What sociology can tell us about ourselves

Readers may recall the commentaries from academics that appeared on these pages as well as on many media outlets, alarmed and appalled by the disbanding of the Marsden panels for humanities and the social sciences.

The Marsden Fund is a “blue skies” initiative established by Simon Upton in the 1990s. Along with Ruth Richardson’s Fiscal Responsibility Act and Pharmac, it was one of the few lasting achievements from that period.

On the face of it, this is a minor adjustment, and academics in these disciplines are likely to continue their work, although with less than support than before. But are there wider issues at play here? Developments in the United States with the change of administration suggest that we may be looking at straws in the wind. There might be broader issues of concern here.

Among other things, the incoming Trump administration has cut billions of dollars out of the research overheads for grants at the National Institutes of Health (though a federal judge has since blocked this), it has undertaken a campaign against use of gender identity and encouragement of diversity, equity and inclusion in federally funded programmes, and it has taken aim at endowments in higher education.

Such developments have even touched our shores, with the University of Auckland caught up in a misinformation campaign associated with USAID disbursements.

How did we get here? I have worked in the humanities and medical and science faculties for nearly half a century and have seen ways in which sociology – my core discipline – can engage constructively without controversy but also cause wider intellectual and even policy ripples.

In my teaching to undergraduate medical students I was able to draw their attention to key insights from the social sciences in medical practice such as social prescribing (connecting patients to a range of non-clinical services), how much health depends on social connection (which for some may be as much benefit as a medication), harnessing the placebo effect to stimulate healing (a positive outcome without invasive therapy), medicalisation and the risk of over-medicalisation of life events (such as in the final years of life), deinstitutionalisation in mental health and disability, and hospitals as complex organisations requiring professional management.

But once I moved beyond the intricacies of the social influences in medical practice, the contributions of my discipline became more far-reaching and potentially controversial.

For example, it was evident that in New Zealand life expectancy doubled from 35 to 70 between 1870 and 1945 before the great advances of modern medicine, suggesting that other factors in public policy, public health and improving living standards were important.

But it went further.

In my early research my collaborators and I learned that despite New Zealand’s egalitarian heritage, socio-economic disparities in death rates were as marked here as in the class-ridden UK. I was associated with research on the epidemic of asthma deaths triggered by fenoterol, a drug promoted in New Zealand by the manufacturer. During the HIV/Aids period, we conducted a national survey on sexual attitudes and behaviour using computer-assisted telephone interviewing.

We investigated and demonstrated that one doctor was not necessarily like another, that there was substantial variation between GPs in terms of intervention, including prescribing. We estimated nearly a third of hospital costs were because of medical injuries, which we estimated to cost the medical system NZ$870 million in 1998, of which $590m went toward treating preventable adverse events. Our research demonstrated that with a predominantly publicly funded hospital system, hospital care received by Māori was marginally poorer than that received by New Zealand citizens of non-Māori/non-Pacific origin.

So, there was a mixed picture: sociology in medicine can produce relatively uncontroversial insights about healthcare systems; whereas the sociology of medicine is a look from the outside that can pick up sometimes inconvenient but important truths about the healthcare system and even the wider society.

For example, the simple distinction that is basic to sociological analysis between biological sex and gender can still be politically controversial, as can sociology’s understanding that race is a social construct (although with biological aspects, such as skin colour). Similarly, the analysis of social disparities in outcomes have contributed to the diversity, equity and inclusion movement, the organisational frameworks developed to promote the fair treatment of people who have been excluded or underrepresented. Such disciplinary insights are basic to sociology, but they can present inconvenient truths that can be politicised and controversial. Nevertheless, we still need them to tackle basic social and policy issues, and basic blue skies research as funded by Marsden allows us to do this.

If we are not careful, the disbandment of the Marsden funding panels for the humanities and the social sciences can lead to a closing of the mind and a narrowing of perspective, with long-term implications that are hard to accept in a liberal democracy.

Sociology can be an unpopular discipline, and doesn’t tend to be favoured by authoritarian governments – for example, the military junta in Greece banned its teaching in high schools. Let’s not be afraid of what sociology has to tell us about ourselves here or now. Let us put these disciplines back where they belong in our pantheon of knowledge and its research application.