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Domestic violence against women is a complex social phenomenon and a widely recognised issue of public health, which requires that all sectors of society, including the health sector, take the necessary action to prevent and address it. This paper aims to contribute to the discussion on the role of the primary health care in addressing domestic violence against women, by analysing health professionals' perceptions of their practice as well as the difficulties they experience in providing healthcare to victims. To fulfil this aim, a qualitative approach was chosen, using focus groups with health professionals working in the area of primary health care in an inland region of Portugal. The main findings point to the lack of a specific protocol and insufficient information and skills to respond to domestic violence situations, which hinders health professionals' confidence to intervene and tends to orientate them towards a more medical response. Resulting from these findings, implications for practice are discussed: the need for clear and specific orientations to guide health professionals' intervention; the need to offer training that enables them to provide appropriate healthcare to women experiencing domestic violence; and the need to position themselves in the context of an integrated, multi-sectoral intervention. [ABSTRACT FROM AUTHOR]

Domestic and family violence is a social and public health issue typically positioned in policy frameworks as a consequence of gendered social and economic structures. In this paper, we deploy an approach that draws on Hörl's neo-ecological thinking to propose that the home, as a site of domestic violence, can be usefully framed as an ecology of the domestic, a posthumanist hybrid matrix of bodies, spaces and objects in which various practices enact the smooth running of the domestic together with practices of domestic and family violence, including coercive control. Our interest is in coercive control and in the impact that the COVID-19 pandemic had on practices which enact this aspect of domestic violence. Our exploration of the practices that enact coercive control draws on the work of Law and others. We examine how practices, which are not compatible, or that do not cohere, are able to coexist in a domestic ecology and what occurs when there is a disruption as occurred with the pandemic. [ABSTRACT FROM AUTHOR]

In this paper we examine how popular media reporting positions dating and hookup app use as a 'social problem' that impacts on health and wellbeing. The paper adopts a mixed-methods media studies approach to create and analyse a dataset of over 6,000 international news articles published within a 12-month period, drawing on thematic content analysis and inductive and deductive techniques. These analyses are framed in relation to online consultations with Australian sexual health professionals and app users. Applying Briggs and Hallin's theory of biocommunicability (2007) – which proposes that contemporary health professionals' scientific framing of public health problems are, in part, shaped by popular media discourses – we identify a significant category of supportive discussions of safer app use within social news and lifestyle reporting. This discursive space features what we have termed 'vernacular pedagogies' of app use, revealing app users' safety strategies, and their experiences of pleasure and playfulness. We argue that an analysis of popular media can provide valuable insights into how everyday experiences of safety, risk and wellbeing are being shaped and contested with dating and hookup app use, and that these insights can be used to develop meaningful health promotion strategies. [ABSTRACT FROM AUTHOR]

Drawing on Foucault's conceptualisation of power, this paper examines public health as a distinctly modern regime of governance. An account of the historical regulation of drug use is traced in order to examine socio-historical shifts and lines of continuity in contemporary technologies of harm reduction. Using qualitative interview data, we examined practices of power in the context of contemporary drug use, including self-governance using techniques of monitoring, self-management and self-tracking. Participants' accounts revealed that they were encouraged to self-govern their drug use through a variety of reformist technologies that are embedded in harm-reduction programs. It is argued that participants' subjectivity is formed at the intersection of authoritative governance and self-governance, through ethical practices of the self which have emerged from disciplinary health practices, and incorporate the body as the site of power. We illustrate this by drawing a distinction between hygienist and sanitationist practices of public health. These governmental practices, which are embedded in public health programs, encourage people who use drugs to transform themselves into moral citizens, aligning their ethical practices with governing interests. [ABSTRACT FROM AUTHOR]

This paper explores how masculinity may help us understand the varying ways political leaders are responding to the coronavirus crisis. By focusing directly on masculinity as a social process, this analysis contributes to the broader literature on gender and leadership, unpacking the gendered double bind that leaders who identify as men must navigate in acknowledging and responding to risks. I examine the responses of Justin Trudeau and Donald Trump suggesting that their respective struggles to acknowledge and respond to the public health threat were not simply the result of a lack of available information to inform rational policy decisions. Acknowledging risk and taking measures to prevent rather than 'fight' are not culturally neutral, they are coded as feminine and 'weak'. Clearly, the delay in the response and subsequent spread of the virus in North America was not inevitable, other jurisdictions were able to respond more quickly. The masculinity double bind may have been one of the factors that undermined a prompt response in the increasingly macho context of North America. [ABSTRACT FROM AUTHOR]

In 2005, the World Health Organisation (WHO) established the Commission on the Social Determinants of Health. It is to produce its final report in May 2008, identifying actions to address the vast health disparities that have accompanied global economic expansion and widespread political turmoil. The Commission and its anticipated report are a major part of a new research and policy approach committed to the advancement of global health equity. This paper explores the fundamental goals, principles and concepts of the health equity 'movement', and its relationship to the 'social determinants of health' approach. It argues that such an approach is an instrument for rendering the problem of health inequity real and actionable by institutional authorities and policy practitioners. However, its prevailing frameworks and methods impose significant constraints on its capacity to identify effectively the mechanisms by which health inequities are produced. Accordingly, the actions suggested by the prevailing approach to the problem of health inequity are likely to be less than efficacious. The paper suggests that a more dynamic understanding of the social, as provided by critical sociology, has much to offer in advancing efficacious policy interventions in the field of health and equity. [ABSTRACT FROM AUTHOR]

As Leader of the Opposition in 1987, the current Prime Minister of Australia John Howard, stated unequivocally that he would dismantle Medicare at his first opportunity. By April 2000, the Health Minister in a Howard-led government proudly proclaimed to the Australian Parliament the Coalition was 'the best friend Medicare ever had'. Such a shift in ideology and policy position appears remarkable, overturning more than 60 years of conservative opposition to a universal, publicly funded, health care system. This paper traces the shift from the lead-up to the 1996 election until 2000, interrogating official policy texts to map how the Coalition reconfigured its own policy narrative about the Australian health care system. This paper argues that in order to understand contemporary reforms to the health care system, we must consider the way in which those reforms provide solutions to discursively, rather than objectively constructed, policy problems. [ABSTRACT FROM AUTHOR]

This paper concerns itself with some of the consequences of legislatively supported public health interventions into smoking. These have emerged from the legislative environment of 'smokefree' in Australia, and centrally concern the constitution of public space under its operation; the conceptualisation of risk which circulates within it; and the way in which agency may be imagined in public health framings of smoking. I make a critical anthropological analysis of the ways in which risk, agency and a certain kind of public are imagined and brought to bear on smokers in particular ways. The paper is equally an invitation into the social practice of smoking, as it is undertaken by smokers and as I have ethnographically encountered smoking practice since I began work in the area in 2005. Both the critical analysis and the invitation are difficult to make in a context where research on smoking is increasingly expected to contribute to a public health cessation agenda. [ABSTRACT FROM AUTHOR]

In Australia we have become preoccupied with the potential adverse impact of our ageing population on our health and social systems. The projected cost of having increasing proportions of our population in the over 70s, retired, chronically ill category of the demographic profile is emerging as a major challenge for governments and private insurers: so much so in fact that the government is now urging older people to stay at work longer. In America, new approaches to the management and self-management of chronic diseases have been invoked to encourage and support older people to improve their quality of life and reduce their recourse to and dependence upon health care technologies, clinical interventions and health care management systems. Unless this is achieved, it is argued, the cost of looking after this emerging ‘bubble’ of elderly people will become increasingly unsustainable as fewer and fewer (proportionately) younger people work to pay the taxes that support ageing, retired, sick and dependent populations. This paper argues that we are at real risk of having our economic wealth and productivity impeded and truncated by the financial burden of looking after high demand and high cost dependants at the aged end of the social demographic. This paper offers an alternative view of our ageing population, as well as highlighting some of the assets we have in our elderly populations, and providing suggestions as to an alternative view of the phenomenon of ageing that incorporates elements such as flexible working arrangements and the application of new, enabling technologies. This approach to our ageing population dilemma is predicated on a concept of lifelong learning and social participation along with better preventive and early intervention systems of health care. [ABSTRACT FROM AUTHOR]

The global economic turmoil that has unfolded since August 2007 promises to change methods for the governance of ageing in ways yet unknown. Against this background, this paper asks how the demographic shifts associated with population ageing interact with other aspects of globalisation: the financialisation of economic systems, changing patterns of migration and transformations to health provision. The emphasis is on understanding the complex interplay between these processes and their relevance for rethinking approaches to population ageing in a time of uncertain transition. Questioning the tendency to understand these fields of change as precipitating distinct crises, the paper suggests that the relative predictability of global population ageing makes it an appropriate area in which to begin a reassessment of wider policy directions. [ABSTRACT FROM AUTHOR]

This paper examines the way some public health campaigns in Australia have been caught within a paradigm shift in the management of 'risk society'. It details this paradigm shift in terms of an intensification of political technologies of 'pre-emption' in response to incalculable threats to physical security. The challenge this presents to public health programs, particularly those dealing with 'life style' health problems such as obesity, depression, and drugs (illegal and legal), is that, in pursuing admirable aims of the prevention of ill-health in the population, such campaigns need to avoid reproducing (and indeed should counter) the harmful effects of the pre-emptive approach to security. Using the example of 'quit smoking' campaigns of 2006-7, key features of the preemption paradigm are outlined, particularly the conservative comportment toward the future that it fosters. With reference to Foucault's concept of 'political technologies of bodies' and Merleau-Ponty's ideas about the temporality and intercorporeality of bodies, the paper also explores deleterious effects of this approach to risk and health on human agency, well-being, and social relations in general. The negative impact of the pre-emption approach is outlined in terms of the way it tends to dampen the openness (or 'potentiality') of bodies toward the future, the world, and other people. However, the temporality and intercorporeality of bodies also explains the operation of resistance by human agents to both the paradigm of pre-emption and the health prevention strategies that employ its way of thinking. This provides the basis for a gesture toward a more 'democratic', respectful, and effective approach to the promotion of health and well-being. [ABSTRACT FROM AUTHOR]

Food is a significant part of the daily worship, health and social life of individuals across cultures and religions. This is especially the case for vegetarian religious minorities such as the Indian sub-continental borne Hare Krishna movement, the Christian Seventh-Day Adventist Church and various Buddhist groups. These devotees define spirituality as more than simply the state or quality of being committed to 'God', religion and immaterial spiritual concerns. This paper argues that there are visible, tangible and even biological frames of reference from which spirituality within the aforementioned religious groups should be considered. The concept of bio-spirituality introduced here, embodies and grounds matters pertinent to faith, health and worship in the everyday social actions and interactions of devotees both inside and outside the sphere of the temple or church. Bio-spirituality is a conceptual tool that accounts for the relationship between supernatural belief, and the natural physical environment. It was formulated to encapsulate the social, nutritional and spiritual dimensions of 18 self-identified religious vegetarians who were interviewed as part of larger qualitative study of alternative food habits and practices. [ABSTRACT FROM AUTHOR]

The increase of chronic illness as a leading cause of death has given rise to self-care and expert patient initiatives. Caring for chronically ill people places a tremendous economic burden on the health care system, informal carers, the labour market and benefit system (Department of Health 2001, 2004, 2005). Thus, in many countries health policy encourages patients to become ‘experts’ in the self-management of their conditions in the belief that it will help save money and improve health and well-being (Wanless 2002). For example, the notion of ‘expert patients’ has emerged in UK policy and is pivotal to government plans to modernise the National Health Service (NHS) by linking patient expertise to ideas of empowerment, a better quality of life, self-esteem and a user-driven NHS (Department of Health 2001; Fox et al 2005). Self-management and expert patient initiatives aim to encourage chronically ill patients to become more actively involved in decisions concerning their care and well-being (Lorig and Holman 2003; Lorig et al 1985, 1999, 2001). [ABSTRACT FROM AUTHOR]

This paper examines the use of the categories bisexual and men who have sex with men (MSM) in sex, sexuality and sexual health research. We study the deployment of these categories in the research literature, using sets of studies published between 1990 and 2004 (bisexual set: n = 2,859; MSM set: n = 986). These sets were established using an approach developed by the authors in an earlier review of sexual health literature for the World Health Organisation (WHO). The approach uses insights from Weberian methodology. We ascribe value to research outcomes which provide contextually sensitive evidence for the design and/or evaluation of sexual health interventions, and are concerned about the creation within research of subjects who become reduced to risky or at-risk groups, or subject of public health surveillance and control. The categories bisexual and MSM are mostly ascribed without attention to social or cultural settings, and to designate risky or at-risk populations or behaviours. [ABSTRACT FROM AUTHOR]

This paper begins with a review of the Chinese government's reforms on the personnel system in the public health care sector since 1978. These policies were designed to give greater economic autonomy to the public health facilities and public doctors in order to stimulate productivity, but failed to satisfy the medical workers. As public employees whose professional knowledge and skills have long been considered as public property, Chinese doctors have been engaged in 'unofficial conduct' to increase income. This 'conduct', which includes taking 'red packets', 'drug kickbacks' and 'moonlighting', is argued to be an unofficial form of the privatisation of professional knowledge and skills. [ABSTRACT FROM AUTHOR]

Sociological theories seldom inform public health interventions at the community level. The reasons for this are unclear but may include difficulties in finding, understanding or operationalising theories. We conducted a study to explore the feasibility of locating sociological theories within a specific field of public health, adolescent risk-taking, and to consider their potential for practical application. We identified a range of sociological theories. These explained risk-taking: (i) as being due to lack of social integration; (ii) as a consequence of isolation from mainstream society; (iii) as a rite of passage; (iv) as a response to social constraints; (v) as resistance; (vi) as an aspect of adolescent development; (vii) by the theory of the 'habitus'; (viii) by situated rationality and social action theories; and (ix) as social practice. We consider these theories in terms of their potential to inform public health interventions for young people. [ABSTRACT FROM AUTHOR]

Food security is an evolving concept with various definitions and associated meanings. The way food security is understood by policy-makers impacts on how it gets addressed in public policy. This research uses an interpretive approach to uncover how food security is represented by stakeholders. Semi-structured interviews were conducted with 24 stakeholders in South Australia between June and September 2010. The findings reveal four dominant representations for food security that locate responsibility for the issue across different stakeholders, namely individuals, governments, communities and private enterprise. These representations hold different underlying assumptions about the role of government in addressing the issue; the neo-liberal perspective supports a reduced role for government whereas the social determinants of health perspective calls for greater government intervention. Food security activists may need a greater awareness of how they represent the issue in order to change public policy action in this area. The approach taken in this research is relevant to other public policy problems and contexts. [ABSTRACT FROM AUTHOR]

Increasingly, people turn to online sources for health information, creating human-non-human relationalities. Health websites are considered accessible in scope and convenience but can have limited capacity to accommodate complexities. There are concerns about who gets to 'assemble' with these resources, and who is excluded. Guided by Ahmed's socio-political theories of emotions, we questioned our feelings as we intra-acted with a consumer information website about back pain (MyBackPain). This encouraged us to approach resource evaluation in a way that alters conventional rational/cognitive judgement processes. Our inquiry was 'supra-disciplinary' involving public health, sociology, allied health and consumer collaborators. Specifically, we considered relationality – the feelings circulating between bodies/objects and implicated in MyBackPain's affective practices; impressions – the marks, images or beliefs MyBackPain makes on bodies/objects; and directionality – how these intra-actions pushed in some directions and away from others. Although Ahmed would likely not consider herself 'post-humanist', we argue that her socio-political theories of how objects and emotions entangle are of great interest to furthering critical post-human understandings of health. Rather than threatening decision-making, we suggest that feelings (and their affects) are central to it. The article demonstrates the productive potential of critical post-human inquiry in identifying/countering 'othering' possibilities, and catalysing a 'nomadic shift' towards new human-non-human formations. [ABSTRACT FROM AUTHOR]

Lactation is a potent signifier of maternal love and care commonly associated with early motherhood and infant survival. It is common, however, for bereaved mothers who have recently undergone miscarriage, stillbirth or infant death to produce breastmilk. Drawing on a critical feminist lens that seeks to understand how maternal subjectivities and lactation norms are constructed through public and reproductive health information, this article tests whether lactation management options after stillbirth and infant death are comprehensively covered in Australia's health organisations' online information. A qualitative directed content analysis was conducted to critique the information provided on 21 Australian websites. Information extracted from websites was compared to a 'best-practice' Lactation After Infant Death (AID) Framework developed by the research team for the review. We found a notable absence of comprehensive lactation management information targeted directly to bereaved mothers. Moreover, the most common lactation option presented for women without a living infant was lactation suppression. This dearth of appropriate and comprehensive lactation information curtails maternal subjectivies and diverse lactation practices and further isolates women dealing with the painful contradictions of lactation after loss. [ABSTRACT FROM AUTHOR]

The author presents an overview of the topics discussed within the issue. The relations between health, gender, class, policy and the labeling of disease and concepts such as social capital are investigated. The use of technologies in clinical work and the management and funding of the healthcare system are examined.

In this article, we review critical research on mobile and wearable health technologies focused on the promotion of 'healthy lifestyles'. We begin by discussing key governmental and policy interests which indicate a shift towards greater digital integration in health care. Subsequently, we review relevant research literature, which highlights concerns about inclusion, social justice, and ownership of mobile health data, which we argue, provoke a series of key sociological questions that are in need of additional investigation. We examine the expansion of what counts as health data, as a basis for advocating the need for greater research into this area. Finally, we consider how digital devices raise questions about the reconfiguration of relationships, behaviours, and concepts of individuality. [ABSTRACT FROM AUTHOR]

Management of a pandemic engages multiple sites where previously settled or uncontroversial understandings may be transformed by global and domestic forces. This article examines the iconography of social distancing implicated in the discourses of 'quarantine' and 'risk control' in public health, and the tension between scientific and popular media readings of the contours of acceptable public health models for managing particular pandemics. The role of culture in shaping and reshaping borders at an operational level is explored as a basis for explaining the apparent paradoxes in the way historic and contemporary pandemics are actually managed, and the different ways particular pandemics are framed. The article argues that a rational-scientific approach to pandemic management is insufficient and that a more nuanced socio-political blend of science, culture and public perceptions offers a more substantial basis for public health policy. [ABSTRACT FROM AUTHOR]

An introduction to the articles within the issue of the journal on topics including privatisation as a form of neo-liberal accumulation by dispossession, impact of the commoditisation of nursing care and pressures toward privatization, is presented.

There is an increasing understanding about the importance of social networks in the overall health of individuals. In the past year studies have found that strong social ties could promote brain health as we age; having obese friends increases the risk for obesity; and older people with many friends outlive those with fewer friends. This manuscript describes capacity-building interventions based on social capital, including empowerment, community youth development and collective efficacy models, which can work at the individual and community level in preventive and treatment-based interventions. These interventions allow public health practitioners working with low-income communities to reduce health disparities, promote well-being, and decrease inequalities. [ABSTRACT FROM AUTHOR]

The ideal of combining biomedicine with traditional, complementary and/or alternative medicine (CAM) is now widespread in global healthcare systems. Called integrative medicine (IM) or integrative healthcare (IHC), biomedicine and CAM are being combined in myriad healthcare settings; select medical curricula are incorporating CAM while new ‘integrative’ physicians are graduating; and widescale health policy on CAM is being created by such organisations as the World Health Organization (WHO). While the IM trend is fast developing, little theory has been applied to examining the epistemology of this new health phenomenon and if, in fact, integration between divergent health paradigms is possible. Drawing on an anti-colonial analysis of new IM settings in Canada, we suggest that fundamental challenges exist to integrating biomedicine and CAM that have been largely ignored in the push for integration. They are: (a) the devaluing of non-biomedical health knowledges; (b) accepting only biomedical evidence; and (c) the creation of a biomedical monolithic worldview. As a part of paradigm appropriation and assimilation, we trace these challenges to the colonial devaluation of Indigenous knowledge. We argue that an anti-colonial analysis of IM provides the ‘missing link’ to understanding the fundamental processes through which biomedicine appropriates CAM, and the reasons it continues to do so. [ABSTRACT FROM AUTHOR]

Population ageing and increasing life expectancy are triumphs of modern times. However, advances in healthy ageing and longevity are not inevitable. Recent data suggest that future generations may not age in as good health as those who are currently over 65 years of age, particularly because of the rising prevalence of obesity. Obesity is a worldwide phenomenon associated with urbanisation and global changes to food availability, eating habits, and increasing sedentary activities. The current and future global impacts of this condition on health, health care expenditure, and human life expectancy are momentous. [ABSTRACT FROM AUTHOR]

The Australian response to the threat of pandemic influenza is part of a broader shift in public health and governance. This shift in approach to risk – from insurance to preparedness – has been triggered by the emergence of incalculable, global, catastrophic risks. Familiar, insurance-driven approaches to governing risk work by intervening at the level of the population. However, incalculable risks of the scale posed by pandemic influenza exceed the scope of insurance. Now preparedness driven approaches are coming to the fore in public health. Preparedness focuses on protecting infrastructures and on guaranteeing the continuity of the political and economic order, and it entails discontinuous, temporal and localised expert responses. Importantly, this approach suggests that there is no need to look at the socio-historical contexts of disease; the population is of little direct concern. This, we suggest, raises doubts about how public health strategies which unfold in accordance with preparedness will recognise and tackle inequities. Finally, we consider the imperative to ‘secure the nation’ that preparedness brings to public health. [ABSTRACT FROM AUTHOR]