Sociology of Health and Illness
Fall 2010
Gretchen Sisson
Office: McGuinn 410 #59
Classroom: Campion 303
Office Hours: MW 9-10,
and by appointment.
gretchen.sisson.1@bc.edu
This course will provide an introduction to the sociology of health and illness.
Sociological principles and perspectives will be applied to a variety of topics including
the experience of illness, the social and cultural factors of health and disease, and the
institutional structures of medicine.
As one of the university’s core course requirements in the social science, this course
necessarily contains elements common to all core courses. These elements include:
1. A concern with the perennial questions of human existence. Many of the
fundamental questions of sociology address these questions of human existence: What
is society and what is the individual’s place within it? How do social hierarchies and
institutions develop, and how do they influence the way we see and treat ourselves and
others? What are sources of inequality; how do they intersect; how do they permeate
our lives? How can social change be achieved, and can sociology inform it?
Specifically, this course will examine the fundamental and perennial conditions of
health and illness, and how each is understood, responded to, and used to create
meaning. We will not attempt to answer these questions fully, but instead learn how
sociology addresses such inquiries and how we might apply such knowledge to our
own lives.
2. A consideration of the role of history in human affairs. Only by incorporating a
historical context can we gain awareness of how our current social institutions and
modes of knowledge, particularly medical knowledge and the modern day authority of
the biomedical model, are themselves cumulative products of sociohistorical
processes. We will consider not only how contemporary models have evolved from
past ways of understanding and responding to illness and achieving health, but look to
see how current constructions and events will influence future models and institutions.
3. An attention to cultural diversity. One of the primary purposes of this course is to
bring attention to the many sources of diversity in the human experience. Although
conditions of health and illness are always cross-culturally present, they are
experienced in different frequencies, for different reasons, and given different
understandings, meanings, and responses based on race, class, gender, ethnicity,
sexuality, country of origin, health status, and religion. Identifying sources of
difference and their intersections, deconstructing hierarchies, and recognizing both the
potential and challenges inherent in organizing a diverse society will be among the
primary goals of the course.
4. An introduction to the methodology of the field. As part of the course, you will be
required to write a final paper that reflects an awareness of the methods of sociological
research and knowledge production. We will consider modes of social observation
and learning specifically as they apply to students’ work, paying particular attention to
the nature of deductive and inductive inquiry, the requirements of a social scientific
investigation, and strategies for moving from data to analysis.
5. A strong writing component. Writing will be an essential component of this course,
as the ability to develop analysis, criticism, and debate is vital to academic
development. The fundamental goals of good writing will be to achieve brevity,
clarity, and relevance in all arguments, and to never confuse complexity of thought
with complicated writing. Students will be required to write two papers that creatively
engage the course readings and topics, and one research paper that responds to a
question of their own choosing.
6. A contribution to the development of a personal philosophy of life. This course is
designed to challenge you to think more critically about your position is life – how
your background, race, class, gender, ethnicity have influenced your goals, beliefs,
politics, and interactions with others, and importantly the meanings of health, illness,
treatment and the medical model. You may develop a more nuanced way of thinking
about this positionality and your role in society, as well a more complex way of
considering how societies function and change, how individuals within society interact
with one another.
Grading
Class Participation & Attendance
Response Paper
Medication Project
Discussion Questions
Final Project
10%
20%
20%
15%
35% Total
(25% for Paper, 5% each for Presentation/Proposal)
Final grades will be determined as follows: A= 100-93; A-= 92-90; B+=89-87, B=86-83;
B-= 82-80; C+= 79-77; C=76-73; C-= 72-70; D+= 69-67; D=66-63; D-=62-60; F < 60.
Class Participation (10%): This criterion includes coming prepared to class, actively
sharing your insights into the readings, and contributing knowledge you may have from
other courses, current events, or relevant personal experience to the discussion. Boring
discussions are boring for me, too. Speak up! You’re encouraged to bring relevant news
stories/editorials/blog posts to class that you think would be relevant to the day’s
discussion.
Response Paper (20%): Your first response paper is due October 6. This paper will be
in response to the social epidemiology section of the course, particularly the beginning of
the AIDS epidemic. A specific prompt will be distributed in class. You need not consult
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sources other than those we are reading together for the course, although you are
welcome to. The paper should be between 5-7 pages long.
Medication Project (20%): As part of our section on exploring patient identities, you
are responsible for completing a medication project. This includes researching a specific
illness, its symptomology, course of treatment, medication side effects, and attempting
for one week to simulate as much as possible the changes in schedule, behavior, and
budget that living with that illness would require. More specific details will be
distributed in class, but the final paper will be at least 5-7 pages.
Discussion Questions (15%): By 9pm the evening before class, you are responsible for
submitting at least two discussion questions (to me, via email) relevant to the following
day’s readings. These questions should be thoughtful and attempt to engage the material,
and you should be prepared to discuss them in class. You are responsible for submitting
questions 15 times throughout the semester (each time you submit quality questions on
time will earn you 1% toward your final grade). We have 27 class discussions scheduled,
so you should submit questions for approximately half of the classes this semester.
Final Project (35%): In lieu of a final examination, you will be responsible for writing a
term paper (10-15 pages) on any topic within the field of medical sociology, health, or
illness that you would like to examine more closely. Because there is such a wide range
of topics, you’re encouraged to find something about which you’re very interested, and
will continue to be interested in throughout the semester. If you’re having trouble finding
something, a list of possible topics is included below.
A proposal for your final project is
due November 8, though you are
welcome to discus proposals with
me at any point during the
semester.
Is the class session well organized?
Relates material to previous readings
Provides internal summaries and transitions
Maintains continuity in the discussion
Summarizes main points at end of presentation
Paces class session appropriately
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Presentations of the projects will
take place in class November 22 –
December 8. These presentations
will be approximately 8 minutes
long, and should include a
professional presentation of your
research and findings. The rubric
to the right shows how your
presentations will be graded.
How is the content presented?
Presentation aids are useful
Presents background information for ideas
Explains difficult terms and concepts
Integrates readings and discussion/presentation
Helps clarify material
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Is the presenter credible?
Appears well-prepared
Understands the material
Is able to admit insufficient knowledge
Speaks audibly and clearly
Communicates enthusiasm
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The final paper itself is due
December 8. Because the point of
an independent project is to
explore topics we’ve not
thoroughly discussed in class, you
How is the presenter’s rapport with the other class members?
Encourages participation
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Responds constructively to class members
1 2 3 4 5
Treats members equitably
1 2 3 4 5
Recognizes when others are confused
1 2 3 4 5
Shows3 respect for other’s view points
1 2 3 4 5
must include outside sources (a minimum of 7-10, through you should feel to include
many more). Wikipedia and Ask.com articles are not sources. Generally, journalistic
articles should be considered complementary sources, not the base of your research.
Possible Paper Topics
Alternative treatments
Disability (mental and physical)
Nationalized healthcare systems
Additional at-risk populations
Public health interventions
Gender and the body
Social structure of medical education
Historical models of illness
Sexual and reproductive health
Chronic illness
Death and dying
Genetic testing and diagnosis
Illness branding
Medical experimentation
Caregiving
Narratives of health and recovery
US healthcare policy
Healthcare access and barriers
Additional illness experiences
Metaphors and illness
Race and the body
Medicine and activism
Health education
Health and social justice
Bioethics and medical decision-making
End-of-life care
Assisted reproductive technologies
Illness in literature and film
Developmental illnesses
Readings
The Sociology of Health, Illness, and Healthcare (5th Edition)
The Spirit Catches You and You Fall Down
And the Band Played On
Voices from the Inside
Rose Weitz
Anne Fadiman
Randy Shilts
David Karp &
Gretchen Sisson
All books are available at the BC Bookstore, however used versions of many are also
available for less on Amazon.com. Additionally, all are available at the BC library. If
the cost of the books is a burden for you, please let me know.
Additional articles are available on e-Reserve on the library website, or on
http://bit.ly/SC07801. This is the free version of the coursepack. You are responsible for
either printing the articles and bringing them to class with you, or bringing your laptop to
class with you.
Introduction to
the Sociology of
Health and
Illness
September 8
September 10
First Day of Class – Welcome!
Understanding the Sociological Perspective
• Weitz, pp. 3-8
Introduction to the Biomedical Model
• “The Need for a New Medical Model: A Challenge for
Biomedicine,” (129-136) by Engel in Science 196(4286)
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September 13
September 15
September 17
September 20
September 22
September 24
Social
Epidemiology
September 27
September 29
October 1
October 4
Race, Class,
Gender and
Illness
October 6
October 8
October 11
Case Study: Culture and Epilepsy
• Fadiman, pp. 20-60
Case Study: Culture and Epilepsy
• Fadiman, pp. 60-93
Case Study: Culture and Epilepsy
• Fadiman, pp. 106-118
• Fadiman, pp. 140-153
• Fadiman, pp. 250-261
The Social Sources of Illness
• Weitz, pp. 14-47
Case Study: HIV/AIDS Epidemic
• Shilts, pp. 3-50
Case Study: HIV/AIDS Epidemic
• Shilts, pp. 53-112
Case Study: HIV/AIDS Epidemic
 Shilts, pp. 219-262
 Kramer, “1,112 and Counting”
Guest Lecture: Aimee VanWagenen, The Fenway Institute
Case Study: HIV/AIDS Epidemic
• Film: And the Band Played On
The Social Distribution of Illness in the United States
• Weitz, pp. 48-76
 “Social Conditions as Fundamental Causes of Disease”
(80-94) by Link and Phelan in Journal of Health and
Social Behavior 35
 “Exploration of Health Disparities” (100-107) by
Kawachi and O’Neill in Essays on the Future of
Environmental Health Research
Response Papers DUE
 “Invoking Tuskegee: Problems in Health Disparities,
Genetic Assumptions, and History” (26-24) by Reverby
in Journal of Health Care for the Poor and Underserved
21(3)
 “Gender Matters: an integrated model for understanding
men’s and women’s health” (745-755) by Bird and
Rieker in Social Science and Medicine 48
No Class
Columbus Day
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October 13
October 15
October 18
The Illness
Experience
October 20
October 22
October 25
October 27
October 29
November 1
Health Care
Institutions and
Professions
November 3
November 5
November 8
November 10
Medicine and
Social Control
November 12
The Social Meanings of Illness
• Weitz, pp. 106-129
Illness and Language
Case Study: Cancer
• Excerpt from “Illness and Metaphor” by Susan Sontag,
pp. 3-36
The Experience of Disability, Chronic Pain, & Chronic Illness
• Weitz, pp. 130-159
In-class Film: Sound and Fury
Medication
Case Study: Depression
• Karp and Sisson, pp. 121-148
Sociology of Mental Illness
• Weitz, pp. 160-190
Stigma
Case Study: Bipolar Disorder
• Karp and Sisson, pp. 24-33
• Karp and Sisson, pp. 169-180
Medication Projects DUE
Medicine as Business
Case Study: Birth
• Film: The Business of Being Born
Health Care in the United States
• Weitz, pp. 192-221
Health Care in Other Countries
• Weitz, pp. 222-245
Health Care Settings and Technologies
• Weitz, pp. 246-274
The Profession of Medicine
 Weitz, pp. 276-305
• “Notes on the Sociology of Medical Discourse: The
Language of Case Presentation” (357-375) by Anspach
in Journal of Health and Social Behavior 29(4).
Final Project Proposals DUE
The Profession of Medicine
• “Evolution of Medical Uncertainty” (1-49) by Fox in
Health and Society 58(1).
Deviance and Medicalization
 Chapter from Deviance and Medicalization: From
Badness to Sickness, pp. 17-37 and pp. 241-259, by
Peter Conrad
Case Study: Hospitalization
• Karp and Sisson, pp. 109-120
Case Study: Prison
• Karp and Sisson, pp. 197-206
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November 15
November 17
November 19
Independent
Study
November 22
November 24
November 26
November 29
December 1
December 3
December 6
December 8
Case Study: ADHD
• “From Hyperactive Children to ADHD Adults:
Observations on the Expansion of Medical Categories”
(559-589) by Conrad and Potter in Social Problems.
In-class Film: Selling Sickness: An Ill for Every Pill
No Class
Case Study: Plastic Surgery
• “Women and the knife: cosmetic surgery and the
colonization of women’s bodies” (25-53) by Morgan in
Feminism and the Body 6(3).
Final Project Presentations
Thanksgiving Break
Thanksgiving Break
Thanksgiving Break
Final Project Presentations
Final Project Presentations
Final Project Presentations
Final Papers DUE
Final Project Presentations
Honor Statement
Within this setting of this course, we will be operating on an honor system. Boston
College, as an institution, does not codify academic integrity in this way, but I believe it
to be a fundamental way of ensuring that all participants within the course are turning in
work that is wholly their own. Consequently, it is a requirement of the course that all
enrolled students read, consider, sign, and follow the following statement, which is drawn
from information available on www.bc.edu/integrity.
The Honor Statement is designed to promote academic integrity as a priority for all
participating in the course and to ensure that students who are honest are not placed at an
unfair disadvantage. As a student enrolled in this course, I acknowledge the following:
1. I understand that integrity is essential to the academic setting and that upholding
the integrity of the classroom environment is one of the requirements of this
course.
2. I acknowledge the following definitions of dishonorable behavior, and affirm that
I will not engage in any such behaviors in the context of this course:
Cheating is the fraudulent or dishonest presentation of work. Cheating includes
but is not limited to: the use or attempted use of unauthorized aids in
examinations or other academic exercises submitted for evaluation; fabrication,
falsification, or misrepresentation of data, results, sources for papers or reports;
manipulating or altering data or other manifestations of research to achieve a
desired result; selective reporting, including the deliberate suppression of
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conflicting or unwanted data; falsification of papers, official records, or reports;
copying from another student's work; actions that destroy or alter the work of
another student; unauthorized cooperation in completing assignments or during an
examination; the use of purchased essays or term papers, or of purchased
preparatory research for such papers; submission of the same written work in
more than one course without prior written approval from the instructors
involved; dishonesty in requests for make-up exams, for extensions of deadlines
for submitting papers, and in any other matter relating to a course.
Plagiarism is the act of taking the words, ideas, data, illustrations, or statements
of another person or source, and presenting them as one's own. Each student is
responsible for learning and using proper methods of paraphrasing and footnoting,
quotation, and other forms of citation, to ensure that the original author, speaker,
illustrator, or source of the material used is clearly acknowledged.
Collusion is defined as assistance or an attempt to assist another student in an act
of academic dishonesty. Collusion is distinct from collaborative learning, which
may be a valuable component of students' scholarly development. Acceptable
levels of collaboration vary in different courses, and students are expected to
consult with their instructor if they are uncertain whether their cooperative
activities are acceptable.
3. If I believe a fellow student is breaching the honor code, I recognize that the
following responses are available to me:
I may discuss my concerns with the student whom I suspect of a violation,
recognizing that direct contact by another student may be the best means of
resolving the problem. Repeated demonstration of student concern for academic
integrity will in the long run build a peer-regulated community, which is the
primary goal of participating in the honor code system.
If I believe the incident to be a major violation or part of a repeated pattern of
violations, I will bring my concerns to the attention of the instructor, or to the
appropriate department chairperson or associate dean. Suspected violations by
students reported to members of the faculty or to an associate dean will be
handled according to the procedures set on www.bc.edu/integrity.
4. If I have serious concern that the instructor is not living up to her responsibility to
safeguard and promote academic integrity, I will speak with the faculty member
directly, or bring my concern to the attention of the department chairperson or
associate dean.
Signature: ___________________________________________________________
Name:
___________________________________ Date: __________________
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