Chapter Summary for Chapter 10
In modern societies, bodies are increasingly something we ‘create’ rather than accept as given. Interventions such as dieting and exercise are examples of social technologies of the body. The rise of eating disorders illustrates the socialization of nature: things that used to be seen as ‘natural’ now depend upon social decisions.
Modern medicine has cured many of the diseases which plagued traditional societies, but many people suffering from the diseases of modernity – such as stress, depression and chronic pain – turn to alternative medicine or use complementary therapies in managing to live with them.
For the last two centuries, dominant Western ideas about health have been shaped by the biomedical model, which has three key principles: disease is a breakdown in the normal functioning of the body; the mind and body can be treated separately; trained medical specialists are considered to be the only experts.
Sociologists stress that disease is a social construction: this can be seen in the way aches, pains and emotions become medicalized as ‘symptoms’. The growth in diagnoses of Attention Deficit Hyperactive Disorder, and its drug treatment Ritalin, illustrate how social conditions can cause behaviours, which then become medicalized.
Illich argues that much illness is iatrogenic: medical interventions cause as many physical problems as they cure; medicine invades more and more areas of human experience; the ability to cope with life is reduced as people seek a medical fix for their problems. The biomedical model gives enormous power to doctors and can be used to further political aims such as eugenics.
Both functionalism and symbolic interactionism have contributed understandings of the experience of illness.
Parsons’s functionalist approach outlined the sick role, which has three elements: the sick person is not responsible for being sick; the sick person is entitled to withdraw from normal activities; the sick person must work to get well by agreeing to become ‘the patient’ and consulting a medical professional.
Symbolic interactionists study how individuals who are ill or disabled negotiate their daily lives, social interactions and sense of self and identity. Corbin and Strauss identify that this involves three areas of ‘work’: illness work, everyday work and biographical work.
The study of the distribution and incidence of disease is called epidemiology. The emergence of HIV/AIDS in the 1980s shows that the success of biomedicine is not absolute. Globally, more than 25 million people have died as a result of AIDS and over 38 million live with HIV, with southern Africa being the worst hit area.
There is a strong social class correlation with health and illness. Materialist or environmental explanations locate the cause of health inequalities in the broader social inequalities of wealth, whilst cultural and behavioural explanations look to individual lifestyle decisions as the cause.
Women live longer than men, but are more likely to seek medical attention and have higher levels of self-reported illness. Working-class women encounter life crises more than other groups and have less developed support networks and coping strategies.
Health is ethnically patterned, but there is no clear agreement on the relative importance of biological factors, the impact of class-related factors (ethnic minority groups are concentrated in lower socio-economic groups) and the effects of institutional racism within health services. A controversial theory suggests that the health of a society is not shaped primarily by its wealth, but by its social cohesion: the strength of social contacts and ties.
Disability studies contrasts two approaches to understanding disability. In the individual model, the ‘sufferer’ has ‘problems’ that result from their bodily ‘abnormality’ and this is their ‘personal tragedy’; in the social model, the social world is organized in such a way that it discriminates and disadvantages people on the basis of physical and mental impairments: society disables some individuals. Medical sociologists dislike the impairment/disability distinction because, they argue, ‘impairment’ is as much a socially structured category as ‘disability’.
In the UK, the Disability Discrimination Act (1995) defined a disabled person as ‘anyone with a physical or mental impairment, which has a substantial and long-term adverse effect upon their ability to carry out normal day-to-day activities’. Most disabled people are not born with an impairment: in the UK 77 per cent become disabled after the age of 16.
Globally, disability often arises from the non-treatment of injuries and infections, work-related injuries and poor nutrition. The 2006 UN Convention on the Rights of Persons with Disabilities aims to contribute towards a global paradigm shift in attitudes towards disabled people.
