Rather, low-income countries must manage such problems as infectious disease, high infant mortality rates, scarce medical personnel, and inadequate water and sewer systems. Such issues, which high-income countries rarely even think about, are central to the lives of most people in low-income nations. Due to such health concerns, low-income nations have higher rates of infant mortality and lower average life spans.
One of the biggest contributors to medical issues in low-income countries is the lack of access to clean water and basic sanitation resources. In their World Health Statistics report, they document the following statistics:. Health in Canada is a complex and often contradictory issue. One the one hand, as one of the wealthiest nations, Canada fares well in health outcomes with respect to the rest of the world.
The following sections look at different social aspects of health in Canada. Unlike the United States, where strong health disparities exist along racial lines, in Canada differences in health between non-aboriginal visible minorities and Canadians of European origin disappear once socioeconomic status and lifestyle are taken into account. Moreover, new and recent immigrants from non-European countries tend, in fact, to have better health than the average native-born Canadian Kobayashi, Prus, and Lin Aboriginal Canadians unfortunately continue to suffer from serious health problems.
It is estimated that in the s, prior to contact, there were , aboriginal people living in Canada.
Conditions in the late 19th century to the mid 20th century did not improve markedly after aboriginal people were moved to reserves. Often lacking adequate drinking water, sanitation facilities, and hygienic conditions, these were ideal settings for the spread of communicable diseases. Death rates from tuberculosis TB , for example, remained very high for First Nations peoples into the s, long after the use of antibiotics brought TB under control in the rest of Canada.
In , the TB rate was still 27 active cases per , population for aboriginal people, while it was only 5 active cases per , for the rest of the population. Figure However, it remains significantly lower than for the average population: Aboriginal men and women could expect to live 8. The health conditions of off-reserve aboriginal people are also significantly worse than for the average population.
While some of the difference between aboriginal and non-aboriginal health conditions can be explained by financial, educational, and individual lifestyle variables, even when these were taken into account statistically disparities in health remained. Residents of poorer urban areas in Canada have significantly higher hospitalization rates and lower self-reported quality of health than residents of average or wealthy urban areas see Figures Living and growing up in poverty is linked to lower life expectancy, and chronic illnesses such as diabetes, mental illness, stroke, cardiovascular disease, central nervous system disease, and injury Canadian Population Health Initiative In an interesting study of 17, British civil servants, it was found that differences in even relatively small disparities of wealth and power between civil service employment grades led to significantly better health outcomes for the privileged.
The more authority one has, the healthier one is Marmot, Shipley, and Rose These social determinants of health led the Canadian Medical Association to argue that providing adequate financial resources might be the best medical treatment that can be provided to poor patients. It is important to remember that economics are only part of the socioeconomic status SES picture; research suggests that education also plays an important role. However, once information linking habits to disease was disseminated, these diseases decreased in high SES groups and increased in low SES groups.
This illustrates the important role of education initiatives regarding a given disease, as well as possible inequalities in how those initiatives effectively reach different SES groups. Women continue to live longer than men on average, but women have higher rates of disability and disease. In each age group, men have higher rates of fatal disease, whereas women have higher rates of non-fatal chronic disease.
Spitzer notes that gender roles and relations lead to different responses and exposures to stressors, different access to resources, different responsibilities with regard to domestic work and caregiving, and different levels of exposure to domestic violence, all of which affect chronic health issues in women disproportionately.
Women are also affected adversely by institutionalized sexism in health care provision. We can see an example of institutionalized sexism in the way that women are more likely than men to be diagnosed with certain kinds of mental disorders. This diagnosis is characterized by instability of identity, of mood, and of behaviour, and Becker argues that it has been used as a catch-all diagnosis for too many women. She further decries the pejorative connotation of the diagnosis, saying that it predisposes many people, both within and outside of the profession of psychotherapy, against women who have been so diagnosed Becker N.
Medicalization refers to the process by which previously normal aspects of life are redefined as deviant and needing medical attention to remedy. The medicalization of pregnancy and childbirth has been particularly contentious in recent decades, with many women opting against the medical process and choosing a more natural childbirth.
Fox and Worts find that all women experience pain and anxiety during the birth process, but that social support relieves both as effectively as medical support. In other words, medical interventions are no more effective than social ones at helping with the difficulties of pain and childbirth. Fox and Worts further found that women with supportive partners ended up with less medical intervention and fewer cases of postpartum depression.
Of course, access to quality birth care outside of the standard medical models may not be readily available to women of all social classes. Bad habits that can lead to sleeplessness include inconsistent bedtimes, lack of exercise, late-night employment, napping during the day, and sleep environments that include noise, lights, or screen time National Institutes of Health a.
According to the Toronto-based University Health Network, examining sleep hygiene is the first step in trying to solve a problem with sleeplessness Bernstein and Durkee For many North Americans, however, making changes in sleep hygiene does not seem to be enough. According to a report, sleeplessness is an underrecognized public health problem affecting up to 70 million people. Indeed, a study published in in the Archives of Internal Medicine shows that cognitive behavioural therapy, not medication, was the most effective sleep intervention Jacobs, Pace-Schott, Stickgold, and Otto Now, they pop a pill, and all those pills add up to a very lucrative market for the pharmaceutical industry.
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Is this industry behind the medicalization of sleeplessness, or are they just responding to a need? The treatment received by those defined as mentally ill or disabled varies greatly from country to country. In post-millennial Canada, those of us who have never experienced such a disadvantage take for granted the rights our society guarantees for each citizen.
However, access to things like education, housing, or transportation that most people take for granted, are often experienced very differently by people with disabilities. People with mental disorders a condition that makes it more difficult to cope with everyday life and people with mental illness a severe, lasting mental disorder that requires long-term treatment experience a wide range of effects.
According to the Canadian Community Health Survey, the most common mental disorders in Canada are mood disorders major depression, bipolar disorder. Major mood disorders are depression, bipolar disorder, and dysthymic disorder. A true depressive episode, however, is more than just feeling sad for a short period. It is a long-term, debilitating illness that usually needs treatment to cure.
Bipolar disorder used to be called manic depression because of the way that people would swing between manic and depressive episodes. The second most common mental disorders in Canada are anxiety disorders. Almost 9 percent of Canadians reported experiencing generalized anxiety disorder in their lifetime 2. Anxiety is a normal reaction to stress that we all feel at some point, but anxiety disorders are feelings of worry and fearfulness that last for months at a time.
Anxiety disorders include obsessive compulsive disorder OCD , panic disorders, posttraumatic stress disorder PTSD , and both social and specific phobias. Depending on what definition is used, there is some overlap between mood disorders and personality disorders. In Canada, epidemiological research reporting on antisocial personality disorder shows that about 1.
The American Psychological Association publishes the Diagnostic and Statistical Manual on Mental Disorders DSM , and their definition of personality disorders is changing in the fifth edition, which is being revised in and In other words, personality disorders cause people to behave in ways that are seen as abnormal to society but seem normal to them. The DSM-V proposes broadening this definition by offering five broad personality trait domains to describe personality disorders, some related to the level or type of their disconnect with society.
As their application evolves, we will see how their definitions help scholars across disciplines understand the intersection of health issues and how they are defined by social institutions and cultural norms. The New York Times reported American Centers for Disease Control data showing that the diagnosis of children with ADHD had increased by 53 percent over the last decade, raising issues of overdiagnosis and overmedication Schwarz and Cohen ADHD is one of the most common childhood disorders, and it is marked by difficulty paying attention, difficulty controlling behaviour, and hyperactivity.
In fact, some critics question whether this disorder is really as widespread as it seems, or if it is a case of overdiagnosis. Autism spectrum disorders ASD have also gained a lot of attention in recent years. In Canada, a national tracking system is being set up, but a report from the National Epidemiologic Database for the Study of Autism in Canada found increases in diagnosis in Prince Edward Island, Newfoundland and Labrador, and southeastern Ontario ranging from 39 to percent, depending on the region.
As an example of social construction of disorders, much of the increase in diagnosis is believed to be due to increased awareness of the disorder rather than actual prevalence, with doctors diagnosing autism more frequently and with children with less severe problems NEDSAC Although the view is not widely held, there are some researchers who argue that mental illness is a myth.
For example, to Thomas Scheff , residual deviance—a violation of social norms not covered by any specific behavioural expectation—is what actually results in people being labelled mentally ill. Rather, mental illness is a deviation from what others view as normal, with no basis in biological disease. Szasz calls for greater personal responsibility and less reliance on institutions.
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They use the term impairment to describe the physical limitations, while reserving the term disability to refer to the social limitation. In , 3. Lyn Jongbloed notes that conceptions of disability have gone through several shifts in Canada since the 19th century, leading to significant shifts in public policy on disabilities. In the early 19th century, persons with intellectual impairments were often jailed alongside criminals, suggesting that the distinction was not significant from the point of view of public policy.
Then between and , the asylum model of care was developed specifically for the disabled, in large part to protect them or others from harm. People with physical disabilities were not regarded as disruptive so they were not institutionalized. Finally, since the s, the medical and economic model has been gradually supplanted, or supplemented, by a sociopolitical model that argues that disability results from a failure of the social environment rather than individual impairment.
This led to rights-based challenges of barriers to the disabled and a deinstutionalization movement that saw the closing of the asylum system and its replacement with a community model of care. Imagine being in a wheelchair and trying to use a sidewalk without the benefit of wheelchair-accessible curbs.
Imagine as a blind person trying to access information without the widespread availability of Braille. Imagine having limited motor control and being faced with a difficult-to-grasp round door handle. Ableism refers to both direct discrimination against persons with disabilities and the unintended neglect of their needs. Ableism is linked to the enduring legacy of stigmatizing persons with disabilities. People with disabilities are stigmatized by the perception that they are, in some manner, ill.
Stigmatization means that their identity is spoiled; they are labelled as different, discriminated against, and sometimes even shunned. This can be especially true for people who are disabled due to mental illness or disorders. In response, many disabled groups have begun to assert that they are not disabled, but differently enabled. Their condition is not a form of deviance from the norm, but a different form of normality. As Rod Michalko argues, blindness for example is only seen as a problem or disability from the point of view of sightedness and a world organized for the sighted Michalko This can affect social status, housing, and especially employment.
Disabled men and women are also 8.
The disabled were also only half as likely to complete a university education than the non-disabled What is your reaction to the picture in Figure Many people will look at this picture and make negative assumptions about the man based on his weight. In an example of stereotype interchangeability , the same insults that are flung today at the overweight and obese population lazy, for instance , have been flung at various racial and ethnic groups in earlier history.
Of course, no one gives voice to these kinds of views in public now, except when talking about obese people. Why is it considered acceptable to feel prejudice toward—even to hate—obese people? Puhl and Heuer suggest that these feelings stem from the perception that obesity is preventable through self-control, better diet, and more exercise. Even with some understanding of non-controllable factors that might affect obesity, obese people are still subject to stigmatization. Obese people are less likely to get into college than thinner people, and they are less likely to succeed at work.
Stigmatization of obese people comes in many forms, from the seemingly benign to the potentially illegal. In movies and television shows, overweight people are often portrayed negatively, or as stock characters who are the butt of jokes. In movies and television for adults, the negative portrayal is often meant to be funny. Think about the way you have seen obese people portrayed in movies and on television; now think of any other subordinate group being openly denigrated in such a way.
It is difficult to find a parallel example. Each of the three major theoretical perspectives approaches the topics of health, illness, and medicine differently. According to the functionalist perspective, health is vital to the stability of the society, and therefore sickness is a sanctioned form of deviance. Talcott Parsons was the first to discuss this in terms of the sick role : patterns of expectations that define appropriate behaviour for the sick and for those who take care of them.
According to Parsons, the sick person has a specific role with both rights and responsibilities. However, this exemption is temporary and relative to the severity of the illness. The exemption also requires legitimation by a physician; that is, a physician must certify that the illness is genuine. The responsibility of the sick person is twofold: to try to get well and to seek technically competent help from a physician.
Parsons argues that since the sick are unable to fulfill their normal societal roles, their sickness weakens the society. Therefore, it is sometimes necessary for various forms of social control to bring the behaviour of a sick person back in line with normal expectations. In this model of health, doctors serve as gatekeepers, deciding who is healthy and who is sick—a relationship in which the doctor has all the power.
But is it appropriate to allow doctors so much power over deciding who is sick? According to critical sociology, capitalism and the pursuit of profit lead to the commodification of health: the changing of something not generally thought of as a commodity into something that can be bought and sold in a marketplace. Corporate interests also influence the terms in which debates about public health care are discussed. Corporate think tanks like the Fraser Institute and the CD Howe Institute have long advocated free-market, profit-driven, American-style models rather than publicly funded models to deliver health care in Canada Carroll and Shaw Despite the fact that Canadians persistently state that public, universal health care is their central priority, corporate and neoliberal messaging on health care has become increasingly influential over the last two decades.
Alongside the health disparities created by class inequalities, there are a number of health disparities created by racism, sexism, ageism, and heterosexism. When health is a commodity, the poor are more likely to experience illness caused by poor diet, to live and work in unhealthy environments, and are less likely to challenge the system. In Canada, aboriginal people have been disproportionately marginalized from economic power, so they bear a great deal of the burden of poor health.
Sociological Perspective on Health
Another critical approach to health and illness focuses on the emergence of biopolitics in the 18th and 19th centuries Foucault In a variety of different levels and sites in society—from implementing society-wide public health programs and population controls to various forms of discipline exercised over the bodies of patients, soldiers, children, students, and prisoners—modern scientific knowledge on the functioning of the body establishes new power relations between experts e. Modern biomedicine , for example, is a system of medical practice that defines health and illness in terms of the mechanics of the physical, biological systems of the human body.
It is interesting in this respect to note the various ways in which the knowledge and authority of doctors and the medical establishment are being challenged in contemporary society. This turn to a model of individualized care for the self —i. On the one hand, it enables practices of autonomy and self-formation freed from the power relations of the medical establishment. On the other hand, it can feed into intensified concerns and anxieties with the body that deepen rather than loosen submission to authorities and authoritative knowledge—dieting fads, esoteric knowledge and practices, and nontraditional healers, etc.
As Zygmunt Bauman notes, when individuals take on the responsibility for knowledge about their own bodies and health in a pluralistic medical culture in which there are numerous competing and contradicting claims about treatment, the outcome for the individual can be paralyzing rather than liberating Bauman According to theorists working in this perspective, health and illness are both socially constructed.
As we discussed in the beginning of the chapter, interactionists focus on the specific meanings and causes people attribute to illness. Medicalization and demedicalization affect who responds to the patient, how people respond to the patient, and how people view the personal responsibility of the patient Conrad and Schneider An example of medicalization is illustrated by the history of how our society views alcohol and alcoholism. During the 19th century, people who drank too much were considered bad, lazy people.
They were called drunks, and it was not uncommon for them to be arrested or run out of a town. Drunks were not treated in a sympathetic way because, at that time, it was thought that it was their own fault that they could not stop drinking. In the 20th century, people who drank too much were increasingly defined as alcoholics: people with a psychological dependence, physiological disease, or a genetic predisposition to addiction who were not responsible for their drinking. With alcoholism defined as a disease and not a personal choice, alcoholics came to be viewed with more compassion and understanding, although the paradox of recovery therapies for alcoholics remained.
There are numerous examples of demedicalization in history as well. During the Civil War era, slaves who frequently ran away from their owners were diagnosed with a mental disorder called drapetomania. This has since been reinterpreted as a completely appropriate response to being enslaved. A more recent example is homosexuality, which was labelled a mental disorder or a sexual orientation disturbance by the American Psychological Association until While interactionism does acknowledge the subjective nature of diagnosis, it is important to remember who most benefits when a behaviour becomes defined as illness.
Pharmaceutical companies make billions treating illnesses such as fatigue, insomnia, and hyperactivity that may not actually be illnesses in need of treatment, but opportunities for companies to make more money. The Social Construction of Health Medical sociology is the systematic study of how humans manage issues of health and illness, disease and disorders, and health care for both the sick and the healthy.
The social construction of health explains how society shapes and is shaped by medical ideas. Global Health Social epidemiology is the study of the causes and distribution of diseases. From a global perspective, the health issues of high-income nations tend toward diseases like cancer as well as those that are linked to obesity, like heart disease, diabetes, and musculoskeletal disorders.
Low-income nations are more likely to contend with infectious disease, high infant mortality rates, scarce medical personnel, and inadequate water and sanitation systems. Mental health and disability are health issues that are significantly impacted by medical definitions of normalcy.
The interactionist perspective is concerned with how social interactions construct ideas of health and illness. The Social Construction of Health 1. Who determines which illnesses are stigmatized? Global Health 4.
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What is social epidemiology? According to the World Health Organization, what was the most frequent cause of death for children under five in low-income countries? Which of the following statements is not true? Theoretical Perspectives on Health and Medicine Which of the following is not part of the rights and responsibilities of a sick person under the functionalist perspective? The Social Construction of Health Spend some time on the two websites below. How do they present differing views of the vaccination controversy? What trends do you notice? Some think it is not. Theoretical Perspectives on Health and Medicine Should alcoholism and other addictions be medicalized?
Devlin, Kate. July Sugerman, David E. Barskey, Maryann G. Delea, Ismael R. Ralston, Paul A. WHO Zacharyczuk, Colleen. Conrad, Peter and Kristin Barker. Goffman, Erving. Stigma: Notes on the Management of Spoiled Identity. London: Penguin. Hutchison, Courtney. Sartorius, Norman. Think Before You Pink.
Global Health Bromet et al. Huffman, Wallace E. Organisation for Economic Co-operation and Development. OECD Publishing. World Health Organization. American Psychological Association. Becker, Dana. Bernstein, Lori and Linda Durkee. Developments in medicine, science and technology have both influenced and been influenced by understanding of anatomy; beliefs about health and illness; treatment paradigms; and the social and political environments in which healthcare systems operate. Sociology is the study of social behaviour or society, including its origins, development, organisation, networks, and institutions.
It is a social science that uses empirical research and critical analysis to understand social order, disorder and change. The simplest view of the academic discipline of sociology is that it is somehow concerned with the understanding of human societies. However, this does not take us very far as most people feel they know a good deal about the society in which they live because they experience it every day; this can be described as 'common-sense' or experiential knowledge.
Another approach would be to define sociology as a research-based study of society. However, there are other academic disciplines such as history, politics, economics, anthropology and social psychology that also have human society as the object of study. Probably the best way of defining the contribution of sociology is by looking at the key questions that originally stimulated the development of the academic discipline and which continue to underpin sociological research today:.
Understanding and explaining social phenomena. Theoretical approaches within Sociology. A single unified sociological perspective concerning the nature of social reality does not exist. In this respect sociology is no different to any other academic discipline, for all embrace competing perspectives or paradigms - this is how subject knowledge is advanced. The major long-standing epistemological divide that exists within sociological theory is that between those sociologists who argue that society can be studied in an objective way through identifying and examining the structures of society, and those who argue for an interpretative or subjective approach to social phenomena more focused on social actors.
Structuralist approaches often tend to focus on the macro level while subjectivist approaches tend to focus on the micro level of interaction. However, in more recent times a third position has developed which attempts to breakdown this duality between the relative importance attached to social actors versus social structures. These three approaches are explored below. Social structural approaches to exploring social reality include those empiricist sociologists who believe that an objective 'science of society' is possible in much the same way as a physical science such as biology or physics.
Research in the Sociology of Health Care
This empirical sociology seeks to explain the norms of social life in terms of various identifiable linear causal influences. Social structural approaches would also include those sociologists who see human society as being shaped by an underlying material social and economic structure. These are structures that may not always be visible, but nevertheless are fundamental in explaining social and individual processes. In relation to health, a predominantly social structural approach would draw upon quantitative data derived from social surveys, epidemiological studies and comparative studies in order to point to the relative influence of societal structures and processes in determining health outcomes for social groups.
Within the academic discipline of sociology, two major theoretical perspectives exist which seek to analyse human societies utilising a social structural or systems approach. These perspectives are structural functionalism and Marxism, and their very different organising principles are described in relation to the social determination of health outcomes below. As a brief illustration of the two approaches to structural analysis we will briefly examine the issue of poverty.
The functionalist explanation would set poverty in the context of social stratification and the unequal distribution of rewards associated with complex economies where different tasks are performed by different groups within society. Some groups are relatively less well off than others because they have less skills and knowledge and so their contribution to the functioning of society is not as extensive as other groups.
The Marxist explanation, on the other hand, would set poverty in the context of the class structure, specifically the relationship of social groups within a capitalist system of economic production in which there are the exploited and the exploiters with some intermediate groups of managers and supervisors. This theoretical perspective stresses the essential stability and cooperation within modern societies. Social events are explained by reference to the functions they perform in enabling continuity within society. Society itself is likened to a biological organism in that the whole is seen to be made up of interconnected and integrated parts; this integration is the result of a general consensus on core values and norms.
Through the process of socialisation we learn these rules of society which are translated into roles. Thus, consensus is apparently achieved through the structuring of human behaviour. Within medical sociology, this approach is essentially concerned with the theme of the 'sick role', and the associated issue of illness behaviour. Talcott Parsons, the leading figure within this sociological tradition, identified illness as a social phenomenon rather than as a purely physical condition.
Health, as against illness, being defined as:. Health within the functionalist perspective thus becomes a prerequisite for the smooth functioning of society. To be sick is to fail in terms of fulfilling one's role in society; illness is thus seen as 'unmotivated deviance'. A key assertion of the Marxist perspective is that material production is the most fundamental of all human activities - from the production of the most basic of human necessities such as food, shelter and clothing in a subsistence economy, to the mass production of commodities in modern capitalist societies.
Whether this production takes place within a modern or a subsistence economy, it involves some sort of organisation and the use of appropriate tools; this is termed the 'forces of production'. Production of any type was recognised by Marx as also involving social relations. In modern capitalist societies these 'relations of production' lead to the development of a division of labour reflected in the existence of different social classes.
For Marxists, it is these forces and relations of production together that constitute the economic base infrastructure of society. The superstructure of a society - the political, legal, educational, and health systems and so on - are shaped and determined by this economic base. The orientation of this approach as applied within medical sociology is towards the social origins of disease. Health outcomes for the population are seen as being influenced by the operation of the capitalist economic system at two levels.
First, at the level of the production process itself, health is affected either directly in terms of industrial diseases and injuries, stress-related ill health, or indirectly through the wider effects of the process of commodity production within modern societies. The production processes create environmental pollution, whilst the process of consuming the commodities themselves has long-term health consequences associated with eating processed foods, chemical additives, car accidents and so on. Second, health is influenced at the level of distribution. Income and wealth are major determinants of people's standard of living - where they live, their access to educational opportunities, their access to health care, their diet, and their recreational opportunities.
All of these factors are significant in the social patterning of health. Sociologists within this wide tradition would argue that the social world cannot be studied in the same way as the physical world because people:. In attempting to achieve this goal of interpretative understanding, reliance is placed on essentially qualitative research methodologies in order to get as close as possible to the world of the subjects or social actors being studied.
In terms of health and illness, this interpretative approach focuses upon the symbolic meanings of what it is to be ill in our society, and would not confine its interest in health to what would be perceived as the closed world of clinical biomedicine this would not rule out the study of the interactions of clinicians themselves both with patients and with colleagues. Within this interpretative sociological tradition two distinct perspectives stand out; symbolic interactionism and social constructionism.
These approaches are outlined below in relation to health and illness. This perspective developed from a concern with language and the ways in which it enables us to become self-conscious beings. The basis of any language is the use of symbols that reflect the meanings that we endow physical and social objects with. In any social setting in which communication takes place, there is an exchange of these symbols: that is, we look for clues in interpreting the behaviour and intentions of others.
Communication being a two-way process, this interpretative process involves a negotiation between the parties concerned. The negotiated order that develops therefore involves:. These understandings have consequences in turn for the way in which people act, and the manner in which others react to them. Interactionist sociology asserts that the social identities we possess are influenced by the reactions of others. So if we demonstrate some abnormal or 'deviant' behaviour it is likely that the particular label that is attached within a society at a particular time to this behaviour will then become attached to us as individuals.
This can bring about important changes in our self-identity. A disease diagnosis could be one such label: for example, clinical depression and the assumptions about the person so labelled that then follow; here Goffman's work on this form of social stigma is particularly influential and will be discussed in detail in Section 3 of this module.
Within this perspective, medicine too would be viewed as a social practice and its claims to be an objective science would be disputed. In the doctor-patient interaction, patient dissatisfaction can result if the doctor too rigidly superimposes a pre-existing framework disease categories upon the subjective illness experience of the patient. For example, by presuming that they can understand what that individual is suffering because of an interpretation of their signs and symptoms without reference to their health beliefs explored in Section 4.
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The Social Constructionist perspective of health and illness - The relativity of social reality. This sociological perspective derives from the phenomenological approach of Berger and Luckmann , who argued that everyday knowledge is creatively produced by individuals and is directed towards practical problems. This essentially subjectivist approach embraces a number of very different sociological paradigms, but what such paradigms do have in common in relation to health and illness is a focus on the way we make sense of our bodies and bodily disturbances.
Social constructionism refuses to draw a distinction between scientific medical and social knowledge. Nor would it ignore disease in favour of examining the illness experience, unlike the interactionist perspective. Rather, it maintains that all knowledge is socially constructed. We are seen to come to know the world through the ideas and beliefs we hold about it, so that it is our concepts and categories which are the realities of the world For further reading see Bury - a sociological paper which focuses on social constructionism in relation to biomedicine.
Foucault ,,, and the work of so-called post-structural social theorists are included within this perspective, though their concerns are frequently different from those researching within the tradition of phenomenology. Foucault was interested in power in itself, not as reduced to an expression of some other conceptual starting point such as class, the state, gender or ethnicity.
RN16 - Sociology of Health and Illness
He sought to approach the relationship between agency and structure not through an essentialist analysis but by using an 'interpretative analytics' of practices and discourses, discerning the workings of power and knowledge in social relations. In terms of health and illness, this Foucauldian approach to cultural constructionism draws attention to the ways in which we experience ourselves and our bodies not in some naturalistic way, but in what is termed a 'symbolically mediated fashion' - the body as a 'field of discourse'. As David Armstrong put it, in describing the development of medical knowledge in the latter half of the nineteenth century:.