Rex Taylor

Medicine as Social Science: Rudolf Virchow on the Typhus Epidemic in Upper Silesia

Rudolf Virchows Report on the 1848 typhus epidemic is one of the neglected classics of “social medicine”—a term he did much to popularize. His analysis of the epidemic emphasized the economic, social, and cultural factors involved in its etiology, and clearly identified the contradictory social forces that prevented any simple solution. Instead of recommending medical changes (i.e., more doctors or hospitals), he outlined a revolutionary program of social reconstruction; including full employment, higher wages, the establishment of agricultural cooperatives, universal education, and the disestablishment of the Catholic Church. This article includes the first English translation of these long-term recommendations. It also locates Virchows Report within the context of the Medical Reform Movement of 1848 and traces his influence on the subsequent development of social medicine. Parallels are drawn between Virchows attempts to reform health care and current developments in the political economy of health.

Eliciting the smoker's agenda: implications for policy and practice

Existing health promotion messages and advice on smoking cessation focus upon the negative aspects of continuing to smoke and contrast these to the benefits of giving up. Benefits of cessation are invariably linked to reduced risks of illness and disease with the process of cessation framed as a largely positive and certainly a health enhancing one. In this paper we present an analysis of data from a cross-sectional, exploratory study in the city of Aberdeen, Scotland, undertaken with 54 people, aged 18-44, who are or have been smokers. The multiple and often contradictory agendas of everyday life, smoking and health are explored. Participants spoke of the dangers of smoking and the potential benefits of giving up as these are considered by health promotion and medical research. However, many smokers experienced a number of benefits from smoking (such as socialising with others and breaks from boredom), and health and social problems with the process of cessation (for example, weight gain, stress, colds, flu). Participants appeared to query the validity of the risks of continuing to smoke and yet indicate a range of health and social difficulties in giving up. The authors assert that an acknowledgement of the attractive, pleasurable aspects of smoking may be seen as unacceptable and irresponsible but this could well provide an opportunity to relate to the everyday and multiple practices of smoking and smokers themselves as illuminated by this research.

Inequalities in Old Age

This paper examines the distribution of personal resources - financial, social, health and psychological - between age cohorts, sex groups and social classes in a random sample of community elderly. As expected, the young elderly, males and those from middle-class backgrounds have a disproportionate share of three out of four of these resources, but for social support the balance of advantage is reversed. When age, sex and class are combined to yield eight subgroups, younger working-class males consistently rank high on all resources and older working-class females consistently rank low. Older middle-class females rank low on all resources other than on close friends.

Lifestyle and Ageing

This paper is concerned with the nature, usage and potential of the concept of lifestyle. It concentrates on usage in social gerontology and specifically on the way in which it has been used by three teams of American researchers. Its overall aim is to discover guidelines for establishing the lifestyle concept on a sounder methodological footing. The paper begins with a discussion of diversity within the elderly population and it identifies the need for a systematic conceptual scheme for describing the social life of the individual. It examines the relationship between lifestyle and social class and concludes that they represent complementary rather than competing approaches. The paper goes on to explore three definitions of life-style - as structure, content and meaning - and compares and contrasts these three alternative approaches. The difference between ‘nominal’ and ‘real’ definitions is discussed and the paper ends with a summary account of the way in which the concept has been operationalized in a continuing British study.

Telephone Screening as a Research Technique

This paper reports on a successful experiment in the use of the telephone to screen a large urban population in order to identify a relatively small sub-sample. The problem at hand was the identification of a sample of wives of men working in the offshore oil industry. Alternative ways of identifying such a sample are discussed and reasons are given for the decision to use the telephone. The form of random digit dialling used in the study is described and the results of a pilot and the main screening exercise are presented in some detail. The final section of the paper takes a broader view of telephone interviewing. Data are presented on telephone coverage in the U.K., and the advantages and disadvantages of the telephone are assessed in relation to other data collection methods.

MIGRATION AND THE RESIDUAL COMMUNITY

While all migration involves a sending a receiving and a migrating unit it is rare that equal attention is given to all three. Most migration studies have concentrated on the changing relationship between individual migrants or migrant groups and the receiving or host society. They are in fact studies of immigration; and as such they make an important contribution to our understanding of the processes of assimilation acculturation and since most migrations are rural-urban of urbanization itself. By contrast few studies have examined the changing relationship between the migrant and the sending or residual community and comparatively little is known about the overall effects of migration on the residual community. For sociologists part of this neglect is explained by the urbanindustrial orientation of the discipline. Both the European speculative and the American empirical traditions have been animated principally by urban and industrial themes. Therefore when sociologists have shown an interest in migration they have concentrated on the adjustment of migrants in urban and industrial settings. This concentration on immigration is particularly evident in American sociology where many sociologists are immigrants themselves and the society as a whole has subscribed to a melting pot ideology. (excerpt)

Partings and Reunions

An earlier generation of sociologists would have looked at the oil industry in the context of a body of work concerned with ‘extreme occupations’. Much of that material was predicated upon the notion of a radical separation of home and work, apparently visible in the lives of fishermen (Tunstall, 1962), lorry drivers (Hollowell, 1968), miners (Dennis, Henriques and Slaughter, 1969) and others. This separation allowed the work-place to become the focus of attention, reducing family, kinship and community to the level of dependent variables. As we have already seen (pp. 12–19) such a distinction often serves to mask the complex interrelationships between work and family and is likely to obscure important gender differences with shape experiences in the two arenas. A growing body of writing has therefore begun to examine the work/family nexus and the concept of incorporation (Callan and Ardener, 1984) has been especially helpful in revealing the variety of ways in which women may be co-opted as unpaid collaborators in their husbands’ paid employment. Whilst occupations such as the ministry, general practice or those in which the worker is self-employed provide obvious examples of this phenomenon (Finch, 1983), some of the very jobs which were once classified as ‘extreme’ in character also merit attention.

Differential Aging: An Exploratory Approach Using Cluster Analysis

This article uses cluster analysis to identify different patterns of personal resources within a random sample of the well, elderly population. Ten such patterns or natural groupings are identified and their implications for coping and successful aging are discussed. It is apparent that there are a number of ways both of aging well and aging badly, and that these patterns cannot be predicted solely on the basis of structural data. The article poses a number of questions on the performance of cluster members over time and draws attention to the importance of longitudinal data.

An Editorial Note

Members of a delegation from the People’s Republic of China presented the following papers at the Conference entitled “PublicPrivate Initiatives After TRIPS: Designing A Global Agenda,” which was held in Brussels, Belgium in 1997. These papers are published here to provide a historical look at the status and transition of intellectual property rights in the People’s Republic of China at that time. However, the papers are not intended to provide a comprehensive analysis of such rights, and they do not necessarily reflect the opinions and policies of the government of the People’s Republic of China. While the individual papers have been reproduced as closely as possible to the original form in which they were presented at the Conference, some formatting and grammatical changes were necessary to assist the reader and provide clarity.