Adele E. Clarke

Laura Mamo

Janet K. Shim

Jennifer Ruth Fosket

Jennifer R. Fishman

The rise of Western scientific medicine fully established the medical sector of the U.S. political economy by the end of the Second World War, the first “social transformation of American medicine.” Then, in an ongoing process called medicalization, the jurisdiction of medicine began expanding, redefining certain areas once deemed moral, social, or legal problems (such as alcoholism, drug addiction, and obesity) as medical problems. The editors of this important collection argue that since the mid-1980s, dramatic, and especially technoscientific, changes in the constitution, organization, and practices of contemporary biomedicine have coalesced into biomedicalization, the second major transformation of American medicine. This volume offers in-depth analyses and case studies along with the groundbreaking essay in which the editors first elaborated their theory of biomedicalization. Contributors. Natalie Boero, Adele E. Clarke, Jennifer R. Fishman, Jennifer Ruth Fosket, Kelly Joyce, Jonathan Kahn, Laura Mamo, Jackie Orr, Elianne Riska, Janet K. Shim, Sara Shostak

Technoscience, Health, and Illness in the U.S.

Biomedicalization

Heart disease, the leading cause of death in the United States, affects people from all walks of life, yet who lives and who dies from heart disease still depends on race, class, and gender. While scientists and clinicians understand and treat heart disease more effectively than ever before, and industrialized countries have made substantial investments in research and treatment over the past six decades, patterns of inequality persist. Ina Heart-Sick, Janet K. Shim argues that official accounts of cardiovascular health inequalities are unconvincing and inadequate, and that clinical and public health interventions grounded in these accounts ignore many critical causes of those inequalities. a Examining the routine activities of epidemiologyOCogrant applications, data collection, representations of research findings, and post-publication discussions of the interpretations and implications of study resultsOCoShim shows how social differences of race, social class, and gender are upheld by the scientific community. She argues that such sites of expert knowledge routinely, yet often invisibly, make claims about how biological and cultural differences matterOCoclaims that differ substantially from the lived experiences of individuals who themselves suffer from health problems. Based on firsthand research at epidemiologic conferences, conversations with epidemiologists, and in-depth interviews with people of color who live with heart disease, Shim explores how both scientists and lay people define difference and its consequences for health. Ultimately, a Heart-Sick aexplores the deep rifts regarding the meanings and consequences of social difference for heart disease, and the changes that would be required to generate more convincing accounts of the significance of inequality for health and well-being.

Janet K. Shim

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