Book Review
Sociology of Health and Illness: Australian Readings (2nd edn)
Gillian M Lypton and Jake M Najman (eds)
ISBN: 978-0-7329-2799-8; 1995; 438 pages; Macmillan Education Australia;
Elizabeth Herdman
The second edition of Sociology of Health and Illness is structured along the same lines as the first with some chapters reworked and updated, some entirely new. The book sets out to provide a current overview of the health of the Australian population and an outline of current sociological theories used to analyse health and health care. Lupton and Najman provide a general discussion of the sociology of health and health care in the introduction and an overview of the themes in the book in the last section.
In section two, economist Steven Duckett focuses on the competing objectives of efficiency, equity and quality in the health care system and the increased interest in measuring and improving outcomes. Ann Daniel addresses the problem of entrenched conflict between the medical profession and the state. HIV testing is used as a case study by Evan Willis for a sociological account of medical technology.
In section three, Dorothy Broom argues that an understanding of the gendering of medicine and illness is of central importance if the medical system is to be more responsive to the health needs of the community. Gavin Turrell discusses the overseas and Australian evidence which reveals the link between social class and health status. Gary Easthope examines ethnicity and health, and argues that the variations in illness between and within ethnic groups is not a consequence of ethnicity but can be best accounted for by structural factors. Neil Thompson argues for a sociocultural perspective on Aboriginal health and Margaret Steinberg et al examine popular misconceptions about the aged, demographic changes and the implications for health services.
In section four, Margaret Shapiro examines the reproduction of professional power and argues that if we want to re-orient the health care system to the needs of the community we must consider changes in the nature of medical education. Short and Sharman argue that the strategies used by nursing in Australia to improve its condition, which include professionalisation and unionisation, are inappropriate because they take no account of gender and class. While it is a valuable critique it is now more than six years since it was first published and one must ask, is there nothing new on nursing? Clavarino and Yates examine alternative therapies and their users, and du Toit provides an overview of allied health professions in Australia.
In section five, Pam Byde argues that health promotion represents a new strategy within the health and social fields and that an ideological shift in health care is required. Lowe and Del Mar argue that prevention is still the best hope we have for reducing mortality associated with cancer.
McCamish and Najman examine AIDS and society but their focus on high-risk groups is problematic. The social consequences of an approach which focuses on 'risk groups' have been well-documented. It must be noted that in epidemiological practice 'risk group' has been replaced by that of 'transmission' or 'exposure category'. The discriminatory practices which arise from the use of 'risk groups' are those which treat gay men and others assumed to be 'risk group' members as a priori infected. The use of risk groups is a form of discrimination which creates the perception of difference between groups and reinforces prejudice.
The chapters can be read as discrete units but in total the book provides health care professionals, sociologists and students with a valuable orientation to the social bases of health and illness. The index is comprehensive and the book highly recommended.
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