Showing papers in "Critical Public Health in 2013"
TL;DR: A critical sociological perspective is adopted to identify some of the social and cultural meanings of self-tracking practices via digital devices and how these technologies promote techno-utopian, enhancement and healthist discourses via these devices.
Abstract: Mobile and wearable digital devices and related Web 2.0 apps and social media tools offer new ways of monitoring, measuring and representing the human body. They are capable of producing detailed biometric data that may be collected by individuals and then shared with others. Health promoters, like many medical and public health professionals, have been eager to seize the opportunities they perceive for using what have been dubbed ‘mHealth’ (‘mobile health’) technologies to promote the public’s health. These technologies are also increasingly used by lay people outside the professional sphere of health promotion as part of voluntary self-tracking strategies (referred to by some as the ‘quantified self’). In response to the overwhelmingly positive approach evident in the health promotion and self-tracking literature, this article adopts a critical sociological perspective to identify some of the social and cultural meanings of self-tracking practices via digital devices. Following an overview of the techno...
458 citations
TL;DR: This paper reflects on the theories of public health that lie behind the discourse of assets, together with some of the reasons for, and consequences of, its popularity and influence, notably in Scotland.
Abstract: It is a paradox of recent epidemiology that as material inequalities grow, so the pursuit of non-material explanations for health outcomes proliferates. At one level, a greater recognition of psycho-social factors has deepened the understanding of the societal determinants of health, the links between mental and physical health and the social nature of human need. Too often however, psycho-social factors are abstracted from the material realities of people’s lives and function as an alternative to addressing questions of economic power and privilege and their relationship to the distribution of health. The growing influence of salutogenesis and asset-based approaches is one example of this trend. This paper reflects on the theories of public health that lie behind the discourse of assets, together with some of the reasons for, and consequences of, its popularity and influence, notably in Scotland.
126 citations
TL;DR: It is concluded that social networking systems are positive and pleasurable for young people, but are likely to contribute to pro-alcohol environments and encourage drinking.
Abstract: Alcohol consumption and heavy drinking in young adults have been key concerns for public health. Alcohol marketing is an important factor in contributing to negative outcomes. The rapid growth in the use of new social networking technologies raises new issues regarding alcohol marketing, as well as potential impacts on alcohol cultures more generally. Young people, for example, routinely tell and re-tell drinking stories online, share images depicting drinking, and are exposed to often intensive and novel forms of alcohol marketing. In this paper, we critically review the research literature on (a) social networking technologies and alcohol marketing and (b) online alcohol content on social networks, and then consider implications for public health knowledge and research. We conclude that social networking systems are positive and pleasurable for young people, but are likely to contribute to pro-alcohol environments and encourage drinking. However, currently research is preliminary and descriptive, and we need innovative methods and detailed in-depth studies to gain greater understanding of young people's mediated drinking cultures and commercial alcohol promotion.
120 citations
TL;DR: This study offers a much-needed theoretical engagement with community-based participatory research (CBPR) and raises critical questions about the limits of community engagement in collaborative public health research.
Abstract: The disappointing results of many public health interventions have been attributed in part to the lack of meaningful community engagement in the planning, implementation, and evaluation of these initiatives Community-based participatory research (CBPR) has emerged as an alternative research paradigm that directly involves community members in all aspects of the research process Their involvement is often said to be an empowering experience that builds capacity In this paper, we interrogate these assumptions, drawing on interview data from a qualitative study investigating the experiences of 18 peer researchers (PRs) recruited from nine CBPR studies in Toronto, Canada These individuals brought to their respective projects experience of homelessness, living with HIV, being an immigrant or refugee, identifying as transgender, and of having a mental illness The reflections of PRs are compared to those of other research team members collected in separate focus groups Findings from these interviews are discussed with an attention to Foucault's concept of ‘governmentality’, and compared against popular community-based research principles developed by Israel and colleagues While PRs spoke about participating in CBPR initiatives to share their experience and improve conditions for their communities, these emancipatory goals were often subsumed within corporatist research environments that limited participation Overall, this study offers a much-needed theoretical engagement with this popular research approach and raises critical questions about the limits of community engagement in collaborative public health research
106 citations
TL;DR: Since the WHO (1998) lamented the so-called "obesity epidemic" over a decade ago, there has been much rhetoric and concern about fatness/weight/obesity across an increasing range of national contex as discussed by the authors.
Abstract: Since the WHO (1998) lamented the so-called ‘obesity epidemic’ over a decade ago, there has been much rhetoric and concern about fatness/weight/obesity across an increasing range of national contex
71 citations
TL;DR: This case study shows that previously reported associations with dogs can be linked to the wording and the day-to-day implementation of local governments’ bylaws on pets.
Abstract: Dog walking enables physical activity and positive social interactions, but uncontrolled dogs as well as dog feces can foster conflict and deter physical activity, for both dog owners and nonowners. This case study shows that previously reported associations with dogs (both positive and negative) can be linked to the wording and the day-to-day implementation of, or incompliance with, local governments’ bylaws on pets. In this example of posthumanist health promotion, the policy goal is to optimize the overall impact on well-being of pet animals. Analytically, the case study draws together insights from actor–network theory, Foucault’s theory of governmentality, Bourdieu’s theory of habitus, and anthrozoology (i.e. the study of human–animal interactions as well as related ideas and norms). Posthumanist health promotion is a theoretically informed approach that can assist in developing policy and implementation strategies, not only on pets but on a range of topics.
63 citations
TL;DR: It is argued more generally that predominant ways of measuring the obesity epidemic inscribe notions of normative size that are based in averages and intensify the use of size as the litmus test for health or well-being.
Abstract: Scholars in science studies have coined the concept ‘artifactual constructivism’ to denote the techniques, laboratory practices, conventions, observational methods, instrumentation and measurements that produce scientific facts. Applying artifactual constructivism to biophysical phenomena is not to deny that a particular phenomenon materially exists, but to highlight that it can only be known through the specific tools and techniques of measurement that bring it into being. This article examines some of the tools and techniques that have been deployed to understand the growth in American body sizes to argue that the ‘obesity epidemic’ is an artefact of particular epidemiological measures and conventions. It is not that they are wrong; it is that these tools can paint the picture in ways that may over-dramatize some elements and under-specify others and can also foreclose other problem conceptualizations. It will give specific focus to the use of the Body Mass Index to measure adiposity, the categorization...
58 citations
TL;DR: The potency of overweight and obesity as cultural signifiers for T2DM and its consequences has received little attention and is traced and unpack some of the contours of these convergences, while recognizing their entanglement in earlier moralizing discourses, which continue to have considerable salience.
Abstract: Although overweight and obesity are increasingly seen as the key ‘risk factors’ for Type 2 diabetes mellitus (T2DM), the relationship between them is complex and not well understood. There are many...
56 citations
TL;DR: In this paper, the authors argue that the current weight-centric approach to the promotion and practice of physical activity for health is systematically marginalised or silenced in this discourse, and they outline the significance of a public pedagogy approach in developing alternative ways of promoting, representing and experiencing physical activity beyond weight focused perspectives.
Abstract: This paper examines the current weight-centric approach to the promotion and practice of physical activity for health. We argue that examining the assumptions and belief systems that drive physical activity promotion may provide a foundation for considering and pursuing appropriate forms of social change in the policy, prescription and practice fields. Counter perspectives and critical voices offering alternative health paradigms are systematically marginalised or silenced in this discourse. We outline the significance of a public pedagogy approach in developing alternative ways of promoting, representing and experiencing physical activity beyond weight focused perspectives. We advocate that physical activity policy makers and practitioners, including those promoting a non weight-centric approach to health need to undertake ‘border crossing’ and work across ‘artificial’ institutional barriers. The paper discusses the principles of a non-weight based, cross-disciplinary Health at Every Size (HAES) approach...
55 citations
TL;DR: It is suggested that directive, critical public health campaigns, and the associated social stigma, may actually make it harder for some to stop smoking, and more supportive approaches that move away from a focus on individual responsibility, and from the assumption that pregnant women need to be coerced into healthy decision-making, might better assist some pregnant smokers to seek cessation support.
Abstract: A substantial minority of Western women smoke during pregnancy. Understanding smoking from these women’s point of view may provide a richer understanding of experiences that are very often silenced, and provide some explanation for why pregnant women smoke despite widely disseminated public health campaigns urging them to stop. Strong social pressures directed at women to stop, justified mainly by arguments of protecting the foetus, are reinforced through the policing of women’s bodies, which is particularly powerful during pregnancy. This emerges in the form of criticism, confrontation and judgement, irrespective of individual women’s contexts and social backgrounds. Interviews with 11 Australian women who had smoked during recent pregnancies were conducted to explore their smoking-related experience of stigma. Thematic analysis examined their perceptions of stigma and surveillance, in the strong anti-smoking climate of Australia. Women’s talk constructed medical and social pressures as two separate dime...
50 citations
TL;DR: In this commentary, a review of recent social science writing on the representation of obesity in the media is reviewed and three dominant themes in this research are explored, the framing of Obesity, media reporting of obesity research, and media characterizations of and reporting on obesity policy.
Abstract: Obesity has become a mainstay of media in all its forms and sociologists and others have increasingly sought to understand what reporting on obesity can tell us about the construction of social pro...
TL;DR: Connecting Communities as mentioned in this paper is an experiential learning program to transform the health and well-being of disadvantaged communities by focusing on the nature of the relations between the agents in the system and their interactions with the social environment which determine the system's behaviour.
Abstract: The standard, deficit-based, approach to health promotion tends to focus on health problems, designing services which are meant to solve these problems, of which members of communities are made the passive recipients. An alternative approach recognises that health problems are complex, having many causal pathways and as a result will require locally tailored interventions, involving multiple service providers working with local communities. Using empirical research from the development of two transformational community-led partnerships, an experiential learning programme was developed, Connecting Communities (C2). Complexity science is the underpinning theoretical framework for C2, which seeks to create the conditions to transform the health and well-being of disadvantaged communities. C2 focuses specifically on the nature of the relations between the agents in the system and their interactions with the social environment which determine the system’s behaviour. This is because a key tenet of complexity sc...
TL;DR: The articles explore diverse efforts to track and to exploit healthrelated phenomena and highlight some of the central dynamics that characterize the health-related surveillance of bodies, populations and polities.
Abstract: The papers in this special section of Critical Public Health engage with the broad topic of health surveillance. Originally presented together as a panel at the Surveillance and/in Everyday Life co...
TL;DR: The purpose of this special section is to further explore what is known and what needs to be done to develop an assets evidence base for public health.
Abstract: The concept for this special section of the journal arose from the Second International Symposium on Health Assets in a Global Context: Theory Methods Action, London (2011), a two day event designe
TL;DR: Results of this study contribute to critical obesity scholarship, as they interrupt assumptions that position populations with high obesity rates as unknowing and uncaring about healthy eating and body weight, demonstrate the ways in which a population might resist biopedagogies of obesity, and highlight the need for research disrupting universalist stereotypes about ‘problem populations’ and their health behaviors.
Abstract: High rates of obesity in Newfoundland and Labrador, Canada’s eastern-most province, have helped to position Newfoundlanders as a ‘problem population’ within discourses of the Canadian obesity ‘epid...
TL;DR: In this paper, the profoundly gendered nature of normative body ideals and weight-management practices in Western cultures has been investigated, and critical analyses have shown that normative body idealism and weight management practices are inherently gendered.
Abstract: Numerous critical analyses have already established the profoundly gendered nature of normative body ‘ideals’ and weight-management practices in Western cultures. Such studies have, amongst other t...
TL;DR: In this paper, the authors explore assets for health and well-being for women in extremely poor rural areas in Ghana, Haiti, India, Philippines, and Tanzania through individual interviews and focus group interviews with local women.
Abstract: This paper explores assets for health and well-being for women in extremely poor rural areas in Ghana, Haiti, India, the Philippines, and Tanzania. Data were collected through individual interviews and focus group interviews with local women. The paper asks (i) which assets women draw on for well-being in resource-poor settings, and (ii) whether an assets approach, as understood in the Salutogenic Model, is appropriate and meaningful in the most deprived areas. Low levels of natural, material and infrastructural resources were reported by the respondents to cause stress, and assets of a human, social and cultural character were identified as being important in coping with this stress. By mobilizing the capacity and assets of people and places, local development initiatives will make sense logically (comprehensibility), they will be perceived to be practically realistic (manageability), and they will be motivating because they are meaningful, based on involvement in decision-making (meaningfulness). The as...
TL;DR: In this paper, the authors argue that mainstream dietetics buttresses a conventional weight management agenda that is associated with weight preoccupation, body dissatisfaction, size oppression, and troubled eating.
Abstract: Mainstream dietetics buttresses a conventional weight management agenda that is associated with weight preoccupation, body dissatisfaction, size oppression, and troubled eating. Coterminous with th...
TL;DR: In this article, the authors report on the analysis of 20 interviews with African American women to help elucidate the complicated narratives of body image in women's lives and discuss the implications for obesity and body image research.
Abstract: Since the turn of the century, obesity has emerged in the public consciousness as an important public health concern. While the illnesses considered to be associated with obesity are pressing, related individual-level interventions may not be sufficient and may also stigmatize overweight and obese individuals as deficient. Weight-related stigma has a more significant impact on body image for women than men, though the majority of research on African American women suggests that they are culturally protected from body weight dissatisfaction. This article reports on the analysis of 20 interviews with African American women to help elucidate the complicated narratives of body image in women's lives. Implications for obesity and body image research are discussed.
TL;DR: The conundrum of apparently low levels of perinatal depression among Black British Caribbean women despite significant levels of psychosocial risk is explored and the intersections of ethnicity, gender and spirituality might provide at least a partial explanation for apparent underdiagnosis.
Abstract: Ethnic disparities in UK mental healthcare persist despite decades of policy and practice initiatives to eradicate them Inequalities in access, care and outcomes are most evident among people of Black Caribbean origin However, much of this evidence is derived from clinical practice and research among men with serious mental illness Lack of evidence about common mental health issues in Black British Caribbean women is an important omission as reducing inequalities in mental healthcare and providing effective interventions require improved understanding of aetiology, epidemiology, symptom profile and ways of coping In this paper, I explore the conundrum of apparently low levels of perinatal depression among Black British Caribbean women despite significant levels of psychosocial risk and against the backdrop of high prevalence of diagnosed mental illness among Black British Caribbean men I posit that the intersections of ethnicity, gender and spirituality might provide at least a partial explanation fo
TL;DR: It is argued that health promotion in community settings occupies a paradoxical space that is continuously negotiated by both health promotion workers and community residents, and health Promotion workers need to be able to move between cooperative and procedural approaches in order to navigate the frequently conflicting demands of community, agency and professional expectations inorder to achieve the best outcomes for communities.
Abstract: Health promotion is informed by epidemiology, requires engagement with socially situated subjects and can involve diverging emphases. For some practitioners, health promotion is a specialised set of activities and technical knowledge for disseminating health information. For others, it advances broad-based and interlinked goals of socio-economic and health equality through processes of community engagement and participation. These diverging approaches are explored in qualitative data gathered from health promotion workers and residents involved in an area-based initiative that included aims to reduce health inequalities. The findings describe two distinctive approaches to health promotion that are characterised as ‘procedural’ and ‘cooperative’. Procedural styles, in the manner of ‘top down’ approaches, tend to differentiate between lay communities and professionals, involve predefined channels for community input, rely on ‘off the shelf’ health promotion packages and minimise the significance of local co...
TL;DR: In this paper, the experiences of two researchers working to develop critical accounts of fatness with very different research participants (Town planners and English Channel swimmers) were used to draw a conclusion about fatness.
Abstract: This paper draws on the experiences of two researchers working to develop critical accounts of fatness with very different research participants – town planners and English Channel swimmers. Drawin...
TL;DR: Opportunities for successful transition could be enhanced by a more ‘joined-up’ settings perspective and it is proposed that a settings-based approach to health promotion should be applied to prisons to reduce, rather than exacerbate, inequalities.
Abstract: Through qualitative exploration with soon-to-be released men in three prisons in England, this article examines the difficulties that prisoners envisage on returning back to community settings, entering other settings such as workplaces, and the implications the transition may have for their health. Interviews and focus groups were conducted with 36 prisoners, some of whom were convicted of sexual offences and based on a vulnerable prisoner unit. While not all prisoners offered the information, approximately two-thirds of the sample had offended previously. The transition that individuals make from the prison setting to the community can be potentially complex and often detrimental to health. Accommodation issues were forecast as a major concern for those men without family ties. Temporarily residing with friends or living in hostel residences were viable options for many prisoners, but both had drawbacks which could increase the probability of engaging in substance misuse. Resettlement issues were percei...
TL;DR: This article retraces the policy narratives in documentary materials (parliamentary debates, policy documents, public advocacy and empirical research) to reflect on the causes for policy impermeability in this contested arena.
Abstract: In 2006, 2010, and 2011 attempts were made by health policy advocates to ignite policy debate about the introduction of supervised injecting facilities (SIFs) in Melbourne, Australia. Although there have been a number of attempts to introduce SIFs in Australia, only one facility has been introduced in Sydney, and it has only recently achieved full operating status beyond an extended nine-year trial period. This article retraces the policy narratives in documentary materials (parliamentary debates, policy documents, public advocacy and empirical research) to reflect on the causes for policy impermeability in this contested arena. Interest in supervised injecting rooms, whilst always an exemplar of harm reduction, actually emerged in New South Wales in the mid-1990s from government concern over endemic police corruption. Subsequent policy narratives in Victorian SIF advocacy tended to focus heavily on the health and welfare of drug users, with a notable absence of concern about SIFs as a response to police ...
TL;DR: Results suggest that nondisclosure prosecutions appear to have affected the STI testing practices of the participants in this research who were: (a) the most likely to have reported a sexual history involving unprotected receptive anal sex, and (b) the least likely toHave undergone testing for STIs.
Abstract: In 1998, the Supreme Court of Canada ruled that prosecuting people for HIV-status nondisclosure would neither affect people’s willingness to undergo HIV testing, specifically, nor undermine HIV prevention, more generally. Since that time, limited research has explored this topic. This paper reports a survey of a convenience sample of 721 gay, bisexual, and other men who have sex with men. The aim was to examine participants’ sexually transmitted infection (STI) and HIV testing practices, sexual activities, and perceptions about nondisclosure prosecutions. Results suggest that nondisclosure prosecutions appear to have affected the STI testing practices of the participants in this research who were: (a) the most likely to have reported a sexual history involving unprotected receptive anal sex, and (b) least likely to have undergone testing for STIs.
TL;DR: Focus groups with Black women aged 18–45 years in Broward County, Florida suggest that participants were aware of the importance of healthy eating and physical activity, but that ‘healthy’ behavior was perceived as requiring considerable ‘pre-planning’ and commitment.
Abstract: Black women’s experiences of, perceptions of, and attitudes to healthy eating and physical activity have been suggested as contributors to their high rates of obesity. This paper uses data from four focus groups with Black women aged 18–45 years in Broward County, Florida, to explore their views. Findings suggest that participants were aware of the importance of healthy eating and physical activity, and motivated by wanting to model healthy behaviors for their families, but that ‘healthy’ behavior was perceived as requiring considerable ‘pre-planning’ and commitment. Programs addressing Black women that incorporate their perceptions and work with them to overcome challenges are needed.
TL;DR: The manner in which the Australian border control regime functions as a technology of surveillance in relation to the ‘threat’ of TB and the effects it both produces for individuals and affected communities is highlighted.
Abstract: Surveillance has always been intricately connected to both the theory and practice of public health. The salience of epidemiologic method, particularly the enumeration of ‘risk factors’ and the interpolation of different population ‘groups’, underscores this reality. However, in the post 9/11 era, there has been a conflation between public health and ‘national security’ concerns. Consequently, border control, imagined as a frontier where the two most readily connect, now co-opts public health concerns, for instance ‘threats’ to legitimate specific forms of securitisation, including the case of infectious diseases such as tuberculosis. In this paper, we highlight the manner in which the Australian border control regime functions as a technology of surveillance in relation to the ‘threat’ of TB and the effects it both produces for individuals and affected communities. Specifically, we highlight how spectacles enacted in the name of border control need to be carefully attended to, lest they ultimately serve ...
TL;DR: The authors presented an account of African Caribbean men and women's beliefs and perceptions about the barriers of practising a healthy lifestyle, focusing specifically on the effects of social exclusion, racism and ethnic identity.
Abstract: While studies have focused on tangible indicators of the practice of healthy lifestyles, there remains a dearth of research exploring the inter-relationships between the practice of healthy lifestyles and the prevailing living circumstances of Black and other visible minority ethnic communities in Western societies. This article presents an account of African Caribbean men and women's beliefs and perceptions about the barriers of practising a healthy lifestyle, focusing specifically on the effects of social exclusion, racism and ethnic identity. A total of 18 participants from the north of England participated in the study, with in-depth interviews conducted in their homes. The participants believed that principles of healthy lifestyles were largely not relevant to their lived experiences because they failed to take into account their experiences of racism, social exclusion, ethnic identity, values and beliefs. Indeed, participants argued that, with their emphasis on illness prevention and perceived Euroc...
TL;DR: This position paper outlines some disparities in African Caribbean women's reproductive experiences in relation to contraception, abortion and infertility in contemporary UK, and calls for greater research into their reproductive experiences, in order to better understand and meet their reproductive needs.
Abstract: Race and reproductive politics have been intimately entwined in Britain over centuries of colonialism and imperialism. As a critical reading of the autobiography of formerly enslaved Mary Prince testifies, African Caribbean women entered Britain against an established backdrop of racialised mythologies of errant black female sexuality and hyperfertility. Such beliefs prevail, producing disparities in black women°s reproductive choices, and informing and shaping public policy. Despite the evidence of racialised disparities in their reproductive choices, health and care, there is a paucity of scholarship addressing African Caribbean women°s reproductive experiences. Appreciating the historical function of race is vital to understanding contemporary reproductive experiences of black women, whose bodies continue to be critical sites in the exercise of state power. This position paper outlines some disparities in African Caribbean women°s reproductive experiences in relation to contraception, abortion and infe...
TL;DR: In this article, the authors examine recent debates in the USA regarding the communication of personal biomonitoring data to research participants and examine the uncertainties that currently surround the interpretation of these data: health implications are typically unknown and measured chemical concentr...
Abstract: This article examines recent debates in the USA regarding the communication of personal ‘human biomonitoring’ data to research participants. Biomonitoring is a technique used to measure environmental chemicals, their metabolites, and/or byproducts in human fluids and tissues. Though first used in occupational settings in the early twentieth century, the tools and techniques used in biomonitoring have been substantially refined in recent decades, resulting in the production of a progressively large volume of human exposure data. While the use of biomonitoring has shed new light on human exposures to a wide array of chemicals ranging from pesticides to plasticizers, it has also raised new scientific, social, and ethical questions. Among these is whether or not researchers are obligated to provide research participants with personal data in light of the considerable uncertainties that currently surround the interpretation of these data: health implications are typically unknown and measured chemical concentr...