HEALTH IN AUSTRALIA:SOCIOLOGICAL CONCEPTS AND ISSUES
Carol Grbich (ed)
Prentice Hall, Sydney, 1996, 318pp, $35.95 (soft)
Reviewed by
Kerry Mahony
School of Nursing and Health Administration
Charles Sturt University
Dennis McIntyre
Department of Behavioural Sciences
University of Sydney
Another attempt to replicate, update and go beyond what Cherry Russell and Toni Schofield pioneered in 1986 with their text, 'Where It Hurts.'
The editor Carol Grbich in her preface wrote that she aimed to produce a text that met the shortfalls of the other sociology of health and illness texts available to undergraduate students of the health sciences. Grbich aimed firstly to direct her text at all the different health care professions, secondly to ensure that it was not too focused on one area, such as public health, and thirdly that it be written in such a style that students would not be 'put off', by the first three pages. The challenge was that the text be accessible whilst at the same time not too simplistic or written from one paradigm.
Having taught sociology to student nurses for the last seven years , from the books Grbich refers to, we ,the reviewers, consider that Carol Grbich has met all her aims admirably. This is no mean feat given that each chapter was written by a different author. Unlike many other readers an attempt has been made to integrate the various chapters, such that they all interconnect yet stand alone and none is more difficult to comprehend than the other. The text works well because the authors are all experienced teachers of sociology to health science students. The authors know what works and what does not work through sheer experience. These teachers realise that they are teaching sociology to a group of students who are essentially conscripts to sociology; a captive audience who did not volunteer to study sociology as part of an arts or social science degree. The authors were aware that the material that they presented had to be immediately relevant and engaging; assuming no prior knowledge of social theory.
Grbich took on the theory chapter herself. There is nothing esoteric or turgid about this chapter. She begins with a case study that students will be able to readily relate to, and continues by explaining the different theoretical perspectives by way of an application to a hypothetical case study. The students can immediately see how theory can be either very telling and explanatory, or just the opposite; purely academic.
It is pleasing to note that contemporary issues have been included. For example, in addition to the well trodden areas of -class, ethnicity, gender and age - emerging substantive areas such as the sociology of the emotions, the body and consumers have also been included. Theoretically the text departs from the usual classical distinction between conflict/consensus, and micro/macro debates and incorporates a wider range of contemporary social theory and debates.
A chapter that we were less impressed with is the chapter on class and health by Neil Burdess. For years, in our respective lectures on class and health, we have been alerting students to the confusion which is created when socio-economic status is conflated with social class. By arguing that 'in this chapter the two terms are used interchangeably' Burdess has maintained this confusion. It would be far more enlightening if socio-economic status (consensus) and social class (conflict) were treated as separate concepts - which they are - and it was made clear that the former only describes stratification while the latter treats class as a fundamental social relationship and process. It would seem that Burdess like others he has cited (Baxter et al 1989; Najman 1994) find class to be problematic because they themselves have created the confusion; a problem which must arise when attempts are made to synthesise incommensurate paradigms. As teachers we are grateful for the excellent empirical data and the numerous references to contemporary Australian research in the chapter. None-the-less in order to undo the class and health nexus we will still need to refer students to Bob Connell's classic article "Class and 'Just' Health Strategy" (1987) International Journal of Health Services.
All the authors use a written communication style that is accessible without compromising the content. Even Foucault and Habermas are presented in an easily digestible and relevant manner. As teachers we know that students can become easily discouraged if you present material beyond their capabilities. We can see that the authors went to a lot of effort to write for a targeted audience.
At the end of each chapter there is a list of definitions which will be very useful for our overseas students and those for whom English is a second language; students who have often expressed to us that some of the present texts are dense and incomprehensible.
The book is a boon to teachers as each topic comes complete with tutorial exercises and further readings. One minor shortcoming is that the book does not have a general bibliography which is more a disadvantage for the teacher than the student as the further reading lists have all been well considered, with the undergraduate student in mind.
All-up we would recommend this introductory text to our fellow teachers of student nurses.
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