With Inclusion, Steven Epstein argues that strategies to achieve diversity in medical research mask deeper problems, ones that might require a different approach and different solutions.
Formal concern with this issue, Epstein shows, is a fairly recent phenomenon. Until the mid-1980s, scientists often studied groups of white, middle-aged men—and assumed that conclusions drawn from studying them would apply to the rest of the population. But struggles involving advocacy groups, experts, and Congress led to reforms that forced researchers to diversify the population from which they drew for clinical research. While the prominence of these inclusive practices has offered hope to traditionally underserved groups, Epstein argues that it has drawn attention away from the tremendous inequalities in health that are rooted not in biology but in society.
“Epstein’s use of theory to demonstrate how public policies in the health profession are shaped makes this book relevant for many academic disciplines. . . . Highly recommended.”—Choice
“A masterful comprehensive overview of a wide terrain.”—Troy Duster, Biosocieties
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Steven Epstein is professor of sociology and director of the Science Studies Program at the University of California, San Diego. He is the author ofImpure Science: AIDS, Activism, and the Politics of Knowledge and coauthor ofLearning by Heart: AIDS and Schoolchildren in America's Communities.
“Steven Epstein masterfully weaves together sociologies of science, policy, social movements, and stratification to provide a cogent—and very readable—analysis of inclusion and difference as they have played out in biomedicine and politics. He deftly traces the emergence and implementation of the sex/gender, race, and age inclusion policies of the federal government’s health research apparatus. In doing so, Epstein identifies some of the ironic consequences of the contemporary focus on difference—for example, how attempts to address disadvantage and exclusion of vulnerable groups end up exacerbating stigma or discrimination against them. As such, his book makes an important contribution to knowledge about the interworkings of science, state, and society.”
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