International Society for History, Philosophy, and Social Studies of Biology


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Program

TUESDAY, JULY 7  /  17:30 - 19:00  /  DS-R510
Organized session / standard talks
Risk perception: Issues in public health and medical practice
Organizer(s):

Annick Opinel (Institut Pasteur, France)

In this session, we will analyse risk perception. We will address several issues linked to risk perception in terms of public health: is risk perception a matter of individuals, of gender, of genetics? In what way social determinants impact this perception? Wouldn’t a broader focus on higher-level social phenomena instead of individual risk factors be more relevant in such a perception analysis? How, in the case of vaccination, real or suspected adverse effects after immunisation modify disease risk perception in general population and therefore health policies?


Risk perception and the individualization social determinants of health

Jonathan Kaplan (Oregon State University, United States)

Many researchers argue that, at least in developed countries, the social determinants of health have a greater impact on health outcomes (longevity, morbidity) than do many other risk factors, including variations in the medical systems. Nevertheless, while relatively small associations between genes and particular health outcomes (say) or the availability of a particular treatment option and health outcomes are considered newsworthy, even relatively large differences in the social determinants of health are routinely ignored. The search for genes that might explain some part of the association between relatively poor health outcomes and being “Black” in the U.S. exemplifies this pattern. Part of the reason for this may be that individual risk factors, whether they are under the control of the individuals or not, are easily understood, and fit into our standard narratives about health, well-being, and risks. Broader risk factors associated with higher-level phenomenon, on the other hand, do not fit into our narratives of risks, and are therefore harder for people to take seriously. Attempts to understand the causal pathways by which the social determinants of health have their effects may help by showing how these risks can be understood as impacting on individuals, but the danger is that by doing this, social harms may be reinterpreted as individual harms that can (or should) be responded to by modifying individuals’ risk factors. So, for example, if one way that economic inequality impacts health is through the stresses associated with relative scarcity and deprivation, individual interventions designed to target the stress might be recommended. These would be unlikely to have much of an impact on population-level health outcomes, but fit much better within a system that addresses individual risks. It is therefore important that we resist the individualization of the social determinants of health, and keep the focus on the higher-level social phenomena.


Suspected adverse events after immunisation, subsequent public health policy process and risk perception : The case of hepatitis B in France and MMR in UK (1998-2010)

Annick Opinel (Institut Pasteur, France); Helen Bedford (University College London, United Kingdom)

This paper focuses on the development of public health policy following public concerns over suspected adverse events associated with immunisation. Using the examples of hepatitis B vaccine in France and combined measles, mumps and rubella (MMR) vaccine in UK (1998-2010), we compare two events occurring in 1998. In France following several case reports that hepatitis B vaccination may be linked to new cases or relapse of multiple sclerosis (MS), the French Ministry of Health temporarily suspended the school-based adolescent hepatitis B vaccine programme. In UK following publication of a now discredited article in a medical journal which was interpreted as showing a link between MMR vaccine and the development of autism and bowel disorders (Wakefield et al, 1998), the vaccine continued to be offered as part of the routine programme. In comparing the French and British approach to these potential threats to the immunisation programmes we highlight on the one hand how national behaviours differ and the link between public health decision-making and, on the other hand, differences in national risks perception.


"The Future of Humanity": A critical analysis of gender, risk, and the human microbiome

Jessica Houf (University of Utah, United States)

The discourses of science and medicine are powerful, and their influence on what it means to be a woman or a man or something more are seemingly inescapable. This presentation concerns itself with how the body is gendered through science and medicine, and how this gendering functions to constitute bodies and gendered medical practices. Feminist science studies scholars, such as Evelyn Fox Keller, have argued for the recognition of science as a construction project and urged researchers to explore scientific moments of transition to unravel the linkages between humans, nature, and life. This study is a critical analysis of the formation of gender as it is unfolding within human microbiome discourse; specifically, I focus on two gendered discourses of risk coalescing around pregnancy, male circumcision and the human microbiome. I argue that gender's function within human microbiome discourse is to inscribe very different relations with microbes for men and women, it is not simply a case of finding differing microbiomes. Overall, by tracing this process of scientific construction it allows humanities scholars to intervene in this world making endeavor, which is a difficult task that scientists and physicians must face.