Sociological perspective on health and illness look at health problems from a social perspective. In general, the analysis related to health in the community uses medical analysis. Sociology tries to see health from its own perspective, including social construction.
Biomedicine is the dominant way of understanding health and illness in Western culture, and it is widely accepted by both the medical profession and the general public. According to contributors to medical sociology debates, the medical model of explanation has several distinguishing characteristics. Nettleton, for example, lists five characteristics. Nettleton (1995, p. 5)
Mind-body dualism is a concept that describes the relationship between the mind and the body.
This refers to the understanding that the mind and body can be treated as two distinct entities when treating illness. Medicine is concerned with the physical body rather than the more problematic mind.’ Because of medicine’s appropriation of the body, sociologists have written very little about the body until recently; this was the domain of the medical profession.
Nettleton employs this metaphor to highlight how medicine regards the hum an body as a machine whose operation is dictated by biological and scientific laws. Medical practitioners can repair any dysfunction by understanding how the body works.
This refers to the weight given to medical interventions, whether pharmacological or surgical, in the treatment of the body. As we will see, there is a tendency to overemphasize the curative aspect of biomedicine while downplaying the positive contributions made by, for example, dietary or environmental changes.
While advancements in medical technology have significant benefits, they also come at a cost, which can measure the harmful effects of medicines or medical interventions.
Nettleton characterizes biomedicine as reductionist,’ implying that all explanations are reduced to the physical workings of the body. The dualistic nature of medicine and the importance attached to the “technological imperative” in the primary role assigned to all things physical echo this reductionist tendency.
One of the most common criticisms leveled at the medical model is its apparent unwillingness to acknowledge that social and psychological factors impact health.
The specific etiology doctrine
The doctrine of specific etiology believes that all disease stems from a single, well-understood cause.
Such a description of the medical model may strike you as relatively rigid and a far more accurate representation of medicine and medical practice in the past than in the present. However, we would argue that while central elements of medical knowledge remain, medicine is a living body of knowledge that can change and adapt in response to discoveries.
Because medical knowledge is in constant flux, some aspects of the medical model may be more or less important than they were previously.
When infectious diseases were the leading cause of morbidity and mortality, it was perhaps easier to see the relevance of such a model.
On the other hand, long-term, chronic illnesses are the leading causes of death in the twentieth and twenty-first centuries. The fact that social factors cause these conditions sets them apart from previous illnesses. In Scotland, heart disease is the leading cause of death, and some cities, such as Glasgow, have exceptionally high rates of heart disease.
While some causes of heart disease can be traced back to a specific organ malfunction, the most common cause is an unhealthy lifestyle. When public awareness campaigns place such a high value on individuals changing their lifestyles rather than the medical profession repairing what appears to be a broken machine, it may be challenging to defend Nettleton’s medical model.
Lipids and other pharmaceuticals can help reduce the adverse effects of heart disease and hypertension, but they cannot cure them. The social dimensions of heart disease and the British Medical Association’s recent acknowledgment that diseases like ME have both a physical and a psychological dimension are recent examples of this.
Accepting the medical model as a static representation of medical thought and practice would be a mistake.
Medicine and medical practice are no longer solely concerned with the biological and physical. However, they can place disease and the diseased body in a social context due to the changing nature of the disease. Sociological perspective on health and illness.
According to the social model of medicine, medical intervention is only a partial explanation for patterns of morbidity and mortality. Social factors such as improvements in hygiene and nutrition, it is argued, are more important in explaining these patterns.
Medicine has progressed beyond simply treating disease and is now actively engaged in a moral crusade to change people’s lifestyles and influence their decisions. According to Turner (1994), the rise of medicine’s influence in our lives, combined with the decline of religious influence, has resulted in a new moral order: “the doctor has replaced the priest as the custodian of social values” (1994: 37).
This’moralistic’ aspect of medicine cannot be adequately explained by the five characteristics listed above. We must be prepared to extend the traditional medical model to a more complex body of thought that can and does encompass social and psychological aspects of health and disease to embrace the modern dimensions of medicine and medical practice.
” Medical paradigms “: the social construction of medical knowledge
Sociological perspective on health and illness: This chapter has looked at the intellectual and cultural roots of medicine and the main characteristics of the medical model. This discussion and those in the following chapters are important because it allows a sociology student to place the development of medicine in a historical context, which is one of the critical requirements of the request to use the “sociological imagination.”
The social construction of medical paradigms: Sociological perspective on health and illness
The emphasis on how human beings actively and creatively produce societies characterizes social constructionism. The world is depicted as created or invented rather than given or assumed. ‘Individuals and groups weave interpretive nets in social worlds.’ Marshall (1998), p. 609.
Jewson’s concept of medical knowledge paradigms illustrates the extent to which medical knowledge can be said to be socially constructed, that is, the degree to which medical knowledge is a product of those who practice it. The term ‘paradigm’ refers to a model or mode of thought, or a particular way of seeing the world, that defines what we can see, how we can measure and record that information, and which factors are essential and which are not.
The social construction of medical knowledge raises the following significant points:
1. Over time, medical knowledge has evolved and changed. What was once thought to be a reasonable explanation may be challenged and dismissed in the future. The womb of ‘hysterical’ women, for example, was said to move around the body in early medical theories of hysteria.
2. Medical knowledge, and knowledge about health and disease in general, has become increasingly specialized, focusing first on the “whole” person, then on specific parts of the body, and finally on cell structure analysis. Theoretical body knowledge, or learned knowledge, has surpassed experiential knowledge.
Medicine and medical practice have increasingly become the domain of those educated and trained by current practitioners and who are members of their professional bodies. Lay practitioners, such as lay midwives, were routinely excluded from medical practice.
3. Each paradigm shift in thought has resulted in a change like the practitioner-patient relationship. The ‘bedside manner’ paradigm suggests that clients ‘patronized’ practitioners, at least in the case of the wealthy.
Clients paid directly for the service, and those who provided it were frequently regarded as social inferiors; the patient held power. When you compare and contrast this with the quality of and power balance in today’s practitioner-patient relationship, a very different picture emerges.
Despite the apparent benefits of a National Health Service, general practitioners’ status as “independent contractors” within the system means that payment is obtained through the Health Service rather than directly from the patient.
It could be argued that the service provided is organized around the needs of the practitioners rather than the needs of the patients. One example could be appointment times. Most appointments are only available during business hours and, except for emergencies, only Monday through Friday.
Given this, it can be difficult for many working people to find a convenient time to see a doctor without taking time off work.
Clinical or hospital medicine is the paradigm that most closely matches our experiences with medicine in the short term. The following discussion goes into greater depth about this aspect of medical knowledge and practice.
Finally, the development of modern medicine as a specific form of knowledge about the human body is strongly linked to science, rationality, and the Enlightenment.
• Scientific medical knowledge is a way of looking at and comprehending the functions of the human body. The traditional idea of the mind/body split is an example.
• Medical knowledge is dynamic and evolving, as Jewson’s models of the patient/practitioner relationship demonstrate.
• Medical knowledge is a form of power, with the ability to control and influence the lives of those who possess it.
• Medical knowledge is a form of power that can control and influence the lives of those who possess it.
A Sociological Introduction
By: Anne-Marie Barry and Chris Yuill, 2002