Beyond Meaning, Discourse and the Empirical World: Critical Realist Reflections on Health

Abstract

This paper provides a series of critical realist (CR) reflections on the limits of approaches, within and beyond the sociology of health and illness, which begin and end with meaning, discourse and the empirical world. The first part of the paper provides a brief review of traditions, trends and tensions within the sociology of health and illness, with particular reference to the shortcomings of positivist and interpretivist legacies. This in turn provides a backdrop and paves the way, in the second main part of the paper, for a detailed discussion of the merits of CR in moving beyond these former impasses, with particular reference to (i) non-conflationary approaches to ontological and epistemological matters, (ii) principles of stratification and emergence, (iii) habitus and the ‘primacy’ of practice, and (iv) the (morphogenetic) relationship between structure and agency. The relevance of these insights to health is then hammered home in the third part of the paper, through three key examples of realist research in action, so to speak. The paper concludes with some further reflections on the promise and potential of critical realism for health, as an ‘underlabouring philosophy’, and the future agendas it signals.