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Mildred Blaxter. UK: Cambridge, 2004, £50 (hardback), £14.99 (paperback), pp 168. ISBN 0-7456-3082-0 (hardback), 0-7456-3083-9 (paperback)
This book offers a revision of health concept and discusses different meanings of health and illness. It begins with lay definitions and enactments and concludes with speculations about the influence of contemporary trends and technological changes in health. It also explains how people contribute to enact and define these nuclear concepts of health and illness.
It is structured in six chapters. The first one, “How is health defined?”, discusses the use of the definition of health as the opposite of illness. As the author points, this kind of restrictive definition is evidence of the tendency to avoid the complexity involved in these issues. In this part of the book the discussion is focused on the social consequences for communities and individuals of this lack of effort in providing more complex definitions. The first chapter finishes with the consequences of limited definitions on the measurement of health status and on the development of preventive interventions. In other words, the author discusses how the absence of integrated concepts can affect our capacity to know more about health, illness, sickness, and being health or unhealthy.
The second chapter, “How is health constructed?”, explores the social construction of health. Literature is reviewed on how the idea of illness is partly based on real facts but it is also a social construct. More specifically, health and illness constructs related with cultures and different perspectives (feminism, constructivism, relativism) are explored. The discussions on obesity, hysteria, and disability are especially interesting in this chapter.
Lay definitions of health and illness are the main subject of the third chapter, “How is health experienced?”. Based on the knowledge provided by literature on this topic, the chapter provides the reader further information on how people attribute determinants and causes of health and illness. It also gives several ideas related to health like a moral discourse and a metaphor. The discussion continues in chapter four, “How is health enacted?”, examining the way that people enact the states of being healthy or ill. Studies of illness behaviour and their criticisms are the basis of the discussion.
The book finishes with two topics related with the influence of contemporary social changes in health and illness. Chapter five, “How is health related to social systems?”, focuses on the relation between health and society. It is structured in two parts. On the one hand, theories of the relation of health and society are described. On the other hand, health inequalities and their possible explanations are carried out. Finally, chapter six, “Where is the concept of health going in the contemporary world?”, contains information about how contemporary trends may influence and promote changes in the boundaries between ill and not-ill, life and death, self and not-self, and health and illness.
To finish this review it is interesting to comment on the global significance of this book. The author mentions in the introduction that it is not a textbook, but it could provide an important discussion for the academic field. The study of basic concepts related with health could be useful to improve public health professional work as well. Furthermore, this book could support the role of communities and individuals who are involved in the development of policies.
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