Introduction to Medical Sociology Dr Sanusi Abubakar/Fatima Liman Definitions of Sociology • Sociology: society (Latin socio) & logos (Greek study) i.e. society and science. (sociusindividual) or (societa-group) • It is the study of individuals and groups in a society at different places and times • It is also the study of human behaviour i.e. specifically the social determinants of human behaviour Definitions of Medical Sociology • Medical sociology: is a branch of sociology. it is defined as the professional endeavor devoted to social epidemiology, the study of cultural factors and social relations in connection with illness and the social principles in medical organization and treatment” • It includes studies of the medical profession, of the relationship of medicine to the public and the social factors in the etiology, prevalence, incidence and interpretation of diseases Definition of Selected Concepts • Society: is a group of individuals who have organized themselves and follow a given way of life. • Society: is an organization consisting of member agents. It has a system of social relationships between individuals. It regulates and controls the behaviour of the individuals both by law and customs. It forces conformity to its norms. It is dynamic and changes over time and place. • A society differs from a crowd or mob Concepts in Medical Sociology • Community: it is social group determined by geographical boundaries and/or common values or interests. Its members know and interact with each other. It functions within a particular social structure and exhibits and creates certain norms, values and social institutions • Social institutions: is an organized complex pattern of behaviour in which members or individuals participate in order to further group interests. The rights and duties of each member are defined in such an institution Concepts in Medical Sociology • Socialization: is the process by which an individual gradually acquires culture(beliefs, customs, traditions, prejudices) & becomes a member of a social group • Types of socialization include primary &secondary socialization Concepts in Medical Sociology • Customs: practical distillates of the culture of a society. • Culture: is learned behaviour which has been socially acquired. It is transmitted from one generation to another through formal & informal learning processes. It lays down the norms of behaviour & provides mechanisms which secure for an individual his personal & social survival. It stands for the customs, beliefs laws, religion, morals precepts, arts & other capabilities or skills acquired by man as a member of society. Concepts in Medical Sociology • Gender – expectations imposed by society because of possession of male or female sexual characteristics • Sex – possession of typical biological female or male sexual characteristics • Illness - is the subjective response of an individual and those around him, to his being unwell Concepts in Medical Sociology • Disease - is a biomedical label assigned to a patient by a medical professional • Sickness - is a process for socializing disease and illness. It is a process through which worrisome behavioural and biological signs, particularly one originating in diseases are given socially recognizable meanings • The family - is a group of biologically and legally related individuals living together • Household – usually a family or individuals living in same house and eating from a common kitchen • Health (WHO, 1948) – is a complete state of physical, mental, & social well being and not merely the absence of disease and infirmity Main Components of Man’s Total Environment • The circumstances, objects or conditions by which one is surrounded form his environment • Environment can be broadly classified into three components i.e. physical, biologic and social components respectively Main Components of Man’s Total Environment • The social component consist of factors that originate from man’s socio-cultural environment and are unique to man because they are products of his intelligence e.g. interpersonal relationships, acquisition of knowledge, exploitation/manipulation of physical and biological environment, religion, culture, customs etc Some significant applications of Medical Sociology to Health • Looks at how diseases in the population are located among social groupings. • Explains how people respond to diseases with a view to defining them in predictable ways from the perspective of their culture and their social class within a particular culture. • Describes how society prescribes means of treating diseases. • Investigates how social institutions give their support to the medical organizations in their bid to treat the sick. Assignment • Write an essay on three positive, neutral and negative cultural factors each, affecting maternal health in Northern Nigeria Week 2 Social Roles • Social Role: can be an ascribed or acquired role. An ascribed role is “allocated” by virtue of natural attributes such as age, sex • An acquired role is one gotten by virtue of socially (attained) attributes e.g. educational attainments Sick Role • The sick role is an acquired social role that an individual assumes when (s)he falls sick • The concept of the sick role was proposed by an American sociologist called Talcott Parson, and it is sometimes referred to as the Parson’s Sick Role • An individual who is in the sick role has certain rights and obligations • He is expected to relinquish his normal duties, seek medical aid and carry out orders given by the physician. Sick Role • 2 Rights • 1) Exemption from his normal social role • 2) Exemption from blame for his illness • 2 Obligations • 1) He is expected to get well as soon as possible • 2) He is expected to seek/accept competent care Criticisms of the Sick Role The four main criticisms are briefly described below: • 1. The sick role does not account for the considerable variability in behavior among sick persons. Variation occurs not only by age, gender, and ethnicity, but also by the certainty and severity of prognosis. Criticisms of the Sick Role • 2. The sick role is applicable in describing patient experience with acute illness only and is less appropriate is describing persons with chronic illnesses who may not have easily recognizable symptoms and may not get well no matter how much they want to and how faithful they are in following the physician’s instructions Criticisms of the Sick Role • 3. The sick role does not adequately account for the variety of settings in which physicians and patients interact; it is most applicable to a (paternalistic) physician‐patient relationship that occurs in the physician’s office Criticisms of the Sick Role • 4. The sick role is more applicable to middle‐class patients and middle‐class values than it is for persons in lower socioeconomic groups. Not everyone can follow this pathway; for example, lower income persons have less freedom to curtail their normal responsibilities, especially their jobs, and thus have a more difficult time complying with the model. Class Assignment • Why are social roles (e.g. Gender, race, ethnicity etc) important in health? • Why is the sick role important in health? Week 3 Social Classification • Social classification • People are differentiated by certain characteristics which they bear. These may be 1. Personal characteristics e.g. age, sex, mental health status 2. Economic characteristics e.g. occupation 3. Cultural characteristics e.g. language, religion, caste system 4. Educational characteristics e.g. educational level Social Classification • The advantages of using occupation as an index for class differentiation include • 1)Economic rewards • 2) Extent of authority • 3) Extent of obligations • 4) Degree of status • 5)Values and lifestyles Registrar General’s Classification of Social Class • Traditionally, the Registrar General (RG) grouping of social class was widely in use in the past for administrative and research purposes but it has been discarded now. • The RG classification is an ordinal measure which is basically defined according to skills levels, drawing upon occupational title and employment status • It is grouped into 5 classes Registrar General’s Classification of Social Class • Class 1 (broadly professionals) Accountant, doctor, lawyer • Class II (managerial and technical occupations) e.g. manager, school teacher, nurse • Class IIIa Non manual (skilled, non manual) clerical worker, secretary, shop assistant • Class IIIb Manual (skilled, manual) bus driver, carpenter • Class IV(partly skilled) Bus conductor, post man • Class V (unskilled) labourer, cleaner Assignment • Discuss the shortcomings of the RG classification of social class as applied to the Nigerian context • Describe one example of another widely used social classification system • Discuss importance of social classification on health (health inequity, health gradient) Week 4 Social Problems • Personal (usually behavioural) problems that affect an individual become social problems when they in turn, affect a large number of people amounting to a threat to the welfare and safety of the whole group. They tend to develop when vulnerable individuals are not catered for by their family or society • They can also arise when segments of the society are denied necessities of life or are left unprotected against unforeseen crisis that can result in their being exploited. Social Problems • This may lead affected individuals to interact abnormally or injuriously with other members of the society. • Social problems are not the same as public health problem unless when they affect a large population Social Problems • • • • • Examples of social problems include Poverty, Crime, Alcoholism/drug addiction, Prostitution, Social Problems • • • • • Almajirci/delinquency, Broken homes/divorce, Banditry/insurgency/kidnapping, Corruption Etc (provide more examples) Class Discussion • What are the effects of social problems on the health of children and adolescents in Northern Nigeria? • Brainstorming/feedback on the last 3 assignments THANK YOU • ANY QUESTIONS?
