Yes / New wave public health places an emphasis on exhorting individuals to engage in healthy behaviour with good health being a signifier of virtuous moral standing, whereas poor health is often associated with personal moral failings. In effect, the medical is increasingly being collapsed into the moral. This approach is consistent with other aspects of contemporary neoliberal governance, but it fuels moral panics and creates folk devils. We explore the implications and dysfunctional consequences of this new wave of public health policy in the context of the latest moral panic around obesity.

This dissertation examines how certain epidemic outbreaks become "global threats", that is, diseases that become the focus of international regulations and organized responses while others do not. To answer this question, this dissertation draws upon archival data collected at the World Health Organization (WHO) archives in Geneva, the Western Cape Archives in Cape Town, the British Library, British National Archives, the Wellcome Library Archives in London, and twelve qualitative interviews with senior global health actors in order to analyze five cases when disease threats were prioritized internationally as well as how these constructions patterned responses to outbreaks. I begin by exploring the formation of the first international disease controls in the 19th century, the International Sanitary Conventions, created to prevent the spread of three diseases- plague, cholera and yellow fever. I probe how these earliest conventions patterned responses to diseases covered under them and limited responses to those beyond their scope. Examining how these conventions transformed, I explore why the same disease priorities were maintained by the WHO in their International Sanitary Regulations of the 1950's. Finally, I analyze the transformation of the International Health Regulations in 2005 and its effects on the assessment of disease threat. This dissertation shows that three factors structure the construction of disease threat: epidemic orientalism, economic concerns and field dynamics. Epidemic Orientalism, a discourse motivating the construction of disease threat that first emerged in the 17th, 18th and 19th centuries, positioned the colonized world as the space from which Europe and the Imperial powers needed to be protected. This orientalist gaze prioritizes the control of diseases emanating from colonial sites that threaten international trade and commerce and has been re-inscribed in all past and present regulations. These factors explain how and why plague, cholera and yellow fever came to be maintained as the primary diseases of international concern until the 21st century. As the WHO has recently been challenged in its authority to manage disease threats, these two factors are also mediated by the WHO's manipulation of symbolic power within a new field of infectious disease management which conditions responses to outbreaks today.

No description available.

The thesis seeks to interrogate historically the relationship between multinational healthcare service companies and states in the pursuit of market-oriented reforms for healthcare. It constitutes a critical reading of the idea of globalisation as a concept with substantive explanatory value to analyse the causal role of multinational service firms in a commercial transformation in national healthcare service sectors. It analyses the development and expansion of commercial (for-profit) healthcare service provision and financing in the healthcare systems of OECD countries. The hospital and health insurance sectors in the US and UK are analysed as case studies towards developing this critical reading from a more specific national setting. The thesis contributes to developing a framework for analysing the emergence of an international market for trade in healthcare services, which is a recently emerging area of research in the social sciences. As such, it uses an interdisciplinary approach, utilising insights from health policy and international political economy. The research entails a longitudinal study of secondary and primary sources of qualitative data broadly covering the period 1975-2005. I have also made extensive use of quantitative data to illustrate key economic trends that are relevant to the changes in the particular healthcare services sectors analysed. The research finds a substantive shift in the mixed economy of healthcare in which commercial healthcare service provision and financing are increasing. However, while the internationalisation of healthcare service firms is a key element in helping to drive some of this change, the changes are ultimately highly dependent on state-level decision making and regulation. In this context, the thesis argues that globalisation presents an inadequate and potentially misleading conceptual framework for analysing these changes without a historical grounding in the particular developments of national and international markets for healthcare services.

The main objective of this thesis is to analyze the access of refugees to the right of health in Turkey. There are significant problems in the access of refugees to the available health services and there are no special health services designed to meet the needs of the refugees. Through field research in a city where refugees are settled, the problems related with the access to health services by refugees were examined. In a qualitative study design, this piece of research involved in depth interviews with health professionals, representatives of the NGOs working with refugees and refugees to understand the problems associated with the access of refugees to health services and the dynamics of the clinical encounter between the health professionals and refugees. The study has found that refugees cannot reach sufficient and appropriate health services in Turkey and their fundamental right of access to the right to health is not realized in practice. Moreover, it was found that the provision of health services is riddled with many difficulties, such as the lack of professional translators, the stereotypes common among health professionals about refugees. The legislation about health services and health insurance should be revised in a way to cover all asylum-seekers and to provide special health services for refugees such as comprehensive medical screenings on arrival and trauma and psychological counseling.

Vaccinations were noted as the top public health achievement in the 20th century (Centers for Disease Control and Prevention 1999). However, not everyone is getting vaccinated. Taking a sociological approach this study examined the extent to which African Americans, American Indian/Alaska Natives, and Latino populations received an influenza vaccination compared to whites at a micro and macro level from the 2009 Behavioral Risk Factor Surveillance System. Previous research on racial and ethnic health disparities, attitudinal difference, and other demographic characteristics are reviewed in the literature. The Behavioral Model of Health Services was employed as the theoretical framework for this study. The methods consisted of three levels of analysis beginning with multivariate logistic regression at the individual level, least squares dummy variable modeling (LSDV), and hierarchical logistic regression modeling to incorporate aggregate data from the 50 United States. The results from the logistic regression show African Americans and Latino respondents have lesser odds of receiving the flu vaccine compared to whites after controlling for medical costs, access to health care, and a variety of socio-demographic characteristics. Results also show American Indian/Alaska Natives had greater odds of receiving the flu vaccine compared to whites after introducing similar control variables. Least Squares Dummy Variable Modeling controlled for the effects states have on receiving a flu vaccine. The results presented were African Americans and Latinos have significant lesser odds of receiving the flu vaccine compared to whites. While American Indian/Alaska Natives had greater odds of receiving a flu vaccine compared to whites, statistical significance was lost once states were used as control variables. It was also found 13 states had greater odds and 13 states had lesser odds of receiving the flu vaccine compared to North Dakota. Hierarchical logistic regression models examined the influence of state level covariates on the odds of individuals receiving the flu vaccine, and the results indicated that African Americans and Latinos had lesser odds of receiving an influenza vaccine compared to whites, but American Indian/Alaska Natives were found to have greater odds compared to whites, with the results not being statistically significant. The implications of these results are discussed.

Many Thai scholars are skeptical that Thai medical doctors can utilize knowledge and skills in Thailand from experience acquired when they study abroad, due to cultural differences, including a hierarchical culture that places importance on seniority and can prevent medical doctors seeking to actualize those new skills when they return to work in Thailand. Despite growing interest in and study of globalization, there are few existing studies that explore the relationship between social and individual consequences of formal study abroad programs. Nor are there many studies that apply sociological theory on the professions to less developed countries, or that focus on the relationship between power and culture in medical education in Thailand. This thesis will explore these topics by first reviewing and discussing three main bodies of sociological literature on medical professionalization, educational institutions, and study abroad. Given the gaps in the literature, it proposes a comparative study that relies on in-depth interviews with two groups of Thai medical doctors: those who have studied abroad and those who have not. The comparative design will allow the researcher to gain leverage on the consequences of study abroad to individual career trajectories, as well as the broader healthcare system, and contributes to the building of new sociological theory. Despite the many challenges that Thai doctors who go abroad face in adapting and actualizing new skills, I hypothesize that study abroad alters Thailand’s social hierarchy through the creation of a new class of “international doctors,” endowed with new skills, knowledge and cultural capital. While the benefits of belonging to this elite class may not be manifested immediately, due to the seniority system, they become apparent over time.

Indiana University-Purdue University Indianapolis (IUPUI) / Current research on medical students' death experiences is either outdated or produces conflicting results. This research aims to address these issues by analyzing in-depth interviews in order to explore how medical students view and cope view death. The sample consists of twenty third and fourth year students attending a large Midwestern medical school. Grounded theory analyses techniques of line-by-line coding were used to analysis the interviews. The study revealed that students predominantly cope with patient death by talking and that contrary to much of the findings of previous research concerning medical socialization and physicians, students do not always view death as a failure. Beyond the students' death experiences, the study also captured students' perceptions and reactions towards various socialization stages in their medical careers, such as gross anatomy lab. Student beliefs as to what constitutes a good and bad death are also explored as well as their attitudes towards physician assisted suicide. Although these findings are not generalizable to any medical student population, they do provide important qualitative information as to how medical students experience and cope with death.

No description available.

Cuba's community-based health care system is both internationally renowned and the signature of the Cuban revolution. Since the time of Cuba's catastrophic economic crisis known as the Special Period in Time of Peace, the health care system has been closely linked to the state's political legitimacy and the nation's economic development. The Special Period also led to the state's self evaluation of institutional practices in health and social sectors. Lack of disability services and resources to meet the needs of individuals with disabilities and their families was a key finding of the state's assessment. The intent of this study is to present how, during Cuba's Post Special Period, structure and culture come together to help in understanding the subjective experiences of women who care for their children with disabilities in a specific context, the community of Cardenas, Cuba. The experiences of women who mother their children with disabilities were examined through survey, semi-structured interactive interviews and observation of mother-professional interactions in the rehabilitation gym of El Centro de Rehabilitacion y Neurodesarrollo, the site where this study was conducted. This study shows that structural and cultural conceptions of disability, gender, and the authority of health professionals are reflected in how mothers understand their children's conditions, enact their roles as mothers, and navigate institutional arrangements. The dominance of Cuba's health care within the society strongly influences the construction of disability as strictly a medical phenomenon. The continuation of significant structural economic constraints clearly has an impact on the methods mothers use to gain resources for their children and access services. Cultural expectations that mothers with children with disabilities embody traditional "good mother" archetype contradict the state's legislated position of gender equality. This study reveals group differences in how mothers accept or reject the dominant discourse surrounding disability by examining how they explain their children's conditions, the visions they hold for their children and their role in promoting their children's progress. Within group differences are explained by individual location in the social structure, class. The three different approaches that mothers take on in the care of their children are described as provincial, community or cosmopolitan. These categories are distinguished by mothers' educational level, geographical location and their access to material and informational resources. We can conclude that Cuba's economic crisis and a recovery plan that included capitalist initiatives played a role in augmenting economic stratification, resulting in a new but somewhat hidden class structure within this socialist nation. Thus the everyday lived experience of mothers who care for their children with disability in Cuba is influenced by the society's structural and cultural arrangements. / Sociology