From paper to the digital: Towards a conceptualisation of the mediation of health information Michael Hardey and Sarah Net...
Information in Conext <ul><li>We have good detailed descriptions and empirical studies about health and the Internet. </li...
The Internet as new media <ul><li>Reminds us that in the past we had other forms of information that was more or less avai...
Two dimensions  <ul><li>Authoritative health discourse </li></ul><ul><li>Availability of information  </li></ul>
The ‘Authorised Health Discourse’ AHD <ul><li>We view health information in relation to the power/knowledge claims of medi...
AHD – an example <ul><li>The public health concern about obesity is constructed from biomedical knowledge that generated t...
Information <ul><li>Mediated health information is diverse and includes: Books, newspapers, magazines, radio, TV and the I...
A typology of mediated information - four ideal types AHD (weaker) AHD (stronger) Information Scarce <ul><li>Pluralism </l...
1. Pluralism <ul><li>Multiple sources of more or less incoherent authoritative knowledge and information scarce for the ma...
Professionalism  <ul><li>The ‘golden age’ of medicine. </li></ul><ul><li>Parsons - sick role. </li></ul><ul><li>Starr - th...
3. Proliferation <ul><li>Consumerism, social movements etc challenge medical hegemony re-emergence of alternatives ‘medica...
4. Percolation <ul><li>Evidence based culture and reasserted ‘scientific’  basis of AHD. </li></ul><ul><li>Health ‘problem...
Why ‘percolation’ ?  <ul><li>‘ … how can such highly rational production result in the incredible irrationality of informa...
The percolation process  <ul><li>Media convergence and ‘software sorting’ (Thrift) and ‘ordering’ of digital information; ...
Web 2.0 <ul><li>Blogs, SNSs, etc provide new ways for people to read/write about health. </li></ul><ul><li>User generated ...
Conclusion <ul><li>Information about health reflects greater consumerism and need to make ‘responsible’ - informed - choic...
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BSA Medical Sociology Conference 2008 Slides

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A look at meditated information - paper to Web 2.0

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BSA Medical Sociology Conference 2008 Slides

  1. 1. From paper to the digital: Towards a conceptualisation of the mediation of health information Michael Hardey and Sarah Nettleton Hull/York Medical School and Dept Sociology York University BSA Medical Sociology 2008
  2. 2. Information in Conext <ul><li>We have good detailed descriptions and empirical studies about health and the Internet. </li></ul><ul><li>This is an attempt to provide a broader socio-historical context to the role of the Internet: We considerer the nature of mediated health information. W e attempt to identify new ways in which information is created and consumed. </li></ul>
  3. 3. The Internet as new media <ul><li>Reminds us that in the past we had other forms of information that was more or less available to authors and audiences - for example: </li></ul><ul><li>Print media was ‘new’ - the book </li></ul><ul><li>Newspapers and magazines </li></ul><ul><li>Radio and TV </li></ul>
  4. 4. Two dimensions <ul><li>Authoritative health discourse </li></ul><ul><li>Availability of information </li></ul>
  5. 5. The ‘Authorised Health Discourse’ AHD <ul><li>We view health information in relation to the power/knowledge claims of medicine. </li></ul><ul><li>Discourse reflects the way meaning is embedded in language in that concepts like health, illness and disease become a set of knowledge, expertise and techniques are called upon to, for example, fight disease or shape public health interventions. </li></ul><ul><li>The term ‘health’ is used in recognition of the way our understandings of health and illness are shaped by a implicate or explicit acknowledgement of medicine knowledge. </li></ul><ul><li>AHD is also a professional discourse that privileges expert knowledge and values about health and illness. </li></ul><ul><li>Consequent power relationships identify those who have the authority to represent medicine and those who do not. </li></ul><ul><li>AHD works to identify particular forms of knowledge that may be used to create or shape information about health. </li></ul>
  6. 6. AHD – an example <ul><li>The public health concern about obesity is constructed from biomedical knowledge that generated the Body Mass Index (BMI, kg/m²). </li></ul><ul><li>There are many critiques of what WHO (1998) identified as the global obesity epidemic . </li></ul><ul><li>But in shaping health policy or the doctor/patient consultation the boundaries around claims to expertise become tightly drawn (for example, Campos, 2004). </li></ul><ul><li>AHD processes work here to limit broader debate and information by rendering critics as either ill-informed, misguided, or ‘political’ in that they advocate a bodily form and lifestyle that is unhealthy, risky and open to stigma (Aphramor, 2005). </li></ul>
  7. 7. Information <ul><li>Mediated health information is diverse and includes: Books, newspapers, magazines, radio, TV and the Internet. </li></ul><ul><li>Print media was once ‘new’ - expensive and limited to those who could read. </li></ul><ul><li>Now information is so plentiful we have ‘infoglut’ or suffer from ‘information obesity’. </li></ul>
  8. 8. A typology of mediated information - four ideal types AHD (weaker) AHD (stronger) Information Scarce <ul><li>Pluralism </li></ul><ul><li>(‘The past’) </li></ul>2. Professionalism (1900 – 1960s) Information Rich 3. Proliferation (1970s - 1999) 4. Percolation (2000 - the future?)
  9. 9. 1. Pluralism <ul><li>Multiple sources of more or less incoherent authoritative knowledge and information scarce for the masses. </li></ul><ul><li>Competing producers of information vying for authority e.g. astrologists - almanac and medicine - anatomical text (cf Wright, 1979). </li></ul><ul><li>Few users due to literacy rates. </li></ul>
  10. 10. Professionalism <ul><li>The ‘golden age’ of medicine. </li></ul><ul><li>Parsons - sick role. </li></ul><ul><li>Starr - the ‘sovereign profession’. </li></ul><ul><li>Users as ‘deferent’ and ‘obedient’ to AHD. </li></ul><ul><li>Pamphlets providing advice and ‘book of family medicine’ safely stored in the home. </li></ul><ul><li>‘ Lord Hill became popular for his wartime broadcasts as the BBC's Radio Doctor, in which he discussed health problems in lay language’ (BBC Web site). </li></ul>
  11. 11. 3. Proliferation <ul><li>Consumerism, social movements etc challenge medical hegemony re-emergence of alternatives ‘medical pluralism’, reflexive modernisation. </li></ul><ul><li>Users as ‘questioning’ and seeking wellness – not just the avoidance of illness. </li></ul><ul><li>AHD questioned, yet need to know what was ‘reliable’ health information. </li></ul><ul><li>Medical profession ‘re-professionalised’ (Lupton 1997). </li></ul><ul><li>Anxieties, ‘panic’ re dissemination of ‘risky information’ from sources such as the Internet. </li></ul>
  12. 12. 4. Percolation <ul><li>Evidence based culture and reasserted ‘scientific’ basis of AHD. </li></ul><ul><li>Health ‘problems’ defined through AHD e.g. smoking and obesity crisis. </li></ul><ul><li>Citizens responsible for own health and expected to make ‘healthy’ lifestyle choices – which are informed via AHD. </li></ul>
  13. 13. Why ‘percolation’ ? <ul><li>‘ … how can such highly rational production result in the incredible irrationality of information overloads, misinformation, disinformation and out-of-control information. At stake is a disinformed information society .’ (Lash 2002 p.2). </li></ul>
  14. 14. The percolation process <ul><li>Media convergence and ‘software sorting’ (Thrift) and ‘ordering’ of digital information; processes co-construction of hierarchies - commercially influenced and automatic sorting. </li></ul><ul><li>Web 2.0 and personalisation - tailoring of information needs - (e.g. shared book marking del.i.cous which is recursive as people can share bookmarks). </li></ul><ul><li>Information diverse but increasingly ‘sorted out’- filtered - and stratified though AHD. </li></ul>
  15. 15. Web 2.0 <ul><li>Blogs, SNSs, etc provide new ways for people to read/write about health. </li></ul><ul><li>User generated review sites - ‘RateMD’, ‘Patient Opinion’ - constitute ways users can read/write comments about identified practitioners and services. </li></ul><ul><li>Information created by ever more authors – You Tube – Podcasts - Blogs. </li></ul><ul><li>AHD becomes more important as a way of ‘sorting information out’. </li></ul>
  16. 16. Conclusion <ul><li>Information about health reflects greater consumerism and need to make ‘responsible’ - informed - choices. </li></ul><ul><li>Information increasingly feeds back to health care institutions e.g. ‘Patient Opinion’ sends comments to ‘quality mangers’ in NHS. </li></ul><ul><li>AHD increasingly shapes choices but it may also increasingly acknowledge or incorporate consumer information e.g. user reviews – Google ‘health record’. </li></ul>

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