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Strengthening the role of sociology in public health

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A recent Public Health England report set out a strategy for embedding social and behavioural sciences in public health. This was a welcome recognition of the need for new transdisciplinary approaches – but disappointing in the lack of recognition for sociology, compared with the emphasis on the behavioural sciences.

Public health is inherently a social science; the challenges of improving population health lie as much in social and political systems as in biological processes. Progress towards healthy and sustainable cities will rely on step changes in our understanding of the relationships between physiology, places and social practices. This has long been recognised: Chicago School sociology in the early twentieth century focused on the social organisation of health outcomes, and Rudolf Virchow’s writings in the nineteenth century emphasised the importance of the political causes of ill health. Yet in recent decades, sociology has become somewhat marginalised in much public health policy and practice in the UK. We urgently need to move away from more individualised approaches to health behaviours and towards an invigorated social medicine.

Benjamin Hanckel chaired the ‘new theoretical directions’ workshop. This was one of four workshops held during the day

To think about how to consolidate the visibility of sociology in public health, and foster better channels of communication between theory and practice, the KCL Social Science and Urban Public Health Institute (SUPHI) hosted a one-day symposium on Sociological Approaches to Public Health, in April. This was funded by the Foundation for Sociology of Health and Illness to bring together sociologists working with public health, public health leaders and behavioural scientists.

Discussions and presentations built on recent debates around complexityand causation, which have opened up spaces for more explicit theoretical and methodological sociological contributions to public health, beyond the traditional ‘concepts’ that form part of public health training, such as stigma or inequality. Novel applications of approaches from (for example) practice theory and new materialisms have been promulgated as offering ways through impasses in health and health equity improvement. To move from exhortation to practice, theoretical insights need to be integrated into real world settings, in collaboration with policy and practice experts. To this end, sociologists have been active in calling for more creative and productive relationships with public health.

At the symposium, presenters showcased these creative and productive relationships have been used to foster health and health equity.

  • Kate Hunt discussed how theories of masculinity and social practice had informed the very successful Football Fans in Training intervention for men’s health, and how this was now being extended as the intervention spread around the world.
  • Wendy Wills focused on food practices, linking issues of malnutrition, hunger and obesity in her examples to show how habitus and social structures shape possibilities for change.
  • Oliver Bonnington reflected on anti-stigma campaigns in mental health, foregrounding some of the challenges of treating stigma as an issue of attitudes and behaviours, which underplays the material impacts of stigma on lived experience.
  • Jim McManus reiterated shared aims of fostering population wellbeing, the need for the whole range of social science disciplines for this, calling for the need to ‘complexify’ public health.
  • Mike Kelly reflected on his time at the UK National Institute for Health and Care Excellence (NICE) to point to some of the political and practical challenges of ‘translating’ sociology to busy policy makers, and how sociological theory has been incorporated in many evidence reviews (although often not explicitly). Big gaps in evidence still persist around how to narrow inequalities.
  • Oli Williams used his experience of co-producing research findings with graphic artists to highlight the need for dissemination to be woven through projects, and how researchers can use innovative methods to share sociological concepts with diverse publics.

There are many examples of productive collaborations from across the country. The challenge now is how to embed the learning from these in teaching and training, and how to make sociological ideas more available to those in local public health departments who want to use them.

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Features written within the SUPHI research group

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