On difference and doubt as tools for critical engagement with public health

Abstract

This paper argues that critical public health should reengage with public health as practice by drawing on versions of Science and Technology Studies (STS) that ‘de-centre the human’ and by seeking alternative forms of critique to work inspired by Foucault. Based on close reading of work by Annemarie Mol, John Law, Vicky Singleton and others, I demonstrate that these authors pursue a conversation with Foucault but suggest new approaches to studying contemporary public health work in different settings. Proposing that we ‘doubt’ both the unity of public health and its effects, I argue that this version of STS opens up a space to recognise multiplicity; to avoid idealising what is being criticised; and to celebrate or care for public health practices as part of critique. Finally I oppose the view that considering technologies, materials and microbes leads to micro-level analysis or political neutrality, and suggest that it allows us to reframe studies of public health to account for inequalities and to draw attention to weak or retreating states, active markets and the entangled relations of humans and non-humans across the world.

Keywords:

• Theory
• critique
• technology

Acknowledgements

I am grateful to Rebecca Lynch and Simon Cohn for the encouragement to write this paper, to Simon Carter and Judith Green for the initial invitation to present on the topic at the event celebrating 25 years of the journal, and to participants at that event, my colleague Alison Phipps, and two anonymous reviewers for very helpful comments on previous versions.

Notes

1. Though John Law is often associated mainly with Actor Network Theory as a distinct approach, in the last decade he has frequently written with Annemarie Mol and their work has evolved together. He is also a long-term collaborator with a British feminist STS scholar, Vicky Singleton. In several articles these authors explore how foot and mouth disease was identified and managed by the various agencies, experts and stakeholders including farmers living through the foot and mouth outbreak in the UK in 2001. For another example see Singleton’s (2010) discussion of farming practices as offering the potential for more sensitive responses to the disease.