Social Theory & Health

There is evidence that sleep quality and quantity is affected by orthopedic hospitalization due to trauma or surgery. Furthermore, sleep is connected to rehabilitation outcome and patients report sleep as one of the most significant elements going through orthopedic rehabilitation. Part of this literature emphasizes that this significance is connected to the subjective experience of sleep. However, little conceptualization is made about subjective significance of sleep. From an ethnographic position, I study how sleep practices are enacted in rehabilitation at home for older patients discharged from orthopedic hospitalization to explore subjective significance of sleep in rehabilitation. Inspired by a Deleuzian perspective on health and illness, I theoretical approach rehabilitation as the process and the possibility for the changed body to interact with the social and material world in new ways and adapt to the present reality. This concept of rehabilitation brings in a focus on the body as situated in a local context and life in which transformations are mobilized. Through an empirical exploration of sleep practice, I offer new conceptualizations of sleep and how sleep is affected by and affecting rehabilitation. Through this exploration of sleep in rehabilitation, I generate the concept of relatedness as the link to understand how sleep takes on subjective significance in rehabilitation.

Drawing on interviews with Swedish men and women who live in fat bodies, this article articulates people’s own explanations of weight regain and failure to lose weight permanently. The aim is to give a glimpse into a system of explanations where eating is perceived as a way of handling other problems, fatness is considered as a symptom of something else, and where weight-reduction practices are seen as contributing to fatness. The participant’s theorizations of weight regain, here called theorizing failure, are characterized by two types of shift in focus: cause-shifting and problem-shifting. The first seeks to attribute fatness to causes outside the received view, focusing on behaviors and energy consumption. Cause-shifting means that overeating is seen as being caused by underlying problems. The second, problem-shifting, means that fatness is viewed as an effect of an underlying, ‘real’ problem, and defines fatness as a symptom, and weight-centered methods as part of the person’s weight problem. This article pinpoints shortcomings with the weight-centered approach and addresses alternative ways to think about why some people fail to lose weight permanently.

Risk management in pregnant women's everyday lives represents a central feature of the experience of pregnancy. We aim to analyse how the agency of pregnant women and the decisions they make are affected by social influences that reinforce medical norms and moral expectations towards motherhood. With data from a qualitative study conducted in Switzerland, we describe diverging positions on professional norms, distinguishing women who strive to eliminate uncertainty and ensure strict control of the biological development of their pregnancy from women who resist medical norms. Concrete resistance through personal bargaining with the normative framework was reported and justified through a range of arguments, allowing individual representations to match dominant expectations. Concurrently, we highlight the fact that social reinforcement of medical norms and moral expectations regarding proper motherhood limit possible deviations. This study contributes to the analysis of lay strategies towards health risks, emphasizing the articulation of agency and social influences that characterize the extension of risk surveillance in society.

Recent work in medical sociology has provided critical insights into distinguishing between obesity as a condition with severe individual- and population-level health consequences, and obesity as a socially undesirable, stigmatizing construct opposing thinness as the healthy ideal. Less often considered is the role of body mass index (BMI) as the standard by which obesity and healthy weight are measured and defined. Addressing this issue, I begin by distinguishing between BMI as an empirical, objective measure of health, and BMI as an arbitrary, subjective label for categorizing the population. I further consider how BMI is empowered as a measurable quantity through the lens of medicalization and evidence-based medicine, and introduce the “performativity” of BMI as a superior framework for confronting the measure’s conceptual limitations. Emphasizing key parallels between BMI and self-rated health as measures with high predictive validity, yet unspecified mechanisms of action, I propose an epistemological shift away from classifying BMI as a biomarker and toward a more flexible view of the measure as a holistic appraisal of health. In closing, I argue that researchers may continue to leverage BMI’s ease of collection and interpretation, provided they are attuned to its definitional ambiguity across diverse research methods and contexts.

Trong thập kỷ qua, sự lo ngại mạnh mẽ đã phát triển về những gì được mô tả như một đại dịch béo phì ở phương Tây. Sự lo ngại này đi kèm với những tranh luận mạnh mẽ tương tự về tính xác thực của việc mô tả này. Nhiều nhà phê bình coi sự chỉ định đại dịch này như một phần của 'hỗn loạn đạo đức' đang gia tăng về vấn đề béo phì, trong đó cảm xúc về béo phì định hình cuộc thảo luận công cộng và khoa học. Trong bài viết này, chúng tôi khám phá tài liệu phê bình về đại dịch béo phì, lưu ý đến cách mà nó thu hút sự chú ý đến vai trò của cảm xúc trong diễn ngôn về đại dịch. Chúng tôi lập luận rằng hành động của cảm xúc trong bối cảnh này mời gọi thêm các lý thuyết hóa, và rằng lý thuyết hóa này cần được thực hiện thông qua các khái niệm mà: (1) tích hợp rõ ràng cơ thể và cảm xúc với sự hình thành của diễn ngôn chính trị, (2) tránh việc cá nhân hóa và tâm lý hóa các câu chuyện về cảm xúc và (3) phân tích hành động của cảm xúc trong cuộc tranh luận chính trị mà không ngụ ý rằng cần phải loại bỏ cảm xúc trong việc tạo ra các quan điểm công bằng và chính xác hơn. Để đạt được mục đích này, chúng tôi tham khảo công trình của Sara Ahmed, người đã phát triển một giải thích tinh vi về vai trò của cảm xúc trong việc xây dựng các tập thể xã hội thông qua sự gắn kết của chúng với các ý tưởng về cơ thể. Chúng tôi lập luận rằng lý thuyết này có thể được sử dụng để làm sáng tỏ mối quan hệ tổng quát giữa diễn ngôn công cộng và chủ thể, cũng như mối quan hệ cụ thể giữa bản thân, cơ thể và yêu cầu thường không được đáp ứng về sự thon thả.

This paper seeks to use social theory to present a range of perspectives on why the lay voice has been under-represented in sexual health. The paper first of all describes the absence of the lay voice in sexual healthcare in relation to the public health practice of contact tracing in the context of a syphilis outbreak in the Greater Dublin Area. The paper then presents a range of perspectives from social theory which offer ways of understanding such lay–professional relations in sexual health and especially the absence of the lay-voice. It is argued that Parsons's model of the sick role presents an understanding of the process of cultural socialization, which have led to professional dominance over the lay perspective. It is argued that Foucault's understanding of the surveillance powers of medicine offers a critical vantage point on sexual healthcare. However, similar to Parsons, it is also a politically conservative critique as it does not present a radical understanding of how the laity might achieve greater power in their relations with health professionals. Finally, it is argued that Habermas' theory of communicative action and discursive democracy may be usefully applied to healthcare policy making. This is especially so in terms of the development of a communicative structure, which could foster equitable dialogue and the principle of mutual accountability within lay–professional relations in healthcare.

We explore the origins and dynamics of ethical communication with reference to the requirements for informed consent provision in research ethics. We adopt the analytical framework developed in Luhmann’s social systems theory to illustrate how ethical communication about informed consent has developed in the medical, legal and scientific systems. We would like to suggest that the development of ethical communication is the result of the developing semantics of individuality and personhood. Our analysis adds specific observations about how communication about research ethics, and informed consent specifically, reduces complexity in an increasingly functionally differentiated society.

The historical and structural connections between auto-centered transport and fast food franchising are analyzed as comprising a synergistic contemporary mode of consumption. It is a mode that is rooted in individualized, private convenience, and it is implicated in a number of growing public health and environmental problems, including obesity and climate change. Emerging in the US after World War I, this mode of consumption, ‘fast cars/fast foods,’ developed rapidly after World War II, based on the application of mass production techniques to food, and in the development of the Interstate highway system. The analysis suggests that this mode of consumption is associated with a particular socio-material landscape, motorized urban sprawl, and that both promote hyperconsumption.