Revisionist or simply wrong? A response to Armstrong's article on chronic illness

Abstract

This article is a response to David Armstrong's recent, revisionist account of the epidemiological transition which he claims replaced earlier discourses of ageing with new discourses of chronic disease. We argue (i) that he misrepresents a key element in Omran's account of the epidemiological transition, namely the decline in infant, child and maternal mortality; (ii) that he fails to acknowledge debates going back centuries in Western medicine over the distinctions between natural and accidental death and between endogenous and extrinsic causes of ageing and (iii) that he misrepresents the growth of medical interest in the everyday illnesses of old age over the course of the 20th century as a discourse of suppression rather than a process of inclusion. While we would acknowledge that the chronic illnesses of today are different from those of the past, this amounts to something more than the changing semantics of senility.

An unproblematized truth: Foucault, biopolitics, and the making of a sociological canon

“…Perhaps more substantially, this vocabulary has offered for the first time a clear theoretical focus for sociology of health bringing it closer to mainstream debates on modernity, power, and rationalization (Turner 1997). This is, of course, not to say that Foucault or Foucauldian ideas have persuaded everyone in the discipline (for instance, Gilleard and Higgs 2014), or that there are not major critiques of his concepts, even among people significantly inspired by his work. Foucault himself as any genuine thinker, is quite a mobile target, with recognized shifts in his ongoing and unfinished work (Nye 2003).…”

“…The only critique to Foucauldian chronologies in health in my search isGilleard and Higgs (2014) that, however, do not criticize the eighteenth century break suggested by Foucault but the specific point of an epidemiological transition in the twentieth century supported by a first-generation Foucauldian like sociologist David Armstrong.…”