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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