Medical Sociology

Technology and Medical Practice: Blood, Guts and Machines (Book Review)

by Casimir MacGregor

Published in Medical Sociology online 5 (1):37-50

Does intergenerational mobility shape psychological distress? Sorokin revisited

by Jason Houle

Co-authored with Molly Martin

Drawing from Sorokin's hypothesis that socially mobile individuals are at greater risk of experiencing psychological... more Drawing from Sorokin's hypothesis that socially mobile individuals are at greater risk of experiencing psychological distress than their non-mobile counterparts, we investigate whether intergenerational occupational mobility influences psychological distress, as measured by the Center for Epidemiologic Studies Depression (CES-D) scale. Using data for men from the Wisconsin Longitudinal Study (WLS) and Sobel's Diagonal Mobility Models, we find little evidence for Sorokin's hypothesis; mobile individuals are no more likely to be psychologically distressed than their non-mobile counterparts. In fact, one group of mobile men – those who left their farming origins – are actually less distressed than the sons who remain as farmers and non-mobile men in higher-ranked social classes. We speculate that this reflects the fact that farming became very arduous during the late 20th century and these mobile sons of farmers appreciate their improved life chances. Our findings suggest that the association between mobility and psychological distress varies across specific class backgrounds and is contingent upon the broader social and economic context.

The Image in the Mirror and the Number on the Scale: Weight, Weight Perceptions, and Adolescent Depressive Symptoms

by Jason Houle

The first two authors (Michelle Frisco and Jason Houle) were equal contributors to this manuscript.

Double jeopardy and health congruency theories suggest that adolescents’ joint experience of their weight and weight... more Double jeopardy and health congruency theories suggest that adolescents’ joint experience of their weight and weight perceptions are associated with depressive symptoms, but each theory offers a different prediction about which adolescents are at greatest risk. This study investigates the proposed associations and the applicability of both theoretical perspectives using data from 6,557 male and 6,126 female National Longitudinal Study of Adolescent Health (Add Health) Wave II participants. Empirically, results indicate that focusing on the intersection of weight and weight perceptions better shows which adolescents are at risk of depressive symptoms than an approach that treats both predictors as independent, unrelated constructs. Weight pessimists are at greatest risk of depressive symptoms. Thus, results support the health congruency framework, its extension to subpopulations outside of older adults, and its extension to optimism and pessimism about specific health conditions.

Adolescent Weight and Depressive Symptoms: For Whom is Weight a Burden?

by Jason Houle

Co-authored with Michelle Frisco and Molly Martin

Objective. Adolescent weight and depressive symptoms are serious population health concerns in their own right and as... more Objective. Adolescent weight and depressive symptoms are serious population health concerns in their own right and as they relate to each other. This study asks whether relationships between weight and depressive symptoms vary by sex and race/ethnicity because both shape experiences of weight and psychological distress.

Methods. Results are based on multivariate analyses of National Longitudinal Study of Adolescent Health (Add Health) data.

Results. There are no associations between adolescent girls' weight and depressive symptoms, but these associations vary considerably among boys. Underweight is associated with depressive symptoms among all boys and subpopulations of white and Hispanic boys. Among Hispanic boys, those who are overweight (vs. normal weight) have a lower probability of reporting depressive symptoms. Finally, among normal weight boys, Hispanics and blacks are more likely to report depressive symptoms than whites.

Conclusions. Findings are a reminder that understanding population health issues sometimes requires a focus on subpopulations, not simply the population as a whole.

The Impact of Sexual Harassment on Depressive Symptoms During the Early Occupational Career

by Jason Houle

Co-authored with Jeremy Staff, Jeylan Mortimer, Chris Uggen, and Amy Blackstone. Published in Society and Mental Health, 2011.

Sexual harassment has been theorized as a stressor with consequences for the physical and mental health of its... more Sexual harassment has been theorized as a stressor with consequences for the physical and mental health of its targets. Though social scientists have documented a negative association between sexual harassment and mental health, few longitudinal studies have investigated the association
between sexual harassment and depressive symptoms. Using longitudinal survey data from the Youth Development Study, combined with in-depth interviews, this article draws on Louise
Fitzgerald’s theoretical framework, stress theory, and the life course perspective to assess the impact of sexual harassment on depressive affect during the early occupational career. In support of Fitzgerald’s model, our findings confirm that sexual harassment is a stressor that is associated with increased depressive symptoms. Our quantitative results show that women and men who experience more frequent sexual harassment at work have significantly higher levels of depressed
mood than non-harassed workers, even after controlling for prior harassment and depressive symptoms. Moreover, we find evidence that sexual harassment early in the career has long-term effects on depressive symptoms in adulthood. Interviews with a subset of our survey respondents
point to a variety of coping strategies and reveal further links between harassment and other aspects of mental health, such as anger and self-doubt.

The psychological impact of intragenerational social class mobility

by Jason Houle

published in Social Science Research, 2011

This study revisits and extends a classic question in sociology and tests three competing hypotheses about the effects... more This study revisits and extends a classic question in sociology and tests three competing hypotheses about the effects of intragenerational social class mobility on distress and psychological well-being at midlife. Prior research on this topic investigated the effects of intergenerational mobility, but did not look at how mobility during adulthood (intragenerational mobility) affects psychological distress and well-being. Previous literature is also limited by methodological problems that make it difficult to estimate the separate effects of prior social class, current social class, and social mobility. This study overcomes this methodological problem using a novel approach that breaks the linear dependence between prior class, current class, and intragenerational mobility. After accounting for prior and current class, I find that social mobility is not associated with psychological distress and self-acceptance. Instead, mobile individuals come to resemble their nonmobile counterparts in their current class on the outcomes of study.

Configuring maternal, preborn and infant embodiment

by Deborah Lupton

An increasing literature on the biopolitics of contemporary maternity and on risk society, individualisation and... more An increasing literature on the biopolitics of contemporary maternity and on risk society, individualisation and parenting has demonstrated the increasing emphasis that has been placed upon pregnant women and mothers to take responsibility for the health and welfare of their children. The ideal female ‘reproductive citizen’ is expected to place her children’s health and wellbeing above her own needs and desires. Here the subject positions of the ‘good mother’ and the ‘responsible citizen’ as they are produced through the discourses and practices of neoliberalism intertwine. This paper looks at the convergence of various influential discourses, images, practices and technologies in configuring maternal, preborn and infant bodies in certain ways in the context of neoliberalism. These include such factors as the growing importance of the concept of risk in relation to preborn and infant wellbeing, the extension of infant identity back into preborn bodies, the emergence of the concepts of the foetal and embryonic (and even the preconceived embryonic) citizen, the precious child and intensive parenting and the symbolic concepts of permeability, purity and danger and Self and Other as they relate to maternal, infant and preborn embodiment.

Working for the Cure: Challenging Pink Ribbon Activism

by Maya Goldenberg

Published in Configuring Health Consumers: Health Work and the Imperative of Personal Responsibility. Eds. R. Harris, N. Wathen, S. Wyatt. Amsterdam: Palgrave Macmillan, 2010: 140-159.

Captured and branded in the highly recognizable image of the pink ribbon, the politics of breast cancer at the start... more Captured and branded in the highly recognizable image of the pink ribbon, the politics of breast cancer at the start of the 21st century is markedly hopeful (given the grim statistics) and surprisingly compliant with the medical establishment’s defined health goals and approaches to addressing the breast cancer epidemic.  In keeping with this volume’s theme of “Working to be Healthy”, this chapter examines and evaluates how the pink ribbon message has shaped and organized social response to breast cancer. The work in question is “healthwork”, a term found in the critical health literature denoting the active and purposeful work that people do to look after their health (Mykhalovskiy and McCoy, 2002). Healthwork analysis tends to focus on personal care practices—taking medicines, dealing with healthcare practitioners, informal care-giving, health information seeking, etc.—that are then subject to examination of how those individual actions invite extended relations of governance and ruling (Mykhalovskiy, McCoy and Bresalier, 2004).  In this examination of breast cancer campaigns, the same analytic concern with governance is taken, but the health-related work is extended beyond personal care and self-surveillance to also include the volunteer work done by many concerned citizens in their contributions of time, energy, and money to support campaigns for the cure.

In this chapter, I argue that while the appropriation of the language and themes of the early women’s health movement frames pink ribbon activism as a highly personal, emancipatory, and socially-responsible individual effort, this brand of breast cancer activism instead serves to fund a limited biomedical research agenda that is largely shielded from public scrutiny.  This agenda has been universalized through endearing “hero” narratives of personal struggle that inspire civic engagement by complicit consumers rather than critical activists. Pink ribbon activism problematically diverges from the women’s health movement’s demand for participation in setting the research agenda and determining treatment strategies. This neglect is troubling, given that breast cancer discourse is so fraught with contested knowledge claims regarding disease aetiology, prevention, and treatment. While the pink ribbon message offers hope and optimism, it does so by suppressing many counterclaims, disputes, and ambiguities surrounding the problem of breast cancer. Instead of soft “pink”, a more critical social response to breast cancer is needed in order to ensure women’s informed participation in addressing this serious challenge to women’s health.

Multiple Forms of Perceived Discrimination and Health among Adolescents and Young Adults

by Eric Anthony Grollman

Published in the Journal of Health and Social Behavior, June 2012: http://hsb.sagepub.com/content/early/2012/05/14/0022146512444289.abstract

Research on perceived discrimination has overwhelmingly focused on one form of discrimination, especially race... more Research on perceived discrimination has overwhelmingly focused on one form of discrimination, especially race discrimination, in isolation from other forms. The present article uses data from the Black Youth Culture Survey, a nationally representative, racially and ethnically diverse sample of 1,052 adolescents and young adults to investigate the prevalence, distribution, and mental and physical health consequences of multiple forms of perceived discrimination. The findings suggest that disadvantaged groups, especially multiply disadvantaged youth, face greater exposure to multiple forms of discrimination than their more privileged counterparts. The experience of multiple forms of discrimination is associated with worse mental and physical health above the effect of only one form and contributes to the relationship between multiple disadvantaged statuses and health. These findings suggest that past research may misspecify the discrimination-health relationship and fails to account for the disproportionate exposure to discrimination faced by multiply disadvantaged individuals.

'I'm always on the lookout for what could be going wrong': mothers' concepts and experiences of health and illness in their young children

by Deborah Lupton

Sydney Health & Society Group Working Paper No. 1

Mothers in contemporary western societies are expected to adhere to the principles of intensive parenting, spending a... more Mothers in contemporary western societies are expected to adhere to the principles of intensive parenting, spending a great deal of time and effort caring for their children, protecting them from risks and promoting their health, development and wellbeing. This paper draws upon research involving indepth interviews with 60 mothers of infants and young children living in Sydney. The discussion focuses in detail on three major topics discussed in the interviews: how the interviewees conceptualised good health and illness in their children; the role of diet and physical exercise in promoting children’s good health; and space, physical safety and bad influences. The study found that the interviewees reported that they ‘read the signs’ of their children’s bodies and had to ‘know’ their bodies intimately in order to do so. They also interpreted the signals of their own bodies – their ‘gut instincts’ – as part of the process of maintaining careful surveillance of their children’s health state. They represented diet and physical exercise as the most important dimensions of promoting their children’s health, and were very concerned about the risk of obesity in their children. Notions of space and judgements about the bodies within these spaces were also important to some of the women’s concepts of protecting their children’s health and wellbeing.

“Dude! You mean you’ve never eaten a peanut butter and jelly sandwich?!?” Nut allergy as stigma in comic books

by Simon Weaver

with Sarah McNicol, Health Communication, Online 10th May 2012

This article examines the representation of nut allergy in comics aimed at children and young people. It maps the... more This article examines the representation of nut allergy in comics aimed at children and young people. It maps the signification and stigma of nut allergy in comics, and includes an outline of the imagery, stereotypes, and connotations that are created on this condition. Three texts are examined: first, Allergic, a semi-autobiographical story by Adrian Tomine aimed at young adults; second, What's Up With Paulina? from the Medikidz series of comic books that aim to help a pre-teenage audience learn about medical conditions; and third, Peanut, a forthcoming comic book by Ayun Halliday aimed at those in their early to mid teenage years. Using textual analysis, we focus on three principal areas of the texts. First, we consider the way in which the allergic character is represented in relation to examples of felt stigma, typified by feelings of shame and rejection, and compare this representation to common stereotypes of disability. Second, we look at the representation of other characters, drawing attention to the way in which stigma is enacted, highlighting acts of overt discrimination. Last, we examine the way in which the event of an allergic reaction is portrayed, considering how this might be used to help children and young people better understand nut allergy and combat the stigma attached to it. Throughout the article we compare the representation of stigma in comics with that depicted in empirical research on children living with nut allergies.

Rosenfield, Sarah and Dawne M. Mouzon. Forthcoming, 2012. "Gender and Mental Health” in Carol S. Aneshensel and Jo C. Phelan. Handbook of the Sociology of Mental Health. 2nd edition. New York: Springer.

by Dawne Marie Mouzon

Men and women experience different kinds of mental health problems. While women exceed men in internalizing disorders... more Men and women experience different kinds of mental health problems. While women exceed men in internalizing disorders such as depression and anxiety, men exhibit more externalizing disorders such as substance abuse and anti-social behavior, which are problematic for others. These differences also vary by race and social class: for example, African Americans possess better mental health and thus a smaller gender gap in psychiatric problems. What explains these differences? We concentrate on conceptions of gender and gender practices. Research on gender and mental health suggests that conceptions of masculinity and femininity affect major risk factors for internalizing and externalizing problems, including the stressors men and women are exposed to, the coping strategies they use, the social relationships they engage in, and the personal resources and vulnerabilities they develop. This chapter investigates explanations in these areas for gender differences in general and by race and class.

Mouzon, Dawne M. (Revise and Resubmit) "Can Family Relationships Explain the Race Paradox in Mental Health?"

by Dawne Marie Mouzon

Revise and resubmit. Journal article.

Biomedical research consistently finds that Blacks have worse physical health than Whites, an expected finding given... more Biomedical research consistently finds that Blacks have worse physical health than Whites, an expected finding given Blacks' disproportionate exposure to psychosocial stress, poverty, and discrimination. Yet there is surprising lack of consensus regarding race differences in mental health, with most scholars finding either similar or better mental health outcomes among Blacks than Whites. Most past research attributes this "race paradox in mental health" to the idea that Blacks have stronger family networks than Whites, yet few studies explicitly test whether stronger family relationships among Blacks (if they exist) can account for these findings. Using data from the 2003-2005 National Survey of American Life (N = 4,538), I find that minimal race differences in family relationships fail to explain the race paradox in mental health. The findings have implications for mental health measurement, the provision of culturally-appropriate mental health care, and how scholars understand the nature of family relationships among African Americans.

Discourse analysis: a new methodology for understanding the ideologies of health and illness

by Deborah Lupton

Discourse analysis is not so much a 'new' methodology any more, as this paper was originally published 20 years ago. I have regular requests for copies, however, so have scanned it and uploaded it here.

Internet social support groups as moral agents: the ethical dynamics of HIV+ status disclosure: The ethical dynamics of HIV+ status disclosure

by David Rier

Sociology of Health and Illness 29(7):1043-58; 2007

This paper examines how, on Internet HIV/AIDS support groups, participants discuss the ethics of disclosing HIV... more This paper examines how, on Internet HIV/AIDS support groups, participants discuss the ethics of disclosing HIV seropositivity to partners. The data consist of all mentions of disclosure culled from over 16,000 pages overall of posts from 16 different groups, hosted on seven separate sites. The paper focuses on two main
questions. First, apart from providing support and information, did the groups also debate moral dilemmas (and, despite groups’ common perception as ‘safe spaces’ for non-judgmental exchanges, did these discussions include moral judgments and conflicts)? Secondly, did use of this new medium generate a new, alternative ethical discourse, or merely replicate existing discourses? The data demonstrate that online support groups did engage in debating, and trying verbally to enforce, certain views of the ethics of seropositivity disclosure. The most common view advocated full disclosure, though a range of positions existed.
Unlike with most online support groups described elsewhere, these discussions often included harshly-expressed moral judgments. The groups did not generate a truly new, alternative discourse, but served as clearinghouses for and transmitters of existing ‘off-line’ discourses, both mainstream and alternative.
Implications and limitations of the present study, and areas for further research, are discussed.

Keywords: Internet, support group, ethics, HIV

Internet social support groups as moral agents: the ethical dynamics of HIV+ status disclosure: The ethical dynamics of HIV+ status disclosure

by David Rier

Sociology of Health and Illness 29(7):1043-58; 2007

This paper examines how, on Internet HIV/AIDS support groups, participants discuss the ethics of disclosing HIV... more This paper examines how, on Internet HIV/AIDS support groups, participants discuss the ethics of disclosing HIV seropositivity to partners. The data consist of all mentions of disclosure culled from over 16,000 pages overall of posts from 16 different groups, hosted on seven separate sites. The paper focuses on two main
questions. First, apart from providing support and information, did the groups also debate moral dilemmas (and, despite groups’ common perception as ‘safe spaces’ for non-judgmental exchanges, did these discussions include moral judgments and conflicts)? Secondly, did use of this new medium generate a new, alternative ethical discourse, or merely replicate existing discourses? The data demonstrate that online support groups did engage in debating, and trying verbally to enforce, certain views of the ethics of seropositivity disclosure. The most common view advocated full disclosure, though a range of positions existed.
Unlike with most online support groups described elsewhere, these discussions often included harshly-expressed moral judgments. The groups did not generate a truly new, alternative discourse, but served as clearinghouses for and transmitters of existing ‘off-line’ discourses, both mainstream and alternative.
Implications and limitations of the present study, and areas for further research, are discussed.

Keywords: Internet, support group, ethics, HIV

PORTER et al (2012) On being a (modern) scientist - Risks of engaging the public

by James Porter

PORTER (2012) - Better the devil you know? Collaborative tensions in making neuroscience work - LABTEC Annual Conference

by James Porter

Organized ambivalence: when sickle cell disease and stem cell research converge

by Ruha Benjamin

Gendering the migraine market: Do representations of illness matter?

by Joanna Kempner

Migraine is a common, debilitating and costly disorder. Yet help-seeking for and rates of diagnosis of migraine are... more Migraine is a common, debilitating and costly disorder. Yet help-seeking for and rates of diagnosis of migraine are low. Drawing on ethnographic observations of pharmaceutical marketing practices at professional headache conferences and a content analysis of migraine advertising, principally in the USA, this paper demonstrates: (1) that the pharmaceutical industry directs its marketing of migraine medication to women; and (2) as part of this strategy, pharmaceutical advertisements portray women as the prototypical migraine sufferer, through representations that elicit hegemonic femininity. This strategy creates the impression that migraine is a ‘‘women’s disorder’’, which, in turn, exacerbates gender bias in help seeking and diagnosis of migraine and reifies presumptions about the epidemiology of the disorder. I conclude that these pharmaceutical marketing practices have a paradoxical effect: even as they educate and raise awareness about migraine, they also create barriers to help seeking and diagnosis.