Vijay Kumar Yadavendu received his Ph.D in Public Health from Jawaharlal Nehru Univerisity in 2002. He writes on philosophical historiography of public health and public health ethics. His monograph Shifting Paradigms in Public Health: From Holism to Individualism has been published by Springer 2013.
In times of a pandemic, the world lives in the throes of colossal economic and public health cris... more In times of a pandemic, the world lives in the throes of colossal economic and public health crises. The world seems unprepared and ill-equipped to cater to the catastrophic pandemic of COVID-19. The apocalyptic infectious diseases keep revisiting to expose the global widening economic and health inequalities. This review in its different sections argues that with the “financialization of everything,” a new consciousness comprising a more general heightened sense of awareness and interest in personal health and well-being pervades whereby citizens become customers. This effectively forefends the dynamics of interaction between the individual and her/his environment with its consequent impact on health and promotes an individuated risk and responsibility. Even in times of a pandemic, draconian state surveillance, lockdown, behavior modification, self-help, and self-care have emerged as guiding principles of public health. There is an urgent need for a radical reordering of the world order beyond the hegemonic, neoliberal, capitalistic ethos of rabid consumerism and unconstrained private profit.
International Journal of Social Determinants of Health and Health Services, 2023
In times of a pandemic, the world lives in the throes of colossal economic and public health cris... more In times of a pandemic, the world lives in the throes of colossal economic and public health crises. The world seems unprepared and ill-equipped to cater to the catastrophic pandemic of COVID-19. The apocalyptic infectious diseases keep revisiting to expose the global widening economic and health inequalities. This review in its different sections argues that with the “financialization of everything,” a new consciousness comprising a more general heightened sense of awareness and interest in personal health and well-being pervades whereby citizens become customers. This effectively forefends the dynamics of interaction between the individual and her/his environment with its consequent impact on health and promotes an individuated risk and responsibility. Even in times of a pandemic, draconian state surveillance, lockdown, behavior modification, self-help, and self-care have emerged as guiding principles of public health. There is an urgent need for a radical reordering of the world ...
In times of a pandemic, the world lives in the throes of colossal economic and public health cris... more In times of a pandemic, the world lives in the throes of colossal economic and public health crises. The world seems unprepared and ill-equipped to cater to the catastrophic pandemic of COVID-19. The apocalyptic infectious diseases keep revisiting to expose the global widening economic and health inequalities. This review in its different sections argues that with the “financialization of everything,” a new consciousness comprising a more general heightened sense of awareness and interest in personal health and well-being pervades whereby citizens become customers. This effectively forefends the dynamics of interaction between the individual and her/his environment with its consequent impact on health and promotes an individuated risk and responsibility. Even in times of a pandemic, draconian state surveillance, lockdown, behavior modification, self-help, and self-care have emerged as guiding principles of public health. There is an urgent need for a radical reordering of the world order beyond the hegemonic, neoliberal, capitalistic ethos of rabid consumerism and unconstrained private profit.
In times of a pandemic, the world lives in the throes of colossal economic and public health cris... more In times of a pandemic, the world lives in the throes of colossal economic and public health crises. The world seems unprepared and ill-equipped to cater to the catastrophic pandemic of COVID-19. The apocalyptic infectious diseases keep revisiting to expose the global widening economic and health inequalities. This review in its different sections argues that with the “financialization of everything,” a new consciousness comprising a more general heightened sense of awareness and interest in personal health and well-being pervades whereby citizens become customers. This effectively forefends the dynamics of interaction between the individual and her/his environment with its consequent impact on health and promotes an individuated risk and responsibility. Even in times of a pandemic, draconian state surveillance, lockdown, behavior modification, self-help, and self-care have emerged as guiding principles of public health. There is an urgent need for a radical reordering of the world order beyond the hegemonic, neoliberal, capitalistic ethos of rabid consumerism and unconstrained private profit.
This paper argues that the rise of health psychology, has made for a a new consciousness about he... more This paper argues that the rise of health psychology, has made for a a new consciousness about health that comprises a more general heightened awareness and interest in personal health. While this may be beneficial, in the absence of a social and sociological perspective also creates the illusion that individuals control their own existence, and that taking personal action may improve health and satisfy the longing for a varied set of needs. This individuates risk and responsibility and obfuscates the larger political, economic, social and cultural structural determinants of disease and ill health. I Psychology is a fragmented field ---cognitive psychology, mathematical psychology, and social psychology for instance; have little in common although they share a common heritage. Mainstream psychology is governed by the 'variable model'. Under this model, the subject matter of psychology is conceived of as a universe of actually or potentially measurable variables, the relation...
... Deepak Kumar (deepakjnu2008@gmail.com) is with the School of Social Sciences, Jawaharlal Nehr... more ... Deepak Kumar (deepakjnu2008@gmail.com) is with the School of Social Sciences, Jawaharlal Nehru University, New Delhi. ... please email: circulation@epw.in Circulation Manager, Economic and Political Weekly 320-321, A to Z Industrial Estate, Ganpatrao Kadam Marg, Lower ...
ABSTRACT Shifting Paradigms in Public Health: From Holism to Individualism This transdisciplinary... more ABSTRACT Shifting Paradigms in Public Health: From Holism to Individualism This transdisciplinary volume outlines the development of public health paradigms across the ages in a global context and argues that public health has seemingly lost its raison d’être, that is, a population perspective. The older, philosophical approach in public health involved a holistic, population-based understanding that emphasized historicity and interrelatedness to study health and disease in their larger socio-economic and political moorings. A newer tradition, which developed in the late 19th century following the acceptance of the germ theory in medicine, created positivist transitions in epidemiology. In the form of risk factors, a reductionist model of health and disease became pervasive in clinical and molecular epidemiology. The author shows how positivism and the concept of individualism removed from public health thinking the consideration of historical, social and economic influences that shape disease occurrence and the interventions chosen for a population. He states that the neglect of the multifactorial approach in contemporary public health thought has led to growing health inequalities in both the developed and the developing world. He further suggests that the concept of ‘social capital’ in public health, which is being hailed as a resurgence of holism, is in reality a sophisticated and extended version of individualism. The author addresses paradigmatic shifts in public health discourse from the ancient to the modern world, with a focus on epidemiology. The author also draws on perspectives from the social sciences, medicine, and history, while discussing the shift in public health discourses from a population focus to methodological individualism, with adverse consequences for the population. http://www.springer.com/public+health/book/978-81-322-1643-8
In the world of neoliberal globalisation, there has been a profound growth of social inequalities... more In the world of neoliberal globalisation, there has been a profound growth of social inequalities, between and within nations. This has had a most negative impact on the health and quality of life of large sections of the populations in the developed and underdeveloped world. Accompanying this is the emergence of what is referred to as the health divide. The contention of this paper is that the social production of health inequality, as shaped by neoliberalism, has to be understood in this historical context of the emergence of a new capitalist order which is primarily based on unfettered market with the motives of greed and acquitiveness. This divides societies into very rich and very poor. What a truism of coexistence of great wealth and great poverty/inequality. This offends the notion of a just and equal society. Even Richard Wilkinson’s theory of social cohesion, modelled in the Emile Durkheimian tradition of moral individualism (a system in which the individual willingly perfo...
This chapter traces the developments in the three interrelated fields of health, namely, epidemio... more This chapter traces the developments in the three interrelated fields of health, namely, epidemiology, medical sociology and health psychology. In epidemiology, people like Chadwick, Snow, Farr and Virchow began to question the bio-centricism of medical thought and highlighted the environmental and economic factors as responsible for the occurrence of certain kinds of diseases in certain kinds of populations. The sanitary movements in England in the late nineteenth century and the discussions on economic causation of disease (relating disease with poverty) are instances of the impact of methodological holism on epidemiology. The entire shift of focus in epidemiological studies from the population to an individual, from social, economic and natural environmental factors of disease aetiology to behavioural and bio-chemo-physiological factors of disease aetiology, is part and parcel of the shift in the philosophical paradigm from methodological holism to methodological individualism. In medical sociology, the prominent figures included Talcott Parsons, Evert Hughes, Robert Merton and August Hollingshead. Medical sociology can be described as the study of social factors in health and illness (referring to illness as the experience of becoming and being ill and its behavioural counterparts) or as the construction of medical health and illness, reality and social factors in health care. Unfortunately, it has restricted itself to ‘theories of middle range’ and to even narrower hypotheses, which in the last few years have tended to hide behind the pretentious concept of ‘models’. Medical sociology then becomes a mere instrument of propaganda for the welfare state or a producer of ideologies, as formulated by the German sociologist Lepsius. In health psychology, the impact of methodological individualism has been overwhelming, manifesting itself in the form of behaviourism. Behaviourism has been the most instrumental force in structuring the cult of ‘victim blaming’ in public health.
This chapter chalks out the resurgence of interest in the socio-economic dimensions of health ine... more This chapter chalks out the resurgence of interest in the socio-economic dimensions of health inequalities. The Black Report of 1980 in Britain dispelled the prevalent notion that contemporary British society is more egalitarian than in the past and showed that health inequalities have in fact increased over time and are strongly correlated to the economic or occupational status of individuals. The contention of this chapter is that income inequalities with their genesis in class structures have led to health inequalities. Prevalent public health policy, which is rooted in the philosophy of neoliberal philosophy, serves to perpetuate inequalities and in doing so reverses public health logic and history. Even Wilkinson’s theory of social cohesion/capital, modelled in the Durkheimian tradition of moral individualism, distances itself from a true population perspective. In fact, it creates a smokescreen through its claim as an alternative paradigm and thereby pushes the task of public health further back. Under Wilkinson’s model, the real shift has been only that of ‘community blaming’ in place of individual ‘victim blaming’. The attainment of better health status becomes the responsibility of the community as a whole through such measures as better social cohesion and solidarity, and better health is the responsibility of the individual through measures such as behaviour modification, self-help and self-control. In both the cases, the state has no role to play and there is no space for macrostructural change.
It is a widely accepted fact that the twentieth century has witnessed unprecedented improvements ... more It is a widely accepted fact that the twentieth century has witnessed unprecedented improvements in the aggregate health status of nations. For example, in India, life expectation at birth increased from 22 years at the start of the century to 62 years at the turn of the century, and infant mortality rates declined from 200 to about 62 (per 1,000) in the same period. In the developed world, the ‘epidemiologic transition’, which reduced the infectious and communicable disease load of the population, took place when a sizeable proportion of budgetary resources was allocated to the health sector. Thus, in England, the United States and other developed countries, diseases like malaria, tuberculosis and cholera became virtually extinct. Even the developing nations placed a great deal of emphasis on better health services. For instance, India, after liberating itself from the colonial yoke in 1947, followed a mixed economy model in which state investments were channelled to the social sector in general and health in particular. Thus, all over the globe, the period from the latter part of the nineteenth century to the middle of the twentieth century marked the golden age of public health.
Modern epidemiology has, by and large, been based on a narrow model of biomedicine and behaviour ... more Modern epidemiology has, by and large, been based on a narrow model of biomedicine and behaviour modification. It fails to answer, for instance the following questions: Why certain populations are inflicted with certain kinds of disease, and why the access to its cure and prevention is so skewed. The model of social capital that emerged subsequently too fails to address these issues adequately and furthermore suggests that it is possible for a community to escape disease solely through its own initiative. A most recent development that holds a different promise is in the realm of the theory of social capital that is being hailed in influential public health circles as a resurgence of holism. The most significant contribution of this model is that it provides a sociological explanation for health inequalities.
In times of a pandemic, the world lives in the throes of colossal economic and public health cris... more In times of a pandemic, the world lives in the throes of colossal economic and public health crises. The world seems unprepared and ill-equipped to cater to the catastrophic pandemic of COVID-19. The apocalyptic infectious diseases keep revisiting to expose the global widening economic and health inequalities. This review in its different sections argues that with the “financialization of everything,” a new consciousness comprising a more general heightened sense of awareness and interest in personal health and well-being pervades whereby citizens become customers. This effectively forefends the dynamics of interaction between the individual and her/his environment with its consequent impact on health and promotes an individuated risk and responsibility. Even in times of a pandemic, draconian state surveillance, lockdown, behavior modification, self-help, and self-care have emerged as guiding principles of public health. There is an urgent need for a radical reordering of the world order beyond the hegemonic, neoliberal, capitalistic ethos of rabid consumerism and unconstrained private profit.
International Journal of Social Determinants of Health and Health Services, 2023
In times of a pandemic, the world lives in the throes of colossal economic and public health cris... more In times of a pandemic, the world lives in the throes of colossal economic and public health crises. The world seems unprepared and ill-equipped to cater to the catastrophic pandemic of COVID-19. The apocalyptic infectious diseases keep revisiting to expose the global widening economic and health inequalities. This review in its different sections argues that with the “financialization of everything,” a new consciousness comprising a more general heightened sense of awareness and interest in personal health and well-being pervades whereby citizens become customers. This effectively forefends the dynamics of interaction between the individual and her/his environment with its consequent impact on health and promotes an individuated risk and responsibility. Even in times of a pandemic, draconian state surveillance, lockdown, behavior modification, self-help, and self-care have emerged as guiding principles of public health. There is an urgent need for a radical reordering of the world ...
In times of a pandemic, the world lives in the throes of colossal economic and public health cris... more In times of a pandemic, the world lives in the throes of colossal economic and public health crises. The world seems unprepared and ill-equipped to cater to the catastrophic pandemic of COVID-19. The apocalyptic infectious diseases keep revisiting to expose the global widening economic and health inequalities. This review in its different sections argues that with the “financialization of everything,” a new consciousness comprising a more general heightened sense of awareness and interest in personal health and well-being pervades whereby citizens become customers. This effectively forefends the dynamics of interaction between the individual and her/his environment with its consequent impact on health and promotes an individuated risk and responsibility. Even in times of a pandemic, draconian state surveillance, lockdown, behavior modification, self-help, and self-care have emerged as guiding principles of public health. There is an urgent need for a radical reordering of the world order beyond the hegemonic, neoliberal, capitalistic ethos of rabid consumerism and unconstrained private profit.
In times of a pandemic, the world lives in the throes of colossal economic and public health cris... more In times of a pandemic, the world lives in the throes of colossal economic and public health crises. The world seems unprepared and ill-equipped to cater to the catastrophic pandemic of COVID-19. The apocalyptic infectious diseases keep revisiting to expose the global widening economic and health inequalities. This review in its different sections argues that with the “financialization of everything,” a new consciousness comprising a more general heightened sense of awareness and interest in personal health and well-being pervades whereby citizens become customers. This effectively forefends the dynamics of interaction between the individual and her/his environment with its consequent impact on health and promotes an individuated risk and responsibility. Even in times of a pandemic, draconian state surveillance, lockdown, behavior modification, self-help, and self-care have emerged as guiding principles of public health. There is an urgent need for a radical reordering of the world order beyond the hegemonic, neoliberal, capitalistic ethos of rabid consumerism and unconstrained private profit.
This paper argues that the rise of health psychology, has made for a a new consciousness about he... more This paper argues that the rise of health psychology, has made for a a new consciousness about health that comprises a more general heightened awareness and interest in personal health. While this may be beneficial, in the absence of a social and sociological perspective also creates the illusion that individuals control their own existence, and that taking personal action may improve health and satisfy the longing for a varied set of needs. This individuates risk and responsibility and obfuscates the larger political, economic, social and cultural structural determinants of disease and ill health. I Psychology is a fragmented field ---cognitive psychology, mathematical psychology, and social psychology for instance; have little in common although they share a common heritage. Mainstream psychology is governed by the 'variable model'. Under this model, the subject matter of psychology is conceived of as a universe of actually or potentially measurable variables, the relation...
... Deepak Kumar (deepakjnu2008@gmail.com) is with the School of Social Sciences, Jawaharlal Nehr... more ... Deepak Kumar (deepakjnu2008@gmail.com) is with the School of Social Sciences, Jawaharlal Nehru University, New Delhi. ... please email: circulation@epw.in Circulation Manager, Economic and Political Weekly 320-321, A to Z Industrial Estate, Ganpatrao Kadam Marg, Lower ...
ABSTRACT Shifting Paradigms in Public Health: From Holism to Individualism This transdisciplinary... more ABSTRACT Shifting Paradigms in Public Health: From Holism to Individualism This transdisciplinary volume outlines the development of public health paradigms across the ages in a global context and argues that public health has seemingly lost its raison d’être, that is, a population perspective. The older, philosophical approach in public health involved a holistic, population-based understanding that emphasized historicity and interrelatedness to study health and disease in their larger socio-economic and political moorings. A newer tradition, which developed in the late 19th century following the acceptance of the germ theory in medicine, created positivist transitions in epidemiology. In the form of risk factors, a reductionist model of health and disease became pervasive in clinical and molecular epidemiology. The author shows how positivism and the concept of individualism removed from public health thinking the consideration of historical, social and economic influences that shape disease occurrence and the interventions chosen for a population. He states that the neglect of the multifactorial approach in contemporary public health thought has led to growing health inequalities in both the developed and the developing world. He further suggests that the concept of ‘social capital’ in public health, which is being hailed as a resurgence of holism, is in reality a sophisticated and extended version of individualism. The author addresses paradigmatic shifts in public health discourse from the ancient to the modern world, with a focus on epidemiology. The author also draws on perspectives from the social sciences, medicine, and history, while discussing the shift in public health discourses from a population focus to methodological individualism, with adverse consequences for the population. http://www.springer.com/public+health/book/978-81-322-1643-8
In the world of neoliberal globalisation, there has been a profound growth of social inequalities... more In the world of neoliberal globalisation, there has been a profound growth of social inequalities, between and within nations. This has had a most negative impact on the health and quality of life of large sections of the populations in the developed and underdeveloped world. Accompanying this is the emergence of what is referred to as the health divide. The contention of this paper is that the social production of health inequality, as shaped by neoliberalism, has to be understood in this historical context of the emergence of a new capitalist order which is primarily based on unfettered market with the motives of greed and acquitiveness. This divides societies into very rich and very poor. What a truism of coexistence of great wealth and great poverty/inequality. This offends the notion of a just and equal society. Even Richard Wilkinson’s theory of social cohesion, modelled in the Emile Durkheimian tradition of moral individualism (a system in which the individual willingly perfo...
This chapter traces the developments in the three interrelated fields of health, namely, epidemio... more This chapter traces the developments in the three interrelated fields of health, namely, epidemiology, medical sociology and health psychology. In epidemiology, people like Chadwick, Snow, Farr and Virchow began to question the bio-centricism of medical thought and highlighted the environmental and economic factors as responsible for the occurrence of certain kinds of diseases in certain kinds of populations. The sanitary movements in England in the late nineteenth century and the discussions on economic causation of disease (relating disease with poverty) are instances of the impact of methodological holism on epidemiology. The entire shift of focus in epidemiological studies from the population to an individual, from social, economic and natural environmental factors of disease aetiology to behavioural and bio-chemo-physiological factors of disease aetiology, is part and parcel of the shift in the philosophical paradigm from methodological holism to methodological individualism. In medical sociology, the prominent figures included Talcott Parsons, Evert Hughes, Robert Merton and August Hollingshead. Medical sociology can be described as the study of social factors in health and illness (referring to illness as the experience of becoming and being ill and its behavioural counterparts) or as the construction of medical health and illness, reality and social factors in health care. Unfortunately, it has restricted itself to ‘theories of middle range’ and to even narrower hypotheses, which in the last few years have tended to hide behind the pretentious concept of ‘models’. Medical sociology then becomes a mere instrument of propaganda for the welfare state or a producer of ideologies, as formulated by the German sociologist Lepsius. In health psychology, the impact of methodological individualism has been overwhelming, manifesting itself in the form of behaviourism. Behaviourism has been the most instrumental force in structuring the cult of ‘victim blaming’ in public health.
This chapter chalks out the resurgence of interest in the socio-economic dimensions of health ine... more This chapter chalks out the resurgence of interest in the socio-economic dimensions of health inequalities. The Black Report of 1980 in Britain dispelled the prevalent notion that contemporary British society is more egalitarian than in the past and showed that health inequalities have in fact increased over time and are strongly correlated to the economic or occupational status of individuals. The contention of this chapter is that income inequalities with their genesis in class structures have led to health inequalities. Prevalent public health policy, which is rooted in the philosophy of neoliberal philosophy, serves to perpetuate inequalities and in doing so reverses public health logic and history. Even Wilkinson’s theory of social cohesion/capital, modelled in the Durkheimian tradition of moral individualism, distances itself from a true population perspective. In fact, it creates a smokescreen through its claim as an alternative paradigm and thereby pushes the task of public health further back. Under Wilkinson’s model, the real shift has been only that of ‘community blaming’ in place of individual ‘victim blaming’. The attainment of better health status becomes the responsibility of the community as a whole through such measures as better social cohesion and solidarity, and better health is the responsibility of the individual through measures such as behaviour modification, self-help and self-control. In both the cases, the state has no role to play and there is no space for macrostructural change.
It is a widely accepted fact that the twentieth century has witnessed unprecedented improvements ... more It is a widely accepted fact that the twentieth century has witnessed unprecedented improvements in the aggregate health status of nations. For example, in India, life expectation at birth increased from 22 years at the start of the century to 62 years at the turn of the century, and infant mortality rates declined from 200 to about 62 (per 1,000) in the same period. In the developed world, the ‘epidemiologic transition’, which reduced the infectious and communicable disease load of the population, took place when a sizeable proportion of budgetary resources was allocated to the health sector. Thus, in England, the United States and other developed countries, diseases like malaria, tuberculosis and cholera became virtually extinct. Even the developing nations placed a great deal of emphasis on better health services. For instance, India, after liberating itself from the colonial yoke in 1947, followed a mixed economy model in which state investments were channelled to the social sector in general and health in particular. Thus, all over the globe, the period from the latter part of the nineteenth century to the middle of the twentieth century marked the golden age of public health.
Modern epidemiology has, by and large, been based on a narrow model of biomedicine and behaviour ... more Modern epidemiology has, by and large, been based on a narrow model of biomedicine and behaviour modification. It fails to answer, for instance the following questions: Why certain populations are inflicted with certain kinds of disease, and why the access to its cure and prevention is so skewed. The model of social capital that emerged subsequently too fails to address these issues adequately and furthermore suggests that it is possible for a community to escape disease solely through its own initiative. A most recent development that holds a different promise is in the realm of the theory of social capital that is being hailed in influential public health circles as a resurgence of holism. The most significant contribution of this model is that it provides a sociological explanation for health inequalities.
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