Social Construction of
Health and Illness
Social Constructivism
(Constructionism)
• Functionalism declined in the 1970s and social
control re-emerged in Medical Sociology in the
form of Social Constructivism
• It is influenced by:
– the labelling theory and Goffman’s critique of
psychiatry as a total institution.
– Zola (1972) argued that medicine should be
understood as an institution of social control,
‘nudging aside’ the traditional institutions of law and
religion.
– Illich & McKneown’s Role of medicine
• Medical social control advances through
medicalisation
Social Construction of
Illness & Medical Knowledge
• Sociological history of diseases
• Medicalisation
• Mediation of Medicine (social meaning of
illness) e.g. eating disorders
– Process of discovering and characterising
illnesses
– Attribution of new medical knowledge
– Medicine may be based on objective science but
application of medical knowledge is not!
Debates within Social
Constructivism
1. Problemisation of reality
– Interpretation varies between time and place
2. Social creation of ‘facts’
– Products of scientific communities that are
realised within discursive contexts
3. Medical knowledge mediates social relations
4. Application of technical knowledge
5. Medicalisation
Medicalisation Thesis
Originated with Illich (1976):
• Clinical iatrogenesis
– many medical treatments are ineffective/harmful
• Social iatrogenesis
– create passive consumers dependent on
drugs/medicine
• Structural iatrogenesis
– individuals lose ability to cope with pain, sickness
and death in a meaningful way
Four steps of Medicalisation
(Conrad, 2000)
1. Define a problem in medical terms
2. Use medical language to describe a
problem
3. Adopt a medical framework to
understand a problem
4. Use a medical intervention to treat it
‘Illegitimate’ extensions
of medicine’s
power and influence
• Making claims upon medical
achievements that can then be
scientifically justified
• Illegitimate extension of professional
power - patient reliant on doctor
• Shifts focus of a problem away from the
social to the individual
Criticism of Social
Constructivism
• It denies existence of truth and possibility of
finding a single valid account of disease and
body
• It takes issue with traditional histories of
medicine & undermines possibility of
progress
• Social constructivism has implications of
relationships between so-called ‘experts’ and
‘lay people’. Expertise can and is questioned
and all types of knowledge are viewed as
being valid whether it be experimental
knowledge or rational science.