THE REORIENTATION OF
Every institution is embedded in an institutional field, the relatively organized set of organizations and practices and beliefs shaping the discourse and practice toward the core object and norms of the institution. When we first think about health-related institutions we are inclined to think about hospitals and doctors and nurses, medical schools, pharmaceutical companies, and so on. But each of these are part of the institutional field for some of the others. The Federal Drug Administration (FDA), an agency operated by the government, would also be part of the medical field. To the extent that we are concerned with the funding and practices of the FDA we are concerning ourselves with part of the field of health. We would be less inclined to think of behavior in the family to be part of the institutional field, but it is obvious that individual and family behavior has an impact on our health, and professional and state policy often focuses upon efforts to change such behavior. Similarly, agents of the state inspect agricultural products and regulate what is considered safe and unsafe in food production. They are part of the field of public health, which for some purposes can be treated as overlapping the field of health institutions, broadly conceived. It is important to note that social movements can be part of the field of health-related institutions, and also can be treated as institutional objects themselves. That is, they are shaped by expectations, norms, and practices of the participating actors and organizations, as well as other organizations in the society such as police, courts, educational organizations, professions, community groups, and other social movement actors that they engage with.
It is also important to note that fields need not be homogeneous; several different logics and orientations may exist. Indeed, the existence of movements aimed at changing practice is one index of contestation in the field.
Phil Brown and his collaborators have been major contributors to the study of health social movements. In “Field Analysis and Policy Ethnography” (chapter 7 this volume) they focus