Communication, power, and praxis in health: examining the critical turn in health communication scholarship
Article information
Abstract
This review examines Critical Health Communication: Theory and Practice, an edited volume by Shaunak Sastry, Heather M. Zoller, and Ambar Basu that consolidates and advances the critical turn in health communication scholarship. Organized into thirteen chapters, the book foregrounds power, culture, and structural inequality as constitutive forces in communicative processes, challenging dominant functionalist and behaviorist paradigms. The contributors reconceptualize communication not merely as a tool for improving health outcomes but as a site where inequalities are produced, negotiated, and contested. Drawing on frameworks ranging from critical race theory and feminist scholarship to decolonial approaches, the book represents a meaningful bridge between academic critical scholarship and applied health communication. The review evaluates the volume’s contributions and identifies areas for further development, particularly regarding deeper engagement with Global South contexts, digital health infrastructures, new media ecologies, and ethnographic methods, while affirming the book as an essential resource for scholars, students, and practitioners working at the intersection of communication, health, and social justice.
A Book Review on
Critical health communication: Theory and practice.
Sastry, S., Zoller, H. M., & Basu, A. (Eds.), Milton Park, United Kingdom: Routledge, 2025, 280 pages, ISBN: 978-1032725536
Health communication has long been dominated by behavior change models and functionalist approaches that treat communication as a neutral vehicle for information delivery. In an era marked by widening health inequities, global health crises, and persistent structural violence, this paradigm has come under sustained scrutiny. Critical Health Communication: Theory and Practice, edited by Shaunak Sastry, Heather M. Zoller, and Ambar Basu, arrives as a timely and necessary intervention in this debate. The volume positions itself as a definitive contribution to the critical turn in health communication, arguing that communicative processes are embedded within, and often reproduce, relations of power and inequality. Rather than treating communication as a neutral conduit for information dissemination, the editors foreground how it participates in sustaining structures of domination (Sastry et al., 2026). The volume builds on foundational work in the field, including Mohan Dutta’s (2008) culture-centered approach to health communication, Zoller’s prior scholarship on health activism, and broader traditions of critical media studies, while extending these frameworks toward more explicitly intersectional and decolonial terrain. In doing so, it occupies a distinctive position relative to earlier critical health communication texts by foregrounding praxis alongside theory and centering practitioner voices within the same analytical frame. This insistence on politicizing communication is not merely conceptual but also methodological and ethical, compelling scholars to interrogate their own positionalities and the epistemic conditions under which knowledge about health is produced.
Overview and Structure
The volume is organized into thirteen chapters that collectively map the theoretical, methodological, and practical contours of critical health communication (CHC). Moving beyond a narrow focus on individual behavior change, the contributors engage with a wide array of issues, including hunger, reproductive injustice, media representations, and grassroots health interventions. For instance, one chapter examines how race and structural racism are reproduced through clinical communication and public health messaging, while another interrogates the politics of reproductive health narratives in media and policy discourse. A further contribution addresses culture-centered community health interventions in underserved contexts, illustrating how participatory communication can serve as a site of resistance rather than mere information delivery. These contributions are united by a shared commitment to situating health within broader cultural, political, and economic contexts. The book does not adopt a singular theoretical framework; rather, it presents CHC as a heterogeneous and evolving field unified by a commitment to interrogating power, ideology, and inequality in communicative processes (Sastry et al., 2026). This openness allows the volume to incorporate diverse perspectives, from critical race theory and feminist approaches to culture-centered and decolonial frameworks. Such theoretical plurality is both a strength and a productive tension, resisting premature closure while inviting further synthesis.
A distinctive feature of the book is its integration of theory and practice. By foregrounding practitioner perspectives and real-world interventions alongside theoretical contributions, the volume actively challenges the perceived divide between academic theorizing and applied health communication. As the editors note, critical sensibility functions not merely as an abstract intellectual exercise but as a practical orientation that can inform and transform health communication on the ground. This bridging is particularly significant in contexts where policy and practice often proceed without sustained engagement with critical scholarship.
Thematic Analysis
Recentering Power and Structural Determinants
At the heart of the volume lies a sustained critique of dominant paradigms that have historically shaped health communication. Rather than treating race, class, and gender as variables to be controlled, the contributors foreground these as structural conditions that fundamentally shape health outcomes and communicative processes. The volume repeatedly emphasizes that health disparities cannot be understood without engaging with broader systems of economic inequality, racism, and social exclusion, aligning with scholarship that situates health within political economy frameworks. The COVID-19 pandemic is invoked as a critical moment that exposed how health outcomes are patterned along axes of privilege and marginalization (Sastry et al., 2026). Several chapters implicitly call for a rethinking of health communication as part of a wider governance apparatus, where communication operates alongside policy, infrastructure, and institutional arrangements.
This structural orientation marks a decisive departure from individualized models of health communication. Communication is no longer conceptualized as a tool for persuading individuals to adopt healthier behaviors; instead, it is understood as a site where structural inequalities are reproduced and contested. For readers of Health and New Media Research, this reorientation carries particular resonance: the volume’s framework applies directly to analyses of digital health platforms, social media health communication, and algorithmic systems that sort and stratify health information, all of which are deeply implicated in the reproduction of the structural inequalities the book foregrounds.
Communication as a Site of Power and Resistance
A second major contribution is the volume’s reconceptualization of communication itself. Rather than assuming communication to be inherently beneficial, the book challenges what it terms the unquestioned beneficence of communication interventions and calls for a reflexive engagement with their potential to perpetuate harm (Sastry et al., 2026). This critique resonates with broader debates in critical media studies that caution against technological and communicative solutionism. The intervention is particularly significant in the context of global health communication, where top-down messaging campaigns often fail to account for local cultural contexts and power dynamics.
By foregrounding communication as a site of both domination and resistance, the volume opens new possibilities for rethinking health interventions. Communication emerges as a contested terrain where meanings are negotiated, resisted, and rearticulated. Several chapters illustrate how marginalized communities actively negotiate and reinterpret dominant health discourses, highlighting community agency while also revealing the constraints imposed by structural conditions. The book thereby advances a dialectical understanding of communication as both enabling and constraining. It also gestures toward the importance of listening as a methodological and ethical practice, though this remains an underdeveloped thread that future scholarship could productively pursue.
Praxis and the Bridging of Theory and Practice
One of the most compelling aspects of the volume is its emphasis on praxis. The editors explicitly frame the book as a response to the long-standing critique that critical scholarship is disconnected from practice. By incorporating practitioner perspectives and case studies, the volume demonstrates how critical theories can inform real-world health interventions. The discussion of grassroots initiatives, including the work of nongovernmental organizations with marginalized communities, illustrates how communication practices can be reoriented toward social justice goals. Community-based health initiatives highlight how local knowledge systems and participatory communication can challenge dominant health paradigms (Sastry et al., 2026), underscoring the importance of co-creation, dialogic engagement, and sustained community participation.
This emphasis on praxis is particularly important for bridging the gap between academic scholarship and policy or practice. It suggests that critical health communication is not merely an analytical framework but a transformative project aimed at reshaping communicative and health systems. At the same time, unevenness across chapters in translating theory into actionable insights points to the continuing challenge of operationalizing critical frameworks in applied settings. Several chapters would have benefited from more explicit discussion of how their analyses might inform practitioner or policy decisions.
Toward a Decolonial and Global Perspective
The volume also gestures toward a decolonial rethinking of health communication. By including examples from diverse global contexts and engaging with issues of epistemic inequality, the book challenges the dominance of Western-centric frameworks. It raises important questions about whose knowledge counts, whose voices are heard, and how global health agendas are shaped by asymmetries of power. The editors acknowledge the limitations of the volume in fully capturing the diversity of global experiences, positioning the book as a starting point for further work centering voices from marginalized communities and regions often excluded from mainstream scholarship. This reflexive acknowledgment underscores the ongoing nature of the critical project and the need for continued engagement with decolonial perspectives.
Future work in critical health communication might more explicitly engage with infrastructures of communication, including community media, local health ecologies, and informal networks that sustain everyday health practices. Such a move would deepen the field’s engagement with the material and technological conditions through which health communication occurs, connecting macro-level structural critique with the micro-level practices through which inequality is lived and contested.
Critical Evaluation
The volume’s primary strength lies in its ability to consolidate and advance the critical turn in health communication. By bringing together a diverse set of contributions, it offers a comprehensive overview of the field while also pushing its boundaries. The emphasis on power, inequality, and praxis provides a robust framework for rethinking health communication in more socially just terms. Another notable strength is the book’s interdisciplinary orientation. Drawing on insights from sociology, anthropology, media studies, and public health, the volume reflects the inherently interdisciplinary nature of health communication and serves as a valuable pedagogical resource for advanced students engaging with critical approaches.
However, the volume is not without limitations. While it gestures toward global and decolonial perspectives, these are unevenly developed across chapters. A more sustained engagement with Global South contexts and indigenous knowledge systems would have further strengthened its critical claims. The relative absence of extended ethnographic engagement also limits the depth of some analyses. Additionally, while the emphasis on praxis is commendable, some chapters remain more theoretically oriented, leaving practical implications underdeveloped. For a journal such as Health and New Media Research, perhaps the most pressing gap is the volume’s limited engagement with digital infrastructures, algorithmic governance, and platform-mediated health communication. In an era when search engine results shape health-seeking behaviour, social media platforms amplify or suppress health information along racialised and classed lines, and health apps harvest intimate biometric data under the cover of wellness promotion, a critical health communication framework urgently needs to grapple with these new media ecologies. The COVID-19 pandemic foregrounded these stakes dramatically, as infodemic dynamics on Twitter and WhatsApp intersected with structural inequalities in ways that existing chapters on media representations only partially address. Future editions, or companion volumes, would benefit from chapters specifically devoted to critical platform studies, critical data studies, and the political economy of digital health.
Conclusion
Critical Health Communication: Theory and Practice represents a significant contribution to health communication scholarship and beyond. By foregrounding power, inequality, and culture, the volume challenges dominant paradigms and repositions communication as a central site of struggle in the pursuit of health equity. The book is particularly valuable for scholars and students seeking to engage with critical perspectives, as well as for practitioners interested in developing more reflexive and socially just communication strategies. Its emphasis on praxis, interdisciplinarity, and global perspectives makes it a timely and relevant resource in an era of profound health challenges. Ultimately, the volume calls for a reimagining of health communication as a transformative project, one that demands sustained attention to power, digital infrastructures, and the everyday communicative practices through which health inequalities are lived and contested. For researchers and readers in the field of health and new media, it offers both a critical vocabulary and an urgent agenda.