Sociology
This chapter discusses the challenges and perceived actionable opportunities offered by nature for health and wellbeing (nature-based health services) from the perspectives of the public, the local government and the third sector, in the context of the COVID-19 pandemic. Using Walsall, a medium-sized urban area in the West Midlands of England, as a case study, the chapter suggests that nature-based health services operate in complicated ecosystems of overlapping jurisdictions, multiple sectors, uncertain funding and competing interests. It concludes that if the potential affordances of urban nature are to be actualised, the following four conditions must be met: (1) the value of nature-based health services and the key role of the third sector in their delivery must be recognised in policy and in the knowledge and expertise of stakeholder organisations responsible for commissioning and delivery; (2) nature-based health services must be adequately resourced, with funding pathways tailored to the specific needs of the third sector; (3) the provision of the high-quality accessible urban green infrastructure, which is the foundation for nature-based health services, must be secured; and (4) improved mechanisms for stakeholder collaboration are required, to enable effective collaboration and ensure equity in access to resources, knowledge and expertise.
Over the last two decades, social and economic anxieties associated with antimicrobial resistance, food and zoonotic disease risk, as well as the recent pandemic, have prompted a surge in social and cultural studies of the microbial and the human biome. Human existence is always a more-than-human achievement, with its urgent need for further development of more-than-human methods that support sensing, understanding and ‘doings’ with microbial worlds. Amidst calls to develop new techniques that ‘allow us to engage with diverse and multiple worlds and non-human agencies’, this chapter advances a more-than-human microbial methodology, using the example of public health videos created during the recent pandemic. Taking the lead from geography’s ‘creative turn’ in research methods, the more-than-human microbial methodology presented here draws on three bodies of literature: filmmaking as research; affect theory; and artistic microbial methods. The main portion of this chapter is framed around a conversation that took place on the video calling platform Zoom between co-investigator and artist-academic Paul Hurley and co-investigator and landscape scholar Charlotte Veal in April 2022 as part of the project Routes of Infection, Routes to Safety: Understanding Risk and the Viral Imagination on Public Transport. Deliberately dialogical, the chapter raises questions about how stories of the trials and tribulations of research, particularly in fast-paced and fluctuating socio-political and scientific contexts, are told. Lightly edited, the format is also intended to be provocative and free flowing, creating a reflective exploratory space to think about and push thinking on more-than-human and microbial methods.
The ‘Reset Ethics’ research explored the everyday ethical challenges of reconfiguring England’s NHS maternity and paediatrics services during the coronavirus (COVID-19) pandemic. This ‘resetting’ created a unique context in which it became critical to consider how ethical considerations did (and should) underpin decisions about integrating infection control measures into the routine practice of healthcare. Ethical challenges encountered by decision-makers were often embedded in changes to working practices intended to keep staff safe, and to protect hospital communities from COVID-19 infection. However, these changes reduced healthcare professionals’ ability to ‘care’ for their patients, where care is understood as embracing the interpersonal relationships between the patient (and their family) and the healthcare provider. Offering such care was experienced as an ethically important dimension to healthcare delivery, and an essential component of patient-centred care. Research findings suggest that, although they protected healthcare staff and patients from COVID-19, infection prevention and control measures caused harm by creating barriers to relational interaction and engagement. Participants’ reflections are situated in a discussion about the significance of relationships in a healthcare context. The theoretical underpinnings of a logic of relationality in healthcare are described, which the authors argue should underpin healthcare decision-making. They contend that an explicit attention to relationships is required to support to healthcare professionals in responding both to the everyday stresses and strains of working in healthcare, and to the extraordinary impacts of a public health emergency.
People with dementia were disproportionately impacted by the COVID-19 pandemic. The effects of lockdown measures and restrictions, combined with staffing shortages and working conditions in care homes, were associated with deterioration in the health and wellbeing of residents. Culture Box was a research project that used arts-based approaches to improve wellbeing for people living with dementia in care homes during the time of COVID-19 restrictions. For twelve months, the project sent out boxes containing interactive creative resources and activities for residents and care staff to complete in dyads or groups. This chapter considers the effect of the creative resources and some of the lessons learnt from undertaking an innovative study during a global pandemic. The team focusses on the ways Culture Box facilitated creative connection between resident and staff dyads, and promoted care staff wellbeing, creative agency and methodological innovation. In particular, the authors explore the role of creative practice for care home staff is considered, with recommendations for future research, practice and crises, based on the study’s findings. For more than twenty years, Clod Ensemble’s Performing Medicine programme, directed by Suzy Willson, has brought healthcare professionals and medical students together with world-class artists including dancers, movement artists and musicians, to share invaluable knowledge and experience of working non-verbally and working creatively to improve healthcare provision. This chapter will explore how Performing Medicine (PM) responded to the outbreak of COVID-19 and shares findings from Communicating through Covid – a collaborative research project undertaken during the pandemic. We share the findings of interviews with healthcare professionals and creative workshops with artists, which aimed to understand the challenges faced by these groups as a result of COVID-19 and to discover if there were lessons from creative practice that could address the challenges experienced. Informed by these findings, we outline our programme of creative interventions that were co-developed with a small group of artists. The research undertaken by a combined team of academic, artistic and healthcare professionals shows that arts-based strategies can play an integral role in recovery from the pandemic for those working in healthcare settings. The findings offer viable strategies to address critical issues and bring teams together who have been fragmented by the demands of the response to COVID-19. This chapter throws a spotlight upon the rapid innovations achieved by arts and cultural organisations, from civic institutions to grass-roots enterprises, in response to COVID-19 in one specific city region, Liverpool. It explores the valuable lessons to be learned for practice and policy from the ways in which these novel solutions have stimulated a re-imagining of arts in mental healthcare in the aftermath of the pandemic. Liverpool City Region (LCR) has one of the richest concentrations of culture in the UK and a pioneering history of harnessing arts for mental health care. Yet, even before the current crisis, LCR had some of the poorest mental health outcomes in the country, and the highest concentration of adults seeking mental health services nationally. With the NHS increasingly overstretched, the role of arts and culture in providing stigma-free environments to re-connect the vulnerable and isolated, is more critical than ever. This chapter offers compelling case studies of the extraordinary adaptations to COVID-19 by arts organisations, their beneficiaries and health and social care providers. These dynamically responsive examples of regional arts-in-health innovations speak powerfully to a growing interest in understanding how a local arts-in-health infrastructure might contribute towards improved outcomes for individuals and communities. They also highlight our key finding and its relevance to the current levelling up agenda: the urgent priority of mobilising the transformative power of arts and culture for mental health and wellbeing needs through cooperative partnerships, co-ordinated programmes for social prescribing and targeted support for digital literacy.
As mass vaccination programmes for COVID-19 gathered pace, they were was accompanied by a nexus of social and political shaming around vaccine hesitancy or refusal. Frequently, shame has been directed at individuals posthumously; for example, in the online sharing of obituaries for notable or vocal anti-vaxxers. While some of the most visible instances of ‘death shaming’ have been decried, they nonetheless remain as extreme iterations – and a logical product – of a more pervasive culture of shame over vaccination, or lack of it. Rather than paying close attention to the contexts (including a trusting and shame-less engagement with public health messaging and communication) which enable different publics to make informed decisions about vaccination, the ‘unvaccinated’ have increasingly taken on the characteristics of a shamed population, culpable for the spread of the virus, for other adverse health outcomes produced by a health system under strain, for the threat of future public health restrictions to everyday life, and for their own suffering and death. In turn, explicit death-shaming has sedimented down into a broader sense of inevitability around deaths that might otherwise be shocking or difficult to ignore. In this chapter, we examine recent discourses on vaccine hesitancy, death and dying through a ‘shame lens’. Future crises, we suggest, will introduce novel relationships between shame and death; critical reflection on the COVID-19 pandemic allows us to anticipate some of the contexts and processes which are likely to condition how and where they land.
In June 2021 the United Nations produced a report on the rise of violence and abuse towards older people during the COVID-19 pandemic. In particular, older people in care homes across the world faced an increased risk of ‘neglect, isolation and lack of adequate services’. The report also highlighted the increase in gender-based violence (GBV) against older people whose mobility was further restricted due to lockdowns (extensive restrictions on movement and measures to promote social distancing that were imposed to control the spread of COVID-19). While numerous studies from around the world have found that the more intensified living spaces produced by the lockdowns have led to an increase in GBV (Hourglass, 2020; Peterman et al., 2020), the higher incidence of GBV amongst older women has not received adequate attention due to the wider invisibility of GBV stories written or spoken by older women. Importantly for our project, as well as being constrained in terms of their own movements and contact with others, the immobilities of the pandemic also made visible injustices that had already existed. This chapter highlights the absence of older women in stories of GBV during the pandemic. We argue that the ‘invisibilising’ of older women in accounts of GBV not only diminishes our understanding of GBV overall but creates a new injustice. The chapter thus makes a plea for storytelling as a tool for producing knowledge in research seeking to make visible the lives and experiences of this historically overlooked group.
Recent decades have seen steady growth of clinical diagnostic tests that can be used at home, at pharmacies or GP practices. From home pregnancy tests to Fitbits and smart watches, the analytical chemistry and analysis technology has been miniaturised and automated, allowing an increasing range of tests to be taken outside laboratories and hospitals, and brought into the community. Following the roll-out of regular home and workplace testing for COVID-19 during the pandemic, an initial dramatic scale-up of centralised testing was followed by widely publicised mass-testing. To accompany the tests, different kinds of instructions explained to people how to carry out a lateral flow test (LFT). Instructions for these tests range from booklets that accompany NHS and government testing kits, to videos, animations and posters produced by people of all ages from many different backgrounds and with different experiences. During the pandemic, many people learned how to carry out a test – and became proficient and confident about carrying it out accurately. This chapter intervenes in this landscape, through a study of the design and usability of instructions for point-of-use COVID-19 lateral flow rapid tests. The chapter outlines unresolved tensions between the needs of final users and the constraints posed by needing to meet regulations within timeframes. At its heart is an argument that such tests don’t simply need better instructions, but that we need a richer, more nuanced account of what is meant by ‘good instructions’ in the first place.
This chapter interrogates the meanings and experiences of ‘togetherness’, specifically in the context of the coronavirus (COVID-19) prompted expansion in the online delivery of community arts practice. It frames the simultaneous loss and pursuit of togetherness as a key territory of the pandemic, something that occurred at both community and individual levels, became problematically politicised and yet was also genuinely desired. The utilisation of online community practice to instil a sense of togetherness, wellbeing and resilience has the potential to be a lasting legacy of COVID-19. The objective of this chapter is to think through virtual togetherness, developing a critical framework to help us better evaluate experiences of being together while apart. Specifically, this chapter examines what produces authentic and meaningful experiences of togetherness within online community arts practice. It uses as a key case study the Creative Doodle Book (CDB) project, which between November 2020 and June 2021 delivered online arts workshops with partners across the UK, in contexts including learning disabilities, mental health, care homes and young people. Discussion considers insights from the CDB project in the context of ideas of communitas and selfhood, proposing that authentic experiences of togetherness require both a letting go and strong holding onto personal and collective identity. Its conclusions reflect on how claims for togetherness during COVID-19 are time exclusionary, and it suggests that active consideration of inclusion is essential to future thinking about being together while in online spaces
During COVID-19, the UK government failed to engage publics with the ethical challenges that arose during a period of intensive pandemic decision-making. Government-led public engagement focused on surveys that rendered publics passive and tokenistic consultative on narrow policy decisions. There was a void not only in engaging publics with collaboratively grappling with the numerous ethically laden decisions the government had to make in response to the pandemic, but in also recognising the importance of values, particularly public values, in public policy at all. Through their work on the UK Pandemic Ethics Accelerator, the authors conducted a public dialogue and hosted a policy workshop in the House of Commons to provide a platform for public values to be integrated into public policy. Through this work, we experienced the challenges of institutionally embedding more substantive public engagement in public policy, and reflect on them in this chapter. We end with some recommendations for bridging the gap between policymakers and publics, stressing the need to institutionalise mechanisms by which citizens can deliberate on ethically value-laden policy decisions, through which public policy can be made accountable to public values.
The Hill Fight of the Korean War constitutes an important chapter of the formative military conflict of the mid-twentieth century where the South Korean and other UN forces confronted the Chinese and North Korean forces. Currently, it has become a vital site of contested memory, especially in relation to the growing contest of power between the United States and the People’s Republic of China. Describing South Korea’s recent initiative of missing in action (MIA)/killed in action (KIA) accounting activities on these old battlegrounds since 2000, this article looks at how public actions concerning the remains of war are intertwined with changing geopolitical conditions. This will be followed by a reflection on the limits of the prevailing art and technology of war-remains accounting.