectrum, with some children and young people at the most acute end. The employment of the term ‘the most vulnerable’ carries with it a strong implied ethical responsibility to address the plight of these particular children and young people. In academic literature it appears as a summarising concept in articles, abstracts, or even titles of books, though in the main body of text it is rarely referenced let alone defined (see for example Paxon and Haskins, 2009; Dearden and Becker, 2000; Beddoe, 2006). Sometimes, the phrase ‘highly vulnerable’ is used in the same way (see Scaife et al, 2009: 235). This label of most vulnerable is also used in relation to adults, but perhaps less frequently (see Hicks-Coolick et al, 2007; Pring, 2003).
At the time of the completion of the main literature review (Spring 2010), all of the
‘big 5’ children’s charities (Barnardos, The Children’s Society, NSPCC, Action for Children and Save the Children) emphasised the centrality of vulnerable groups or the ‘most vulnerable’ in their work. Action for Children’s ‘strapline’ was that they supported ‘the UK’s most vulnerable and neglected children and young people’
(www.actionforchildren.org.uk). Barnardos’ mission statement stated, ‘We believe in the abused, the vulnerable, the forgotten and the neglected’
(www.barnardos.org.uk). Between these five charities, a search for ‘vulnerable’ on their websites (April 2010) returned 1529 results, which were mainly descriptions of issues related to the ‘most vulnerable’ children and young people, or descriptions of their work with ‘vulnerable children’ in various projects or campaigning or research work. The NSPCC highlighted the ‘particular’ vulnerability of disabled children and young people (nspcc.org.uk).
There are also literatures related to specific adversities faced by some children and young people where vulnerability terminology seems to be particularly heavily utilised. ‘Vulnerable families’ also appears as a motif in the literature related to
these adversities (cf Scott and Arney, 2010; Morris, 2012)11. Substance misuse literature referring to children and young people is one arena where the idea of
‘vulnerability’ is frequently drawn upon. Information and guidance produced by the Home Office under the Every Child Matters policy initiative includes; Drug use among vulnerable young people: developing local profiles (Home Office, 2007).
Every Child Matters: Change for Children: Young People and Drugs (Department for Education and Skills, 2005a: 1) refers to reducing drug use by young people,
‘particularly the most vulnerable’. Vulnerability is also heavily drawn upon as a notion in the official and academic literature related to children and young people who are involved in the sex industry or in ‘sexual exploitation’ (see Department for Children Schools and Families, 2009, Department of Health and Home Office, 2000;
Department for Education, 2011). Often, vulnerability to a specific adversity is merged with the more general term ‘vulnerable children’. As one example, Scaife et al’s (2009) study on ‘vulnerable young people and substance misuse’ focuses on young people’s ‘vulnerability’ to drug use, but throughout the research, young people being vulnerable to substance misuse seems to be conflated with, vulnerable groups per se (p. 229). This would not appear to be uncommon; for similar usage see as examples Goulden and Sondhi (2001), Lloyd (1998) and NICE (2007).
For some writers, the rise of the phenomenon of ‘vulnerable groups’ is heavily associated with particularism (see Levy-Vroelent, 2011). McLaughlin (2012) argues that social activism in contemporary society is now based on ‘vulnerable identities’, a trend which runs contrary to more collective approaches to social movements such as unionisation. McLaughlin associates ‘vulnerable identities’ with the individualisation of social problems, arguing that this configuration of issues renders unacceptable the analysis of wider social and cultural factors which shape experiences. Although McLaughlin offers a convincing account of the connection between ‘vulnerable identities’, ‘vulnerable groups’ and particularism, the benefits of such classifications for certain groups who are included in constructions of
11 There is further comment in Chapter 3 regarding the notion of ‘vulnerable families’ in relation to anti-social behaviour and configurations of ‘vulnerability’ (see 3.1.3).
vulnerability are perhaps overlooked to some degree. Levy-Vroelent (2011) sees benefits as well as draw-backs, an issue which is further explored in Chapter 3.
In terms of influential notions of ‘vulnerability’, literature which draws upon the idea of ‘vulnerable groups’ would generally seem to reaffirm and/or challenge the dominant conceptions of individuals’ or groups’ vulnerability. Although there seems to be some degree of tacit agreement about which groups are ‘vulnerable’, defining where the boundaries are or should be drawn around this population is very
difficult, as ‘vulnerability’ is used somewhat vaguely in this literature.
2.4 ‘Vulnerability’ and ‘risk’
There would appear to be similarities and overlaps in the use of the concepts ‘risk’
and ‘vulnerability’, and to some extent a lack of clarity across the literature about how far these concepts are the same, or different. Some authors who have been interested in notions of vulnerability have been critical of the relative obscurity of
‘vulnerability’ when compared to ‘risk’:
Too often vulnerability lies in the shadow of risk, or worse still, the concepts are integrated with a net result of losing focus on vulnerability as a distinct contributor to outcomes that we observe but seek to avoid (Sarewitz et al, 2003: 810).
As Appleton (1999) notes, the term ‘vulnerability’ is often used interchangeably with the concept of risk. Taylor-Gooby (2000: 6) also positions these notions as heavily intertwined, arguing that there has been an ‘explosion of concern about risk, vulnerability and social need’ within contemporary society. Given this
inter-relationship, a brief overview of sociological theories of ‘risk’ is provided here, along with reflections on what this literature can offer in terms developing
understandings of vulnerability.
The concept of risk has attracted significant sociological attention (see Lupton, 1999 for a useful overview), with ideas and theories related to this sometimes referred to as the ‘risk society’ thesis (referring to Beck, 1992). Beck (1992), Giddens (1991) and Bauman (2000) suggest a novelty to the changes in society in ‘late modernity’,
linking the modernisation process with a loosening of the structural ties that bind us and constrain us. Technological developments are viewed as instrumental to such changes; Beck (1992) links increasing ‘risk’ to industrialisation, whereas
Bauman (2000) and Giddens (1991) emphasise ‘speed’ and the altering relationship between space and time due to developments in transport and ‘globalisation’.
Other theorists have used the risk society thesis to explain a growing preoccupation with risk in everyday life, especially risk of hazards such as crime (Garland, 2001;
Burney, 2005; Zender, 2006). The risk society thesis suggests that we are less tightly bound to ‘structures’ within society, so we feel less in control of our lives and more insecure; thus we concentrate more effort on factors which we see as threatening to our security. Such ideas have been used to argue that ‘vulnerability’ has similarly become a pervasive and defining feature of the state’s relationship to the individual (see McLaughlin, 2012; Furedi, 2006, Waiton, 2008; Kemshall, 2002).
In social care policy and practice, risk has also gained prominence and credence as a concept (Mitchell and Glendinning, 2007). A growing body of empirical work has developed about the role of risk in social policy and welfare; for example, Alaszewski (1998) in health, Kemshall (2002) in welfare, Parton (2007) in child protection and Culpitt (1999) on the role of risk in social policy. In her analysis of concepts utilised in the child protection process, Daniel (2010: 233) notes that ‘risk’
denotes the ‘chances of adversity translating into actual negative outcomes for children’ and also that risk has a certain predictive element as it plays a role in determining ‘likelihood’ (a parallel with Sarewitz et al, 2003). Waugh (2008: 113) notes a ‘narrow’ and ‘broad’ definition to notions of risk. Narrow definitions, she argues, emphasise individual events and risk of harm, whereas broader definitions are based on a more comprehensive assessment from ‘ecological and feminist’
perspectives.
Something of a consensus has emerged about the pervasiveness of the concept of risk, its link to institutional power, and its function in processes by which official authorities appraise and regulate people. Lupton (1999) argues that ‘risk’ is central to the way that individuals are monitored and managed by governments, in the context of attaining neo-liberal goals. According to some authors interested in ‘risk’
and social policy, the proliferation of commentaries and information which promotes risk-avoiding behaviour by citizens (pregnancy-related health advice is one example given by Lupton) is argued to be a moral enterprise that can be understood within a context of the responsibilisation of individuals (Lupton, 1999;
Culpitt, 1999). The literature review undertaken for this thesis would indicate that although it may be a similarly pervasive concept in welfare settings, ‘vulnerability’
has received much less attention than ‘risk’ from academics in sociology and social policy. However, references to vulnerability can be found within the ‘risk’ literature which offer potential insights pertinent to this study.
Kemshall (2002) is one example, whose analysis firmly asserts that the concept of
‘vulnerability’ functions in a similar way to ‘risk’ within policy. She argues that as the ‘personal social services’ became increasingly preoccupied with the auditing and assessment of individuals and with bureaucratic systems of ‘risk management’, the concept of vulnerability was taken on by local authorities (making explicit reference to welfare for older people) to further enable the implementation of
‘top-down’ priorities (p. 78). Kemshall sees the rise of ‘vulnerability’ within social care settings as linked with the ascent of New Right agendas of reducing welfare. As agencies struggled to meet the ‘needs’ of people, she argues, a shift took place whereby welfare provision was framed in terms of more ‘selective’ notions:
Gatekeeping was considerably simplified by replacing the inclusive, ambiguous concept of need with the exclusive and managerially defined concept of ‘vulnerability’ in which clearer positions could be set. (Kemshall, 2002: 28)
That ‘vulnerability’ may function as a conceptual instrument by which official bodies are able to more effectively limit the distribution of welfare resources is an issue which will be further explored in Chapter 3 (see 3.2.3).
In terms of how ‘vulnerability’ is conceptually distinct from ‘risk’, writing in the field of the human sciences, Sarewitz et al (2003: 805) argue that vulnerability refers to the ‘characteristics of a system that create the potential for harm’, whereas risk is the ‘risk of occurrence’ or the probability of a particular outcome. These authors
argue that there can be potential for harm present (vulnerability) without a high risk of a certain hazard occurring. In the social sciences, the conceptual distinction is rarely made in the literature, and a lack of clarity about both concepts would
appear to be common. Both ‘risk’ and ‘vulnerability’ are often used to refer to an ill-defined combination or range of issues. Considering this lack of definition, any attempt to draw a precise distinction between indicators for ‘risk’ and ‘vulnerability’
would be to over-simplify the conceptual relationship.
Perhaps two facets of ‘vulnerability’ would seem to mark it out as conceptually distinct from ‘risk’ in the literature. Firstly, ‘vulnerability’ would appear to have stronger ethical connotations than ‘risk’, perhaps linked in some way to implied duty of care. The concept of vulnerability has a moral weight that is more
pronounced than risk, as is highlighted by the vulnerability thesis writers (see 2.1.3).
A second key difference is what could be called the ‘contingent’ nature of vulnerability, meaning the association the concept has of potentiality of harm rather than likelihood of harm. ‘Vulnerability’ may be more contingent than ‘risk’ as it may be hard to anticipate or even hidden. Thus there is a variance and even a tension between the way vulnerability can denote something which is potentiality harmful, and at the same time is used to describe the actuality of something negative happening.
To summarise how sociological understandings of ‘risk’ might relate to influential notions of vulnerability, the risk society thesis could go some way in explaining the trend towards the use and popularity of the concept ‘vulnerability’ in contemporary policy and social care practice. Furthermore, theories of universal vulnerability (see 2.1.3) draw on sociological theories about modernisation processes. Overlap also extends into obvious parallels between the way in which ‘risk’ and ‘vulnerability’
have been ‘institutionalised’ within systems and processes which appraise and manage people.