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Chapter 1

Chapter 1 Ways of thinking Sociologically about Health.docx

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Health Studies
Dan Silver

1 Ways of thinking Sociologically about Health, Illness and Medicine Introduction  Most types of morbidity and mortality are inversely related to income o Statistically correct to say that the lower the income, the higher the rates of sickness, disability and death  Working definition: the sociology of health and illness seeks to describe and explain the social causes and consequences of illness, disease, disability and death; to show the ways lay people and professionals alike constitute or construct their categories of disease and illness, identities with wellness and illness and how illness affects and is affected by social interaction  The sociology of medicine is the study of the ways institutionalized medical systems construct what it deems to be illness out of what is recognizes as signs and symptoms and constitutes its response to such illness through treatments it prescribes o Examines and offers explanations for topics as varying types of medical practice and medical discourse: ideology and organization of medicine, different ways of financing medical care, the structure and operation of hospital and occupational world of nurse and doctor  Explains the relationship b/w different health care and role of system in context of the culture and political globalizing world  4 paradigms; structural-functional theory, conflict, symbolic interactionist/interpretive and feminist/anti racist theory Structural Functionalism  dominated north American sociology for years  the normal science of the discipline  Emile Durkheim provided theory and methodological models  Assumed proper level of study for sociologist is the society or the system  Social system is composed of parts, institutions that functions to maintain order in the social system  Often associated with a positivist methodology; they view science in the same way that physicists view physics as a science  5 principles distinguish structural functionalism from others: o 1. Sociology aims to discover and explain the impact of social facts on human behavior, attitude, and feeling o 2. Social facts are to be treated as real and external to human actions and determine behavior o 3. Social facts can be seen in aspects of the social structure such as the norms aspects that guide behavior in social institutions o 4. Sociology is science that seeks to describe the world in series of universal causal laws o 5. This science considers that human behavior is objectively and quantitatively measurable through methods such as experiments and survey research  most influential contribution to medical sociology rom structural point of view us Talcott’s work on the “sick role”  to understand sick role it is necessary to understand that each individual plays a # of roles in society  roles rise out of the institutions with which the individual is associated  main concern was to describe the processes that maintain societal institutions o notion of sick be looked at in this context o sickness lead to societal breakdown; inability of the sick to fulfill their necessary social roles o 4 components: 2 rights and 2 duties; must be fulfilled if equilibrium of society is to be maintained  1. The sick person is exempt from ‘normal’ social roles o legitimate excuse for missing major work for staying in bed, in order to win exemption individual may need formal medical acknowledgement o may obtain medical diagnosis or certificate as proof of illness  2. The sick person is not responsible for his/her condition o must be result of accident and other circumstances beyond the control of person o not to be blamed, punished and sympathy is appropriate reaction  3. The sick person should try to get well o person given the legitimacy of sick role is duty bound to try to get well, example of person with pneumonia diagnosis must follow doctors orders or else legitimacy of sick role is turned into foolish, immoral careless  4. The sick person should seek technically competent help and cooperate with the physician o duties of sick role to seek appropriate medical attention o illness according to parsons is a deviance, potential threat to social system unless managed o medicine is institution responsible for providing justification and bringing the sick back to normal or wellness; can be seen as agents of social control o sick role of parsons was theoretical; not based on empirical investigation  empirical analysis subjects his definition of the sick role to a # of criticism o 1) extent to which person is allowed exemption on the nature, severity and longevity of sickness o 2) sick person may be held responsible for a cold in instance because of their own actions o 3) many illnesses are terminal o 4)  positivism is the research methodology most closely related with the structural- functional perspective, but all positivists are not structural functionalists  contemporary positivists; study human health behaviors as both independent and dependent variables o ex: exam of impact of diagnosis like cystic fibrosis on family of ill treats health behavior as independent on other hand when impact of income level on the incidence of disease then human health behavior becomes dependent  positivists following Durkheim assume that the social structure has a constraining impact on ind’vls  social-structural positions determine individual thoughts, behaviors, feelings in this case health illness and medical utilization and so on  change in one institution necessitates change in another  the social determinants of health; perspective could be considered a contemporary illustration of this methodology Summary  goal of sociology to explain the place of social facts in human behavior, attitudes, or feelings  based on quantitative analysis of objective social phenomena Conflict Theory  less dominant role in the role of development of sociology  provides a radical critique of the more conservative aspects of the mainstream of structural-functional sociology  in conflict theory all social arrangements have political and economic bases and consequences  tends to focus on class or economic based power relation/dynamics  model of paradigm is the work of Karl Marx o directly involved in analysis and organizations for changes in society o leader of first communist international in Europe  he asserted that human behavior and thought was the result of socio-economic relations; both were alterable for betterment of society  he described each period in history as struggle between classes and this struggle is related to the means of production  Conflict theory can be distinguished in the following ways: 1) the sociologists work is to discover injustice and attempt to change it; all knowledge is rooted in social, material and historical contexts; research methods must acknowledge social, economic and historical contexts  Friedrich Engels: “the condition of the working class in England”; showed working conditions and living conditions that resulted from capitalist production had negative health effects o People lived in slums because they couldn’t afford anymore than cheap shelter and food; which was the breeding ground for diseases endemic to these conditions o ill health was related to living conditions of the working class  Continuous contradiction between the needs of the workers for a good living and working conditions and the needs of the capitalists for expansion and profit  Some of the ways in which this occurs first that the class structures of society are reproduced within the medical sector o So that the distribution of the functions and responsibilities of occupational groups and medical care system mirrors the ethnic, gender hierarchies within the sectors of capitalist society o The medical system has a bourgeois ideology of medicine that regards both the cause and cure of illness as the responsibility of the individual o State supports aliena
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