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Health, Aging and Society
Elena Neiterman

CHAPTER ONE Introduction: -The lower the income, the higher the rates of sickness, disability, and death -The sociology of health and illness seeks to describe and explain the social causes and consequences of illness, disease, disability, and death -As of December 2005, chiropractic services were removed from OHIP, through which chiropractors previously had received a small amount of financial support for their patients -the sociology of medicine is the study of the ways the institutionalized medical system constructs what it deems to be illness out of what it recognizes as signs and symptoms, and constitutes its response to such ‘illness’ through treatments it prescribes Structural Functionalism: -this has dominated North American sociology for many years and most sociological studies have adopted this perspective -Auguste Comte (1798-1857) gave the name of sociology to the society of science and is known as the godfather of sociology. He believed that sociology’s goal was to better society so that it might become orderly and progressive. -Emile Durkheim (1858-1917) provided theoretical and methodological model for structural functionalism. He defined sociology as a science of social facts which were to be treated and studied as if they were real, external to individuals, and yet capable of constraining and directing human behaviour and thought. He believed human beings were predictable and controllable through the power of norms that exist in their own right, aside from their manifestations in individuals. -social system is said to be composed of parts, institutions that function to maintain order in the social system -refer to table 1.2 for 4 sociological perspectives -structural-functional theory is often associated with a positive methodology -positivists view sociology as a science -positivists believe that social facts are to be treated as real and external so they tend to rely on data that are assumed to be objective, collected from interviews and questionnaires administered to individuals in survey research, and analyzed and organized to reflect the probability of the occurrence of certain behaviours among a certain aggregate or group of individuals -5 things distinguish structural functionalism from conflict theory, symbolic interactionism, and feminist and critical race theory. Assumptions are:  Sociology aims to discover and to explain the impact of social facts on human behaviour, attitudes, and feelings  Social facts are to be treated as things that are real and external to human actions, and that determine human behaviour  Social facts can be seen in aspects of the social structure such as the norms that guide behaviour, in social institutions such as the family or the economy, and in social behaviours such as those in relationships, in marriage, or at work  Sociology is a science that seeks to describe the world in series of universal casual laws  This science considers that human behaviour is objectively and quantitatively measurable through methods such as experiments and survey research -Talcott Parson’s work on the sick role: To understand the sick role, we need to understand that each individual plays a number of roles in society Roles arise out of the institutions with which the individual is associated (ex. an individual will play various family roles like daughter, son, mother, father) CHAPTER ONE Roles reflected something of the intermeshing of the individual in society Ideal of role helps to conceptualize the relationship between the individual and society from the perspective of structural functionalism Parson’s main concern was to describe the processes that maintain societal institutions Sickness could lead to societal breakdown resulting from inability of the sick to fulfill their necessary social roles such as parenting, maintaining a home, and working in the paid labour force. Therefore sickness must be managed. This legitimation is temporary and is contingent on the fulfillment of certain obligations by the individual who claims the sick role 4 components to the sick role: first 2 are rights and the second 2 are duties In order to maintain equilibrium of society, both rights and duties of the sick role must be fulfilled (1) The sick person is exempt from ‘normal’ social roles: -the sick individual has a legitimate excuse for missing an exam or a major presentation at work, for neglecting household chores and other responsibilities -In order to receive exemption, the individual may need formal, medical acknowledgement -they may have to get an official medical diagnosis and even a medical certificate as proof of illness (2) The sick person is not responsible for his or her condition: -sickness must be a result of an accident or other circumstances beyond the control of the individual (sick role) -the individual can’t be blamed or punished -sympathy rather than blame is considered the appropriate reaction of others (3) The sick person should try to get well: -the person who is given the legitimacy of the sick role is duty bound to try and get well -sick role exemption is temporary -if an individual doesn’t want to get better then the sick role is no longer considered legitimate and the sick label deteriorates into shameful labels like “foolish” or “careless” (4) The sick person should seek technically competent help and co-operate with the physician: -the ill person must seek appropriate medical attention and comply with the treatment provided Parson’s view: -believed illness was a form of deviance -can be a potential threat to the social system unless its managed for the benefit of the social system -medicine provides legitimation and justification for the sick role, and brings the sick back to wellness -medical institutions can be seen as social control Criticisms of the sick role: (1)The sick person is exempt from ‘normal’ social roles: -the extent of the exemption depends on nature, severity, and longevity of the sickness and the characteristics and normal social roles of the person -example: university student’s sick role is informal…this is because professors don’t take attendance; they can skip library study times without being noticed. The university will only send an official notice CHAPTER ONE when assignments, tests and exams occur. This is when the student needs to adopt the sick role by obtaining a medical note. (2) The sick person is not responsible for her or his condition: -this belief varies depending on the nature of the condition and the circumstances through which the individual received the condition -people who succumb to disease because they have been overworked or worried may be chastised for having failed to take preventive action -a number of diseases are thought to reflect on the moral and social worth of the individual, and when the person succumbs to these diseases, he or she is blamed by virtue of the stigma attached -Crandall and Moriarty (1995) found that diseases most likely lead to social rejection. They did not find that gender, age, or ethnicity had an impact. -negative associations of some diseases have caused discrimination and exile (3) The sick person should want to get well: -there are illnesses from which people cannot or are not expected to recover -patients are not granted legitimacy for wanting to get well once they have been diagnosed with a terminal illness (like cancer) -people continue to want to get well when they have been diagnosed as terminal. This leads to criticism because they may be said to be denying reality -people with a whole range of chronic illnesses are not
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