'Live Beautiful, Live Well' ('Vivir Bonito, Vivir Bien') in Nicaragua: Environmental health citizenship in a post-neoliberal context

The concepts Vivir Bien and Buen Vivir, often translated as 'living well' or 'collective well-being,' are central to contemporary social medicine reforms in Latin America. Owing to increasing social inequalities, notably in the public healthcare sector, Vivir Bien has regional significance as it redefines the neoliberal development goals from economic improvement to so-called post-neoliberal social goals of harmonious co-existence between society and the physical environment. To examine how this abstract concept is conceptualised, is incorporated into, and shapes state-sponsored public health strategies, I analyze the 'Vivir Limpio, Vivir Sano, Vivir Bonito, Vivir Bien ... !' ('Live Clean, Live Healthy, Live Beautiful, Live Well ... !') national campaign in Nicaragua that began in 2013. The campaign promotes normative socio-political ideals around environmental health citizenship, including the adoption of indigenous grammars and solidarity. However, analyses of dozens of interviews and 143 household surveys in four historically impoverished, untidy, and unhygienic communities suggest that the campaign's discourses do not resonate with citizens or their socio-economic contexts. In highlighting discrepancies between state-sponsored normative sociopolitical ideals and citizens' lived realities and perspectives, this paper introduces the term 'post-neoliberal citizenship' to reflect contemporary - and changing - conceptualizations of health, wellbeing, and citizenship in post-neoliberal Latin America.