Chapter 14: Health and Medicine

Sociology of Medicine

Central notions:

Social inequalities are important in explaining health and illness in modern societies.

Medicine is a system of social regulation.

Figure 14.2 Private Insurance by Race and Ethnicity

Figure 14.3 Percentage of Uninsured

Health

Health: The normal functioning of an organism.

Examples of health depend on a given society’s definition of which functions are “normal,” reflecting the society’s concept of the good life.

Disease

Disease: A general lack of comfort.

Examples of disease depend on a given society’s definition of what is “comfortable,” reflecting the society’s concept of the good life.

Health and Disease

A society’s conception of health necessarily tends to involve a moral description of “the good life.”

The description of the average is often used as a measure of morality.

Medicalization of Deviance

Medicalization of Deviance: The process by which medicine has taken over some of the functions previously attributed to religion and the law in terms of defining what is normal or desirable versus what is deviant.

Table 14.1 Global Summary of the AIDS Epidemic

Figures 14.4 and 14.5 Adults and Children with HIV/AIDS

Figure 14.6 Deaths of Adults and Children Due to AIDS, 2005

Figure 14.7 Sub-Saharan Africa HIV/AIDS Statistics

Sick role

As defined by Talcott Parsons, a role governed by social expectations. On the one hand, the sick role is a form of deviance insofar as it enables a person to ignore his or her social obligations and responsibilities; on the other, it is legitimate if the individual expresses a desire to be well again and seeks out appropriate treatment.

Stigma

A label that changes the way an individual is viewed in society, typically in a negative manner. For example, because AIDS has become associated with homosexuals and drug users, it carries a stigma—despite the fact that its sufferers include newborn babies.

American Medical Association

Established in 1847

Founders adhered to the medical belief system dubbed allopathy

In the early decades of the twentieth century, the AMA achieved a dominant position in the medical profession

Biomedical Model

The dominant set of beliefs, values, and assumptions in Western medicine.

Assumes a separation between mind and body

Treatment concentrates on the body like it were a machine

Takes very little account of social, psychological, or behavioral factors

Table 14.2 Use of Complementary and Alternative Medicine

Emile Durkheim

According to Durkheim, variations in certain mortality rates, such as suicides, could be regarded as signs of whether a society had a healthy or “pathological” level of social integration.

Durkheim

Durkheim hypothesized that both excessive individualism and excessive social integration were pathological.

Durkheim

The two most common forms of pathological integration in modern society were those in which individuals were left without moral support, giving rise to “egoistic suicide,” and those in which individuals were given too little guidance about attainable norms and thus were likely to have unrealistic goals, resulting in “anomic suicide.”

Life expectancy

A measure that refers to the average number of years individuals are expected to live

Social factors, such as nutrition, housing, unsanitary living conditions, types of occupation, family situation, and lifestyle affect life expectancy

Life expectancy in the U.S.

Black Americans have a significantly lower life expectancy than white Americans. Why?

Life expectancy: Blacks Whites

in 1920 45.3 54.9

in 2002 72.3 77.7

Reason for disparity

Higher infant mortality among blacks

The rate for blacks is now 2.4 times that for whites

Even allowing for greater poverty and other material inequalities, experts are now suggesting that some of the difference may be attributable to the stress of racial discrimination and minority status experienced by black mothers.

Gender differences

Women are more likely than men to consult a doctor and use medically prescribed drugs.

It may be that women are more willing than men to express and report their symptoms to others.It may also be that women are socialized in ways that lead them to be more focused on health matters.There may also be a difference in the “vocabulary of illness” available to women compared to men.

Study Questions

What is the difference between the sociological and medial approaches to health and illness? What evidence supports the sociological argument that health is a social construction?Explain why health and disease are moral as well as medial concepts.Explain Talcott Parsons’s perspective on sickness as a form of deviance. Under what circumstances is this deviance legitimate? What have been the main criticism of Parsons’s model of the sick role?

Study Questions (continued)

How did the American Medical Association help the medical profession establish a monopolistic control over the field of health and the treatment of illness in the United States? What medical belief system did its first members adhere to? How did the AMA’s rise to dominance create gender, race, and class disparities in the medial profession?Briefly describe the main components of the biomedical model. What criticisms have been directed against it?

Study Questions (continued)According to Emile Durkheim, what is the relationship between social integration and mortality rates? What did he consider a “pathological” level of integration, and which two forms of such integration were most common in modern society? How did his study contradict the conventional wisdom about suicide?What social factors contribute to the lower average life expectancy and high infant mortality rate among black Americans?Why are women more likely than men to seek medical consultation and to take medically prescribed drugs? How do doctors contribute to this pattern?