Sociology of Health and Illness Lecture Notes PDF

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Sociology of Health and Illness Lecture Notes Week One Lecture: Key Features, Sociological Approach to Health and Illness; Applying the sociological imagination to health and illness (Germov 2019). History: How the past shapes current ways of thinking and acting in relation to health and illness. Structure: Structural and Material factors as causes of illness: Political and economic factors, social stratification patterns, gender related division of labour, working and living conditions, social inequality all affect health. Cultural: Meanings and experiences of health and illness viewed as social constructions that vary between groups, over time etc. Critical: Public policy, state intervention, community participation are the preferred focus when trying to address health problems rather than the behaviour or bodies of individuals.

Structure: Social Production of Health and Illness; It is common for people to describe illness as either the result of fate or bad luck. However, Illness is not randomly distributed but socially patterned as are the resources needed to manage poor health. Exploring that social distribution gives insights into the distribution of resources and power in any society.

Culture: Social Construction of Health and Illness; What people view as disease, health and illness varies between cultures, over time, and within societies. This affects the meanings we give to various health related issues and experiences-examples of this include being weight in the past showed someone was in good health and cigarettes were considered to be healthy.

Structure and Culture: Social Organisation of Health Care; How do we manage healthcare? Decisions about the best arrangements for health care are representative of social and ideological values. Should money be invested in prevention or more towards acute medical care (hospitals). How and who should pay? Role of informal healthcare.

Health care professions and occupations.

A Key Concept in the Sociology of Health and Illness: Medical Model; Sociological commentators have typified the medical explanation of disease. Agree on several key characteristics, this is often described as the medical (or the biomedical) model.

The Medicine Model: Disease is regarded as the consequence of certain malfunctions of the human body conceptualised as a biochemical machine. Assumption that all human dysfunctions might eventually be traced to such specific causal mechanisms within the organism (doctrine of specific aetiology);The medical model is reductionist (physical reductionism)in the sense that all disease and illness behaviours would be reduced causally to a number of specific biochemical mechanisms. Finally the medical model presupposes a clear mind/body distinction where ultimately the causal agent of illness would be located in the human body (Turner 1987:9).

Comparing the Medical Model with a Social Model: Medical Model-Key feature of the medical model: Focus on the individual (and their body) in terms of interventions and the way that health and illness are understood. Social Model-In contrast a sociological approach to health and illness is focused on the societal level of health determinants and interventions. Your textbook refers to this as a social model of health. We need both of these models.

Week Two Lecture: Social Production and Distribution of Health and Illness: Health and illness both appear to be socially produced resulting in social patterning. The distribution of health and illness across the population shows differences by social variables such gender, ethnicity and social class. There is unequal social distribution of health “whereby some social groups suffer higher rates of morbidity and mortality” (Germov 2009:18). The social patterning of health and illness shows that health is about more than bad luck or bad genes etc. It is related to life chances.

Life Chances: It’s a concept that emerged from Weber. Life Chances are the opportunities an individual has to improve their quality of life or the extent to which an individual has access to important social resources, such as healthy affordable food, shelter, education, employment and healthcare. Weber argued that life chances are shaped by our class and status. Social reproduction/ social mobility. When looking at Life Chances we are acknowledging that Social Stratification is heavily affecting individuals from bettering their circumstances.

Life Chances and Health: When we examine life chances and health we can take a broader view of life chances that also recognises gender, race/ethnicity and place. The study of life chances and health is also referred to as the study of health inequalities, health inequities or the social determinants of health. It shifts attention away from individual responsibility and the idea of healthy lifestyles in an individualised sense.

Social Determinants of Health: The social determinants of health (SDH) are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. The most significant predictor of health status is income. Social factors are interrelated, income, occupation, education (Class or SES), gender, ethnicity and employment and health intersect with place, age and other factors.

Social Factors as Causes of Diseases: Phelan, Link and Tehranifer (2010), argue that there are fundamental causes of disease and that socioeconomic status (SES) is one of these.

Listen to the rest of the lecture if you want a case study on Aboriginal people.

Week Five Lecture, Medicalisation and Technology: Social Construction of Medical Knowledge: Social constructionists argue that medical knowledge (and all knowledge) is socially constructed (socially produced).

Medical Knowledge as Socially Produced: Sociologists differ on this topic. This is usually written from a critical/Marxist perspective. Science has a social foundation-Thomas Coone was one of the first theorists to write about this. Look at slides if you want examples of medical knowledge being socially produced.

Foucault and Discourses: Post-structural theory, and in particular, Michel Foucault. Foucault argued that discourses are powerful ways that ideas and values are put into speech and action. Those discourses that carry the most weight, or legitimacy, are those that receive high social rewards. Judith Butler is another sociologist in this area.

Discourses are ‘socially, culturally and historically contingent’: The way we think, speak and act about specific issues is shaped by the socialcultural and political context. A key way of understanding the changing nature of discourse is to consider how explanations for illness have changed over the ages, cultural context, social setting etc. e.g. mental illness and the different ways in which it has been understood at different periods in history, within and between societies, and in different cultures.

Medicalisation: The process by which human experiences are defined as medical problems. It legitimates medical control over an area of life, typically by asserting and establishing the primacy of a medical interpretation of that area.

“Medicalisation consists of defining a problem [not previously seen as medical] in medical terms, using medical language to describe a problem, adopting a medical framework to understand a problem, or using medical intervention to treat it.” Conrad 1992:211) Benefits of Medicalisation: Medical treatments can remove/reduce suffering. Calling something a medical condition can be a huge relief to people who have been suffering without a label- can access the sick role. Individuals and groups can benefit from medicalisation in so far as being ‘ill is generally viewed more sympathetically than being 'sinful’ or ‘bad. However, sociologists have tended to focus more on the possibly detrimental aspects of medicalisation.

Detriments/Criticisms of Medicalisation: 1. Pathologise everyday life-normal conditions such as aging, periods, birth control, weight are now seen as medical conditions. 2. Emphasize individual rather than social causes for problems; Think back to the comparison between the social model of disease and the medical model. Example postnatal depression or weight loss surgery. 3. Enrich the Pharmaceutical and Biotechnology Industries; Nearly 300 million prescriptions dispersed in Australia every year. 4. Latrogenesis; Iatrogenesis is defined as the development of new health problems as the result of treatment for existing health problems. Iatrogenesis is often part of a cycle of medicalisation. 5. Medicalisation, Deviance, Social Control; The concept of medicalisation is closely linked to sociological arguments that medicine is an institution of social control. Many of the authors who first wrote about medicalisation were concerned that medicine seemed to be becoming an increasingly powerful agent of social control.

Powerful Groups Determine what is Viewed as “Normal”: E.g. Until 1987 the American Psychiatric associations diagnostic and Statistical manual of Mental disorders (DSM-III and DSM-III-R) characterized participations in nonwestern religions or new age religions as characteristics of a mental disorder.

Demedicalisation: Demedicalization, the process by which a condition or life process under medical jurisdiction is reconsidered as being no longer a medical problem. An example of Demedicalisation is Homosexuality as it was seen as a curable psychiatric disorder.

Health Technologies: Health technologies are now an integral part of any interaction in health care. Our experiences of health and illness are often reliant on access to technologies, to protect us from disease, to screen us for possible early detection of disease, to diagnose illnesses, and to treat illnesses. Coexisting with 'official' use of technology is our reliance on information technologies to inform us about possible signs and symptoms of illness outside of the consultation process. Social processes are embedded within technologies that shape their use and value. ‘the concept of technology has come to refer not only to the machine or tool, but also the way in which machines or tools work’ (Collyer 2004:48).

Biomedicalisation: New concept – an extension of medicalisation. “changes in the organisation and practices of contemporary biomedicine, implemented largely through the integration of technoscientific innovations” → let to ‘biomedicalisation’ (Clarke et al 2003).

Week Six, Health and Healthism Lecture: What is Health?: Defining health is not straightforward. Varies culturally, over time and between different groups/perspectives. Lay and professional definitions, and context appears to be important. That there appear to be a range of different ways of defining and ‘making sense’ of health fits with a social constructionist view of health and lay/professional knowledge.

Health as the Absence of Illness: A pervasive definition is that health is a state of normality for a person where illness is seen as deviation from this. This can be problematic because the majority of the population live with illnesses and health is relative.

Health as Balance: This idea comes from the concept of Homeostasis-that the body is operating normal. This has problems as things like pregnancy change the “normal” state of the body but this has nothing do with health.

Health as Function: Being healthy is about being able to physically do things and function without pain. Health is linked to being able to reach goals. This is challenged by people with disabilities-this is pretty obvious.

Health as a State or Status: Is health defined as a temporary state (I am healthy today) or as a longer term status (I am a basically healthy person)?

Influential Definitions of Health: Biomedical definition-Health is the absence of disease. WHO Holistic-WHO 1948: “a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity”

Wellness/Wellbeing: The WHO definition reflects a holistic understanding of health that goes beyond the physical body. The linked concepts of wellness/wellbeing arose from holistic understandings of health. Wellness is often defined in a way that emphasises interconnection between different aspects of our lives (physical, social, intellectual, spiritual, emotional, occupational). Many definitions include mention of ‘doing’ or striving. "Wellness is a conscious, self-directed and evolving process of achieving full potential.“

Health as a Virtue: Healthism: Health has become the new fountain of youth, the promise of “potential perfection” a new version of the eternal quest for immortality, and a new form of a badge of honour by which we can claim to be responsible and worthy both as citizens and individuals” Cheek 2008. Think of how our relationship with food has a lot to do with what we think is “healthy”. Examples of Healthism include detoxing, paleo, eating clean etc.

Commodification of Health and Wellbeing: Late 20th C health became a consumption item. Belief that health could be achieved and maintained by lifestyle practices. Overlap between health, beauty and fitness industries (wellness industry). Created opportunities for many people to improve the quality of their lives but also an ever growing audience for dubious advice and the sale of products and services that claim to improve health and wellness....