Health Discourse Research Articles

Mental health services for the deaf: an exploratory study of the aetiology, sources of information, and access to mental health services among deaf persons in Ghana.

The global burden of mental health disorders is on the increase, which has contributed to discussions on mitigation strategies. While mental health discourses in respect of access to services are still ongoing, there is limited focus on vulnerable groups. Deaf persons are at risk of exclusion from health services due to their unique modes of communication. In order to advocate for the inclusion of deaf persons in mental health services, there is a need for a study eliciting information on their knowledge about mental health and accessibility to services. The study was guided by a mixed-methods design and a two-phase data collection. In phase one, a questionnaire was distributed to 284 deaf persons to gather information on their knowledge of mental health conditions, causes, sources of information, and accessibility of services. Frequencies were used to report the trends identified in the data. Following this, an interview guide was designed based on the trends identified in the first phase to develop an in-depth insight into the experiences of deaf persons (n = 40) in respect of awareness and accessibility to mental health services. The results showed convergences and divergence between the qualitative and quantitative data. For instance, they were convergences between both datasets relative to knowledge on and causes of mental health conditions. The study highlights the need for health policymakers to leverage the information gathered on the study participants' knowledge to develop appropriate mental health training programmes for deaf persons.

Climate silence: a comparative study of governmental and non-governmental messaging on soil health in Wisconsin, USA

ABSTRACT Soils are the foundation of healthy ecosystems, and promoting soil health is a primary aim of agricultural strategies intended to sequester carbon and combat climate change. In this exploratory study, we conducted a qualitative content analysis to characterize soil health messaging from 10 governmental and 10 non-governmental sources targeting Wisconsin farmers. Data were collected through internet searches, focusing on accessible web content from governmental agencies, public universities, and local offices, as well as prominent industry, nonprofit, and advocacy groups within the agricultural sector. A coding framework, developed through an iterative and inductive approach, identified six primary categories and 37 sub-categories representing key themes in soil health messaging. The study compared messaging across source types by analyzing code term frequency, highlighting differences in content emphasis between governmental and non-governmental sources. Findings indicate that governmental messaging largely advocates for conservation agriculture and associated principles but does not reference climate change nor connections between soil health and broader environmental issues. In contrast, non-governmental messaging offers a wider array of information while drawing connections among soil health, organic agriculture, ecosystem health, and climate change. The omission of climate change by governmental sources may be a significant constraint on soil health discourse and climate action.

Mitigating the Stigma of Mental Illness: The Impact of Story-Telling in the Black Community

Racial/ethnic minorities, including the Black community, experience stigma as a significant barrier to mental health care, with fears of being devalued or discriminated against deterring individuals from seeking help. Racial stigma further exacerbates mental health issues and negatively influences perceptions of service utilization. To address this, our research team partnered with a national non-profit storytelling organization to develop and evaluate a virtual narrative storytelling intervention series that amplifies the voices and experiences of Black Americans living with mental illness and addiction. We randomly assigned 193 participants to either the intervention (n = 102) or an active control condition (n = 91) and used a pre–post survey design to assess the changes in the outcome variables. Contrary to our hypothesis, there were no race-based interactions; instead, the results show significant reductions in public stigma and perceived discrimination and increased positive attitudes toward seeking treatment universally among all the intervention participants. This study provided preliminary evidence that a virtual storytelling intervention is instrumental across varied demographic cohorts, transcending potential cultural barriers in the discourse and understanding of mental health to effectively mitigate stigma and improve attitudes toward mental health treatment.

Body Positivity, Physical Health, and Emotional Well-Being Discourse on Social Media: Content Analysis of Lizzo's Instagram.

Weight stigma is a fundamental cause of health inequality. Body positivity may be a counterbalance to weight stigma. Social media is replete with weight-stigmatizing content and is a driver of poor mental health outcomes; however, there remains a gap in understanding its potential to mitigate the prevalence and impact of harmful messaging and to promote positive effects on a large scale. We selected musical artist Lizzo, whose brand emphasizes body positivity and empowerment, for an instrumental case study on the discourse on social media and specifically Instagram. We focused on 3 domains, including body positivity, physical health, and emotional well-being. These domains challenge social norms around weight and body size and have the potential to positively affect the physical and psychological health of people with diverse body sizes. We evaluated posts by Lizzo, comments from Instagram users, and replies to comments over a 2-month period (October 11 to December 12, 2019). Two coders rated Lizzo's posts and Instagram users' comments for their sentiments on the 3 domains. Replies to Instagram users' comments were assessed for their reactions to comments (ie, did they oppose or argue against the comment or did they support or bolster the comment). Engagement metrics, including the number of "likes," were also collected. The final sample included 50 original posts by Lizzo, 250 comments from Instagram users, and 1099 replies to comments. A proportion of Lizzo's content included body positive sentiments (34%) and emotional well-being (18%); no posts dealt explicitly with physical health. A substantial amount Instagram users' comments and replies contained stigmatizing content including the use of nauseated and vomiting emojis, implications that Lizzo's body was shameful and should be hidden away, accusations that she was promoting obesity, and impeachments of Lizzo's health. In spite of the stigmatizing content, we also discovered content highlighting the beneficial nature of having positive representation of a Black woman living in a larger body who is thriving. Moreover, analysis of the discourse between users illustrated that stigmatizing expressions are being combated online, at least to some degree. This study demonstrates that Lizzo has exposed millions of social media users to messages about body positivity and provided more visibility for conversations about weight and shape. Future research should examine the extent to which body positive messages can lead to greater acceptance of individuals living in larger bodies. Instagram and other social media platforms should consider ways to reduce body-shaming content while finding ways to promote content that features diverse bodies. Shifting the landscape of social media could decrease stereotypes about weight and shape while increasing dialog about the need for greater acceptance and inclusion of people with diverse bodies.

Health professionals’ knowledge discourses concerning health: a qualitative study in Norway

ABSTRACT This study contributes to the body of professional knowledge about discourses of health. To our knowledge, no previous studies have focused on how health professionals who are being educated or have recently graduated as master’s students in health science have expanded and deepened their discussion of health. Therefore, the current study aimed to explore health professionals’ knowledge discourses concerning health developed at the master’s degree level. A discourse analysis approach based on the ethnomethodological discourse analytical tradition was chosen. Group interviews were used to collect data. Each group consisted of four participants. All participants were Norwegian; specifically, there were eleven women and one man, all of whom were aged between 29 and 49 years and had heterogeneous health professional backgrounds. The results were formulated as two discourses: 1) a health idea-oriented knowledge discourse and 2) a health context-oriented knowledge discourse. A discourse of health idea-oriented knowledge was supplemented with a discourse of health context-oriented knowledge, indicating that health professionals’ understanding of health was further developed. This study concluded that knowledge discourses concerning health developed at the master’s degree level represent a renewal of health professionals’ discursive practice more than a revision of discourses dominant at the bachelor’s degree level.

‘Everywhere you get models of what you should be like’: ideals of masculinity and therapeutic culture constraining young men’s mental health and gendered subjectivities

ABSTRACT This paper presents a novel approach to youth mental health by examining the connections between young Finnish men’s mental health, ideals of masculinity, and public discourses of mental health. Drawing from critical sociological and feminist theories on gender, power, and therapeutic culture, we apply a thematic discursive analysis to a questionnaire data (n = 910) about men’s mental health targeted at young men (primarily aged 15-29). The findings illustrate how young Finnish men consider ‘traditional’ ideals of masculinity widespread in Finland, restricting the actions of men, and upheld by narrow representations of gender. In addition, young men display critical reactions to the public discourses of mental health, especially the ones they feel are repeated in the media. These discourses are seen as insufficient and too individualised, echoing therapeutic culture. Based on our results, we argue that the highly individualised and gendered discourses of mental health, deriving from therapeutic culture and rooted in Finnish cultural and institutional practices, are inadequate for supporting young men’s mental health. Instead, these practices can create a vicious cycle where the often-well-intended efforts can limit and guide young men towards restricted gendered possibilities to express themselves, talk about mental health, and seek support if needed.

Diet Impact Assessment model: an interactive tool for analysing the health, environmental and affordability implications of diets

Abstract Global diets, environmental factors, and health require a holistic approach in public health discourse that takes into account the well-being of both humans and planetary health. Modeling tools have demonstrated being useful to estimate priorities and differences between countries and gain insight into future paths that depend on predetermined priorities. Modeling efforts that include environmental goals indicate the possibility of reducing environmental impacts while both improving food quality and overall health outcomes, especially in high-income settings. The aforementioned forecasts highlight the effectiveness of giving priority to dietary recommendations that lead to better, balanced patterns as the most effective approach to reducing mortality risks and environmental implications. The presentation will introduce the Diet Impact Assessment (DIA) model - a new interactive modelling tool for analysing the health, environmental and affordability implications of diets and dietary change. The tool enables countries to analyse user-specific scenarios of dietary change, and to estimate the health, environmental and cost burden of each scenario in terms of diet costs, avoidable deaths, changes in resource use and compatibility with global environmental targets, including those associated with food-related greenhouse gas emissions, land use, water use and fertilizer application. The tool was commissioned by the WHO Regional Office for Europe and is based on analytical frameworks developed by Marco Springmann and colleagues.

The future of AI in medicine and education - 10th anniversary of E- methodology community

Abstract This special edition of the E-methodology journal and conference, marking its 10th anniversary, explores the dynamic intersection of technology, science, and society. Dur- ing a decade we have seen a revolution in the meaning of “e” from being just a digi- tal version of human activity to a totally new world of LLMs (Large Language Models) and other deep learning possibilities. The articles in this volume delve mainly into the transformative potential of artificial intelligence (AI) across diverse fields such as forensic science, education, healthcare, One Health, and public discourse, while examining the broader implications of technology on human life. Keywords: Artificial intelligence, technology, education, medicine

Comparative dimensions of COVID-19 visual health literacy: social media news imagery in Germany and China

The COVID-19 pandemic prompted governments worldwide to utilise social media news platforms for disseminating critical public health information and safety protocols. Visual aids, including photographs, videos, charts, and infographics, played a key role in conveying health-related messages. However, there are variations in visual communication practices across countries, influenced by local health communication habits and cultural contexts. This study examines these variations in the visual health discourse that emerged in China and Germany during the pandemic, focusing on metaphorical mapping as a central analytical tool. We introduce the concept of “visual dataset fingerprints,” outlining the distinct composition of public health visuals on eight social news media platforms in Germany and China. Our descriptive analysis encompasses over 3700 digital visual media posts related to COVID-19, shared by leading national news media accounts in German, English, and Mandarin on microblogs in 2022. As a preliminary outcome of our study, we observe differences in image use based on the analysis of 1678 media posts by four Chinese outlets and 1329 media posts by four German outlets. These differences may reflect variations in how public opinion, perceptions, and attitudes toward COVID-19 policies are shaped across languages and cultures. Through its comparative visual analysis, our pilot study offers the potential for a new research approach to global healthcare communication in social news media and digital visual cultures.

Exploring Research Dynamics in Aggression and Violence

Background: From 1994 to 2023, the research landscape on the subjects of aggression and violence has grown considerably, influenced by a growth in concerns around mental health, the prevention of violence, and cross-disciplinary approaches in the study of human behavior. The rising complexity of such fields requires a bibliometric analysis for an understanding of the thematic trends, key research areas, and scholarly collaborations that have shaped this body of knowledge. Objective: This study attempts to conduct an inclusive bibliometric analysis representing important themes, research trends, and interdisciplinary relationships of scholarship on psychology, aggression, violence prevention, and other public health-related topics in the past three decades. This paper aims at identifying influential topics, authors, and emerging areas of interest as well as shedding light on potential gaps in this research area. Methods: A bibliometric approach has been applied using VOSviewer for network visualization and mapping. The dataset includes scholarly publications in the period between 1994 and 2023; co-authorship, citation analysis, and keyword co-occurrence are included. Major research clusters, prominent authors, and thematic trends identified in this paper represent the main findings in a visual manner. An overview of key topics and their interrelations is shown visually in word clouds and network visualizations. Findings: Results show that psychology is the most dominant discipline in the discourse of aggression, violence, and public health. Dominant topics include mental health, suicide prevention, poison control, and occupational safety. Other fast-growing topics deal with cyber-aggression and media-fueled violence, reflecting technological changes impinging on behavioral studies. There is considerable interdisciplinary interaction, especially between psychology and medicine and/or public health. These three issues do not cover the broadness of research; other areas, such as environmental health and substance abuse, are underrepresented in the scholarship. Conclusion: This bibliometric analysis underlines the role of psychology and public health as significant in addressing aggression, violence, and mental health. The research landscape is large and interdisciplinary, with future research needing to cover environmental, socio-economic, and systemic factors of public health even more. Enhanced interdisciplinary collaboration and embedding of hitherto less explored topics will play a decisive role in the further development of a comprehensive understanding of the complex issues at play. Novelty: The paper therefore carves out a distinctive bibliometric perspective on the evolution of research in psychology, aggression, and violence within the period 1994-2023, pointing not just toward the themes at the forefront, but also the emergent trends and lacunae in the literature. By identifying key areas of scholarly concentration and underrepresented areas, the analysis constructs a roadmap to future research and advances a more integrated approach toward resolving behavioral and public health problems.

Navigating the body’s double nature in a sedentary environment: Swedish primary school children’s use of physical activity during the school day

ABSTRACT The structuring of time and space in schools influences when children’s bodies should be active and when they should be still. The growing interest in physical activity interventions in schools today highlights a pattern where schools act as sites meant to regulate and educate children’s bodies according to adult-centric interests. Drawing on existential phenomenology, particularly the dual nature of the body as both object and subject, this article examines how children themselves use physical activity in school. Sixty-three children aged 8 – 13 in Sweden participated in semi-structured focus groups where they discussed the significance of movement for them in the school environment. Reflexive thematic analysis in an ‘experiential mode’ was used to understand how the children related to their bodies in terms of objectivity and subjectivity, creating different types of incentives for movement. This is illustrated through two themes: ‘Physical activity for a healthy body (The body as object)’, which shows how children use physical activity based on instrumental motives, and ‘The sentient body (The body as subject)’, where the feeling body is presented in two states: both as trapped and as liberated. The children used movement as a way to balance the structuring of time and place imposed by their school environment, which generated various subjective corporeal states. Thus, the analysis shows that the school environment produces subjective bodies that children understand in objective terms influenced by contemporary health discourses, which in turn shapes their use of movement.

Use of large language models as a scalable approach to understanding public health discourse.

Online public health discourse is becoming more and more important in shaping public health dynamics. Large Language Models (LLMs) offer a scalable solution for analysing the vast amounts of unstructured text found on online platforms. Here, we explore the effectiveness of Large Language Models (LLMs), including GPT models and open-source alternatives, for extracting public stances towards vaccination from social media posts. Using an expert-annotated dataset of social media posts related to vaccination, we applied various LLMs and a rule-based sentiment analysis tool to classify the stance towards vaccination. We assessed the accuracy of these methods through comparisons with expert annotations and annotations obtained through crowdsourcing. Our results demonstrate that few-shot prompting of best-in-class LLMs are the best performing methods, and that all alternatives have significant risks of substantial misclassification. The study highlights the potential of LLMs as a scalable tool for public health professionals to quickly gauge public opinion on health policies and interventions, offering an efficient alternative to traditional data analysis methods. With the continuous advancement in LLM development, the integration of these models into public health surveillance systems could substantially improve our ability to monitor and respond to changing public health attitudes.

Selective neglect of viral risk: Tokyo’s commuter trains during the COVID-19 pandemic

This article asks why Tokyo’s crowded trains were largely absent from official discourses of viral risk in Japan during the COVID-19 pandemic. While public transport environments were often framed as spaces of contagion in other countries, Japanese public health discourses instead tended to emphasize the viral safety of urban railway transport. Drawing on an analysis of media and expert discourse, auto-ethnographic fieldwork, and repeat interviews with commuters, this article examines the processes through which Tokyo’s urban railway network was extracted from discourses of viral risk. It identifies four factors that contributed to this: (1) dominant definitions of risk spaces in public health messaging, (2) trains’ integral role in the operation of socio-economic life, (3) elusiveness of public transport in the epidemiological data, and (4) a focus on “unruly” passenger conduct. This analysis of the selective treatment of viral risks is tied to a critical engagement with theoretical distinctions between “essential” and “existential” mobilities developed in prior anthropological scholarship on the pandemic. Exploring the discursive framing of pandemic mobility practices on one of the world’s most extensive urban railway networks, the article thus contributes to the anthropological study of mobilities and transport in Japan and beyond.

“Someone Who Is Going to Preserve Your Surname and Clan Name”: A Sesotho Cultural Perspective on Male Partner Involvement in Maternal and Newborn Care in the Free State, South Africa

In the global public health discourse, involving men in maternal and neonatal health is regarded as crucial for positive outcomes in both health and development. In South Africa, health interventions designed to promote male partner involvement among low-income indigenous populations have been framed within social constructivist notions of masculinities and have produced mixed outcomes. This has necessitated calls to explore alternative approaches, including the need to decolonise men and masculinities studies in Africa. As part of one phase of formative research for a mixed-method project aimed at adapting a male involvement intervention for the context of Sesotho-speaking men and women in the Free State, we applied a multi-site case study research design and collected qualitative data using focus group discussions and key informant interviews. Verbatim-recorded transcripts were translated, transcribed, and thematically analysed with NVIVO 14. The results indicate that customary practices in pregnancy, delivery, and newborn care are not static and vary between families based on belief systems, socioeconomic status, geographical setting (peri-urban/rural), and kinship networks of care. Therefore, these practices and beliefs should be understood, affirmed, and contested within the complex African-centred material and immaterial worldviews on personhood in which they were generated, transmitted, rejected, or adopted. It is recommended that a decolonised approach to male partner involvement in this context must be cognisant of the intersections of racial and gendered power relations, contestations in beliefs and practices, the resilient effect of colonialism on indigenous gender systems, as well as contemporary global entanglements that inform North–South power relations on the best practices in maternal and newborn health in the public health sector in South Africa.

Intersectionality matters for hispanic health: A replication study using the All of Us Research Program

BackgroundDespite research dedicated to understanding the health profiles and health-related outcomes of Hispanic individuals, the prevailing body of literature frequently homogenizes the Hispanic population, failing to address the role of race in Hispanic health discourse. Thus, the current study applies an intersectional lens to identify health differences and similarities among Hispanic subgroups.MethodsSociodemographic characteristics and health domain variables (i.e., health status, health services, and health behaviors) from participants (N = 11,192) were included in the analyses. Bivariate Chi-squared tests examined the relationship between sociodemographic and health domain variables Black Hispanic individuals, white Hispanic individuals, and non-Hispanic Black individuals.ResultsFindings suggest that Non-Hispanic Black American individuals reported the highest rates of hypertension (49.09%) and diabetes (19.62%) compared to Black-Hispanic individuals (22.45% and 12.98%) and white Hispanic individuals (22.22% and 8.02%). Black Hispanic individuals reported the greatest proportion of asthma diagnoses (35.10%) and those who saw a doctor in the previous year (95.52%) compared to white Hispanic individuals (26.84%, and 91.10%, respectively) and non-Hispanic Black individuals ( 21.74%, and 94.69%, respectively).ConclusionSpecifically, we found that several health behaviors and health-related outcomes significantly varied across different racial/ethnic groups, demonstrating the advantage of an intersectional approach to identify health disparities among racially diverse ethnic groups.Public Health significanceWe encourage the development of health care services with an awareness of the complexities resulting from racial differences within the Hispanic diaspora.

Intersections of Genre and Identity in Contraceptive Health Discourses

This study aims to examine online contraception texts as a way to interrogate the intersections of identity, inclusivity, and access in contraception and reproductive health discourses. At the center of this project is the understanding that, while many contraceptive technologies are designed for and marketed towards "women" for the sole use of preventing pregnancy, the actual users of contraception and their purposes for its use are diverse and involve considerations of sexuality, gender identity, socioeconomic status, ability, cultural and religious norms, and access to healthcare. By examining the genre of contraception texts through systematized coding and rhetorical analysis, this study examines how the constitutive genre features of these texts do and do not recognize the diversity of users, with a particular focus on users in the trans community.

What's in the Blood? Temporalities at Play in Diet-Related Risk Management Testing Practices

In this paper, I look at two different sets of practices that are part of the risk management apparatus in place in Québec & Canada to apprehend and control risks associated with food consumption. More specifically, I contrast diabetes and chemical contaminants risk management testing practices, so as to compare how both frame and approach risks, in a context where recent research in social sciences, epigenetics and environmental sciences increasingly points to “environmental” pathways of disease causation while many chronic conditions remain highly individualized in public and health discourses. The analysis pays close attention to the different temporalities discursively created, considered, and neglected in these practices in order to understand how risk is approached and worked on. This highlights the power relations that inform how we care (or not) for (certain) bodies, inflecting in particular ways their—uneven—becomings. I argue that the Canadian biotechnological apparatus of testing practices meant to apprehend and control diet-related risks contributes to foreclosing the temporalities of health and illness considered and acted upon. As such, the apparatus contributes to (re)producing inequalities, here mostly health related ones, as well as creating differentiated biological materialities.

‘It’s really embarrassing […] to ask for help:’ navigating invisible and intersecting inequities in barriers to getting vaccinated

The arrival of COVID-19 vaccines in Canada marked the first time since the H1N1 influenza pandemic that adult vaccination became central in public health discourse, thus evoking feelings and discourse about individuals’ responsibility to get vaccinated. Public health institutions made efforts to ensure vaccines were accessible, and various local organizations worked to fill gaps in accessibility (e.g. vaccine clinics for equity-denied communities). However, despite knowledge of barriers to accessing healthcare, and specifically vaccines, public and health discourses emphasized individual objection as the main barrier to optimal vaccine uptake. This study explored how individuals who identified as a racialized minority or Indigenous person, perceived their personal responsibility to get vaccinated. We gathered perspectives in qualitative interviews (N = 27) when vaccines were first becoming available to adults living in Canada (May-June 2021). Theory about moral regulation, risk governance, and emotion informed our analysis. Findings suggest that individuals engaged in the governance of oneself and others towards getting vaccinated. However, participants also critiqued discourses that hold individuals responsible for accessing vaccines. They identified substantial barriers to accessing vaccines for individuals with fewer resources (e.g. travel time, missing work, childcare). When referencing individuals who do not know how to access information about vaccination, one participant stated, ‘it’s really embarrassing […] to ask for help.’ Feelings of individual responsibility may prevent some people uncertain about vaccines from asking for more information and support. We argue that the focus on vaccine hesitancy without attention to systemic barriers deflects responsibility for making vaccines accessible from centralized institutions to individuals.

A temporal dynamics framework and methodology for computationally intensive social media research

The growing availability of expansive social media trace data (SMTD) offers researchers promising opportunities to create rich depictions of societal and social phenomena. Despite this potential, research analysing such data often struggles to construct novel theoretical insight. This paper argues that holistically incorporating temporality enhances data collection and data analysis, subsequently facilitating process theory construction from SMTD. Recommendations to integrate temporality are outlined in the proposed Temporal Dynamics Framework and Methodology (TDFM). We apply the TDFM to investigate the temporal dynamics of mental health discourse on Twitter (now X) across different phases of the COVID-19 pandemic, theoretically framed in the context of innate psychological needs satisfaction. The findings reveal dynamic shifts in social media use, indicating that different phases of the pandemic triggered changes in the needs motivating, and being motivated by, social media use. This illustrative case reflectively evaluates the TDFM's usefulness in contextualising SMTD collection, analytical strategies, and process theory construction by incorporating a dynamic perspective on time.

“New food cultures” and the absent food citizen: immigrants in urban food policy discourse

AbstractMulticultural cities in the Global North are rapidly developing and releasing urban food policies that outline municipal visions of sustainable food systems. In turn, these policies shape conceptions of food citizenship in the city. While these policies largely absorb activities previously associated with “alternative” food systems, little is known about how they respond to critical food and race scholars who have noted that these food practices and spaces have historically marginalized immigrants. A critical discourse analysis of 22 urban food policies from Global North cities reveals that most policies do not meaningfully consider immigrant foodscapes, foodways, and food-related labour. Many promote hegemonic and/or ethno-nationalistic understandings of “healthy” and “sustainable” food without recognizing immigrants’ food-related knowledge and skills. Policies largely fail to connect the topic of immigrant labour with goals like shortening supply chains, subject immigrant neighbourhoods to stigmatizing health discourses, and lack acknowledgement of the barriers immigrants may face to participating in sustainable food systems. Relatedly, policy discourses articulate forms of food citizenship that emphasize individual obligations over rights related to food. This jeopardizes the potential for immigrants to be seen as belonging to dominant political urban food communities and benefitting from the symbolic and material rewards associated with them.