Sociological Perspectives in Health and Illness
Sociological Perspectives in Health and Illness
Health refers to a state of complete mental, physical, and social well-being, but not purely the absence of infirmity or disease. It is defined as a dynamic condition of a body’s adaptation and constant adjustment to changes and stresses in the environment for maintaining an internal equilibrium referred to as homeostasis. On the other hand, illness refers to poor health, sickness, unhealthy condition, and indisposition. Health and illness are things that have been there since history, and their constructions continue to be broad with the emergence of modernity and globalization (Langdon and Wiik 460). Just like in all social issues and concerns, there are sociological perspectives, which explain the origin of health and illness. These are studied in the sociology of health, which brings two different focuses of analysis to understanding health and illness. At one level, the study attempts to make sense of illness by using sociological approaches to the social structuring of disease and health, as well as, to an assessment of the experience of illness (Langdon and Wiik 460). At this level, sociology contributes significantly to multi-disciplinary study into concerns of interest to health professionals and clinicians, epidemiological studies, and the development of healthy policy. At the other level, sociological enquiry can open up doors to a comprehension of the implication of broader social processes on the health of people and social groups. These processes include professional relationships, social inequalities, self identity and change, power and knowledge, and consumption and risk. Some of perspectives on health and illness include functionalism and symbolic inter-actionist theory.
Functionalism perspective emphasizes on the essential cooperation and stability within modern societies. Social events that occur in societies are explained by reference to the roles they play in enabling survival and continuity in society. A community is likened to a biological organism in that the whole is composed of interrelated and integrated parts, which is the result of a universal accord on core norms and values. Through the process of socialization, we learn the laws of society, which are translated into roles. Therefore, accord is actually attained through the structuring of individual behavior (Crinson 4). This perspective is fundamentally concerned with the ‘sick role’, theme and the related issue of illness behavior. Talcott Parsons, a leading figure within this sociological tradition, perceived illness as a social phenomenon rather than as entirely physical state. Health, in this case, is defined as the condition of optimum capability of a person for the effective performance of the tasks and roles for which ha or she has been socialized. Within the Functionalist perspective, health; therefore, becomes a precondition for the smooth functioning of society. According to the approach, being sick is to failing in terms of fulfilling one’s role in society. Thus, illness is viewed as ‘unmotivated deviance’. The control of this deviance or sickness happens through the system of the sick role concept, as well as, the related social control role of doctors and other health professionals in allowing a person to take on a sick status.
Illness is a fact of life. Every individual experiences illness, and ultimately must cope with it among close relatives and friends. To the person, illness can seem a purely personal and internal experience. However, illness is a social phenomenon that has social roots and consequences. According to James (15) social factors play a significant role in promoting illness within communities and in determining which groups in a given community will what illness with what consequences. Functionalism perspective emphasizes on illness as a social concept, a form of experience and, therefore, a subjective response or reaction of a patient. It has to do with the origin, its significance, its interpretation, and how it affects the patient’s behavior and his or her relationship with others. In this case, therefore, illness does not only involve the patient’s experience of ill-health, but also the meaning that the patient gives to it. The individual’s level of defining oneself as ill is based on the individual’s perception and that of others or both. In this case, illness is something which is negotiated between the individual, the doctor, and society.
The process of becoming ill involves a person’s experiences that are physical and emotional. The signs manifested by an individual are defined as abnormal depending on a group’s perception. The role of the patient becomes dynamic as it becomes a society’s issue as it becomes essential for the patient to get other people’s cooperation. Sick role refers to an emergency associated with the patient’s role where people described as ill are temporarily unable to deliver their normal services to others. Society is obliged to care for the patient. The sick role gives a legitimate channel of withdrawal from one’s responsibilities and the basis for eligibility of others to care for the patient (James 15). However, the worst of this occurs when the symptoms are validated by health professionals. However, the concept of the sick role has certain limitations. For instance, some people use it as a scapegoat especially when one is engaged in negative behavior. A sick role may be shameful. People living with the patient may not be willing to enter into a sick role. Three things may happen after a sick role has been declared. One can exit the sick role, a patient, may permanently remain in a sick role, or a patient can die. This is what functionalists argue about health and illness. Another sociological theory in health and illness is the symbolic inter-actionist perspective.
The symbolic inter-actionist approach emerged from a concern with language, as well as, the ways in which it enables individuals to become self-conscious beings. The foundation of any language is the application of symbols, which are a reflection on the meanings that individuals give social and physical objects. In any social setting that communication happens, there is an exchange of symbols (Crinson 5). This implies that people look for clues in interpreting the intentions and behavior of other people. As communication is a two-way process, the process of interpretation entails a negotiation between the parties involved. The negotiated order, which emerges; thus, involves individuals constructing comprehension about themselves and others out of the situations they find themselves in and experiences they have. This form of comprehension understandings has consequences for the way in which individuals act, as well as, the manner in which others react to them (Crinson 5). The approach, therefore, holds that the social identities possessed by individuals are affected by the reactions of others. Consequently, if people demonstrate some deviant or abnormal behavior, it is possible that the particular label attached within a society at a certain time to this behavior will then become attached to the individuals. This can result to essential changes in people’s self-identity. An illness diagnosis is one such label.
Within this approach, medicine is seen as a social practice, and its claims to be an objective science would be uncertain. In the interaction between the doctor and patient, a patient’s dissatisfaction can arise if the health professional too rigidly superimposes a pre-existing framework (disease categories) on the subjective illness experience of the patient. For instance, by presuming that they can comprehend what that person is suffering from because of an interpretation of their symptoms and signs without reference their health beliefs. Symbolic interactionism holds that illness and health are socially constructed (Conrad and Kristin 67-79). The theorists of this perspective focus on meanings and causes individuals attribute to health and illness as mentioned earlier. In order to understand the application of this theory, there is a need to define medicalization of deviance. This refers to the process that changes bad behavior into sick behavior. The opposite is demedicalization, in which sick behavior is normalized. This process affects the individual responsible for responding to the patient, how individuals respond to the patient, and how individuals view the personal responsibility of the sick person. A perfect example to illustrate this is demonstrated by the history of how society views alcohol and alcoholism. In the 19th century, people who drank too much were regarded as lazy, bad people. They were referred to as drunks, and it was normal for them to be run out of town or arrested (OpenStax College 4-6). At that time, they were not treated in a sympathetic manner as it was thought that it was their own fault that they could not stop drinking. However, in the last half of the 20th century individuals who drank a lot were defined as alcoholics. They were seen as individuals with an illness or a genetic predisposition to obsession who were not responsible for their drinking. Alcoholics came to be perceived with more understanding and compassion with alcoholism defined as a disease rather than a personal choice.
There is a variety of examples of demedicalization in history. For instance, in the Civil War period, slaves who often ran away from their servants were diagnosed with drapetomania, a mental disorder. Since then, this has been reinterpreted as an entirely proper reaction to being enslaved. According to OpenStax College (6), a recent case is homosexuality, which is often labeled as a mental disorder or a disturbance of a sexual orientation by the American Psychological Association (APA) until 1973. Although, interactionism acknowledges the subjective nature of diagnosis, it is essential not to forget who is most gains when behavior becomes defined as illness. Pharmaceutical firms make a profit a lot treating illnesses such as insomnia, fatigue, and hyperactivity that may not actually be diseases that require treatment, but chances for firms to make more money.
In order to understand the social concepts of health and illness, it is essential for medical practitioners to understand the sociological perspectives that explain the two concepts (Bill 356-379). Apart from functionalism and symbolic interactionism perspectives, there are other approaches, which are also relevant for all medical practitioners. These include Marxism (conflict), feminism, post modernism/post structuralism, contemporary modernism, and Weberianism. All these theories need to be understood as they clearly discuss the concepts of illness and health in a wider framework. However, there is also need to understand other frameworks from other disciplines that are essential in understanding health and illness.
Crinson, Mathew. (2007) Concepts of Health and Illness: The Sociological Perspective
Langdon, Esther, and Wiik, Flavio. “An Introduction to the Concept of Culture Applied to the Health Sciences.” Anthropology, Health and Illness 18.3 (2010): 459-466. Print.
Bill, George. “Health, Illness, and Medicine”. Introductory Sociology 16.2: (2009) 356-379.
Conrad, Peter, and Kristin Barker. “The Social Construction of Illness : Key Insights and Policy Implications.” http://hsb.sagepub.com/ Social Behavior Journal of Health and 51.67 (2010): 67-79. Print.
Nugus, Peter (2010) The Organisational World of emergency clinicians
OpenStax College (2008) Theoretical Perspectives on Health and Medicine
James, Clinton (2008) Sociological Perspectives on health and illness
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