Despite the emergence of various "health coaches" in recent decades, little is known about the nature of their work in addressing medicalized conditions. Utilizing in-depth interviews with 51 ADHD coaches, participant observation data from 7 ADHD national symposia, and qualitative content from ADHD coach publications, I examine access to and characteristics of the practice of coaching for a classic case of medicalization: attention deficit hyperactivity disorder (ADHD). Findings indicate certain elements of a neoliberal and consumerist response to what is perceived to be limited, prescriptive, hierarchical medical care. Often drawing upon personal experiences and working with "clients" as opposed to "patients," ADHD coaches characterize their practice as highly-tailored support grounded in partnership, accountability, accessibility, and choice - factors often facilitated by the use of digital technologies. Client empowerment is partially constrained and coach/provider empowerment is partially enhanced, however, by determinations of "coachability," an emphasis on individual responsibility, and limited reimbursement options. Additionally, findings point to the role that intersecting stakeholder identities (e.g., clinician/coaches, coach/clients) may play in such dynamics. I discuss the relevance of such findings for theorizing about the engaged health client within an era of increased health consumerism, corporatization, growing and intersecting forms of "expertise," and increased personal responsibility over health.
Trauma has become a dominant framework for understanding social suffering across contemporary mental health care and social welfare. The rise of Trauma-Informed Care (TIC), presented as a progressive and compassionate approach to service delivery, reflects this broader "trauma turn." In this paper, we examine TIC using the concept of psychocentrism. We focus on how suffering is increasingly interpreted and addressed at the level of the individual, while social, political, and material conditions are marginalised. Drawing on scholarship from psychiatry, psychology, sociology, and critical social theory, we critique trauma discourse and its translation into policy and practice. We examine the growing authority of neuroscience and how adversity is translated into individualised interventions, risk management, and self-regulation. While cumulative adversity can undoubtedly shape people's experiences, we argue that the dominance of trauma risks narrowing how social suffering is understood and responded to. It can also constrain how people understand their circumstances and exercise their agency. Despite the rapid institutionalisation of TIC, its conceptual foundations are contested, and its empirical support remains equivocal. We argue for approaches that engage more fully with the social, relational, and everyday conditions shaping social suffering. Rather than treating trauma as a master explanatory framework, we suggest that it is better understood as one perspective among many.
Since the 1990s, marked by Health's inaugural issue and the publication of Boltanski and Thévenot's De la justification, the Sociology of Health and Medicine has been shaped by traditions rooted in Critical Sociology, particularly Foucauldian, Marxist, and Bourdieusian paradigms. These frameworks have offered incisive critiques of power, biopolitics, medicalization, and neoliberal reframing of health responsibility. Concurrently, another sociological movement emerged through the development of French Pragmatic Sociology, or the "sociology of critical capacity." By foregrounding actors' justifications, plural conceptions of worth, and regimes of engagement, it reorients the analysis from structural domination to situated critique, one that is attuned to the complexity, uncertainty, and ambivalence of health-related action. It enables a relational, context-sensitive approach to the lived experiences of patients and professionals as they engage with institutional arrangements and enact critique within situated action. Drawing on a non-exhaustive, interpretive review of empirical studies engaging with Pragmatic Sociology, particularly in healthcare controversies, clinical decision-making, patient-professional interactions, and health innovation, this article shows how this perspective fosters nuanced understandings of normativity, critique, and coordination in health practices. It traces this theoretical realignment and argues that Pragmatic Sociology offers a compelling, flexible, and still underutilized epistemological and methodological framework for health research, sustaining and extending critique through an empirically grounded analysis.
This article examines how East Asian COVID-19 scholarship conceptualizes vulnerable groups and communication inequality, and what this regional corpus contributes to comparative health communication and the sociology of epidemics. Drawing on bibliometric mapping and article-level thematic coding of 184 peer-reviewed studies published between 2020 and 2025 on China, Japan, and South Korea, the study compares East Asia-focused research with global COVID-19 literature. The findings show that East Asian scholarship tends to define vulnerability through situational system mismatch. Children, students, older adults, women, people with disabilities, chronic disease patients, and low-income groups become vulnerable when crisis governance disrupts the institutions, platforms, family relations, and support systems on which they depend. The article further identifies four mechanisms through which communication inequality intensifies vulnerability: institutional and technological exclusion, failures of understanding and judgment, interruptions of support, and governance exposure and stigma amplification. Even within East Asia, the literature shows important internal differences. Japanese studies foreground aging and norm pressure, Chinese studies emphasize urban-rural educational inequality and youth vulnerability, and Korean studies appear closer to global research in their attention to digital inequality, gendered isolation, discrimination, and health management. By bringing East Asian scholarship into comparative pandemic research, this article shows how vulnerability can be generated through everyday system configurations and crisis communication infrastructures. It argues that future pandemic preparedness requires inclusive communication systems alongside medical and epidemiological capacity.
Antimicrobial stewardship (AMS) is a systematic programme to optimise antimicrobial use and forms a key pillar of the strategies that are developed to address the global threat of antimicrobial resistance. Nurses constitute the highest number of healthcare professionals, and engagement of nursing is key to AMS. Intensive care units (ICUs) have a high-volume antimicrobial use, and yet nursing integration in AMS in the ICUs is undertheorised. Using constructivist grounded theory, we conducted 36 in-depth interviews with ICU clinicians in two Australian hospitals to explore the processes involved in navigating their roles in AMS. The resulting theory, metaphorised as 'Setting a bonfire in a newfound cave' mapped a phased process of integration reflecting the situated and variable ways nurses encounter, interpret and engage with AMS in practice. Beyond clinical insights, this study theorises AMS as jurisdictional project where nurses negotiate limits of expertise and authority, while navigating organisational and interprofessional challenges. Findings reframe AMS as a politics of care wherein players experience tensions between bureaucratic constraints and ethical obligations. The resulting theory specified the processes required to embed AMS into the core of nursing identity and practice. Situating the discretionary actions of nurses within logic and bureaucracy, we offer nuanced accounts and perspectives of how power, hierarchy and cultural norms influence and shape implementation of innovative strategies such as AMS. The theoretical insights of this study contribute to health sociology, ethics of care and implementation studies by illustrating how authority and transactions in AMS are negotiated, shared and redistributed in practice.
This article addresses the lack of empirical evidence about how gender dynamics shape clinical research careers within health service environments. Informed by a feminist organisational theoretical perspective, this paper advances evidence-based understandings of systemic gender inequalities. The research generates knowledge of the extent to which core dimensions of clinician research activity in a large Australian hospital network varied by gender, clinical speciality, and/or health discipline. A survey instrument was iteratively developed with input from a clinician-scientist reference group and distributed to employees who had undertaken research in the past 5 years. The survey covered demographics, role, and research activities, outputs, support, and barriers. The 268 valid respondents (67.5% women) included medical (25.4%), allied health (44.8%), and nursing (22.8%) researchers. Analysis comprised descriptive statistics, non-parametric comparisons, regression models, and thematic coding of open-text questions. Substantive and systemic gendered differences were evident in opportunities, experiences, and outcomes, irrespective of level of experience or employment duration. Gendered differences were evident across key markers of research performance and reputation. Hours spent on research and employment duration both positively predicted publications for men but not women. Women were significantly more likely to adopt what are often seen as less prestigious methodologies. Importantly, men's and women's experiences of research processes, cultures and interactions differed, as was particularly evident in medicine, where women also reported significantly lower levels of workplace belonging. This research provides robust empirical evidence necessary for the development of effective organisational responses to address gender inequalities in research practices, cultures, and interactions.
In 1997, 3 years ahead of WHO's target of delivering Health for All, critical health scholarship was energised by the mainstreaming of social determinants and the optimism of the new public health. Yet alongside these collective ambitions, lifestyle discourses, rooted in 1970s healthism, proliferated across consumer cultures, framing health as a matter of personal responsibility. Over the past three decades, these individualising logics have intensified. Initially expressed through behavioural risk management, they now extend into molecular and algorithmic regimes, producing the 'genomic citizen', tasked with managing biological futures via data-driven infrastructures and market-mediated technologies. Framed as empowering, these paradigms obscure structural determinants and embed health within a political economy of anticipation, where promissory narratives justify investment while deepening responsibilisation. The COVID-19 syndemic exposed the fragility of individualised discourses, reaffirming the salience of systemic inequality. In response, this paper reflects on the concept of metabolic justice, a framework that reframes the relationship between behavioural and biological discourses while foregrounding redistribution, ecological embeddedness and systemic reform. By situating health within networks of exposure and dependency rather than individual optimisation, metabolic justice revives the ambitions of Health for All and its descendants as a materially grounded, politically transformative project for an era of social inequality and stratified medicine.
