Special Issue Of Social Science Research Articles

Testing and Diagnosis as Social Interventions: An Interview with Annemarie Jutel

Kiran Pienaar (KP) and Alan Petersen (AP): Thank you, Annemarie, for agreeing to share your perspectives in this interview. We are delighted to have this opportunity to engage with your insights and scholarly contributions on the sociology of diagnosis. In 2011 you co-edited a special issue of Social Science and Medicine entitled ‘Toward a Sociology of Diagnosis’ in which you called for sociologists to pay more attention to medical diagnosis as a central practice and classification tool of medicine. In the introduction, you note that ‘diagnosis has had an absent presence in the sociology of health and illness’ (Jutel & Nettleton, 2011, p. 793). Do you think this is still the case or has the field developed since then to attend more closely to the social issues and processes at work in diagnosis? In your view, does diagnosis merit continued/renewed sociological attention? And if so, why?

Practicing health geography in 2017 IMGS 2017 Editorial

This commentary is an introduction the special issue of Social Science and medicine composed of pieces of work presented at the International Medical Geography Symposium (IMGS) held in Angers, France in July 2017. Every two years, the symposium brings together health geographers and others interested in applying a spatial approach to their research to share findings and form new ideas about the progress of this exciting sub-discipline. 279 delegates from 30 countries attended this symposium hosted only for the second time outside the Anglo-Canadian-American triangle.

Let’s dance: Organization studies, medical sociology and health policy

This Special Issue of Social Science & Medicine investigates the potential for positive inter-disciplinary interaction, a ‘generative dance’, between organization studies (OS), and two of the journal’s traditional disciplinary foundations: health policy and medical sociology. This is both necessary and timely because of the extent to which organizations have become a neglected topic within medical sociology and health policy analysis. We argue there is need for further and more sustained theoretical and conceptual synergy between OS, medical sociology and health policy, which provides, on the one-hand a cutting-edge and thought-provoking basis for the analysis of contemporary health reforms, and on the other hand, enables the development and elaboration of theory. We emphasize that sociologists and policy analysts in healthcare have been leading contributors to our understanding of organizations in modern society, that OS enhances our understanding of medical settings, and that organizations remain one of the most influential actors of our time. As a starting point to discussion, we outline the genealogy of OS and its application to healthcare settings. We then consider how medical sociology and health policy converge or diverge with the concerns of OS in the study of healthcare settings. Following this, we focus upon the material environment, specifically the position of business schools, which frames the generative dance between OS, medical sociology and health policy. This sets the context for introducing the thirteen articles that constitute the Special Issue of Social Science & Medicine.

New approaches to researching patient safety

This article presents an overview of contemporary research into patient safety. The article suggests that patient safety research to date has tended to privilege the formal and structural dimensions of safety at the expense of the social and affective dimensions of safety. The article previews the research articles brought together in this special issue of Social Science & Medicine, paying particular attention to the impact of these studies on the field of patient safety research generally. The present article summarises this impact in the form of the following three patient safety research principles. First, to account for whether and how safe and improvement-oriented practice is achieved, research must engage with both the predictability and the complexity of the sites and processes it seeks to describe, explain and/or impact on. Second, engaging with complexity implicates researchers in experiencing it, and this implicates the research process and its methodology in a process of sense-making of the practical and affective consequences for and with practitioners inhabiting and enacting that complexity. Third, besides numerically-based descriptions, abstracted explanations and procedural prescriptions, patient safety research evidence must encompass experiential data, collaboratively-produced accounts and/or experience-based designs.

Patient organizations and public health

In a stimulating paper in the British Medical Journal ,1 Show and Baker described the turmoil produced 15 years ago in the medical profession by what has since then been coined the ‘expert patient’; a patient whose specific knowledge about his disease challenges the power of the medical profession to decide alone the nature and the way his care should be organized. Several alternative models of the clinical encounter have emerged, focusing on the ability of a patient to cope actively with his disease, and emphasizing the ‘patient empowerment’ which is facilitated by the specific knowledge which the patient draws from his experience.2 A ‘patient collective identity’ sometimes emerges from the experiences shared between members of the same disease group. Patient organizations (POs) have been a strong factor in shaping these identities. As a recent special issue of Social Science and Medicine shows, some of these POs have got involved in activities (e.g. medical research or health planning) previously considered a professional prerogative.3 The community of public health researchers has not yet fully appreciated the impact these developments may have on their activities. While a recent viewpoint in this Journal seems to reflect a certain awareness of this ‘blind spot’, when it acknowledges the fact that ‘a new partnership to involve the whole society in reorienting health policies’ is necessary,4 POs are not mentioned as potential stakeholders. Sharing patients’ experiences with a specific disease has been the basis of the action of many POs. Until the 1980s, POs were frequently dominated by professionals in their boards or scientific councils, so they lacked the capacity to develop specific knowledge and shape their actions autonomously. Two sets of closely related factors can be considered as major drivers towards a better institutional recognition and autonomy. The first, fuelled by …

Place, social exchange and health: proposed sociological framework

A sociological framework is proposed to better understand how spatial characteristics translate into people’s physical and psychosocial conditions that are relevant to their health. In particular, high susceptibility to poor health among specific adult population groups is analyzed in terms of exclusion from or inadequate participation in a society’s structure of opportunities. Acquisition of, and agency through, core social roles, such as the work role, the family and marital role, and civic roles, are essential prerequisites for successful personal self-regulation in adult life, strengthening a sense of self-esteem, self-efficacy, and belonging (self-integration). It is argued that exclusion from, or loss of core social roles, threats to their continuity and confinement to non-reciprocal exchange impair personal self-regulation and trigger a state of ‘social reward deficiency’. This state, in turn, elicits prolonged stressful experience, and it may reinforce a person’s craving for stress-relieving, potentially addictive health-damaging behavior. This framework is applied to the explanation of the life expectancy gap between Western and Central/Eastern European countries. Although most of the epidemiological evidence reviewed in support of this approach originates from investigations that were conducted in western countries several results reported in the collection of articles published in this Special Issue of Social Science and Medicine are in line with the proposed framework.

Social Science and Health in Canada, Special Issue of Social Science and Medicine 18(3): 189-286, 1984

Social Science and Health in Canada, Special Issue of Social Science and Medicine 18(3): 189-286, 1984

Health policies in Africa and Latin America: Adopting the primary care approach

The central problem of this special issue of Social Science and Medicine is: why and how governments adopt (or fail to adopt) the primary care approach to health care delivery. The papers approach this problem from different perspectives, including the international arena, economic and social constraints, regime and institutional characteristics, and development projects. Recommendations for changing health policy are also reviewed, leading to the conclusion that more research into the process of policy-making is necessary.