Racism in and for the Welfare State

Marx, Engels, and Marxisms Series Editors Marcello Musto, York University, Toronto, ON, Canada Terrell Carver, University of Bristol, Bristol, UK The Marx renaissance is underway on a global scale. Wherever the critique of capitalism re-emerges, there is an intellectual and political demand for new, critical engagements with Marxism. The peer-reviewed series Marx, Engels and Marxisms (edited by Marcello Musto & Terrell Carver, with Babak Amini, Francesca Antonini, Paula Rauhala & Kohei Saito as Assistant Editors) publishes monographs, edited volumes, critical editions, reprints of old texts, as well as translations of books already published in other languages. Our volumes come from a wide range of political perspectives, subject matters, academic disciplines and geographical areas, producing an eclectic and informative collection that appeals to a diverse and international audience. Our main areas of focus include: the oeuvre of Marx and Engels, Marxist authors and traditions of the 19th and 20th centuries, labour and social movements, Marxist analyses of contemporary issues, and reception of Marxism in the world. Fabio Perocco Editor Racism in and for the Welfare State Editor Fabio Perocco University of Venice Venice, Italy ISSN 2524-7123 ISSN 2524-7131 (electronic) Marx, Engels, and Marxisms ISBN 978-3-031-06070-0 ISBN 978-3-031-06071-7 (eBook) https://doi.org/10.1007/978-3-031-06071-7 © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Cover illustration: Cristian Dina/Alamy Stock Vector This Palgrave Macmillan imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Titles Published 1. Terrell Carver & Daniel Blank, A Political History of the Editions of Marx and Engels’s “German Ideology” Manuscripts, 2014. 2. Terrell Carver & Daniel Blank, Marx and Engels’s “German Ideology” Manuscripts: Presentation and Analysis of the “Feuerbach chapter,” 2014. 3. Alfonso Maurizio Iacono, The History and Theory of Fetishism, 2015. 4. Paresh Chattopadhyay, Marx’s Associated Mode of Production: A Critique of Marxism, 2016. 5. Domenico Losurdo, Class Struggle: A Political and Philosophical History, 2016. 6. Frederick Harry Pitts, Critiquing Capitalism Today: New Ways to Read Marx, 2017. 7. Ranabir Samaddar, Karl Marx and the Postcolonial Age, 2017. 8. George Comninel, Alienation and Emancipation in the Work of Karl Marx, 2018. 9. Jean-Numa Ducange & Razmig Keucheyan (Eds.), The End of the Democratic State: Nicos Poulantzas, a Marxism for the 21st Century, 2018. 10. Robert X. Ware, Marx on Emancipation and Socialist Goals: Retrieving Marx for the Future, 2018. 11. Xavier LaFrance & Charles Post (Eds.), Case Studies in the Origins of Capitalism, 2018. v vi TITLES PUBLISHED 12. John Gregson, Marxism, Ethics, and Politics: The Work of Alasdair MacIntyre, 2018. 13. Vladimir Puzone & Luis Felipe Miguel (Eds.), The Brazilian Left in the 21st Century: Conflict and Conciliation in Peripheral Capitalism, 2019. 14. James Muldoon & Gaard Kets (Eds.), The German Revolution and Political Theory, 2019. 15. Michael Brie, Rediscovering Lenin: Dialectics of Revolution and Metaphysics of Domination, 2019. 16. August H. Nimtz, Marxism versus Liberalism: Comparative RealTime Political Analysis, 2019. 17. Gustavo Moura de Cavalcanti Mello and Mauricio de Souza Sabadini (Eds.), Financial Speculation and Fictitious Profits: A Marxist Analysis, 2019. 18. Shaibal Gupta, Marcello Musto & Babak Amini (Eds), Karl Marx’s Life, Ideas, and Influences: A Critical Examination on the Bicentenary, 2019. 19. Igor Shoikhedbrod, Revisiting Marx’s Critique of Liberalism: Rethinking Justice, Legality, and Rights, 2019. 20. Juan Pablo Rodríguez, Resisting Neoliberal Capitalism in Chile: The Possibility of Social Critique, 2019. 21. Kaan Kangal, Friedrich Engels and the Dialectics of Nature, 2020. 22. Victor Wallis, Socialist Practice: Histories and Theories, 2020. 23. Alfonso Maurizio Iacono, The Bourgeois and the Savage: A Marxian Critique of the Image of the Isolated Individual in Defoe, Turgot and Smith, 2020. 24. Terrell Carver, Engels before Marx, 2020. 25. Jean-Numa Ducange, Jules Guesde: The Birth of Socialism and Marxism in France, 2020. 26. Antonio Oliva, Ivan Novara & Angel Oliva (Eds.), Marx and Contemporary Critical Theory: The Philosophy of Real Abstraction, 2020. 27. Francesco Biagi, Henri Lefebvre’s Critical Theory of Space, 2020. 28. Stefano Petrucciani, The Ideas of Karl Marx: A Critical Introduction, 2020. 29. Terrell Carver, The Life and Thought of Friedrich Engels, 30th Anniversary Edition, 2020. 30. Giuseppe Vacca, Alternative Modernities: Antonio Gramsci’s Twentieth Century, 2020. TITLES PUBLISHED vii 31. Kevin B. Anderson, Kieran Durkin & Heather Brown (Eds.), Raya Dunayevskaya’s Intersectional Marxism: Race, Gender, and the Dialectics of Liberation, 2020. 32. Marco Di Maggio, The Rise and Fall of Communist Parties in France and Italy, 2020. 33. Farhang Rajaee, Presence and the Political, 2021. 34. Ryuji Sasaki, A New Introduction to Karl Marx: New Materialism, Critique of Political Economy, and the Concept of Metabolism, 2021. 35. Kohei Saito (Ed.), Reexamining Engels’s Legacy in the 21st Century, 2021. 36. Paresh Chattopadhyay, Socialism in Marx’s Capital: Towards a Dealienated World, 2021. 37. Marcello Musto, Karl Marx’s Writings on Alienation, 2021. 38. Michael Brie & Jörn Schütrumpf, Rosa Luxemburg: A Revolutionary Marxist at the Limits of Marxism, 2021. 39. Stefano Petrucciani, Theodor W. Adorno’s Philosophy, Society, and Aesthetics, 2021. 40. Miguel Vedda, Siegfried Kracauer, or, The Allegories of Improvisation: Critical Studies, 2021. 41. Ronaldo Munck, Rethinking Development: Marxist Perspectives, 2021. 42. Jean-Numa Ducange & Elisa Marcobelli (Eds.), Selected Writings of Jean Jaurès: On Socialism, Pacifism and Marxism, 2021. 43. Elisa Marcobelli, Internationalism Toward Diplomatic Crisis: The Second International and French, German and Italian Socialists, 2021. 44. James Steinhoff, Automation and Autonomy: Labour, Capital and Machines in the Artificial Intelligence Industry, 2021. 45. Juan Dal Maso, Hegemony and Class Struggle: Trotsky, Gramsci and Marxism, 2021. 46. Gianfranco Ragona & Monica Quirico, Frontier Socialism: Selforganisation and Anti-capitalism, 2021. 47. Tsuyoshi Yuki, Socialism, Markets and the Critique of Money: The Theory of “Labour Notes,” 2021. 48. Gustavo Moura de Cavalcanti Mello & Henrique Pereira Braga (Eds.), Wealth and Poverty in Contemporary Brazilian Capitalism, 2021. 49. Paolo Favilli, Historiography and Marxism: Innovations in MidCentury Italy, 2021. viii TITLES PUBLISHED 50. Levy del Aguila Marchena, Communism, Political Power and Personal Freedom in Marx, 2021. 51. V Geetha, Bhimrao Ramji Ambedkar and the Question of Socialism in India, 2021. 52. Satoshi Matsui, Normative Theories of Liberalism and Socialism: Marxist Analysis of Values, 2022. 53. Kei Ehara (Ed.), Japanese Discourse on the Marxian Theory of Finance, 2022. 54. Achim Szepanski, Financial Capital in the 21st Century, 2022. 55. Stephen Maher, Corporate Capitalism and the Integral State: General Electric and a Century of American Power, 2022. Titles Forthcoming Vesa Oittinen, Marx’s Russian Moment Kolja Lindner, Marx, Marxism and the Question of Eurocentrism Adriana Petra, Intellectuals and Communist Culture: Itineraries, Problems and Debates in Post-war Argentina George C. Comninel, The Feudal Foundations of Modern Europe Spencer A. Leonard, Marx, the India Question, and the Crisis of Cosmopolitanism Joe Collins, Applying Marx’s Capital to the 21st century Jeong Seongjin, Korean Capitalism in the 21st Century: Marxist Analysis and Alternatives Marcello Mustè, Marxism and Philosophy of Praxis: An Italian Perspective from Labriola to Gramsci Shannon Brincat, Dialectical Dialogues in Contemporary World Politics: A Meeting of Traditions in Global Comparative Philosophy Francesca Antonini, Reassessing Marx’s Eighteenth Brumaire: Dictatorship, State, and Revolution Thomas Kemple, Capital after Classical Sociology: The Faustian Lives of Social Theory Xavier Vigna, A Political History of Factories in France: The Workers’ Insubordination of 1968 Attila Melegh, Anti-Migrant Populism in Eastern Europe and Hungary: A Marxist Analysis ix x TITLES FORTHCOMING Marie-Cecile Bouju, A Political History of the Publishing Houses of the French Communist Party Peter McMylor, Graeme Kirkpatrick & Simin Fadaee (Eds.), Marxism, Religion, and Emancipatory Politics Mauro Buccheri, Radical Humanism for the Left: The Quest for Meaning in Late Capitalism Rémy Herrera, Confronting Mainstream Economics to Overcome Capitalism Tamás Krausz, Eszter Bartha (Eds.), Socialist Experiences in Eastern Europe: A Hungarian Perspective Martin Cortés, Marxism, Time and Politics: On the Autonomy of the Political João Antonio de Paula, Huga da Gama Cerqueira, Eduardo da Motta e Albuquer & Leonardo de Deus, Marxian Economics for the 21st Century: Revaluating Marx’s Critique of Political Economy Zhi Li, The Concept of the Individual in the Thought of Karl Marx Lelio Demichelis, Marx, Alienation and Techno-capitalism Dong-Min Rieu, A Mathematical Approach to Marxian Value Theory: Time, Money, and Labor Productivity Salvatore Prinzi, Representation, Expression, and Institution: The Philosophy of Merleau-Ponty and Castoriadis Agon Hamza, Slavoj Žižek and the Reconstruction of Marxism Éric Aunoble, French Views on the Russian Revolution Terrell Carver, Smail Rapic (Eds.), Friedrich Engels for the 21st Century: Perspectives and Problems Patrizia Dogliani, A Political History of the International Union of Socialist Youth Alexandros Chrysis, The Marx of Communism: Setting Limits in the Realm of Communism Paul Raekstad, Karl Marx’s Realist Critique of Capitalism: Freedom, Alienation, and Socialism Alexis Cukier, Democratic Work: Radical Democracy and the Future of Labour Christoph Henning, Theories of Alienation: From Rousseau to the Present Daniel Egan, Capitalism, War, and Revolution: A Marxist Analysis Genevieve Ritchie, Sara Carpenter & Shahrzad Mojab (Eds.), Marxism and Migration TITLES FORTHCOMING xi Emanuela Conversano, Capital from Afar: Anthropology and Critique of Political Economy in the Late Marx Marcello Musto, Rethinking Alternatives with Marx Vincenzo Mele, City and Modernity in George Simmel and Walter Benjamin: Fragments of Metropolis David Norman Smith, Self-Emancipation: Marx’s Unfinished Theory of the Working Class José Ricardo Villanueva Lira, Marxism and the Origins of International Relations Bertel Nygaard, Marxism, Labor Movements, and Historiography Marcos Del Roio, Gramsci and the Emancipation of the Subaltern Classes Marcelo Badaró, The Working Class from Marx to Our Times Tomonaga Tairako, A New Perspective on Marx’s Philosophy and Political Economy Matthias Bohlender, Anna-Sophie Schönfelder, & Matthias Spekker, Truth and Revolution in Marx’s Critique of Society Mauricio Vieira Martins, Marx, Spinoza and Darwin on Philosophy: Against Religious Perspectives of Transcendence Jean Vigreux, Roger Martelli, & Serge Wolikow, One Hundred Years of History of the French Communist Party Aditya Nigam, Border-Marxisms and Historical Materialism Fred Moseley, Marx’s Theory of Value in Chapter 1 of Capital: A Critique of Heinrich’s Value-Form Interpretation Armando Boito, The State, Politics, and Social Classes: Theory and History Anjan Chakrabarti & Anup Dhar, World of the Third and Hegemonic Capital: Between Marx and Freud Hira Singh, Annihilation of Caste in India: Ambedkar, Ghandi, and Marx Salvatore Engel-Di Mauro, An Introduction to Ecosocialism Contents 1 Racism in and for the Welfare State Fabio Perocco 2 The Welfare State Struggling with Capitalist Hybris Alain Bihr 3 Welfare State and the Hunt for “Social Benefit Cheaters and Profiteers” Migrants: The Case of Belgium Nouria Ouali 1 45 63 4 The Swedish Racial Welfare Regime in Transition Diana Mulinari and Anders Neergaard 5 The Public Charge: The Capitalist Politics of Labor, Migration, and Austerity in the United States Justin Akers Chacón 117 Whose Welfare State? A Racialised Logic to [Un]Protect Immigration and Asylum in Spain Olga Jubany and Alèxia Rué 141 The 23 Million Romanians, Igor, and the Others: Welfare State, Migration, and Racism in Hungary Petra Andits 165 6 7 91 xiii xiv CONTENTS 8 Continuities and Transformations of Racism in German Welfare Capitalism Christoph Gille and Jonas Kohlschmidt 181 In a Country Boasting a Welfare State, Do Black Lives Matter Less? Steve Jefferys 199 9 10 11 12 13 Welfare State as a Political Weapon: Institutional Racism Against Arabs, Asylum Seekers and the Minorities in Israel Diego Alberto Biancolin 229 The System of Racial Discrimination in the Italian Welfare State Fabio Perocco 261 Anti-Immigrant Racism Within the Brazilian Welfare State and the Expulsion of Cuban Doctors Patricia Villen 299 Japanese Welfare State and Racism: Is the Myth of Social Homogeneity Overshadowing Discrimination Patterns on Migrants? Nicola Costalunga Index 317 345 Notes on Contributors Akers Chacón Justin is an activist, labour unionist and educator living in the San Diego-Tijuana border region between the US and Mexico. He is a Professor of Chicana/o History at San Diego City College. His previous books include No One is Illegal (with M. Davis), Radicals in the Barrio, and The Border Crossed Us: The Case for Opening the US-Mexico Border. Andits Petra is a Hungarian anthropologist. She received her Ph.D. from Monash University, Australia. Her fields of interests include migration, diasporas, social movements, emotions, ethnographic film-making and the Israeli–Palestinian conflict. Recent publications include: “One of my eyes was crying, the other was laughing”: Understanding the ambivalence in the post-1990 Australian–Hungarian homeland discourses (2021); Decay, dirt and backwardness (2020); Framing mosque-opposition in Catalonia (2019), Dangerous Black sexualities: African Asylum-seekers and the Israeli Ethno-sexual Hysteria (2018). Biancolin Diego Alberto is a Ph.D. candidate at the North-western Italian Philosophy Consortium. His research interests revolve around Marxian and Marxist thought, which are at the core of his articles. Her Ph.D. research focuses on the diachronic reconstruction of the role played by Machiavelli’s thought within Antonio Gramsci’s theoretical production. xv xvi NOTES ON CONTRIBUTORS Bihr Alain is Honorary Professor of Sociology at the University of Bourgogne-Franche-Comté. His works were upon social classes, inequalities between men and women, far right extremism, neoliberal politics and history of capitalism. His last publications are: Le système des inégalités (2021, with R. Pfefferkorn); Thomas Piketty, une critique illusoire du capital (2020, with M. Husson); Le premier âge du capitalisme 1415–1763 (2018–2019, three volumes); La novlangue néolibérale. La rhétorique du fétichisme capitaliste (2017). Costalunga Nicola is a Ph.D. candidate in Global Studies at the University of Macerata. His research interests are focused on labour market, political economy and immigration in Japan, in comparison with Italy. In 2019–2020 he was selected to participate in the Japan Foundation’s Program for Specialists in Cultural and Academic Fields, Ōsaka. Recent publication: “Entry denied: Japan’s border restrictions in the time of the Covid-19 emergency”, Two Homelands (2021). Gille Christoph is substitute professor for theories of social work at the University of Applied Sciences in Koblenz, Germany. His main areas of interests are transformation of the welfare state, (un)employment, lowthreshold organizations and inter- and transnational aspects of social work. Recent research examines the influences of the far-right on social work in Germany. Jefferys Steve is Emeritus Professor, London Metropolitan University, who graduated from the LSE in 1968. After working in a Scottish car factory and as a journalist, his first academic job was in Manchester in 1984. Appointed Research Professor at the London Metropolitan University in 2000, he directed its Working Lives Research Institute until 2015, leading several European research projects on racism in the workplace. Books include Liberté, Egalité and Fraternité at Work: Changing French Employment Relations and Management; Management and Managed: Fifty years of Crisis at Chrysler. Jubany Olga is a social anthropologist, accredited Full Professor, author of several investigations and publications in the fields of identity, migration, gender and social control, from the ethnographic tradition of anthropology. Her current research focuses on asylum processes, hate speech, LGBT-phobia and restorative justice. Doctor by the LSE, she is currently Director of the European Social Research Unit at the Department of Anthropology at the Universitat de Barcelona. Jointly with Saskia NOTES ON CONTRIBUTORS xvii Sassen, she is the editor of the Migration, Diasporas and Citizenship Series of Palgrave Macmillan. Her recent publications include “The Unspoken Legacy of Asylum” in The Wiley Blackwell Companion to Race, Ethnicity, and Nationalism (2020). Kohlschmidt Jonas is a research associate and Ph.D. candidate at the Faculty of Education at the University of Hamburg. Within his general interest in topics like flight, migration and social work his research is concerned specifically with the educational processes of unaccompanied minor refugees in German residential care institutions. Mulinari Diana is Professor in gender studies at the Department of Gender Studies, Lund University, Sweden. Her research is inspired by black feminist traditions and explores gender and the doing of the political from social movements to racist political parties. Recent publications: “«And they cannot teach us how to cycle»: The category of migrant women and Antiracist Feminism in Sweden”, Sociology (2020); Feminisms in the Nordic Region. Neoliberalism, Nationalism and Decolonial Critique (2020, Palgrave, with S. Keskinen and P. Stoltz); “Hegemonic Feminism Revisited: On the Promises of Intersectionality in Times of the Precarisation of Life”, Nordic Journal of Feminist and Gender Research (2020, with P. de los Reyes). Neergaard Anders is Professor in sociology at (REMESO), Linköping University, Sweden. His research focuses on power, inequality, resistance, solidarities and social movements, especially linked to racism and anti-racism, but also class and gender. Recent co-written publications include “Why are care workers from the global south disadvantaged? Inequality and discrimination in Swedish elderly care work”, Ethnic and Racial Studies (2020); “Crisis of Solidarity? Changing Welfare and Migration Regimes in Sweden”, Critical Sociology (2019); “Theorising racism: Exploring the Swedish racial regime”, Nordic Journal of Migration Research (2017); Reimagineering the Nation: Crisis and Social Transformation in 21st Century Sweden (2017, Peter Lang). Ouali Nouria is a sociologist and an associate professor at the Faculty of Philosophy and Social Sciences of the Université Libre de Bruxelles. She is a lecturer at the Institut d’études du Travail of the Université Lumière Lyon 2. Her research is focused on the intersectional analysis of the processes of precariousness, social downgrading and social exclusion of Black, Migrants and Ethnic minorities, on racism and discrimination xviii NOTES ON CONTRIBUTORS and on resistance process of racialized women in Belgium. She published many articles in several national and international scientific journals and chapters in edited volumes. Perocco Fabio is an associate professor of sociology at Ca’ Foscari University of Venice. His research interests are inequalities, migration, racism and transformations of work; on these issues he participated in many international projects. Recent co-written publications include “The Coronavirus crisis and migration” (2021); Visages du racisme contemporain (2021); “The struggles of asylum seekers in Italy” (2021), Didd Al-Islamofobia: Al-Onsoriya Didd Al-Muslimin Fi Oropa Wa Atharuha Al-Ijtim’aiyati (2020, Against Islamophobia: Anti-muslism racism in Europe and its social consequences); “Voluntary work as a new frontier in the precarisation of migrant workers”; Torture and Migration (2019); “Subcontratação e explotação diferenciada dos trabalhadores imigrados” (2019). Rué Alèxia is a social and cultural anthropologist working on bureaucracy, humanitarianism and asylum. Currently a researcher at the European Social Research Unit at the Universitat de Barcelona, she is a doctoral candidate at the Universitat Autònoma de Barcelona. Her Ph.D. research focuses on the management of eligibility in the asylum reception system in Spain through an ethnographic approach to the work of public and humanitarian actors. Her latest publications include “The [dis]order of the Spanish asylum reception system”, in Quest for refuge: Reception responses from the Global North (2020). Villen Patricia, Ph.D. in sociology at Universidade Estadual de Campinas, researcher at Odisseia Abdelmalek Sayad Research Group, University of Montes Claros, Brazil, member of the Karl Polanyi Research Center for Global Social Studies at Corvinus University of Budapest. She published “International Migration to Brazil and Crises of Democracy”, in To democratize or not? Trials and Tribulations in the Post Colonial World (2020); (In)visíveis globais: imigração e trabalho no Brasil (2018), Amílcar Cabral e a crítica ao colonialismo (2013). List of Figures Fig. 3.1 Fig. 4.1 Fig. 4.2 Fig. 4.3 Fig. 9.1 Fig. 9.2 Fig. 9.3 Fig. 9.4 Share of social security and social assistance beneficiaries of 25–64 years old by nationality of origin among inactive population in 2016 (%) (Source Datawarehouse marché du travail et protection sociale, BCSS. SPF ETCS. Monitoring socioéconomique 2019. https://emploi.bel gique.be/fr/statistiques) The ‘Nordic model’ as a registered trademark of SAMAK Election poster, 1985: ‘I vote for the Social-Democrats because I want the economy to be in order’ Election poster, 2018: ‘We safeguard Sweden’s security: The Swedish model must be developed, not phased out’ Immigration as one of the UK’s most important political issues, 1997–2021 (Source Ipsos MORI [2021], Chart p. 11) Net migration to the UK before and after the 2016 Referendum, 2010–2020 (Source ONS [2020a]. Figure 2) Age-standardised COVID-19 Deaths among men and boys aged 9 and over per 100,000 by ethnicity, England and Wales, March 2 to July 28, 2020 (Source White & Ayoubkhani, 2020: Figure 1) COVID-19 Hazard Ratios for ethnic minority compared to White male mortality, after accounting for Age, Geography, Socio-Economic and Health Status, England, March 2–July 28, 2020 (Source White & Ayoubkhani, 2020: Figures 1 and 2) 72 101 103 109 211 212 216 218 xix xx LIST OF FIGURES Fig. 13.1 History of social security in Japan. Population and social security in Japan, 2019 (Source National Institute of Population and Social Security Research [IPSS], 2019 [https://www.ipss.go.jp/s-info/e/pssj/pssj2019.pdf]) 334 List of Tables Table 3.1 Table 9.1 Table 9.2 Minimum guaranteed income by nationality 2006–2019 Age-standardised COVID-19 Deaths per 100,000 by ethnicity and gender, England & Wales, Men and Women aged 9 and over, March 2 to July 28 2020 Raised rates of COVID-19 mortality remain for both males and females of five ethnic groups in England compared to the White ethnic group after taking into account age, demographic, socio-economic and health-related factors 65 215 219 xxi