Pub Date : 2022-07-31DOI: 10.1080/09581596.2022.2101432
Judith Green, R. Lynch
Epidemics of chronic disease are widely recognized as deeply rooted in economic, social, and political structures and their histories. Yet strategies to address them continue to drift further downstream, to the ‘modifiable risk factors’ associated with conditions such as diabetes, cancer, and hypertension (Glasgow & Schrecker, 2016). In the context of this seemingly intractable gulf between evidence and policy, this Special Section highlights some of the tensions faced by contemporary public health in relation to chronic disease. Bringing together research exploring chronic conditions from Australia, the UK, Puerto Rico, and Senegal, the papers in this Section all address the multiple, and entangled, temporalities of illness at different scales. We argue that greater attention to these temporalities might open spaces for developing and implementing public health approaches that take seriously the complex causation of chronic conditions, and which begin to disengage with an overly biomedical approach of individualizing behaviouralism.
{"title":"Rethinking chronicity: public health and the problem of temporality","authors":"Judith Green, R. Lynch","doi":"10.1080/09581596.2022.2101432","DOIUrl":"https://doi.org/10.1080/09581596.2022.2101432","url":null,"abstract":"Epidemics of chronic disease are widely recognized as deeply rooted in economic, social, and political structures and their histories. Yet strategies to address them continue to drift further downstream, to the ‘modifiable risk factors’ associated with conditions such as diabetes, cancer, and hypertension (Glasgow & Schrecker, 2016). In the context of this seemingly intractable gulf between evidence and policy, this Special Section highlights some of the tensions faced by contemporary public health in relation to chronic disease. Bringing together research exploring chronic conditions from Australia, the UK, Puerto Rico, and Senegal, the papers in this Section all address the multiple, and entangled, temporalities of illness at different scales. We argue that greater attention to these temporalities might open spaces for developing and implementing public health approaches that take seriously the complex causation of chronic conditions, and which begin to disengage with an overly biomedical approach of individualizing behaviouralism.","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43259417","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 : 2022-07-29DOI: 10.1080/09581596.2022.2104155
Ariane Prohaska
ABSTRACT The news media has consistently promoted weight loss as a solution to the “obesity epidemic”, despite research refuting the connection between fatness and health. In this paper, I examine the framing of weight loss in news articles during lockdown months of 2020, addressing whether healthist ideologies about weight loss persisted or declined during the pandemic. Most articles reflected a healthism lens, encouraging weight loss to achieve good health and to prevent COVID-19. However, some articles rejected weight loss or utilized a Health at Every Size perspective. This study has implications for research on body surveillance, neoliberalism, public health, and media reporting about weight loss and COVID-19.
{"title":"“Help curb the hunger pangs”: news media frames of weight loss during the COVID- 19 lockdown","authors":"Ariane Prohaska","doi":"10.1080/09581596.2022.2104155","DOIUrl":"https://doi.org/10.1080/09581596.2022.2104155","url":null,"abstract":"ABSTRACT The news media has consistently promoted weight loss as a solution to the “obesity epidemic”, despite research refuting the connection between fatness and health. In this paper, I examine the framing of weight loss in news articles during lockdown months of 2020, addressing whether healthist ideologies about weight loss persisted or declined during the pandemic. Most articles reflected a healthism lens, encouraging weight loss to achieve good health and to prevent COVID-19. However, some articles rejected weight loss or utilized a Health at Every Size perspective. This study has implications for research on body surveillance, neoliberalism, public health, and media reporting about weight loss and COVID-19.","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43486513","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 : 2022-07-26DOI: 10.1080/09581596.2022.2101917
Kia Ditlevsen, B. Halkier, L. Holm
ABSTRACT Dietary health is a key theme of health policy and public debates on health and inequality. The social gradient in dietary health is evident, but less is known about the processes in everyday life through which less healthy diets are shaped among people with low socio-economic status. In this mixed methods study we recruited 30 men and women living in low income households in Denmark and combined qualitative interviews about household practices with quantitative estimates of the quality of participants’ diets. The qualitative findings show that in general, the participants’ food practices were conditioned by budget restrictions and bundled with other non-food practices in their everyday life, which in most, but not all, cases conflicted with engagement in healthy eating. Only few participants reported feeling able to provide ‘proper foods’ according to their own preferences. We identified five distinct pathways through which food practices were performed. All were structured by distinct life situations which created different ways in which food practices were bundled with other practices. The quantitative estimates of participants’ diets show that none of the participants’ diets categorized as healthy. The combined analysis showed that estimated dietary quality varied between the five pathways, and that the degree of budget restraint and the practice of handling a disease in the household were notably important for the performance of food practices.
{"title":"Pathways of less healthy diets. An investigation of the everyday food practices of men and women in low income households","authors":"Kia Ditlevsen, B. Halkier, L. Holm","doi":"10.1080/09581596.2022.2101917","DOIUrl":"https://doi.org/10.1080/09581596.2022.2101917","url":null,"abstract":"ABSTRACT Dietary health is a key theme of health policy and public debates on health and inequality. The social gradient in dietary health is evident, but less is known about the processes in everyday life through which less healthy diets are shaped among people with low socio-economic status. In this mixed methods study we recruited 30 men and women living in low income households in Denmark and combined qualitative interviews about household practices with quantitative estimates of the quality of participants’ diets. The qualitative findings show that in general, the participants’ food practices were conditioned by budget restrictions and bundled with other non-food practices in their everyday life, which in most, but not all, cases conflicted with engagement in healthy eating. Only few participants reported feeling able to provide ‘proper foods’ according to their own preferences. We identified five distinct pathways through which food practices were performed. All were structured by distinct life situations which created different ways in which food practices were bundled with other practices. The quantitative estimates of participants’ diets show that none of the participants’ diets categorized as healthy. The combined analysis showed that estimated dietary quality varied between the five pathways, and that the degree of budget restraint and the practice of handling a disease in the household were notably important for the performance of food practices.","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2022-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42966571","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 : 2022-07-08DOI: 10.1080/09581596.2022.2095255
Marisa Westbrook, M. Harvey
ABSTRACT Despite the increasing focus within public health on the social determinants of health and ‘structural approaches’ over the past three decades, controversy remains regarding the field’s relative emphasis on the behaviors of individuals versus the organization of societies when explaining why some are healthy and others are not. This research seeks to clarify how authoritative sources within public health instruction frame the relationship among behavior, society, and health by identifying common themes within social and behavioral science textbooks assigned within MPH programs located primarily in the US. Textbook analysis was informed by a modified grounded theory approach and is situated broadly within the critical discourse analysis tradition. Common themes include: the primacy of behavior to health outcomes; the purpose of public health theory is explaining behavior and informing behavior change; social and individual factors influence health behaviors; and ecological approaches are necessary for behavior change. Notable divergences from these themes are also discussed. These findings suggest a continuing need to think critically about how health, behavior, and society are framed within public health instruction specifically and within the field of public health more broadly. We close by considering the relevance of social theories of health inequality and structural competency to these discussions.
{"title":"Framing health, behavior, and society: a critical content analysis of public health social and behavioral science textbooks","authors":"Marisa Westbrook, M. Harvey","doi":"10.1080/09581596.2022.2095255","DOIUrl":"https://doi.org/10.1080/09581596.2022.2095255","url":null,"abstract":"ABSTRACT Despite the increasing focus within public health on the social determinants of health and ‘structural approaches’ over the past three decades, controversy remains regarding the field’s relative emphasis on the behaviors of individuals versus the organization of societies when explaining why some are healthy and others are not. This research seeks to clarify how authoritative sources within public health instruction frame the relationship among behavior, society, and health by identifying common themes within social and behavioral science textbooks assigned within MPH programs located primarily in the US. Textbook analysis was informed by a modified grounded theory approach and is situated broadly within the critical discourse analysis tradition. Common themes include: the primacy of behavior to health outcomes; the purpose of public health theory is explaining behavior and informing behavior change; social and individual factors influence health behaviors; and ecological approaches are necessary for behavior change. Notable divergences from these themes are also discussed. These findings suggest a continuing need to think critically about how health, behavior, and society are framed within public health instruction specifically and within the field of public health more broadly. We close by considering the relevance of social theories of health inequality and structural competency to these discussions.","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42845311","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 : 2022-07-08DOI: 10.1080/09581596.2022.2077701
Judith Green, E. Fischer, Des Fitzgerald, T. S. Harvey, F. Thomas
ABSTRACT This commentary reflects on what has been learnt from government and public health responses to COVID-19, suggesting a tension between ‘business as usual’ forms of public health in the face of crisis, and the possibilities for a step-change towards a ‘healthy publics’ approach. We set out a range of ways that diverse, multiple publics have been implicated or brought into being during the COVID-19 pandemic, and we argue that these have generally been ignored or erased by agents or agencies of public health, keen to preserve certainty in their messaging and public confidence in their authority. We conclude with five principles for re-organising pandemic responses around a richer, more context-dependent and diverse account of ‘the public’.
{"title":"The publics of public health: learning from COVID-19","authors":"Judith Green, E. Fischer, Des Fitzgerald, T. S. Harvey, F. Thomas","doi":"10.1080/09581596.2022.2077701","DOIUrl":"https://doi.org/10.1080/09581596.2022.2077701","url":null,"abstract":"ABSTRACT This commentary reflects on what has been learnt from government and public health responses to COVID-19, suggesting a tension between ‘business as usual’ forms of public health in the face of crisis, and the possibilities for a step-change towards a ‘healthy publics’ approach. We set out a range of ways that diverse, multiple publics have been implicated or brought into being during the COVID-19 pandemic, and we argue that these have generally been ignored or erased by agents or agencies of public health, keen to preserve certainty in their messaging and public confidence in their authority. We conclude with five principles for re-organising pandemic responses around a richer, more context-dependent and diverse account of ‘the public’.","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46953879","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 : 2022-07-07DOI: 10.1080/09581596.2022.2096427
Samuel Ojima Adejoh, I. Kuznetsova, S. Dhesi
ABSTRACT The paper documents environmental health conditions and healthcare access challenges faced by internally displaced people (IDPs) from Borno State living in informal settlements in Lagos, Nigeria, in 2020, during the early stages of the COVID-19 pandemic. This qualitative study with 32 IDPs suggests a high vulnerability to COVID-19. Their accommodation often lacked basic sanitation including water and toilet facilities; overcrowding and high population density restricted ability to adhere to social distancing; and IDPs experienced serious consequences from lockdown, as the majority depended on daily wages, and did not receive food packages or other support from the State. Finally, there were obstacles to accessing healthcare. We highlight the importance of an integrated approach, consolidating the efforts of communities, non-governmental organisations, environmental and public health, and international organisations to address the health and well-being issues of IDPs in urban informal settlements.
{"title":"Internally displaced people in Lagos: environmental health conditions and access to healthcare in the context of COVID-19","authors":"Samuel Ojima Adejoh, I. Kuznetsova, S. Dhesi","doi":"10.1080/09581596.2022.2096427","DOIUrl":"https://doi.org/10.1080/09581596.2022.2096427","url":null,"abstract":"ABSTRACT The paper documents environmental health conditions and healthcare access challenges faced by internally displaced people (IDPs) from Borno State living in informal settlements in Lagos, Nigeria, in 2020, during the early stages of the COVID-19 pandemic. This qualitative study with 32 IDPs suggests a high vulnerability to COVID-19. Their accommodation often lacked basic sanitation including water and toilet facilities; overcrowding and high population density restricted ability to adhere to social distancing; and IDPs experienced serious consequences from lockdown, as the majority depended on daily wages, and did not receive food packages or other support from the State. Finally, there were obstacles to accessing healthcare. We highlight the importance of an integrated approach, consolidating the efforts of communities, non-governmental organisations, environmental and public health, and international organisations to address the health and well-being issues of IDPs in urban informal settlements.","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47517833","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 : 2022-06-22DOI: 10.1080/09581596.2022.2090316
Louise Tomkow, Paul Pascall-Jones, D. Carter
ABSTRACT This paper explores how the rationing of medical care for older people by frailty score was justified and operationalised in the UK during the COVID-19 pandemic. COVID-19 was expected to overwhelm the National Health Service (NHS) in the UK. In March 2020, the National Institute for Health and Care Excellence (NICE) published the ‘COVID-19 rapid guideline: critical care in adults’, which advised that clinicians use the Clinical Frailty Score (CFS) to inform decisions about which patients over the age of 65 should be offered ventilatory support. We present a Foucauldian Critical Discourse Analysis of this guidance and the supporting online resources. Analysis shows how the guidance merchandises the CFS as a quick and easy-to-use technology that reduces social and physical complexity into a clinical score. This stratifies older people by frailty score and permits the allocation of resources along these lines. We show how this is justified through epidemiological discourses of risk, which are merged with the language of individual mortality prediction. We discuss the proceduralisation of the CFS alongside a growing body of research that problematises its application in resource allocation. We argue that the pandemic has increased the use of the concept of frailty and that this effectively obfuscates the concept’s limitations and ambiguities; the ageism implicit in the response to COVID-19 in the UK; and the relative resource scarcity facing the UK’s NHS.
{"title":"Frailty goes viral: a critical discourse analysis of COVID-19 national clinical guidelines in the United Kingdom","authors":"Louise Tomkow, Paul Pascall-Jones, D. Carter","doi":"10.1080/09581596.2022.2090316","DOIUrl":"https://doi.org/10.1080/09581596.2022.2090316","url":null,"abstract":"ABSTRACT This paper explores how the rationing of medical care for older people by frailty score was justified and operationalised in the UK during the COVID-19 pandemic. COVID-19 was expected to overwhelm the National Health Service (NHS) in the UK. In March 2020, the National Institute for Health and Care Excellence (NICE) published the ‘COVID-19 rapid guideline: critical care in adults’, which advised that clinicians use the Clinical Frailty Score (CFS) to inform decisions about which patients over the age of 65 should be offered ventilatory support. We present a Foucauldian Critical Discourse Analysis of this guidance and the supporting online resources. Analysis shows how the guidance merchandises the CFS as a quick and easy-to-use technology that reduces social and physical complexity into a clinical score. This stratifies older people by frailty score and permits the allocation of resources along these lines. We show how this is justified through epidemiological discourses of risk, which are merged with the language of individual mortality prediction. We discuss the proceduralisation of the CFS alongside a growing body of research that problematises its application in resource allocation. We argue that the pandemic has increased the use of the concept of frailty and that this effectively obfuscates the concept’s limitations and ambiguities; the ageism implicit in the response to COVID-19 in the UK; and the relative resource scarcity facing the UK’s NHS.","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2022-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47260153","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 : 2022-06-02DOI: 10.1080/09581596.2022.2082923
R. Williamson, C. Banwell, A. Calear, Christine Labond, L. Leach, Anna Olsen, Christine B Phillips, E. Walsh, T. Zulfiqar
ABSTRACT Bushfires, and resulting bushfire smoke, were major environmental, social and health crises in Australia in the summer of 2019–20. In Australia’s national capital the smoke pollution index topped global charts, and public health communications were rapidly developed that advised people to stay indoors to avoid smoke exposure. Drawing on interviews with a diverse range of housed residents, we explore people’s experiences of navigating public health advice and managing the bushfire smoke in relation to the materiality of their homes. Given the increasing likelihood of living with such crises in the Anthropocene, we highlight the need for future bushfire public health advice to recognise local housing geographies, residents’ embodied vulnerabilities and the relational ways people live with their everyday built environment, and suggest possible policy responses.
{"title":"‘I didn’t feel safe inside’: navigating public health advice, housing and living with bushfire smoke","authors":"R. Williamson, C. Banwell, A. Calear, Christine Labond, L. Leach, Anna Olsen, Christine B Phillips, E. Walsh, T. Zulfiqar","doi":"10.1080/09581596.2022.2082923","DOIUrl":"https://doi.org/10.1080/09581596.2022.2082923","url":null,"abstract":"ABSTRACT Bushfires, and resulting bushfire smoke, were major environmental, social and health crises in Australia in the summer of 2019–20. In Australia’s national capital the smoke pollution index topped global charts, and public health communications were rapidly developed that advised people to stay indoors to avoid smoke exposure. Drawing on interviews with a diverse range of housed residents, we explore people’s experiences of navigating public health advice and managing the bushfire smoke in relation to the materiality of their homes. Given the increasing likelihood of living with such crises in the Anthropocene, we highlight the need for future bushfire public health advice to recognise local housing geographies, residents’ embodied vulnerabilities and the relational ways people live with their everyday built environment, and suggest possible policy responses.","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2022-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48333620","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 : 2022-05-27DOI: 10.1080/09581596.2022.2077700
Wei Zhang, Xuan Chen
ABSTRACT Does social class matter in understanding health inequalities in early 21st century China, when the country experienced unprecedented social stratification? Using nationally representative data from the latest waves of China Household Income Project surveys, we examine to what extent an individual’s health is structured by social class and how that structure evolved. We draw on a neo-Marxist measure of social class to tap into the hidden mechanism that engenders and sustains inequalities. Four classes are defined based primarily on their relationships to productive resources: owners/managers, professionals/skilled workers, less-skilled workers, and farmers. Such a measure has not been considered in the health gradient literature in the Chinese context. Our results show that, despite remedial policies that helped mitigate economic inequalities, inequalities in health have mostly widened during the early years of the current century between the ‘haves’, who own productive assets and/or managerial authority, and the ‘have-nots’. In 2002, self-rated health (SRH) was not clearly associated with class rank; in 2007, when China’s economic inequality reached a historical zenith, a gradational pattern between SRH and class emerged, and the largest health gap was found between the class of owners/managers and farmers; in 2013, when China’s income inequality reached a plateau, the health gap between owners/managers and less-skilled workers grew larger. Further, we identify job security as a mediator that links class and health among the lower social strata. In addition to improving the health of the disadvantaged, policies designed to narrow health inequalities should be orientated towards addressing social stratification.
{"title":"Does ’class count’? The evolution of health inequalities by social class in early 21st century China (2002–2013)","authors":"Wei Zhang, Xuan Chen","doi":"10.1080/09581596.2022.2077700","DOIUrl":"https://doi.org/10.1080/09581596.2022.2077700","url":null,"abstract":"ABSTRACT Does social class matter in understanding health inequalities in early 21st century China, when the country experienced unprecedented social stratification? Using nationally representative data from the latest waves of China Household Income Project surveys, we examine to what extent an individual’s health is structured by social class and how that structure evolved. We draw on a neo-Marxist measure of social class to tap into the hidden mechanism that engenders and sustains inequalities. Four classes are defined based primarily on their relationships to productive resources: owners/managers, professionals/skilled workers, less-skilled workers, and farmers. Such a measure has not been considered in the health gradient literature in the Chinese context. Our results show that, despite remedial policies that helped mitigate economic inequalities, inequalities in health have mostly widened during the early years of the current century between the ‘haves’, who own productive assets and/or managerial authority, and the ‘have-nots’. In 2002, self-rated health (SRH) was not clearly associated with class rank; in 2007, when China’s economic inequality reached a historical zenith, a gradational pattern between SRH and class emerged, and the largest health gap was found between the class of owners/managers and farmers; in 2013, when China’s income inequality reached a plateau, the health gap between owners/managers and less-skilled workers grew larger. Further, we identify job security as a mediator that links class and health among the lower social strata. In addition to improving the health of the disadvantaged, policies designed to narrow health inequalities should be orientated towards addressing social stratification.","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2022-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47778188","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 : 2022-05-27DOI: 10.1080/09581596.2022.2077548
Leda Blackwood, Jeffrey Gavin, Emma Arnott, J. Barnett, C. Dack, Jessica Johansen
ABSTRACT People living with Type 1 and Type 2 diabetes (T1DM &T2DM) report that media – including journalism, health promotion, and popular culture – are a primary source of stigmatic representations of diabetes, and that this compromises their physical and mental health. This view of diabetes as stigmatised is not shared by many health professionals and nor the wider public. We used an existing representation of diabetes on Instagram, #DiabetesOnAPlate, to examine how stigmatic representations of diabetes are (re)produced, discussed, and contested. Our analysis found that, consistent with the notion of diabetes as stigmatised, use of the hashtag #DiabetesOnAPlate on Instagram is associated with public health discourses of indulgent eating and with posts that signal recognition of this as a moral transgression. A subsequent on-line survey found that participants who did not have diabetes did not recognise a prototypical #DiabetesOnAPlate post as stigmatic. Whilst some with T1DM and T2DM did perceive and contest the stigma, T1DM participants did so for their group (but not for T2DM); and there was evidence that some T2DM participants internalised the stigma. These findings support concerns about the everyday, divisive nature of stigmatic representations of diabetes on social network sites, which on the one hand reflect public health discourse and on the other may compromise health policy objectives and exacerbate health inequalities.
{"title":"#DiabetesOnAPlate: the everyday deployment and contestation of diabetes stigma in an online setting","authors":"Leda Blackwood, Jeffrey Gavin, Emma Arnott, J. Barnett, C. Dack, Jessica Johansen","doi":"10.1080/09581596.2022.2077548","DOIUrl":"https://doi.org/10.1080/09581596.2022.2077548","url":null,"abstract":"ABSTRACT People living with Type 1 and Type 2 diabetes (T1DM &T2DM) report that media – including journalism, health promotion, and popular culture – are a primary source of stigmatic representations of diabetes, and that this compromises their physical and mental health. This view of diabetes as stigmatised is not shared by many health professionals and nor the wider public. We used an existing representation of diabetes on Instagram, #DiabetesOnAPlate, to examine how stigmatic representations of diabetes are (re)produced, discussed, and contested. Our analysis found that, consistent with the notion of diabetes as stigmatised, use of the hashtag #DiabetesOnAPlate on Instagram is associated with public health discourses of indulgent eating and with posts that signal recognition of this as a moral transgression. A subsequent on-line survey found that participants who did not have diabetes did not recognise a prototypical #DiabetesOnAPlate post as stigmatic. Whilst some with T1DM and T2DM did perceive and contest the stigma, T1DM participants did so for their group (but not for T2DM); and there was evidence that some T2DM participants internalised the stigma. These findings support concerns about the everyday, divisive nature of stigmatic representations of diabetes on social network sites, which on the one hand reflect public health discourse and on the other may compromise health policy objectives and exacerbate health inequalities.","PeriodicalId":51469,"journal":{"name":"Critical Public Health","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2022-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41924350","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}
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