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Chapter 25

HLTB03 - Chapter 25

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Health Studies
Michelle Silver

Chapter 25- Personal and Structural Determinants of Health and Illness; Lifestyles and life chances Introduction: -lifestyles, healthy living, health promotion have emerged as important areas of investigation in medical sociology -distinction is often made b/w societal factors that are beyond one’s control and influence health, and individual behavioural factors, over which one presumably has control and for which one can make healthy choices -for societal factors, the focus is on the social-structural conditions, including economic and social inequality, that influence health status - in terms of behavioural factors, the approach focuses on overall aggregate patterns of health behaviour and health practices which constitute lifestyles, such as smoking, alcohol consumption, exercise, and diet -it is assumed that lifestyles are matters of individual choice, and that these choices have either positive or negative health consequences -within this framework, the responsibility for staying healthy is shifted to individuals -one perspective suggests there would be a decrease in mortality if focus was put toward changing lifestyles -on the other hand, the studies from a historical, materialistic, epidemiological perspective argue that the solution lies in changing the social, economic and environmental conditions that produce illness and mortality -life chances: consumer behaviour and lifestyle choices individuals make within the limits and constraints imposed upon them by the social and cultural environment and their material conditions -this constitutes the study of the relative importance of the role of structure (chances) and agency (choices) in shaping social behaviour in teh structure=agency debate in the sociological literature -structuralists give primacy to institutional factors, which both enable and constrain individuals to act, whereas agency refers to the ability of the individuals to act and to choose their behaviours regardless of structural constraints -specific studies of health lifestyles and health behaviour would make significant contributions to the structure-agency debate -sociological perspective allows us to take into account social-structural factors in the discussion of lifestyles -discussion of reductionist orientation in medicine will take place Background to Reductionism in Medicine -there are individualistic, biomedical and reductionist orientations in medicine -individualasitic approach has been taken, whereby humans are looked at as something that can be fixed -diseases are looked at as malfunctions-technical defects in body machinery-treatments are oriented to restoring “normal” function of human body -mechanistic-individualistic concept of disease which engenders a disease centered, high0technology orientation in medical practice and research, also largely absolves teh economic and political systems of responsibility for disease, and denies the social foundations and social causation of disease - reductionist approach -emphasizes in
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