Book Review
Health and social change: A critical theory
Graham Scambler
ISBN: 0-335204-79-1; 2002; 192 pages; Open University Press;
Maria Fedoruk
School of Nursing and Midwifery, Division of Health Sciences, University of South Australia, Adelaide SA
This book /volume forms part of the series Issues in Society edited by Tim May.
This scholarly work examines the changes that have occurred in capitalist societies and their impact on health systems, management and delivery. The author a noted medical sociologist reviews the major paradigms of his discipline from a post- modern perspective or as is presented in the text a 'post- modern turn.'
Scambler's intent is not to synthesise existing theories and paradigms but rather identify their perceived limitations while at the same time put forward possible reframing and re-theorising measures using what he calls their 'credible findings.' The critical analysis of capitalist societies seems to centre primarily on the United States and the United Kingdom encouraging readers from other capitalist societies to apply the theoretical perspectives to their own health system environment.
The book as others in the series is divided into three parts the first part critically analysing the research paradigms that have informed medical sociology to this point beginning with positivism and neo-positivism with the author describing the latter as the offspring of the former. The reader is then taken on a post modern journey starting with structural-functionalism moving onto interactionism then a pause at phenomenology to examine life-worlds finally stopping at conflict theory.
Perhaps the most interesting section of the book is chapter five in Part Two where using the concept of 'disorganised capitalism' Scambler draws on a number of critical theoretical perspectives to emphasise the inequities and inequalities in the health systems of capitalist societies. It is this chapter that enables the reader (not a medical sociologist) to draw some conclusions about the impact of structural reforms in capitalist health care systems on populations.
Chapter seven of the book (which is Part Three) draws the multi theoretical facets underscoring the central theme of the book 'Health and Social change' together while asking that an agenda be developed that examines this from a critical sociological perspective.
The text is written for medical sociologists and while this approach will be of interest to all those contemplating health system reform, the discourse used could present barriers to understanding certain concepts.
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