Photo: Authors' own

Rumours of the death of the book may be exaggerated, but its persistence remains a puzzle.  Who and what are academic books for, now that information is largely accessible at the press of a button?   Reviewing the three books shortlisted for the Foundation for Sociology of Health and Illness (FSHI) book prize prompted reflection on what academic books do, and why we still need them.

Data are hard to come by, but academic publishing is certainly a rapidly changing ecology, with incentives for open access publication, and evolving preferences for hard and e-books across the market.  For authors, the worth of a monograph depends the discipline.  Publishing with a reputable press remains a cornerstone of professional validation in the humanities.  For sociologists of health, writing a books might be career enhancing, if not essential, in social science departments, but seen as self-indulgence in medical schools. With a business case achievable on around 200 sales, mostly to libraries, it is fair to say that most academic books will have few readers, and even fewer personal owners. So why write them?  After all, journal papers can convey key findings, and policy recommendations are better targeted through other media.

A first consideration is the symbolic and sensory capital of a book – particularly a well-produced hardback.  Hardbacks still signal value – a publisher considered the material important enough to literally take up space.  Book publications are still an event, perhaps celebrated with a launch – few journal publications attract a glass of warm wine and a seminar on publication – and reviewed. Judging by the backdrops of many senior academics on zoom meetings over the last 18 months, a well-stocked library, preferably on handsome shelves, remains a key marker of scholarly bookcase credibility. So, what of the shortlisted books as consumer durables?

Travelling with Sugar: chronicles of a global epidemic by Amy Moran-Thomas, currently available from the publisher at around £27 for the paperback or e-book, and a little cheaper on other platforms (proceeds help fund food justice projects led in Belize). From a university press, this is a well-produced, solid book, with maps and pictures.  My copy is already thoroughly pencil annotated, with underlinings and folded corners (more fastidious book owners, please don’t @ me – one pleasure of owning a book is doing exactly what you like with it).

If you want a physical copy of Wandering the Wards: an ethnography of hospital care and its consequences for people living with dementia, by Katie Featherstone & Andy Northcote, it will set you back £72 for the hardback – a not unusual cost for academic books – but an open access pdf is free.  The joy of reviewing is (tetchily) insisting on a hard copy.  This one comes as a serviceable monograph, with a plain cover – perhaps a disappointment if you’d paid £72, but I am delighted to have the ‘real thing’ on my shelf, to dip in and out of and return to.

Kylie Baldwin’s Egg Freezing, Fertility and Reproductive Choice: negotiating responsibility, hope and modern motherhood is also available as a free download, or a very reasonable £20 for a paperback.  However, this is clearly not meant as a keeper: pages soon detach from the spine.  Numbered sub-sections presumably help readers navigate the e-version, but again, I’m delighted to have the ‘real’ book to carry in my bag, read on trains, or prop up over breakfast.  Hard copies somehow encourage slow and thoughtful reading; reading on screen feels awkward for anything other than instrumental and rushed information gathering.

The ‘content’ of these books is, then, affordable, or even free if you don’t mind a pdf.  But does it justify a book length treatment?

Featherstone & Northcott’s ethnography of dementia care on NHS wards recalls – and is a lovely homage to – classic hospital ethnographies of the 1960s and 70s.  Depressingly, they document little has changed.  Across what they refer to as ‘these wards’ (a phrase that recurs with haunting repetition throughout the book), people with dementia are inevitably ill-served by the overwhelming task-orientation and depersonalisation of hospital routines. For anyone with direct experience of care for relatives, their descriptions of disorienting interaction and care fragmentation are harrowingly resonant.  I hoped for a redemptive narrative arc – perhaps they would end with finding a model of excellent care?  Spoiler alert: they do not.  Organisational inertia constrains change: a rare example observed of slow, engaging care from health care assistants is swiftly curtailed as ‘non-work’ by ward colleagues.  ‘Wandering the wards’ of course describes the ethnographers as well as the patients, and it is the ‘wander’ here that justifies a book.  Over several chapters, it the sheer accumulation of detail and example that carries the punch.

Kylie Baldwin’s excellent study of ‘pioneers’ in egg-freezing also concerns a social issue that will affect many.   Her introduction is a sobering account of the narrow window many women face in achieving ‘legitimate’ reproduction – too early is irresponsible, too late risks biological constraints.  Faced with disruptions in their expected life trajectories, her participants chose to freeze their eggs as an ‘investment’ for the future.  This relatively new technology raises pressing issues around biomedicalisation and gendered discourses and burdens of reproduction. Baldwin undertakes a careful and empathetic analysis of interviews with women living these issues.  The case for a monograph here is not from the need for a sustained argument – indeed, her peer-reviewed publications have already made sophisticated contributions to theory. Rather, this serves as a more accessible text for a non-specialist audience: generously referenced, but uncluttered by specialist vocabulary or dense theory.

Sections of Moran-Thomas’ book have also already been published in papers.  Her monograph, though, is necessary and urgent. A deep, looping, and astonishing account of her ‘travels with sugar’, this ethnography of the epidemic of diabetes in Belize weaves in stories of battles with glucose testing machinery that fails to travel, limb amputations, deaths and spirits with the ecological and economic intergenerational traumas wrought by colonial displacement and the sugar trade. This is a profound and moving explication of the political causes of ill-health, and a devastating critique of medicalised understandings centred in the global north.  It should be required reading for anyone still characterising diabetes as a ‘lifestyle disease’, or tempted to recommend behavioural nudges for chronic illnesses.

All the shortlisted authors profess to have written for audiences outside academia as well as scholarly colleagues – primarily for those affected by the topics or in a position to change policy.  If direct impact is unlikely, books of course provide the cultural backdrop through which issues come onto a policy agenda and through which social attitudes change. All three books have the potential to make critical contributions. Whether they will travel beyond the academy is hard to know. However, these authors write clearly and well for non-specialist audiences. This will ensure that their ideas travel at least beyond their narrow fields.  Books, rather than papers in increasingly niche specialty journals, are more likely to reach across disciplinary boundaries, and enable ideas to circulate.  Books can help insights from sociology escape the seminar room, be talked about, and do things in the world. We still need books – in diverse and affordable formats – for more than providing zoom backdrops.

The winner of the FHSI Book Prize will be announced at this year’s BSA Medical Sociology Conference.