Week 2 – Social Models of Health and Illness 03/11/2014
Objective: explain and critique the theory of Structural Functionalism and ‘Conflict Theory’ (Marxism).
Society as system of integrated parts existing in equilibrium
Key concept ▯ Sick Role
Society = conflict/inequality between social classes (with upper class having more resources and
Key concept ▯ Social Stratification
Example: Black Lung
Structure vs. Agency
This is a central debate in sociological theory. It is centered around if people have freedom of choice
(agency) or are their choices determined by their social position (structure).
Structure: determinism, not very much control or choice
It is a key debate in sociology over the extent in which human behavior is determined by social structure.
Agency: the ability of people, individually and collectively, to influence their own lives and the society in
which they live.
Sociological Theories Structural Functionalism, Marxism, Weberianism, Feminism, Human Rights and AntiRacism Frameworks,
Symbolic Interactionism, Poststructuralism/ Postmodernism.
Focus on Structural Functionalism, Marxism and Weberianism for the midterm**
What distinguishes the theories from each other?
Where they sit in relation to the structureagency debate (do we shape society or does society shape us)
The questions they ask (e.g. about health, illness, health care, etc.…)
Their conceptualization of society (stability vs. conflict)
Their ultimate goal (to understand and explain social phenomena, to promote social change, etc…)
“A society is a system of integrated parts, each of which have certain needs (or functional prerequisites)
that must be fulfilled for social ordeoo r to be maintained”
Concerned with how the various parts of society function to maintain social order and social stability
Social work, greatly influenced by structural functionalism
See page 2629 of textbook**
Role of health care professionals: “to rehabilitate individuals to carry out their social roles”
Four Key Assumptions of SFT
Like the body, society (a social system) is made up of interrelated and interdependent parts.
Each part has a function and works to sustain the unity of the whole. Cohesion and unity are maintained by the sharing of a central value system (beliefs and norms ▯ value
consensus). When members have differing goals, unity becomes harder to maintain.
Each person fulfills a particular role ▯ which carries particular rights and responsibilities (function). This is
not just people, it includes institutions, schools and religions.
Four Key Characteristics of Social Systems
Interdependence of Parts
Needs of requirements
Analogy – the body (inputs/outputs ▯ equilibrium)
Functional parts: those that help meet the needs of the system
Dysfunctional parts: those that are harmful to the rest of the system
Nonfunctional parts: those that are irrelevant to the system
When all parts fulfill their functions, a society or a group is in a ‘normal’ state
When some parts do not fulfill their functions, a society or a group is in an ‘abnormal’ or ‘pathological’ state.
Sick Role – Talcott Parsons (1951)
Sick role is “a concept used by Talcott Parsons to describe the social expectations of how sick people are
expected to act and how they are meant to be treated”
Parsons argued that the health of individuals was essential for the maintenance of social stability and order.
Page 28 textbook**
Illness conceptualized as a form of deviance (a violation of normal societal expectations). Believed to
prevent people from fulfilling their social rules and to threaten the smooth functioning of society.
Parsons also believed that individuals who are sick have specific rights and obligations. Rights of Sick Individuals
The sick person is exempt from ‘normal social rules.
This sick person is not responsible for his or her condition.
Responsibilities of Sick Individuals
The sick person should try to get well.
The sick person should seek technically competent help and cooperate with the physician.
Sick Role Concept – Critique
While the concept applies to acute illness (e.g. flu), it does not work well for “chronic, terminal, or
permanently disabling conditions”
The ability to adopt the sick role is influenced by age, social class, ethnicity, gender, etc.…Not everyone has
access of the affordability to health care.
Alexander Segal argued that we should distinguish between the informal sick role and the formal patient
Seeking assistant from professionals is not always necessary, and sometimes may be detrimental to the
health care system.
“…its uncritical acceptance of the role of the medical profession and its neglect of the limitations of the
In contemporary Western society, if you adopt the sick role (or are placed in it), you are expected to use as
few medical services as possible (cost reductions, emphasis on health promotion)
Health promotion: instead of interacting with health care professionals, look at lifestyle (i.e. nutrition), the
goal of this objective is to reduce cost to make the system more sustainable.
Healthism: idea that it is the individual’s own fault that they are in the condition they are in, they have full
responsibility. Additionally, we are less likely to afford people rights and more likely to hold them responsible
(blaming people for their illness). Research Example of Structural Functionalism – Suicide
Durkhiem analyzed suicide data from 11 countries
Found patterns in suicide rate between countries and between different groups within countries.
Protestant countries had higher rates of suicide than Catholic countries.
Jewish people had the lowest rates of suicide of all.