Contemporary Health Studies. Louise Warwick-Booth

Foreword

      I welcome the second edition of this excellent text. The Introduction sets out what the book is designed to provide and it delivers on these promises. One test of a book is that it engages the reader from the outset. The early chapter on Contemporary Threats to Health led me to think about the way some specific threats were perceived at the start of my own professional life in health promotion. At that time, the impact of the physical environment on health was addressed but there was little mention of climate change; some discussion of malnutrition associated with food shortages and nutritional deficits but less with obesity; there was early discussion of what became known as HIV/AIDS but little general consideration of pandemics; and there was a growing recognition that health inequalities in the UK continued to exist, despite the welfare state. Where inequalities were concerned, the nature of these was analysed and explanations for them debated, especially after the 1980 Black Report and the reports that followed, and strategies to ameliorate them were discussed. I recall some optimism that as appropriate strategies were identified there would be the will to implement them and a reduction of inequalities would follow. Over the intervening years there have been policies and actions with the potential to reduce health inequalities, with initiatives to reduce child poverty being one example; but they have not been sustained, and inequalities continue to prevail. Moreover, there is the realization that COVID-19 has led to a further widening of gaps. In comparison with that early naive optimism, the resistance to implementing changes designed to achieve greater health equity is now very clear. This book provides a thorough consideration of health inequalities, which should enable health-studies students to understand their nature and make future contributions to the task of overcoming these and the other key barriers to achieving health for all.

Health studies is a distinct discipline, which integrates concepts and theories from contributory ones. There will be debates about what these disciplines should be and the relative weight to be given to each. In this book, the authors focus on four key ones and give readers the tools to draw on each of these in analysing health matters. The later chapter on social policy provides a further important disciplinary perspective. The guidance on how to use the book makes readers aware from the outset that they will be on a journey in which they will reflect on and critique the meanings of health and the influences on it, as well as examining conceptual models of health and its determinants. Although a social model informs the book, readers are enabled to think critically about all models and, specifically, to compare and contrast the social and medical ones. The encouragement to readers to think about health in salutogenic terms and not simply as absence of disease – and to consider lay as well as professional perspectives – is important. The use of the Dahlgren and Whitehead model in the third section, and modifications to include a stronger global emphasis, is a particular strength of the book. In analysing health issues this model facilitates the consideration of multi-level influences and their interactions.

      Given the scope of health studies, ensuring that depth is not sacrificed to breadth is a challenge. The authors have successfully met this challenge. Their own extensive teaching experience in health studies and health promotion is evident in the clarity of their explanations of complex ideas, while encouraging readers to reflect on these ideas and read further. Relevant theory is drawn upon throughout the book and critiques offered. The inclusion of learning tasks and case studies, particularly the integrative ones in the last chapter, all serve to keep the reader actively engaged. These updated case studies provide excellent models for analysing existing and newly emergent health issues, such as COVID-19. Although each of the chapters contributes to an integrated whole, many can stand alone. The Investigating Health chapter, for example, offers a succinct but critical introduction to the research process and could usefully be read by students on courses other than health-related ones. I especially welcome the global focus of the book and this is informed by the professional experience of the authors. Overall, the book offers an excellent amalgam of content, theory, critique and practical examples. While offering an essential text for health-studies courses, it can be strongly recommended to related ones.

      Sylvia Tilford

      Emeritus Professor of Health Promotion, Leeds Beckett University