Social Movements in Health (review)

This is an edited volume that attempts to bridge the gap between the social movement literature and studies in health. As such, it is an interesting and welcome contribution, particularly to sociologists of health and medicine. The collection is tidy (nine essays in all) with just enough breadth to whet the appetite of those inclined toward health activism. The entries range from the theoretical to the empirical, and employ a wide range of methodological strategies.

Brown and Zavestoski organize the essays in response to four questions. Two theoretical pieces address the first question ("Where do HSMs [Health Social Movements] fit within the broader cultural trend of public involvement in science?"). Hess uses the concept of medical modernization to illustrate how HSMs and CAM (complementary and alternative medicine) are incorporated into traditional medicine without challenging the fundamental validity of science. He argues that a theoretical synthesis of medical sociology and the sociology of science is necessary to understand these epistemic challenges to medicine. Goldner, on the other hand, merges social movement and institutional theories to understand how physicians and hospitals respond to the CAM movement. She argues that medical elites can avoid, acquiesce to, compromise with, manipulate or defy challenges to their dominance. Co-optation is a strong warning in both of these pieces; something health activists should bear in mind in the struggle for recognition and validation.

Three chapters address the second question: "Is there an organized 'health social movement'?" The strongest of these chapters is by Joffe, Weitz and Stacey. They describe a fascinating relationship between pro-choice physicians and feminist health activists that, among other things, results in the development of freestanding abortion clinics (as opposed to incorporating abortion into the hospital). Allsop, Jones and Baggott draw on two empirical studies of the health consumer movement in the United Kingdom. They learn that health consumer groups grow out of patients' expertise with illness, pain and loss. While group networks and alliances are important, the ability of these groups to challenge health professionals and affect policy is questioned. Ganchoff argues that biotechnology, most specifically as it relates to embryonic stem cells, operates through a politics of potentiality that creates contested terrains between competing imagined futures.

Beard addresses the third question through the lens of the Alzheimer's movement: "How do full-fledged social movement organizations emerge from a hodge-podge of interest or support groups?" She argues sympathetically that the symbolic liminality – between life and death – of people with Alzheimer's mutes their effectiveness as spokespeople for their movement. This is conveyed most effectively by the words of people in the early stages of Alzheimer's, although the perspectives of staff members of the Alzheimer's Association are given voice as well.

The last question is addressed within the context of the breast cancer movement: "How do HSMs use cultural resources to achieve their goals?" Drawing on Congressional testimony and media accounts, Kolker identifies three cultural frames – breast cancer as an epidemic, as a problem of gender equity, and as a threat to families – to convert breast cancer from a private trouble to a major, publicly-funded health problem. Klawiter uses a case-study to illustrate two temporally-specific breast cancer regimes. The earlier regime (in 1979) empowered physicians while it individualized, isolated and attempted to hetero-normalize breast cancer "victims." The latter regime (in 1997) replaced surgical hegemony with an empowered breast cancer "survivor" who had access to knowledge, services, resources, allies and organizations, as she also embraced environmental causes of breast cancer.

While the editors' organizational logic certainly is creative and non-linear, it is not readily obvious when reading the essays themselves. Unless the material from the introduction is borne in mind throughout the reading, the editors risk the impression of skipping from topic to topic. A simple change in the layout of the Contents, or an introductory paragraph at the beginning of each of the four sections, would have easily remedied this concern. Another quirk is the Notes on Contributors; they appear to bear...