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The COVID-19 pandemic has disproportionately impacted ethnic minorities in the global north, evidenced by higher rates of transmission, morbidity, and mortality relative to population sizes. Orthodox Jewish neighbourhoods in London had extremely high SARS-CoV-2 seroprevalence rates, reflecting patterns in Israel and the US. The aim of this paper is to examine how responsibilities over health protection are conveyed, and to what extent responsibility is sought by, and shared between, state services, and 'community' stakeholders or representative groups, and families in public health emergencies. The study investigates how public health and statutory services stakeholders, Orthodox Jewish communal custodians and households sought to enact health protection in London during the first year of the pandemic (March 2020–March 2021). Twenty-eight semi-structured interviews were conducted across these cohorts. Findings demonstrate that institutional relations – both their formation and at times fragmentation – were directly shaped by issues surrounding COVID-19 control measures. Exchanges around protective interventions (whether control measures, contact tracing technologies, or vaccines) reveal diverse and diverging attributions of responsibility and authority. The paper develops a framework of public health relations to understand negotiations between statutory services and minority groups over responsiveness and accountability in health protection. Disaggregating public health relations can help social scientists to critique who and what characterises institutional relationships with minority groups, and what ideas of responsibility and responsiveness are projected by differently-positioned stakeholders in health protection. • COVID-19 produced diverse responses and relations around health protection in London. •Pandemic preparedness can be enhanced by mapping possible partners in localities. •Establishing public health partnerships requires adequate resources. •Public health services cannot defer responsibility entirely to local partners. •Households are key constituents of public health relations. [ABSTRACT FROM AUTHOR]

In this conceptual paper, we argue that at times of crisis, what is sometimes called "evidence-based" or "science-driven" policymaking—establishing scientific truths and then implementing them—must be tempered by a more agile, deliberative and inclusive approach which acknowledges and embraces uncertainty. We offer pragmatism as one potential option, using examples from the UK to illustrate how such an approach might have changed particular crisis decisions and led to better outcomes. We propose that to better prepare for the next public health crisis, five pragmatism-informed shifts are needed in the science-policy relationship: from scientism to science-informed narrative rationality that emerges from practice; from knowledge-then-action to acting judiciously under uncertainty; from hierarchies of evidence to pluralist inquiry; from polarized camps to frame-reflective dialogue; and from an "inside-track" science-policy dialogue to greater participatory democracy. We suggest an agenda for a pragmatist-informed program of applied research on crisis public health policymaking. • Conceptual paper arguing for pragmatism in crisis public health policymaking. • Particularly in crises, certainty is elusive; there is no single scientific truth. • Deliberate on real-world problems from multiple epistemological and moral angles. • Surface and explore how different actors frame and assign meaning to an issue. • Link ideas to emergent action with (rather than on) partner communities. [ABSTRACT FROM AUTHOR]

Social science and public health research has pointed to, firstly, the challenges women face in terms of the management of menstruation and, secondly, to the negative symbolic associations made with the menstruating body. This research, however, seldom engages with philosophical issues relating to embodied subjectivity in order to explain and understand the trends noted. In this paper, we attempt to bridge the divide between feminist theory and current research on the menstruation-related challenges facing women today. We provide a feminist phenomenological account of menstruation in which women's shared bodily lived experiences of menstruation—the body as situation —are set within contexts that enable and/or restrain freedom—the body in situation . This account allows us to understand the universal and differentiated aspects of menstruation and menstrual management, thereby providing a nuanced picture of the interplay between the physical occurrence of menstruation, the symbolic associations made with menstruation, and the socio-material, historical and political conditions within which women live. Such an account, we suggest, should inform advocacy around public policy and institutional civic society that promotes the freedom of women to engage in important life projects, and ground public health interventions around menstruation related challenges. [ABSTRACT FROM AUTHOR]

John Dewey long ago challenged the philosophical tradition by arguing that uncertainty is a central, but undertheorized, trait of existence. His challenge to philosophy is also a challenge to the social sciences, including those that focus on health. In this paper, I set out to accomplish two goals. One is to present Dewey''s view on uncertainty and thereby develop an argument for an underappreciated theoretical construct. The second is to explore the congruence of uncertainty and health geography with a focus on uncertainty''s meaning and validity for inquiry in a health geography context. I begin with an explication of Dewey''s position on uncertainty and assess it within a larger philosophical milieu. I then discuss various implications of this view for health geography and argue that the Deweyan case for uncertainty fits the discipline well. In the final part of the paper, I share an analysis of assisted living for older persons that displays different forms of uncertainty playing important roles in the health and place experience. I conclude that Dewey''s philosophical position on uncertainty is a potentially important avenue for further inquiry into health and place. [Copyright &y& Elsevier]

Difficult health care encounters often do not translate into expressions of dissatisfaction with care. This paper focuses on the ‘non-expression’ of dissatisfaction with care in the accounts of 12 people in Canada who provided care to a relative or friend who died of breast cancer.The analysis foregrounded in this paper began from the observation that as difficult health care experiences were elaborated, speakers located health professionals’ actions in relation to various situational factors, including the fact of a (cancer) death and conditions of constraint in the health system. Set alongside these two realities, expressions of dissatisfaction tended to be disarmed. Results of this study suggest that the cost of articulating dissatisfaction with care is high where the cared-for person has died, and the perceived value of focusing on difficult experiences is low. Further, respondents in this study took the specificity of the situation and the setting into account in formulating beliefs about the care outcomes for which health professionals could be held responsible. When conditions in the health system and the disease process of advanced cancer were positioned in talk as ‘ultimate limits’ on health professionals’ actions, perceived lapses in care were excused. [Copyright &y& Elsevier]

Abstract: There is now an extensive literature on therapeutic landscapes, those settings and places that can contribute to wellbeing and good health. Less attention has been paid to the therapeutic qualities of the act of moving from one place to another. The recent emergence of a significant mobilities ’turn’ in social science is welcome, but this has as yet had relatively little to say about the consequences of mobility for health and wellbeing. This paper maps the relations between one form of mobility – walking – and wellbeing and health. Such relations may be theorised as ‘therapeutic mobilities’, a concept that sits comfortably alongside that of therapeutic landscapes. I explore three elements of such relations: activity; connection; and context. Although only one form of mobility is considered, the notion of therapeutic mobilities can be extended to other forms of travel. [Copyright &y& Elsevier]

Abstract: Complex and dynamic societal factors continue to challenge the capacity of the social and behavioral sciences in preventive medicine and public health to overcome the most seemingly intractable health problems. This paper proposes a fundamental shift from a research approach that presumes to identify (from highly controlled trials) universally applicable interventions expected to be implemented “with fidelity” by practitioners, to an applied social and behavioral science approach similar to that of engineering. Such a shift would build on and complement the recent recommendations of the NIH Office of Behavioral and Social Science Research and require reformulation of the research–practice dichotomy. It would also require disciplines now engaged in preventive medicine and public health practice to develop a better understanding of systems thinking and the science of application that is sensitive to the complexity, interactivity, and unique elements of community and practice settings. Also needed is a modification of health-related education to ensure that those entering the disciplines develop instincts and capacities as applied scientists. [Copyright &y& Elsevier]

Abstract: Childhood asthma is a major chronic condition affecting millions of children in this country, yet little is known about its potential long term consequences. In this paper, we estimate the relationship between childhood asthma and several outcomes as a young adult. To overcome many of the methodological issues plaguing earlier research on this topic, we estimate sibling fixed effect models that correct for measurement error using parental reports of asthma status. In our preferred specification, we find substantial long term impacts of childhood asthma on general health status, obesity, and missed work and school days as a young adult. Broadly, our findings contribute to the growing literature in social sciences on the impacts of early life health conditions on later life health and social outcomes and suggest early treatment of asthma may have long-run benefits on young adult health and socioeconomic outcomes. [Copyright &y& Elsevier]

Abstract: Conducting anthropological research into situations where public health interventions are ongoing raises a number of complex ethical issues. This paper addresses this by focusing on recent debate around questions of informed consent in research situations into health care in the ‘developing’ world. Two issues are developed: firstly, that of anthropological engagement with medical research trials; and secondly, how medical ethics debates have impinged upon and influenced anthropological ideas of ethics. Drawing on personal anthropological research into the implementation of the WHO prescribed tuberculosis control programme (DOTS) in the context of Nepal, I outline a number of ethical dilemmas and issues that arose. This research context included other ongoing research into DOTS implementation, as well as the local culture of health care provision. It involved moving between a number of sites and subject positions while interacting with heath professionals and patients. In conclusion, rather than prescribing ethical norms for researchers in such situations, I argue that we need more ethnographic examples and case studies as a means of thinking through the issues. I suggest that we need to reflect on both the ethical issues that arise when undertaking research into multifaceted public health interventions and into the situations where ethical guidelines and stipulations are formulated. The best place for this may be the Internet, where we increasingly see the conditions emerging for open dialogue. [Copyright &y& Elsevier]

Abstract: Children who live with a mentally ill parent are viewed primarily as being ‘at risk’ of developing a mental illness themselves and those who remain well are considered extraordinarily resilient. This particular risk/resilience discourse is embedded within larger contemporary discourses about risk and childhood. Childhood is seen as a critical period of development during which children need protection due to their physical and psychological vulnerabilities. In this paper, the implications of this dominant casting of children are explored and it is argued that the conceptual repertoire about those living with a mentally ill parent should be expanded. A critique of the literature that established the risk/resilience discourse is followed by a discussion of research about parenting with a mental illness within which children are surprisingly absent. Recent thinking about children arising out of the ‘new’ social studies of childhood is summarized to illustrate its resistance to the hegemonic image of children as passive, developing, ‘unfinished’ persons. A recasting of children as complex young persons who have competencies as well as vulnerabilities linked to their developmental stages, would lead to different lines of inquiry about children''s experiences of mental illness in a parent. [Copyright &y& Elsevier]

Abstract: The social and behavioral sciences are at a crossroads in public health. In this paper, we attempt to describe a path toward the further integration of the natural and behavioral sciences with respect to the study of behavior and health. Three innovations are proposed. First, we extend and modify the “stream of causation” metaphor along two axes: time, and levels of nested systems of social and biological organization. Second, we address the question of whether ‘upstream’ features of social context are causes of disease, fundamental or otherwise. Finally, we propose the concept of a risk regulator to advance the study of behavior and health in populations. To illustrate the potential of these innovations, we develop a multilevel framework for the study of health behaviors and obesity in social and biological context. [Copyright &y& Elsevier]

The socio-political context of modern environmental health disasters tends to be defined as being outside the scope of official public health and epidemiological investigations into the causes of such disasters. On the other hand, popular accounts of these disasters tend to focus exclusively on the role of particular individuals and/or political actors, while minimizing the role of ecological factors. It is argued that an exclusive focus on either set of causal factors gives an incomplete or distorted picture of the origins of an environmental health disaster. In this paper, a socio-ecological analysis is developed to demonstrate how the largest outbreak of waterborne E. coli O157:H7 in Canadian history was the emergent product of a complex interplay and intertwining of social and ecological processes. The socio-ecological autopsy approach that is developed here traces the social and ecological chain of events that ultimately led to the outbreak and demonstrates, in particular, the need for investigative analysis to focus on the socio-ecological “incubation” of an environmental health disaster. Drawing from both the social sciences (particularly, the sociology of disasters and organizational sociology), and from the ecological sciences (particularly disease ecology), the analysis developed here responds to the call for the application of a more transdisciplinary approach to the study of contemporary environmental health problems. [Copyright &y& Elsevier]

Much of the evidence suggesting that inequalities in health have been increasing over the last two decades has come from studies that compared the changes in relative health status of areas over time. Such studies ignore the movement of people between areas. This paper examines the population movement between small areas in Northern Ireland in the year prior to the 1991 census as well as the geographical distribution of migrants to Northern Ireland over the same period. It shows that deprived areas tended to become depopulated and that those who left these areas were the more affluent residents. While immigrants differed a little from the indigenous population, the overall effect of their distribution would be to maintain the geographical socio-economic status quo. The selective movement of people between areas would result in the distribution of health and ill-health becoming more polarized, i.e. produce a picture of widening inequalities between areas even though the distribution between individuals is unchanged. These processes suggest potential significant problems with the area-based approaches to monitoring health and inequalities in health. [Copyright &y& Elsevier]

The bulk of care provided to elderly people living in the community and needing assistance is provided informally by family and friends. This paper investigates themes from an interpretation of interviews with informal caregivers about their experiences of caring for a frail, ill, or disabled elderly person at home. These themes include mobility, routine, and inter-relationships of scale. The caregivers’ narratives illustrate the interconnected nature of physical, material and social, emotional aspects of care, and the profound spatial and social impact of providing informal care to a family member on their everyday lives. These are often at odds with political and social constructions of what it means to care at home. Concepts of space, place, and time are shown to be a helpful framework through which to understand issues and experiences of caring. The social and the physical aspects of the many interconnected scales and places which caregivers negotiate on an everyday basis both shape and are shaped by caregiving. [Copyright &y& Elsevier]

Public health was recently described as being ‘everywhere and nowhere’ (Br. Med.J. 319(7213)(1999)839). This image captures the idea that public health is shaped by a range of social, environmental and physiological influences, and that these are mapped across the activities and practices of a range of players. It also suggests it is difficult to capture the spaces of public health. This paper explores how theoretical and methodological developments in the social sciences, in particular ideas around reflexive modernisation, can help us to read the complex terrain of public health policy and practice, and visualise these spaces more clearly. [Copyright &y& Elsevier]