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Introduction

The overall aim of this volume is to enable the reader to examine how health is conceptualized in various ways and how it is understood from a variety of disciplinary perspectives (terms in bold appear in the Glossary at the end of the book). Health studies is a distinct discipline in its own right, which attempts to explore all of the factors that can and do influence health, while examining the very meaning of health itself, which is the starting point for this book in chapter 1. As the scope of health studies is extremely large, this book will enable the reader to focus upon the central tenets of health studies by exploring the human experience of health across several contexts; for example, community in chapter 9, the environment in chapter 10, the policy context in chapter 11 and the global context in chapter 12. The book also discusses critically and analyses the many factors that are influential in relation to health, such as the contemporary threats to health that are considered in chapter 2 and the individual characteristics considered in chapter 8. Indeed, as there are many diverse discourses that surround health, these are illustrated in detailed case studies throughout the chapters. Health studies is also interdisciplinary in its nature and so draws upon many different disciplines, including sociology (chapter 4), anthropology, (chapter 5), psychology (chapter 6) and health promotion (chapter 7). Through the examination of different disciplines and influences, health is shown to be overwhelmingly socially influenced, and is situated within a multi-disciplinary critical framework. The key strength of health studies as a discipline is its ability to synergise understandings and influences from a variety of fields, as chapter 13 clearly demonstrates. Indeed, another key aspect of the discipline of health studies is the scope of analysis that can be achieved across a variety of fields, aided by the examination of evidence and research findings, which are discussed in detail in chapter 3. Through easy to navigate interactive chapters this book also enables the reader to develop and enhance subject specific skills, such as the ability to compare health contexts and to understand the range of influences upon health (part III), the ability to draw upon research methodologies and to analyse research findings (chapter 3) and the ability to enhance theoretical understandings (part II).

Detailed outline of the book

This book is divided into three parts, which take readers on a journey through several specific areas related to health studies. The first part of the book, Understanding and Promoting Health, begins with three chapters that introduce the reader to key issues within the field of health studies. From the outset, these chapters encourage students to begin to think both critically and reflectively about health. Chapter 1 tackles the very complex question of What is Health? Readers are encouraged to consider the concept of health critically and in depth and to think deeply about a concept that is often taken for granted, by considering definitions and conceptions of health. Widespread understandings of health as the absence of disease are challenged through discussions drawing upon both lay and theoretical perspectives. The second chapter in this first part of the book gives a critical overview of the main contemporary threats, issues and challenges in relation to public health within the twenty-first century, considering a range of both communicable and non-communicable diseases, and broader threats such as climate change. This chapter also explores the ways in which these problems can be tackled through both prevention and treatment. The third and final chapter in this first part tackles the importance of research in relation to health and health studies. This chapter introduces students to the entire research process, discussing the methods and processes by which information about health is gathered, analysed and used. The chapter demonstrates that health can be investigated in a number of different ways, exploring both quantitative and qualitative approaches to researching health. The strengths and weaknesses of these different techniques for gathering data are also considered. Readers are also shown how to formulate questions about health and how to decide upon the most appropriate research approaches, with the chapter offering practical examples to support those working on dissertations.

The second part of the book is called Disciplinary Context and introduces the reader to four specific disciplinary areas that all have relevance and influence within the health-studies arena. Hence, this section introduces the reader to the disciplinary context in which health studies itself is located. By understanding this complexity of disciplines underpinning health studies at different levels, readers will be able to conceptualize the importance of a range of factors and influences upon health. Chapter 4 introduces students to the discipline of sociology, demonstrating what sociology as a discipline tells us about health being ultimately socially influenced. Social influences upon health are discussed through consideration of different theoretical perspectives and the social model of health. Chapter 5 focuses upon anthropological perspectives and concentrates upon the importance of culture as an influence upon health. The chapter discusses interesting examples of different cultural practices that affect health from across the world, considering how culture can be both positive and detrimental for health. The next chapter in this section, chapter 6, turns the reader’s focus to the discipline of health psychology and specifically, health behaviour. The chapter concentrates upon what health psychology has to offer in terms of understanding how people behave, the choices that they make and the risks they take with regard to their health. The reader is also given a critical discussion of why behaviour change is so complex. The final chapter in this section is chapter 7, which defines and illuminates the scope of the field of health promotion. The key values and principles of health promotion are illustrated and models of health promotion are both discussed and evaluated to provide a foundation for the final chapter of the book, which considers how to address public-health issues in detail.

The third part of this book considers a range of influences upon health, examining a number of determinants outlined in Dahlgren and Whitehead’s (1991) rainbow model, shown in the figure. This model is thirty years old but is still being referred to here because it is a seminal diagram, widely used to illustrate the importance of the relationship between individuals, the social conditions in which they live and their health outcomes. The model has informed research about health inequalities, determinants of health and their interrelationship since it was developed.

Chapter 8 begins with an exploration of individual characteristics in relation to health, drawing upon Dahlgren and Whitehead’s framework. Individual characteristics considered are developmental factors such as foetal experiences and age, constitutional factors such as genetic inheritance and social constructs such as gender (how concepts of femininity and masculinity influence health). Chapter 9 then examines the importance of social and community networks as determinants of health. Concepts such as social support, social capital and social dominance are evaluated in relation to and how they mediate health status. The features of healthy communities are also explored. Chapter 10 explores the physical environment to show how living and working environments influence and impact upon health. Chapter 11 provides the reader with an overview of social policy and then more specifically demonstrates that many facets of policy combine to influence and determine health in a number of ways. The chapter also discusses and evaluates health policy in depth. Chapter 12 examines health determinants within a global context because the global environment is important in determining some aspects of health. Hence, this chapter examines how being part of a global society affects health in both positive and negative ways, particularly in relation to globalization. The final chapter, chapter 13, synthesizes the perspectives that have been discussed throughout the book. Three detailed case studies are used to explain how understanding determinants of health can aid the development of public-health strategy and action. Critique of the Dahlgren and Whitehead determinants model is also provided to conclude the volume, alongside discussion of more recent models. Despite its seminal nature and widespread use, there have been criticisms of the rainbow model related to what it omits; for example, the importance of the global is not reflected within the imagery. This led to the development of an alternative by Barton and Grant (2006) incorporating the importance of the global ecosystem for human health within the imagery. Solar and Irwin (2010) then provided a diagrammatic framework for action on the social determinants of health, so this is also discussed in the final chapter.

Figure i.1 The Dahlgren and Whitehead determinants of health rainbow

Source: Dahlgren and Whitehead (1991)