bluuebunny/crossref_metadata_2025 huggingface dataset:
Social Policy in a Fast‐growing Economy: The Case of Chile
Authors: Hiscock Julia , Hojman David E.
Published: March 2003

Chile has adopted a package of free‐market, neo‐liberal social policies. This follows a pattern established by the country’s largely successful economic policies. Neo‐liberal social policy consists of a series of two‐tier systems, which are not in contradiction with the economic model. On the contrary, a key function of the social policies is to supplement a dynamic style of capitalist economic development through a number of mechanisms. These include: improving the skills, education and health standards of the labour force; increasing savings in a privately‐run pension system; reducing labour costs to firms; and providing a safety net to those whom the “trickle down” does not reach. The paper examines social policy in three sectors: pensions, health and education. It explores historical roots, present characteristics, and the degree of success or othewise of policy in these sectors. The discussion refers to the role played by the legacy of the Pinochet military dictatorship (1973–90), the interface between public and private spheres, the whole question of social policy in the context of fast economic growth under free‐market conditions (and the possible presence of causality links), the changing balance of power between suppliers and users of social sector services in favour of the latter, the threat of market failure, and questions such as whether these policies have been successful and whether (or why) Chileans are prepared to accept this unequal two‐tier system.
Facing Up to Underfunding: Equity and Retrenchment in Community Care
Authors: Blackman Tim
Published: March 2003

Local social services departments in the UK are expected to distribute their cash‐limited budgets for community care in ways that achieve an equitable allocation of resources in situations where, with present levels of funding, they cannot meet all the needs with which they are presented. This paper discusses a case study of the introduction of a "needs‐based" formula to allocate a local authority’s budget for home care services and a follow‐up survey to investigate whether services reached the people intended to benefit. The article argues that the "gatekeeping" role of community care assessments is important to safeguard equity without the inflexibility of highly standardized tests of eligibility. However, with the new Labour government seeking to reduce dependency on public expenditure, and a growing lobby for national standards of social care, it will be increasingly important that local authorities justifiy their different practices with evidence about how they relate to local needs.
Trickle‐down or Rising Tide? Lessons on Mainstreaming Gender Policy from Colombia and South Africa
Authors: Beall Jo
Published: March 2003

As a result of the United Nations Decade for Women (1976–1985) many member states of the United Nations in the South put in place some form of national machinery for the advancement of women. This paper considers that process, identifying three main phases. The first was heavily overlaid by the agendas of international development agencies and coincided with efforts to advance a "women in development" or WID agenda within international development cooperation. The second, explored here in relation to Colombia, saw a shift towards attempts to institutionalize gender awareness in development policy, the so‐called "gender and development" or GAD approach. Against this background, the later South African experience is evaluated. It is argued that this potentially represents a third and distinguishable phase in the establishment of national machineries. Here structures were set up in the context of less aid dependence than many other countries and as a result of a process that was largely internally driven. Nevertheless, South Africa enjoyed tremendous support from international women’s networks and lessons were learnt from past experience elsewhere, both positive and negative. The South African approach to advancing gender equality is arguably the most progressive to be found anywhere. What remains to be seen is whether it will be possible to implement, given the persistence of poverty and inequality nationally and South Africa’s increasing identification with international neo‐liberal agendas.
Knowledge Communities, Spatial Theory and Social Policy
Authors: Pinch Steven
Published: March 2003

This paper uses the concept of knowledge communities to account for the relatively low impact of spatial perspectives on welfare policy (marginalization in the economic sphere; limited uptake in the social sphere). However, recent developments in the social sciences include a growing recognition of relationships between discourse, knowledge and power. Central to this work is a recognition of the territorialized nature of knowledge. These developments suggest that social policy has the potential to be reconfigured in a much more geographically sensitive manner.
Needs Assessment, Street‐level Bureaucracy and the New Community Care
Authors: Ellis Kathryn , Davis Ann , Rummery Kirstein
Published: March 2003

In the wake of the Seebohm reforms of the personal social services, a number of studies were carried out in the 1970s to explore the role of frontline professionals in identifying and meeting social need. A common finding was that social workers behaved like “street‐level bureaucrats”, using their discretionary authority defensively to manage an otherwise overwhelming workload. In the 1990s, top‐down assessment and care management systems were put in place as part of community care reforms. Their aim was to reduce the scope of professional discretion so as to standardize responses to need and control demand according to resources available. In this paper, the authors consider the success of new systems in controlling “bottom‐up” decision‐making by drawing on a recent empirical study of needs assessment practice in three types of social work team. They point out that the assessment practice of those teams facing the highest bombardment rates was most obviously criteria‐driven, reinforced by the use of new technology. Rather than creating informal stereotypes to manage demand, social workers could mobilize legitimate forms of rationing to protect their time and other resources. Yet the sense of professional identity, the level of frontline autonomy, and the ways in which this was exercised, varied across the different types of team. The authors conclude, therefore, that the scope of discretionary space available to frontline staff in social services departments, and the practices to which it gives rise, are empirical questions only adequately addressed by methodologies able to connect with “bottom‐up” decision‐making.
Social Security in a Rapidly Changing Environment: The Case of the Post‐communist Transformation
Authors: Fajth Ga´spa´r
Published: March 2003

Overcoming the economic crisis and implementing institutional change in Central and Eastern Europe and the former Soviet Union has been greatly facilitated by a pre‐existing social security network—although adaptations to the new circumstances have been necessary. This paper offers a review of these adjustments and the various strategies that have been employed for mitigating losses in income and in social cohesion with the market reforms. The paper shows how countries first expanded, then curtailed their social programmes, and have started moving away from collective to individualized solutions, not only in the economic but also in the social field. Although this thrust promises many advantages, such as greater personal responsibility and system transparency, several population groups—typically those that fail to form a powerful interest group—risk being left behind by the reform process. The paper concludes that these experiences from the region offer valuable lessons for social programmes assisted by international exchanges that aim to counter the negative impacts of rapid economic and institutional change increasingly a worldwide phenomenon.
“Risk Society”: The Cult of Theory and the Millennium?
Authors: Dingwall Robert
Published: March 2003

The relation between theory and empirical data in sociology and social policy is explored through a critique of Ulrich Beck's influential book, Risk Society. Consideration is given to the extent to which a book that purports to describe contemporary societies in general is actually rooted in the unique circumstances of postwar Germany. The various arguments of Risk Society are reviewed and tested against relevant empirical reports from England. Many of the historical and contemporary generalizations made by Beck are shown to be questionable. The conclusion reflects on the popularity of the genre in which Beck is working and questions the consistent glumness of its attitude to contemporary societies—whether those of the 1890s or the 1990s. The new millennium might be a time for a new spirit and the rejection of the nostalgia and conservatism of humanities‐oriented scholarship.
Lone Motherhood: the Impact on Living Standards of Leaving a Violent Relationship
Authors: Wilcox Paula
Published: March 2003

This paper presents findings from doctoral research which looked at the social support of women leaving domestic violence. In this paper the focus is on one aspect of that study: the living standards of women who have left a violent relationship. An exploratory, area‐based study using in‐depth interviews and participant observation with twenty white working‐class women examinedthis issue. This exploratory study makes visible the links between violence and living standards. Debts incurred during the violent relationship when women had little if any control over finances, rent arrears incurred as a result of leaving, when women were temporarily housed in a refuge or hostel, and increased housing, travel and communication costs all contributed to the women'sexperience of poverty. If findings of previous research are correct, that between 20 and 40 per cent of lone parents (overwhelmingly mothers) experienced domestic violence in their previous relation‐ship, then more extensive research in this area is indicated.
Actors in Processes of Inclusion and Exclusion: Towards a Dynamic Approach
Authors: Vobruba Georg
Published: March 2003

The terminological substitution of the poor/rich distinction by the exclusion/inclusion distinction marks an important innovation within social research, because it provides a multidimensional approach for the analysis of disadvantaged groups within society. The multidimensionality also implies that interactions between different dimensions of exclusion and inclusion become visible, hence offering a dynamic approach. Thus, research on exclusion/inclusion might be linked with longitudinal‐data analyses. The dynamic aspect of the exclusion/inclusion research analytically upvalues the people involved in the processes of exclusion and inclusion. Social sciences no longer see them as nothing but victims, rather as actors coping with given circumstances. Thus, actors’ own strategies become of crucial importance. As a consequence the notions of exclusion as ‘bad’ and inclusion as ‘good’ become unclear. Thus one has to take into account that actors perceive both inclusion and exclusion as ‘good’’ or ‘bad’’.
Public Participation in the New NHS: No Closer to Citizen Control?
Authors: Rowe Rosemary , Shepherd Michael
Published: March 2003

Over the last decade support for increasing public participation in decisions regarding the planning and delivery of health services has become a familiar feature of the policy agenda for the UK National Health Service. This paper reviews current Labour policy towards public participation and reports on the response of primary care groups (PCGs) to recent Labour directives to make patient and public involvement an integral part of the way they work, presenting the findings of a survey conducted in one English health region. The experience of these PCGs suggests that, despite the diverse backgrounds of board members, there is marked consensus between local and central decision makers as to their understanding of public participation. Whilst academic debates have tended to conceptualize participation in dualist terms as a form of consumerism or of citizenship, the survey data suggest that in the context of local implementation public participation is framed within a new public management perspective which values it as an aid to organizational learning. The findings of this study highlight obstacles to securing effective public participation, including a lack of substantive guidance regarding policy implementation that produces uncertainty amongst local decision makers as to how best to proceed. The inherent limitations of public participation within the new public management paradigm suggest that democratic renewal, one of the goals of the government’s modernization agenda, is unlikely to be achieved.
Future of Care Services in Ireland: Old Answers to New Challenges?
Authors: Timonen Virpi , McMenamin Iain
Published: March 2003

Until recently, the small proportion of older people in the Irish population and low labour‐market participation rates among women provided the underpinnings of the informal care model in Ireland. However, changes in family structures, women’s labour market participation and population ageing are making this model less sustainable. A detailed analysis of policy changes and initiatives in the area of care provision shows that while the challenges facing the system are new, most of the solutions provided continue to rely on the model of home‐based care.
New Labour, Work and the Family
Authors: Driver Stephen , Martell Luke
Published: March 2003

New Labour has put support for the family at the core of its notion of the “strong community”. Across a range of policy areas the Labour government can be seen to be developing a direct and explicit family policy. But what kind of community is the government trying to shape by these policies? On the one hand, Labour appears to support the family as the basis of a more moral, dutiful and cohesive community. On the other hand, the government has given weight to policies that support social inclusion in the community through paid work. This paper examines whether there is a tension in Labour’s social policies between its emphasis on the importance of stable family life and the primacy given to paid work. Are critics like Ruth Levitas right when they argue that the government’s emphasis on paid work devalues, and is unsupportive of, unpaid work, especially caring for children and other family members? Alternatively, can this combination of communitarianisms—community as “stable family” and community as “paid work”—be seen to be marking out some “third way” on the family? We shall show that different aspects of the government’s family policies reflect different perspectives and policy agendas within New Labour and third‐way thinking more broadly. And while recognizing the tensions between work and the family, we shall suggest that they are often overstated and fail to give sufficient weight to the complementary aspects of Labour’s welfare reforms.
Regional Welfare System Developments in Russia:Community Social Services
Authors: Thomson Kate
Published: March 2003

Micro‐level studies of welfare service developments are largely absent from the literature on Russian social policy issues, which tends to concentrate on macro‐level social security arrangements. This paper highlights the emergence of community‐based social services in the post‐1991 era, examining their development in two provincial Russian cities, based on an empirical study carried out in 1998. The paper adds to a growing literature which seeks to understand “welfare systems” from the perspective of welfare services as opposed to a social security or policy‐based approach. It takes a user‐group perspective on the services by looking at their use by, and relevance for, disabled children regarded as having learning difficulties, and their families. The empirical data indicate the shape of “new” services in the field sites, the means by which such institutions were maintained and their integration into the welfare sphere as a whole. Their development and maintenance at the local level is explained in part by socio‐economic, political and administrative factors in these regions. By highlighting the various factors that help to maintain welfare provision and drive change at the local level, the case studies indicate the possible shape of future welfare developments in Russia as a whole.
Partnerships, Power and the “New” Politics of Community Participation in British Health Care
Authors: Milewa Timothy , Dowswell George , Harrison Stephen
Published: March 2003

Multi–sectoral approaches to health improvement in its broadest sense have entailed an emphasis by the British government upon partnership working in and around community involvement in planning processes. New service planning and delivery organizations in the health service—primary care groups and primary care trusts—thus have to ensure that public and patient involvement strategies reflect a coordinated, if not integrated, multi–sectoral approach to such involvement. But how are these enforced partnership arrangements shaping the approach taken by primary care groups and trusts to the issue of public and patient involvement? More particularly, is the traditional dominance of health service managers and the medical profession in decision–making processes under challenge? This article draws on a study of primary care groups and trusts in three districts in order to gauge perceptions and calculations with regard to partnerships for involvement. Results appear to suggest that health service managers and practitioners continue to exercise considerable influence in comparison to that of patients and citizens. But, if the findings are viewed in the broader contexts of government managerialist strategies of surveillance and accountability and the growth of service–user and advocacy organizations, partnerships may offer significant scope for “lay” challenges to managerial and medical power.
Australian Welfare Reform: From Citizenship to Supervision
Authors: Shaver Sheila
Published: March 2003

This paper examines the implications of welfare reform for the meaning of social citizenship in Australia. Australian welfare reform has been under way since the late 1980s, and reflects the themes of activity and participation that are shaping social policy in many advanced industrial nations. The paper suggests that Australian welfare reform is following a liberal trajectory of change which places a continuing emphasis on market and family as the preferred institutions for social support with a newly salient appeal to moral ideas about the responsibility of citizens to be self‐sustaining. The paper argues that welfare is being transformed from a limited social right to support provided on condition, and from treating the claimant as a sovereign individual to a subject of paternalistic supervision. Together, these changes are redefining the meaning of equality in Australian social citizenship.
De‐globalization of Food Markets? Consumer Perceptions of Safe Food: The Case of Norway
Authors: Nygård Berit , Storstad Oddveig
Published: March 2003

Food and agricultural products differ from other commodities on a global market. The classic economic models are not able to explain the food preferences of different consumer groups in an era of various ‘food scares’. This paper argues that consumer concern about safe food, together with national or regional differences in food culture, taste and traditions, will limit the globalization process. It also investigates how the globalization of food markets is reflected in the marketing of various agricultural products. In several countries there has been a focus on the country of origin in the marketing of different food products. There is a discussion of whether consumers have a natural preference for local products, whether national produce is regarded as something better and safer than imported food products, and whether consumer perceptions of safe food could set limits on the globalization of food markets.
The Revival of Cultural Celebrations in Regional Sweden. Aspects of Tradition and Transition
Authors: Ekman Ann‐Kristin
Published: March 2003

A noticeable revival of local and regional festivals and celebrations took place in Sweden during the 1980s. Similar trends can be seen elsewhere in Europe. Annual celebrations of all kinds, some focusing on the past (such as local historical events), others on the present (such as local market days), are being arranged. Some of the celebrations are aimed at tourists, others are directed toward the local population. Local cultural festivals have been used by a variety of actors, particularly in regions undergoing structural change, to draw outside attention to their regions and to initiate processes of change and development by mobilizing local people ‘inside.’ This article focuses on a ‘regional development area’ in Sweden. It describes a municipality and analyzes the local festivals, celebrations and plays that both unite and differentiate communities in the municipality. The article tries to explain when and why these celebrations began, which groups of people are involved in them and the way in which they have strengthened local identities, initiated social change or influenced local economic development.
Food Matters and the Matter of Food: Towards a New Food Governance?
Authors: Marsden Terry
Published: March 2003

After over a decade of leading research work which has examined the political economy and globalization of the ‘industrial’ agro‐food system it is clear that there are now important new challenges associated with the incorporation of nature, consumption and alternative food networks. Taking David Goodman's recent paper (Sociologia Ruralis 1999, no. 1) as a starting point, this discussion not cautions against a premature and over‐generalized rejection of political economy on the basis of concepts based upon actor‐network theory. Questions of food governance expose the asymmetry in power relations in food networks, whether conventional or alternative. Moreover, while accepting the need to examine the ‘hybridity’ of nature‐society relations, this needs to be done in ways which expose the degree of interconnection through the development of micro‐analytical research and the development of ‘middle‐level’ concepts.
Globalization, Localization and Sustainable Livelihood
Authors: De Haan Leo J.
Published: March 2003

Despite economic progress made in quite a number of countries in the former ‘Third World’, between 20% to 50% of the world population is still excluded from this progress. By taking sustainable livelihood as a point of departure and by paying attention to actor‐structure inter‐actions, this paper conceptualizes these processes of social inclusion and exclusion. Livelihood is represented as a whole of dynamic interactions between actors and five vital capitals i.e. human, natural, physical, financial and social capital. These vital capitals are embedded in a social, economic, political and ecological structure. Interaction between actors and structure occurs via access and agency and results in processing of capitals to build livelihood. Livelihood is sustainable if it is capable of adequately satisfying self‐defined needs and securing people against shocks and stresses put on capitals by structural factors. Livelihood strategies develop in arenas of conflicting or co‐operating actors. Because livelihood strategies are multiple, individuals may belong to different interest groups and therefore social inclusion and exclusion is never rigid. Globalization is interpreted as localization, meaning a close association between homogenization and diversity or between the global and the local. Diversity it is not limited to socio‐cultural domains but observed in economic and political domains too. Globalization‐localization has important consequences for livelihood. The importance of the international and the local level will increase to the detriment of the national level. On the one hand,livelihood will become increasingly world wide and therefore multi‐local. The different levels of scale in vital capitals and in structure come closer to each other and perhaps will even fuse. The arena will become increasingly global and livelihood strategies will become more homogenous. On the other hand,certain local characteristics of the arena remain or will even become more marked, and consequently livelihood strategies will need to become more specific too. Nevertheless,it is doubtful whether social exclusion will become a thing of the past. Therefore, global governance should have an important role in promoting sustainability of livelihoods. Global governance is explained as a global co‐ordination by supra‐regional and international governmental institutions of national governments balanced by an emerging international ‘civil society’. Both have a task in the regulation of global markets and development co‐operation will have to develop towards a global social security system.As a result, it is concluded that research on sustainable livelihood will increasingly have to become multi‐dimensional,multi‐local and reciprocal.
Food Supply Chain Approaches: Exploring their Role in Rural Development
Authors: Marsden Terry , Banks Jo , Bristow Gillian
Published: March 2003

This paper explores the role of short food supply chains in rural development. By developing a theoretical perspective, it seeks to contribute to debates on the generalized theory of rural development. It argues that in order to more fully understand their role and potential we need to move beyond descriptions of product flows to examine how supply chains are built, shaped and reproduced over time and space. Consideration is given to the definition of short food supply chains, and a three level typology is presented. The paper examines the dimensions and evolution of short food supply chains, and identifies four types of evolution: temporal, spatial, demand and associational or institutional. Case studies from the impact research programme are positioned within this framework, and it is argued that we need conceptualizations that reflect the dynamic and evolutionary nature of supply chains and the businesses they involve. A case study of the Llyn Beef Producers Co‐operative in Wales is expanded to illustrate the evolution of supply chains and their role in rural development, both at the farm level and within the wider rural economy.
Reconsidering ‘Traditional’ Food: The Case of Parmigiano Reggiano Cheese
Authors: De Roest Kees , Menghi Alberto
Published: March 2003

Amongst the hundreds of cases of regional specific products being produced all over Europe, the Parmigiano Reggiano cheese system can be considered one of the most eloquent, mature and successful examples avant la lettre of rural development. About 8,000 dairy farmers, cheese dairies and ripening firms comply with the strict production regulations that guarantee the specificity of this product. Employment in the Parmigiano Reggiano productionsystem is twice as high as in the industrial dairy system and the pressure of the system on the environment is significantly lower.As Parmigiano Reggiano cheese has to compete on the same market as more industrial Grana cheeses, the system is not immune to the cost‐price squeeze affecting European agriculture. The accelerated introduction of cost reducing technologies may compromise the typicality of the product, endanger its competitive position on the market and weaken its future collective performance. A convergence of views and a strong cohesion among actors is necessary to reach new agreements about the directionbeing taken by technological development in order to safeguard the success Parmigiano Reggiano cheese has been able to generate in the past.
Conversion to Organic Farming: A Typical Example of the Diffusion of an Innovation?
Authors: Padel Susanne
Published: March 2003

This paper reviews a large number of studies of organic farmers carried out in several countries over a period of about twenty years, and critically assesses whether or not the results appear to fit the framework of the adoption/diffusion model. After a summary of the adoption/diffusion model and a short description of organic farming and its development in Europe, the personal and social characteristics of early adopters of other innovations are compared with the conversion process to organic farming. Most of the studies reviewed, particularly the earlier ones, were carried out at a time when the organic sector was small and the diffusion of organic farming was at the so‐called innovation stage. The first organic farmers showed similar characteristics to innovators of other environmental innovations and faced problems that were typically associated with this stage, such as opposition in the farming community and social isolation. Several similarities between the studied organic farmers and early adopters of other innovations were identified and the overall conclusion appears therefore justified that the model can be used to gain some further understanding of the diffusion processes of organic farming and the individual adoption or conversion decision.
Governing the Boundaries of Viability: Economic Expertise and the Production of the ‘Low‐Income Farm Problem’ in Australia
Authors: Higgins Vaughan
Published: March 2003

In the last thirty‐five years, the economic viability of farmers both in Australia and internationally has assumed increasing political prominence with governments seeking to restructure agricultural industries. With reference to Australia, it has been argued increasingly by politicians, economists and farm organizations that some farmers have little prospect of survival, and require government assistance to exit the industry in the claimed interests of improved national productivity. However, viability has not always been governed in this way. In fact, the categorization of farmers on the basis of their capacity to earn an ‘adequate’ income emerged only in the late‐1960s. Through an examination of the emergence, from 1967 to 1971, of ‘low‐income’ farms as a national problem, this paper shows how ‘problems’ of restructuring are constituted discursively as objects of knowledge. Applying a Foucauldian‐inspired genealogy of government, I reconstruct the authorities and forms of knowledge through which a low‐income problem was constituted and assembled in a knowable form. Of particular significance in this paper is how economic expertise assumed prominence as key authorities in constituting previous collectivist forms of assistance as irrational, and in linking the future viability of Australian agriculture to the theories and practices of agricultural economists.
Distant bodies ? Rural studies, political–economy and poststructuralism
Authors: Phillips Martin
Published: March 2003

This paper suggests that recent debates over the future of rural studies have been, in some cases, highly dualistic, claiming that it is necessary to choose between political–economy or poststructuralism and between adopting a structuralist/modernist class–analysis or a poststructuralism/postmodernism in which class does not figure. It is argued that there are good reasons for resisting such constructions of choice, and the paper seeks to demonstrate the value of paying attention to discursive constructions of class. Drawing on four pieces of rural research, it is suggested that class is still a salient discursive construct, both within popular images of rurality and within the descriptions of rural life made by, at least some, rural residents. It is also argued that while many rural residents do explicitly reject class identities, often preferring to construct identities through a range of rural lifestyle discourses, these themselves often draw upon cultural textures of class
9. Neighborhood-Based Models for Social Networks
Authors: Pattison Philippa , Robins Garry
Published: March 2003

We argue that social networks can be modeled as the outcome of processes that occur in overlapping local regions of the network, termed local social neighborhoods. Each neighborhood is conceived as a possible site of interaction and corresponds to a subset of possible network ties. In this paper, we discuss hypotheses about the form of these neighborhoods, and we present two new and theoretically plausible ways in which neighborhood-based models for networks can be constructed. In the first, we introduce the notion of a setting structure, a directly hypothesized (or observed) set of exogenous constraints on possible neighborhood forms. In the second, we propose higher-order neighborhoods that are generated, in part, by the outcome of interactive network processes themselves. Applications of both approaches to model construction are presented, and the developments are considered within a general conceptual framework of locale for social networks. We show how assumptions about neighborhoods can be cast within a hierarchy of increasingly complex models; these models represent a progressively greater capacity for network processes to “reach” across a network through long cycles or semipaths. We argue that this class of models holds new promise for the development of empirically plausible models for networks and network-based processes.
The Micro Potential for Social Change: Emotion, Consciousness, and Social Movement Formation
Authors: Summers-Effler Erika
Published: March 2003

Can one explain both the resilience of the status quo and the possibility for resistance from a subordinate position? This paper aims to resolve these seemingly incompatible perspectives. By extending Randall Collins's interaction ritual theory, and synthesizing it with Norbert Wiley's model of the self, this paper suggests how the emotional dynamics between people and within the self can explain social inertia as well as the possibility for resistance and change. Diverging from literature on the sociology of emotions that has been concerned with individual emotional processes, this paper considers the collective level in order to explore how movement action is motivated. The emotional dynamics of subordinate positioning that limit women's options in face-to-face interactions are examined, as are the social processes of developing feminist consciousness and a willingness to participate in resistance work. Pointing toward empirical applications, I conclude by suggesting conditions where resistance is likely.
Political Modernities: Disentangling Two Underlying Dimensions of Institutional Differentiation
Authors: Jepperson Ronald L.
Published: March 2003

This article recommends that we recover two old contrasts from the history of social thought in order to facilitate the recently renewed discussion of multiple variants of European political modernity. Recovering them greatly aids in clarifying the different “modernizing” paths that the European-system polities took during the state-consolidation and nation-building periods of the “long nineteenth century.” Specifically, the basic polity forms delineated in this article capture strikingly well the distinctive “institutional logics” and political cultures of the Anglo, Nordic, Germanic, and French orbits, legacies enduring through the 1960s and beyond. Clarifying these polity forms also helps in isolating underlying institutional changes occurring in the contemporary (post-World War II) period (current institutional convergence, for example).
Behavior, Belonging, and Belief: A Theory of Ritual Practice
Authors: Marshall Douglas A.
Published: March 2003

A new model of ritual based on Durkheim's ([1912] 1995) theory is developed. It is argued that ritual practices generate belief and belonging in participants by activating multiple social-psychological mechanisms that interactively create the characteristic outcomes of ritual. Specifically, the distinctive elements of ritual practice are shown to induce altered subjective states and effortful and/or anomalous behaviors, which are subsequently misattributed in such a way that belief and belonging are created or maintained around the focus of ritual attention. These processes are traced in detail, and the resulting model is shown to be empirically credible, comprehensive, and theoretically fertile.
Doing Nothing is No Choice: Lay Constructions of Treatment Decision‐making Among Women with Early‐stage Breast Cancer
Authors: Charles Cathy , Whelan Tim , Gafni Amiram , Reyno Leonard , Redko Cristina
Published: March 2003

Open‐ended personal interviews were conducted with 20 women with early stage breast cancer attending a regional cancer centre in Southwestern Ontario. We explored three related issues: (1) the extent to which these women perceived that they had treatment options; (2) their understanding of treatment benefits and risks; and (3) the role they wanted for themselves and their oncologists in treatment decision‐making.

We found, first, that many women who were presented with the choice to undergo some form of adjuvant treatment versus no treatment felt that ‘doing nothing was no choice’. Second, when interpreting probabilistic information on treatment benefits and risks, some women retained the idea of probability but thought that they personally would beat the odds. Others transformed the information to make it more personally meaningful, and still others assessed their risk status by comparing themselves with friends or relatives having the same disease. Third, many women preferred some form of shared treatment decision‐making process with their oncologists. Women perceived treatment decisions as either ‘right’ or ‘wrong’ which raised the issue of blame for a ‘bad’ decision should the cancer return. Implications of these findings for clinical practice and for models of treatment decision‐making are discussed.
Is There a Place for Geography in the Analysis of Health Inequality?
Authors: Curtis Sarah , Rees Jones Ian
Published: March 2003

This paper considers how ideas and evidence concerning geographical health variation are used in discourses relating to health inequalities. We consider the different concepts of space and place which are employed in these debates. Much of the discussion in the literature focuses on the relative importance of compositional and contextual effects in determining health variation between different geographical areas. We discuss some of the theory which might illuminate the possible impact of place on health inequalities. In the light of this theoretical debate, and focusing mainly on research from Britain, we review the empirical evidence concerning place as a contributor to health inequalities. It is concluded that while individual characteristics are very important for the health inequalities which are observed between people, their geographical setting also has some significance. This has implications for policies aiming to reduce health inequalities.
Pathways, Pyramids and Icebergs? Mapping the Links Between Dissatisfaction and Complaints
Authors: Mulcahy Linda , Tritter Jonathan Q.
Published: March 2003

In this article the authors report the findings of a study of satisfaction, dissatisfaction and complaining, funded by the National Health Service Executive (NHSE). Although interest in these issues has increased with the introduction of the Citizen’s Charter Initiative and the continued growth of consumerism, few scholars have looked at the relationships between them. Satisfaction and dissatisfaction are commonly viewed as different facets of the same phenomenon. In turn, dissatisfaction is often understood to be a precursor to a complaint, or an embryonic one. The findings presented here suggest that satisfaction and dissatisfaction are linked but are essentially discrete constructs. The authors plot a variety of reactions to dissatisfaction and show that although excessive use is made of formal professional networks, few instances of dissatisfaction emerge as formal complaints. The article concludes that insufficient attention has been paid to understanding the everyday ways in which people cope with dissatisfaction and decisions not to voice a grievance.
Humour as Resistance to Professional Dominance in Community Mental Health Teams
Authors: Griffiths Lesley
Published: March 2003

This paper contributes to the sociological study of humour in health care settings by analysing its use by community mental health team members dealing with referrals made by consultant psychiatrists. It is about humour and hierarchy, and specifically about humour as a strategy used by rank and file team members to resist or attenuate instructions coming from powerful professionals. The paper draws on tape‐recorded data from meetings of community mental health teams and describes the ways in which humour is used by participants to subvert or challenge existing occupational hierarchies.
‘Breast is best’: Infant feeding decisions and maternal deviance
Authors: Murphy Elizabeth
Published: March 2003

The insistence that breast feeding confers unique and significant benefits upon children underpins both health policy and professional practice and is part of the context in which women decide how to feed their babies and, in turn, how they display and defend their decisions. This paper applies a framework, drawn from the sociology of deviance, to the accounts which women give of their infant feeding intentions. It draws upon data from a longitudinal qualitative interview study of the food choices made by mothers on behalf of their infants and young children, to show how such choices are irreducibly moral and that the ways in which women can be judged, or indeed judge themselves, to be deviant are legion. However mothers decide to feed their babies, infant feeding is a highly accountable matter. Whether they intend to breast feed or formula feed, women face considerable interactional challenges as they seek to establish that they are not only good mothers but also good partners and good women.
Difficult Relations: Sex Work, Love and Intimacy
Authors: Warr Deborah J. , Pyett Priscilla M.
Published: March 2003

Female sex workers in Western societies report high rates of condom use with clients. However, their continuing low rates of condom use with private partners place some sex workers at increased risk of STDs and HIV. While researchers have focused on the health risks for female sex workers in their private relationships, from the point of view of the women involved, these relationships are a site of more complex struggles. This paper reports findings from a qualitative study of female sex workers and examines the difficulties associated with sustaining a private relationship while engaging in sex work. Sex work practices, in so far as they parody the features of love‐making, can profoundly disrupt the special characteristics of intimate sexual relationships. Any intervention designed to promote condom use in the private relationships of female sex workers must engage with the complexity of meanings that are attached to sex work, love and intimacy by these women.
Review Article: Normal science? Texts for teaching the sociology of health and illness
Authors: Cox David
Published: March 2003

Ellen Annandale, The Sociology of Health and Medicine

Rob Baggott, Health and Health Care in Britain

David Field and Steve Taylor (eds), Sociological Perspectives on Health,Illness and Health Care

John Germov (ed), Second Opinion: an Introduction to Health Sociology

Ron Iphofen and Fiona Poland, Sociology in Practice for Health CareProfessionals

Lesley Mackay, Keith Soothill and Kath Melia (eds), Classic Texts inHealth Care

Alan Petersen and Charles Waddell (eds), Health Matters: a Sociology ofIllness, Prevention and Care
The heart of the meal: food preferences and habits among rural Australian couples
Authors: Lupton Deborah
Published: March 2003

This article draws upon empirical data from a qualitative study investigating issues around the food choices and preferences of a group of 34 heterosexual cohabiting couples, with and without children living at home, in a rural region of Australia. It explores their everyday food habits and preferences, their notions of a healthy diet and their use of and attitudes towards takeaway food and dining out. The study found that the participants, for the most part, demonstrated a conservatism in their food preferences, lacking the desire for exotica and the gourmand sensibility that characterises members of the metropolitan middle class. The aspects of food they found most pleasurable and valuable were nostalgia, tradition, balance, health, family togetherness and sociality.
Reason, emotion and embodiment: is ‘mental’ health a contradiction in terms?
Authors: Williams Simon
Published: March 2003

Taking as its starting point a series of traditional divisions and debates, this paper approaches issues of ‘mental’ health through the specific lens of the emotions. Key themes and organising principles here include the following: (i) reason versus emotion (ii) biology versus society (iii) the micro and the macro divide, and finally (iv) the medicalisation‐demedicalisation of society. Each of these divisions is critically assessed and some ‘new’ ways forward provided through a commitment to the emotions, their relationship to ‘mental’ health and to rationality and, more generally, to their ‘fate’ in late 20th century Western society. The paper concludes with some further reflections on these and related emotional health matters, including a critique of the very notion of ‘mental’ health as a contradiction in terms.
Invisible women? The importance of gender in lay beliefs about heart problems
Authors: Emslie Carol , Hunt Kate , Watt Graham
Published: March 2003

Coronary heart disease (CHD) accounts for over a quarter of deaths in Britain, yet few qualitative studies have explored beliefs about ‘heart problems’ in the general population. A previous study of lay beliefs about coronary candidacy (or ‘the kind of person who gets heart trouble’) paid little attention to gender. However, semi‐structured interviews with 61 men and women reveal that gender plays a vital role in lay perceptions. Respondents’ accounts of people who were likely ‘candidates’ for heart problems all centred on men. More surprisingly, their accounts of unlikely candidates also focused exclusively on men. Only when specifically asked about relatives, did respondents discuss women with heart problems. While accounts of male ‘victims’ focused on sudden, fatal heart attacks, accounts of women usually concentrated on long‐term CHD morbidity. We argue that CHD continues to be perceived as a male disease and that women remain ‘invisible’ in discourses about heart disease.
Normality, risk and the future: implicit communication of threat in health surveillance
Authors: Olin Lauritzen Sonja , Sachs Lisbeth
Published: March 2003

In the practice of health surveillance, health professionals have to cope with the task of communicating outcomes of tests and measurements, as well as counselling individuals about present and future threats to their own or their children’s health. Research in this field has shed some light on the ‘language of risk’ and its implications for how the individual understands and deals with health in everyday life. Here, we want to further this exploration of the language of risk and to discuss the meaning of risk, normality and deviance. We focus on the implicit or explicit introduction and interpretation of threat in the communication between health professionals and patients in two programmes of health surveillance: child health surveillance and surveillance of 40‐year‐old men. Common themes in these two versions of health surveillance are discussed in relation to the meaning of risk, normality and threats for the future.