My research focuses on philosophical-sociological analysis of public health issues at the interface of science, technology and society. My current projects are all rooted in the notion that we are presently facing some rather paradoxical trends in public health. On the one hand, processes of rationalisation are giving rise to a scientific and technological risk culture and a culture of experts. On the other hand, thanks to processes of democratisation, patient/citizen perspectives on health are being acknowledged and the importance of civil society, mediated by new media, is growing.
These processes of rationalisation and democratisation create issues of public legitimisation, public trust and public accountability of public health interventions. This is all the more essential given the socioeconomic and health disparities between groups in the Netherlands, in Europe and around the world, which make it difficult for public health workers to reach lower educated groups.
As a result, public health is permeated by a clear ‘us’ versus ‘them’ divide, of which we lack an adequate understanding. Greater insight is needed as to whether and how problems of public legitimisation and the limited effectiveness of public health programmes might be connected. As nation states try to improve the health of populations by way of top-down strategies and a focus on expert knowledge, issues of public accountability may be at play in public health even more so than in other professional fields. Now, however, awareness is growing among public health institutions that ‘the public speaks back’. The question therefore arises as to how ‘the public’ is constructed, identified, enacted and mobilised, and how the paradoxes of rationalistic steering and democratic deliberation can be addressed.
I am currently working on various research projects aiming to foster insight into the complex relationships between science, policy, professionals and citizens. These projects critically evaluate the meanings of basic concepts such as expert, professional, individual, family, evidence, body, citizenship and risk. Further, they analyse the tensions between processes of standardisation/localisation and classification/diversification in public health.