The critical perspective refers to attention being paid to
the role upon health and well-being of structural issues
usually involving issues of social control and power by
powerful -- societal interests. It involves a concern with
looking at the not obviously visible -- a grand weakness of
traditional health sciences approaches associated with
positivist thought. The perspective draws upon concepts from
critical sociology, and political economy especially
materialist approaches.

In lay terms it usually involves a focus on "the story behind
the story."  Why is smoking the problem and not tobacco
distribution?  Why is the problem of poor parents' parenting
behaviours the issue, not the increasing incidence of poverty?
Why do we consider establishing community kitchens but not
providing a place for families to live?

For some examples of the perspective see Blake Poland's work
in the Canadian Journal of Public Health and Social Science
and Medicine on population health, Ann Robertson's work on
health promotion in Health Promotion International and
Critical Public Health, David Coburn's work on neo-liberalism
and health in a recent issue of Social Science and Medicine,
or my modest contributions on inequality and health in the
Canadian Review of Social Policy, Critical Public Health and
on governments policies affecting health in the most recent
Canadian Journal of Public Health.

Finally, Kim Travers' article in Social Science and Medicine
"The social organization of nutritional inequities, SSM, 1996,
43, 543-553 is a masterful illustration of the perspective.

My quotation below is also an exemplar of the perspective!


dr

In the early hours I read in the paper of
epoch-making projects On the part of pope
and sovereigns, bankers and oil barons.
With my other eye I watch
The pot with the water for my tea
The way it clouds and starts to bubble and clears again
And overflowing the pot quenches the fire.

   -- Bertolt Brecht

**************************************************************
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Dennis Raphael, Ph.D.
Associate Professor
Department of Public Health Sciences
Graduate Department of Community Health
University of Toronto
McMurrich Building, Room 308
Toronto, Ontario, CANADA M5S 1A8
voice: (416) 978-7567
fax: (416) 978-2087
e-mail:   [log in to unmask]