Critical Public Health

Public perceptions and discussion of scientific facts became crucial during the COVID-19 pandemic, as various risk estimation claims were used to legitimate novel state of exception policies at a global level and related public health intervention programmes. Critical perspectives in the social sciences have argued that the mainstream media presented an exaggerated account of scientific consensus while excluding well-founded critical dissent. This article presents a qualitative-textual analysis of one example of this form of knowledge construction: the use of the ‘conspiracy theory’ category within articles published by The Guardian newspaper in the UK between February 2020 and February 2022. Our analysis shows that these articles tended to conflate engaged critical positions on pandemic policies with irrational conspiracy theories, thus excluding these former positions from rational discussion and debate. We term this mechanism of exclusion epistemic quarantine, arguing that this extension of the conspiracy-theory category to include scepticism or criticism mis-labelled and potentially alienated genuine scientific criticism, eroding trust among some communities, obscuring sincere plural public health perspectives and undermining the longer-term legitimacy of science.

This paper argues for a rethinking of disease preparedness that puts incertitude and the politics of knowledge at the centre. Through examining the experiences of Ebola, Nipah, cholera and COVID-19 across multiple settings, the limitations of current approaches are highlighted. Conventional approaches assume a controllable, predictable future, which is responded to by a range of standard interventions. Such emergency preparedness planning approaches assume risk -where future outcomes can be predictedand fail to address uncertainty, ambiguity and ignorance -where outcomes or their probabilities are unknown. Through examining the experiences of outbreak planning and response across the four cases, the paper argues for an approach that highlights the politics of knowledge, the constructions of time and space, the requirements for institutions and administrations and the challenges of ethics and justice. Embracing incertitude in disease preparedness responses therefore means making contextual social, political and cultural dimensions central.

While most studies examining the weaknesses of the WTO (World Trade Organization) focus on shortcomings of its institutional arrangements and structural tensions between the two fundamental principles of the WTO -the single undertaking and the decision-making by consensus -this work takes a different view. It attributes the WTO's limitations to the neglect of essential subjects on the negotiating agenda and the omission of important actors at the negotiating table. The world trade system is in troubleit has become divided between the organization that supposed to efficiently manage international trade and corporate actors who engage in global trade practices. Consequently, the article argues that to be relevant the WTO has to adapt to the changing nature of international trade by opening its doors to the business community and by allowing negotiations of plurilateral agreements among interested parties. The very idea that the WTO should remain exclusively an intergovernmental organization where only states propose and negotiate contracts appears to be more fitted for the nineteenth century mercantilist world. The globalizing economy of today is driven by powerful players that are not only states but also corporations. However, under the WTO's current arrangement , corporate actors are completely outside the WTO's institutional structure. The organization deals only with states, manages inter-state multilateral agreements, and resolves inter-states disputes Consequently, suggestions are offered on how to revitalize the organization, which still presents opportunities for improving economic development worldwide and making the global economy function more efficiently and cooperatively.

The on--going emergency for refugees is having profound and hidden health consequences for thousands of displaced persons who live in informal 'makeshift' camps across Europe. This interdisciplinary paper reports the results of the first environmental health assessment in such a location, in what was Europe's largest informal refugee camp in 2016, in Calais, northern France. We detail the lack of facilities for sanitation, safe provision of food, water, and shelter, demonstrating how conditions fall short of agreed international standards for formal refugee camps. Rather than the notion of migrants being the cause of health problems, this paper critically reveals the hidden materiality of bodily injury caused by poor health conditions, where the camp itself produces harm. Drawing upon theories of biopolitical exclusion, the paper concludes by (i) emphasising the empirical and conceptual themes that tie refugee politics and biologies together, and (ii) makes a call for increased attention to makeshift camps as key sites of health exclusion in Europe and beyond.

In this commentary, we address community health workers' (CHWs) marginalized social location within the health care systems of Canada and the US. This marginalization is due, in part, to their being a workforce shaped by socio-structural factors, such as gender discrimination, racism, and poor socio-economic conditions. This marginalization challenges their ability to address health equity. We propose system-level and workforce-level policy changes that build toward an empowerment path for CHWs to realize their full potential to address health equity. Regarding the work they do and the populations they serve, system-level changes would allow CHWs to strengthen their intimate connection with, and commitment to, advancing health and well-being in their marginalized communities. Workforcelevel changes would target their peripheral status by addressing multiple structural factors and altering organizational arrangements to remove their marginalization as a workforce. Together these system-level and workforcelevel changes would greatly enhance the health and social services systems.

Introduction: Corona virus stars 2, known as COVID-19, has come as an international health problem since the late of 2019. It has been recognized by the World Health Organization (WHO) as COVID-19 pandemic. Jordan has established several clinics to manage the problem of COVID-19 pandemic. Objectives: To analyze and report the results of existing data of patients who visited Corona clinic in the emergency department in Royal Medical Services, Jordan. Methodology: A retrospective study design was conducted to collect data from files of patients who were examined in corona clinics in the emergency department in Royal Medical Services, Jordan. The following variables were considered: the total number of patients visiting the corona clinics per month, the number of suspected patients to be infected with corona virus per month, and the number of cases confirmed by PCR per month. Data were presented as tables and figures to show the variations in suspected and confirmed cases. The present study showed that during the period between March and April, corona clinics received a total of 3416 patients of whom 2294 cases were suspected to have corona virus, and a total of 1122 cases were confirmed by PCR. Cases followed similar trends in the frequency of corona virus from March to July. In August and September, changes in trends occurred which may be due to the impact of media in which it was perceived that the COVID-19 pandemic is going to end during summer months due to increased temperature degrees. Conclusions: the present study showed increasing incidence of corona cases during the study period from March-September.

The book is organized into seven chapters. Chapter one follows the "the quest for Beta-Israel identity in Ethiopia". It examines the origin of the identity of the Beta-Israel from all possible accounts and debates the ancient roots of the Beta-Israel based on oral history. However, due to the lack of written sources before the 4 th century, none of these accounts can provide conclusive and compelling evidence to establish with absolute certainty when and how the Jewish presence in Ethiopia began. The author, therefore, concludes that even though the Beta-Israel cannot be considered as "a distinct, pure and authentic social group untouched to the multidimensional dynamics in Africa and Ethiopia", their strong religious commitment and struggle to defend their faith supports their claim for historical Jewishness in their own eyes. Thus, they deserve acceptance in Israeli identity, despite being isolated from mainstream Judaism. However, Zegeye's wider theoretical understanding of Beta-Israel identity concerns their constant struggle against isolation from the Christian rules of Ethiopia, which in turn reinforced their peculiarity and perseverance against all odds. Chapter two continues the search for the identity of the Beta Israel by examining the history of Judaism in Ethiopia. His thorough survey of the interpenetration of Judaism and Ethiopian identity leads him to conclude that there is no other country today as highly influenced by Judaism as Ethiopia. Similarly, the identity of the Beta-Israel has undergone Ethiopianisation. Thus, one may say, Ethiopia was Judaized as Judaism was Ethiopianized. This chapter focused on reconstructing the Jewish identity of the Beta-Israel along with the ancient history of Ethiopia. In doing so, the author has unearthed a grotesque image of the extreme violence against the Beta-Israel that shaped the nature of their identity. Zegeye concludes that the Beta Israel have a legitimate claim to Jewishness owing to the endless persecution, violation and discrimination they faced. Chapter three, the shortest of all the chapters, presents a watershed point in the history of the Beta-Israel: the relocation to Jerusalem, which involved the dramatic smuggling out and airlifting of tens of thousands of Ethiopian Jews from Ethiopia and Sudan. Four major operations were carried out from 1983 to 1991: Operation Brothers, Moses, Sheba and Solomon. The title of the chapter, "Back to Jerusalem", captures the age-old aspiration of the Beta-Israel to return to their imagined old religious home, as was the case with the wider

While enormous strides have been made in the representation of women in clinical trials, the percentage of women enrolling in Phase I trials still remains low, which both raises public health concerns about the safety of new drugs and social justice concerns regarding their inclusion in research. As part of a longitudinal study of healthy volunteers in the United States, our inquiry aimed to examine impediments to women enrolling in Phase I trials as well as their experiences participating in these studies at residential research clinics. We analyzed 111 semi-structured interviews conducted with 47 women who had enrolled in at least one Phase I trial. Our study indicates that women face discrimination during all stages of their participation in Phase I trials from their ability to qualify for studies, the treatment they receive in the clinic facilities, and a lack of social support. Specifically, we found that (1) study designs disadvantage participants of childbearing potential, (2) women feel vulnerable in the clinic space when outnumbered by men, and (3) heterosexual women are often discouraged from participation by their husbands or significant others. Placing these findings within the scholarly literature on barriers to women's clinical trial participation, we argue that diverse strategies attending both to physiological and social factors are needed to combat inequalities in U.S. Phase I trial participation.

This paper explores how an array of HIV epidemic responders became embroiled in producing quantitative evidence for HIV interventions in India. Based upon extensive ethnographic fieldwork in Karnataka State, I examine the life history of the Gates-funded AIDS initiative in India known as Avahan as a case study to consider the social and political implications of large-scale, standardizing knowledge regimes enacted in the era of global health. Specifically, I analyze a sample of the key material artifacts that are implicated in the production of standardized knowledge in an attempt to illuminate the workings of what I refer to as 'evidentiary sovereignty' . I argue that documents, forms, and other paperwork used to generate evidence in global health interventions neither merely reflect expert knowledge nor convey information about scientific standards but, rather, are integral to the re-instantiation of sovereignty. The effects of evidentiary sovereignty not only narrow the aperture of global health interventions to overlook the on-theground realities that shape health problems, but they also transform the very ground upon which communities responding to HIV epidemics conceive of and enact politics. As highly HIV-affected communities struggle with the bureaucratic demands of intensive form-filling and query agreed upon standards and systems of classification, a form of politicization of knowledge unfurls that pertains to the documents themselves.

Economic downturns have had profound and far-reaching impacts throughout history. While many people are familiar with the term "recession," fewer are aware of the differences between a recession and a depression. Understanding these distinctions is not only important for academic purposes but also essential for policymakers, economists, investors, and the general public who must navigate and respond to these challenging periods. This paper aims to delve deeply into the subject, exploring the Long Depression of the late 19th century, various recessions throughout history, and the socioeconomic implications of each type of downturn. By analyzing economic indicators, government responses, and case studies of major crises, this comprehensive study will help to clarify how depressions and recessions differ and what can be learned from their occurrences. Economic downturns are generally characterized by a decline in economic activity across the broader economy. However, not all downturns are created equal. A recession is typically defined as two consecutive quarters of negative GDP growth, while a depression is a more prolonged and severe form of economic decline. Recessions are part of the natural economic cycle and occur periodically due to various factors such as supply shocks, financial imbalances, or policy missteps. Depressions, on the other hand, are rare and often involve a collapse of the financial system, long-term unemployment, and widespread poverty. This distinction is crucial for understanding the appropriate policy measures needed to address each scenario. The Long Depression, which began in 1873 and lasted until approximately 1896, is often cited as one of the most severe economic downturns in modern history. Unlike the more well-known Great Depression of the 20th century, the Long Depression is less frequently studied but offers valuable insights into the long-term consequences of economic stagnation. Originating with the Panic of 1873, the Long Depression was triggered by a collapse in the financial markets following over-speculation in railroads and a sudden tightening of credit. The resulting economic contraction affected Europe and North America, leading to high unemployment, deflation, and significant social unrest. The global nature of this downturn also highlighted the interconnectedness of economies even in the 19th century. Recessions have occurred more frequently and with varying degrees of severity. Notable recessions in modern times include the early 1980s recession caused by tight monetary policy to combat inflation, the early 1990s recession driven by a combination of high interest rates and oil price shocks, and the 2008 Global Financial Crisis sparked by the collapse of the housing market and subprime mortgage sector. Each of these events provides insight into how economies contract and recover, as well as the importance of timely and effective policy responses. While painful, recessions can sometimes serve as a reset mechanism for overheated economies. Key differences between depressions and recessions lie not only in their duration and depth but also in their broader societal impacts. Depressions often lead to fundamental shifts in economic structures, political landscapes, and public attitudes. For example, the Great Depression of the 1930s led to the establishment of major social safety nets in the United States and the rise of Keynesian economic policies. Recessions, while disruptive, usually do not lead to such lasting transformations. They may prompt changes in interest rates, fiscal spending, or regulatory policies, but rarely do they redefine the economic order in the same way a depression might.

Large consumer technology corporations are becoming increasingly influential in health and medicine. While this is sometimes beneficial to public health, it also raises many risks, like inequitable returns to the public sector in public-private medical partnerships or new dependencies on technology firms for the provision of public health goods and services. These risks are not always fully captured by existing frameworks. In this paper, we argue that it is time to adopt a public health ethics perspective on the increasing influence of Big Tech in health and medicine. A public health ethics perspective can not only capture the effects of Big Tech on the health of entire populations, but it also raises the important question of whether governments ought sometimes to intervene in the activities of Big Tech in order to safeguard public health.

Children have been made a priority in Australian government obesity interventions, with programmes tending to focus on promoting behaviour change in food and exercise practices. This paper reports findings from ethnographic research with a group of Australian children aged 10-14 years living in a low socio-economic suburban setting. We propose that central to these children's experiences of food and eating is the negotiation and management of hunger. Historically, disadvantage has been embodied and inscribed on children's bodies in very visible ways, and the coexistence of hunger and obesity is part of this continuum. Despite considerable evidence of food insecurity in our research site, issues of hunger were absent in an obesity intervention underway at the time. We examine how hunger was felt in children's lives, how it was managed and the ways in which messages about eating less, while eating more 'healthy foods' , were at odds with the children's experiences of hunger. Moreover, we argue that hunger and obesity in this context were doubly stigmatised, as children were very aware of how their hunger and their bodies marked them as different and disadvantaged. Attention to both the embodied and social impacts of hunger on children and their everyday relationships is key in formulating more sensitive, contextualised public health interventions. A critical body of scholarship has developed in recent years focusing on the concepts of food insecurity, food deserts and food poverty. 1 This area of work has been important in demonstrating the vulnerabilities of those negotiating food insecurity, with individuals and family units engaging in complex strategies in order to access sufficient and affordable food, in circumstances where food supply and quality are often not consistent or accessible. Law, Ward, and Coveney (2011) used the livelihoods framework to demonstrate the range of capabilities that may be drawn upon in Australian food insecure contexts. They argued that human, financial, personal, social, physical and time capabilities can all contribute to people's abilities to access what they perceive to be a healthy diet. These capabilities were seen to be dynamically interrelated, as well as being shaped by specific contexts of vulnerability and the potentially transformative processes and structures that people interact with on a day-to-day basis (see also . However, attending to individual contexts does not guarantee that households will have good quality nutrition. Strategies to survive may include trade-offs involving foods that do ARTICLE HISTORY

The health field is being subjected to a dictate that policy, practice and research should be informed by evidence. The mere generation of evidence, however, does not mean that policy and practice will act upon it. Utilisation and application of research findings (often equalled with 'evidence') is a political process following rationalities that are not necessarily similar to those of researchers. In response to this issue that evidence does not naturally finds its way into policy and practice (and back into research), the concept of 'knowledge translation' is becoming increasingly popular. In this article we demonstrate that 'translation' can have different meanings, and that current perspectives (both Knowledge Translation and the Actor-Network Theory) do not reflect appropriately on actions that can be taken at the nexus between research, policy and practice in order to facilitate more integration. We have developed seven conceptual categories suggesting different action modalities. Actors and actants in this game should be aware of the complex political nature of these modalities.

Developing a deep and contextualised understanding of risk is important for public health responses to young people's alcohol consumption, which is frequently positioned as an outcome of risky behaviour. This paper expands conceptualisations of risk to encompass its wider social and cultural context through a social practice exploration of young people's controlled and managed intoxicated alcohol consumption practice. We report data from a fourteen-month qualitative study of the alcohol consumption practices of 23 young people in England, drawing on group interviews and social media interactions. Our findings provide a nuanced understanding of risk-taking, demonstrating that risk is an important aspect of the ongoing participation and performance in alcohol consumption practice and that health information and advice can be and was frequently incorporated into drinking practice without contributing to fundamental change. This raises new questions about the effectiveness of health interventions that focus on the individual, discussed in the final section of the paper.

Below is a deep-dive article that carefully examines the differences, causes, and legacies of the Great Depression and the Great Recession. A Tale of Two Cataclysms: The Great Depression vs. The Great Recession Economic downturns often serve as pivotal moments in history, marking the vulnerabilities of financial systems and spurring transformative policy changes. Two of the most significant episodes in modern economic history-the Great Depression of the 1930s and the Great Recession of 2007-2009-offer a sobering study in contrasts. While both crises shook the foundations of global economies, they diverged greatly in their origins, severity, policy responses, and long-term societal impacts.

This paper considers linkages between contemporary marketing theory and practice, and emerging conceptualizations of identity, to discuss implications for public health concerns over alcohol use among young people. Particular attention is paid to the theorizing of consumption as a component of youth identities and the ways in which developments of marketing praxis orients to such schemata. Our analyses of exemplars of marketing materials in use in Aotearoa New Zealand, drawn from our research archive, emphasise the sophistication and power of such forms of marketing. We argue that public health policy and practice must respond to the interweaving of marketing and the self making practices of young people counter this complex threat to the health and wellbeing of young people.

Alcohol consumption and heavy drinking in young adults have been key concerns for public health. Alcohol marketing is an important factor in contributing to negative outcomes. The rapid growth in the use of new social networking technologies raises new issues regarding alcohol marketing, as well as potential impacts on alcohol cultures more generally. Young people, for example, routinely tell and re-tell drinking stories online, share images depicting drinking, and are exposed to often intensive and novel forms of alcohol marketing. In this paper we critically review the research literature on a) social networking technologies and alcohol marketing and b) online alcohol content on social networks, and then consider implications for public health knowledge and research. We conclude that social networking systems are positive and pleasurable for young people, but are likely to contribute to proalcohol environments and encourage drinking. However currently research is preliminary and descriptive, and we need innovative methods and detailed in-depth studies to gain greater understanding of young people's mediated drinking cultures and commercial alcohol promotion.

Encyclopedias in the Social Sciences serve as the definitive reference works to their fields. Each Encyclopedia is overseen by an editor internationally recognised as a leading name within the field, and contains a multitude of entries written by key scholars, providing an accessible and condensed overview of the key topics within a given subject area. Volumes in the series are commissioned across the breadth of the social sciences, and cover areas including, but not limited to, Political Science, Sociology, Human Geography, Development Studies, Social Policy, Public Management and Public Policy. Individual entries present a concise and logical overview of a given subject, together with a list of references for further study. Each Encyclopedia will serve as an invaluable resource for practitioners, academics, and students, and should form an essential part of any research journey.

The reception of Michel Foucault's work in the social sciences and humanities has been phenomenal. Foucault's concepts and methodology have encouraged new approaches to old problems and have opened up new lines of enquiry. The study of health and medicine is no exception and his influence is so profound here that few topics in the field are discussed without some reliance on his work. Foucault, Health and Medicine assesses the contribution of Foucault's work in this area. The foreword offers some reflections on Foucault's contribution to medical sociology as a whole. Part I problematises Foucault's work, examining the different 'readings' to which it lends itself. Part II deals with his concept of 'discourse' and explores some of its applications: the study of personality disorder and the problem of the 'dangerous individual', the study of the problem of child mental health, and the critique of the 'medicalisation' thesis. Part III turns to the analysis of the body and the self, major themes in Foucault's work. The implications of Foucault's concepts for feminist research on embodiment and gendered subjectivities are explored, and the notion of 'biopower' is considered in the context of health education. Finally, Part IV explores the application of Foucault's concept of governmentality to the analysis of health policy, health promotion and the consumption of health. Common themes in these chapters include the emergence of risk culture, the concept of the enterprising self and the role of expertise in liberal technologies of government.

In Canada and other western nations there has been an unprecedented expansion of criminal justice systems and a well documented increase of contact between people with mental illness and the police. Canadian police, especially in Vancouver, British Columbia, have been increasingly at the forefront of discourse and regulation specific to mental health. Drawing on critical discourse analysis, this paper explores this claim through a case study of four Vancouver Police Department (VPD) policy reports on "Vancouver's mental health crisis" from 2008-2013, which include recommendations for action. Analyzed is the VPD's role in framing issues of mental health in one urban space. This study is the first analysis to critically examine the VPD reports on mental health in Vancouver, B.C. The reports reproduce negative discourses about deinstitutionalization, mental illness and dangerousness that may contribute to further stigma and discrimination of persons with mental illness. Policing reports are widely drawn upon, thus critical analyses are particularly significant for policy makers and public health professionals in and outside of Canada.

Insufficient attention has been given to the social aspects of HIV and mental health in the Philippines despite their profound impact on Filipinos, particularly gay and bisexual men and other men who have sex with men. Past evidence shows that these health conditions are intertwined, amplified by the combined impact of power and oppression. Yet, scholarly works, programs, and interventions focusing on understanding the social, structural, and political aspects of HIV and mental health are still in the early stages in the Philippines, calling for urgency in tackling the ongoing epidemics these men face. Therefore, we have developed this essay with the following objectives: 1) to provide context for the overlapping of the two health epidemics faced by Filipino gay and bisexual men and men who have sex with men; 2) to illustrate how critical perspectives such as syndemics and intersectionality can deepen our understanding of these conditions; 3) to showcase strategies for integrating syndemics and intersectionality into research and practice. Our aim is to foster the discussion on the use of critical perspectives in addressing health conditions in the Philippines and to advocate for comprehensive, inclusive, and culturally informed research, programs, and interventions for these men in the broader Filipino community.

This paper shows some views on the mathematical structure of the diffusion of the Coronavirus (COVID-19), often claimed to have a positive exponential structure. However, we find that the exponential growth rate is past the inflection point and that growth is much slower than this implication. It presents conclusions on the future expected outcome of the current situation-not only in terms of diffusion of the disease but also for the hysteria that have been created around it.

This paper unpacks the concept of “spatial violence” to examine the social justice dimensions of race, place, space, and the Indigenous and Black communities in Canada. The paper highlights the larger socio-spatial processes that create disproportionate exposure and vulnerability to the harmful social, economic, and health impacts of inequality in Indigenous and Black communities. It also argues that the lived experience of spatial violence and toxic exposure live together and that it is not possible to understand their impacts in Indigenous and Black communities in isolation. The paper also disrupts traditional notions of “the environment” that are centered on harmonizing cities and nature by highlighting the symbolic and materiality of space, especially with respect to how it harms Indigenous, Black and other racialized communities.

Indigenous and Black women in Canada are disproportionately impacted by racial and gendered forms of environmental violence that are rooted in a legacy of colonialism, white supremacy, and patriarchy. Gender, race, class, and other social identities render Indigenous and Black women more susceptible and vulnerable to a web of inequalities that inflict violence on their bodies, lands, and communities. In response, Indigenous and Black women have been building grassroots social and environmental justice movements for decades to challenge the legal, political, and corporate agendas that sanction and enable environmental violence in their communities. This article examines the disproportionate social, economic, and health impacts of multiple forms of environmental violence in the lives of Indigenous and Black women in Canada, including low income and poverty, systemic racism in employment and law enforcement, and environmental racism and climate change. The article also calls attention ...

In the spring of 2012, the author agreed to direct a project on environmental racism in Nova Scotia after meeting with Dave Ron, a social and environmental activist who had been involved for some time in the Save Lincolnville Campaign, a community-led initiative for the removal of the landfill near the African Nova Scotian community of Lincolnville. Thirsty for a new challenge that had the potential to effect real change in racially marginalized communities, she understood that the significance of the project lay in its uniqueness: few, if any, studies exist that examine environmental racism in both the Indigenous and Black communities in Canada. Given the dearth of research on environmental racism in Nova Scotia, particularly from the perspectives of these two communities, the project serves as a kind of case study for telling a particular kind of story situated in the Nova Scotian context and, in many cases, in the larger Canadian context.That project, which was later titled the E...

The need for effective youth suicide prevention is uncontested, and is particularly urgent for Indigenous populations. The Indigenous youth suicide rates in some North American communities can be 18 times greater than for other young people. Despite the clear need, evidence in support of Indigenous youth suicide prevention strategies remain mixed. The most common approach to youth suicide preventiongatekeeper trainingmay have limited effects in Indigenous communities. Based on recent work undertaken with Indigenous leaders in rural Alaska, we describe culturally grounded, practical alternatives that may be more effective for Indigenous communities. We highlight the ways in which research informed, grassroots interventions can address cultural, practical and systemic issues that are relevant when addressing risks for suicide on a community level. Built on a transactional-ecological framework that gives consideration to local contexts, culture-centric narratives and the multiple, interacting conditions of suicide, the innovative approach described here emphasizes community and cultural protective factors in Indigenous communities, and extends typical suicide prevention initiatives in ways that have important implications for other ethnically diverse communities.

This paper offers a commentary on Havi Carel and James Kidd's conception of 'vulnerabilisation' as a theoretical tool to critically interrogate the iatrogenic harms of the healthcare industry. I draw on the experience of those suffering from 'functional neurological disorder' (FND) to underscore the significance of their project, shedding light on how patient symptoms are frequently dismissed and invalidated by healthcare professionals as being 'unreal' or 'all in your head.'

Official version of record available from Critical Public Health here. Gómez, A. M., Mann, E. S., & Torres, V. (2018). 'It would have control over me instead of me having control': Intrauterine devices and the meaning of reproductive freedom.

Challenging the dominant narrative Since the WHO (1998) lamented the so-called 'obesity epidemic' over a decade ago, there has been much rhetoric and concern about fatness/weight/obesity across an increasing range of national contexts. 1 Alarmist claims about an 'obesity time-bomb' are continually recycled in policy reports, reviews and white papers, each of which begin with the assumption that fatness is fundamentally unhealthy and damaging to national economies (UK examples include: AMRC 2013; Foresight 2007; HOC 2004). This rhetoric and the associated moral panic have been amplified by a dramatising mass media (Boero 2012; also, see Boero in this issue) and have in no way dissipated even though certain 'sceptics' maintain the 'crisis' is coming to an end (Gard 2011; for a critique, see . Recent examples of what Saguy and Almeling (2005) call 'fat panic' are not difficult to find. In February 2013, shortly before we finalised this special issue, the AMRC (2013, 7) released a well-publicised report, Measuring Up, which reiterated the dominant view: fatness is 'a problem of epidemic proportions' that 'must now be tackled urgently'. Similar to earlier manifestations of fat panic (see McPhail 2009, for example), these public health concerns intersect with broader political economic anxieties about poor national fitness, with the UK labelled as 'the "fat man" (sic) of Europe' (AMRC 2013, 3). This document, like others before it, legitimises calls for various interventions to tackle the 'problem of obesity' (e.g. intensified surveillance inside and outside of the clinic, including injunctions that healthcare professionals must attend to their own weight); interventions which aim to literally reduce the number of bodies of 'size' and the size of individuals' bodies . This dominant 'obesity epidemic' narrative and rhetoricwhat John Evans et al. ( ) term 'fat fabrications'not only emerges in policy reports but also in academic literature, including papers written by respected contributors to this journal. For example, Bagwell (2013) and De Vogli et al. ( ) are concerned respectively with public health efforts to 'tackle' and 'control' the 'obesity epidemic'. Such studies, similar to sociological publications on obesity rates (Crossley 2004) and geographical work on so-called 'obesogenic environments' (Smith and Cummins 2008; for critiques see Colls and Evans forthcoming; Evans, Crookes and Coaffee 2012; Guthman 2011; Kirkland 2011), are useful insofar as they draw attention to the ways in which social, political and economic factors shape and constrain people's life chances and consumptive practices. However, we disagree with the common research and policy emphasis on body size/weight/fatness as a proxy for health as well as the assumption that diet and/or physical activity unequivocally explain trends in obesity regardless of other possible contributors (e.g. endocrine disruptors, sleep debt, smoking cessation and side effects from medicines) (see . Specifically, we question the assertion of a

The legislation of health warning labels on cigarette packaging is a major focus for tobacco control internationally and is a key component of the World Health Organization's Framework Convention on Tobacco Control. This population-level intervention is broadly supported as a vital measure for warning people about the health consequences of smoking. However, some components of this approach warrant close critical inspection. Through a qualitative content analysis of the imagery used on health warning labels from 4 countries, we consider how this imagery depicts people that smoke. By critically analyzing this aspect of the visual culture of tobacco control, we argue that this imagery has the potential for unintended consequences, and obscures the social and embodied contexts in which smoking is experienced.

Men's apparent resistance to recommended health practices and their engagement with 'high-risk' behaviours has been associated with an increased risk of morbidity or mortality. Recent work has highlighted the need to think critically about the health-promoting behaviours that men appear reluctant to engage in, as well as examining those they embrace, and explore the gendered meanings that men attribute to their beliefs and behaviours. This article presents men's discussions of the 'practices of masculinity' and examines their relation to, and implications for, men's health-related behaviours as articulated in 15 focus group discussions (59 participants in total). The data capture both the experiences of men who felt pressured to engage in behaviours that may be harmful to their health in order to appear masculine and the accounts of those who regarded themselves as freer to embrace salutogenic health practices. Less is known about the circumstances that might encourage men to rethink their engagement in performances of masculinity that have potentially detrimental effects on their health. The data presented here suggest that ageing, illness, and fatherhood were some of the experiences that prompted men to re-evaluate their health practices.

Aims: To explore the experiences of low-risk, HIV anxious gay and bisexual men (GBM) who use HIV Pre-Exposure Prophylaxis (PrEP) and the impact PrEP use has on their sexual behaviour and experience of anxiety. Background: PrEP has demonstrated significant protection against HIV infection among GBM who are high-risk and is becoming increasingly popular. Anecdotal reports suggest that low-risk, HIV anxious GBM are using PrEP. HIV anxiety in GBM is a poorly understood phenomenon that is usually conceptualised within cognitive-behavioural models. This may neglect the impact of minority status and the specific psychosocial processes associated with this, such an internalised homophobia. PrEP use is associated with less worry and improved sexual functioning and it is unknown whether these benefits will be realised among PrEP-using, low-risk GBM who are HIV anxious. Methodology: Qualitative methodology was employed within an interpretivist paradigm. 10 gay men were recruited from sexual he...

The COVID-19 pandemic has had enormous effects on health, wellbeing, and economies worldwide. Governments have responded with rapid and sometimes radical public health interventions. As nations grapple with the question of how to regain normality without unnecessarily endangering lives or healthcare systems, some scientists have argued for policies to encourage or compel the use of face coverings in community (nonclinical) settings, despite acknowledged gaps in the evidence base for the effectiveness of such a measure. This commentary has two objectives. First, in the face of strong arguments that face coverings are a commonsense intervention, with negligible downsides, that can only do good, we make the case for caution in changing policy. Many seemingly benign public health interventions have the potential to cause harm, and that harm is often socially differentiated. We present five arguments for caution in policy change. Second, we reflect on the wider implications of the increasingly overt approaches to policy advocacy taken by some scientists. Drawing from the theory of post-normal science, we argue that the science-policy interface in the case of face coverings has taken a surprisingly traditional form, falling short of interdisciplinary integration and failing to incorporate insights of the full range of relevant experts and affected stakeholders. We sketch a vision for an alternative, more mature, relationship between science and society that accepts uncertainty, embraces deliberation, and rises to the challenge of developing knowledge to improve public health.

Objective Epidemics impact individuals unevenly across race, gender, and sexuality. In addition to being more vulnerable to COVID-19 infection, evidence suggests racialized gender and sexual minorities experienced disproportionate levels of discrimination and stigma during the COVID-19 epidemic. Drawing on Critical Race Theory (CRT), we examined the experiences of gay, bisexual, queer, and other men who have sex with men (GBQM) of colour facing discrimination during COVID-19. Design Engage-COVID-19 is a mixed methods study examining the impact of COVID-19 on GBQM living in Vancouver, Toronto, and Montréal, Canada. We conducted two rounds of qualitative interviews (November 2020 to February 2021, and June to October 2021) with 93 GBQM to explore the evolving impact of COVID-19 on their lives. Transcripts were coded using inductive thematic analysis. Data analysis was conducted using Nvivo software. Results Fifty-nine participants identified as Black, Indigenous, and/or a Person of Co...

A federal law prohibits the US Government from negotiating pharmaceutical prices. This law comes with an opportunity cost: resources spent on unnecessarily highly priced drugs cannot be spent on other social goals. To calculate the opportunity cost of this spending, this analysis first identified a proxy for unnecessarily high pharmaceutical spending. We then estimated the value of the outcomes which this money would produce if invested in an alternative, high-value use. We estimated the excess price increases in a set of 80 commonly prescribed drugs paid for by the Centers for Medicare and Medicaid Services from 2010 to 2014. The value of price increases among these drugs above the rate of medical inflation was $11.5 billion dollars. This money has alternative uses, including some that promote health and other social goals. This is the opportunity cost of unnecessarily high pharmaceutical spending. Investment in high-school dropout prevention programs was chosen as a measure of alternative uses for this spending because of the importance of education as a social determinant of health and because medical spending has been shown to specifically crowd out education spending. Invested in programs to increase high-school graduation rates, this money could create an additional 200,000 high-school graduates, which in turn would generate an estimated $32 billion in returns (net present value) to government and health improvements of up to 1 million quality-adjusted life years (QALYs) per year of redirected expenditures.

New interest is being shown in the geographical approach to health inequality at both the research and the service provider level. The scientific and methodological basis of this approach does not take into consideration the social structure and the history of the locations/communities under investigation. The analysis of geographical differences must be verified and consideration given to possible variations in internal health inequalities between entities compared. Our approach to health inequalities is based on the theory that social health inequalities are essentially the final product of living conditions and lifestyle taking account of individual and collective history.

Post Traumatic Stress Disorder (PTSD) and chronic pain have been identified as global health challenges for health professionals, and there is a robust literature linking PTSD and chronic pain. Much of the research is focused on high-income countries, leaving a serious gap when chronic pain is considered globally. Using the concept of Continuous Traumatic Stress (CTS), we look at how broader social conditions impact on the experience of chronic pain. We review the relevant literature on chronic pain, PTSD, and CTS, and suggest a research agenda for a more globally relevant and contextual understanding of chronic pain. Over the past 30 years, there have been developments in the understanding and treatment of post traumatic stress disorder (

An integral part of colonisation is the suppression and marginalisation of indigenous knowledges. The indigenous health system within Aotearoa (New Zealand) was supplanted with a colonial infrastructure and praxis which has proven ineffective in addressing systemic health inequities created by the processes of colonisation. This novel study interrogates discursive representations of Māori (Indigenous peoples of Aotearoa) within colonial public health policy between 2006 and 2016. Colonial policy refers to generic or mainstream policy that are designed for 'all' New Zealanders. We utilised thematic analysis to examine 106 policies and, after excluding 13 ethnic specific policies, identified 68 policies containing no mention of Māori. The analysis highlights five themes relating to discursive representations of Māori. These were: i) silence about Māori health; ii) Māori as especially at risk; iii) Crown (lack of) responsiveness to te Tiriti o Waitangi obligations; iv) recognition of Māori philosophical approaches to service provision; and v) utilising mātauranga Māori (Māori knowledge). These findings suggest colonial policy presents a barrier to the pursuit of health equity and is poorly aligned to global Indigenous human rights declarations. Within the context of Aotearoa it echoes the sentiments of the key Waitangi Tribunal [WAI 2575] finding that health policy is contributing to health inequities and failing Māori. Health policy must be decolonised to better engage with human rights declarations and te Tiriti o Waitangi obligations in order to achieve health equity.

Persons living with dementia and their carers experience stigma. Stigma intensifies social exclusion and threatens health and well-being. Decreasing stigma associated with dementia is a public health priority across national and international settings and is a key component of National Dementia Strategies. Research-based drama is an effective public health strategy for reducing stigma and enhancing well-being. In this article we focus on survey data from an evaluation of a research-based drama called Cracked: new light on dementia. Our analysis illustrates the effectiveness of Cracked in reducing stigma by: decreasing health care practitioners' and family carers' prejudice, fostering critical reflection about relational practices, and fostering a commitment to individual and collective action to address stigma. Cracked is well-positioned to respond to urgent calls for culture change, which include reducing societal misconceptions and stereotypes around dementia and promoting inclusive and meaningful engagement of persons living with dementia across all levels of society.

Success in the Polio Eradication Initiative now hinges on a very few endemic countries. Maximising household vaccination in these places is key. Evidence suggests that while vaccinator performance generally, and physical access related to security, create blockages in the vaccination supply-side, unwillingness to be vaccinated by small groups of households and communities constitutes the principal demand-side barrier. The question is why. Culture has been treated as a dominant factor determining resistance to vaccination in the global programme. Resistance, often occurring in areas with substantial Muslim population, has been associated with fear and rumour fuelled by ignorance, and religious objectionproblematically merged in a religio-cultural interpretation of resistance as a kind of Islamic obscurantism. Yet attitudes to the polio programme appear to vary substantially within small geographic areas. Rather than being a matter of common belief, public orientation appears to be shaped by a combination of religio-cultural and more localised socio-economic and political factorsin particular, the potentially aggressive nature of mass vaccination, and the perceived under-supply of other development goods. Interpreting resistance to vaccination as essentially religio-cultural marginalises an understanding of resistance as the rational and strategic response by households and communities to systematic conditions of inequity and exclusion.

Weight-based oppression, including negative attitudes about body weight, and harassment, stigma, and discrimination based on body weight, is a widespread phenomenon that leads to considerable distress and poor health and wellbeing outcomes. Conversely, body positivity is a multi-faceted concept that encompasses body acceptance, body appreciation, and body love, and adaptive approaches protective of health and wellbeing. The aim of this study was to evaluate the impact of a brief health promotion activity informed by Health at Every Size ® and critical health promotion principles on body positivity and internalized weight-based oppression in female students at Qatar University. A quasi-experimental mixed methods pre-post evaluation design was used, with quantitative assessment of body positivity and internalized weight-based oppression before the activity, immediately afterwards, and 10 weeks later, and qualitative assessment at the 10-week follow up. Measures used were the Body Appreciation Scale 2, Modified Weight Bias Internalization Scale, Fat Attitudes Assessment Toolkit Size Acceptance and Self Reflection on Body Acceptance subscales, and an open-ended questionnaire. Body acceptance and appreciation increased significantly after the activity. Qualitative results suggest that these improvements were sustained at follow up. Brief Health at Every Size ® informed health promotion activities show potential to improve health and wellbeing.

In Ethiopia, microfinance programs are currently being promoted by the government as well as nongovernmental organizations (NGOs) as a solution strategy for simultaneously addressing both poverty alleviation and women's empowerment. However, only a limited number of researches attempted to explore the relationship between women's participation in microcredit programs and their empowerment by using empirical data. To fill this gap, we conduct a cross-sectional study with overall aim of assessing the role of Micro finance institutions (MFI's) on women's empowerment. We employed a multi-stage sampling approach and a total of 374 women's, 182 (Micro finance institution) MFI clients and 192 non-clients were included in to study. Using a structured questionnaire adopted from the 2011 Ethiopian demographic health survey, we collected data on background characteristics of women's and their household and characteristics specific to women's empowerment.

Informed by the theory of the social construction of reality, this paper examines media framing of the tobacco issue in the United States over time. A comparative analysis reveals that both the New York Times and the Wall Street Journal defined the situation in the same manner -that smoking was associated with cancer and other illnesses, and that smokers should assume responsibility for smoking. However, although the New York Times coverage became less supportive of the tobacco industry over time, the Wall Street Journal supported the tobacco industry both over the 1964 Surgeon General's report and during the 1998 Minnesota trial. This suggests that ideology may play a role in the framing of reality.

Introduction: Fibromyalgia is a common condition characterized by widespread pain and debilitating symptoms. It is a complex, varied and unpredictable condition, which can frustrate and complicate the relationship between patient and practitioner. There is currently little evidence regarding fibromyalgia patients' perspectives on physiotherapy in the United Kingdom (UK). Objective: To investigate the experiences of physiotherapy from the perspective of people with fibromyalgia in the UK. Methods: A UK-based mixed-methods survey gathered broad-ranging data from 941 people in the UK with fibromyalgia, regarding living and working with, and being diagnosed and treated for the condition. Qualitative data regarding experiences of physiotherapy were extracted from the full survey dataset, which included responses from 205 participants. Results: Thematic analysis generated two themes, each with two subthemes. "Access to the Physiotherapist: 'The Long and the Short of It'&q...