The Sociology of Health Promotion: Critical Analyses of Consumption, Lifestyle and Risk

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However, a consistent contribution of contemporary historiography has been to show the weight of sociocultural considerations in drawing up proposals for health intervention. The present situation is the result of a given historical array of changing—even non-existent—health policies in a complex frame of groups and interests, both national and international. The last point we would like to mention is concerned with reflection upon the consequences of public health actions. At first sight, any initiative to keep disease and death away would seem to be beneficial for the whole society.

Things are not so straightforward, however, and numerous studies over recent decades have shown that actions carried out in the name of public health can be interpreted in many different ways. Thus, the social significance of public health related actions and decisions must be considered. At this stage, history is again a useful tool to develop a critical perspective on public health. Our direct contact with public health workers and researchers has shown us that it is not always easy to gain this kind of awareness about the social scope of their activities.

However, the attempt to locate the purpose of the action and the part it plays in the social matrix sheds considerable light on public health work itself. The lines of thought that have opened up in recent decades are very varied and illustrate different positions that are worthy of consideration.

`Transgressing Venues': `Health' Studies, Cultural Studies and the Media | SpringerLink

After the optimistic confidence in the victory of science, most notably expressed by George Rosen 82 83 new ways to understand the general path followed by public health have multiplied. Others emphasise the relation of public health interventions to power and social control issues, to surveillance and discipline. There are also those who regard health as a melting pot that can be used to explain many of the features and identities of our time.

Without necessarily rejecting these approaches, some researchers have taken a particular interest in a unified approach to public health within the framework of wider health policies, analysing the greater or lesser degree of interrelation coordination between preventive and health care initiatives over time. They have taken account of the context of the health systems, which have themselves been modified, both in their theoretical foundations and practical aims for the health condition of populations, as a result of the ups and downs of economic policy.

It is therefore possible to use the historical approach to enrich our perception of the social effects of research and intervention initiatives undertaken in the name of public health.

The Sociology of Health Promotion: Critical Analyses of Consumption, Lifestyle and Risk

For example, when the so called exotic epidemic threats appeared one after the other throughout the 19th century, clear discrepancies were found among the different countries in their application of general protection measures, particularly as regards international transport and trade.

Baldwin 11 has rigorously examined the national origins of these discrepancies, which only disappeared when the toughest measures, those which most distorted the daily life of the peoples affected, were shifted towards the eastern limits of the European area of influence. During the influenza epidemic in , a public health oriented action was taken in Alicante, a Spanish city located in the Mediterranean coast, which ended with the demolition of an entire area of the city and the expulsion of its inhabitants.

The fact that the most disadvantaged socioeconomic sectors were the most seriously affected by the epidemic established an association between the disease and the conditions of poverty and unhealthiness in which a large number of these families lived.

Health & Medicine: Crash Course Sociology #42

The houses they occupied came to be considered as real sources of infection and even the origin of the disease itself, with the occupants becoming the vehicles for spreading disease and contagion. Based on this analysis, an intervention process was developed that ended up with the evacuation and demolition of an entire district of the city. In other words, the non-native population was removed from the city to avoid the spreading of disease. The connection between the interests of the ruling class, morals and hygiene has been very common throughout history and has been applied to all sorts of problems.

Critical Analyses of Consumption, Lifestyle and Risk, 1st Edition

One example is provided by Didier Fassin's study of the link between health assumptions and urban policies in present day Paris, which underlined the risk that public health arguments might be used to legitimise social exclusion policies. Many of these strategies insist on the need to discipline and blame the population 95 96 in order to achieve the indisputable and self explained good of health.

However, it is of paramount importance to situate health in its historical dimension so as to clarify its actual meaning at each historical stage. At the same time, these strategies have been instrumental to set apart different social groups and have implied the successive introduction of governmentality into an increasing number of life situations through the institutionalisation of expertise.

We believe that the history of public health should be accorded its rightful place among public health concepts and methods. In other words, we posit a process of hybridisation between both disciplines in order to overcome the limitations in scope and understanding that we have underscored in this paper. The hallmarks of the historical approach, the consideration of problems in their context, the time scope and the critical perspective should become common tags in public health's inner schemes of work. After all, public health as scientific activity is but a mixture of diverse knowledge and practices brought together by a focus on a given population.

Furthermore, the content of public health is unavoidably bound to locality in so far as it refers to the living conditions and practical life of human groups, an aspect that a historical view would strengthen. Some new epidemiological research is already widening the time span for observations and seeks to gather data related to earlier periods of life of the populations under scrutiny.

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Data interpretation should overcome the shortcomings of the risk model. It should not be limited to the consideration of singular events in the past but should rather rely on contextual information. For instance, historical research on the incidence of water supply in infant and childhood mortality showed the difficulties of usng a single factor to explain shifts in the health conditions of a given population.

It is true that epidemiology has afforded more depth to multilevel studies on the complex social and environmental systems that are the context for health and disease. Finally, the use of history can improve epidemiology and public health through the design of causality models. Recent controversies have shown that the plural nature of problems imposes the selection of different research models. You will be able to get a quick price and instant permission to reuse the content in many different ways.

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    • Abstract The aim of this article is to highlight the importance of the history of public health for public health research and practice itself. Statistics from Altmetric. History and public health It is worth remembering that during the 18th and early 19th century there was a mutual hybridisation between history and epidemiology that is, the science of epidemics, or diseases affecting large numbers of a given population , with the first pragmatically used as a source of practical knowledge and the second contributing to the creation of the history of medicine as a specialised discipline.

      The relevance of the context The use of history in public health highlights the importance of contextualising health problems and contributes decisively to the genesis of a theory of the social conditioning of health and disease processes. The critical view The last point we would like to mention is concerned with reflection upon the consequences of public health actions. Conclusion We believe that the history of public health should be accorded its rightful place among public health concepts and methods.

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      The Sociology of Health and Illness at the Turn of the Century: Back to the Future?

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