Fiddling While Rome Burns? Conducting Health Research When The NHS Is In Crisis: Implications For Health Sociology
Bradford Institute for Health Research, United Kingdom
The NHS in the UK is said to be crisis, with many areas of the health service struggling to meet increasing demand with fewer resources. The deepening of this crisis over the past few years has led to a lack of healthcare staff on the ground, with increased pressure on those who remain in clinical practice. Consequently, health research is becoming increasingly difficult to conduct. This is having a demonstrable impact on the conduct and findings of health research with an intended health sociological output/remit. I draw on both my own and other research teams’ experiences in order to demonstrate that this difficulty is a near universal problem for the health services research community in the UK and is encroaching on the health sociology community. In doing so, I discuss the idea that recruitment and engagement issues across differing clinical environments are, in the literature, often erroneously ascribed as being related to individual context or setting. Rather, I propose that these problems are actually writ large across nearly the entire whole system of the NHS. I offer both macro and micro level ideas for what can be done to alleviate the worst of this situation. Macro, urgently increase healthcare spending to improve the conditions under which NHS staff are working. Micro, health sociologists may need to employ more pragmatic, rapid methods to engage exceptionally busy healthcare staff. Throughout, I use the Great Fire of Rome as an allegory to understand the above situation.
The Valuation of Mental Health. Approaching Valuation Studies through the case of "Parity of Esteem" in England
Department of Anthropology, London School of Economics
This paper explores the valuation of mental health based on the notion of Parity of Esteem between mental health and physical health, as recently adopted by the UK Government and the NHS England. How, and to what extent, has “mental health” come to count as being of value for the English authorities through the creation and use of the notion of Parity of Esteem? How has this value been legitimized and what does it mean in practical terms? Through such questions, this paper brings to light some critical points in the way Valuation Studies have been thought by scholars of the movement. It ultimately questions what the Parity of Esteem study of valuation reveals about theoretical and methodological assumptions made by scholars of the Valuation Studies movement. Subsequently, it seeks to identify the limitations of this perspective and consider if there is a way forward for the study of valuation from an anthropological and critical viewpoint.
It first examines the place of Valuation Studies in the literature on value and takes up the study of Parity of Esteem on a theoretical level. It then explores the valuation process of Parity of Esteem through the Valuation Studies perspective, discussing, in particular, the use of standardized, quantifiable and technocratic language and the politics of knowledge in such operations, while inquiring into the subsequent limitations for Valuation Studies. It finally draws attention to several critical aspects of the study of valuation and the way it has been approached by scholars of Valuation Studies.
Post-Trauma: Healthcare Practitioners’ Social Media Use during Times of Political Tension
1David Yellin Academic College, Jerusaem, Israel; 2Western Galilee Academic College, Akko, Israel
The theoretical approach of context collapse and the notion of unintentional context collisions are of importance to scholars of social media. Israeli public hospitals are a particularly suitable venue for studying these topics, as they employ both Jewish and Arab practitioners, who care for both Jewish and Arab patients amid an ongoing violent conflict. In-depth interviews were conducted with 50 managers and healthcare practitioners (physicians and nurses), both Jewish and Arab, employed at 11 public hospitals in Israel. Findings show that despite hospital managers’ instructions to avoid political discourse, it erupts nonetheless whenever the Israeli-Palestinian national conflict escalates. Fearing damage to professional relations and care of patients, political discourse spills over into social media (primarily departmental WhatsApp groups and practitioners’ personal Facebook accounts), where political opinions are expressed mostly by Arab practitioners and stereotypical attitudes against Arabs are expressed mostly by Jewish ones. Reactions to the posts reverberate in the wards, disrupting the fragile relations among the mixed teams. Generally speaking, healthcare organizations are based on the ethos of neutrality. Consequently, political discourse in social media platforms is considered particularly sensitive and problematic, demanding specific policies for appropriate handling. Nevertheless, many of the legal and ethical issues associated with social media use in the health professions remain rather obscure. This study exemplifies the usefulness of the context collapse approach—focusing specifically on unintentional context collisions—in workplaces, especially healthcare organizations, that cope with these challenges.
The Institutional Agency Of Cancer Screening: Does It Matter For The Education Gradient In Cancer Screening Participation?
Ghent University, Belgium
Background: While there is a growing literature that examines how cross-national differences in health inequalities are related to variations in the provision of welfare across Europe, the study of inequalities in preventive healthcare use from this point of view is rather scarce. Also for cancer screening, it remains poorly understood why educational inequalities in cancer screening participation vary across European countries. In the current study, we draw on an institutional approach to identify which specific healthcare system factors and cancer screening policies affect the association between people’s educational attainment and their participation in cervical, breast and colorectal cancer screening.
Methods: Data from 16 EU-countries were obtained from two successive cross-sectional waves (2006-2009; 2013-2015) of the European Health Interview Survey (EHIS). Final samples consisted of 108,382; 57,445; and 114,260 individuals for cervical, breast and colorectal cancer screening, respectively. To estimate the logistic regression coefficients and cross-level interactions, a three-level multilevel design was applied with individuals nested within country-periods and countries.
Preliminary results: People with higher levels of education have a higher probability to participate in cervical, breast, and colorectal cancer screening than their counterparts. The results highlight the importance of the institutional context, with this education gradient in cancer screening participation being significantly smaller in countries with an organised screening programme, high expenditures on social protection and healthcare as well as low levels of out-of-pocket-payment, income inequality and gender inequality.
Conclusion: Health policy makers should be aware of the fact that in addition to service-specific policies, countries’ broader institutional setting play a key role as moderator in the influence of educational attainment on preventive healthcare use.
Mindfulness: Secular or Religious (and why it matters)?
Cardiff University, UK
Highly abstract yet deeply embodied notions such as mindfulness, presence, and stillness have gained considerable currency in modern western societies. Despite its ubiquity however, the mindfulness movement has so far garnered little attention from the social sciences. Our current understanding of this milieu thus remains dominated by research based on randomised controlled trials that are focused primarily on the health benefits of mindfulness practice alone. In an effort to expand our sociological appreciation of this contemporary trend, this paper will draw on a three-year project titled 'Mapping Mindfulness in the UK' (Leverhulme Trust) and present a social cartography of the people, places, and practices that constitute the mindfulness milieu today. Drawing on 400 survey responses and 30 interviews with UK-based mindfulness teachers, as well as ethnographies and focus groups with key stakeholders in the field, I will present original empirical evidence into (1) the social make-up of the people at the forefront of the UK mindfulness milieu; (2) how they define and engage in a fully committed mindful life; and (3) the extent to which they identify mindfulness as a secular or religious practice. Taken as a whole, I illustrate how mindfulness now offers a unique platform for a great deal of spiritual work in mainstream public institutions, and discuss the wider implications of such trends for the modern co-evolution of social movements in health and religion.