Digital technologies and the biomedicalisation of everyday activities: The case of walking and cycling

Walking and cycling have been transformed by digital technologies, which range from mapping apps for wayfinding, through ‘wearables’ which monitor activity, to social media apps for comparing activity within social groups. Some technologies are explicitly orientated to health projects, others are not, yet all have potentially profound effects on bodies, health‐orientated identities, and understandings of health. This paper uses the concept of biomedicalisation to explore emerging literature on the intersection of digital technologies with everyday mobility, focusing on walking and cycling. Beyond simply ‘medicalising’ mobility (by bringing it into the realm of public health), digital technologies contribute to various transformations of health: encouraging some health practices, inhibiting others; creating or excluding individual and collective health‐related identities; and reconfiguring health and well‐being. There is research evidence on the contingent and multiple relationships between digital technologies and social practices, with specific themes including quantification; the role of apps in framing walking as extraordinary, cycling as competitive; enabling users to perform as healthy, neoliberal citizens; and digital careers. There has been less attention on how social divisions are reproduced or disrupted by the mediation of mobility through digital technologies. Further research should consider the impact of digital technologies on political economies of health.     

Health activism and the logic of connective action. A case study of rare disease patient organisations

This exploratory work investigates the role of digital media in expanding health discourse practices in a way to transform traditional structures of agency in public health. By focusing on a sample of rare disease patient organisations as representative of contemporary health activism, this study investigates the role of digital communication in the development of (1) bottom-up sharing and co-production of health knowledge, (2) health public engagement dynamics and (3) health information pathways. Findings show that digital media affordances for patient organisations go beyond the provision of social support for patient communities; they ease one-way, two-way and crowdsourced processes of health knowledge sharing, exchange and co-production, provide personalised routes to health public engagement and bolster the emergence of varied pathways to health information where experiential knowledge and medical authority are equally valued. These forms of organisationally enabled connective action can help the surfacing of personal narratives that strengthen patient communities, the bottom-up production of health knowledge relevant to a wider public and the development of an informational and eventually cultural context that eases patients’ political action.     

Racial projections: cyberspace,public space,and the digital divide

Scholars of critical race studies, urban history, and information and communications technologies (ICTs) share an interest in the relationship between spatial and racial disparities, including the quality of basic infrastructure, degrees of connectivity, and participatory culture. However, contemporary research on the digital divide struggles to link historical legacies of uneven development, as well as social justice strategies, with digital participation in urban spaces. By examining contemporary digital art that critiques the spatial inequalities encountered by U.S. racial minorities, this article illustrates how public intellectuals use ICTs in ways that draw upon past strategies to territorialize space for political ends. It focuses on digital pop-ups, open-air installations that cast images onto public space using projectors. Historicizing these new efforts illustrates a continuity of tactics engaged by communities of color in response to socio-spatial inequalities in the urban United States, such as the 1970s mural movement’s efforts to re-politicize spaces of exclusion. While existing literature finds that digital inequality results in differential digital human capital, this research indicates that place-based claims, such as digital pop-ups, are important sites for combatting racial injustice and creating more inclusionary spaces, especially among youth adults.     

Crisis and public intellectuals: From the transnational intellectual field to the digital global public circuit

We examine the modes of intervention of global public intellectuals at times of crisis. In critical situations, public intellectuals take positions on matters that affect the societies they inhabit and, eventually, all humanity. To this end, they take advantage of the opportunities afforded by new communications technologies, establishing an important distinction between the “analog” intellectual (who relies on the slow time of books, opinion columns, and bookstores) and the “digital” intellectual who uses modern information and communications technologies. To study the activities of global public intellectuals and their political influence, we propose to leave aside the notion of “transnational intellectual field” in favor of an understanding of a transnational intellectual stage peopled by a certain type of intellectual agent whose symbolic and cultural production is disseminated through a digital global public circuit. To illustrate the functioning of a circuit of this type, we take the example of the Project Syndicate platform.     

Interactive Health Communication Technologies in the Public Health Sector: Positive Perceptions Still Outpace Actual Utilization

ABSTRACT

Effective population-based and patient-centered public health care is highly dependent on timely and reliable health-related information. The continuous growth and availability of health-related information brought about by the emergence of a new digital communications environment offers a range of opportunities that facilitate access to useful health information for the public health sector–for providers as well as patients. Such advancements, however, can only be realized if public health professionals are knowledgeable about existing sources of online health information, have the ability to successfully judge the reliability of online health information, and are able to acquire the information in a timely and efficient manner. This research follows on the heels of a survey of public health professionals in New York State that concluded that limited access and knowledge negatively impacted utilization of interactive health communication technologies. In this study, a survey was administered to providers at a large county health department located in central Michigan. Results indicate that perceptions regarding the advantages of online health information still far outweigh actual utilization. Barriers to actual utilization include lack of easy access to computers with high-speed connections, trusted and timely online information, training and staff development issues, and organizational policies concerning computer access and usage.     

Medical tourism: reverse subsidy for the elite

The medical tourism sector in India has attracted global attention, given its phenomenal growth in the past decade. India is second only to Thailand in the number of medical tourists that it attracts every year. Estimates indicate that the medical tourism market in India could grow from $310 million in 2005 to $2 billion by 2012. These figures are significant when contrasted with India's overall health care expenditure - $10 billion in the public sector and $50 billion in the private sector. Factors that have contributed to this growth include the relative proficiency in English among health care providers and the cost effectiveness of medical procedures in India. Generally, most procedures in Indian hospitals cost a quarter (or less) of what they would cost in developed countries. The expansion of medical tourism has also been fueled by the growth of the private medical sector in India, a consequence of the neglect of public health by the government. India has one of the poorest records in the world regarding public financing and provisioning of health care. A growing driver of medical tourism is the attraction of facilities in India that offer access to assisted reproductive care technologies. Ironically, this is in sharp contrast with the acute neglect of the health care needs of Indian women. The Indian government is vigorously promoting medical tourism by providing tax concessions and by creating an environment enabling it to thrive. However, there is a distinct disjunction between the neglect of the health care needs of ordinary Indians and public policy that today subsidizes the health care of wealthy foreigners.     

The self in selfies—Conceptualizing the selfie-coordination of marginalized youth with sociology of engagements

This article develops a theory of selfies as reflexive practices of self-coordination. Building on pragmatist sociology of engagements, I conceptualize selfies as digital practices of coordinating with the self in formats that are recognizable for others. This framework allows approaching the self as an act of coordination, simultaneously shaped by, and equipped to subvert the cultural conditions of how we ought to be. As these conditions are increasingly enforced and negotiated in the socio-technological arrangements of digital platforms, the article proposes an approach for making sense of selfies as key contemporary tools of self-making. Based on ethnographic work among activists with marginalizing experiences, I ask how the self is coordinated in the activists' selfies. I identify four ways of coordinating with the self in selfies: the self in a plan, the self in exploration, the affirmed self, and the self as public critique. The article contributes to our understanding on how practices of self-making evolve in an increasingly visual-digital society, and provides an approach for conceptualising the self as plural. By approaching the selfie as different formats of relating to the self, the framework proposed accounts for the possibility of multiple selves now afforded by digital technologies and enables analysing their politicizing potential.     

The power reinforcement framework revisited: mobile technology and management control in home care

Whereas digital technologies are often depicted as being capable of disrupting long-standing power structures and facilitating new governance mechanisms, the power reinforcement framework suggests that information and communications technologies tend to strengthen existing power arrangements within public organizations. This article revisits the 30-year-old power reinforcement framework by means of an empirical analysis on the use of mobile technology in a large-scale programme in Danish public sector home care. It explores whether and to what extent administrative management has controlled decision-making and gained most benefits from mobile technology use, relative to the effects of the technology on the street-level workers who deliver services. Current mobile technology-in-use might be less likely to be power reinforcing because it is far more decentralized and individualized than the mainly expert-dominated and centrally controlled technologies that were the main focus of the 1970s and 1980s studies. Yet this study concludes that there is general support for the reinforcement framework in the contemporary application of mobile technology in public sector home care.     

Automation: is it really different this time?

This review examines several recent books that deal with the impact of automation and robotics on the future of jobs. Most books in this genre predict that the current phase of digital technology will create massive job loss in an unprecedented way, that is, that this wave of automation is different from previous waves. Uniquely digital technology is said to automate professional occupations for the first time. This review critically examines these claims, puncturing some of the hyperbole about automation, robotics and Artificial Intelligence. The review argues for a more nuanced analysis of the politics of technology and provides some critical distance on Silicon Valley's futurist discourse. Only by insisting that futures are always social can public bodies, rather than autonomous markets and endogenous technologies, become central to disentangling, debating and delivering those futures.     

Medical Innovations: Their Diffusion,Adoption, and Critical Interrogation

The 1950s and 1960s were a ‘golden age’ of medical progress: an era of high expectations, widespread faith, and life‐saving innovations. In the 1970s, as it gradually became clear that medicine's technological advance also contributed to the rising costs of health care, policy makers began to question the ways in which new technologies diffused. Sociologists soon found that professional and institutional interests, the search for competitive advantage, and processes of ‘institutional isomorphism’ played major roles. By the end of the millennium, as a result of growing patient (and ‘health care consumer’) activism, and of globalization, the context in which new technologies were developed, introduced, and used had become politicized, and technologies had become more heterogeneous. The patient perspective offered a new vantage point from which to study medical technology in use, and one which fitted many sociologists' normative and methodological commitments. Many recent sociological studies highlight failures, contradictions, and the (often concealed) interests involved in the promotion of new drugs and other medical technologies. However, resources for studies aligned with dominant interests, perspectives, and claims are more readily available.     

The “Obesity Epidemic”: Evolving Science,Unchanging Etiology

“Obesity epidemic” discourse relies on scientific and epidemiological research to justify subjecting certain bodies to healthist messaging and disciplinary technologies. The science and framing of obesity has evolved, potentially partially due to critical obesity scholars. However, critical obesity scholars are now reliant on outdated critiques of ever progressing evolving/adapting discourse. Recent discoveries have been made concerning the determinants of obesity and the complexity of weight loss. Scientific discourse often now references environmental factors as contributors to obesity, low levels of sustained weight loss, and limitations of common measures such as the body mass index. Despite this refinement, the ultimate conclusion of studies, as presented within the scientific articles or in related media reportage, remains unchanged. Individuals are still expected to attempt to “correct” their non‐normative bodies through lifestyle changes, regardless of the evidence underscoring the likely futility of these endeavors. This paper updates obesity science and public health responses and evaluates the extent to which new findings, with the potential to greatly subvert standard weight loss advice, have altered supposedly evidence‐based public health communications and recommendations. As emerging scientific insights have further muddied already‐complex obesity‐related pathways, solutions have largely remained the same.     

The Medical Assessment of Migrants: Current Limitations and Future Potential

Attempts to control the importation of infectious diseases through the medical screening and evaluation of immigrants and refugees represent the modern application of some of the earliest recorded public health interventions.
States with long-standing immigration programmes continue to require the medical examination and screening of migrants for certain diseases. In some instances, the public health effectiveness of these immigration medical assessments is of questionable value when considered from a population health basis.
This article reviews current practices and describes recent studies where more modern and epidemiologically based immigration medical interventions have been undertaken. A more effective immigration medical assessment process is proposed through the use of results of this more empirical approach to immigration medical screening.     

All the News that’s Fat to Print: The American “Obesity Epidemic” and the Media

In the last twenty years scientific, medical, and public health interest in obesity has skyrocketed. Increasingly the term “epidemic” is being used in the media, medical journals, and public health policy literature to describe the current prevalence of fatness in the U.S. Using social scientific literature on epidemics, social problems, and feminist theories of the body, this paper traces the historical emergence of the “obesity epidemic” through an analysis of 751 articles on obesity published in The New York Times between 1990 and 2001. Through the identification and analysis of three discursive pairings I argue that the “obesity epidemic” is a part of a new breed of what I call “post-modern epidemics,” epidemics in which unevenly medicalized phenomena lacking a clear pathological basis get cast in the language and moral panic of “traditional” epidemics. I show how this moral panic together with the location of the problem within the individual precludes a more macro level approach to health and health care delivery at a time when health care services are being dismantled or severely cut back.

Standby Mothering: Temporalities,Affects, and the Politics of Mobile Intergenerational Care

ABSTRACT

In this paper, I showcase how left-behind mothers in the Philippines use digital communication technologies in delivering care to their overseas adult children in Melbourne, Australia. As part of a broader research project on transnational family life, the findings were drawn upon in-depth interviews, visual methods, a simple participant observation, and field notes taking and analysis. The study deployed a mediated mobilities lens, paying close attention to the different forces that shape the provision of intergenerational care through mobile device use. Building upon a critical analysis of the digitalization of intergenerational relationships in a transnational context, I coin the term ‘standby mothering.’ This conception encapsulates the femininized, ubiquitous, networked, and ambivalent intergenerational care practices that are experienced and negotiated by distant mothers. On the one hand, mobile device use enables left-behind mothers to deliver emotional and practical caregiving. On the other hand, everyday temporal conditions and technological barriers impede the provision of intergenerational care. Communicative constraints are constantly managed through various tactics, ensuring the sustenance of transnational relationships. By interrogating the contradictory outcomes of transnational caregiving, I underscore the politics of mediated mobilities in a digital society. Here, the mobilization of gendered, networked, and differential care practices is influenced by uneven structural and even socio-technological dimensions. Ultimately, this paper elucidates a critical stance on re-examining the provision of informal, gendered, and networked care practices.     

Media, ‘Fat Panic’ and Public Pedagogy: Mapping Contested Terrain

Discourses regarding a ‘global obesity crisis’ and alternative frames (e.g. weight‐inclusive approaches to health) have proliferated through various media of communication. These media range from traditional print and visual formats (e.g. newspapers and television shows) to digital media (e.g. Twitter, Facebook, YouTube), which enable different publics to produce, and not just consume, text, images and other data relating to the body. Reflecting a sociological understanding of educational practices as extending beyond formal schooling, mediated obesity discourse and counter‐movements have also been conceptualised as public pedagogies, which instruct people how to relate to their own and other's bodies, health and subjectivities. This article examines what is critically known about various media at a time when governments and agencies are reinvigorating the global war on obesity, with populations being ‘advised’ to become and remain conscientious weight watchers. In conclusion, the article underscores the salience of social studies of the media when seeking to rethink obesity, incorporating critical reference to moral panic theory and the need to better understand what media can ‘do’ as enactments of public pedagogy.     

Contemporary Epidemiology: A Review of Critical Discussions Within the Discipline and A Call for Further Dialogue with Social Theory

The discipline of epidemiology, which holds major influence on public health policy as well as on clinical medical practice, has in recent decades to a large extent been concerned with the identification of factors and markers of risk for disease. Much health information and intervention is thus informed by a wealth of studies on a variety of risk factors, of which the individual is encouraged to keep informed and to be responsible about. Meanwhile, risk factor epidemiology has been subject to intense debate, both within and outside the discipline. The following review offers an overview of critical intradisciplinary debates. It then opens discussion on three partially overlapping areas where social theory has been called upon to contribute to epidemiological inquiry, namely analysis of macro‐social determinants of health and disease, of categories of human difference and of embodiment. The review ends with, and is motivated by, a plea for further integration of and dialogue between epidemiology and social theory.     

Knowledge,boundaries, and bodies: Social construction between medical sociology and science and technology studies

Medical sociology and science and technology studies (STS) emerged from different positions, but often closely related concerns, within the broad discipline of sociology. Their interface and areas of overlap have mostly been shaped by theoretical positions broadly considered “social constructionist.” Taken together, these perspectives provide empirical and theoretical tools to analyze important questions about how social inequalities, forms of scientific knowledge, and patterns of human health come to be produced and feedback into one another. Examining their intersection enables sociological questions such as: How is medical and public health scientific knowledge produced, stabilized, and taken as fact? How are scientific facts about health and illness used, experienced, and challenged? What is the relationship between health inequalities and public health or medical knowledge? This article seeks to briefly trace the important contributions that social constructionist research has made at the interstices of medical sociology and STS, further clarifying the history, points of intersection, and areas of diversion between them. The current COVID-19 pandemic has unveiled the political struggles that constitute public health scientific knowledge and circulation. The interface between STS and medical sociology can help us to make sense of the interrelationships between politics, power inequalities, and public health scientific knowledge.     

The Internet of Things: Social dimensions

The Internet of Things (IoT) is a vast, dispersed system in which a diverse array of objects, humans, and other living things is connected via “smart” technologies and the Internet. In this article, I present a thematic review of the literature that focuses on the social dimensions of the IoT. Drawing on research published in sociology, anthropology, cultural geography, critical urban studies, science and technology studies, environmental studies, and human–computer interaction studies and design, I outline key conceptual approaches and then discuss four major themes emerging across these dispersed but cognate literatures: (a) techno‐utopian imaginaries, (b) risks and harms, (c) lived experiences, and (d) interventions into futures. As I show, to date, most of the social research literature has focused on the topics of smart cities and smart homes in the context of the Global North. Some researchers have begun to employ innovative methods to generate new and alternative ways of imagining IoT technologies. The article concludes with proposing directions for future research. These include directing more attention to publics' role in intervening in the futures of IoT, to applications of smart technologies beyond the smart city and home, and the IoT in the context of the Global South.     

Chapter 9: Disaster Consequence Management

SUMMARY

The critical element in a workplace approach to consequence management for disaster, terrorism and other critical incidents is the integrated planning and response across numerous workplace functions including human resources, employee assistance, security and facilities, medical, occupational health, wellness and work-life. These corporate functions ensure the performance, health, safety and human continuity of the workplace. In this model, workplace professionals charged with the human capital and continuity of their organizations play new crucial roles that require an understanding of (1) the integration of mental health into a public health approach for managing the psychological and behavioral implications of terrorism; (2) the integration of operational continuity planning with human continuity resources; and (3) the integration of workplace preparedness into the larger sphere of population health interventions for the 21st century. This new role of workplace health and productivity professionals is necessary to the health and resiliency of our global community and its citizens in the workplace and at home.     

Surgeon and Safari: producing valuable bodies in Johannesburg

This essay explores how concepts of value and cheapness circulate around the bodies of clients of the Johannesburg-based cosmetic surgery tourism company Surgeon and Safari. I show how the production of a luxurious experience and the mitigation of risk take place within a transnational network enabled by the presence of medical tourism in multiple locales. By placing Surgeon and Safari's activities within the context of the neoliberalization of health care in South Africa, I explore how the division between private versus public health spaces functions as both a technique of valuing clients' bodies and as a process of racialization.