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Toward Comprehensive Conceptualizations of Contemporary Public Health

Participation as the Cornerstone of Appropriate Methodologies

Harry Nijhuis

This article explores the development of appropriate conceptualizations of public health, and, more importantly, adequate practices and methodologies to be applied in today’s societal context. Popular concepts like “positive health,” “comprehensive approaches,” and “participation” represent only specific components of larger complexities. My intention is to come up with useful notions for a more holistic comprehension of public health. First, two strands of reasoning, on which my argument is based, are discussed: (1) interpretations regarding major public health discourses of the past two centuries; (2) critical appraisal of influential societal tendencies (to be able to identify what today is “appropriate”). Then, based on these interpretations, notions are developed regarding ontological, epistemological, and societal aspects of public health. This leads us to the discussion of adequate methodologies for today’s practice of public health. I argue that emancipated participation of citizen communities—organized as cooperatives—ought to be a cornerstone in elaborations of contemporary public health.

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Confronting Tyranny in a Public Health Agency

Crafting a ‘Philosophy of Praxis’ into a ‘Community of Resistance’

Brian McKenna

This article details how a community of practice came crashing down on the iron rocks of bureaucracy. I apply Brown and Duguid’s theorisation of the dialectics of ‘working, learning and innovating’ illustrating how these three aspects came to conflict with one another, and how I worked to resolve them. As an anthropologist leading an environmental health project in a mid-Michigan public health agency, I formed a ‘community of practice’ and proceeded as a researcher, ethnographer and community activist for nearly three years, gathering findings to change the agency’s organisational structure, as a form of ‘disruptive innovation’. The community ‘roundtable’ of external project advisors highly supported the penultimate reports on water pollution, air pollution and restaurant health. The interdisciplinary strategies pursued resulted in valuable integrations of new knowledge in public anthropology across several thematic areas: critical public pedagogy, sustainability, citizen science, radical journalism and anthropologies of violence, trauma and transformation.

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Gretchen Schafft

Anthropologists who were also medical doctors often had a particularly active role in the Nazi regime, including the SS. One of these, Herbert Grohmann, studied under Eugen Fischer at Kaiser Wilhelm Institut of Anthropologie (KWIA) in Berlin from 1937 to 1938 and became his assistant. Grohmann, an SS officer, was sent to Poland as the head of public health in Lodz while maintaining his association with the KWIA. This article describes the interconnections of anthropology and public health in occupied Poland including the elimination (killing) of mentally ill patients, the implementation of the Deutsche Volksliste and the culling of 'racially fit' children for abduction to Germany. All of these activities are seen through the career of Herbert Grohmann.

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Robin Oakley

The constitution, the law of the land of the modern state, is fertile ground for the Eurocentric imagination of the Canadian polity as a result of the resiliency of Victorian-era sentiments. The ethno-racial hierarchy contained within this political imagery merges well with the public health mandate process of 'othering'. Othering situates the causes of disease and illness in foreign bodies rather than in the social structures of industrial capitalism. Chief among its morbid symptoms, othering produces a sense of alienation in those subjected to it. Sri Lankan Tamils are one of the newer migrant populations who have been subjected to, and have resisted this intrinsically violent othering process. This article examines the Canadian constitution as it relates to ethno-racial classification, and then explores how this scheme is reproduced in common experiences of the public health system and its effects on the health and well-being of Canadian Tamils.

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Social Quality and Modern Public Health

Developing a Framework for the Twenty-First Century

Paul Ward

The central focus of this special issue of the European Journal of Social Quality is exploring and understanding the utility, relevance and operationalisation of the Theory of Social Quality for public health policy and practice. In keeping with the aim of this special issue, the authors work with the Theory of Social Quality and make attempts to ground it in the reality of public health practice and policy. However, the Editorial Board stress that in the future papers will be published which discuss, critique and provide counter-arguments to this theory, in the hope of providing extra theoretical and empirical depth. In so doing, we intend to develop the journal as a place for critical debate and discussion.

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William W. Darrow

Public health in the United States has lost its edge. It made a significant impact on human well-being, capacities, and potential in the late nineteenth and early twentieth centuries. Now it takes a backseat to biomedical research and therapeutic medicine. Population health with its traditional emphasis on preventing harm has been displaced by an exorbitantly expensive and continually expanding medical care system devoted almost exclusively to restoring or rehabilitating the health of patients – no matter the cost. The failure to control the spread of human immunodeficiency virus (HIV) in the United States can be attributed to adherence to an inadequate biomedical model that ignores the social. Social quality theory, designed to further social justice, solidarity, equal value, and human dignity, can contribute to identifying and correcting deficiencies in biomedical approaches to HIV prevention and other public health problems that continue to plague the people of the United States.

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Operationalizing the Theory of Social Quality

Theoretical and Experiential Reflections from the Development and Implementation of a Public Health Programme in the UK

Paul Ward, Paul Redgrave and Cathy Read

The main purpose of this short paper is to provide reflections on the potential to operationalise the Theory of Social Quality within public health and also on its utility for both public health policy and practice. In addition, we outline the inter-relationships between the theory of social quality and other areas of social theory and social policy. We do not attempt to provide a wide ranging or in-depth critique of social quality as it applies across the board in public health. Rather, we wish to provide an outline of a public health programme (or set of integrated interventions) which is currently running in a location in the UK (called Fit for the Future), and show how the different domains inherent within social quality may be operationalised.

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Social Capital and Health

Research Findings and Questions on a Modern Public Health Perspective

Ota de Leonardis

This article aims at contributing to the discussion on the features of public health systems consistent with the broader definition of health – broader than the strictly bio-medical one – which is currently accepted in the related literature. The questions it raises are on how social capital influences well-being, and on whether and how it can be recognized and cultivated as a basic resource for health, and integrated into the health systems. In the first part, research literature on the ways health conditions are correlated with both poverty and social capital is briefly discussed. In the second part, several cases on health prevention and rehabilitation programs are analysed in some detail, as they appear to improve the health conditions of a community by investing in its 'social capital'. The main insights are on how to combine social protection with individual agency.

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Forcing Things Together That Are Normally Kept Apart

Public Health Knowledge and Smoking Practice

Simone J. Dennis

Current anthropological investigations of smoking offer limited insights into the practice, as they fail to account for how smokers and smoke itself draw things together that are assumed or desired to be kept apart. One of the qualities of smoke is its capacity to link disparate temporalities, spaces, and persons, whether or not connections between them are desirable. Smokers, themselves, too, draw together things as ostensibly different as cautionary public health information about smoking with its potentialities. The capability of smoke and smokers to connect disparate things tends to be overlooked in prevailing presentday anthropological analyses. This occurs when anthropologists align with public health approaches that privilege cessation agendas, rather than taking an independent approach that is anthropologically curious.

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Paul Bissell

Although community pharmacists have a well-established and culturally acknowledged role supplying medicines, the reconfiguration of occupational boundaries within healthcare in England and other countries (Charles-Jones et al. 2003) has resulted in increasing policy and professional interest in developing the role of the pharmacist in a number of areas. Whilst many of the new roles for pharmacists involve the sale or supply of medicines by different means (for example, via patient group directions or pharmacist prescribing) and are mainly aimed at improving access to medicines, other suggested developments shift community pharmacy practice into rather more unfamiliar territory. In particular, there is now increasing interest in the role that pharmacists might play in public health, and the term ‘pharmaceutical public health’ is increasingly heard within practice research circles and pharmacy policy more generally, both in the UK and abroad (Boorman et al. 2001; Anderson et al. 2003; Jones et al. 2004). For example, the Department of Health in England has devoted considerable attention to the idea of pharmaceutical public health.