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Abstract For almost two decades prior to the election of the New Labour government in 1997, inequalities in health were largely absent from the political debate in Britain. New Labour sought to bring inequalities, and the role of poverty as a ‘root cause’ of ill-health, back on to the public agenda. This paper analyses four key documents (Green and White Papers) laying out their proposals for public health. We explore the shifting emphasis on health inequalities between the four official documents, and between the documents and their associated press release. The paper also analyses how this translated into media coverage. It identifies common themes across the press coverage – such as criticisms about lack of targets – but also shows how coverage varied (e.g. between UK ‘national’ and ‘Scottish’ press). Finally, the study highlights the crucial issue of political context and news timing, illustrating how the English White Paper was overshadowed by other health stories which formed the basis for attacks on the Labour government in general and the Health Minister in particular. [ABSTRACT FROM AUTHOR]

Abstract: This paper investigates the association between the Great Recession and educational inequalities in self‐rated general health in 25 European countries. We investigate four different indicators related to economic recession: GDP; unemployment; austerity and a ‘crisis’ indicator signifying severe simultaneous drops in GDP and welfare generosity. We also assess the extent to which health inequality changes can be attributed to changes in the economic conditions and social capital in the European populations. The paper uses data from the European Social Survey (2002–2014). The analyses include both cross‐sectional and lagged associations using multilevel linear regression models with country fixed effects. This approach allows us to identify health inequality changes net of all time‐invariant differences between countries. GDP drops and increasing unemployment were associated with decreasing health inequalities. Austerity, however, was related to increasing health inequalities, an association that grew stronger with time. The strongest increase in health inequality was found for the more robust ‘crisis’ indicator. Changes in trust, social relationships and in the experience of economic hardship of the populations accounted for much of the increase in health inequality. The paper concludes that social policy has an important role in the development of health inequalities, particularly during times of economic crisis. [ABSTRACT FROM AUTHOR]

Given the difficulties of implementing 'top-down' quality improvements, health service leaders have turned to methods that empower clinicians to co-produce 'bottom-up' improvements. This has involved the adoption of strategies and activities associated with social movements, with clinicians encouraged to participate in collective action towards the shared goal of improvement. This paper examines the adoption of social movement methods by hospital managers as a strategy for implementing a quality improvement 'campaign'. Our case study suggests that, despite the claim of empowering clinicians to develop 'bottom-up' improvements, the use of social movement methods can be more narrowly concerned with engaging clinicians in pre-determined programmes of 'top-down' change. It finds a prominent role for 'hybrid' clinical leaders and other staff representatives in the mobilisation of the campaign, especially for enrolling clinicians in change activities. The work of these 'hybrids' suggests some degree of creative mediation between clinical and managerial interests, but more often alignment with the aspirations of management. The study raises questions about the translation of social movement's theories as a strategy for managing change and re-inventing professionalism. [ABSTRACT FROM AUTHOR]

The aim of this empirical investigation is to analyse the social movements brought about by autism-related issues. It is suggested that both the autism-category changes in the late 1980s, and the development of educational and behavioural methods in the United States, have given rise to a large-scale mobilisation around the changes in the definition of autism and interventions in many countries. The present paper highlights the historical dynamics of the mobilisation of French parents’ associations and the engagement of autistic persons’ organisations. The role of the French parents’ associations has been studied over the last 40 years to show how they have contributed to shaping public policy in France and how they have favoured the American model of autism despite the French professionals’ resistance. At the international level, the newly-born associations of autistic individuals have introduced new actors who sometimes reproach the parents’ associations for speaking on their behalf. These new associations, such as self-help groups, have a political identity problem. Their members no longer want to be considered as patients but as individuals with a different cognitive mode of functioning. Their actions can be analysed in the broader context of the disability movement. If the disability movement is considered as the latest generation of social movements, the action of autistic persons can be viewed as the latest generation of the disability movements. [ABSTRACT FROM AUTHOR]

Using the implementation of the Griffiths Report as an example, this paper examines the way in which sociologists and others have examined the process of managing change within the NHS. Several studies of Griffiths have documented a number of unintended consequences of its implementation but it is argued that none of these have adequately theorised these unintended outcomes of the policy implementation process. It is suggested that the process-sociological approach of Norbert Elias, and in particular his game models, enable us better to understand the complex interweaving of planned and unplanned processes which is involved in all processes of managed change. [ABSTRACT FROM AUTHOR]

In this article we address activist, patient advocate and medic perspectives on framing intersex, variations of sex characteristics and disorders/differences in sex development medical treatment as human rights abuses. Problematic aspects of intersex medical treatment have increasingly been highlighted in national debates and international human rights bodies. Some intersex activists have framed aspects of intersex medical treatment as human rights abuses since the 1990s. Other stakeholders in shaping medical treatment, such as patient advocates and medical professionals, are not always content with human rights framing, or even the term intersex. In order to address the different perspectives in this arena we provide background on the primary rights claims that have arisen followed by key human rights framing of these claims. We provide a short discussion of activism styles, looking at pan‐intersex social movements and variation‐specific patient associations as different styles of health social movements. The analysis of stakeholder perspectives on the use of human rights strategy in health areas provides a useful case study for medical sociology and policy in general. [ABSTRACT FROM AUTHOR]

This study addresses two issues currently under critical discussion in the epidemiology of cardiovascular diseases ( CVD), the relative neglect of women and the individualised nature of key risk factors. It focuses on the North Karelia project ( NKP), a community programme aimed at coronary heart disease ( CHD) prevention in a predominantly rural Finnish region in the early 1970s, that is, during a period when the epidemiological understanding of CVD still was relatively new and actively promoted. Adopting the notions of lay epidemiology and coronary candidacy, culturally mediated explanatory models lay people use to assess who is likely to develop heart disease and why, the study shows that locals targeted by the project critically engaged with both of these bias. Based on the rich materials resulting from project activities the study shows, first, how many locals subsumed the individualised and lifestyle-based approach to CHD prevention promoted by NKP under a more general framework emphasising the health effects of ongoing structural changes in the area, and second, how women constructed themselves as viable coronary candidates. The case supports the position in the current discussions on lay expertise that wants to integrate lay experiences more firmly into epidemiological studies and public health. [ABSTRACT FROM AUTHOR]

Social class differences in health have been found in ail societies that have looked for them. In spite of an apparently stable historical pattern of upper social classes living longer and faring better than lower ones, there is a certain amount of variation in the size, trends and nature, even the direction of such differences, indicating that they might be modified by policy and social change. Social class differences in health, as well as other health inequalities, have in fact become a part of the political agenda. But policymaking in this area is weak and unconvincing in most countries. There is little consensus as to why policies to reduce health inequalities are important. Should they be pursued for the reason that health is a 'right', as suggested by some writers, and often in the political rhetoric? Or because they are important for a country's level of health in general? The purpose of this article is firstly, to examine some of the moral justifications for the reduction of health inequalities and, secondly, to suggest that the public health policy agenda can be improved by focussing on the public health significance of health inequalities. It is argued that the reduction of health inequalities may represent a great potential for improving the health of the population, but there is a moral justification for equal distribution of health risks and health resources even if this did not contribute greatly to improved general health. [ABSTRACT FROM AUTHOR]

A study of the British Mental Health Users' Movement (MHUM) is reported based upon interviews with some of its participants. These accounts are analysed in terms of three main themes: ideology and policy; relationships between users and non-patients: and relationships between the movement and statutory and voluntary agencies. The data are discussed in relation to international comparisons and with regard to preceding opposition to traditional psychiatric theory and practice in Britain. The emergence of the MHUM is accounted for within the context of existing theoretical analyses of new social movements. Strengths and weaknesses of the movement are highlighted and prospects for its future discussed. [ABSTRACT FROM AUTHOR]