Showing papers in "Critical Public Health in 2006"
TL;DR: The authors examines and expands existing research approaches in relation to three levels at which coherence and conceptual clarity can be improved: in defining and theorizing racism, in conceptualizing how racism may relate to health and in characterizing racism as an exposure that can be operationalized and measured.
Abstract: The examination of racism as a determinant of health is an emerging area of research. This paper examines and expands on existing research approaches in relation to three levels at which coherence and conceptual clarity can be improved: in defining and theorizing racism, in conceptualizing how racism may relate to health and in characterizing racism as an exposure that can be operationalized and measured. A definition of racism in relation to the broader concept of privilege/oppression is detailed along with a discussion of the implications of this definition in relation to the concept of power, the perpetration of privilege/oppression, intention vs. effect and objective vs. subjective racism. This is followed by a conceptualization of the relationship between racism and health, which incorporates both previous approaches in health research and pertinent social theory and is designed to aid in organizing and synthesizing knowledge, defining concepts and variables, generating specific research questions an...
236 citations
TL;DR: In this article, the authors begin to unpunch the underpinnings to conventional approaches to public health research and service provision related to youth sexual health in Canada. And they draw on the works of Foucault to show how discourses concerning risky groups, risky behaviour and risky persons have been advanced as sanctioned discourses in Canada (particularly related to HIV).
Abstract: Significant public health attention has been focused on the problems of youth sexual behaviour. Empirical public health research in this area has attempted to account for mostly negative sexual health outcomes (e.g. sexually transmitted infections and teenage pregnancies) by examining individual characteristics and risk-taking behaviour. Public health practice has followed suit, focusing primarily on modifying sexual risk behaviour and lifestyle ‘choices’. In doing so, we may be unwittingly committed to an unarticulated and unrealistic set of assumptions about the level of agency and control that is afforded to many young people. The purpose of this paper is to begin to ‘unpack’ the underpinnings to conventional approaches to public health research and service provision related to youth sexual health in Canada. Drawing on the works of Foucault to show how discourses concerning risky groups, risky behaviour and risky persons have been advanced as sanctioned discourses in Canada (particularly related to HIV...
143 citations
TL;DR: By considering the effects of hepatitis C diagnosis in light of Goffman's theory of stigma, and by linking stigmatization to the binary logic common to thinking about infection, health and identity, this paper offers a starting point for designing health-promotion materials that minimize despairing responses to infection.
Abstract: Hepatitis C is a potentially debilitating disease of the liver, the impact of and prognosis for which vary significantly from person to person. Although the health consequences of contracting hepatitis C are extremely diverse, becoming infected with the disease is sometimes experienced in terms of an absolute shift from healthy to sick, clean to contaminated, good to bad. In this paper, we use interview material derived from a study on hepatitis C and blood awareness to look at one rarely discussed response to diagnosis with hepatitis C: a sense of despair and absolute contamination, leading to a belief that contraction of other blood-borne viruses is of no consequence. By considering the effects of hepatitis C diagnosis in light of Goffman's theory of stigma, and by linking stigmatization to the binary logic common to thinking about infection, health and identity, we offer a starting point for designing health-promotion materials that minimize despairing responses to infection.
85 citations
TL;DR: A critical assessment of pharmacy's response to this agenda through a review of key pharmacy relevant policy documents is provided and the contribution of pharmacy to public health from a micro- and macro-level framework is assessed.
Abstract: Community pharmacy in the UK is often described as the most accessible of all primary healthcare providers, situated on the 'high street' and requiring no appointment. But what does the new public health movement mean for pharmacy, and where is pharmacy in terms of the new public health agenda? In this paper, the authors provide a critical assessment of pharmacy's response to this agenda through a review of key pharmacy relevant policy documents. In particular, in the context of pharmacy's re-professionalization agenda, they assess the contribution of pharmacy to public health from a micro- and macro-level framework. The aim is to provide a critical context in light of current proposals for the profession to develop a public health strategy.
54 citations
TL;DR: In this paper, the authors defined and discussed new social movements in terms of their actual and potential impact in the health domain, and identified a series of rhetorics associated with, and intermittently enacted through, NSMs, leading to a provisional typology of mobilizing potentials characteristic of NSMs.
Abstract: The potential of social movements to accomplish change relevant to people's health, longevity and empowerment has received little sustained attention in medical sociology outside the USA. In the current era of global or disorganized capitalism the most discussed movements in Europe have been the new social movements (NSMs). In this paper the NSMs are defined and discussed in terms of their actual and potential impact in the health domain. Within a broadly Habermasian framework, a series of rhetorics associated with, and intermittently enacted through, NSMs are identified. This leads to a provisional typology of ‘mobilizing potentials’ characteristic of NSMs. It is suggested that it is the organic bases and flexibility of health-related NSMs, together with their potential to comprise a ‘culture of challenge’ in the public sphere of the lifeworld, which makes them serious political agents for lifeworld de-colonization.
50 citations
TL;DR: A lack of attention to health concepts and their clarification, as indicated by the use of ‘well-being’ as an ill-defined tag to health, is having a negative impact on public health's ability to deliver health gain, and that commitment to clarifying concepts would lead to a range of benefits.
Abstract: In recent years, health and well-being have been ‘mainstreamed’ as a policy issue and have become the concern of a widening range of agencies. Simultaneously, increasing weight has been placed on the measurement of population health status, the implementation of evidence-based practice in public health and the more effective evaluation of policy interventions targeted at health gain and health inequalities. Thus, at a time when greater conceptual clarity is crucial, there are more stakeholders in ‘health’, each with a potentially different perspective and understanding of what ‘health’ is. In this study, we explore the need for greater conceptual clarity in relation to health, using the term ‘well-being’ as an exemplar. We draw on findings from a research project undertaken with community and professional groups in the Black Country and Shropshire that explored shared ways to measure aspects, and determinants, of health. We suggest a lack of attention to health concepts and their clarification, as indicat...
46 citations
TL;DR: This paper explores recent developments in prison public health, recommending that future prison health policies and practices become more ‘upstream’ in their outlook and approach, and advocating a progressive and more sustainable approach to developing and commissioning health services for prisoners.
Abstract: This paper explores recent developments in prison public health, recommending that future prison health policies and practices become more ‘upstream’ in their outlook and approach. It is argued that this will require much firmer acknowledgement of the significance of broad, systemic and
structural determinants of prisoner health, particularly if the World Health organization’s vision for a ‘healthy prison’ is to be realized. Epidemiological evidence plainly shows that prisoners have experienced—and continue to experience—worse health than the general population, despite the fact that prison settings across the European Union have been targeted for health promotion by the World Health Organization since 1994. In 2005, WHO launched a new 10-year prison public health plan, which it envisages will begin to address key prison health determinants. In the UK, New Labour has identified prison health as a key public health objective within Choosing Health, although health interventions within prisons continue to be predominantly geared towards efficient and effective primary and secondary healthcare, and much less towards public health goals. This paper strives to open up the debate on prison public health, advocating a progressive and more sustainable approach to developing and commissioning health services for prisoners.
35 citations
TL;DR: The justifications of smoking in web discussions are analysed, concentrating on perceptions of risk, and it is suggested that disregard of risks represents a real challenge for smokers.
Abstract: It has been argued that with the decline in the prevalence of smoking, a number of the remaining smokers have become more resilient to health-promotion efforts. In this article, the justifications of smoking in web discussions are analysed, concentrating on perceptions of risk. While previous research concerning lay knowledge has brought out ambivalent meanings of the concept, smoking as a well-known health risk provides an excellent example for studying counter-reactions to current health discourses. Analysis shows the similarities between justifications of smoking and current health ideologies: argumentation stressed personal responsibility and self-management. However, following rules and health recommendations was juxtaposed with ideals of the autonomous, competent individual. While argumentation reflected the basic principles of the imperative of health, a challenging feature emerged through the accounts that disregarded risk. It is suggested that disregard of risks represents a real challenge for th...
33 citations
TL;DR: This paper presented the results of a critical discourse analysis of the portrayal of HIV/AIDS in the 20 highest circulating mass print media magazines in Canada in 1991, 1996, and 2001, focusing on celebrities and those working to help people with HIV.
Abstract: This paper presents the results of a critical discourse analysis of the portrayal of HIV/AIDS in the 20 highest circulating mass print media magazines in Canada in 1991, 1996 and 2001. It is a follow-up of studies describing the conflation of homophobia and HIV/AIDS in media portrayal studies beginning in the 1980s. It provides an examination of more recent stories during a time when the epidemiological characteristics of HIV/AIDS changed to incorporate widespread heterosexual transmission. While the paper documents the continuing presence of homophobia, its portrayal has become indirect and subtle. It is not evident in the explicit descriptions of the sexual or drug-taking characteristics of people with HIV/AIDS, as in the past, but rather in the paradoxical extolling of heterosexuality and hegemonic masculinity. It is also evident in the emphasis on the differences between innocent and guilty victims of HIV/AIDS. There is also a focus on celebrities, both those with HIV/AIDS and those working to help th...
24 citations
TL;DR: It is argued that child health research and interventions need to proceed from an explicit recognition of the fundamental causes of poor child health, namely parents’ socioeconomic status and the social context in which children live.
Abstract: While significant progress has been made on several fronts in child health research in recent years, research findings have not always been readily translated to better policies and programs for creating healthy conditions for children. Child health policies and research have not always aligned in a manner that would inform each other to the benefit of children. In this paper it is argued that child health research and interventions need to proceed from an explicit recognition of the fundamental causes of poor child health, namely parents’ socioeconomic status and the social context in which children live. A conceptual framework is presented that organizes the key domains of child health determinants and the possible causal pathways that link these domains to produce health outcomes. This framework assisted the development of a multi-method research program specifically linking community members, program developers and policy-makers in the research process. It also helped to identify methodological issues...
23 citations
TL;DR: It is argued that constructions of prophylactic mastectomy can be seen to draw on traditional gendered discourses, and on notions of responsibility central to the new public health, and promote general acceptance of the procedure and risk management more generally.
Abstract: In this paper, the authors examine a popular media account of prophylactic mastectomy—the surgical removal of ‘healthy’ breasts for preventive purposes—focusing on the ways in which the account works to normalize what might alternatively be considered extreme preventive health behaviour. Although the procedure remains controversial, prophylactic mastectomy is increasingly presented as a treatment option for women considered to be at high risk of developing breast cancer. A discursive analysis focuses on how one woman's ‘decision’ to undergo prophylactic surgery of this type was accounted for in terms of two broad identity constructions or positionings: as ‘mother’, and as ‘certain to die of breast cancer’ in the absence of such surgery. It is argued that constructions of prophylactic mastectomy, such as that depicted in this account from a popular women's magazine, can be seen to draw on traditional gendered discourses, and on notions of responsibility central to the new public health. Such media accounts...
TL;DR: Workplace health discourse encourages the employee to take responsibility for self-assessment and behaviour adjustment to become healthier employees as mentioned in this paper, which results in an ethical project that results in the alignment of personal and corporate goals.
Abstract: This paper reports a case study of a workplace health programme in an international information technology company. Discourse analysis was used to identify how specific forms of knowledge create understandings of health and influence power relations between employee and organization. These forms of knowledge are shown to make employee health both visible and invisible in particular ways. Workplace health discourse encourages the employee to take responsibility for self-assessment and behaviour adjustment to become healthier employees. This is shown to be an ethical project which results in the alignment of personal and corporate goals.
TL;DR: In this article, the authors report on a study that sought to answer three key questions: which relationships are important for improving health, what are the key areas in these relationships that might impact on delivery of improved public health, and what issues should be addressed in developing emerging relationships.
Abstract: The British National Health Service has enjoined public health and primary care via a series of policy initiatives. Inter-organizational relationships provide the foundation for managing the system changes required to deliver policy, but are often taken for granted. This article reports on a study that sought to answer three key questions. First, which relationships are important for improving health? Second, what are the key areas in these relationships that might impact on delivery of improved public health? Third, what issues should be addressed in developing emerging relationships? Following a questionnaire to a sample of primary care organizations and a series of intensive workshops with key informants, findings indicate that there is an extensive network of relationships in which public health staff may participate. However, active participation is problematic in terms of identifying the most relevant relationships and ensuring protected time to develop these. Key relationship dimensions impacting o...
TL;DR: In this article, the authors present the findings of an empirical study that examined the everyday life of the Norwegian mother and child health service and address the dilemmas faced by practitioners as a result of expectations that they base their practice on inconsistent discourses.
Abstract: In current Norwegian discourses and policy debates dealing with children's health and well-being ideas of appropriate methods vary, as do ideas regarding the role parents play in the improvement of their children's health. The present paper draws attention to these discourses, and it presents the findings of an empirical study that examined the everyday life of the Norwegian mother and child health service. The paper also addresses the dilemmas faced by practitioners as a result of expectations that they base their practice on inconsistent discourses. It argues that within this practical field there is a struggle for legitimacy between two sets of values, and that this in turn creates the dilemmas in question. The analysis is based on qualitative interviews with 30 Norwegian public health nurses.
TL;DR: The degree to which neo-Marxist conceptualizations of class position are ‘upstream’ determinants of health and well-being is explored.
Abstract: Although the relationship between socioeconomic status and health has received careful attention from health researchers over the past half-century, the means by which income, education and occupational prestige are accumulated in society have received relatively short shrift in the health literature. This article explores the degree to which neo-Marxist conceptualizations of class position are ‘upstream’ determinants of health and well-being. Utilizing data from a survey sample of randomly selected and full-time employed residents of 25 communities in the Canadian province of British Columbia, it evaluates the usefulness of class position distinctions derived from the work of Erik Olin Wright as predictors of physical and mental health before and after controlling for socioeconomic status.
TL;DR: It is concluded that a process of medicalization of the male midlife stage is occurring in Finland, and that popular magazines play an important role in this process.
Abstract: The aim of this study was to investigate the construction of male menopause by examining articles published on the topic between 1982 and 2002 in Finnish popular magazines. The main research question was how men's midlife stage was medicalized in the articles analysed. The number of articles published grew during the study period. In the articles, male menopause was initially presented as a social problem related to men's working careers but during the study period this changed as writers increasingly presented it as an illness managed by medical experts and treated with hormones. Through the whole period there were diverse opinions on whether male menopause even exists. In some articles the authors asserted that symptoms that appear with age are ‘normal’, in others testosterone medication was said to restore normal values, and sometimes the decline in testosterone was said to be normal. Symptoms associated with male menopause were mostly similar to those associated with ageing and they were presented as ...
TL;DR: A ‘one-size-fits-all’ approach to health promotion would be inadequate to bring about changes in practice; that health promotion campaigns should focus on addressing the contextual difficulties, e.g. absenteeism, recruitment and retention.
Abstract: A 2001 survey of public (n = 28), private (n = 113) and voluntary sector (n = 64) workplaces in Sefton, Merseyside indicated that there were significantly different levels of health-related policy provision across the three sectors, with the public sector having the highest level of provision (7.18 policies on average), followed by the voluntary (5.09 policies on average) and the private sector (3.94 policies on average). Policies already in place were mostly based around health and safety (89%), smoking (80%), sickness absenteeism (68%) and manual handling (49%). Workplaces reported that in order to benefit their employees’ health they wanted to improve: the physical work environment (38%); communications (31%); job content/organization (30%) and wage levels (29%). In addition, they wanted to develop stress management (51%) and family-friendly (25%) policies. The major perceived barriers to implementing these policies were: lack of time/monetary resources (70%); not having the skills/expertise (37%); kno...
TL;DR: Evaluating the process of implementation; comparative regional mapping of the service context including inter-agency partnership working; and assessing effectiveness using a quasi-experimental design and adjusted, population-based, behavioural and sexual health outcomes contribute to a balanced appraisal of a complex, community-based health promotion and service delivery intervention.
Abstract: There has been criticism of systematic reviews and meta-analyses that have shown little evidence of effect of interventions to improve teenage sexual health. Moreover, there is considerable controversy surrounding the validity of outcomes and rigour of design in evaluation methods for community-based programmes. In this climate, Scotland launched Healthy Respect, one of four community-based national Demonstration Projects, to address teenage sexual health. Healthy Respect is a complex and multi-stranded intervention in Lothian Region that includes education and health-promotion activities and alternative ways to provide sexual health services for young people. A multidisciplinary research team at the University of Aberdeen was appointed to undertake an independent evaluation of this demonstration project. Challenging some aspects of theory-based evaluation, it is argued that adopting both quantitative and qualitative methods will provide an understanding of both the context and process of this Health Demo...
TL;DR: In this article, the authors examine some of the main features of public discourse concerning tobacco control, analyzing parliamentary debate in New South Wales between 1980 and 2003, and find that the overall evolution of tobacco control policy was shaped by legislators' commitment to the ideals of deliberative democracy.
Abstract: In this paper the authors examine some of the main features of public discourse concerning tobacco control, analyzing parliamentary debate in New South Wales between 1980 and 2003. They ask how deeply tobacco industry discursive frames (e.g. the ‘right to smoke’) penetrated and organized parliamentary discourse and also identify what kinds of ideas were mobilized to justify tobacco control despite government reluctance to intervene. They find that the overall evolution of tobacco control policy was shaped by legislators’ commitment to the ideals of deliberative democracy. It is argued first that parliamentary debate on tobacco control was conducted in highly moralized language that effectively excluded the tobacco industry's arguments. Second, it is shown that this discourse was constructed and validated through the extensive use of personal anecdote and references, through which MPs sought to reflect public opinion and engage in authentic deliberation. Finally it is argued that MPs positioned this concer...
TL;DR: If the demands of critical public health have apparently been met, with a public health agenda now firmly at the centre, where is the ‘edge’, and what role, if any, is there for a critical perspective?
Abstract: Twenty years ago, an issue of Radical Community Medicine (RCM, 1986) was devoted to debate concerning the future of public health in the UK. The contributors between them covered the demands of the critical health movement of the time: for a debate on professional power in medicine, for participative democracy and active community engagement, for action on the determinants of health, and for those in public health to act as activists regarding those issues that are core to providing health for all, such as maternity rights, housing and tobacco control. It has become a truism that these concerns have moved to the mainstream, with public policy now espousing a very similar agenda. Injury prevention provides an illustrative case, with UK national policy being typical of many high-income countries. First, the fact that injury prevention has become a core issue for many public health professionals and an international and national strategic priority reflects a readiness to engage with health issues that are rooted clearly in the social environment. The WHO World Health Day in 2004 was devoted to road safety. National policies on injury prevention increasingly, at least superficially, reflect a social, rather than narrowly medical, model of ill health, accepting that reductions in mortality and morbidity are likely to come from the activities of road engineers, legislators or manufacturers, rather than those of health professionals, and advocating partnerships at the level of strategic planning and implementation to address the broad social determinants of injury. Second, there is often an explicit focus on inequalities in health, with funding for schemes that focus on deprived areas and an obligation for local authorities to show how their plans will take deprivation into account. Community engagement is widely advocated, in terms of both including citizens in planning committees and developing interventions with public participation. So, if the demands of critical public health have apparently been met, with a public health agenda now firmly at the centre, where is the ‘edge’, and what role, if any, is there for a critical perspective? One is of course keeping up the momentum for change and, as Robin Bunton and Jane Wills noted in an editorial in this journal, ‘public health needs to be kept at the forefront of any political agenda’ (Bunton & Wills, 2004). Whilst not wanting to underplay gains that have been made, there is, though, also a continued vital role for those on the margins, providing an explicitly critical voice as well as support for the progressive inclusion of public health at the centre. This task is not only as essential as ever but also as uncomfortable, given the dominance of an evidence-based and increasingly rationalist public policy. Against a centre simultaneously claiming both the liberal moral high ground and scientific justification, critique can too easily be dismissed as irrational, romantic or reactionary. To stay with the example of injury, there are some obvious indicators of the continued and urgent need for such a critique. First, inequalities in mortality are a reminder of the enormous task still facing us in achieving equity. Internationally, 1.2 million people a year die from a road traffic injury. About 85% of those are in lowand middle-income
TL;DR: In this article, the authors examined how responsibility for the planning of state-funded HIV prevention services shifted from UK central government to local commissioners during the "era of normalization" in the 1990s.
Abstract: This paper examines how responsibility for the planning of state-funded HIV prevention services shifted from UK central government to local commissioners during the ‘era of normalization’ in the 1990s. It explores whether according to literature from the period these changes experienced were those that would be predicted by theories of ‘advanced liberalism’, i.e. delegation of operational planning, centralization of strategic target setting, and increased scrutiny of ‘expert’ providers. The paper examines the changes that were described in power relations among key players, using advanced liberalism to structure this examination. The paper concludes that many but not all of the reported changes conformed to these predictions. Although the government did set targets, these targets did not function as effective levers on local activity. Although delegation of planning to local commissioners did occur, their authority was restrained by the retention of specific earmarked HIV prevention funding. Although scru...
TL;DR: It is suggested that various processes of professional boundary maintenance combined with perceptions of public health amongst the wider community of practitioners may constrain the establishment of new ways of collaborative working between specialist public health practitioners and the wider public health workforce within and beyond the NHS.
Abstract: This paper aims to stimulate critical reflection and debate on the future development of multidisciplinary and collaborative public health practice. Focusing on the early experience of public health networks, it suggests that various processes of professional boundary maintenance combined with perceptions of public health amongst the wider community of practitioners may constrain the establishment of new ways of collaborative working between specialist public health practitioners and the wider public health workforce within and beyond the NHS.
TL;DR: In this article, it is argued that evidence of effective interventions plays a relatively small part in decision-making at a local level, and that greater attention should be directed to ways in which inequalities can be conceptualized and prioritized at local level and barriers to its implementation.
Abstract: Evidence of effectiveness is prominent as a basis for decision-making. Addressing inequalities is a key UK policy objective to be implemented through national and local strategies. Tensions that emerge in adopting an evidence-based approach for tackling inequalities in health are only partly due to limitations of the evidence base in this area. Three research and development projects on different aspects of addressing the inequalities agenda, carried out in the North East of England between 2000 and 2002, explored how local decision-makers tackled inequalities in health and how this issue was reflected in local strategies. These projects illustrate the breadth of this agenda, different ways in which it can be conceptualized and prioritized at a local level and barriers to its implementation. It is argued that evidence of effective interventions plays a relatively small part in decision-making at a local level. In order to address inequalities in health, greater attention should be directed to ways in whic...
TL;DR: Choosing Health is the first English public health strategy to highlight the concepts of corporate social responsibility and corporate citizenship and discuss their importance for health improvement as mentioned in this paper, and a subsequent mapping exercise identified North West England as being one of the regions with a particularly well-developed approach.
Abstract: Choosing Health is the first English public health strategy to highlight the concepts of corporate social responsibility and corporate citizenship and discuss their importance for health improvement Although the terms are used most widely in relation to private corporations, there has been growing discussion of their application to public sector organizations The King's Fund report Claiming the Health Dividend led to a growing recognition that corporate citizenship within the National Health Service can make an important contribution to public health, regeneration, sustainable development and the reduction of inequalities—and a subsequent mapping exercise identified North West England as being one of the regions with a particularly well-developed approach This paper introduces the concepts of corporate social responsibility and corporate citizenship; explores the theoretical and policy contexts relating to its application within the NHS—discussing links to sustainable development, Investment for Health
TL;DR: The role of the media and information industries in representing and constructing problems, policies and individual and collective identities becomes a significant one as discussed by the authors, as well as the importance of face-to-face social interaction and the immediacy of social life are exaggerated.
Abstract: It has been claimed that throughout the 20th century, public health was concerned less with contagion and potentially dangerous individuals and increasingly with flows of populations, interactions between bodies and the spaces of their interaction. The 21st century is likely to extend a more detailed and extensive gaze on the public health whose primary concern becomes the surveillance and regulation of potentially risky behaviours, practices and public policies. If these trends are discernable, they may begin to explain the increased importance of disciplines that purport to study the social and geographical spaces that are central to understanding contemporary epidemics and pandemics, as well as the so-called diseases of civilization which dominate contemporary public health practice. We can see some increase in the profile of the social sciences in recent years, not least their influence on epidemiology and medical sciences. And yet, in certain respects the importance of face-to-face social interaction and the immediacy of social life are exaggerated. Everyday-life is increasingly mediated by flows of information and the rapid circulation of cultures across time and space, and the role of the media in both speaking to, and constructing ever wider and more diverse communities becomes a significant one. The newer information technologies have made global flows of information and knowledge as a feature of social life, even within the most remote of communities, classes and other groupings. Knowledge and information are central to contemporary economic organization and to global capitalism, as we know it. Any serious consideration of the contemporary social organization and the make up of public health populations must thus be cognizant of the role of the media and information industries in both representing and constructing problems, policies and individual and collective identities. The roles of those who are responsible for shaping the information we receive from diverse media, the movers and shakers of the information society, or what the French sociologist Bourdieu referred to as the ‘new cultural intermediaries,’ (those that have supplanted the traditional ideologues of the church, state, the professions and the academy) need to be accounted in the strategies to address the social relations of public health. Unsurprisingly, public health practice and research has always been concerned with the media representation of health as an important site for the shaping of public opinion and behaviours towards the health issues of the day. There is, however, perhaps a heightened awareness of the power of the media in recent decades. Public health activists are aware that they may be battling as much with negative, inaccurate or inappropriate representation of public health topics such as HIV/AIDS, sexual health, drug misuse, tobacco products and food risks, for example, as they are with the consequences of current everyday health practices relating to these areas. We are aware that there are huge inequalities in access to the production of popular knowledge and different public health interest groups must often fight for the right to representation. The concentration
TL;DR: While women at low to moderate risk of developing breast cancer generally felt reassured after counselling, many did not understand the information they had been given and some continued to overestimate their own risk of disease.
Abstract: A high demand exists in the United Kingdom for breast cancer genetic counselling. Due to the disease's high incidence, many women who received such counselling are eventually assessed as not being at high genetic risk. This study elicits the experiences and perceptions of such women, as little research has been conducted. A qualitative interview-based study was conducted in the north-east of Scotland with a sample of women at low to moderate risk of developing breast cancer, who had received genetic counselling. The interviews addressed the women's reasons for attending genetic counselling, their prior expectations and their perceptions of the outcomes of counselling. A thematic analysis was conducted to identify the key themes. The women themselves were mainly responsible for raising concerns regarding family history and, in general, sought information and reassurance about their own risk. Whilst they generally felt reassured after counselling, many did not understand the information they had been given ...
TL;DR: For example, Critical Public Health as discussed by the authors is a journal dedicated to the management of public health information and knowledge in the context of e-mail lists, discussion groups, and e-notices of conferences.
Abstract: It has become a truism to say we are living in a shrinking world, or a global village, with globalisation affecting every facet of modern life (Scholte, 2000; Bech, 2005). This is as true of the public health field as of other aspects of contemporary society (Lee & Collin, 2005; McMichael & Beaglehole, 2000). One of the underlying drivers of globalisation has been the revolution in information technology, in particular the growth and increasing speed of the internet. We have access to a wider range of information and knowledge than ever before, often with virtually instantaneous access. Many of us are members of electronic public health discussion groups or email lists, receive electronic public health newsletters and e-notices of conferences, new books and journal tables of contents. Inevitably this has changed the way public health practitioners and academics access and use public health literature. Increasingly we are utilizing online search engines such as Google Scholar (http://scholar.google.com/) and PubMed (http://www.ncbi.nlm.nih.gov/ entrez/) to find and download individual articles of interest to us. Fewer and fewer of us now subscribe to and read through whole paper issues of journals, if we ever did. Indeed, many academic institutions are cancelling their paper subscriptions to journals and prioritising their scarce library resources on collections of e-journals. The benefits of this technological revolution are undoubted. Whereas once one might spend weeks visiting libraries, photocopying dog-eared bound volumes or waiting further weeks for interminable inter-library loans to arrive, now the latest research is available at the click of a mouse. Of course the well recognised downside of the information technology revolution is that as well as having access to more information than ever before, we also have to try to manage it. And too often public health practitioners and academics face the challenge of information overload. This can range from receiving hundreds of not always wanted emails a day, to the availability of so much research literature at one’s fingertips that one is swamped by it. At the extreme, too much information can be as dysfunctional as too little. Thus information and knowledge management have become new core public health skills (Yasnoff et al., 2000). As are other journals, Critical Public Health is seeking to respond to this new reality of balancing increased expectation for instant access with the need to manage public health information and knowledge. Electronic subscriptions to Critical Public Health are increasing, particularly from the libraries of academic institutions, and those of you with institutional e-subscriptions are probably already practiced at downloading Critical Public Health articles of interest. For those without a subscription, there is a facility on the
TL;DR: Examining the OECD Guidelines’ construction of public health policy in poor countries is examined, drawing attention to the ideological agenda and linked conflicts of interest.
Abstract: The OECD's Guidelines on Poverty and Health are compromised by neoliberal assumptions and corrupted by several major conflicts of interest. These conflicts of interest are embodied in the DAC guidelines, whereby specific OECD commercial interests influence the public policies of developing countries. Commercial agendas are being incorporated into developing country health policy through development assistance doctrine. Yet better critical health outcomes generally occur in the well-coordinated, public health systems, rather than those with high levels of private supplementation. This paper examines the OECD Guidelines’ construction of public health policy in poor countries, drawing attention to the ideological agenda and linked conflicts of interest.
TL;DR: Social responsibility, ethical investment, sustainable development—these are the new pillars of good organizational behaviour, leading us from a consideration of the single bottom line of profit to the new era of triple bottom lines—environmental, social and economic.
Abstract: Hospitals are the icons of the healthcare system, our latter-day temples of healing Rightly or wrongly (and let's face it, it is wrongly), they have come to represent health Moreover, they are of