History and Social Change in Health and Medicine

Abstract

In general, qualitative research – in health or otherwise – has not paid much attention to history. And why should it? While most qualitative scholars, particularly the more constructivist among us, would naturally acknowledge that the people and societies they study are different to those that preceded them, this mostly has little or no influence in practice on research design or conduct. History is interesting, yes, but in most cases must seem either too arcane, or too removed, to inform health research. There are, however, occasions where history may seem to have some instrumental value for health research: to learn about the efficacy and impacts of interventions in the past; to avoid past mistakes or reinventing the wheel; to be more influential advocates. For example, health researchers may be interested in social histories of Prohibition-era USA in order to think about the feasibility of drug bans. Similarly, studies using oral history interviews with politicians and other stakeholders involved in tobacco control legislation were conducted to delineate the set of social conditions and processes that resulted in legislative change, in order to identify any generalisable features that might allow advocates to achieve further tobacco control more quickly and efficiently in the future, or at least to predict and produce conditions conducive to accomplishing further control (Bryan-Jones & Chapman, 2006; Claire Hooker & Chapman, 2006). These studies have empirically verified the utility of Kingdon’s model of policy change (Claire Hooker & Chapman, 2006; Jacobson, Wasserman, & Anderson, 1997; Studlar, 2002) and underscored the key role of ‘policy entrepreneurs’ and ‘windows of opportunity’ in getting tobacco control onto the policy (and eventually, legislative) agenda. These sorts of studies are certainly compelling and often useful. What they do not do, however, is capture the unique qualities of people’s action and experience in a specific time and place, nor situate or understand these things in relation to wider social influences. There are different, good, reasons for qualitative researchers to be interested in history: for its capacity to enhance sensitivity to social context and its unique critical perspectives on health and medicine. The approaches and perspectives of history – the development of what I refer to as an ‘historian’s nose’ – can lead scholars to ask important new analytic questions, challenging their assumptions and goals, and leading to much deeper or more novel analyses.