Sociology of health & illness最新文献

This paper intervenes in the dichotomous debate on the 'privatisation' of the UK's National Health Service (NHS). Whilst research suggests that involving private-sector actors and principles deviates from the founding aims of the NHS to deliver equitable healthcare for all, the opposing argument to 'keep our NHS public' also limits understanding and alternative possibilities. Through focusing on maintaining overarching structures, these campaigns fail to address everyday medical practices that have long been critiqued by those allied with the sociology of health and illness. This paper draws on feminist critiques of public/private to expand the structural economic lens of mainstream political debates and explore how multiple forms of economic, social, cultural, and symbolic capital, operate in everyday healthcare practices. Through an historically-informed ethnographic exploration of routine hip replacements, I find that capital itself emerges through relations between people and things, and that public/private boundaries play an integral role in forming these relations to instil value on particular patients and forms of labour, demarcating what kind of healthcare is given to whom. I therefore suggest future action should focus on assembling healthcare relations beyond the dualism of public/private categories, to create multiple safe places and relations for all.

This study investigates how a lack of social support differentially affects men and women's colorectal cancer (CRC) screening participation, considering different screening strategies implemented across European countries. Although health sociology has stressed gender differences in social support and its effects on health behaviours, this was overlooked by cancer screening research. Using a data set of 65,961 women and 55,602 men in 31 European countries, we analysed the effect of social support variables on CRC screening uptake. We found that living alone and lower perceived social support were associated with lower screening uptake for both men and women. These effects were, however, stronger among men. Population-based screening programmes mitigated these effects, particularly for women, but not for men living alone. In countries with opportunistic screening programmes, social support variables remained associated with screening uptake. We conclude that cancer screening interventions should pay attention to social support and its gender-differentiated effects.

Schools are increasingly positioned as sites for intervening on the bodies and minds of children in the here and now in order to bring about health gain for the future. Public health interventions for schools bring together coalitions of commercial, statutory and philanthropic actors with children and their teachers and carers. Drawing on ethnographic case studies in London, UK, this paper explores two such interventions: one aiming to increase levels of physical activity and one to reduce exposure to air pollution. Both interventions not only evoke care for children's own current and future wellbeing but also fold in imaginaries of collective health futures, which orient and legitimise particular intervention logics and actions. As interventions unfold, children are recruited as monitors of health risks in the present. They are also positioned as risk ambassadors, who will leverage care about unhealthy environments and lifestyles across space, to risky domestic environments, and into imagined health futures. These 'futuring' school-based interventions open up small alternative spaces in which imaginaries of collective and resistant public health practices emerge. However, in the here and now, children appear to be bearing a disproportionate burden of responsibility, as ambassadors for, and imagined saviours of, public and environmental health.

Diagnostic encounters can be seen as complex socio-material processes. Drawing on the new materialist ideas of Barad, we studied how an innovative technology became part of the intra-actions between different human and non-human materialities in a cervical cancer diagnostic process. While researching the development of a technology intended to improve cervical cancer detection, we carried out a series of observations of diagnostic encounters involving clinicians, patients and the device in a hospital. The intra-actions between the different materialities had rhythmic properties, repeated activities and timings that varied in intensity, for example, movements, exchanged looks, and talk that helped co-produce the diagnosis and maintain consent. Sadly, the device interfered with the rhythms, undermining the clinicians' desire to adopt it, despite it being more accurate at diagnosing ill health than previous assistive technologies. Studying rhythms as part of diagnostic encounters could help with the design and subsequent integration of novel technologies in healthcare, because they encompass relationships created by human and non-human materialities. Importantly, highlighting the role of rhythms contributes another way diagnostic encounters are co-produced between clinicians and patients, and how they can be disrupted, improving the understanding of how consent is maintained or lost.

While previous research studies have focused on either caregivers' or residents' perception and use of social robots, this article offers an empirical and theoretical examination of joint activities in triadic human-robot interaction. The symptomatology of dementia creates an asymmetrical relation wherein the impetus to employ a robot often originates from the caregiver. Drawing on field work and video recorded interactions in dementia care homes, the article investigates how caregivers draw on embodied resources to involve residents and robot animals in interaction. The analysis demonstrates how caregivers promote commitment and encounter resistance with residents. We draw on the theory of sociomaterial interactionism to study situated interaction between bodies in a meaning-generating process. By re-conceptualising the theoretical notions of manipulation and recruitment, the article offers an approach for studying orientations that distinguish between reciprocity of agential objects. We show that caregivers usually distinguish between interactions with people and machines by anticipating a specific response from the robots (manipulation), while they invite participation in a broader sense from residents (recruitment). Social friction arises, however, if caregivers act upon the residents as embodied objects in manipulative ways.

Health and illness identities have been presented as important for the experience of health and illness, and they are a widespread research interest. However, these identities are conceptualised in many different ways. This conceptual diversity calls for us to take stock of existing understandings of health and illness identities to provide conceptual clarity and reliability. The study performs an integrative review of these understandings in scientific articles identified through the databases PsychInfo, Pubmed and Scopus. The final sample consists of 64 articles, on which a thematic analysis has been performed. Health and illness identities are regarded as constructed and can be understood in terms of being, acting and judging, answering the questions 'Who are you, with regard to health/illness?', 'How do you deal with health/illness?' and 'How are people judged by their health/illness?', respectively. The terms health identity and illness identity are understood in varied, not necessarily compatible ways, and need to be applied carefully. Health identity concepts appear to be less well established and based upon a more varied theoretical background, while illness identity concepts appear to be more well established and usually relate to a (bio-)medical context. A potential understanding of health identity for medical sociology is suggested.

Over recent decades, sickness absence due to common mental disorders has increased among young workers. The phenomenon is mostly understood on the basis of epidemiological research, and knowledge regarding the viewpoints of young workers themselves is lacking. Our study explored the explanations for mental health-related sickness absence in the narrative accounts of young workers in high-risk health and social care occupations. Semi-structured narrative interviews were conducted with 23 Finnish young workers (aged 21-34), with self-reported sickness absence related to common mental disorders over the previous year. Our analysis identified three narrative explanations for the onset of mental health problems leading to sick leave: work as the sole cause, work as an additional cause and work as a trigger. These findings indicate that mental health-related sickness absences form a complex phenomenon related to various life and work-related circumstances. More comprehensive preventive measures are needed in the health and social care sector to help tackle mental health problems among young workers.

Exoskeletal devices are new technologies that have been developed in the medical field to provide assistance and rehabilitation for persons with motor impairments. Among these impairments, spinal cord injury and stroke are the most common. Drawing on materials collected during multi-sited ethnography conducted in France, Germany and Switzerland from 2014 to 2019, I suggest that exoskeletons contribute to a more general process that I identify as 'aiming at the "proper" body'. As they materially craft motor impaired bodies but also are responsible for datafication and dataveillance, exoskeletons allow to categorise new aspects of 'risky' bodies. Simultaneously, they foster conflicts between experts' perspectives about rehabilitation practice and the users' phenomenological experiences that exoskeletons aim to transform. After describing how exoskeletons expand the realm of contemporary medical technologies in their purpose of 'aiming at "proper" bodies' while being 'miraculous', I identify two conceptions of 'risky' bodies: a first one related to materiality, a second one to processes of digitalisation to which exoskeletons actively participate. Finally, I investigate some conflicting levels between the regimes of expert knowledge and the phenomenological experiences of the users and reassess the latter's role in rehabilitation practice with exoskeletons.

The engagement between markets and cultural hegemonies is shaped by the politics that promote or deny the emergence of fresh legitimations in response to the opportunities offered to consumers by new commodities. In the case of Islam and the assisted reproductive technology (ART) market, core cultural values concerning procreation, family and lineage come into direct conflict with the potential consumer demand generated by new ART technologies. Shaped by the character of multiple Islamic modernities and the authority structures of religion and state, it is the Shi'a-Sunni divide which most illuminates the politics of emergence driving the different Islamic responses to those cultural tensions. In Sunni states the hegemonic challenge of the ART commodity market is contained by the senior clerics, the traditional intellectuals of Islamic authority, often acting in concert with the state apparatus. In contrast, in Shi'a states the flexibility of its religious authority structures underpinned by the principles of ijtihad allows the formation of an alliance between traditional and medical organic intellectuals which facilitates the consumer choice of both ART commodities and legitimating values. However, what remains unresolved is the long-term impact of that trasformismo on the stability of the social structures which the Shi'a moral economy serves.