Jonathan Gabe | Royal Holloway, University of London (original) (raw)
Papers by Jonathan Gabe
... has evoked an argument across the editorials of the British Medical Journal (BMJ) and ... 222... more ... has evoked an argument across the editorials of the British Medical Journal (BMJ) and ... 222EUROPEAN SOCIOLOGICAL REVIEW industrial societies, often focus on the individual as a unit of ... Social selection could be direct and take the form of 'health discrimination' (West, 1991 ...
Key Concepts in Medical Sociology
Routledge eBooks, Jun 24, 2021
In-depth interviews were conducted with 44 asymptomatic HIVpositive men infected through homosexu... more In-depth interviews were conducted with 44 asymptomatic HIVpositive men infected through homosexual relations or medical treatment for haemophilia. The objective was to better understand interrelations between: the consequences of infection on everyday life; the meanings given to being HIV-pwsitive; and the reconstruction of identities. The consequences for everyday life are examined in relation to: the importance of keeping one's immune status secret; self-imposed restraints and the constraints ensuing from the immune status; and the resources interviewees tapped to cope with their new situation. The meanings given to infection arose as these men reinterpreted their individual and collective pasts. This biographical reconstruction reinforced components of identity that, prior to HIV-infection, had been built around haemophilia or homosexuality. This is what is called biographical reinforcement, a notion developed in relation to biographical disruption.
PubMed, 1997
This paper offers an analysis of the events surrounding the suspension of the licence for the wid... more This paper offers an analysis of the events surrounding the suspension of the licence for the widely used sleeping tablet Halcion (triazolam) by the British Licensing Authority in October 1991. It is argued that these events highlight a growing crisis in modern medical treatments and in the social relations of health care. This is illustrated by focusing on four elements which have contributed to Halcion becoming a public issue and to its suspension and subsequent banning, namely the claims-making activities of medical experts, the development of legal challenges to medicine, the role of the media and the response of the state.
Health Economics, Policy and Law, Jan 18, 2021
Public reporting of clinical performance is increasingly used in many countries to improve qualit... more Public reporting of clinical performance is increasingly used in many countries to improve quality and enhance accountability of the health system. The assumption is that greater transparency will stimulate improvements by clinicians in response to peer pressure, patient choice or competition. The international diffusion of public reporting might suggest greater similarity between health systems. Alternatively, national and local contexts (including health system imperatives, professional power and organisational culture) might continue to shape its form and impact, implying continued divergence. The paper considers public reporting in the USA and England through the lens of Scott's 'pillars' institutional framework. The USA was arguably the first country to adopt public reporting systematically in the late 1980s. England is a more recent adopter; it is now being widely adopted through the National Health Service (NHS). Drawing on qualitative data from California and England, this paper compares the behavioural and policy responses to public reporting by health system stakeholders at micro, meso and macro levels and through the intersection of ideas, interests, institutions and individuals through. The interplay between the regulative, normative and cultural-cognitive pillars helps explain the observed patterns of ongoing divergence.
Journal of racial and ethnic health disparities, Dec 3, 2019
Background In post-industrial countries, ethnic minorities suffer poorer health and premature dea... more Background In post-industrial countries, ethnic minorities suffer poorer health and premature deaths. The present study examined ethnic differences in life expectancy and related features among elite heavyweight boxers. Methods Dates of birth and death, anthropometry, and championship years were gathered from media archives for champions and challengers (never been a champion) between years 1889 and 2019. Cox regression adjusted for age at contest, nationality, BMI, champion/challenger status, and number of contests was used to assess survival. Results All 237 boxers, 83 champions (37.3% whites) and 154 challengers (61.0% whites), who contested for heavyweight championships were identified. By 2019, 110 (75 whites, 34 non-whites) were known to have died. Non-white boxers died at an earlier age than whites boxers (mean ± SD = 59.8 ± 14.2 years versus 67.3 ± 16.4 years, p = 0.018) and had shorter survival: HR = 2.13 (95% CI = 1.4-3.3). Among non-white boxers, deaths were higher from neurological disorders: OR = 8.2 (95% CI = 1.3-13.5) and accidents: OR = 15.1 (95% CI = 2.3-98.2), while death from natural causes was lower: OR = 0.2 (95% CI = 0.03-0.8). After boxing careers, fewer non-white boxers had non-manual jobs (34.4% versus 71.8%) than manual (34.4% versus 19.7%) or were unemployed (28.1% versus 2.8%). Reported substance abuse was similar across ethnicity (8.0% versus 8.8%) but conviction rates were higher among non-white boxers (17.6%) than white (1.3%). Conclusions Compared with white boxers, non-white boxers tend to die younger with excess neurological and accidental deaths, and they have lower social positions in later life. Sporting authorities should reappraise the wisdom of permitting head injuries in sport and monitor and support the health and wellbeing of sports men and women after retirement.
Sociology of Health and Illness, Sep 18, 2015
The ketogenic diet is a high-fat diet used to treat drug-resistant childhood epilepsy. Given that... more The ketogenic diet is a high-fat diet used to treat drug-resistant childhood epilepsy. Given that negative meanings tend to be attached to fatty foods and children's food consumption is seen to be the responsibility of parents, the ketogenic diet may be problematic for parenting identity. This article draws upon in-depth semistructured interviews with 12 parents from 10 families that have a child whose epilepsy is being treated with the ketogenic diet. The main focus of the article is the meanings these parents attached to foods and how they were drawn upon or altered to overcome some of the contradictions presented by the diet. It will be argued that the diet was medicalised and parents came to view food as medicine. When viewing food in this way, negative associations with fat were reversed. Furthermore, parents also used food as a symbol of inclusion and prioritised portion size or the child's enjoyment of food in order to use food as a symbol of love. In turn this enabled parents to feel they were being good parents. Overall, it seems that diet can be medicalised and the identity of the good parent maintained if dietary treatment is successful.
Addiction, Nov 1, 1994
This paper presents a review of health promotion strategies to help people to stop using benzodia... more This paper presents a review of health promotion strategies to help people to stop using benzodiazepines. Four strategies are described and evaluated: health persuasion, personal counselling, state action and community development. It is argued that the first two strategies have been the most popular to date, especially among doctors, and have an important part to play in changing individual behavior. Less consideration has been given to the other two strategies, but these are equally important if a comprehensive policy is to be developed concerned with social as well as individual change.
PubMed, May 1, 1990
All long term benzodiazepine users in one inner London general practice were asked to participate... more All long term benzodiazepine users in one inner London general practice were asked to participate in a study of their attitudes to their drugs. The 64 respondents had mixed views about benzodiazepines and did not conform to the stereotype presented in the media. Although 58% of the sample had attempted to stop taking benzodiazepines, this was usually not until at least one year of taking the drug. At the time of interview, 50% of the sample expressed a desire to stop taking their tablets. However, the majority were uncertain whether their general practitioner wished them to continue taking the drugs or not. It is argued that users' views of their medication must be taken into account in the debate about tranquillizer dependence.
Social Science & Medicine, Sep 1, 2004
Since the late 1990s, the term ‘partnership’ has increasingly been inserted into the literature a... more Since the late 1990s, the term ‘partnership’ has increasingly been inserted into the literature and rhetoric of the UK health-care system. In this paper, the assumptions and implications surrounding the usage of the term in relation to doctor–patient interaction are examined in the context of paediatric services. The paper considers recent ideas about partnership in medical encounters, especially those of
Taylor & Francis eBooks, Feb 16, 2010
Contemporary Sociology, Nov 1, 1987
SAGE Publications Ltd eBooks, 2013
Qualitative Health Research, Nov 21, 2018
Health Care Analysis, Jul 29, 2017
The use of platelet rich plasma (PRP) as a novel treatment is discussed in the context of a quali... more The use of platelet rich plasma (PRP) as a novel treatment is discussed in the context of a qualitative research study comprising 38 interviews with sports medicine practitioners and other stakeholders working within the English Premier League during the 2013-16 seasons. Analysis of the data produced several overarching themes: conservatism versus experimentalism in medical attitudes; therapy perspectives divergence; conflicting versions of appropriate evidence; subcultures; community beliefs/practices; and negotiation of medical decision-making. The contested evidence base for the efficacy of PRP is presented in the context of a broader professional shift towards evidence based medicine within sports medicine. Many of the participants while accepting this shift are still committed to casuistic practices where clinical judgment is flexible and does not recognize a context-free hierarchy of evidentiary standards to ethically justifiable practice. We also discuss a tendency in the data collected to consider the use of deceptive, placebo-like, practices among the clinician participants that challenge dominant understandings of informed consent in medical ethics. We conclude that the complex relation between evidence and ethics requires greater critical scrutiny for this emerging specialism within the medical community.
... has evoked an argument across the editorials of the British Medical Journal (BMJ) and ... 222... more ... has evoked an argument across the editorials of the British Medical Journal (BMJ) and ... 222EUROPEAN SOCIOLOGICAL REVIEW industrial societies, often focus on the individual as a unit of ... Social selection could be direct and take the form of 'health discrimination' (West, 1991 ...
Key Concepts in Medical Sociology
Routledge eBooks, Jun 24, 2021
In-depth interviews were conducted with 44 asymptomatic HIVpositive men infected through homosexu... more In-depth interviews were conducted with 44 asymptomatic HIVpositive men infected through homosexual relations or medical treatment for haemophilia. The objective was to better understand interrelations between: the consequences of infection on everyday life; the meanings given to being HIV-pwsitive; and the reconstruction of identities. The consequences for everyday life are examined in relation to: the importance of keeping one's immune status secret; self-imposed restraints and the constraints ensuing from the immune status; and the resources interviewees tapped to cope with their new situation. The meanings given to infection arose as these men reinterpreted their individual and collective pasts. This biographical reconstruction reinforced components of identity that, prior to HIV-infection, had been built around haemophilia or homosexuality. This is what is called biographical reinforcement, a notion developed in relation to biographical disruption.
PubMed, 1997
This paper offers an analysis of the events surrounding the suspension of the licence for the wid... more This paper offers an analysis of the events surrounding the suspension of the licence for the widely used sleeping tablet Halcion (triazolam) by the British Licensing Authority in October 1991. It is argued that these events highlight a growing crisis in modern medical treatments and in the social relations of health care. This is illustrated by focusing on four elements which have contributed to Halcion becoming a public issue and to its suspension and subsequent banning, namely the claims-making activities of medical experts, the development of legal challenges to medicine, the role of the media and the response of the state.
Health Economics, Policy and Law, Jan 18, 2021
Public reporting of clinical performance is increasingly used in many countries to improve qualit... more Public reporting of clinical performance is increasingly used in many countries to improve quality and enhance accountability of the health system. The assumption is that greater transparency will stimulate improvements by clinicians in response to peer pressure, patient choice or competition. The international diffusion of public reporting might suggest greater similarity between health systems. Alternatively, national and local contexts (including health system imperatives, professional power and organisational culture) might continue to shape its form and impact, implying continued divergence. The paper considers public reporting in the USA and England through the lens of Scott's 'pillars' institutional framework. The USA was arguably the first country to adopt public reporting systematically in the late 1980s. England is a more recent adopter; it is now being widely adopted through the National Health Service (NHS). Drawing on qualitative data from California and England, this paper compares the behavioural and policy responses to public reporting by health system stakeholders at micro, meso and macro levels and through the intersection of ideas, interests, institutions and individuals through. The interplay between the regulative, normative and cultural-cognitive pillars helps explain the observed patterns of ongoing divergence.
Journal of racial and ethnic health disparities, Dec 3, 2019
Background In post-industrial countries, ethnic minorities suffer poorer health and premature dea... more Background In post-industrial countries, ethnic minorities suffer poorer health and premature deaths. The present study examined ethnic differences in life expectancy and related features among elite heavyweight boxers. Methods Dates of birth and death, anthropometry, and championship years were gathered from media archives for champions and challengers (never been a champion) between years 1889 and 2019. Cox regression adjusted for age at contest, nationality, BMI, champion/challenger status, and number of contests was used to assess survival. Results All 237 boxers, 83 champions (37.3% whites) and 154 challengers (61.0% whites), who contested for heavyweight championships were identified. By 2019, 110 (75 whites, 34 non-whites) were known to have died. Non-white boxers died at an earlier age than whites boxers (mean ± SD = 59.8 ± 14.2 years versus 67.3 ± 16.4 years, p = 0.018) and had shorter survival: HR = 2.13 (95% CI = 1.4-3.3). Among non-white boxers, deaths were higher from neurological disorders: OR = 8.2 (95% CI = 1.3-13.5) and accidents: OR = 15.1 (95% CI = 2.3-98.2), while death from natural causes was lower: OR = 0.2 (95% CI = 0.03-0.8). After boxing careers, fewer non-white boxers had non-manual jobs (34.4% versus 71.8%) than manual (34.4% versus 19.7%) or were unemployed (28.1% versus 2.8%). Reported substance abuse was similar across ethnicity (8.0% versus 8.8%) but conviction rates were higher among non-white boxers (17.6%) than white (1.3%). Conclusions Compared with white boxers, non-white boxers tend to die younger with excess neurological and accidental deaths, and they have lower social positions in later life. Sporting authorities should reappraise the wisdom of permitting head injuries in sport and monitor and support the health and wellbeing of sports men and women after retirement.
Sociology of Health and Illness, Sep 18, 2015
The ketogenic diet is a high-fat diet used to treat drug-resistant childhood epilepsy. Given that... more The ketogenic diet is a high-fat diet used to treat drug-resistant childhood epilepsy. Given that negative meanings tend to be attached to fatty foods and children's food consumption is seen to be the responsibility of parents, the ketogenic diet may be problematic for parenting identity. This article draws upon in-depth semistructured interviews with 12 parents from 10 families that have a child whose epilepsy is being treated with the ketogenic diet. The main focus of the article is the meanings these parents attached to foods and how they were drawn upon or altered to overcome some of the contradictions presented by the diet. It will be argued that the diet was medicalised and parents came to view food as medicine. When viewing food in this way, negative associations with fat were reversed. Furthermore, parents also used food as a symbol of inclusion and prioritised portion size or the child's enjoyment of food in order to use food as a symbol of love. In turn this enabled parents to feel they were being good parents. Overall, it seems that diet can be medicalised and the identity of the good parent maintained if dietary treatment is successful.
Addiction, Nov 1, 1994
This paper presents a review of health promotion strategies to help people to stop using benzodia... more This paper presents a review of health promotion strategies to help people to stop using benzodiazepines. Four strategies are described and evaluated: health persuasion, personal counselling, state action and community development. It is argued that the first two strategies have been the most popular to date, especially among doctors, and have an important part to play in changing individual behavior. Less consideration has been given to the other two strategies, but these are equally important if a comprehensive policy is to be developed concerned with social as well as individual change.
PubMed, May 1, 1990
All long term benzodiazepine users in one inner London general practice were asked to participate... more All long term benzodiazepine users in one inner London general practice were asked to participate in a study of their attitudes to their drugs. The 64 respondents had mixed views about benzodiazepines and did not conform to the stereotype presented in the media. Although 58% of the sample had attempted to stop taking benzodiazepines, this was usually not until at least one year of taking the drug. At the time of interview, 50% of the sample expressed a desire to stop taking their tablets. However, the majority were uncertain whether their general practitioner wished them to continue taking the drugs or not. It is argued that users' views of their medication must be taken into account in the debate about tranquillizer dependence.
Social Science & Medicine, Sep 1, 2004
Since the late 1990s, the term ‘partnership’ has increasingly been inserted into the literature a... more Since the late 1990s, the term ‘partnership’ has increasingly been inserted into the literature and rhetoric of the UK health-care system. In this paper, the assumptions and implications surrounding the usage of the term in relation to doctor–patient interaction are examined in the context of paediatric services. The paper considers recent ideas about partnership in medical encounters, especially those of
Taylor & Francis eBooks, Feb 16, 2010
Contemporary Sociology, Nov 1, 1987
SAGE Publications Ltd eBooks, 2013
Qualitative Health Research, Nov 21, 2018
Health Care Analysis, Jul 29, 2017
The use of platelet rich plasma (PRP) as a novel treatment is discussed in the context of a quali... more The use of platelet rich plasma (PRP) as a novel treatment is discussed in the context of a qualitative research study comprising 38 interviews with sports medicine practitioners and other stakeholders working within the English Premier League during the 2013-16 seasons. Analysis of the data produced several overarching themes: conservatism versus experimentalism in medical attitudes; therapy perspectives divergence; conflicting versions of appropriate evidence; subcultures; community beliefs/practices; and negotiation of medical decision-making. The contested evidence base for the efficacy of PRP is presented in the context of a broader professional shift towards evidence based medicine within sports medicine. Many of the participants while accepting this shift are still committed to casuistic practices where clinical judgment is flexible and does not recognize a context-free hierarchy of evidentiary standards to ethically justifiable practice. We also discuss a tendency in the data collected to consider the use of deceptive, placebo-like, practices among the clinician participants that challenge dominant understandings of informed consent in medical ethics. We conclude that the complex relation between evidence and ethics requires greater critical scrutiny for this emerging specialism within the medical community.