Health

Sociology of health definition

The sociology of health, also referred to as medical sociology, studies the relationship between human health issues, medical institutions and society, through the application of sociological theories and research methods. First, we need to know what health is and then the sociology of health.

Huber et al. (2011) quoted the World Health Organization (WHO) definition of health as;

What is the sociology of health?

According to Amzat and Razum (2014)...

The sociology of health is interested in social factors that affect human health, such as race, gender, sexuality, social class, and region. It also studies the structures and processes in healthcare and medical institutes and their impact on health issues and patterns.

The role of sociology in public health

Now, we understand there is a strong relationship between health and sociology. Societies have their cultural definitions of health and illnesses. In Public Health, sociology can help to understand the definitions, prevalence, causes, and associated perspectives of diseases and illnesses. Moreover, it also helps to understand the treatment-related issues in different societies. The concepts are further described in the social construction of health.

The importance of sociology of health

The sociology of health plays a vital role in analysing the social and cultural reasons for diseases and illnesses. It provides information starting from the issues' onset, preventative measures, and managements.

Physicians focus more on the medical perspectives rather than on the social conditions of the diseases. At the same time sociologists may find that those living in a certain region are more likely to catch certain diseases compared to those living outside that region. This finding is directly related to medical sociology as it concerns human health issues with the social factor of geographical location.

Continuing with the example, let us assume that sociologists have found the reason for the higher susceptibility to certain diseases for people living in that region: they do not have access to adequate healthcare for prevention and treatment. Sociologists will ask why this is the case. Is it because the local medical institutions do not have the resources to deal with certain diseases? Is it because the region, in general, has lower trust levels in healthcare for cultural or political reasons?

Fig. 1 - Medical sociology studies the relationship between human health issues, medical institutions, and society.

Holistic concept of health in sociology

The word holistic means wholeness, and holistic health means all perspectives included. To get a complete picture, not only the individuals but also the societal and cultural factors are essential. Svalastog et al. (2017) explained that health is a relative state that describes the physical, mental, social, and spiritual perspectives of health, further presenting the full potential of individuals in a social context.

Sociological perspectives in health and social care

Mooney, Knox, and Schacht (2007) explain the word perspective as "a way of looking at the world”. However, the theories in sociology give us different perspectives on understanding society. In sociology, three major theoretical perspectives exist, functionalist, symbolic interactionist, and conflict perspective. These sociological perspectives explain health and social care in specific ways;

Functionalist perspective of health

According to this perspective, society works as a human body, where every part plays its role in keeping its functions properly. Similarly, the effective management of health issues is essential for societies’ smooth functioning. For example, patients need treatment, and physicians need to provide this treatment.

Conflict perspective of health

Conflict theory states that two social classes exist where the lower class has less access to resources. They are more prone to illness and have less access to good quality health care. Equality should be ensured in society so that everyone gets good healthcare.

Symbolic interactionist perspective of health

This approach states that health-related issues and social care are socially constructed terms. For example, understanding schizophrenia differs in different societies, so their treatment methods are diverse and require social perspectives for their implementation.

What is the social construction of health?

The social construction of health is an important research topic in the sociology of health. It states that many aspects of health and illness are socially constructed. The topic was introduced by Conrad and Barker (2010). It outlines three main subheadings under which diseases are stated to be socially constructed.

The cultural meaning of illness

• Medical sociologists state that while diseases and disabilities exist biologically, some are considered worse than others because of the added 'layer' of socio-cultural stigmas or negative perceptions.

• The stigmatisation of illness can prevent patients from receiving the best care. In some cases, it may prevent patients from seeking medical assistance at all. An example of a commonly stigmatised illness is AIDS.

• Suspicion from medical professionals about the genuineness of the patient's disease can affect the patient's treatment.

The experience of illness

• How individuals experience illness may be down to individual personalities and culture, to a large extent.

• Some people may feel defined by a long-term illness. Culture can heavily influence the experience of patients' illnesses. For example, some cultures do not have names for certain illnesses as they simply did not exist. In Fijian cultures, larger bodies are culturally appreciated. Therefore, eating disorders did not 'exist' in Fiji prior to the colonial period.

Fig. 2 - The experience of illness is socially constructed.

The social construction of medical knowledge

Although diseases are not socially constructed, medical knowledge is. It is changing all the time and does not apply equally to everyone.

Beliefs about illness and pain tolerance can lead to inequalities in medical access and treatment.

• For example, it was a common misconception among some medical professionals that Black people were biologically wired to feel less pain than white people. Such beliefs started in the nineteenth century but are still held by some medical professionals today.

• Until the 1980s it was a common belief that babies did not feel pain, and that any responses to stimuli were simply reflexes. Due to this, babies were not given pain relief during surgery. Brain scan studies have shown that this is a myth. However, many babies still undergo painful procedures today.

• In the nineteenth century, it was believed that if pregnant women danced or drove vehicles it would harm the unborn child.

The above examples show how medical knowledge can be socially constructed and affect particular groups of people in society. We will be learning more about the social construction of medical knowledge in the topic of health.

The social distribution of health

Below we will outline key points about the social distribution of health in the UK by the following factors: social class, gender, and ethnicity. These factors are called social determinants of health, as they are nonmedical in nature.

Sociologists have various explanations about why factors such as where you live, your socioeconomic background, gender, and religion affect your likelihood of getting ill.

Social distribution of health by social class

According to the data:

• Working-class babies and children have higher infant mortality rates than the national average in the UK.

• Working-class people are more likely to suffer from heart disease, strokes, and cancer.

• Working-class people are more likely to die before retirement age than the national average in the UK.

• Social class inequalities exist at every age for all major diseases in the UK.

The 'Inequalities in Health Working Group Report' (1980), known as the Black Report, found that the poorer a person is, the less likely they are to be healthy. The Inverse Care Law, named as such in the Report, states that those with the most need for healthcare get the least, and those with the least need get the most.

The Marmot Review (2008) found that there is a gradient in health, namely that health improves as social status improves.

Sociologists have cultural and structural explanations for why differences in social class lead to health inequalities.

Cultural explanations suggest that working-class people make different health choices due to different values. For example, working-class people are less likely to take advantage of public health opportunities such as vaccinations and health screenings. In addition, working-class people generally make 'riskier' lifestyle choices such as having poor diets, smoking, and less exercise. The cultural deprivation theory is also an example of a cultural explanation for the differences between working and middle-class people.

Structural explanations include reasons such as the cost of healthy diets and gym memberships, the inability of working-class people to access private healthcare, and the quality of housing in poorer areas, which may be damper than more expensive homes. Such explanations claim that society is structured in a way that disadvantages the working class, and therefore they cannot take the same measures to stay healthy as middle-class people.

Social distribution of health by gender

According to the data:

• On average, women have a greater life expectancy than men in the UK by four years.

• Men and boys have a greater likelihood of dying from accidents, injuries and suicide, as well as from major diseases such as cancer and cardiovascular diseases.

• Women are at greater risk of sickness throughout their lives and seek medical attention more than men.

• Women are more prone to mental health difficulties (such as depression and anxiety) and spend more of their lives with a disability.

There are several social explanations for the difference in health between men and women. One of them is employment. Men are more likely to take risky jobs leading to a higher likelihood of accidents or injuries due to machinery, hazards and toxic chemicals, for example.

Men are more likely to generally participate in risky activities, such as driving under the influence of alcohol or drugs, and extreme sports activities such as racing.

Men are more likely to smoke, leading to long-term and serious health conditions. However, more women have started to smoke in recent years. Women are less likely to drink alcohol and are less likely to drink over the recommended alcohol intake.

Social distribution of health by ethnicity

According to the data:

• Those of South Asian origin have higher rates of heart disease and stroke.

• Those of African-Caribbean origin have higher rates of stroke, HIV/AIDS and schizophrenia.

• Those of African origin have higher rates of sickle-cell anaemia.

• Generally, non-white people have higher mortality rates for diabetes-related conditions.

Cultural factors can explain why some of these differences exist, for example, differences in diets, or attitudes towards the medical profession and medicine. Sociologists have also found that social class is a significant intersection with ethnicity, as the social distribution of health by ethnicity is not the same across different social classes.

Mental health

Galderisi (2015) gave the WHO definition of mental health as;

How is mental health distributed by social class, gender, and ethnicity?

Different social groups have different experiences with mental health in the UK.

Social class

• Working-class people are more likely to be diagnosed with mental illness than their middle-class counterparts.

• Structural explanations suggest that unemployment, poverty, stress, frustration, and poorer physical health may make it more likely for working-class people to suffer from mental illnesses.

Gender

• Women are more likely than men to be diagnosed with depression, anxiety, or stress. They are also more likely to be put on drug treatments to treat mental illness.

• Feminists claim that women have higher stress levels due to burdens of employment, housework, and childcare, which increases the likelihood of mental illnesses. Some also claim that the same illness is treated differently by doctors depending on the gender of the patient.

• However, women are more likely to seek medical help.

Ethnicity

• Those of African-Caribbean origin are more likely to be sectioned (involuntary hospitalisation under the Mental Health Act) and more likely to suffer from schizophrenia. However, they are less likely to suffer from more common mental health issues than other ethnic minority groups.

• Some sociologists suggest there are cultural explanations, such as medical staff being less likely to understand the language and culture of Black patients.

• Other sociologists claim there are structural explanations. For example, ethnic minorities are more likely to live in poorer conditions. This can increase stress, and the likelihood of mental illness.

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