Where history meets
qualitative health research
Dr Claire Hooker
Public Health Sciences
Aims
• To reflect on the differences (if any)
between historical research in the history of
health and medicine, and qualitative
research in health and medicine
• To discuss the utility and consequences of
formalising research procedures
• To identify what we could do better
Aims
…purpose??
- Reinventing the wheel
- Conversation and pleasure
- Intuition, nuance, experience, perception
My ‘narrative’
• Honours, PhD in
history
• History and material
culture of public
health in Australia
• History and
Philosophy (& a lot of
sociology) of science
• Political history of
tobacco control in
Australia
• Public health sciences
Disciplinary Shock
• ‘obfuscate, confuse, elude,
obscure, mislead, betray, lie …’
• A ‘methods’ section
• ‘qualitative research’ … software,
textbooks, a whole journal
• chronologies
…. What would this have looked
like if I’d done it in history/ HPS?
The historian
approaches …
Principles:
(a) to make things strange
(b) Symmetry
(c) To scrutinise power/ knowledge relations,
expertise, hegemonies
(d) To understand: which means, to identify the
wider context and its interaction at a local level,
and especially to celebrate complexity,
ambivalence, confoundings
All of this is probably inimical to actually achieving
tobacco control!
… and goes to work
• What did smoking mean to people?
• what discourses were used to support tobacco control?
• How did it feel to be a company executive or a
premier?
• Why did company practices develop as they did?
• How was thinking about tobacco control shaped by
thinking about concepts like ‘risk’ or ‘drugs’?
• What insights can the history of tobacco control offer
into a late modern therapeutic consumer culture?
• NB - these are *not* the same questions that older
generations of historians might have asked
How?
• Gathering material
• Oral history
• Listening to the material
Versus:
‘document research’
‘semi structured or open ended interviews’
Coded / thematic analysis
Outcomes
For the tobacco control group:
• Chronologies
• A few criticisms of ‘magicked quotations’
• recommendations to Senate committees
For me:
- Notion of deliberation
- A discourse about drugs
- A new moralism
- relations between politicians were complicated by
adherence to particular political cultures that had
changed over the period of tobacco control
History v Qual Health Research
1. History looks at change - qual looks at the
present
2. History has more of a focus on ‘meta’ issues –
qual more focused on specifics
3. Qual health research is fundamentally
instrumental – history is not
4. Qual health research is formalised – history is
not
Major implication: in comparison to history, qual
makes claims on objectivity and predictability
that history does not (indeed, is opposed to in
some sense)
Evidence!
• ‘theory and method’ 1992: Ranke;
structuralism; Annales school; Marx
and historical materialism; Gramsci
and hegemony; (political history)
social history; cultural history;
feminist history; postmodern history
• 2003: ideas about evidence; history
wars; audio; visual; material;
memory; biography; movies; public
• What is not included: statistics,
history of ideas, political history,
military history, archiving, and
paradigm shift, inter alia
But wait! Not so fast!
History IS a form of qualitative research!
I could start by telling you who uses them:
philosophers,
psychologists,
sociologists,
anthropologists, students of literature, historians,
biologists...anyone, in fact, who finds the methods
of the physical sciences somehow inappropriate
for understanding human (and, occasionally, even
animal) realities.’ C. George Boeree
http://www.ship.edu/~cgboeree/qualmethone.html
Current Philosophical
Similarities
Both stand in critical relation to quantitative
research: ‘qualitative research exchanges the
tyranny of numbers for the enigma of words’
‘… rooted in a non tangible domain, fundamentally
experiential and intuitive’
‘… polyvocal attempts at interfacing with cultural /
linguistic/ relational accounts of the real. They are
therefore interpretations, not truths in the positivist
sense’
www.nova.edu/ssss/QR/QR9-1/jones.pdf
Hence, similarities in analytical
methods
•
•
•
•
•
•
Narrative
Storytelling
Identity
Frames
Reflexive
Differences between history of public health and
qualitative studies in public health would seem to
lie in scope, focus, interest, language (best
described qualitatively!)
Grappling with validity
• both feel that their accounts
capture some aspect of ‘truth’
• Both try to generalise from
multiple instances
• Both try to explain river systems
as well eddies: both generate
macro and micro levels of theory
• Both make claims to influence
future actions
Process similarities
1. oral history and interview are concerned with
memory, context, how the interviewer’s relation
with the subject alters things, how the subject
constructs their narrative.
2. both grapple with issues of authenticity,
reliability and truth
3. both require their practitioners to go through an
informal process of trying to get themselves out
of the picture
4. Coding turned out to be the same! I just didn’t
count
…I’ll be better next time?
• The IMRD format can really help crystallise the
purpose of your research, and whether the method is
adequate for that purpose
• A ‘methods section’ can help ensure your research is
sufficiently complete, and invites readers/reviewers to
scrutinise whether your conclusions are justified
• To historians I should think this would help in the
interpretive questions they claim to be interested in:
what can we learn from each piece of evidence?
• ie formalising one’s methods in advance and at the
conclusion of research, like peer review, can aid in
‘objectivity’, the strength of research
I’ll also always be an historian
• A narrative piece invites playfulness, new
kinds of coherence, intuitive and
experiential facets for the audience
• Making strange, attention to change, and
attention to a variety of evidence are good
ways of keeping macro and micro engaged
with each other, and of being constructively
critical and reflexive
Conclusions and Implications
• Method should be thought of as
dynamic until the paper is published:
it is a kind of grappling
• Private research audits are probably
a good idea
• Dialogue and deliberation are even
better ones
• Living in someone else’s discipline
once every 15 years is really good
for you