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Book part
Publication date: 1 October 2013

Manuel Vallée

Since the beginning of the 20th century environmental health researchers have known about the association between toxicant exposure and disease. However, that knoweldge…

Abstract

Purpose

Since the beginning of the 20th century environmental health researchers have known about the association between toxicant exposure and disease. However, that knoweldge has not been well integrated into mainstream medicine. Shedding light on why is the focus of this chapter.

Methodology/approach

To shed light on this issue I analyze the 2011 American Academy of Pediatrics’ clinical practice guidelines for Attention Deficit/Hyperactivity Disorder (ADHD), focusing specifically on the omission of environmental health research pertaining to ADHD symptoms and exposures, such as lead and mercury.

Findings

I found that while environmental researchers have been documenting the link between lead and ADHD for over forty years, the American Academy of Pediatrics has completely omitted this research from its 2012 clinical practice guidelines. Moreover, I argue this omission can be traced to competitive pressures to protect medical jurisdiction, and a reductionist worldview that emphasizes treatment over prevention.

Originality/value of paper

This is the first attempt to analyze the way clinical practice guidelines help reinforce and perpetuate dominant medical perspectives. Moreover, to shed explanatory light, this chapter offers a synthetic explanation that combines materialist and ideological factors.

Research implications

Beyond the specific case of ADHD, this chapter has implications for understanding how and why environmental health research is omitted from other materials produced by mainstream medicine, such as materials found in the medical school curriculum, continuing medical education, medical journals, and on the medical association web sites.

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Book part
Publication date: 1 January 2004

Stephen Zavestoski, Rachel Morello-Frosch, Phil Brown, Brian Mayer, Sabrina McCormick and Rebecca Gasior Altman

Health social movements address several issues: (a) access to, or provision of, health care services; (b) disease, illness experience, disability and contested illness;…

Abstract

Health social movements address several issues: (a) access to, or provision of, health care services; (b) disease, illness experience, disability and contested illness; and/or (c) health inequality and inequity based on race, ethnicity, gender, class and/or sexuality. These movements have challenged a variety of authority structures in society, resulting in massive changes in the health care system. While many other social movements challenge medical authority, a rapidly growing type of health social movement, “embodied health movements” (EHMs), challenge both medical and scientific authority. Embodied health movements do this in three ways: (1) they make the body central to social movements, especially with regard to the embodied experience of people with the disease; (2) they typically include challenges to existing medical/scientific knowledge and practice; and (3) they often involve activists collaborating with scientists and health professionals in pursuing treatment, prevention, research, and expanded funding. We present a conceptual framework for understanding embodied health movements as simultaneously challenging authority structures and allying with them, and offer the environmental breast cancer movement as an exemplar case.

Details

Authority in Contention
Type: Book
ISBN: 978-0-76231-037-1

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Book part
Publication date: 23 October 2003

Beth E Jackson

Epidemiology is often described as “the basic science of public health” (Savitz, Poole & Miller, 1999; Syme & Yen, 2000). This description suggests both a close…

Abstract

Epidemiology is often described as “the basic science of public health” (Savitz, Poole & Miller, 1999; Syme & Yen, 2000). This description suggests both a close association with public health practice, and the separation of “pure” scientific knowledge from its application in the messy social world. Although the attainability of absolute objectivity is rarely claimed, epidemiologists are routinely encouraged to “persist in their efforts to substitute evidence for faith in scientific reasoning” (Stolley, 1985, p. 38) and reminded that “public health decision makers gain little from impassioned scholars who go beyond advancing and explaining the science to promoting a specific public health agenda” (Savitz et al., 1999, p. 1160). Epidemiology produces authoritative data that are transformed into evidence which informs public health. Those data are authoritative because epidemiology is regarded as a neutral scientific enterprise. Because its claims are grounded in science, epidemiological knowledge is deemed to have “a special technical status and hence is not contestable in the same way as are say, religion or ethics” (Lock, 1988, p. 6). Despite the veneer of universality afforded by its scientific pedigree, epidemiology is not a static or monolithic discipline. Epidemiological truth claims are embodied in several shifting paradigms that span the life of the discipline. Public health knowledges and practices, competing claims internal and external to epidemiology, and structural conditions (such as current political economies, material technologies, and institutions) provide important contexts in which certain kinds of epidemiological knowledge are more likely to emerge.

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Gender Perspectives on Health and Medicine
Type: Book
ISBN: 978-1-84950-239-9

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Article
Publication date: 13 February 2017

Hamish Robertson

The purpose of this paper is to explore the potential value of applying spatial science and technology to the issue of care integration across what are the often…

Abstract

Purpose

The purpose of this paper is to explore the potential value of applying spatial science and technology to the issue of care integration across what are the often fragmented domains of health and social care provision. The issue of focus for this purpose is population ageing because it challenges existing information and practice silos. Better integration, the author proposes, needs to adopt a geographic approach to deal with the challenges that population ageing present to health and social care as they currently function in many countries.

Design/methodology/approach

The approach utilised here explores the role that could be played by enhancing spatial perspectives in care integration. Spatial and temporal strategies need to be coordinated to produce systems of integrated care that are needed to meet the needs of growing numbers of older people.

Findings

The author’s premise is that, with some rare exceptions, geographies of care are needed to address important shifts in demography such as population ageing and their epidemiological consequences. The rising intersection between the ageing and disability concepts illustrates how the fluid nature of health and social care client groups will challenge existing systems and their presuppositions. Health and medical geography offer a theoretical and practical response to some of these emerging problems.

Research limitations/implications

This is a brief conceptual piece in favour of integrating geographic concepts and methods in the context of changing demography and the social, economic and service implications of such changes. It is limited in scope and a more detailed explanation would be required for a proof of concept.

Practical implications

Practically we know that all human services vary across space as do both healthcare and related social services and supports. Issues of quality and safety are numerous in these policy domains generally, with aged care evidencing a growing number of problems and challenges. Being able to inquire on significant challenges in health and social care through a spatial lens has the potential to provide another, highly practical, kind of evidence in this field of work. This lens is, the author contends, very poorly integrated into either health or social care at present. However, doing so would have a variety of useful outcomes for monitoring and intervening on real problems in care integration. An example could be “frequent flyers” in emergency departments as has been done in Camden, New Jersey through patient mapping.

Social implications

The author’s position in this paper is that the challenges we face in providing integrated care to ageing and increasingly disabled (including both physical and cognitive impairments) populations will only grow in the face of variable governmental responses and increasingly complex funding and service provider arrangements. Without a geographical perspective and the concepts and tools of spatial science the author does not see an adequate response emerging. The shift to community-based care for many groups, including the aged, means that location will become more important rather than less so. This is a societal concern of major proportions and the very concept of integrated care requires of us a geographical perspective.

Originality/value

This is a short but, the author believes, conceptually rich piece with a variety of potential practical implications for health and social care service provision. Issues of equity, quality, safety and even basic access can only grow as population ageing progresses and various forms of chronic disease and disability continue to grow. Knowing where the most affected people and their social and service connections are located will support better integration. And better integration may resolve some of the financial and related resource problems that are already evident but which can only continue to increase. In this context, the author suggests that the integrated care of the future needs to be geographically informed to be effective.

Details

Journal of Integrated Care, vol. 25 no. 1
Type: Research Article
ISSN: 1476-9018

Keywords

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Article
Publication date: 26 October 2010

David Collison, Colin Dey, Gwen Hannah and Lorna Stevenson

This paper seeks to consider the impact and potential impact of social accounting at the macro level. It aims to explore the potential for “silent” or “shadow” social…

Abstract

Purpose

This paper seeks to consider the impact and potential impact of social accounting at the macro level. It aims to explore the potential for “silent” or “shadow” social accounting to hold Anglo‐American capitalism to account for its social outcomes relative to other “varieties of capitalism”.

Design/methodology/approach

The role of accounting in spreading Anglo‐American capitalist values is outlined. This is followed by a discussion of macro social indicators and their potential to problematise social outcomes. In particular the paper reports on, and updates, an investigation of comparative child mortality figures in wealthy countries that appeared in the medical literature. This evidence is used both as an exemplar and as a substantive issue in its own right.

Findings

The specific empirical evidence reported, based on a cross‐sectional and longitudinal analysis of child mortality and its relationship to income inequality, exemplifies the consistently poor and relatively worsening performance of the Anglo‐American capitalist model. A rationale, and evidence, is also presented for the potential of such social reporting to act as an accountability mechanism.

Originality/value

The paper introduces to the accounting literature specific evidence of poor social outcomes associated with Anglo‐American capitalism. It considers the wider potential role of social indicators, as a component of silent and shadow reporting at a macro‐level, in problematising dominant forms of economic and social organisation.

Details

Accounting, Auditing & Accountability Journal, vol. 23 no. 8
Type: Research Article
ISSN: 0951-3574

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Book part
Publication date: 23 October 2003

Lynn Weber and Deborah Parra-Medina

Scholars and activists working both within and outside the massive health-related machinery of government and the private sector and within and outside communities of…

Abstract

Scholars and activists working both within and outside the massive health-related machinery of government and the private sector and within and outside communities of color address the same fundamental questions: Why do health disparities exist? Why have they persisted over such a long time? What can be done to significantly reduce or eliminate them?

Details

Gender Perspectives on Health and Medicine
Type: Book
ISBN: 978-1-84950-239-9

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Article
Publication date: 1 February 1996

Richard A.E. North, Jim P. Duguid and Michael A. Sheard

Describes a study to measure the quality of service provided by food‐poisoning surveillance agencies in England and Wales in terms of the requirements of a representative…

Abstract

Describes a study to measure the quality of service provided by food‐poisoning surveillance agencies in England and Wales in terms of the requirements of a representative consumer ‐ the egg producing industry ‐ adopting “egg associated” outbreak investigation reports as the reference output. Defines and makes use of four primary performance indicators: accessibility of information; completeness of evidence supplied in food‐poisoning outbreak investigation reports as to the sources of infection in “egg‐associated” outbreaks; timeliness of information published; and utility of information and advice aimed at preventing or controlling food poisoning. Finds that quality expectations in each parameter measured are not met. Examines reasons why surveillance agencies have not delivered the quality demanded. Makes use of detailed case studies to illustrate inadequacies of current practice. Attributes failure to deliver “accessibility” to a lack of recognition on the status or nature of “consumers”, combined with a self‐maintenance motivation of the part of the surveillance agencies. Finds that failures to deliver “completeness” and “utility” may result from the same defects which give rise to the lack of “accessibility” in that, failing to recognize the consumers of a public service for what they are, the agencies feel no need to provide them with the data they require. The research indicates that self‐maintenance by scientific epidemiologists may introduce biases which when combined with a politically inspired need to transfer responsibility for food‐poisoning outbreaks, skew the conduct of investigations and their conclusions. Contends that this is compounded by serious and multiple inadequacies in the conduct of investigations, arising at least in part from the lack of training and relative inexperience of investigators, the whole conditioned by interdisciplinary rivalry between the professional groups staffing the different agencies. Finds that in addition failures to exploit or develop epidemiological technologies has affected the ability of investigators to resolve the uncertainties identified. Makes recommendations directed at improving the performance of the surveillance agencies which, if adopted will substantially enhance food poisoning control efforts.

Details

British Food Journal, vol. 98 no. 2/3
Type: Research Article
ISSN: 0007-070X

Keywords

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Book part
Publication date: 16 August 2014

Parnali Dhar Chowdhury and C. Emdad Haque

The purpose of this chapter is to offer reflections on conventional theories concerning causes and determinants of diseases. It also intends to examine both theoretical…

Abstract

Purpose

The purpose of this chapter is to offer reflections on conventional theories concerning causes and determinants of diseases. It also intends to examine both theoretical and empirical bases for adopting an Integrated Social-Ecological Systems (ISES) lens as a tool for understanding complexities related to drivers, determinants and causes of diseases.

Design/methodology/approach

We assessed the theoretical underpinnings of a range of historical and contemporary lenses for viewing infectious disease drivers and the implications of their use when used to explain both personal (i.e. individual) and population health. We examined these issues within the empirical context of the City of Dhaka (Bangladesh) by adopting an ISES lens. Within this study an emphasis has been placed on illustrating how feedback loops and non-linearity functions in systems have a direct bearing upon various aspects of infectious disease occurrences.

Findings

A brief triumph over microbes during the last century stemmed in part from our improved understanding of disease causation which was built using disciplinary-specific, monocausal approaches to the study of disease emergence. Subsequently, empirical inquiries into the multi-factorial aetiology and the ‘web of causation’ of disease emergence have extended frameworks beyond simplistic, individualistic descriptions of disease causation. Nonetheless, much work is yet to be done to understand the roles of complex, intertwined, multi-level, social-ecological factors in affecting disease occurrence. We argue, a transdisciplinary-oriented, ISES lens is needed to explain the complexities of disease occurrence at various and interacting levels. More theoretical and empirical formulations, with evidence derived from various parts of the world, is also required to further the debate.

Originality/value

Our study advances the theoretical as well as empirical basis for considering an integrated human-nature systems approach to explaining disease occurrence at all levels so that factors at the individual, household/neighbourhood, local, regional and global levels are not treated in isolation.

Details

Ecological Health: Society, Ecology and Health
Type: Book
ISBN: 978-1-78190-323-0

Keywords

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Article
Publication date: 25 December 2019

Jacquie McGraw, Rebekah Russell-Bennett and Katherine M. White

The purpose of this paper is to investigate the role of masculine identity in generating value destruction and diminished well-being in a preventative health service.

Abstract

Purpose

The purpose of this paper is to investigate the role of masculine identity in generating value destruction and diminished well-being in a preventative health service.

Design/methodology/approach

This research used five focus groups with 39 Australian men aged between 50 and 74 years. Men’s participation in the National Bowel Cancer Screening Program informed the sample frame. In total, 12 Jungian male archetypes were used to identify different masculine identities.

Findings

Thematic analysis of the data revealed three themes of masculinity that explain why men destroy value by avoiding the use of a preventative health services including: rejection of the service reduces consumer disempowerment and emasculation, active rejection of resources creates positive agency and suppressing negative self-conscious emotions protects the self.

Research limitations/implications

Limitations include the single context of bowel cancer screening. Future research could investigate value destruction in other preventative health contexts such as testicular cancer screening, sexual health screening and drug abuse.

Practical implications

Practical implications include fostering consumer empowerment when accessing services, developing consumer resources to create positive agency and boosting positive self-conscious emotions by promoting positive social norms.

Originality/value

This research is the first known study to explore how value is destroyed in men’s preventative health using the perspective of gender identity. This research also is the first to explore value destruction as an emotion regulation strategy.

Details

Journal of Service Theory and Practice, vol. 30 no. 3
Type: Research Article
ISSN: 2055-6225

Keywords

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Book part
Publication date: 14 November 2012

William Smith, Daniel Salinas and David P. Baker

Understanding of the effects of formal education on HIV/AIDS infection in South Saharan Africa (SSA) has been a complex task because consecutive waves of research offer…

Abstract

Understanding of the effects of formal education on HIV/AIDS infection in South Saharan Africa (SSA) has been a complex task because consecutive waves of research offer different, seemingly contradictory results and explanations of what exactly are the schooling effects on HIV/AIDS and the causal mechanisms driving those effects. This chapter concentrates on the narrative and implications of the key substantive findings from a multidisciplinary scientific team that was formed to explore the precise nature of the relationship between population education and the HIV/AIDS pandemic in SSA and to determine the main causal mechanisms behind the association. As members of this team, this chapter reviews and synthesizes our technical demographic, epidemiological, and health research. This, and other relevant research, suggests that, like in other cases of education and health risk, because of a historical change in the public health and information environment during the pandemic there was a shift in which outcomes of education dominated individual's sexual and disease prevention behavior. The SSA HIV/AIDS case is thoroughly examined, and then used to bridge to a general discussion of the effects of educational development on population health.

Details

The Impact of HIV/AIDS on Education Worldwide
Type: Book
ISBN: 978-1-78190-233-2

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