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This chapter explores the rise in genetic approaches to health disparities at the turn of the twenty-first century.
Analysis of public health policies, genome project records, ethnography of project leaders and leading genetic epidemiologists, and news coverage of international projects demonstrates how the study of health disparities and genetic causes of health simultaneously took hold just as the new field of genomics and matters of racial inequality became a global priority for biomedical science and public health.
As the U.S. federal government created policies to implement racial inclusion standards, international genome projects seized the study race, and diseases that exhibit disparities by race. Genomic leaders made health disparities research a central feature of their science. However, recent attempts to move toward analysis of gene-environment interactions in health and disease have proven insufficient in addressing sociological contributors to health disparities. In place of in-depth analyses of environmental causes, pharmacogenomics drugs, diagnostics, and inclusion in sequencing projects have become the frontline solutions to health disparities.
The chapter argues that genetic forms of medicalization and racialization have taken hold over science and public health around the world, thereby engendering a divestment from sociological approaches that do not align with the expansion of genomic science. The chapter thus contributes to critical discussions in the social and health sciences about the fundamental processes of medicalization, racialization, and geneticization in contemporary society.
This chapter takes a critical look at the sociological notion of ‘medicalisation’ in relation to recent trends and developments in neuroscience, neurotechnology and…
This chapter takes a critical look at the sociological notion of ‘medicalisation’ in relation to recent trends and developments in neuroscience, neurotechnology and society, taking memory, medicine and the brain as our prime focus and the disease category of mild cognitive impairment (MCI) as our empirical case study. Five relational nexuses in particular are identified as relevant to these developments and debates, namely the bio-psych nexus, the pharma-psych nexus, the selves-subjectivity nexus, the wellness-enhancement nexus, and the neuroculture-neurofuture nexus. We show that developments in memory medicine and the shifting boundaries of cognitive health, as embodied and expressed in the case of MCI, shed further valuable light on these issues and the interconnectivity of these relational nexuses. As an emergent disease and susceptibility category, MCI illuminates not only the fuzzy boundaries between normal and abnormal cognitive functioning, but also the working of neuroscientific, neurocultural and pharmacological interests, which, in this case, are already claiming MCI as the next locus of enhancing the mind and optimising aging. Thinking both within and beyond medicalisation challenges us to find new ways to critically understand the ideas about life and health as they travel, translate or migrate from (neuro)scientific and clinical spheres to cultural life and patient experience.
The biomedical paradigm enjoys growing importance in our society. Biomedicine (e.g., Genetics) seems to occupy the position once held by religion and politics. In this…
The biomedical paradigm enjoys growing importance in our society. Biomedicine (e.g., Genetics) seems to occupy the position once held by religion and politics. In this context, every trivial problem of daily life is thought to require an appropriate remedy, and perfect health becomes a paramount value, especially within the upper class.
Medicalization is not only promoted by doctors. Today, other engines of medicalization are also available. These include pharmaceutical companies through marketing, advertising, and disease mongering; active consumers who seek a pharmacological solution – a magic bullet – to solve non-organic problems; technology, because highly sensitive diagnostic tools can now detect potential abnormalities even in very low quantities; and the culture of risk, which is connected to the evolution of diagnostic tools, because it is now always possible to be at risk of something.
The parts of life today considered pathological or quasi-pathological are ever increasing shyness, sadness, imperfect blood pressure, or glucose levels. Progressing editions of the Diagnostic and Statistical Manual (DSM) – the text from which diagnoses of mental illnesses are made – reveal a growing number of syndromes. These “diseases” are diagnosed on the grounds of certain symptoms and the number of weeks they last (quantification). Smartphones, with their tremendous capacity for data collection, contribute to a growth in self-diagnoses. For example, invited to log our every moment of sadness through a “trustworthy” avatar from our app (gamification), we can easily make too much of normal moments of discomfort, immediately seeing them – with a simple computation – transformed into something pathological in need of a cure.
This chapter compares interdisciplinary research that engages genomic science from economics, political science, and sociology. It describes, compares, and evaluates…
This chapter compares interdisciplinary research that engages genomic science from economics, political science, and sociology. It describes, compares, and evaluates concepts and research findings from new and rapidly developing research fields, and develops a conceptual taxonomy of the social environment.
A selection of programmatic and empirical articles, published mostly since 2008 in leading economics, political science, and sociology journals, were analyzed according to (a) the relationship they pose between their discipline and genomic science, (b) the specific empirical contributions they make to disciplinary research questions, and (c) their conceptualization of the “social environment” as it informs the central problematique of current inquiry: gene-environment interaction.
While all three of the social science disciplines reviewed engage genomic science, economics and political science tend to engage genomics on its own terms, and develop genomic explanations of economic and political behavior. In contrast, sociologists develop arguments that for genomic science to advance, the “environment” in gene-environment interaction needs better theorization and measurement. We develop an approach to the environment that treats it as a set of measurable institutional (rule-like) arrangements, which take the forms of neighborhoods, families, schools, nations, states, and cultures.
Interdisciplinary research that combines insights from the social sciences and genomic science should develop and apply a richer array of concepts and measures if gene-environment research – including epigenetics – is to advance.
This chapter provides a critical review and redirection of three rapidly developing areas of interdisciplinary research on gene-environment interaction and epigenetics.
This study analyzes the rise of genome instability in the life sciences and traces the problematic of instability as it relates to the sociology of health. Genome…
This study analyzes the rise of genome instability in the life sciences and traces the problematic of instability as it relates to the sociology of health. Genome instability is the study of how genomes change and become variable between generations and within organisms over the life span. Genome instability reflects a significant departure from the Platonic genome imagined during the Human Genome Project. The aim of this chapter is to explain and analyze research on copy number variation and somatic mosaicism to consider the implications of these sciences for sociologists interested in genomics.
This chapter draws on two multi-sited ethnographies of contemporary biomedical science and literature in the sociology of health, science, and biomedicine to document a shift in thinking about the genome from fixed and universal to highly variable and influenced by time and context.
Genomic instability has become a framework for addressing how genomes change and become variable between generations and within organisms over the life span. Instability is a useful framework for analyzing changes in the life sciences in the post-genomic era.
Genome instability requires life scientists to address how differences both within and between individuals articulate with shifting disease categories and classifications. For sociologists, these findings have implications for studies of identity, sociality, and clinical experience.
This is the first sociological analysis of genomic instability. It identifies practical and conceptual implications of genomic instability for life scientists and helps sociologists delineate new approaches to the study of genomics in the post-genomic era.
Biological understandings of mental illness are promoted by both anti-stigma campaigners and increasingly by activists protesting against social security cuts. The purpose of this paper is to analyse the pitfalls of the “illness” conceptualisation for reducing discrimination, comments on divisions between those arguing for a right to work and those who seek a right not to work, and proposes bridge building and more effective messages, drawing on the UN Convention on the Rights of Persons with Disabilities.
Review of relevant evidence on the effectiveness or lack of it of the “mental illness is an illness like any other” message in anti-stigma work, and discussion of grey literature from campaigners and bloggers.
There is a growing body of evidence that the “illness like any other” message entrenches rather than reduces stigma and discrimination: this message should not be used in anti-discrimination work. At the same time some social security bloggers and campaigners have argued they are “sick” in order to resist efforts to compel them to seek work or face sanctions; whilst older disability rights campaigners have argued for the right to work. The paper argues for new bridge building and use of evidence based messages in campaigning.
This paper is based on review of evidence on the impact of using the “illness” message to reduce stigma and discrimination; and on discussion of campaigns and blogs. It is not based on a systematic review of campaigns.
There is a need for campaigns that support rights holistically – the right to a decent standard of living and the right to work. This requires bridge building between activists, which could usefully be rooted in the UN Convention on the Rights of Persons with Disabilities. The “illness” conceptualisation is harmful to the effort to reduce stigma and discrimination. Mental health staff can act as allies to those they serve in securing all these rights.
This is the only recent paper to analyse the evidence that the “illness like any other” message is harmful in anti-stigma work, together with its implications for the recent phenomenon of mental health campaigners moving from opposition to the medical model, to a new argument that they are “too sick” to work. This paper suggests ways forward for everyone with an interest in combatting stigma and discrimination.