Primary author: Tilicia Mayo
With Edits
Critical Social Theory
As MacKinnon (2009) states, “Critical social theory aims to provoke critiques and stimulates social activism (MacKinnon, p. 513, 2009). Critical social theories focus on how social environments prevent the ability of human beings to prosper. This can be thought of as theories that assess the denial of certain privileges due to skin color, gender, religion and even sexual orientation. According to Cooke (2005), the purpose of critical social theory is to bring about change for the better (Cooke, 2005). Some of the most common critical social theories are critical race theory, feminist theory, and standpoint. These theories are a representation of the cultural side of critical social theory. CST is also geared toward allowing individuals to live freely within a society. Using this focus, critical social theory has a broader perspective and thus, can be applied to other disciplines (Foss & Littlejohn, 2005).

One of the disciplines in which critical social theory can be applied is public health. When using critical social theories in public health it is important to reflect on the questions CST attempts to answer: Who does and does not get to speak? Who stands to benefit from a particular system? What does and does not get said (Foss & Littlejohn, 2005)? These questions play a pivotal role in understanding the health status and risks among marginalized groups. As previously stated, critical social theories address the injustices and lack of liberation within minorities and marginalized groups. According to O’Hair, Sparks & Wright (2008) people who are marginalized have the most risk for health problems. In addition, those who are already at risk for health problems also are subjected to health disparities in access to healthcare and the quality of care they receive due to their social status. These individuals are likely to live in areas with low social resources and limited social capital. “These factors often put members of such groups at higher risk for health problems such as environmental health threats, susceptibility to disease, substance abuse, mental illness, and depression (O’hair et al, p 216, 2008).

In an article by Dickinson (1999) critical social theory is applied to adolescents with diabetes. This is a group in which it members often do not understand they are being mistreated and as a result, are unable to advocate for themselves. Their inability to speak regarding their treatment put them in a subordinate role their treatment becomes oppression. The result of adolescents with diabetes being oppressed is an inability for them to effectively manage their diabetes in the future. According to Dickinson, one of the methods of preventing this is advocacy by nurses.

Boutain (1999) takes the ideas used by Dickinson a step further. In using CST to analyze the marginalized group adolescents with diabetes, a more detailed analysis can be used to look at African American adolescents with diabetes. According to Boutain, “Because CST promotes nursing scholarship about conditions that impede human health and fulfillment, using knowledge from African American studies is significant for developing research and theory tailored to the concerns of African Americans” (Boutain, 1999, p. 46). Using the idea that nurses can also be advocates, if nurses understand the cultural ramifications of having diabetes in the African American community, the behaviors leading to poor diabetes management such as low self-esteem and passive-aggressive behavior will be minimized (Boutain, 1999, Dickinson, 1999).

One important question that CST poses is whose interests are being served through

One important question that CST poses is whose interests are being served through existing power structures? As Toofany states, “Empowerment is the process by which people, organizations, and communities gain control of their lives.” For individuals to feel empowered, they must believe that they have been given the proper tools to make necessary decisions and achieve a favorable outcome. If individuals are to be empowered therefore, they must be helped to participate in their health care. But their ability to do so can be affected by their lack of power. According to Toofany (2006), simply giving patients health education material is not empowering them and thus does not required patients to become active participants (Toofany, 2006).

While the questions critical social theories present allow for the discussion of medical issues, there is a still a point where the cultural side of CST begins to intermingle with public health. For example, specific critical social theories such as critical race theory allow for an analysis of how race, cultural differences, and empowerment in society influence health disparities and how the information known about a population shapes our perceptions of that population. According to Airhihenbuwa & Collins (2010), the incorporation of critical race theory with interventions used in public health is the basis for a Public Health Critical Race framework. Acknowledging race when developing health theories can, “bridge gaps in health, housing, employment and other factors that condition living,” (Airhihenbuwa & Collins, S20).

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Boutain, D. (1999). Critical nursing scholarship: exploring critical social theory with African American Studies. Advances Nursing Science, 21(4), 37-47.
Boutain, D. (1999). Critical nursing scholarship: exploring critical social theory with African American Studies. Advances Nursing Science, 21(4), 37-47.
Cooke, M. (2005). Avoiding authoritarianism: on the problem of justification in
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Foss, K.A., Littlejohn, S.W. (2005). Theories of human communication. Belmont, CA

Dickinson, J. (1999) A critical social theory approach to nursing care of adolescents with
diabetes. Issues in Comprehensive Pediatric Nursing, 22, 143-152.
MacKinnon, S.T. (2009). Social work intellectuals in the twenty-first century: critical
social theory, critical social work and public engagement. Social Work Education,
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O’Hair, H.D., Sparks, L., Wright, K.B. (2008). Health communication in the 21st
century. Malden, MA: Blackwell Publishing.
Toofany, S. (2006). Patient empowerment: myth or reality?. Nursing Management, 13(6),