Medical Sociology Research Articles

Manfred Pflanz (1923-1980) - A key Protagonist for the Institutionalization of Social Medicine and Medical Sociology in Germany

Manfred Pflanz, an internist with his focus on social medicine, medical sociology and epidemiology, (1923-1980) played a key role in the institutional integration of social science expertise into medicine in the Federal Republic of Germany during the 1960s and 70 s. The present study, a biographic sketch of Pflanz, describes his work, his programmatic ideas on social medicine and medical sociology, and his activities as an expert consultant in public health for various political entities. This should enable getting an insight into the origins and ramifications, as well as the contemporary programs and international embeddedness of the overlapping fields of social medicine and medical sociology in Germany.

Pfaff: ‚Ideas are not enough to achieve success‘

Two presentations in particular gave rise to heated, sometimes very controversial, but therefore also interesting discussions during the MVF Congress ‚The impact of the pandemic on healthcare‘. The first was the statement by Prof Dieter Köhler, MD, former Medical Director of Kloster Grafschaft Hospital, that uncritical adherence to the S3 guideline ‚Recommendations for inpatient treatment of patients with Covid-19‘ had led to an unnecessarily high number of corona deaths during the pandemic. The second was the presentation by Prof Dr Holger Pfaff, Head of the Institute for Medical Sociology, Health Services Research and Rehabilitation Science at the University of Cologne, who presented a new approach to how serious decisions can still be made on an uncertain data basis.

Sociological Research and Teaching in the Context of Medical Faculties - An Autobiographical Report

With the introduction of medical psychology and medical sociology as examination subjects in the medical curriculum, as enacted by the year 1970 in Germany, medical faculties established professorships and departments for these disciplines. This raised the concern of how the two separate scientific cultures of the social and behavioural sciences and of medicine, rooted in basic sciences, could reconcile their teaching and research activities in a constructive way. It turned out that the quality and the thematic affinity of new research aligning with core medical interests were important preconditions of successful integration of the new disciplines. This paper exemplifies a respective success in case of a scientific development in medical sociology. Based on a theoretical model, a longstanding, internationally collaborating research program analysing social determinants of stress-related disorders resulted in a series of innovative insights. Furthermore, the paper illustrates close links between biographical luck and structural opportunities and constraints, and it emphasizes the important role of committed inter-disciplinary scientific collaboration.

Interview with Professor Edwin van Teijlingen

Edwin van Teijlingen is Dutch by birth and a Professor of Reproductive Health at Bournemouth University in the south of England. He has achieved a PhD in Medical Sociology at the University of Aberdeen, UK. Prof. Edwin van Teijlingen connected with Nepal while supervising Nepali PhD scholars in UK, and he has been a frequent visitor to Nepal since 2006. He has supervised more than 35 PhDs, among which 13 are Nepali. He has examined more than 50 PhDs. He has published around 300 academic papers and book chapters in health promotion, midwifery, and health services research. He serves as a peer reviewer for worldwide famous health journals such as PLOS One and BMC Pregnancy and Childbirth. He delivered a speech to the Members of Parliamentarians in Kathmandu in 2016 as part of a workshop to promote evidence-based policymaking. He is a committee member on various grant-awarding bodies in the UK, Belgium, the Netherlands, Norway, Switzerland, and the USA. He is a visiting Professor at the Centre for Disability Studies, Mahatma Gandhi University, Kerala in India (2020-present); the School of Health Sciences at the University of Nottingham in England (2017-2026); Nobel College, affiliated with Pokhara University, Nepal (2012-present); and Manmohan Memorial Institute of Health Sciences affiliated with Tribhuvan University (2009-present). We would like to express our gratitude for his acceptance to share personal and academic lives, which can inspire young and energetic scholars in Nepal and elsewhere.

Cultural health capital and patient partner recruitment into healthcare improvement work

A rising emphasis on patient involvement in clinical research and healthcare improvement has led to the steady incorporation of patients and caregivers into this work. However, interactional factors shaping recruitment processes are not well understood. In this paper, we present a qualitative analysis of interviews with twenty-six patients, family members, engagement staff and healthcare providers who are engaged in healthcare improvement work in the United States. We focus on how stakeholders account for recruitment decisions to participate in healthcare improvement work. We find that expressions of and judgments about patients' and caregivers' cultural health capital shape providers’ decisions to extend invitations to participate in healthcare improvement work. These findings extend current conceptualizations of cultural health capital beyond the clinical encounter to reveal factors shaping patient recruitment into healthcare improvement work. In theorizing how cultural health capital shapes action in this new setting, we found that healthcare providers, engagement staff, and patients/caregivers attended to different aspects of cultural health capital when accounting for why they extended or received a recruitment pitch. We further found that participating in healthcare improvement work led to a boost in cultural health capital for patients and caregivers, which they could use to develop transmissible forms of cultural health capital for less centrally involved patients and caregivers. Finally, we describe how participants in healthcare improvement collaboratives account for a lack of diversity among partners. These findings help us hypothesize the consequences of recruitment processes that rely on displays and judgments of cultural health capital and identify possibilities for change. Using the case of healthcare improvement work in Collaborative Learning Health Systems, our findings advance past work on cultural health capital in medical sociology by theorizing the role of cultural health capital in recruitment processes.

Medicalizing disabled people's emotions-Symptom of a dis/ableist society.

The theoretical-conceptual article at hand explores how emotional discourses shape social relations by specifically focusing on the medicalization of disabled- and chronically ill-people's emotions. Medicalization is a concept from medical sociology that describes medicine's expansion into non-medical life areas, for instance into the realm of emotions, sometimes in order to challenge this expansion. The emotions of disabled people are often presented as a medicalized problem, rather than recognizing their embeddedness in a dis/ableist socio-cultural context. Such discourses instrumentalize feelings in order to individualize the responsibility for disability. For a contextualized and emancipatory approach, this study reviews papers on medicalized emotions from Disability Studies-a research program that can provide a rich archive of experiential accounts yet to be theorized through a comprehensive emotional perspective. The medicalization of disabled people's emotions can manifest in different ways: (1) In a dis/ableist society, able-mindedness is compulsory; i.e., we fail to question that a healthy mind is the norm and something to strive for unconditionally. This is also true on an emotional level; after all, some medical diagnoses are based on the wrong degree or temporality of emotionality. (2) Unpleasant feelings such as sadness are misunderstood as symptoms of impairment rather than effects of discrimination. (3) The expression of hurt feelings, e.g., related to discrimination, can easily be dismissed as hysterical. This assumption epistemologically disables patients. (4) Love and desire are delegitimized as fetish, for example, the desire for a disabled lover or the wish to start a family despite a chronic illness. The medicalization of disabled people's emotions individualizes and delegitimizes unpleasant emotions that emerge in a dis/ableist society. Different facets of medicalization enforce medical treatment instead, albeit in different ways. Disabled and sick people are cast as not feeling and desiring the right way, while hegemonic discourse prescribes psychological treatment against the effects of discrimination and bodily symptoms it cannot explain. Beyond the dismissal of disabled people's experience, adverse effects on healthcare delivery and health outcomes can be expected.

From chart-topper to gold record: The effects of Billboard chart popularity on RIAA gold or platinum certification of #1 R&B/Hip-Hop singles in the Pre-SoundScan and SoundScan eras, 1977–2008

IntroductionThe purpose of this paper was to examine the effects of genre-specific and mainstream Billboard chart popularity on RIAA gold or platinum certification of #1 R&B/Hip-Hop singles in the Pre-SoundScan (1977–1992) and SoundScan (1993–2008) eras. The first aim was to determine if there were any statistically significant differences in genre-specific and mainstream popularity between singles that achieved RIAA gold or platinum certification and those that did not reach that pinnacle in both eras. The second aim assessed the relative predictive power of genre-specific and mainstream popularity on RIAA gold or platinum certification of #1 R&B/Hip-Hop singles in the Pre-SoundScan and SoundScan eras while controlling for established brand. MethodsIn this comparative assessment of the relationships between Billboard chart data and RIAA gold/platinum certification data in the Pre-SoundScan and SoundScan eras, genre-specific popularity was measured by total weeks at #1 on Billboard's R&B/Hip-Hop charts and total weeks on the charts regardless of position. Mainstream popularity was evaluated with peak position on Billboard's Pop charts. The established brand construct was assessed with the artist's total prior #1 R&B/Hip-Hop singles and total prior #1s by the record label. ResultsA Mann–Whitney U test revealed statistically significant differences in mainstream popularity between gold or platinum singles and non-gold or platinum singles in both the Pre-SoundScan and SoundScan eras. Statistically significant differences in genre-specific popularity were also observed in both periods, but not in the hypothesized direction in the SoundScan era. A binary logistic regression model demonstrated that the two popularity constructs, while controlling for established brand, predicted RIAA gold or platinum certification of #1 R&B/Hip-Hop singles in both the Pre-SoundScan and SoundScan eras. The model better predicted gold or platinum certification in the Pre-SoundScan era. The most powerful predictor was mainstream popularity in both eras. ConclusionGold or platinum certified #1 R&B/Hip-Hop singles had a significantly higher peak position on the mainstream Pop charts than those not certified gold or platinum in both the Pre-SoundScan and SoundScan eras. When observing genre-specific popularity, gold or platinum singles spent significantly more total weeks on the R&B/Hip-Hop charts than non-gold or platinum singles in the Pre-SoundScan era. In contrast, the reverse was observed in the SoundScan era. Mainstream popularity, as measured by peak position on the Pop charts, and genre-specific popularity, as measured by total weeks on the R&B/Hip-Hop charts, were good predictors of gold or platinum certification in both the Pre-SoundScan and SoundScan eras. The model was a better predictor of RIAA gold or platinum certification in the Pre-SoundScan era, suggesting that the Billboard chart methodology in the earlier era was more aligned with the RIAA auditing process than the SoundScan era methodology. Findings also raise questions about whether the initial exclusion of several African American independent retailers, who were generally the primary source for sales data in the Pre-SoundScan era, reduced the validity of SoundScan sales data. In other words, did the SoundScan data measure what it intended to measure, which was the popularity of R&B/Hip-Hop singles among the target audience of that genre? Future research should examine how the transition to SoundScan may have contributed to redefining the target audience for R&B/Hip-Hop music, impacted the quantity and quality of R&B/Hip-Hop music available to the public, and the effects of those outcomes on the broader culture and society. Areas of InterestRecording industry, organizations, stratification, race and ethnic relations, medical sociology, political sociology, quantitative and qualitative methods.

Navigating uncertainties in critical care with Covid-19: A cross country analysis of patient narratives from Brazil and the United Kingdom

Uncertainty is inherent in medicine and has been an enduring focus of enquiry in medical sociology. It is a particularly salient analytic concept in the context of a new emerging disease. Whilst a substantial body of work explores how clinicians manage uncertainty, scholarship that explores patients’ experiences and ways of managing uncertainty is less well developed. In this cross country research, we draw on two narrative interview studies with patients who were critically ill with Covid-19 in Brazil and in the United Kingdom (UK) in the first year of the pandemic. In Brazil, Covid-19 surveillance was introduced in hospitals, with tight restrictions on visitors in non-Covid-19 services and a visitor ban in Covid-19 services. In the UK, hospital visits were suspended entirely for several months, and later seriously restricted. Using a cross country analysis, we mobilize the concept of ‘navigation’ to highlight how a rapidly changing environment facilitates or impedes how well patients could act in, and on, their circumstances. We explore the ways in which four intersecting uncertainties affected patients, namely those relating to contagion, treatment, protocols and practice, and individual prognosis. We demonstrate how patients sought to navigate these uncertainties through relationships – with family members, clinical staff, other patients and technologies – which could provide temporary relief. We argue that it is important to attend to how patients invest in relationships in critical care, and to facilitate and support these wherever possible.

The Withering Away of the Physician in Medical Sociology: Medicalization, Biomedicalization, and Pharmaceuticalization

The Withering Away of the Physician in Medical Sociology: Medicalization, Biomedicalization, and Pharmaceuticalization

Making patients political: Narrating, curating, enacting, and navigating the ‘idealised policy patient’

In this article we develop the concept of the ‘idealised policy patient’ to contribute to a better understanding of patient-family activism and the mechanisms through which powerful and persuasive patient narratives are facilitated and mobilised. The context through which we explore the idealised policy patient is the UK debates about the legalisation of mitochondrial donation, which primarily took place between 2011 and 2015. In our example, the idealised policy patient was constructed around a culturally persuasive narrative of patient suffering, where mitochondrial donation was presented as a desirable and ethical solution. We draw on interviews with patient-families and stakeholders, and documentary analysis to identify four dimensions of the idealised policy patient – narrating, curating, enacting and navigating. Narrating describes how the idealised policy patient appears in public and policy spaces, as a culturally available narrative which conveys certain meanings and is designed to invoke an emotional and practical response. Curating identifies the multiple forms of labour and facilitation involved in supporting patient-families in activist activities which strengthen the dominant narrative and its embodiment. Enacting focuses on the work of patient-families themselves in supporting and contributing to the idealised policy patient in a way that enlivens and embodies the specifically curated narrative. Finally, navigating considers how those offering an opposing viewpoint position themselves in relation to the idealised policy patient. To conclude, we argue that medical sociology has often given insufficient scrutiny to how the capacity of patients to leverage their status for political ends is bolstered through alignment with existing powerful groups, particularly in hegemonic campaigns. We encourage future researchers to examine how the idealised policy patient is reproduced and reorientated within different policy contexts.

Вплив травми на психологічне здоров’я та насильство в Українi

During the past couple of years, Ukrainians have been experiencing major traumatic and stressful events, including the Russian annexation of Crimea and the war against Ukraine that started in 2014 and is ongoing. Moreover, in 2020, the whole world faced another disaster – the COVID-19 pandemic. Undoubtedly, such cumulative adverse events negatively influence life outcomes of this vulnerable population. Prior research has shown that pandemic and war-related stress can affect mental health and violent behaviour. However, there is a gap in the literature focusing on how various contemporary traumatic events, including war exposure and associated stressors, shape mental health and violence among Ukrainians. This study uses survey data recently collected among adults in Ukraine, which is a part of the larger project “A Cross-National Study of the Global Pandemic, Deviance and Health,” and conducts a series of regression analyses. It draws on two major theoretical perspectives in criminology and medical sociology, to examine how traumatic conditions, including exposure to war and pandemic-related stressors (contracting the virus and daily problems) influence depression and violence among Ukrainian people. First, using regression models, we found a significant relationship between reporting exposure to disasters (e.g., war, genocide) and depressive symptoms. Additionally, we found that those who experienced health stress (i.e., have contracted the virus) were more likely to report depressive symptoms. Further, Ukrainians reporting more family problems and financial issues experienced higher levels of depression. Next, we found that reporting frequent family problems and financial issues increased the likelihood of violent behaviour among Ukrainian residents. On the other hand, health stress and war exposure reports were not significantly associated with violence, which could potentially be attributed to stress reaching a ceiling effect, where Ukrainians may feel “numb” to traumatic conditions they experience routinely. Finally, we provide suggestions for future research and discuss implications for policy and practice.

Recent Approaches to the Study of Health, Healing, Illness, and Care in Africa

So far, the twenty-first century has been a boom time for studies of health, illness, healing, and care work in Africa, and the COVID-19 pandemic has only increased attention to these issues. Yet again, current events remind us that history, politics, social relationships, and public health are inextricably linked. These five books encompass a range of approaches to the questions and sources that animate these studies from a variety of disciplinary perspectives, including anthropology, public health, gender studies, medicine, political science, and history. Each of these authors and editors is explicit about their commitment to reaching an interdisciplinary audience and, for most of them, interdisciplinary work is core to their professional identities. Paul Farmer, Luke Messac, and Simukai Chigudu all earned medical degrees as well as doctoral degrees in medical anthropology, history and sociology of science and medicine, and international development respectively; Nolwazi Mkhwanazi and Lenore Manderson describe themselves as working “at the intersections of medical anthropology, public health and gender studies” (vii). These five books reflect the wide range of authors and audiences engaging in questions about what constitutes health, how it is achieved or undermined, and how the past has contributed to present conditions on the continent.

“Why would we take men? This is an OB/GYN”: Gender, hysterectomy, and the patriarchal dividend

AbstractHysterectomy experiences among transmasculine individuals represent a powerful case to examine gendered dynamics in healthcare, especially given the continued cultural association between the uterus and womanhood. In this paper, I draw on theories from feminist science and technology studies and medical sociology to examine in‐depth interviews with 46 trans or nonbinary individuals who have had, want, or are considering an elective premenopausal hysterectomy. I find that trans men and nonbinary patients must negotiate what I call the structural feminization of gynecology which often leads to poor healthcare experiences. This paper also extends theories of a “patriarchal dividend” in medicine by examining reported differences in medical experiences when patients are perceived as cisgender women versus as trans men or nonbinary. I find a double bind inherent in the patriarchal divided in healthcare: masculinity often leads to better care, but the patriarchal dividend is constrained by the stigma introduced by being a trans patient. In the process, I extend social scientific knowledge of a highly common yet understudied procedure while expanding scholarship on medicine, gender, and embodiment.

'To improve quality of life': Diverging enactments of a value in nephrology clinical practices.

Quality of life has become a central value in the provision of healthcare for patients with chronic conditions. This has engendered debates in critical medical sociology on the non-neutral effects that valuing health and illness, medical interventions, and health care delivery in terms of quality of life yields. Focusing on the case of nephrology, this paper presents qualitative data collected in Austria of two dialysis units in which nephrologists initiated projects aimed towards 'the improvement of patients' quality of life'. Whereas the first involved nurses supporting patients in the administration of peritoneal dialysis at home, the second implied the provision of treatment and care exclusively focused on a well-being 'in the here and now' to patients. By conceptualising physicians as actors within networks of relations and values enacted in practices, it analyses how in both dialysis units reference to quality of life enabled nephrologists to problematise the provision of standard haemodialysis treatment to multi-morbid, elderly patients, to develop a new treatment protocol, and to interest and enrol others in the provision of healthcare according this new protocol. Valuing medical interventions in terms of quality of life not only leads to a governmentalization of living and an economisation of health. It also allows physicians to articulate a socio-medico-ethical problem - the availability of life-prolonging technologies for a growing population of elderly, multi-morbid patients - and develop solutions locally. What the solutions consist in may fundamentally differ, however.

Social construction of risk and prevention practices related to Aedes mosquito-borne disease in an endemic municipality in Colombia.

This article analyzes risk discourses around dengue, zika and chikungunya constructed by lay people, community leaders and disease control experts from the fields of medical anthropology, medical sociology, and public health. A qualitative ethnographic study was conducted in a municipality in Colombia (December 2016 and January 2018) with semistructured and open-ended interviews, informal dialogues, and fieldwork journal observations. This study found a mismatch in risk discourse about vector-borne diseases among health officials, lay people, and community leaders. These discourses are linked to the sociocultural contexts in which people live, and offer particular ways of giving meaning and acting in the face of disease prevention. The findings show a multisituated risk that refers to the inside and outside of homes; and the prevention practices mentioned by different actors, in which a continuity of tensions between lay people, leaders and government officials can be observed.

'I am more than just my label': Rights, fights, validation and negotiation. Exploring theoretical debates on childhood disability with disabled young people.

Through the creation of safe spaces in which to explore and challenge dominant negative views of disabled children and young people, this co-written paper presents unique insight into the meaning and impact upon disabled young people's lives of medical lenses and deficit models of disability. Bodies of work and dominant debates in medical sociology, disability studies and childhood studies have so far largely overlooked the experiences and positioning of disabled children and young people and have rarely involved them in the development or discussion of theory. Drawing on empirical data, and through a series of creative, reflective workshops with a UK-based disabled young researchers' collective (RIP:STARS), this paper discusses areas of theoretical importance identified by the disabled young researcher collective-the validation of their lives, negotiation of their identity and acceptance in society. The implications, and possibilities, of platforming disabled children and young people's voices in theoretical debates are deliberated and are achieved through the yielding of privileged academic voice and the development of a symbiotic, genuine partnership which resonates with disabled young people and recognises them as experts in their own lives.

Introduction to special issue: New dialogues between medical sociology and disability studies.

Sociology of Health & IllnessEarly View INTRODUCTION Introduction to special issue: New dialogues between medical sociology and disability studies Janice McLaughlin, Corresponding Author Janice McLaughlin [email protected] Newcastle University, Newcastle upon Tyne, UK Correspondence Janice McLaughlin. Email: [email protected]Search for more papers by this authorSasha Scambler, Sasha Scambler King’s College London, London, UKSearch for more papers by this authorGareth Thomas, Gareth Thomas Cardiff University, Cardiff, UKSearch for more papers by this author Janice McLaughlin, Corresponding Author Janice McLaughlin [email protected] Newcastle University, Newcastle upon Tyne, UK Correspondence Janice McLaughlin. Email: [email protected]Search for more papers by this authorSasha Scambler, Sasha Scambler King’s College London, London, UKSearch for more papers by this authorGareth Thomas, Gareth Thomas Cardiff University, Cardiff, UKSearch for more papers by this author First published: 26 May 2023 https://doi.org/10.1111/1467-9566.13652Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Early ViewOnline Version of Record before inclusion in an issue RelatedInformation

A History of Teaching Medical History in Medical Schools in Europe and America.

Medical history was an important part of medicine in the West from antiquity, through the Middle Ages, and until the Renaissance. Hippocrates, Galen, and Avicenna were historical figures, but they dominated the medicine of the Western world at least until Renaissance. The medicine of the past, which did not become history, still remained an important part of present medicine. In the 19th century, medicine in the past is now relativized as an object of history. At the same time, the 'practicality' of medical science was emphasized. The practicality referred to here means that, unlike previous times, medicine in the past has been historicalized, but it can provide practical help to current medicine. In particular, in the era of positivism that dominated the late 19th century, this practicality was a core value of medical history. In the 20th century, the era of scientific medicine, the new role is given to medical history. It was to give a integrated view on contemporary medicine which was subdivided into many specialized fields. Along with this, medical history, once a main part of medicine, moves to the field of history. At the same time, the rise of medical humanities in medical education becomes an opportunity to redefine the role of medical history. Seeking productive cooperation with other humanities and social sciences that deal with medical issues, such as medical anthropology, medical sociology, and literature, will be a new task given to medical history today.

Can a disability studies-medical sociology rapprochement help re-value the work disabled people do within their rehabilitation?

This paper draws attention to the health-related work that disabled people do when engaging with rehabilitation services. Medical sociology has a rich history of looking at the 'illness work' that patients do, while disability studies scholars have explored the cultural value placed upon paid work and the effects on social status of being unable to work. Yet, a longstanding froideur between these two disciplines, which have fundamentally opposed ontologies of illness and disability, means that neither discipline has attended closely to the rehabilitation-related work that disabled people do. The concept of 'adjusting' to illness highlights seemingly irreconcilable disciplinary differences. Yet this article argues that the notion of 'adjustment work' can elucidate the socio-political character of the work disabled people do in their rehabilitation, which could create a more substantial and sustainable dialogue on this subject between disability studies and medical sociology. To make this case, we discuss interview data from the Rights-based Rehabilitation project, which sought to explore disabled people's lived experiences of rehabilitation.

Black feminist theory in maternal health research: A review of concepts and future directions.

Black maternal health and well-being has become a necessary focal point for health researchers due to higher rates of maternal mortality and morbidity for Black women. However, what is often absent from this scholarship within medical sociology is Black Feminist Theory as a framework for understanding Black women's health and well-being. Drawing on Black feminist and maternal health scholarship, I argue that integrating Black feminist approaches in maternal health research expands our understandings of what processes and mechanisms are impacting the health and well-being of Black mothers, while also highlighting the importance of maternal health research that solely centers Black women. Specifically, I focus on three concepts of Black Feminist Theory as it relates to Black maternal health research: (1) examining Black women's standpoint as credible, (2) acknowledging the historical context of multiple systems of oppression against Black women, and (3) incorporating a perspective that acknowledges both disadvantages, as well as empowerment, in the lives of Black women. I end this review with a discussion of future directions for sociological research in maternal health, including the importance of acknowledging how Black mothers are both impacted by, and resisting, social structures that may add nuance to our current understandings of Black maternal health and well-being.