Virchow: Medicine, Social Science & Politics

individual

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INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

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group

“Medicine is a social science ... Medicine as a social science, as the science of human beings, has the obligation to point out problems and to attempt their theoretical solution; the politician, the practical anthropologist, must find the means for their actual solution”. Virchow	... and politics is nothing else but medicine on a large scale."

See also:

https://www.britannica.com/biography/Rudolf-Virchow

'Medical sociology' on W2tQ

My source:
specific tweet with an image lost!

Towards isomorphisms in Hodges' model

"The concept that best captures the process of homogenization is isomorphism. In Hawley's (1968) description, isomorphism is a constraining process that forces one unit in a population to resemble other units that face the same set of environmental conditions. At the population level, such an approach suggests that organizational characteristics are modified in the direction of increasing comparability with environmental characteristics; the number of organizations in a population is a function of environmental carrying capacity; and the diversity of organizational forms is isomorphic to environmental diversity." p.149.

"We identify three mechanisms through which institutional isomorphic change occurs, each with its own antecedents: 1) coercive isomorphism that stems from political influence and the problem of legitimacy; 2) mimetic isomorphism resulting from standard responses to uncertainty; and 3) normative isomorphism, associated with professionalization. This typology is an analytic one: the types are not always empirically distinct." p.150.

DiMaggio, P. J., & Powell, W. W. (1983). The Iron Cage Revisited: Institutional Isomorphism and Collective Rationality in Organizational Fields. American Sociological Review, 48(2), 147–160. https://doi.org/10.2307/2095101

"Some of them went further, using approaches based in political economy, world systems theory, and theories of neocolonialism and underdevelopment to show that economic imperatives on a global scale were a major force in shaping education worldwide. Others interpreted such change through an institutional lens, arguing that the convergence toward accepted models of modernity has resulted in a process of educational isomorphism within and across countries." p.1.

Carnoy, M., & Rhoten, D. (2002). What Does Globalization Mean for Educational Change? A Comparative Approach. Comparative Education Review, 46(1), 1–9. https://doi.org/10.1086/324053

"The movement is inspired by Rudolf Virchow (1821-1902), who coined the term zoonosis, arguing that there should be no dividing lines between animal and human medicine. This position has been gathering momentum in the last fifteen years. The One Health Initiative is a rather daring interdisciplinary alliance that unites physicians, osteopaths, veterinarians, dentists, nurses, and other scientific-health and environmentally related disciplines, on the basis of a simple hypothesis, which is the isomorphism of structures between humans and animals in immunology, bacteriology, and vaccine developments. This means that humans are both exposed and vulnerable to new diseases, like bird flu and other epidemics, which they share with animal species." p.16.

Rosi Braidotti. (2015). Yes, There Is No Crisis. Working Towards the Posthumanities. DiGeSt. Journal of Diversity and Gender Studies, 2(1–2), 9–20. https://doi.org/10.11116/jdivegendstud.2.1-2.0009

"The chapter begins by developing the logic of strategic voting in a single- member district system, thus won by whichever party or candidate gets the most votes (first past the post, or FPTP). This represents the simplest and easiest case for the logic of strategic voting, and similarities (and sometimes theoretical isomorphism) exist between strategic voting— sometimes called instrumental voting (or voting as an investment)— and expected- utility maximization." p.3.

Aldrich, J. H., Blais, A., & Stephenson, L. B. (2018). Strategic Voting and Political Institutions. In J. H. Aldrich, A. Blais, & L. B. Stephenson (Eds.), The Many Faces of Strategic Voting: Tactical Behavior in Electoral Systems Around the World (pp. 1–27). University of Michigan Press. http://www.jstor.org/stable/j.ctvh4zhzr.4 

"Let us take a closer look at this important topic: what might be termed the isomorphism between the realm of care and the realm of perception/oikeiôsis-allotriôsis." p.57.

Joaquim Braga & Mário Santiago de Carvalho (eds.) (2021). Philosophy of Care - New Approaches to Vulnerability, Otherness and Therapy. Cham: Springer Verlag.
https://link.springer.com/book/10.1007/978-3-030-75478-5

- will add here ... suggestions welcome h2cmng AT yahoo.co.uk

Medical sociology ... "food for thought" c/o POHG

I replied to the message copied below by Alex Scott-Samuel on the Politics of Health Group Mail List. Following up with respondents, I have copied Alex's reply and others:

----- Forwarded message -----

From: Alex Scott-Samuel <alexscottsamuel AT gmail.com>

To: "pohg AT jiscmail.ac.uk" <pohg AT jiscmail.ac.uk>

Sent: Saturday, 26 November 2022 at 13:05:25 GMT

Subject: [POHG] Illich

Just came across this from 19 years ago: still offers food for thought

 

[The graphic file downloaded should be legible. PJ]
 

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On 26 Nov 2022, at 17:46, peter jones <h2cmng AT yahoo.co.uk> wrote:

Thanks Alex,

This is very useful - short but very sweet and as you say food for thought - especially in our (ongoing) consumptogenic age.

You've prompted a draft blog-post I will add an acknowledgement and link to POHG.

I've no evidence, that is reading, so what follows are thoughts ... musings ... but I keep wondering: what has happened to 'medical sociology'?

Is medical (health) sociology - history as a discipline?

Is there ongoing development - has the discipline morphed into others?

Is there a case to stress not only public health, but public MENTAL health? As I often do. Am I over-reacting?

In information technology there is talk of functionality being placed in wrappers. Has sociology been subsumed - it's there - but underneath - policy rhetoric (integrated, person-centred, holistic care)?

Who are the leading current figures - and recent equivalents of -

"Aaron Antonovsky (19 December 1923 – 7 July 1994) was an Israeli American sociologist and academic whose work concerned the relationship between stress, health and well-being (salutogenesis)."

Canguilhem

Virchow ...?

https://en.wikipedia.org/wiki/Medical_sociology

Should I take heart by the arrival of the SDGs, and the recognition of not only the social determinants of health, but political and commercial too and others..?

I keep writing regarding the potential and utility of Hodges' model:

https://hodges-model.blogspot.com/search?q=sociology

Thanks again,

Peter
====

----- Forwarded message -----

From: Alex Scott-Samuel <alexscottsamuel AT gmail.com>

Cc: "pohg AT jiscmail.ac.uk" <pohg AT jiscmail.ac.uk>

Sent: Saturday, 26 November 2022 at 18:41:10 GMT

Subject: Re: [POHG] Illich - wither et al. ?

Interesting questions Peter. I sense that the answers are out there but not necessarily concentrated in this list. Although I retired from academic public health almost 7 years ago, I have no reason to think that what is now called the sociology of health and illness is not as strong as ever. The kind of places I would look are on the one hand journals such as Sociology of Health and Illness, Social Science & Medicine and Critical Public Health and on the other, popular outlets such as Laurie Taylor's Radio 4 programme Thinking Allowed. 

As far as I know the Medical Sociology Group of the British Sociological Association still exists and holds regular conferences. There has for many years been a Journal of Public Mental Health though it's a while since I've looked at it

Antonovsky's ideas were popular in the health promotion field as well as in academic social science. I remember that a number of people in the WHO Healthy Cities movement were interested in salutogenesis. I've not thought about it for many years but I was on a research group with Antonovsky in the mid 80s when he was developing his Sense of Coherence construct. I  I have to say that despite the attractiveness of problematising health rather than sickness, I never thought the sense of coherence was adequately or well theorised. I do recall seeing quite a few papers from people who rushed out to measure the coherence of people in various situations using the tool which Antonovsky produced. I don't know whether this kind of work continues nor whether it developed

All the best, Alex

=============

----- Forwarded message -----

From: Alderson, Priscilla <p.alderson AT ucl.ac.uk>

Sent: Saturday, 26 November 2022 at 18:55:08 GMT

Subject: Re: [POHG] Illich - wither et al. ?

Dear Peter,

My book Critical Realism for Health and Illness Research: A Practical Introduction (Policy Press 2021) reviews the main traditions in medical sociology and critically updates sociology research that is relevant to the COVID-19 pandemic and beyond. The medical sociologists are the largest subgroup among all UK sociologists.

best wishes

Priscilla

Priscilla Alderson PhD,  Professor Emerita,  

Social Research Institute, University College London,
18 Woburn Square, London WC1H ONR p.alderson AT ucl.ac.uk     

http://iris.ucl.ac.uk/iris/browse/profile?upi=DPALD60  

   

Alderson P. 2021 Critical Realism for Health and Illness Research. Policy Press. 

Winner of the IACR Cheryl Frank award 2022.

Children’s consent to heart surgery research website:  

https://www.ucl.ac.uk/ioe/departments-and-centres/centres/social-science-research-unit/consent-and-shared-decision-making-healthcare/heart-surgery

Alderson, P. and Morgan, J. 2022 Realist by inclination, childhood studies, dialectic and bodily concerns: an interview. Journal of Critical Realism, 10.1080/14767430.2022.2068261
Alderson P, Morrow V. 2020 The Ethics of Research with Children and Young People: A Practical Handbook. SAGE.

=============

 

----- Forwarded message -----

From: Eileen O'Keefe <e.okeefe57 AT gmail.com>

To: Alex Scott-samuel <alexscottsamuel AT gmail.com>;

Cc: Professor Lesley Doyal <l.doyal AT bristol.ac.uk>

Sent: Sunday, 27 November 2022 at 19:52:16 GMT

Subject: Lesley Doyal

Dear Peter and Alex

 

Lesley Doyal set the agenda simultaneously with Illich with her Political Economy of Health. She continues to lead the pack re socially produced global inequities in health, eg her Living with HIV and Dying with AID: diversity, inequality and human rights in the global pandemic. Routledge Global Health Series. 2013.

Cheers

Eileen O’Keefe

===========

<->

By way of background:

I've always been impressed (in awe of) and reassured by 'medical sociology', the pioneers (as above), as a discipline, and in terms of sociology's explanatory potential.

Another - not so much an 'explanation' but an avenue to explore, has long been the continuum of care (yes, just one initially?). This spans the need for compassion, empathy, rapport, allied with the importance of hands - in nursing, medicine, surgery ... their being steady, vision true with rapid, safe, reliable, effective judgement and decision-making. In short, the need for humanistic and mechanistic synergy. Finding, and taking up Hodges' model perhaps this can account for the idea of holistic bandwidth(?).

It is an exaggeration surely, but it feels like I made two simultaneous connections in first reading psychology and philosophy. These are mind - body, and the way that many in society are 'remote' from science (knowledge), for a variety of reasons. Sociology can help account for those reasons.

Seeing (literally) the potential of visualization (as posted on W2tQ and in papers) in the 1970s, in 1990s research programs were dedicated to facilitate the development and application of visualization in the humanities. Visualization should not just be the preserve of high energy physics, bio-science and proteomics ... (although the attraction to what is 'quantifiable' is understandable). This is the question that drives this effort (I think!).

So the 'humanities' still have a requirement in information systems, informatics and literacy terms, and Hodges' model can, I believe, offer a way forward.

The replies above are much appreciated and I will follow them up.

"Isomorphism of structures": intra- interDomain & model as theory?

"Another illuminating example of the advantages of a posthuman scientific position is the One Health Initiative. The movement is inspired by Rudolf Virchow (1821-1902), who coined the term zoonosis, arguing that there should be no dividing lines between animal and human medicine. This position has been gathering momentum in the last fifteen years. The One Health Initiative is a rather daring interdisciplinary alliance that unites physicians, osteopaths, veterinarians, dentists, nurses, and other scientific-health and environmentally related disciplines, on the basis of a simple hypothesis, which is the isomorphism of structures between humans and animals in immunology, bacteriology, and vaccine developments. This means that humans are both exposed and vulnerable to new diseases, like bird flu and other epidemics, which they share with animal species." p.16.

 
Rosi Braidotti. (2015). Yes, There Is No Crisis. Working Towards the Posthumanities. DiGeSt. Journal of Diversity and Gender Studies, 2(1–2), 9–20. https://doi.org/10.11116/jdivegendstud.2.1-2.0009

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I have felt for many years that there is an implicit 'theory' in Hodges' model.

"Lastly, model is defined by May Brodbeck as "an isomorphic representation of objects that leads to an unmistakable identification of the expression of the object with the physical object." p.235.

"Though, Models like theories, are systems of generalizations based on empirical findings yet there are differences between them. A theory basically involves a set of statements, called either laws or propositions which are related to each other and which express relationships between variables under varying states of the system. It has to be kept in mind that although some tentative or untested theories are called models, a model and a theory are only roughly identical, because a model has a more static connotation. Unlike concepts, models are not arbitrary, and can be confirmed or disconfirmed. They differ in the degree of isomorphism they have with the modelled phenomena. In social science, a model is not a concrete of "real" structure. For that would be complete and idiosyncratic, from which it would be difficult to develop generalizations. An important distincton between theory and model is that while the model has primarily predictive power, a theory has both predictive and explanatory power. However, this is not true in all cases. Apart from making predictions, models can also direct us towards new materials and ground which are not yet covered thereby helping us to discover more relationships, thus serving few heuristic functions." p.237.

PATNAIK, L. K. (1989). MODEL BUILDING IN POLITICAL SCIENCE. The Indian Journal of Political Science, 50(2), 234–250. http://www.jstor.org/stable/41855908

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I will add other useful references from here:

"Furthermore, in philosophy of science, a pragmatic view on modelling has emerged over the last decade, in which the relation between a model and its target, traditionally expressed as representation in the form of formal, structuralist or syntactic morphism (such as isomorphism), is being replaced by emphasizing a pragmatic relationship, often simply described as a situation where somebody creates a model of something with some purpose (Gelfert 2016, 113)." pp.344-45.

Ciula, A., Eide, Ø., Marras, C., & Sahle, P. (2018). Models and Modelling between Digital and Humanities. Remarks from a Multidisciplinary Perspective. Historical Social Research / Historische Sozialforschung, 43(4), 343–361. https://www.jstor.org/stable/26544261

Plus for completeness:
Gelfert, Axel. 2016. How to do science with models: a philosophical primer. Cham: Springer. 

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In the conclusion: "Despite the growing body of research pertaining to a nascent theory of emergence, its central themes are based on a limited theory–model–phenomena conception that does not adequately support those conceptual abstractions. Take, for instance, the direct transfer of microscopic concepts to macroscopic levels of analysis. Strengthening the conceptual link beyond metaphorical device is essential to a robust process of theory building and holds numerous applications, such as underpinning further social science research and theory-building pursuits. Without an effective isomorphism of theory and structures to real-world behaviour, it is an arguable conclusion that a theory of emergence for human organisation does not currently exist. Such is the importance of ontological adequacy and the interchange between conceptual models. It facilitates the practice of interdisciplinary science that characterises much of complexity research." p.319.

Yezdani, O., Sanzogni, L., & Poropat, A. (2015). Theory of emergence: introducing a model-centred approach to applied social science research. Prometheus, 33(3), 305–322. https://doi.org/10.1080/08109028.2016.1144669

My emphasis.

On models, gaps, deficits, neglect

This a.m. I responded to an email from -

the SDOH Listserv at https://listserv.yorku.ca/cgi-bin/wa?SUBED1=SDOH&A=1

- about a forthcoming book (news to follow). 

I replied, with thoughts (edited) that link to the post earlier today:

On the 'front' - or behind the line(s)?

As a community mental health nurse, I've always recognised (as best I can) the critical, power relation of psychiatry.

This is why I study - champion Hodges' model, because the -

• medical model
• bio-medical
• bio-psycho-social models 

- are all inadequate (in the 21st C. and supposedly post-Institutional care?).*

Inclusion of the 'Political' domain in Hodges' model, is critical in the negotiation between the person and collective.

This is what opens up the wide, expansive 'front' in Hodges' model, where relations can be explored in abstract and concrete terms.

A point I'm currently working through (post - paper?): is it ironic that that education and health have acknowledged and try to mitigate(?) the 'deficit model', but in the very conceptual frameworks / models that these disciplines & professions deploy (esp. medicine?), there is a deficit* - manifest in were we are and how we Care today and tomorrow. This is further aggrevated as capitalism clearly has its way (counter-lobbying the health and care professions)?

*tantamount to neglect?

Despite the pioneering efforts and work of several leaders e.g. Virchow, and fields of medical sociology and public (mental) health.

See also - Joe Wicks: Licensed to Kill Channel 4 UK. 2000hrs 6th October 2025.

'Cereal'