Health Social Movements Research Articles

Leveraging social media for mentorship in surgery

Mentorship is a key component of success in surgery that benefits both mentors and mentees. It is associated with increased academic productivity, funding, leadership roles, job retention, and career advancement. Until recently, mentor-mentee dyads have connected through traditional communication channels; however, in an increasingly virtual world, academic communities are adopting new communication methods, including over social media platforms. In recent years, we have witnessed how social media helps effect positive change by facilitating patient and public health initiatives, social movements and campaigns, and professional pursuits. Given its ability to transcend constraints of geography, hierarchy, and time, social media can benefit mentorship, too. Social media helps strengthen preexisting mentorships, identify new mentorship opportunities locally and remotely, and facilitates modern mentorship models, such as team mentorship.Furthermore, it increases the durability of mentor-mentee relationships and helps expand and diversify mentorship networks, which may especially benefit females and those underrepresented in medicine. Despite the many advantages of social media, it is not a replacement for traditional local mentorship. Herein, we discuss the benefits and risks of using social media for mentorship and propose approaches to optimize the virtual mentorship experience. With best practice guidelines that aim to balance virtual and in-person interactions and provide tailored education to all mentorship levels, we believe mentors and mentees will become more adept in using social media professionally, and these platforms will help foster meaningful connections that ensure mutual fulfillment.

The practice of social movement unionism: COVID-19 and the Hong Kong medical workers’ strike

In this Theory into Practice article we discuss the collective agency of Hong Kong medical workers in COVID-19 in the context of social movement unionism (SMU). In particular, the article utilises Dhatt’s framework defining factors influencing health social movements (2019). We focus on the way the pro-democracy movement underpinned and shaped the five-day strike by 7000 healthcare workers that forced the government to close the Hong Kong–China border in February 2020. We argue that the strike was made possible by the political opportunities linked to collective fear arising from the SARS epidemic in 2003 and to revitalised civil society resulting from the Anti-Extradition Bill Movement in 2019. It illustrates that framing strategies and organisational capacity capitalised on the discursive power and solidarity linked to these political opportunities. However, the failure to achieve demands related to resource redistribution, occupational safety and union rights reflect professionals’ dilemma on fulfilling their duty of care and the limitations of SMU in Hong Kong.

A humanização do nascimento, o empoderamento das mulheres e a reapropriação de ações e conhecimentos das parteiras: experiências do Québec e do Chile

ABSTRACT Whether in pre-pregnancy, pregnancy, birth and/or the postnatal and neonatal periods, midwives’ practices are underpinned by humanism. However, in this era of postmodernity, there is an ever-growing need for rehumanization. This article adopts an auto-ethnographic approach in order to undertake a reflective analysis on the humanization of birth based on the practice of midwifery in two different contexts, namely Quebec (Canada) and Chile. In light of the evolution of the profession in these two countries, and the influence of health policies and social movements, there are factors such as the systematic use of technology and the hypermedicalization of reproductive processes which are maintaining women’s ignorance and keeping them from being able to participate in their maternity process. Women’s autonomy and empowerment become a key element for their participation in decisions regarding their maternity, assistance methods, or type of care. Concurrently, midwives’ autonomy is a prerequisite for fully exercising their role in supporting and assisting women in this re-appropriation of their power by means of a comprehensive approach that takes into account psychological and social aspects as well as biomedical ones.

Gender and Instagram Activism in Teenagers: Social Discourse in a Digital Age

Social media activism—posting or reposting ideas, images, or words surrounding different social movements—has swelled in recent years with the growth of the internet. Teenagers have begun using their social media accounts to share their opinions and current events related to issues they deem important. This study had two main aims: to assess factors that influenced high school-aged teenagers’ motivation to post activist content on Instagram, and then to explore how those factors differed between genders. A survey was distributed to students at a midsize high school in Washington state that collected participants’ (n=114) demographic information, willingness to post activist content, and motivation levels to post about five popular issues. Results were analyzed by identifying key themes in qualitative responses and categorizing them using the preexisting Scale of Motives for Using Social Networking Sites (SMU-SNS). It was found that nonbinary and particularly female teenagers were more likely to post activist content than male teenagers. Participants indicated that relation to personal identity, personal/public knowledge on the issue, and perceived severity/importance of the issue were main reasons for posting activist content. Further analysis showed these themes fell under the SMU-SNS categories of Social Connectedness, Information, and Self-expression. These conclusions have great significance for public health organizations and social justice movements looking for teenagers willing to engage in this form of advocacy, suggesting they should tailor activist content for Instagram Stories and that they need to look for alternative ways to get male teenagers involved.

Archives at the Margins: Toward a Liberatory Pedagogy in Anthropology

This essay reflects on the academic margins as a space of openness for anthropological teaching and learning. I describe an activity in which students in a medical anthropology course analyzed primary source materials documenting Black health social movements that were curated for the class by a community archive in Los Angeles. Using this example, I explore possibilities for reshaping anthropological teaching toward an engaged, liberatory pedagogy that reconceptualizes knowledge as co-created, centers marginalized voices and experiences, and links theory to justice-oriented social action.

Four urban health paradigms: The search for coherence

Scholars, practitioners and policymakers view urban health based on their foundational ontologies, or paradigms, which provide a framework of norms that specifies the policy goals or research questions, the preferred policy instruments or research methodologies, and defines the nature of the urban health issue. This paper identifies four paradigms in current research and practice that address the links between the urban built environment and human health: the ‘medical-industrial city’, ‘urban health science’, ‘healthy built environment’ and ‘health social movement’ paradigms. We argue that scholars, practitioners and policymakers must recognise their diverse and sometimes contradictory views in order to create an opportunity for coherence in understanding knowledge generated from different paradigms.

Counter‐Clinical Spaces1

Intermediary spaces between health social movements and biomedicine have proliferated since the 1970s and have typically been analyzed through the lenses of co‐optation or hybridization. In this article, we present data from two separate empirical projects (teaching and learning the pelvic exam in medical schools and feminist anti‐violence counseling programs) in order to theorize what we call “counter‐clinical spaces.” Counter‐clinical spaces are medicalized sites of knowledge production and practice that are produced through social movements’ contestations with biomedicine. Other examples include sexual assault nurse examiner programs, LGBT health centers, and sexual health clinics. Counter‐clinical spaces are “counter” and “clinical” in several ways. First, these spaces are distinctly clinical in that they intervene in the health of the body. Second, these spaces are counter‐clinical in that they are organized in critique of dominant medical practices. Crucially, counter‐clinical spaces engage the clinical encounter as a site of transformation: social movement actors target clinicians’ deployment of medical power, especially in their interactions with marginalized persons. We thus attend to the scale upon which social movements make a change in and against medicine, and we highlight how social movement logics can and do change practices even when they are unable to shift structures.

Understanding low mobilization for non-communicable diseases among people living with NCDs: A qualitative study on hypertension in urban South India

There is low civil society mobilization for NCD policies in low- and middle-income countries (LMICs) despite a growing NCD burden. While existing research explains low mobilization largely through constraints such as inadequate funding and capacity at the organizational level, we explore the issue from the perspective of people living with NCDs and ask how lay understandings of hypertension may inform potential mobilization for multisectoral policy actions by people living with hypertension. To explore this question, we develop a theoretical framework that casts mobilization as a function of people's recognition of disease importance, attribution of NCD risk factors to government policies, beliefs about who bears responsibility for NCD prevention and management, and beliefs around efficacy of multisectoral policies. We present findings from 45 semi-structured interviews with people living with hypertension in a qualitative study in Chennai, India. Our thematic analysis reveals that respondents can dedicate limited time and resources to actions around hypertension. People living with hypertension also strongly internalize responsibility for developing and managing their condition and focus primarily on achieving lifestyle changes. Instead of demanding multisectoral policy action around hypertension, respondents recommend that government actions focus on measures that enable their lifestyle changes, such as increasing awareness and health care capacities, and express doubts about the efficacy of government policies. Our findings expand existing theories around mobilization by revealing how people's own understanding of their illness, its risk factors and their underlying drivers, as well as their perception of challenges in NCD policy making can present barriers to mobilization around multisectoral policies. Theory on health social movements would benefit from a deeper integration of individual perspectives and a closer consideration of the specific challenges of living with NCDs given the local context.

From Medicine to Health: The Proliferation and Diversification of Cultural Authority.

In his account of the medical profession's ascent, Paul Starr drew a distinction between the social authority of physicians and the cultural authority of medicine-between doctors' capacity to direct others' behavior and the ability of medical institutions and discourses to shape meanings of illness, health, wellness, and treatment. Subsequently, scholars have reflected on the social-structural transformations challenging physicians' social authority but neglected shifts in cultural authority. Focusing on the United States, we find a proliferation and diversification of cultural authority, reflecting a partial movement from the domain of medicine into new terrains of health. This shift is apparent in the resurgence of alternative healing, the advent of new forms of self-care and self-monitoring, the rise of health social movements, and the spread of health information online. We advance a research agenda to understand how the mechanisms and dynamics of cultural authority shape contests to speak in the name of health.

Why Do People (Not) Engage in Social Distancing? Proximate and Ultimate Analyses of Norm-Following During the COVID-19 Pandemic.

COVID-19 has had a profound negative effect on many aspects of human life. While pharmacological solutions are being developed and implemented, the onus of mitigating the impact of the virus falls, in part, on individual citizens and their adherence to public health guidelines. However, promoting adherence to these guidelines has proven challenging. There is a pressing need to understand the factors that influence people’s adherence to these guidelines in order to improve public compliance. To this end, the current study investigated whether people’s perceptions of others’ adherence predict their own adherence. We also investigated whether any influence of perceived social norms was mediated by perceptions of the moral wrongness of non-adherence, anticipated shame for non-adherence, or perceptions of disease severity. One hundred fifty-two Australians participated in our study between June 6, 2020 and August 21, 2020. Findings from this preliminary investigation suggest that (1) people match their behavior to perceived social norms, and (2) this is driven, at least in part, by people using others’ behavior as a cue to the severity of disease threat. Such findings provide insight into the proximate and ultimate bases of norm-following behavior, and shed preliminary light on public health-related behavior in the context of a pandemic. Although further research is needed, the results of this study—which suggest that people use others’ behavior as a cue to how serious the pandemic is and as a guide for their own behavior—could have important implications for public health organizations, social movements, and political leaders and the role they play in the fight against epidemics and pandemics.

Nursing is a health equity and social justice movement.

Nursing has been grounded in the pursuit of health equity and social justice for over 100years. Escalating health care costs, COVID-19, and racial conflict have spotlighted the impact of our social and health inequities and the interconnectedness of everyone's health. This study discusses two key nursing movements for health and social justice, the public health nursing movement and the nurse practitioner movement. This study also describes how the re-emerging focus on population health nursing and the increasing nurse activism are building on our history of addressing the social and environmental root causes of ill health. Changes in health care design, delivery, and payment will create more opportunities for population health nursing to continue nursing's long-standing efforts in pursuit of health equity and social justice.

#March for Our Lives: Health Activism, Diagnostic Framing, Gun Control, and the Gun Industry

ABSTRACT This article investigates #March for Our Lives as health activism. Students organized a social media campaign, major marches and other events after surviving the 2018 school shooting at Marjory Stoneman Douglas High School in Parkland, Florida. Many commentators praised the group’s success in rallying public attention to gun violence, promoting gun safety legislation, and challenging the National Rifle Association. This critical analysis sheds light on how the students’ Twitter activism addressed longstanding framing and attribution practices that impede structural and policy responses to gun violence, including efforts to address the gun industry. We investigated how the activists’ diagnostic, prognostic, and motivational framing attributed the causes of gun violence, promoted solutions, and fostered support. The conclusion discusses the implications of #March for Our Lives strategies for our understanding of health social movements, challenges to corporate power and influence, and the politics of framing and illness attributions.

Redressing the Corporate Cultivation of Consumption: Releasing the Weapons of the Structurally Weak.

Corporate control of the global food system has resulted in greater global availability of highly processed, packaged and very palatable unhealthy food and beverages. Environmental harm, including climate change and biodiversity loss, occurs along the supply chains associated with trans-national corporations’ (TNCs’) practices and products. In essence, the corporatization of the global food system has created the conditions that cultivate excess consumption, manufacture disease epidemics and harm the environment. TNCs have used their structural power – their positions in material structures and organizational networks – to establish rules, processes and norms that reinforce and extend the paradigm of the neoliberal corporate food system. As a result, policy and regulatory environments, and societal norms are favourable to TNC’s interests, to the detriment of nutrition, health and environmental outcomes. There is hope, however. Power, of which there is many forms, is held not just by the TNCs but by all actors concerned about and connected to the food system. This paper aims to understand these power dynamics, and identify how structurally weak, public-interest actors can release their agency and work to achieve positive structural change. Such an analysis will help understand how the status quo can be disrupted and healthy and sustainable food systems created. The paper draws from the health governance and social movement literature, examining the Doha Declaration on the Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement and Public Health, the Framework Convention on Tobacco Control (FCTC), and the Divestment movement. These cases demonstrate the many ‘weapons of the weak’ that can, against all odds recalibrate structural inequities. There is no one approach to transforming the corporate food system to become a healthy and sustainable food system. It involves coalition building; articulation of an ambitious shared vision; strategic use of multi-level institutional processes; social mobilization among like-minded and unusual bedfellows, and organized campaigns; political and policy entrepreneurs, and compelling issue framing.

How can stigma contribute to our understanding of the formation and mobilization of collective identities in health social movements?

AbstractScholars across several theoretical traditions have become increasingly interested in understanding the underlying factors and mechanisms that contribute to the formation and mobilization of collective identities in health social movements (HSMs). In this essay, I make the case that stigma can serve as a useful theoretical and conceptual framework in understanding the processes through which collective identities emerge and mobilize around health‐related issues. I begin by introducing the concepts of HSMs, collective identity and stigma and reviewing how scholars have defined these concepts. Next, I establish theoretical, conceptual, and empirical links among stigma, collective identity, and HSMs. I conclude by further specifying how and why stigma can serve as a unifying framework for medical sociologists, social psychologists, and social movement researchers to advance scholarship on HSMs.

'You're basically calling doctors torturers': stakeholder framing issues around naming intersex rights claims as human rights abuses.

In this article we address activist, patient advocate and medic perspectives on framing intersex, variations of sex characteristics and disorders/differences in sex development medical treatment as human rights abuses. Problematic aspects of intersex medical treatment have increasingly been highlighted in national debates and international human rights bodies. Some intersex activists have framed aspects of intersex medical treatment as human rights abuses since the 1990s. Other stakeholders in shaping medical treatment, such as patient advocates and medical professionals, are not always content with human rights framing, or even the term intersex. In order to address the different perspectives in this arena we provide background on the primary rights claims that have arisen followed by key human rights framing of these claims. We provide a short discussion of activism styles, looking at pan-intersex social movements and variation-specific patient associations as different styles of health social movements. The analysis of stakeholder perspectives on the use of human rights strategy in health areas provides a useful case study for medical sociology and policy in general.

Studying the Icarus Project Through Digital Bricolage: How Digital Platforms Reflect Shifting Strategies in a Social Movement Organization's Development

Abstract This article describes digital bricolage as a way to study the digital history of a social movement organization. Drawing from our separate research projects on The Icarus Project (TIP), we describe our respective strategies as a health humanities scholar and a journalist to trace the organization's evolution; and our research findings describe TIP's gradual shift from grassroots leadership to professional staff. In tracing TIP's digital evolution, we argue that digital bricolage can contribute to our understanding of digital organizing tactics used in modern health social movements.

How Civil Society Organisations Changed the Regulation of Clinical Trials in India

ABSTRACTIn 2005 India changed its pharmaceutical and innovation policy that facilitated a dramatic increase in international clinical trials involving study sites in India. This policy shift was surrounded by controversies; civil society organisations (CSOs) criticised the Indian government for promoting the commercialisation of pharmaceutical research and development. Health social movements in India fought for social justice through collective action, and engaged in normative reasoning of the benefits, burdens and equality of research. They lobbied to protect trial participants from structural violence that occurred especially in the first 5–6 years of the new policy. CSOs played a major role in the introduction of new regulations in 2013, which accelerated a decline in the number of global trials carried out in India. This activism applied interpretations of global social justice as key ideas in mobilisation, eventually helping to institutionalise stricter ethical regulation on a national level. Like government and industry, activists believed in randomised controlled trials and comparison as key methods for scientific knowledge production. However, they had significant concerns about the global hierarchies of commercial pharmaceutical research, and their impact on the rights of participants and on benefits for India overall. Pointing to ethical malpractices and lobbying for stricter ethical regulations, they aimed to ensure justice for research participants, and developed effective strategies to increase controls over the business side of clinical research.

Against alienation treatment, we stand for!

Who would be our most contemporary monsters? Who are the outcasts? Who are the ones that (or whom) we don’t want to speak about? The Brazilian society still has places where the established concept of human by Human Rights Standards seems not to be reaching. The so-called “legal asylums” or “judiciary asylums” are places that aggregate not only the “lunatics” but also the ones with mental disorders that additionally committed a crime. As a consequence, of these two main attributes, such persons are not remembered or considered worthy to be advocated, being under a moral judgment. With this in mind, this paper is focused on constructing a critical engagement with the Brazilian Mental Health issue, under the analysis of “legal asylums” and it aims to contribute to the epistemological aspect of the issue. In addition, it aims to bring up a mix of theoretical notions and paradigms about the Brazilian mental health struggle, as well as its political historical background both of the health professionals and patients social movements. Mental Health Social Movements can be understood as an individual and institutional response to stop producing and reproducing inequalities and discrimination, and a path towards a more inclusive society.

Health needs of the rural population in environmental conflict due to the installation of Irrigated Perimeters

The transformations in the Brazilian agricultural scenario have reconfigured lifestyles in the countryside, with repercussions on the health of the rural population. The scope of this paper is to analyze health needs of farmers, identified by a collective of university actors, the Unified Health System and social movements. It is action-research, with a group comprised of community health workers, workers in a Reference Center in Occupational Health, a university professor and representatives of social movements. Semi-structured interviews and field visits were conducted, as well as workshops and seminars. The thematic categorization revealed five health need groupings: the need for revision of the agrarian development model; the need for good living conditions; the need for social mobilization; the need to avoid the use of pesticides; and the need for action of the Unified Health System (SUS). The dialogue of knowledge and exchange of experience elicited the recognition of health needs that require intersectoral action. Health needs must be understood in the context of the territories to which the individuals and groups belong, acknowledging the complexity of social, economic, cultural and environmental issues.

Latin American social medicine across borders: South–South cooperation and the making of health solidarity

ABSTRACTLatin American social medicine efforts are typically understood as national endeavours, involving health workers, policymakers, academics, social movements, unions, and left-wing political parties, among other domestic actors. But Latin America’s social medicine trajectory has also encompassed considerable between-country solidarity, building on early twentieth century interchanges among a range of players who shared approaches for improving living and working conditions and instituting protective social policies. Since the 1960s, Cuba’s country-to-country solidarity has stood out, comprising medic exchanges, training, and other forms of support for the health and social struggles of oppressed peoples throughout Latin America and around the world, recently via Misión Barrio Adentro in Venezuela. These efforts strive for social justice-oriented health cooperation based on horizontal power relations, shared political values, a commitment to social and economic redistribution, bona fide equity, and an understanding of the societal determination of health that includes, but goes well beyond, public health and medical care. With Latin America’s left-wing surge now receding, this article traces the provenance, dynamics, impact, challenges, and legacy of health solidarity across Latin American borders and its prospects for continuity.