Health social movements (HSMs) are an important political force concerning health access and quality of care, as well as for broader social change. We define HSMs as collective challenges to medical policy, public health policy and politics, belief systems, research and practice which include an array of formal and informal organisations, supporters, networks of co-operation and media. HSMs make many challenges to political power, professional authority and personal and collective identity. These movements address (a) access to, or provision of, health-care services; (b) disease, illness experience, disability and contested illness; and (c) health inequality and inequity based on race, ethnicity, gender, class and/or sexuality. This introductory essay has three goals. First, we aim to explain why an entire volume on health social movements is warranted, by specifying the important analytical questions to be answered and by situating the volume in the midst of a growing interest in the topic among scholars from various sociological fields and even other disciplines. Second, we seek to offer an explanation for the phenomenon of health social movements generally, and more specifically what appears to be a recent growth in their presence and power in contemporary societies. We do this by noting the growing tendency across all movements to challenge authority structures, and by emphasising the ways in which HSMs challenge the authority of medicine, science, governments and corporations. Third, we further develop the concept of health social movements, and offer some conceptual tools that may be of use in reading the contributions to the volume, which we introduce in a manner that offers insight into the ways in which they advance our understanding of HSMs. In the last SHI Monograph, Health and Media, Clive Seale (2003) introduced the volume by pointing to the fact that media studies and the sociology of health and illness ‘stand at a distance from one another’. Seale used the Monograph as a vehicle to bridge that gap. The same holds true for health social movements: many medical sociologists have studied such movements without reference to social movement theory and literature, while social movement specialists rarely take up issues of health. Fortunately, we are seeing recent attention to health social movements that has the potential to reduce this gap. The Society for Social Studies of Science, in both the 2001 and 2003 annual meetings, had a stream of four sessions on the topic. Stemming from that 2003 stream, a special issue of Science as Culture on health, the environment, and social movements is now in press, edited by David Hess. The current volume editors were invited to lead a multi-session workshop at the American Sociological Association's Collective Behavior and Social Movements Section Conference in August 2002. A medical social movements symposium was held in Sweden in June 2003, with a resultant special issue of Social Science and Medicine on patient-centred movements, edited by Joe Dumit, published in 2004. A special issue on health and the environment of Annals of the American Academy of Political and Social Science, in November 2002, focused on the role of health social movements. Sociology of Health and Illness has published a significant amount of research on health social movements, and it is fitting that this volume reflects this tradition. In our recent article in this journal, Embodied health movements: uncharted territory in social movement research (Brown et al. 2004), we put forth our first attempt to systematise the study of these movements. Previous research has focused on individual cases of health social movements; we consider them as a collective group that when taken together have been an important force for social change. Scholars writing about individual social movements dealing with health have covered areas such as occupational safety and health (Rosner and Markowitz 1987), the women's health movement (Morgen 2002), AIDS activism (Epstein 1996) and environmental justice organizing (Bullard 1994). Other scholars, who focus more generally on changes in the health care system, point to the significance of these movements in medical history (Porter 1997) and health policy (Light 2000). Despite this significant body of research, scholars have not examined the forces that gave rise to the wide array of health social movements, nor carried out comparative analysis of these movements’ different strategic, tactical and political approaches. Generally, scholars have not explored the collective development and impact the myriad health social movements have had on public health, medical research and health-care delivery. We believe there is an analytical benefit to considering the origins and impacts of HSMs collectively, and this work is part of a larger project to integrate and synthesise this material. Why has this new class of health social movements emerged in the last decade? A central reason is that science and technocratic decision-making have become an increasingly dominant force in shaping social policy and regulation. Governmental and scientific demands for ‘better science’ in policy-making have become a significant and powerful authority used to support dominant political and socioeconomic systems. Through this ‘scient-ization’ (Morello-Frosch et al. forthcoming) of decision-making, industry exerts considerable control over debates regarding the costs, benefits and potential risks of new technologies and industrial production by deploying scientific experts who work to ensure that battles over policy-making remain scientific, ‘objective’ and effectively separated from the social milieu in which they unfold (Beck 1992). The end result of this process is threefold: First, scientists are asked to answer questions that are virtually impossible to answer scientifically due to data uncertainties or the infeasibility of carrying out a study. Second, the process inappropriately frames political and moral questions (i.e.‘transcientific’ issues) in scientific terms, thus limiting public participation in decision-making and ensuring that it becomes the purview of ‘experts’ (Weinberg 1972). Third, the scientisation of decision-making delegitimises the importance of those questions that may not be conducive to scientific analysis. All of these processes can exclude the public from important policy debates and diminish public capacity to participate in the production of scientific knowledge itself. The continuing advance of societal rationalisation raises the role of objective scientific expertise above that of public knowledge for most social issues. Ironically, however, the quest for better science to inform good decision-making is often a veiled attempt to hide the politicisation of the policy process (Weiss 2004). This has been recently demonstrated in the United States by the persistent opposition of the Bush Administration to the widening scientific consensus on the question of global climate change and its attendant ecological and human health impacts (Gelbspan 1997). The Bush Administration has extended such antiscientific actions to a wide range of issues that go against consensus held by scientists, and that purge responsible scientists from expert panels and replace them with industry supporters: revoking major elements of the Clean Air Act's regulatory regime11 The Clean Air Act, enacted into law in 1970, is one of the most central components of environmental protection in the United States. Its mandate for revision of standards every five years, based on new scientific data, has led to increasing regulation of air pollution, but the Bush Administration has sought to combat that process. , allowing high mercury emissions from power plants, allowing lead industry representatives on Centers for Disease Control panels to stall lead regulation, firing pro-regulatory officials who seek to enforce existing policies (Union of Concerned Scientists 2004). The extent of such actions is so great that 60 Nobel Laureates signed a protest letter in February 2004. In their efforts to counter this trend, health social movements have leveraged medical science and public health to marshal resources, conduct research, and produce their own scientific knowledge. Until recently, most health social movements have focused on expanding access to health care and improving the quality of health care. The latest emerging crop of HSMs, what we term embodied health movements (EHMs are discussed in greater detail below), are highly focused on the personal understanding and experience of illness, while often addressing some of the access concerns from earlier movements. EHMs have some notably different goals, strategies and targets from other health social movements. By using science to democratise knowledge production, embodied health movements can engage in effective policy advocacy and challenge aspects of the political economy, as well as transform traditional assumptions and lines of inquiry regarding disease causation and strategies for prevention. This emergence of EHMs has been catalysed by: growing public awareness about the limits of medical science to solve persistent health problems that are and the rise of issues and of scientific knowledge and the collective to participation in social policy and regulation. The rise of medical authority is one of the most of and concerning are to make health and to care, of and of the knowledge for medicine, and the power of medical to with a of social problems that may not be authority is into the broader we discussed above the rise and of scientific in which science an increasing role in and social authority has health scientists and in increasing medical authority has increasing challenges to this HSMs the of and challenges into formal and In scientific and medical authority structures, HSMs focus on the of social increasing in which are of social and a that many out of what be care. scholars authority as an of power, with or potential in our science and have become increasingly powerful of authority that a central role in dominant political and socioeconomic systems. such as social and the of have demonstrated health belief and the of the health care support and existing and the power of the health care a of the political medical science has become a HSMs often on its expertise and while its and with medical science that HSMs their use of medical science in a that their of its and the one HSMs attempt to on the authority of medical science, and its as an of and the other HSMs to the manner in which science and are used as of in and 1987), health their are in their against the in the industry from the that they had by awareness of of authority have to as the public has of such as the The for years, and is the most of research in the United States. were for their so that their The over this led to major in and other research , the history of and the of on in and the to other of in the there is attention to research of interest in medical research and in In the of such the of science and and social movements have powerful these new the of science and medicine, to include the political and dominant and health social movement challenges take on a social without the of health movements the women's health movement to in so many of that it was for women's health activism to a of The public can more challenge science it now has a of ways to and scientific for personal use and to policy change. knowledge of health concerns in and support is major of scientific knowledge by the media and by wide access the to medical research studies and of the challenges of research in the of medical the public has become more of the of medical science to effectively address the persistent and most health issues of the medical go with an of medical to as well as that can lead to health 1994). this has led to the of traditional medical with and body the in medical science is by the use of other to disease and health. health research that in have not by the in improving the health of research, emphasising individual the of regulatory a significant body of research that the health of is by such as race, and other environmental et al. and 2000). This is by the of that are now on new and in and the of that the public and medical had had been or at debates on questions medical science have public The of for a of has about the use of that by to in the and the of from and et al. 1997). concerns have been further by of of interest in the support of research by and the increasing power of to research in the of scientific research has been by of and that the process or the of research that with and and 2002, and In a of highly in human research has concerns about the of using human as research and has the at research for to study The of an in a at the of and the 2001 of a in an study at are the cases that have the of attention in the United States In the one of the at the and the that the was an in the the may have been and inappropriately by or by to participate in the These concerns the of in medical research can be the that science is an objective the these problems the of science, and which the for a of the dominant political and its on the health. health concerns are so are more to focus many a of health. an and of high it is that make demands for broader and better health and for of to include the in an industrial environmental is increasingly and in which the has to of environmental regulation and it becomes for the public to health with political and concerns and for regulation of industrial production and participation in the of environmental of this for is due to social that a for the growth of health social movements; some of it is due to the of health social movements The is that increasing of believe they have the and the authority to health policy, access quality of care, and of some of that at the individual the most effective from the collective efforts of health social movements. we our of HSMs a we a that of HSMs, even we that the and of some movements may into more one of these The (Brown et al. to the process of a wide range of movements that with health a of Health access movements seek access to health care and provision of health care These include movements such as those health care to specialists and of health to Embodied health movements address disease, disability or illness experience by science on and prevention. Embodied health movements include that are by current medical knowledge or have environmental that are often a these to medical and/or some embodied health movements include who are not but who as to the many this in other who do have the In to the this the AIDS and the control health movements address health inequality and health inequity based on race, ethnicity, gender, class and/or These address and by the scientific and/or include the women's health and health movement and environmental justice The of our are is often with other the women's health movement can be as a but at the same it elements of both access movements in more for and embodied movements in assumptions about for We this as one into a new and we believe there are other that can the same one of the in this volume, by and a with the of that focus on with all or a such as or across a range of and up of other but by a interest such as or we work with such we are to what social are to into and well they can explain the development and of HSMs. In on the development of HSMs, the to important questions about the and in the ways the different of HSMs work on embodied health movements from social movements and science and studies scholars to on the that the development of many health social movements have the political above by health and other social as the These them to policies and for more regulation of industrial production that from a control to a (Morello-Frosch can be in of the concept of movement and which to ways a movement can movements: the political and it in the environment, and by the and the movement and The environmental movement such a process. from the women's health AIDS and the and environmental movements was to the development of a collective illness of with that has their in the of scientists and their own emerging from their experience in the women's movement to their disease it was and was of the health of many from the AIDS in which that their to and for more of AIDS This over into the which significant in for research, of on and research as well as the power to for scientific The social movement that benefits the development of EHMs to of their In the authority of science and by both and the of EHMs can be as movements’ concept from and concept of and of In the of health care, EHMs to traditional of social movements. can and expert for to their own research when the science research not make their a EHMs often on scientists by with to the and the scientific We have the of social movement and movements in our analysis of embodied health movements. The of health social movements we introduced above the question of these conceptual tools for the development and of embodied health movements can be to the other of HSMs in the A across the of HSMs, but in of the be to be at three ways in which HSMs First, they produce changes in the health care and public health systems, both in of health care social policy and regulation. Second, they produce changes in medical science, the of new to research and changes in Third, health social movements produce changes in by to democratise those that medical research and policy-making of these three of HSMs, et al. 2004). of HSMs to be more or in one of but not is further use the to and introduce the contributions to this volume, we point to further questions that be answered the research do HSMs the broader of public in In the first David out that HSMs, as well as the of and medicine, challenge the authority of medical knowledge. the medical of such challenges as has a in the by HSMs, and the public more that is by and specifically those of the industry These forces are in what the shaping of which there is both greater of social advocacy and greater of the of that the of HSMs the movement the public shaping of science, a of medical sociology and the sociology of the challenges the and movement make to the authority of medical knowledge. focus is on the that and to these a of different In on social movement and health social movements can access to formal are often more have many ways of to social movement as a contemporary for the of in the of activism on the the and the there an social In the and point to a significant the of HSMs in to the of when were significant they are for the and they into a broader This up the important social movements and social movement organisations, and to about what it to that a larger movement et article to the emergence of a health movement that the lines of many different and This health movement is in the networks and of that among individual health analysis of which to held in across a of social with a of different and of research, that we may to of HSMs more on social movement theory and science and studies to develop the concept of a of development of this concept is significant in of its to focus analytical attention a of and which of is and both and the that and and across its and of a of to the movement one disease who to benefit from potential in research while allowing to and as central in the In the analysis to about the ways in which political and scientific participate in the of knowledge. In the article we health social movements often result in and detail the and recently, the movement in the United States has an even these et al. one and a that may them as and and an increasingly professional The role these in shaping the and strategies of the in the they to be studied further in movements such as the medical and movements. do social movement from a of interest or support this the of the in the volume of social movements. The article with to the further development of a health social of the in the United that the fact that more with to can benefit the Association's the of personal for the movement the same and as so of to the Association's and its to the of research have it from more research to important for other movements the or the of the those by the disease from the of the do HSMs use to their In one of the most and health social movements, the a question of this that can be extended to other health social movements: do health social movements use to engage in analysis to the significance of the to disease be to use the or by as they to for further research into research a to the that health activism is about science be central to many all movements take a broader the to and great significance for scientific knowledge. The volume with of one the movement has the of so that public social and with a experience from work is significant in of sociological of in that most work has the politicisation of this politicisation the experience of for one this work an important advance in the study of HSMs its focus on the of social movement activism on the illness take of use of experience as a of social movement these to a body of that HSMs are a social phenomenon while insight into the of conceptual for further analysis. The of explain the great range of one and for all of health and use to on the they the the illness of one to the in which the experience of over as a result of changes in the of changes in medicine, changes in the public and awareness of the emergence of the and a specifically of In the and use and analysis to in to and with from four social movements, and material. analysis of media and other to the and the research in this volume to the for and even to the study of and health social movements. health social movements offers insight into an and powerful of political at the health care system, experience of illness and addressing broader social of health and disease of Health social movements challenge and in to public participation in social policy and regulation, and to democratise the production and of scientific knowledge in medical science and public health In to their goals, HSMs an array of strategies and are in the they of The of HSMs their capacity to impact on scientific and policy as they with movements other such as the environmental HSMs a range of they engage in the public health research, such as new to medical science, media to the for social change and true disease and engage the policy to public power to and industrial activism in scientific knowledge production may introduce potential in scientific is this process can and that be political and in scientific may among movement those on with to more and access other it is important to in that as to take science into their own they with some of the same issues and that they had some health movement have major over to take to support their This issue has been for the environmental have to from major have that such can a or of interest and the of an to and scientific data regarding for new Other address such as American that work with scientists to the presence of persistent in human In carrying out this research, have sought to develop that address the of the and not individual and they ways to individual and collective study to the and Despite these HSMs have leveraged their embodied experience of illness and a new for social movements can effectively engage in scientific knowledge HSMs as a at and social policy and regulation in a that the socioeconomic and political that of health and disease among was the of to from the the and was and We the who gave of the and for The were to of revision and in our research group have our interest in health social movements, and have in about these we are to the and and and