Sarah Nettleton

The body in everyday life

Jonathan Watson Health Education Board for Scotland, Edinburgh Bill Bytheway Stratford upon Avon, Julie Johnson Stratford upon Avon, Nick Watson University of Edinburgh, Alexandra Howson University of Edinburgh, Bethan Williams and Julie Barlow both at Coventry University, Sarah Cunningham-Burley University of Edinburgh, Eileen Fairhurst University of Manchester, Gillian Bendelow and Simon Williams both at University of Warwick, Mick Bloor University of Wales Cardiff, Mike Hepworth and Mike Featherstone University of Aberdeen, Deborah Lupton Charles Strut University, Bathurst, Australia, Professor Emily Martin Princeton University, USA.

VIRTUAL COMMUNITY CARE? SOCIAL POLICY AND THE EMERGENCE OF COMPUTER MEDIATED SOCIAL SUPPORT

This article argues that the emergence and growth of internet use in Britain has important implications for the analysis of social policy. It attempts to outline a research agenda for social policy in relation to one particular aspect of internet use, that of on-line self-help and social support – what we term here virtual-community care . The article presents data on patterns of home based internet use in Britain and outlines some contemporary debates in social policy about the importance of self-help and social support. It also considers how the internet is being used for self-help and social support with a particular emphasis on the emerging situation in Britain. Three illustrations of on-line self-help and social support are presented: two from newsgroups, which are part of the ‘uk.people.* hierarchy’: one concerned with disability and one with parenting issues; and one web based forum concerned with issues surrounding mortgage repossession. Drawing upon this illustrative material the article discusses some emergent issues for contemporary social policy discourse: the rise of self-help groups; the privileging of lay knowledge and experience over the ‘expert’ knowledge of health and welfare professionals; the nature of professional-client relationships; the quality and legitimacy of advice, information and support; dis/empowerment; and social exclusion.

Mortgage Debt, Insecure Home Ownership and Health: An Exploratory Analysis

This paper is a direct response to Wilkinson’s (1996) call for more research into housing insecurity and health. It explores the consequences of mortgage arrears for both the health of indebted home owners and their use of primary health care services. It is based on the results of a secondary analysis of the British Household Panel Survey. It demonstrates that the experience of mortgage indebtedness has an independent effect on the subjective well being of men and women, and that it increases the likelihood that men will visit their general practitioners. The paper draws upon the sociological notions of ‘ontological security’ and ‘individualisation’ to make sense of these empirical findings. It suggests that policies which have encouraged the growth of home ownership are premised on the idea of individual responsibility, a notion which underpins other spheres of contemporary welfare policies. Within this context, the consequences of mortgage indebtedness are likely to have profound psychosocial consequences for those who have direct experience of it. The spectre of mortgage debt may also contribute to the insecurity which has come to form a feature of our contemporary social and cultural life.

Towards a sociology of diagnosis: Reflections and opportunities

The North East Medical Sociology Group is pleased to announce details of the next half day seminar to be held on the afternoon of Wednesday 26 March 2014 at Teesside University, Darlington Campus. There will be a keynote presentation by Professor Sarah Nettleton from the Department of Sociology at University of York. There will additionally be three presentations from local speakers, together with a participatory session exploring a current topic of interest. A draft programme is set out overleaf.

The emergence of E-scaped medicine?

This article asks the question, is it possible to decipher a new ‘medical cosmology’ that possesses an elective affinity with contemporary socio-technological changes? It tentatively answers in the positive and attempts to identify the parameters of a new medical cosmology that it terms e-scaped medicine.To discern the conceptual underpinnings of e-scaped medicine the article draws on De Mul’s theorization of the ‘informatization of the worldview’.The article elaborates on this thesis in relation to medicine’s prime object - the body - and to a number of medical practices that surround it.

Measurement of patient perceptions of pain and disability in relation to total hip replacement: the place of the Oxford hip score in mixed methods

OBJECTIVES: To describe the practical difficulties experienced by patients when completing the Oxford hip score, and to highlight the need to reconsider aspects of its structure and conceptual base. DESIGN: Qualitative study incorporating the Oxford hip score in semi-structured interviews with patients before and four months after their operation. SETTING: Two hospitals in the North of England. SUBJECTS: Osteoarthritic patients undergoing primary elective total hip replacement. RESULTS: Use of the Oxford hip score provided quantitative data on disability in the sample, particularly about pain and immobility. It also facilitated the collection of qualitative data, serving as a useful starting point for interviews and as a prompt for indepth discussion. Concerns about the clarity, coverage, and content validity of the score were identified, however, raising questions about the measures conceptual base. CONCLUSION: The Oxford hip score was found to be a useful precursor to the semi-structured interviews. However, deficiencies in instruction and lack of clarity in purpose have implications for its ongoing development and future application, both in this type of study and other, more general, contexts.

Running away with health: the urban marathon and the construction of ‘charitable bodies’

The increase in fundraising through mass-participation running events is emblematic of a series of issues pertinent to contemporary conceptualizations of health and illness. This increasingly popular spectacle serves as an indicator of present-day social relationships and broader cultural and ideological values that pertain to health. It highlights contemporary discourses on citizenship; ‘active citizens’ can ostentatiously fulfil their rights and responsibilities by raising money for those ‘in need’. Involvement in such events comprises an example of the current trend for drawing attention to illness, and sharing one’s experiences with others. We examine these issues through a consideration of charity advertisements and offer a fourfold typology of runners in terms of their orientations to both mass-participation running and charity. We conclude that ‘charitable bodies’ are constructed out of the interrelationships between philanthropic institutions, sport and individual performance.

Food allergy and food intolerance: towards a sociological agenda.

This article asks what sociological insights an analysis of food allergy and food intolerance might afford. We outline the parameters of debates around food allergy and food intolerance in the immunological, clinical and epidemiological literatures in order to identify analytic strands which might illuminate our sociological understanding of the supposed increase in both. Food allergy and food intolerance are contested and contingent terms and it is salient that the term true food allergy is replete throughout medico-scientific, epidemiological and popular discourses in order to rebuff spurious or ‘nonallergic’ claims of food-related symptoms. Complexity theory is introduced as a means of gaining analytic purchase on the food allergy debate. The article concludes that the use of this perspective provides a contemporary example of the ‘double hermeneutic’, in that the meanings and interpretations of contemporary explanations of food allergy are both permeated by, and can be made sense of, through recourse to complexity thinking.

Cementing Relations within a Sporting Field: Fell Running in the English Lake District and the Acquisition of Existential Capital

This article presents findings from an ethnography of fell running in the English Lake District. A provocative concept – existential capital – is proposed to underscore the profits acquired from fell running as an embodied technique, and as a means of defining the shared passions within the field. These gains are acquired through corporeal techniques that require sustained physical effort, embodied vigilance, and knowledge of an environment that is topographically challenging and aesthetically arresting. The visceral pleasures intrinsic to existential capital are appreciated by those within the field and this, in turn, means that this solitary sport gives rise to an intense sociality that ‘only a runner can understand’. Field analysis conventionally focuses on struggles; it is suggested here that a focus on what is shared allows us to understand how a field gains an identity. Thus the notion of existential capital highlights the field as passionately defined in ways that challenge the instrumentalism inherent to conventional modes of field analysis.

Architecture and health care: a place for sociology

Sociologists of health and illness have tended to overlook the architecture and buildings used in health care. This contrasts with medical geographers who have yielded a body of work on the significance of places and spaces in the experience of health and illness. A review of sociological studies of the role of the built environment in the performance of medical practice uncovers an important vein of work, worthy of further study. Through the historically situated example of hospital architecture, this article seeks to tease out substantive and methodological issues that can inform a distinctive sociology of healthcare architecture. Contemporary healthcare buildings manifest design models developed for hotels, shopping malls and homes. These design features are congruent with neoliberal forms of subjectivity in which patients are constituted as consumers and responsibilised citizens. We conclude that an adequate sociology of healthcare architecture necessitates an appreciation of both the construction and experience of buildings, exploring the briefs and plans of their designers, and observing their everyday uses. Combining approaches and methods from the sociology of health and illness and science and technology studies offers potential for a novel research agenda that takes healthcare buildings as its substantive focus.