14.1 The Sociology of Medicine, Health, and Illness
Our physical selves have socially constructed meanings and are also affected by social forces.
Health is influenced by where and when we live as well as what statuses we hold in our society.
Social, cultural, and subcultural factors affect just about everything having to do with health and illness.
14.2 Definitions of Health and Illness
Types of illness: Acute diseases and chronic diseases.
Types of health care: Curative or crisis medicine, preventative medicine, and palliative medicine.
14.3 Medicalization and the Social Construction of Health and Illness
Medicalization is the process of transforming problems that were once not considered medical conditions into illnesses over time.
Addiction, hyperactivity, and obesity, which were all once considered a result of weak will, are now all now seen as medical diseases that can be controlled with medicine and surgery.
Birth and death have been medicalized.
The social meaning of mental illness has changed over time. In the fourteenth century, mental illness was thought to be caused to by demon possession. In colonial American, mental illness was treated by bleeding and long-term induced vomiting. In the 1930s, lobotomies were used to cure mental illness. Now, we treat mental illness as a problem of brain chemistry which is managed through medicine.
14.4 Disease Patterns as Social Epidemiology
Epidemiology is the study of the social aspect of disease patterns. Epidemiologists collect and analyze data in order to understand the causes of a particular illness, how it is communicated, the factors affecting its development and distribution in a population, where it is likely to spread, and what the most effective interventions might be.
The global climate change may contribute to growing epidemics.
14.5 Social Inequality, Health, and Illness
SES affects health and illness. People with higher SES not only can afford more and better health care, but they also have greater access to other resources that positively impact their health. People with lower SES have substantially higher rates of disease with higher death rates and shorter life expectancy.
Many problems that affect people of lower SES are further exacerbated in minority groups. Blacks have high rates of death and disease, and shorter life expectancy than whites. Blacks and Hispanics are less likely to be able to afford health insurance, and are more often exposed to unhealthful surroundings at work and in residential neighborhoods.
Health is one place where gender inequality benefits women over men. Women are generally healthier and enjoy a long life expectancy in spite of having a lower SES than men.
A food desert is a community in which the residents have little to no access to fresh, affordable, healthy foods. Most food deserts are located in densely populated, urban areas that may have convenience stores and fast-food restaurants, but no grocery stores or other outlets for fresh fruits, vegetables, meats, and other healthy foods. Food desserts are often in neighborhoods that are predominantly low-income or nonwhite in population.
14.6 Medicine as a Social Institution
Friedman was a vocal critic of the AMA, arguing that the AMA limits admissions to medical schools and restricts medial licensing to advance the interests of the physician. He viewed the AMA as a monopolizing organization that reduced the quantity and quality of medical care by forcing the public to pay more for medical services due to the lack of qualified physicians.
14.7 The Power of the Institution to Define the Situation
Once the medical institution labels an individual as “sick” or “unwell,” all of the individual’s actions are interpreted under that label. For example, in Rosenhan and Goffman’s studies, once people are diagnosed as mentally ill, they become unable to convince others that they are normal because the institutional label is sticky.
Patients are robbed of their agency and autonomy at a time when they are most defenseless and least able to assert themselves.
14.8 Doctor-Patient Relations
The institutional setting does not always exert the type of power we might think it does over the interactions that occur within it. Instead, the people involved in interactions must establish who has power or status, as they must also distinguish good from bad.
Other relationships within the medical profession are important. The rules, roles, and other elements of institutional order are emergent and situational. They are not necessarily written down somewhere for the rest of us to follow, but instead are created and maintained in interaction.
14.9 The Sick Role
Parsons argues that the sick role is, from a functional perspective, a form of deviance. As part of the sick role, the patient is exempted from regular responsibilities and is not held responsible for the illness. However, the patient has a new set of duties, which include seeking medical help as part of an earnest effort to recuperate and get back to normal. Those who do not attempt to recuperate are labeled deviant.
The sick role has changed due to advances in medical technology. Genetic testing has identified those who are not sick, but are at risk for certain diseases. The at-risk role demonstrates that the experience of health and illness is not as straightforward as Parsons originally hypothesized.
14.10 Issues in Medicine and Health Care
Health care reform has been identified as a national priority since 1974, but it was not until March 2010 that the Patient Protection and Affordable Care Act was signed into law. This act has been controversial and is being challenged.
Complementary and Alternative Medicine (CAM) involves everything from deep breathing and herbal remedies to chiropractics and massage. This growing field is slowly gaining legitimacy in the world of conventional medicine, but is still generally not covered by medical insurers.
With the development of medical technology, bioethics—the study of controversial moral or ethical issues related to scientific and medical advancements—has become more involved. The Human Genome Project raises the issue of genetic testing, and whether parents should be able to choose whether or not to bear a disabled child
It has been said that the US has a “bifurcated health care system,” meaning that in many ways our health care system is the envy of the world, but in other ways we fall far short of the achievements of other, even poorer countries. Even within the US there are great differences in health care access and health care outcomes.
What ideas from the text and the power points are relevant to the study of health and illness in the United States, based on the results of the studies and research from the above articles?
Is this best understood as a “dysfunction” in the system, and if so, what changes could bring it back into equilibrium? Or is it best understood in terms of conflict theory – and what changes would be necessary to level the playing field?