A crucial contemporary public health issue is the construction and contestation of the relevance of the natural world to human health. Taking a critical approach, this thesis examines how the natural environment as a health determinant is positioned in relation to the ‘social’ within social epidemiological studies of health, illness and disease. Using conceptual and empirical forms of enquiry, this study shows how current constructions of natural environmental health drivers contour public health practice in the UK and that by challenging the limits of existing structures, innovative responses emerge, which can generate new frameworks for health policy and practice.
Having identified a lacuna in research on the ‘natural’ environment in medical sociology, this inductive qualitative research project brings into conversation the findings from extensive desk and field research. Specially, a study of the elaboration of environmental health discourses within the UK public health policy arena and disciplinary wide discourse analyses of key academic journals are read together to describe the discursive practices shaping environmental public health work in the UK. Linking theory to practice, data from in-depth interviews with sixty health professionals working on health and the environment in the UK and internationally are used to investigate how public health practitioners produce the environment within their work remits.
The research breaks ground for further social scientific studies of health and the environment and in particular substantiates the call for an extended notion of the ‘environment’ using ecological principles. Methodologically, the interdisciplinary reach of this research draws attention to the tensions that arise when working across the medical, natural and social sciences. Practical and philosophical questions about the challenge of expanding the sociological imagination in the contemporary moment are also considered. Empirically, to medical sociology the ‘EcoBioPsychoSocial’ framework is offered as a tool for studying health at the nexus between the ‘social’ and the ‘natural environment.’ Finally, the ways informal public health institutions are serving as ‘invisible’ forces impeding the uptake of prevention oriented environmental health policies are findings offered to the health policy arena
