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Critical Realism for Health and Illness Research

A guest post by Priscilla Alderson about her new book:

Alderson P. 2021. Critical Realism for Health and Illness Research: A Practical Introduction. Policy Press. 

 All are welcome to the book launch on Wednesday 21st April 5-6pm, London time.
Speakers: Chris Yates, Douglas Porpora, Brenda Hayanga, Rosa Mendizabal, Priscilla Alderson.
Register at:
30% discount offer on the book for those who attend the launch.

While researching health and illness for about 30 years, I became increasingly puzzled about contradictions between the main social research paradigms. Some interpretivists deny the facts and the reality of the body, a great problem in research about children’s heart surgery and diabetes. In contrast, positivists tend to mistake facts (truth claims) for realities. Other seemingly irresolvable problems included inadequate attention to: cause-effect sequences and explanations; values; power; relations between structures and agents and between the political economy and individuals’ health; transformative change; alternative future possibilities; contradictions between the main social research paradigms; and contradictions between the social and life sciences, which block interdisciplinary research.    

 Very fortunately for me, Roy Bhaskar was teaching his critical realism (CR) reading course for doctoral students at the Institute where we worked, now part of UCL. I found the course invaluable.  

 Roy’s death in 2014 was a great loss. As no one else was available, I’ve convened Roy’s course since then, and interest in CR grows every year. In 2019-2020, 70 people signed on to join the final course we held. As I’m a sociologist, the course became less philosophical and more practical in applying CR to research. At each session, a student would explain how a specific CR concept illuminates his or her research.  

 My new book is based on Roy’s course and his order of presenting CR concepts. The nine detailed contributions from researchers follow the student’s practical presentations. Questions and activities are suggested through the book to help readers to apply CR to their work. My aim is to give a clear basic introduction, and to help readers to become confident in working with CR, and ready to study the many more advanced ideas that the book does not cover.  

 Although the examples are all of health and illness, the ideas apply to any topic and are intended to help a wide range of readers. And ‘health and illness affect every interrelated aspect of all our lives’. I wrote that sentence in 2019 when it seemed to need to be justified. The COVID-19 pandemic began when the book was half written and it has made the sentence startlingly obvious. The pandemic eerily validates such CR concepts as causal mechanisms unseen by normal vision in the viruses, the creaking economic and social systems, and everyone’s moral responses and motives.  

 As I discuss in an article for Transforming Society, it is very disappointing that (as usual) sociologists are absent from government advisory bodies and mass media debates about managing the pandemic. Sociologists have been compared to an orchestra of soloists all pursuing disconnected directions, as if their own method is self-sufficient and stand-alone and compensates for the failings of all the others. They urgently need to resolve their disagreements and establish their common ground where their paradigms can complement rather than contradict one another. CR provides this larger coherent framework of analysis. It helps to unravel relations between science and policy beyond simplistic ‘evidence based policy’, to take account of real complex social relations.  

 I hope the book will help social science researchers and teachers to meet the growing demand for CR courses and doctoral supervision, as well as the need for more coherent and critical sociology to inform public policy and debate. 

Priscilla Alderson, Professor Emerita, University College London 

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