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The controversy over vaccines, which has recently intensified following the COVID-19 pandemic, provokes heated debates, with both advocates and opponents raising allegations of bias and fraud in research. Researchers whose work raises doubts about the safety of certain vaccines claim to be victims of discriminatory treatment aimed at suppressing dissent, including the unjustified retraction of their published research. Such practices have previously been discussed in other controversial fields in science (e.g., AIDS, the environment, and water fluoridation) but not in the field of vaccines. The purpose of this study was to analyze, for the first time, the subjective views of researchers whose papers were retracted. Study participants are active researchers, most with international reputations in their respective fields. They perceived retraction as a means of censoring and silencing critical voices with the aim of preserving the pro-vaccination agenda of interested parties. Participants also reported additional measures aimed at harming them personally and professionally. These findings point to the need for a fair, open, and honest discourse about the safety of vaccines for the benefit of public health and the restoration of trust in science and medicine. [ABSTRACT FROM AUTHOR]

Scotland is faced with pernicious health inequalities, which stem from inequalities in living conditions and the societal structures that create them. While action is needed to address the wider structural causes of health inequalities, the role of general practitioners (GPs) merits attention due to health care's potential to mitigate or exacerbate health inequalities. Minimal research, however, has explored how GPs understand the fundamental causes of health inequalities nor how they conceptualise their role in mitigating these. This paper aims to fill this gap using in-depth qualitative interviews with 24 GPs working in some of Scotland's most socio-economically disadvantaged, urban areas. Using Raphael's SDH discourse framework, this paper found clear linkages between GPs' perceptions of their patients, how they defined the 'problem' of health inequalities, and what they thought could be done to tackle them in disadvantaged areas. In general, there was convergence on how interviewees viewed their role in mitigating health inequalities through their work with individual patients. However, greater variation was found when describing the boundaries of their role and how far these extended beyond individual encounters. Specifically, only those GPs fluent in discussing structural causes of health inequalities discussed obligations to change local systems via strengthening community linkages and to influence higher level policies related to the SDH. This suggests that while there is a degree of what Metzl and Hansen deem 'structural competency' amongst some GPs working in disadvantaged areas, the scope remains to deepen this competency more broadly. [ABSTRACT FROM AUTHOR]

Queer women have been elided from HIV discourse, in part due to heterosexist constructions of HIV transmission risk categories that omit women’s sexual orientation. In this paper, I reflect on presenting at two international HIV research conferences on queer women and their erasure from HIV discourse. I employ critical discourse analysis to conference interactions to investigate how my personal experiences as a queer woman presenting at these HIV conferences mirrored queer women’s marginalization in HIV research. Reactions to my presentations focused on dominant biomedical and neoliberal discourses that neglect social and structural drivers of the epidemic. These interactions also highlighted intersectional and compulsory heterosexism where the context, topics, and structures of discourse were called into question in ways that (re)produced queer women’s invisibility and institutional, social, and material exclusion. This paper calls for HIV researchers to integrate analyses of women’s complex sexualities and reconsider the purpose of knowledge production. [ABSTRACT FROM PUBLISHER]

In this paper, we examine a situated example of the media’s (re)production of shared understandings around smoking, pregnancy and health. Through a discursive lens, we address the way in which Australian media personality Chrissie Swan accounted, on radio, for her continued smoking while pregnant after photographic evidence of her tobacco use entered the public domain. We argue that Swan’s account of her smoking privileges a version of ‘the good mother’ as solely responsible for the health of her foetus, and right to feel ashamed when putting this at risk. A construction of smoking as a (medicalised, irrational) addiction enables her to manage a positive identity in the face of this construction: she presents as being ‘thwarted’ in her quitting efforts by a force beyond her control. Ultimately, we argue that the version of ‘good motherhood’ constructed in Swan’s account is paradoxical, and may serve both to support, and constrain, pregnant smokers’ capacity to sustain quitting behaviours over the long term. In turn, we argue that ‘moralising’ anti-smoking interventions aimed at pregnant women may be less useful than an approach that interrogates the range of socio-cultural expectations of ‘good motherhood’ by which pregnant women are simultaneously positioned. [ABSTRACT FROM AUTHOR]

This paper analyzes a form of community engagement that differs from the way it is usually conceived and practiced in the domain of global health. This story takes place in the Cuban context and more specifically in a recent programme of oncology clinical trials implemented in primary healthcare (PHC) centres. By considering both the genealogy of this program and local interactions between PHC professionals and patients and their close relatives, I show that, in the context of Cuban socialist biomedicine, community engagement emerges as an implicit practice that forms part of the PHC professional ethos. I explore the ways cancer biomedicine is adapted in order to address specific needs and demands related to public acceptance of cancer in the Cuban society, diagnostic communication and palliative care. I argue that the way community engagement is enacted within Cuban socialist biomedicine is alternative to the global health dominant paradigm since it does strengthen existing relations between citizenry, health professions and public health infrastructures. Finally, by questioning the specificity of such socialist approach to community engagement, I suggest it greatly contributes to global health literature, because it creates continuity within existing state infrastructures rather than bypasses them, and, furthermore, offers a unique vantage on the treatment of chronic disease. [ABSTRACT FROM AUTHOR]

The importance of community involvement in public health research processes is well established. The literature is, however, less forthcoming about processes of community inclusion in public health project implementation, especially when it comes to projects focusing on key populations. The Step Up Project is the first multi-city harm reduction service provision project for people who inject drugs in South Africa. Since inception, the Project has made concerted efforts to work with and alongside people who actively identify as people who inject drugs. This paper outlines two features in relation to project-beneficiary dynamics that emerged in a qualitative project evaluation conducted by an external researcher and a funder representative. The first was that people accessing the project comfortably expressed criticisms of both themselves and the project, and noted when their behaviour contradicted project ideals. The second was the extent to which engagement with the project was reported to be fostering a renewed sense of personhood and right to exist in the world. These findings are, we suggest, in principle related to two forms of community engagement: consistent empathic response and community advisory groups. This implies that programmes need to focus on their mode of approach as much as on the content of their approach. It further implies that programme impact not be limited to quantitative assessment measures. [ABSTRACT FROM AUTHOR]

Healthy eating campaigns that promote unprocessed foods to children using character licensing and fun appeals hope to offset the aggressive marketing of highly processed, unhealthy foods to children. Such campaigns are equally premised on the assumption that fruits, vegetables, and other whole foods are not desirable enough in the current food environment and must be marketed as child friendly to be appealing. This paper examines how children in Canada classify foods and whether they think of whole, unprocessed foods as ‘for them.’ Children aged 7–12 (n = 183) completed a survey asking them to classify various foods (fruit, vegetables, milk, eggs, beef, whole grains) as for ‘kids’, ‘adults’ or ‘both’. Most children classified these foods as for both adults and kids, suggesting that promotional initiatives to convince children that whole foods are uniquely children’s fare may not be necessary. Given the questionable efficacy of marketing whole foods as fun and ‘for kids,’ alongside the ethical stakes of commercializing childhood, we recommend that public health initiatives reject attempts to market whole foods as kids’ foods. Instead a key opportunity exists to emphasize the message that good food is for everyone – which is the most conducive to a building a healthy food environment and positive food habits across a lifetime. [ABSTRACT FROM PUBLISHER]

Since the 1980s, the primary public health response to injecting drug use in the UK has been one of harm reduction. That is, reducing the harms associated with drug use without necessarily reducing consumption itself. Rooted in a post-Enlightenment idea of rationalism, interventions are premised on the rational individual who, given the right means, will choose to avoid harm. This lies in stark contrast to dominant addiction models that pervade popular images of the ‘out of control’ drug user, or worse, ‘junkie’. Whilst harm reduction has undoubtedly had vast successes, including challenging the otherwise pathologising and often stigmatising model of addiction, I argue that it has not gone far enough in addressing aspects of drug use that go beyond ‘rational’ and ‘human’ control. Drawing on my doctoral research with people who inject drugs, conducted in London, UK, this paper highlights the role of the injecting ‘event’, which far from being directed or controlled by a pre-defined individual or ‘body’ was composed by a fragile assemblage of bodies, human and nonhuman. Furthermore, in line with the ‘event’s’ heterogeneous and precarious make-up, multiple ways of ‘becoming’ through these events were possible. I look here at these ‘becomings’ as both stabilising and destabilising ways of being in the world, and argue that we need to pay closer attention to these events and what people are actually in the process of becoming in order to enact more accountable and ‘response-able’ harm reduction. [ABSTRACT FROM PUBLISHER]

This paper argues that critical public health should reengage with public health as practice by drawing on versions of Science and Technology Studies (STS) that ‘de-centre the human’ and by seeking alternative forms of critique to work inspired by Foucault. Based on close reading of work by Annemarie Mol, John Law, Vicky Singleton and others, I demonstrate that these authors pursue a conversation with Foucault but suggest new approaches to studying contemporary public health work in different settings. Proposing that we ‘doubt’ both the unity of public health and its effects, I argue that this version of STS opens up a space to recognise multiplicity; to avoid idealising what is being criticised; and to celebrate or care for public health practices as part of critique. Finally I oppose the view that considering technologies, materials and microbes leads to micro-level analysis or political neutrality, and suggest that it allows us to reframe studies of public health to account for inequalities and to draw attention to weak or retreating states, active markets and the entangled relations of humans and non-humans across the world. [ABSTRACT FROM PUBLISHER]

Diagnosis constitutes a major categorisation tool in medicine. This paper adds to the paucity of knowledge about part of the work such a tool performs. It examines the ways in which diabetes epidemiology translates into attempts to prevent diabetes from occurring through screening and diagnosing, and then managing those categorised as ‘at high risk’. Using a qualitative design in the context of a small-scale Danish intervention study, the findings suggest that health professionals overinterpreted relative risk reductions and exaggerated treatment effects; simultaneously, prediabetics called into question the scientifically set thresholds. Nonetheless, arguments concerning changed behaviour’s benefits were sought to be incorporated into self-care routines. The data highlight how, by identifying a normatively set threshold, a diagnosis can determine health promotion messages’ impact in ‘high-risk’ prevention strategies. [ABSTRACT FROM PUBLISHER]

This paper is an analysis of the social interaction between drug sellers, their clients and local health care workers within a medical trial that introduced rapid diagnostic tests for malaria into private sector drug shops in Mukono District, Uganda. It locates the introduction of a new technology to test blood and a system of referral within the context of local concerns about the choice and evaluation of treatment; and the socially legitimated statuses, roles and hierarchies within the local health care system. Based on the multi-layered interpretation of 21 focus group discussions, we describe three key aspects of the trial central to local interpretation: openly testing blood, supervisory visits to drug shops and a new referral form. Each had the potential to shift drug shop vendors from outsider to insider of the formal health service. The responses of the different groups of participants reflect their situation within the health care system. The clients and patients welcomed the local availability of new diagnostic technology and the apparent involvement of the government in securing good quality health services for them from providers with often uncertain credentials. The drug shop vendors welcomed the authorization to openly test blood, enabling the demonstration of a new skill and newfound legitimacy as a health worker rather than simple drug seller. Formal sector health workers were less enthusiastic about the trial, raising concerns about professional hierarchies and the maintenance of a boundary around the formal health service to ensure the exclusion of those they considered untrained, unprofessional and untrustworthy personnel. [ABSTRACT FROM PUBLISHER]

A large body of literature has considered the way that places contribute to the health of their residents. The bulk of this research has considered the numerous risks and resources that are contained within the bounded spaces of neighborhoods and communities. Only recently have scholars begun to consider how these material and social conditions interact with the symbolic dimensions of place to further affect health. In this conceptual paper, we draw on a broad literature in order to develop a conceptual framework that connects negative representations of place, or spatial stigmas, to health. We argue that spatial stigma can affect health through three primary pathways: (1) access to material resources; (2) processes of stress and coping; and (3) processes related to identity formation and identity management. Our model suggests that spatial stigma is likely an important and understudied mechanism through which disadvantaged places contribute to multiple physical and mental health outcomes. Furthermore, by considering the larger sociocultural meanings that surround marginalized places, the concept of spatial stigma introduces new considerations for the development of effective policies to address geographic health inequality. [ABSTRACT FROM AUTHOR]

This paper presents the results of the qualitative phase of Healthy Foundations, a study that groups people according to their motivations to live healthily or otherwise, their lifestyles, and the circumstances that affect this. These segments are ‘Health Conscious Realists’, ‘Balanced Compensators’, ‘Live for Todays’, ‘Unconfident Fatalists’ and ‘Hedonistic Immortals’. The aim was to explore people’s attitudes and motivations to live healthily or otherwise and the targeted healthcare interventions appropriate for each segment. The qualitative phase involved two strands: (i) focus groups and immersion in-depth interviews and (ii) video ethnographic ‘pen portraits’. It provides robust insight into the five segments’ motivations and behaviour and how these are constructed within and influenced by the wider environment. It also enabled the segments to give their views of and design appropriate interventions aligned to their individual requirements, lifestyles and structural environments. It demonstrates the usefulness of the qualitative approach to health segmentations and enhances the case for methodological pluralism, and a critical perspective, to enable development of health-related behaviour change interventions and policy more widely. [ABSTRACT FROM PUBLISHER]

In this paper, we examine how New Zealand children engage with public health agendas that seek to shape their understandings of health. We shed light on the ways children make sense of what they see, hear and come to know through public health ‘work’, and consider what effects this has for how they come to think of their ‘selves’ and relations with others. We pay attention to the way public health messages assemble, bolstered by dispositions, behaviours and ruminations expressed in schools, families and communities. Children’s talk exemplifies the sheer volume of public health missives saturating their worlds and the range of media used to reach into children’s lives. In many cases, children are ‘doing it for themselves’ in the sense that they are attempting to enact health imperatives about healthy eating, regular exercise and weight management. However, alongside the willingness of many to simply believe and enact health information, we draw attention to the capacity of some children to think through public health messages, negotiate and make sense of them in relation to their own lives. Despite the ubiquity and mantra-like quality of public health messages currently directed at children we contend they are variously interpreted and embedded in children’s lives. We regard the messiness and complexity of children’s engagement as affirmation that a critically informed variety of public health could provide opportunities for children to come to know health as more than simply eating the right foods and running a lot. [ABSTRACT FROM PUBLISHER]

The standard, deficit-based, approach to health promotion tends to focus on health problems, designing services which are meant to solve these problems, of which members of communities are made the passive recipients. An alternative approach recognises that health problems are complex, having many causal pathways and as a result will require locally tailored interventions, involving multiple service providers workingwithlocal communities. Using empirical research from the development of two transformational community-led partnerships, an experiential learning programme was developed, Connecting Communities (C2). Complexity science is the underpinning theoretical framework for C2, which seeks to create the conditions to transform the health and well-being of disadvantaged communities. C2 focuses specifically on the nature of the relations between the agents in the system and their interactions with the social environment which determine the system’s behaviour. This is because a key tenet of complexity science is that systemic change cannot be externally directed, but occurs as a result of the self-organising interactions and relationships within the system. C2 takes an explicit asset-based community development approach, seeking to facilitate and support the development of local neighbourhood partnerships which focus on the strengths and aspirations of the community, rather than perceived deficits. This paper reports on the development of C2, its delivery, presents a case study of one of the first groups to undertake the Programme, and assesses its subsequent impacts on the participants’ ways of working, and in the local community. [ABSTRACT FROM PUBLISHER]