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Where the NHS came from and where it could lead

With a foreword by Tony Benn.

Drawing on clinical experience dating from the birth of the NHS in 1948, Julian Tudor Hart, a politically active GP in a Welsh coal mining community, charts the progress of the NHS from its 19th century origins in workers’ mutual aid societies, to its current forced return to the market. His starting point is a detailed analysis of how clinical decisions are made. He explores the changing social relationships in the NHS as a gift economy, how these may be affected by reducing care to commodity status, and the new directions they might take if the NHS resumed progress independently from the market.

This edition of this bestselling book has been entirely rewritten with two new chapters, and includes new material on resistance to that world-wide process. The essential principle in the book is that patients need to develop as active citizens and co-producers of health gain in a humanising society and the author’s aim is to promote it wherever people recognise that pursuit of profit may be a brake on rational progress.

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The making and unmaking of a problem
Author: Lisa Arai

In the last decades of the 20th century, successive British governments have regarded adolescent pregnancy and childbearing as a significant public health and social problem. Youthful pregnancy was once tackled by attacking young, single mothers but New Labour, through its Teenage Pregnancy Strategy, linked early pregnancy to social exclusion rather than personal morality and aimed, instead, to reduce teenage pregnancy and increase young mothers’ participation in education and employment. However, the problematisation of early pregnancy has been contested, and it has been suggested that teenage mothers have been made scapegoats for wider, often unsettling, social and demographic changes. The re-evaluation of early pregnancy as problematic means that, in some respects, teenage pregnancy has been ‘made’ and ‘unmade’ as a problem.

Focusing on the period from the late-1990s to the present, “Teenage pregnancy” examines who is likely to have a baby as a teenager, the consequences of early motherhood and how teenage pregnancy is dealt with in the media. The author argues that society’s negative attitude to young mothers is likely to marginalise an already excluded group and that efforts should be focused primarily on supporting young mothers and their children.

This comprehensive examination of teenage pregnancy focuses on the situation in the UK, but will be useful for readers in other developed world countries. It will be of interest to students in sociology, social policy, health studies and public health, and also to policy makers and young people’s interest groups.

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Action research on health inequalities

Improving health in populations in which health is poor is a complex process. This book argues that the traditional government approach of exhorting individuals to live healthier lifestyles is not enough - action to promote public health needs to take place not just through public agencies, but also by engaging community assets and resources in their broadest sense.

The book reports lessons from the experience of planning, establishing and delivering such action by the five-year Sustainable Health Action Research Programme (SHARP) in Wales. It critically examines the experience of SHARP in relation to current literature on policy; community health and health inequalities; and action research. The authors make clear how this regional development has produced opportunities for developing general concepts and theory about community-based policy developments that are relevant across national boundaries and show that complex and sustained community action, and effective local partnership, are fundamental components of the mix of factors required to address health inequalities successfully.

The book concludes by indicating the connections between SHARP and earlier traditions of community-based action, and by arguing that we need to be bolder in our approaches to community-based health improvement and more flexible in our understanding of the ways in which knowledge and inform developments in health policy.

The book will be of interest to practitioners and activists working in community-based projects; students in community development, health studies and medical sociology; professionals working in health promotion, community nursing and allied areas; and policy makers working at local, regional and national levels.

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From Acheson to ‘Choosing Health’

This book offers a unique multi-disciplinary perspective on tackling health inequalities in a rich country, examining the New Labour policy agenda for tackling health inequalities and its inherent challenges.

The book presents an overview of progress since the publication of the seminal and ambitious 1998 Acheson Inquiry into health inequalities, and the theoretical and methodological issues underpinning health inequalities. The contributors consider the determinants of inequality - for example, early childhood experience and ethnicity - the factors that mediate the relationship between determinants and health - nutrition, housing and health behaviour - and the sectoral policy interventions in user involvement, local area partnership working and social work.

Challenging health inequalities offers a combination of broad analysis of progress from differing perspectives and will be key reading to academics, students and policy makers.

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This Handbook is the definitive resource for anyone wishing to quickly look up and understand key concepts and measurements relating to socioeconomic position and inequalities.

A range of key concepts is defined and measures of socioeconomic position and inequality described. Alphabetical listings, cross-referencing, graphs and worked examples, references to web and other sources of further information, all contribute to making the Handbook both engaging and accessible for a wide audience.

For students, academics and others involved in social science research it answers questions such as:

'What's the official government measure of poverty?'

'What factors make up the Townsend Index of Deprivation?'

'What is a gini coefficient?'

'I have to write a report on tackling inequalities in my area - what are the key issues I should consider before I begin?' For practitioners, policy makers, journalists and others who must read, understand and use research in fields as diverse as health, criminology, education, the environment, transport and housing it provides a one-stop, authoritative guide to making sense of and evaluating the significance of often complex methodologies. The authors are all eminent researchers in the field of health inequalities. They have together produced two glossaries for the Journal of Epidemiology and Community Health and have published a large number of books and articles in learned academic journals.

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Continuity and change in Sweden

Foreword by Lisa Berkman, Professor of Public Policy, Harvard University

How welfare states influence population health and health inequalities has long been debated but less well tested by empirical research. This book presents new empirical evidence of the effects of Swedish welfare state structures and policies on the lives of Swedish citizens.

The discussion, analysis and innovative theoretical approaches developed in the book have implications for health research and policy beyond Scandinavian borders. Drawing on a rich source of longitudinal data, the Swedish Level of Living Surveys (LNU), and other data, the authors shed light on a number of pertinent issues in health inequality research while at the same time showing how health inequalities have evolved in Sweden over several decades. Topics covered include how structural conditions relating to family, socio-economic conditions and the welfare state are important in producing health inequalities; how health inequalities change over the lifecourse and the impact of environment on health inequalities - at home, at school, in the workplace.

Health inequalities and welfare resources will be invaluable to researchers, students and practitioners in sociology, social epidemiology, public health and social policy interested in the interplay between society and health.

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