Phil Brown

Naming and framing: the social construction of diagnosis and illness.

This paper examines the social construction of diagnosis and illness in several ways. First, I discuss the centrality of social construction in medical sociology. Next I discuss the major role of diagnosis in social construction, leading to the need for a sociology of diagnosis. I emphasize controversial and conflictual diagnoses, as a first step toward a more general sociology of diagnosis. Then I put forth a typology of social construction, involving four combinations based on whether a condition is generally accepted and whether a biomedical definition is applied. Next I detail a series of stages in the social construction of a condition. In that process, my primary concern is the initial social discovery, which is essentially a matter of diagnosis, with a secondary emphasis on illness experience. This is followed by stages of treatment and outcome, which recursively affect social construction. I conclude by noting the health policy implications of the social constructionist perspective.

Confronting environmental racism : voices from the grassroots

By reading, you can know the knowledge and things more, not only about what you get from people to people. Book will be more trusted. As this confronting environmental racism voices from the grassroots, it will really give you the good idea to be successful. It is not only for you to be success in certain life you can be successful in everything. The success can be started by knowing the basic knowledge and do actions.

Popular Epidemiology Revisited

The concept of popular epidemiology is updated by examining it as a form of citizen science and a type of social movement. As a citizen science, popular epidemiology is a lay way of knowing that is based in part on an appropriation of expert knowledge by non-experts. As a social movement, popular epidemiology is a mobilization of citizens around the goal of identifying and ameliorating environmental stressors and local illness patterns. The updated concept of popular epidemiology shows the important influences of the environmental justice movement and of critical epidemiology among professional epidemiologists. Case study materials are provided to illustrate arguments.

“MAKING A BIG STINK” Women's Work, Women's Relationships, and Toxic Waste Activism

Women constitute the majority of both the leadership and the membership of local toxic waste activist organizations; yet, gender and the fight against toxic hazards are rarely analyzed together in studies on gender or on environmental issues. This absence of rigorous analysis of gender issues in toxic waste activism is particularly noticeable since many scholars already make note that women predominate in this movement. This article is an attempt to understand how women activists transcend private pain, fear, and disempowerment and become powerful forces for change by organizing against toxic waste in their communities. This article systematically looks at these connections by examining data from survey research and case studies. The authors are particularly interested in the transformation of self of these women, with an emphasis on “ways of knowing.” They also examine the potential of existing social movement theories to explain womens activism against toxic waste.

The transfer of care : psychiatric deinstitutionalization and its aftermath

Phil Brown provides a comprehensive analysis of recent mental health policy and practice by focusing on three main themes: political-economic structures, the pitfalls of professionalism, and institutional obstacles to adequate care.

Print media coverage of environmental causation of breast cancer

Given the growing concern with breast cancer as a largely unexplained and common illness of our time, we would expect considerable print media coverage. An accurate portrayal of breast cancer would also include a good amount of attention to the potential environmental factors since many women with breast cancer and activists are pointing to such potential causes. Our examination of daily newspapers, newsweeklies, science periodicals, and women’s magazines showed that there was little coverage of possible environmental causation. There was also scant attention paid to corporate and governmental responsibility. Articles often focused on individual responsibility for diet, age at birth of first child, and other personal behaviours. Articles also emphasised genetic causation, even though this explained only a small fraction of breast cancer incidence. These factors combine to place personal responsibility on women for preventing the disease. Despite gains in understanding possible environmental causation and much scientific dialogue about it, especially in light of the endocrine disrupter hypothesis, and despite growing social activism, the print media have not paid much attention to environmental causation of breast cancer. Because the media have significant influence over public understanding and social action, this lack of attention may hold back scientific and activist pursuit of environmental causes of breast cancer.

“A Lab of Our Own” Environmental Causation of Breast Cancer and Challenges to the Dominant Epidemiological Paradigm

There are challenges to the dominant research paradigm in breast cancer science. In the United States, science and social activism create paradigmatic shifts. Using interviews, ethnographic observations, and an extensive review of the literature, we create a three-dimensional model to situate changes in scientific controversy concerning environmental causes of breast cancer. We identify three paradigm challenges posed by activists and some scientists: (1) to move debates about causation upstream to address causes; (2) to shift emphasis from individual to modifiable societal-level factors beyond an individual’s control; and (3) to allow direct lay involvement in research, which may raise new questions and change how questions are approached, the methods used, and the standards of proof. We use our model to examine controversies about doing scientific research, interpreting scientific results, and acting on science. Ultimately, we aim to understand what impedes construction of new methodologies and knowledge about environmental factors in human disease.

Public Involvement in Breast Cancer Research: An Analysis and Model for Future Research

Public involvement in health program planning has been taking place for many years, and has provided a precedent for the emergence of public involvement in research conducted since the early 1990s. Such involvement is now widely seen in breast cancer research, due to the large public concern and major social movement activity. This article reviews current practices and general models of public involvement in research and constructs a prototype. The authors interviewed researchers, program officers, and laypeople in order to understand the obstacles, processes, and benefits. They conclude that public involvement has major ramifications for the democratization of science and the construction of knowledge by teaching lay people about science and sensitizing researchers to concerns of the public. There is growing support on the part of scientists and government agents for public involvement.

Linking Exposure Assessment Science With Policy Objectives for Environmental Justice and Breast Cancer Advocacy: The Northern California Household Exposure Study

OBJECTIVES We compared an urban fence-line community (neighboring an oil refinery) and a nonindustrial community in an exposure study focusing on pollutants of interest with respect to breast cancer and environmental justice. METHODS We analyzed indoor and outdoor air from 40 homes in industrial Richmond, California, and 10 in rural Bolinas, California, for 153 compounds, including particulates and endocrine disruptors. RESULTS Eighty compounds were detected outdoors in Richmond and 60 in Bolinas; Richmond concentrations were generally higher. Richmonds vanadium and nickel levels indicated effects of heavy oil combustion from oil refining and shipping; these levels were among the states highest. In nearly half of Richmond homes, PM(2.5) exceeded Californias annual ambient air quality standard. Paired outdoor-indoor measurements were significantly correlated for industry- and traffic-related PM(2.5), polycyclic aromatic hydrocarbons, elemental carbon, metals, and sulfates (r = 0.54-0.92, P < .001). CONCLUSIONS Indoor air quality is an important indicator of the cumulative impact of outdoor emissions in fence-line communities. Policies based on outdoor monitoring alone add to environmental injustice concerns in communities that host polluters. Community-based participatory exposure research can contribute to science and stimulate and inform action on the part of community residents and policymakers.

Spinning on its Axes: DSM and the Social Construction of Psychiatric Diagnosis

Through a critical examination of the psychiatric professions heavy reliance on the Diagnostic and Statistical Manual of Mental Disorders, the authors explore the central role of diagnosis in the theory and practice of psychiatry. The set of beliefs that have guided the psychiatric profession since the creation of DSM-III are viewed as being tied to the new extension of the biopsychiatric medical model. From a sociological perspective, the authors address the issue of psychiatric nosology with reference to practice styles and professional dominance, and consider the impact of DSMs intrinsic social biases both within and outside psychiatrys traditionally drawn boundaries. They conclude that working solely within the confines of a medical framework of diagnosis, with little attention to the wider social and cultural contexts that should surround diagnostic practice, psychiatry will be unable to understand and explain the changing needs of its clientele.