A socioecological discourse of care or an economistic discourse: which fits better with transition?

Abstract

Objective: To analyse a ‘socioecological’ health promotion discourse and its relationship to orthodox ‘economistic’ discourse in Australia. Method: In research on health promotion addressing equity and environmental sustainability, we identified a socioecological discourse, based on an ethic of care for people and ecosystems. Using Foucault's concept of discourse as a regime that produces and legitimises certain kinds of knowledge, and ecofeminist historical analysis, we analysed this discourse and its relationship to economism. Results: The socioecological discourse takes social and ecological wellbeing as primary values, while economism takes production and trade of goods and services, measured by money, as primary. Following British invasion, property‐owning white men in Australia had the right to control and profit from land, trade, and the work of women and subordinate peoples. A knowledge regime using money as a primary measure reflects this history. In contrast, a First Nations’ primary value expressed in the study was ‘look after the land and the children’. Conclusion and implications for public health: Public health often attempts to express value through economism, using monetary measures. However, socioecological discourse, expressed for example through direct measures of social and ecological wellbeing, appears more fit for purpose in promoting a fair and sustainable society.

Addressing hidden tensions and grey areas of general practice: a qualitative study of the experiences of newly qualified GPs attending a course on generalist medicine

“…We know from previous research that opportunities for successful change can arise when health providers are enabled to actively engage in healthcare initiatives (46). This could mean redesigning of primary care services to prioritise care work (47), or involving newly qualified GPs in the design of their own education and research to shape healthcare's decision-making paradigms. In medical education settings, newly qualified GPs can build on each other's knowledge by sharing their clinical experience and developing contextual knowledge needed to address the complexities of real-life clinical decision-making (48).…”