Pub Date : 2022-03-14DOI: 10.1080/09581596.2022.2048632
E. Garnett, Angeliki Balayannis, S. Hinchliffe, T. Davies, T. Gladding, Phillip Nicholson
ABSTRACT Waste has become a pivotal public health and environmental problem during the COVID-19 pandemic. In this interdisciplinary review, we move beyond the ‘coronalitter’ and ‘coronawaste’ discourses, which have come to dominate public imaginaries of waste, to consider less-visible dimensions of waste infrastructures and systems . We demonstrate how waste is coming to matter in new ways that offer opportunities for reconfiguring health research. By examining the literature addressing the impacts of COVID-19 on the geographies of waste, we shed light on how waste is being problematised and researched through logics of public, environmental, and occupational health. We argue that these logics structure understandings and practice, whilst drawing attention to the overlaps and limits that allow links across disciplinary silos and problem domains to be forged. Developing a multi-logics approach, the paper outlines a research agenda for approaching waste as a critical public health problem at a time of intersecting health crises.
{"title":"The work of waste during COVID-19: logics of public, environmental, and occupational health","authors":"E. Garnett, Angeliki Balayannis, S. Hinchliffe, T. Davies, T. Gladding, Phillip Nicholson","doi":"10.1080/09581596.2022.2048632","DOIUrl":"https://doi.org/10.1080/09581596.2022.2048632","url":null,"abstract":"ABSTRACT Waste has become a pivotal public health and environmental problem during the COVID-19 pandemic. In this interdisciplinary review, we move beyond the ‘coronalitter’ and ‘coronawaste’ discourses, which have come to dominate public imaginaries of waste, to consider less-visible dimensions of waste infrastructures and systems . We demonstrate how waste is coming to matter in new ways that offer opportunities for reconfiguring health research. By examining the literature addressing the impacts of COVID-19 on the geographies of waste, we shed light on how waste is being problematised and researched through logics of public, environmental, and occupational health. We argue that these logics structure understandings and practice, whilst drawing attention to the overlaps and limits that allow links across disciplinary silos and problem domains to be forged. Developing a multi-logics approach, the paper outlines a research agenda for approaching waste as a critical public health problem at a time of intersecting health crises.","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":"32 1","pages":"630 - 640"},"PeriodicalIF":2.8,"publicationDate":"2022-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44013595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-11DOI: 10.1080/09581596.2022.2050184
S. Paine, Rhiannon Walker, Arier C. Lee, T. Signal
ABSTRACT Experiences of major, stressful life events (SLE) prior to and during pregnancy, and in early childhood, are associated with a range of adverse outcomes that disproportionately impact Indigenous women and their families. However, little is known about Indigenous women's experiences of SLE . The aim of this study was to investigate: (1) inequities in the prevalence and patterning of SLE between Indigenous and non-Indigenous mothers over time, and; (2) associations between maternal SLE and ethnicity, age, socioeconomic deprivation and time. Data were from the Moe Kura prospective cohort study of 418 Indigenous Māori and 768 non-Māori women in New Zealand. Questionnaires were completed at 35–37 weeks gestation, 12-weeks postpartum, and when their child was 3–4 years of age. The prevalence of five SLE domains was estimated by ethnicity. Generalised linear mixed effects models examined associations between SLE domains and ethnicity, age, socioeconomic deprivation, and time. The prevalence of SLE was greater for Māori than non-Māori at each time point. The probability of reporting SLE increased as neighbourhood deprivation worsened. The probability of reporting SLE reduced with older age, although changes in the estimates were greater for non-Māori than Māori women. Findings show that Indigenous women experience persistent and significant inequities in SLE. Younger maternal age and greater socioeconomic deprivation explain some but not all of the inequities observed. Policies and interventions to address how colonialism and racism structure experiences of SLE for Indigenous women, including via socioeconomic deprivation, are required.
{"title":"Inequities in maternal stressful life events between Indigenous and non-Indigenous women – evidence from a prospective cohort study in New Zealand","authors":"S. Paine, Rhiannon Walker, Arier C. Lee, T. Signal","doi":"10.1080/09581596.2022.2050184","DOIUrl":"https://doi.org/10.1080/09581596.2022.2050184","url":null,"abstract":"ABSTRACT Experiences of major, stressful life events (SLE) prior to and during pregnancy, and in early childhood, are associated with a range of adverse outcomes that disproportionately impact Indigenous women and their families. However, little is known about Indigenous women's experiences of SLE . The aim of this study was to investigate: (1) inequities in the prevalence and patterning of SLE between Indigenous and non-Indigenous mothers over time, and; (2) associations between maternal SLE and ethnicity, age, socioeconomic deprivation and time. Data were from the Moe Kura prospective cohort study of 418 Indigenous Māori and 768 non-Māori women in New Zealand. Questionnaires were completed at 35–37 weeks gestation, 12-weeks postpartum, and when their child was 3–4 years of age. The prevalence of five SLE domains was estimated by ethnicity. Generalised linear mixed effects models examined associations between SLE domains and ethnicity, age, socioeconomic deprivation, and time. The prevalence of SLE was greater for Māori than non-Māori at each time point. The probability of reporting SLE increased as neighbourhood deprivation worsened. The probability of reporting SLE reduced with older age, although changes in the estimates were greater for non-Māori than Māori women. Findings show that Indigenous women experience persistent and significant inequities in SLE. Younger maternal age and greater socioeconomic deprivation explain some but not all of the inequities observed. Policies and interventions to address how colonialism and racism structure experiences of SLE for Indigenous women, including via socioeconomic deprivation, are required.","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":"33 1","pages":"207 - 217"},"PeriodicalIF":2.8,"publicationDate":"2022-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45451958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-07DOI: 10.1038/s41419-022-04653-8
Qiang Zhang, Dimitrios-Ilias Balourdas, Bruno Baron, Alon Senitzki, Tali E Haran, Klas G Wiman, Thierry Soussi, Andreas C Joerger
The extremophile Alvinella pompejana, an annelid worm living on the edge of hydrothermal vents in the Pacific Ocean, is an excellent model system for studying factors that govern protein stability. Low intrinsic stability is a crucial factor for the susceptibility of the transcription factor p53 to inactivating mutations in human cancer. Understanding its molecular basis may facilitate the design of novel therapeutic strategies targeting mutant p53. By analyzing expressed sequence tag (EST) data, we discovered a p53 family gene in A. pompejana. Protein crystallography and biophysical studies showed that it has a p53/p63-like DNA-binding domain (DBD) that is more thermostable than all vertebrate p53 DBDs tested so far, but not as stable as that of human p63. We also identified features associated with its increased thermostability. In addition, the A. pompejana homolog shares DNA-binding properties with human p53 family DBDs, despite its evolutionary distance, consistent with a potential role in maintaining genome integrity. Through extensive structural and phylogenetic analyses, we could further trace key evolutionary events that shaped the structure, stability, and function of the p53 family DBD over time, leading to a potent but vulnerable tumor suppressor in humans.
{"title":"Evolutionary history of the p53 family DNA-binding domain: insights from an Alvinella pompejana homolog.","authors":"Qiang Zhang, Dimitrios-Ilias Balourdas, Bruno Baron, Alon Senitzki, Tali E Haran, Klas G Wiman, Thierry Soussi, Andreas C Joerger","doi":"10.1038/s41419-022-04653-8","DOIUrl":"10.1038/s41419-022-04653-8","url":null,"abstract":"<p><p>The extremophile Alvinella pompejana, an annelid worm living on the edge of hydrothermal vents in the Pacific Ocean, is an excellent model system for studying factors that govern protein stability. Low intrinsic stability is a crucial factor for the susceptibility of the transcription factor p53 to inactivating mutations in human cancer. Understanding its molecular basis may facilitate the design of novel therapeutic strategies targeting mutant p53. By analyzing expressed sequence tag (EST) data, we discovered a p53 family gene in A. pompejana. Protein crystallography and biophysical studies showed that it has a p53/p63-like DNA-binding domain (DBD) that is more thermostable than all vertebrate p53 DBDs tested so far, but not as stable as that of human p63. We also identified features associated with its increased thermostability. In addition, the A. pompejana homolog shares DNA-binding properties with human p53 family DBDs, despite its evolutionary distance, consistent with a potential role in maintaining genome integrity. Through extensive structural and phylogenetic analyses, we could further trace key evolutionary events that shaped the structure, stability, and function of the p53 family DBD over time, leading to a potent but vulnerable tumor suppressor in humans.</p>","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":"24 1","pages":"214"},"PeriodicalIF":9.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8901663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81594325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-02DOI: 10.1080/09581596.2022.2046705
Sophie A. Lewis, K. Willis, Marika Franklin, L. Smith
ABSTRACT Chronic health conditions represent a key challenge for contemporary public healthcare. Current policy promotes self-management support to reduce demands on health services and improve patients’ health and wellbeing. Though there is emerging recognition that self-management is achieved in collaboration between health professionals and patients, how chronicity is managed in interaction remains relatively underexplored in research. In this paper we report on research examining how people are supported to self-manage their conditions through their healthcare encounters. We draw on observational data from consultations between people with multiple chronic health conditions and their healthcare professionals, and semi-structured interviews with both patients and professionals about these consultations. We illuminate points of disconnect between patients and health professionals and demonstrate how these disconnects unfold in self-management support interactions. We argue that self-management is temporally and socially situated, incorporating past, present and (anticipated) future experiences. However, there is a disjuncture between the temporal logics of self-management enacted by health professionals and the subjective temporalities of people’s lived experience of chronicity. Health professionals focus on patients progressing toward optimistic futures but give less attention to the complexities of patient life histories that render self-management more difficult. For self-management support to be effective, we argue that health professionals need to consider the complexities of people’s life histories and how these shape imagined futures. Policy guidelines, we argue, should attend to how relations between patients and professionals shape self-management support, and the historical and social factors that shape experiences of living with chronic conditions.
{"title":"Challenging times: disconnects between patient and professional temporalities in chronic condition management","authors":"Sophie A. Lewis, K. Willis, Marika Franklin, L. Smith","doi":"10.1080/09581596.2022.2046705","DOIUrl":"https://doi.org/10.1080/09581596.2022.2046705","url":null,"abstract":"ABSTRACT Chronic health conditions represent a key challenge for contemporary public healthcare. Current policy promotes self-management support to reduce demands on health services and improve patients’ health and wellbeing. Though there is emerging recognition that self-management is achieved in collaboration between health professionals and patients, how chronicity is managed in interaction remains relatively underexplored in research. In this paper we report on research examining how people are supported to self-manage their conditions through their healthcare encounters. We draw on observational data from consultations between people with multiple chronic health conditions and their healthcare professionals, and semi-structured interviews with both patients and professionals about these consultations. We illuminate points of disconnect between patients and health professionals and demonstrate how these disconnects unfold in self-management support interactions. We argue that self-management is temporally and socially situated, incorporating past, present and (anticipated) future experiences. However, there is a disjuncture between the temporal logics of self-management enacted by health professionals and the subjective temporalities of people’s lived experience of chronicity. Health professionals focus on patients progressing toward optimistic futures but give less attention to the complexities of patient life histories that render self-management more difficult. For self-management support to be effective, we argue that health professionals need to consider the complexities of people’s life histories and how these shape imagined futures. Policy guidelines, we argue, should attend to how relations between patients and professionals shape self-management support, and the historical and social factors that shape experiences of living with chronic conditions.","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":"32 1","pages":"438 - 449"},"PeriodicalIF":2.8,"publicationDate":"2022-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46051545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-11DOI: 10.1080/09581596.2022.2039379
Wanda Spahl, M. Pot, K. Paul
ABSTRACT In some countries, far-reaching ‘lockdown’ measures to contain the spread of coronavirus were implemented early in 2020. In Austria, these early measures were met with a high degree of compliance among the country’s population. In this paper, we draw upon qualitative interviews, and ask how people made sense of the restrictions imposed during the first lockdown in April 2020 and what shaped their compliance. Empirical research has so far tried to explain compliance by means of people’s disposition and motivations as well as demographic and social characteristics. Instead of focussing on who is compliant, we aim to understand how people practice compliance. We do this by approaching compliance through the concepts of values and practice. First, our findings indicate that people assess whether measures are suitable and legitimate in relation to the values of science, the law, and morality. Second, people assign additional personal value to compliance by stressing its positive implications on their own lives. By adopting a nuanced perspective on compliance as inextricably linked to peoples’ values and practices, our paper critically contributes to the political and scholarly discussion of pandemic public health measures. Understanding compliance through the lens of values shows how people make sense of the measures in the context of their everyday lives, helping us to move away from a binary understanding of (non-)compliance that has become morally charged.
{"title":"Understanding compliance as multi-faceted: values and practices during the COVID-19 pandemic in Austria","authors":"Wanda Spahl, M. Pot, K. Paul","doi":"10.1080/09581596.2022.2039379","DOIUrl":"https://doi.org/10.1080/09581596.2022.2039379","url":null,"abstract":"ABSTRACT In some countries, far-reaching ‘lockdown’ measures to contain the spread of coronavirus were implemented early in 2020. In Austria, these early measures were met with a high degree of compliance among the country’s population. In this paper, we draw upon qualitative interviews, and ask how people made sense of the restrictions imposed during the first lockdown in April 2020 and what shaped their compliance. Empirical research has so far tried to explain compliance by means of people’s disposition and motivations as well as demographic and social characteristics. Instead of focussing on who is compliant, we aim to understand how people practice compliance. We do this by approaching compliance through the concepts of values and practice. First, our findings indicate that people assess whether measures are suitable and legitimate in relation to the values of science, the law, and morality. Second, people assign additional personal value to compliance by stressing its positive implications on their own lives. By adopting a nuanced perspective on compliance as inextricably linked to peoples’ values and practices, our paper critically contributes to the political and scholarly discussion of pandemic public health measures. Understanding compliance through the lens of values shows how people make sense of the measures in the context of their everyday lives, helping us to move away from a binary understanding of (non-)compliance that has become morally charged.","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":"32 1","pages":"665 - 676"},"PeriodicalIF":2.8,"publicationDate":"2022-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49439402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-08DOI: 10.1080/09581596.2021.1937525
S. Agergaard, A. B. Jakobsen, L. Mortensen, K. Ryom
ABSTRACT Increasingly restrictive immigration policies and political attention to newcomers’ civic integration currently intersect with the individualisation of the responsibility for health care and health promotion in Western societies. We aim to examine how such policies shape women newcomers’ perceptions of health and experiences of civic health promoting activities in the first years after granted asylum and temporary residence permit in Denmark. Drawing on conceptualisations of healthism as a super-value for the individual in Western societies, we analyse 29–50 year old Syrian women newcomers’ experiences of meeting an all-encompassing and individualised concept of health that is promoted by various societal institutions in Denmark (including schools and leisure sites). While the women describe their everyday lives in Syria as unconsciously healthy, in the receiving context, they came to appear as consciously unhealthy. Further through individual and focus group interviews, the women characterise white Danish women as a healthy and active group, while describing themselves as the ‘unhealthy others’. The Syrian women take on feelings of blame and individual responsibility for promoting their health, despite also describing a number of structural barriers for their healthy and active living. However, the Syrian women newcomers also deliver an implicit critique of the individual quest for health in Western societies and showcase more collective approaches to health care.
{"title":"The quest for health and the unhealthy ‘others’. A critical case study of Syrian women newcomers’ meeting with health promotion and civic integration discourses upon arrival in Denmark","authors":"S. Agergaard, A. B. Jakobsen, L. Mortensen, K. Ryom","doi":"10.1080/09581596.2021.1937525","DOIUrl":"https://doi.org/10.1080/09581596.2021.1937525","url":null,"abstract":"ABSTRACT Increasingly restrictive immigration policies and political attention to newcomers’ civic integration currently intersect with the individualisation of the responsibility for health care and health promotion in Western societies. We aim to examine how such policies shape women newcomers’ perceptions of health and experiences of civic health promoting activities in the first years after granted asylum and temporary residence permit in Denmark. Drawing on conceptualisations of healthism as a super-value for the individual in Western societies, we analyse 29–50 year old Syrian women newcomers’ experiences of meeting an all-encompassing and individualised concept of health that is promoted by various societal institutions in Denmark (including schools and leisure sites). While the women describe their everyday lives in Syria as unconsciously healthy, in the receiving context, they came to appear as consciously unhealthy. Further through individual and focus group interviews, the women characterise white Danish women as a healthy and active group, while describing themselves as the ‘unhealthy others’. The Syrian women take on feelings of blame and individual responsibility for promoting their health, despite also describing a number of structural barriers for their healthy and active living. However, the Syrian women newcomers also deliver an implicit critique of the individual quest for health in Western societies and showcase more collective approaches to health care.","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":"32 1","pages":"725 - 736"},"PeriodicalIF":2.8,"publicationDate":"2022-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46154099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-07DOI: 10.1080/09581596.2022.2031888
Christian Nyemcsok, H. Pitt, P. Kremer, Sa Thomas
ABSTRACT Online wagering has expanded significantly in recent decades and has emerged as a serious public health issue. Research investigating online wagering has predominantly used quantitative methods to explore the determinants that influence young men’s engagement with these products, with fewer qualitative insights. Social practice theory offers a framework in which to qualitatively analyse how online wagering practices are shaped, modified, and evolve. This study explored the online wagering practices of sixteen, 18–24 year old, young men, in Victoria, Australia. In-depth, qualitative interviews explored the contexts and motivations in their early and current wagering practices and the influence of social and structural conditions. Data were interpreted using a reflexive approach to thematic analysis. The data were theoretically conceptualised through a social practice lens, focusing on materials, meanings, and competencies. Materials included social networks and spaces, and wagering infrastructure and marketing. Meanings encompassed peer belongingness and bonding. Perceived competencies included an exaggerated confidence that influenced the type of gambling chosen and perceived spending strategies to achieve financial gain. Importantly, these three elements intersected to form a bundle of wagering practices. Interrupting the interconnection of these bundles may form the basis of public health intervention. Public health research must also continue to monitor how online wagering practices evolve and change in response to a range of interacting determinants and move away from a focus on the individual.
{"title":"Viewing young men’s online wagering through a social practice lens: implications for gambling harm prevention strategies","authors":"Christian Nyemcsok, H. Pitt, P. Kremer, Sa Thomas","doi":"10.1080/09581596.2022.2031888","DOIUrl":"https://doi.org/10.1080/09581596.2022.2031888","url":null,"abstract":"ABSTRACT Online wagering has expanded significantly in recent decades and has emerged as a serious public health issue. Research investigating online wagering has predominantly used quantitative methods to explore the determinants that influence young men’s engagement with these products, with fewer qualitative insights. Social practice theory offers a framework in which to qualitatively analyse how online wagering practices are shaped, modified, and evolve. This study explored the online wagering practices of sixteen, 18–24 year old, young men, in Victoria, Australia. In-depth, qualitative interviews explored the contexts and motivations in their early and current wagering practices and the influence of social and structural conditions. Data were interpreted using a reflexive approach to thematic analysis. The data were theoretically conceptualised through a social practice lens, focusing on materials, meanings, and competencies. Materials included social networks and spaces, and wagering infrastructure and marketing. Meanings encompassed peer belongingness and bonding. Perceived competencies included an exaggerated confidence that influenced the type of gambling chosen and perceived spending strategies to achieve financial gain. Importantly, these three elements intersected to form a bundle of wagering practices. Interrupting the interconnection of these bundles may form the basis of public health intervention. Public health research must also continue to monitor how online wagering practices evolve and change in response to a range of interacting determinants and move away from a focus on the individual.","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":"33 1","pages":"241 - 252"},"PeriodicalIF":2.8,"publicationDate":"2022-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49220904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-07DOI: 10.1080/09581596.2022.2035319
E. Kirby, Katherine Kenny, A. Broom, Z. Lwin
ABSTRACT The landscape of cancer is changing, with earlier detection and the emergence of new treatment options signalling the potential reconfiguration of cancer (for some) as a chronic condition. Cancer is increasingly experienced in terms of chronicity, incorporating both ongoing episodes of acute treatment alongside the long-term management of disease, symptoms, and side effects. This emphasis refocuses attention toward living-with, as well as beyond, cancer. Yet, how cancer chronicity is understood and experienced by both patients and healthcare professionals remains underexplored. While sociological scholarship has critically analysed how chronic illness has been positioned as a problem of/for the person and/or the healthcare system, less attention has been paid to instances like cancer, where chronicity might be viewed as reflective of forms of success (e.g. through the deferral of mortality even in the absence of ‘cure’). In this paper we draw on qualitative interview data from a large study of cancer survivorship including patients, their family carers and health professionals, across two Australian hospitals. We critically analyse the dimensions of chronicity in the cancer sphere, understanding cancer-as-chronicity as producing a particular form of subjectivity, shaped by the everyday management and experience of treatment, impairment, symptoms, and side-effects. We posit that constructions of cancer as chronic, and associated imperatives linked to longevity, commitment, and resilience, are placing new demands on patients, family carers, and professionals alike.
{"title":"Chronicity in/and cancer: a qualitative interview study of health professionals, patients, and family carers","authors":"E. Kirby, Katherine Kenny, A. Broom, Z. Lwin","doi":"10.1080/09581596.2022.2035319","DOIUrl":"https://doi.org/10.1080/09581596.2022.2035319","url":null,"abstract":"ABSTRACT The landscape of cancer is changing, with earlier detection and the emergence of new treatment options signalling the potential reconfiguration of cancer (for some) as a chronic condition. Cancer is increasingly experienced in terms of chronicity, incorporating both ongoing episodes of acute treatment alongside the long-term management of disease, symptoms, and side effects. This emphasis refocuses attention toward living-with, as well as beyond, cancer. Yet, how cancer chronicity is understood and experienced by both patients and healthcare professionals remains underexplored. While sociological scholarship has critically analysed how chronic illness has been positioned as a problem of/for the person and/or the healthcare system, less attention has been paid to instances like cancer, where chronicity might be viewed as reflective of forms of success (e.g. through the deferral of mortality even in the absence of ‘cure’). In this paper we draw on qualitative interview data from a large study of cancer survivorship including patients, their family carers and health professionals, across two Australian hospitals. We critically analyse the dimensions of chronicity in the cancer sphere, understanding cancer-as-chronicity as producing a particular form of subjectivity, shaped by the everyday management and experience of treatment, impairment, symptoms, and side-effects. We posit that constructions of cancer as chronic, and associated imperatives linked to longevity, commitment, and resilience, are placing new demands on patients, family carers, and professionals alike.","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":"32 1","pages":"472 - 484"},"PeriodicalIF":2.8,"publicationDate":"2022-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41416661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-07DOI: 10.1080/09581596.2022.2036701
M. Kelly-Irving, W. P. Ball, C. Bambra, C. Delpierre, R. Dundas, J. Lynch, G. McCartney, Katherine Smith
ABSTRACT Persistent health inequalities pose a challenge to researchers and policymakers. Decades of research have illuminated mechanisms that underlie health inequalities, now we must move beyond these observations to enable policies that can reduce them. In this paper, we highlight tensions in the field of health inequalities research regarding the relationship between social determinants and health outcomes, and the effectiveness of welfare policies. We draw on recent evidence to analyse and discuss these areas of debate and provide insight into the evidence on causality, welfare systems and policies aiming to address the social determinants of health inequalities. First, we examine the evidence that inequalities in the social determinants of health are causally related to health inequalities. Second, we discuss whether more egalitarian social policies provide a solution to redressing health inequalities. In conclusion, we suggest that current debates around causal understandings risk sending the field down ‘rabbit holes’ that distract from solution. We argue that, if we combine epidemiological evidence with the broader canon of social science evidence, the case for causal inference is sufficiently strong to suggest we now need to focus on effectively supporting and promoting research-informed policy responses to health inequalities.
{"title":"Falling down the rabbit hole? Methodological, conceptual and policy issues in current health inequalities research","authors":"M. Kelly-Irving, W. P. Ball, C. Bambra, C. Delpierre, R. Dundas, J. Lynch, G. McCartney, Katherine Smith","doi":"10.1080/09581596.2022.2036701","DOIUrl":"https://doi.org/10.1080/09581596.2022.2036701","url":null,"abstract":"ABSTRACT Persistent health inequalities pose a challenge to researchers and policymakers. Decades of research have illuminated mechanisms that underlie health inequalities, now we must move beyond these observations to enable policies that can reduce them. In this paper, we highlight tensions in the field of health inequalities research regarding the relationship between social determinants and health outcomes, and the effectiveness of welfare policies. We draw on recent evidence to analyse and discuss these areas of debate and provide insight into the evidence on causality, welfare systems and policies aiming to address the social determinants of health inequalities. First, we examine the evidence that inequalities in the social determinants of health are causally related to health inequalities. Second, we discuss whether more egalitarian social policies provide a solution to redressing health inequalities. In conclusion, we suggest that current debates around causal understandings risk sending the field down ‘rabbit holes’ that distract from solution. We argue that, if we combine epidemiological evidence with the broader canon of social science evidence, the case for causal inference is sufficiently strong to suggest we now need to focus on effectively supporting and promoting research-informed policy responses to health inequalities.","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":"33 1","pages":"37 - 47"},"PeriodicalIF":2.8,"publicationDate":"2022-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47981805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-07DOI: 10.1080/09581596.2021.1999395
Oheneba A. Boateng
ABSTRACT This paper examines how Ebola survivors in Sierra Leone are enacting biological citizenship to effect responsive and accountable engagement with their government. Disaster survivors are often left without avenues to hold policymakers accountable, but, recently, injured or disabled people have taken legal action against their governments over issues such as negligence, delays, damaged property, and death. However, in Sierra Leone, members of the Ebola survivors’ association have sued the government at the ECOWAS Community Court of Justice over a less conventional issue: corruption. After audit reports uncovered instances of financial impropriety that compromised the country’s response to the 2013–2016 Ebola outbreak, two plaintiffs sued the government with the argument that corruption and the failure of the government to hold the culprits accountable constitute abuses of the rights to life and health of those affected by the disaster, and the entire population. Based on this case, the paper argues that the lawsuit is an attempt to redefine corruption as a health hazard and a human rights violation. This challenges authorities to give serious attention to how financial improprieties affect the ability of state agencies to guarantee equitable, dignified healthcare, and to take the post-disaster rehabilitation of survivors as a critical component of reconstruction programmes. Ultimately, the lawsuit might set a precedent for other disaster survivors to demand equitable and dignified access to health and proper rehabilitation. This paper draws on scholarly literature, official documents, and conversations with some of the survivors and their lawyer to make this argument.
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