Sociology of health & illness最新文献

This paper articulates a sociological approach to bodies that function differently after birth. We suggest that post-birth bodies are distributed across a variety of areas of existing scholarship and that this can make it difficult to grapple with experiences that encompass gestation, altered functioning/injury, parenting and medical knowledge. We review and synthesise this rich literature to illustrate how it can be mobilised to sociologically theorise and explore physical recovery from birth, characterising this as the development of sociological care for such bodies. Our analysis draws on autoethnographic reflection on the post-birth body of a cis/queer/neurodivergent/white/middle-class mother alongside four pilot interviews concerning experiences with post-birth bodies in England. By placing these lived experiences into thematic dialogue with existing feminist/STS and sociological scholarship we illustrate why bodies altered through birth are good for sociologists to think with and outline potential avenues for future research in this field. We suggest that a focus on care for post-birth bodies enables critical exploration of assumptions about temporal relations between pregnancy, birth and mothering/parenting, as well as how these forms of labour are socially distributed and supported.

The paper discusses the role of the interaction between parents and healthcare professionals in overcoming or heightening childhood vaccine hesitancy. Childhood vaccine hesitancy is seen as a set of attitudes and behaviours-that is, dispositions-that are highly dependent on how trust and vulnerability intersect during vaccination appointments. Drawing on a rapid team ethnography conducted in the Northwest of Italy, we discuss how parents' trust in vaccination changes along specific trajectories, depending on how healthcare professionals manage epistemic conflicts with hesitant parents. We employ the concept of interactional trust to show how trust can be eroded or restored during specific interactions, regardless of the initial trust capital. Healthcare professionals' discursive and interactive strategies during inoculation can have long-term effects on parents' interpersonal trust and institutional trust in both immunisation and in the healthcare system. If parents and healthcare professionals fail to embrace their reciprocal vulnerability, the trust building system is flawed.

The end of life is replete with relational complexities. Yet, despite the work of humanities and social science scholars in the field of death and dying, our final days and weeks are still often framed through a highly individualistic lens. As a result, the collective encounters of dying can become sidelined within the management of an individual's embodied journey. This, in some cases, has the effect of obscuring the presence and power of collective affective intensities in shaping the experience of dying. In this paper, we seek to recentre dying as a collective encounter, drawing on the experiences of people receiving care at a palliative care unit in the last few weeks or days of their life, and exploring three key affective tensions: proximity and distance, obligation and negation and acceptance and refusal. This relational framing of dying as tussle and tension allows us to comprehend the inevitable push-and-pull between the multiple bodies, subjects and (shifting) atmospheres of dying which evade atomistic, individualistic configurations of dying, often perpetuated by its medical management.

Encounters with stigma in healthcare settings are well-documented. In recent years, significant attention has begun to be paid to how we can reduce these stigmas, including through the identification and reformation of structural forces that shape and sustain them. This article analyses 30 interviews conducted with clinical and nonclinical healthcare workers, as part of a larger project that aims to reduce health-related stigma for all. A major theme running through the interviews was the constitutive role of medical records in the production of stigma. Interview participants expressed several concerns about the ways such records can produce and reproduce stigma associated with numerous health conditions, identities, and practices. We examine how the very process of producing medical records can be implicated in stigma. We ask, how do systems shape data production, reproduction, access and dissemination? To what extent might processes and systems help to generate, maintain or exacerbate stigma through the demands of medical record keeping, and are reforms needed at these levels too? In addressing these questions, we work with Latour's notion of affordances to examine medical records as a technology that can reflect and reproduce social and political arrangements, including stigma. We argue that institutions and structures responsible for the governance of these systems need to contend with the important entanglements between medical record systems and stigma. We conclude with recommendations for how policymakers, health service leaders and researchers might intervene in the production of stigma afforded by these forms of communication.

We propose a sociological approach to healthcare robots that emphasises the heterogeneous ethics of mutual labour and the complex definitions of care that emerge through robot design/deployment. This argument is the product of a narrative literature review that examined assistive robots deployed in care settings. We found that although the deployment of healthcare robots has redefined the concept of care, as featured in geography, legal studies, and philosophy, it rarely appears in sociological inquiry. There are three fields that this approach to a sociology of health and illness complements. These are (1) phenomenology and the new approaches to touch and recognition in embodied relations with robots, (2) biopolitics, where the governance of life is conceptualised as a conjunction between the biological and artificial and (3) the reconfiguration of healthcare labour around mutuality, where robots both maintain and are maintained by the human. We end by suggesting that the increased implementation of robotics into care work provides a broader sociological opportunity for addressing how boundaries of 'human' can be rethought alongside new healthcare technologies.

Scholars in the field of social studies of reproduction have recently turned their attention to the booming cross-border reproductive industry. In the case of gay men seeking donor ova and surrogacy to become fathers, there are issues of uneven accessibility and disparity between privileged intended gay fathers and comparatively less affluent women who offer reproductive labour. Despite being the first country in Asia to legalise same-sex marriage, Taiwan still holds back on LGBTQ+ reproductive rights. This compels intended queer parents to travel abroad for assisted reproduction. This article draws on 53 in-depth interviews with Taiwanese gay men seeking transnational surrogacy. Adopting a Bourdieusian perspective, I examine how they 'bargained with' economic, social, cultural and symbolic capital to achieve reproductive goals at the intersections of sexuality, nationality, race and sociolegal constraints. When it comes to multilayered stratified reproduction, my findings highlight disparities between (1) heterosexuals and LGBTQ+ people, (2) intended gay fathers and (3) gay fathers and surrogates. This article enriches our understanding of stratified reproduction, transnational surrogacy and queer reproductive justice by introducing the concept of 'reproductive capital' that was strategically accumulated and mobilised by gay fathers in order to navigate the complex multilayered reproductive stratifications in transnational reproduction.

How do online communities impact men's health? How does hegemonic masculinity harm men's health? In this paper, we analyse an online looksmaxxing community that receives 6 million unique visitors per month and is aimed at men seeking to improve their appearance. We qualitatively analysed 8072 discussion board comments in total. Our findings first demonstrate how users apply a hegemonic masculine gaze as they critique men's bodies (e.g., facial asymmetries and brow ridges). Second, we show how the community encourages men to substantially alter their bodies (e.g., with leg lengthening surgeries or by mewing). Third, we argue that the community subjects users to masculine demoralisation, wherein they are seen as failed men and encouraged to self-harm. Drawing on masculinities theory, we argue that looksmaxxing and similar self-improvement communities harm the health of the men who participate in them.

Age- and dementia-friendliness are major areas of contemporary urban policy and scholarship, seeking to maintain older people and those with cognitive impairment in their own homes and communities. Such work relies on architectural augmentation to maximise the functionality of ageing bodies and minds and has been criticised for conceptualising place as a static unidirectional determinant of individual disability. New materialist scholarship on place, ageing and disability is challenging such conceptions, theorising people and places as dynamically co-constituting socio-material ecologies that co-age and co-dis/enable. Moreover, a critical tradition is resituating dementia-friendliness in the materialising capacities of political economy in everyday public living with dementia. Building on that work, this paper reports on a yearlong creative go-along ethnography conducted with eight passengers with dementia on public transport in Greater Manchester, UK. Through interviewing, multimedia generation and map-making, their stories highlight unequal materialisations of (im)mobilities in relation to the fractious political economies of urban infrastructures in the all-ageing metropolis.

This paper examines the micro-processes of jurisdictional change in the eco-systems of healthcare work. This qualitative study investigated the expansion of geriatrician involvement in the perioperative pathway for older people. This study shows how, in response to opposition from surgeons and anaesthetists, geriatricians developed linked strategies that involved claiming the medical needs of surgical patients, and simultaneously integrating geriatric expertise into the non-surgical peripheries of the pathway. By progressively demonstrating their ability to mitigate risks and improve surgical outcomes, geriatricians acquired an expanded role in the care pathway. This paper develops the concepts of 'demonstrable claims' and 'jurisdictional clipping' to explain the strategies of jurisdictional expansion. It also problematises these strategies by suggesting that role expansion was controlled and contained by more powerful incumbent groups, whereby the expansion of work was limited to temporal and spatial peripheries that were less valued by surgeons or anaesthetists.

This article examines leisure time physical activity (LTPA) for middle-class women as relational, intricately linked with societal understandings of personal responsibility to work, to family and to health and entangled with the emotion management of 'successful' middle-class womanhood. We focus on middle-class Danish women who engage in routinised participation in LTPA. We illuminate through our qualitative study how emotional reflexivity involves dispersed practices that are entangled with this lifelong physical activity and how these entangled, mutually evolving practices enable women to dutifully enact 'successful' womanhood, in line with contemporary ideals. First, emotional reflexivity during LTPA represents a habituated way to handle the routine pressures of everyday working and caring, enacted through practices of switching off and working through. Second, women are better able to manage their emotions during challenging everyday situations because of their routinised LTPA that both still emotions and enables engagement with them. Particularly, exercising in nature strengthens the women's capacity for emotion management. Emotional reflexivity practices become part of the LTPA practice template. Lifelong LTPA enables busy middle-class women to succeed at, and sustain, overwhelming and unrealistic caring and working practice performances that meet neoliberal ideals.