Concepts of Ill Health
How do you view ill health?
There are different ideas as to what ill health is.
The following are concepts of ill health which look at how
individuals and society view ill health.
Illness, Disease & Disability
Iatrogenesis
The sick role
The clinical iceberg
What Are Illness, Disease & Disability?
Are Illness, Disease & Disability
Indicators of Ill Health?
• What do you consider to be ill health?
• Does someone with a prosthetic leg and
who can do all the things that an able
bodied person do, have a disability?
• Do all people with disabilities have ill
health?
• Do all illnesses and diseases cause ill
health?
What is Illness?
• Illness is subjective.
• “I feel ill” can
mean different
things to different
people.
• Both these boys
have the same
symptoms, one
feels ‘ill’ and one
doesn’t.
What is Disease?
• Disease is Objective.
• Symptoms have
been diagnosed
and have been
given a specific
name, eg
Chickenpox or
Cancer or
Depression or
Multiple Sclerosis etc
This child has measles
• Either you have a
disease or you don’t.
The Clinical Iceberg
1/3
patients
visit the
doctor
2/3 patients do not
visit the doctor
or health professionals
This theory says that because only
1/3 of patients present their
symptoms to a health professional
we are never really sure how
many people have ill health.
It gives an indication that
peoples’ concepts of ill health are
different.
Why do you think only 1/3 of
people visit the doctor?
The Clinical Iceberg
1/3
patients
visit the
doctor
2/3 patients do not
visit the doctor
or health professionals
What is mental ill
health?
Why might people
not see health
professionals about
having mental ill
health?
Iatrogenesis
Ivan Illich (1976)
identified that
some medical
interventions
could cause ill
health. He
called this
‘Iatrogenic Ill
health’
Imagine the surgeon slipped –
what might happen to the
patient?
Clinical Iatrogenesis
Ill health caused by
medical intervention
such as an unwanted
reaction to a
prescribed drug or an
infection acquired
while under medical
care, eg MRSA
Research a
prescription drug and
list ALL the sideeffects caused.
Prescribed drugs often
cause side-effects like:
•dizziness
•tiredness
•headache
•nausea
Social Iatrogenesis:
The loss of the ability to COPE
This maybe linked to:
• the medicalisation of everyday life (can’t cope
with life without medication)
• the instititutionalisation of individuals in medical
settings such as psychiatric hospitals.
‘One Flew Over The
Cuckoos Nest’. The
majority of patients
were ‘voluntary’ and
felt unable to live life
by themselves
because they relied on
the institution.
Cultural Iatrogenesis
• The loss people experience from the unrealistic
expectations raised by modern medicine.
• We expect to be treated for EVERYTHING that is wrong
with us by medical professionals, and so we do not
expect to suffer at all.
• Illich says we are unable to cope with normal pains or
suffering because we expect a ‘magic wand’.
• Therefore, cultural Iatrogenesis is where we experience a
feeling of loss because we can’t be made better. The
doctors have not ‘made’ us ill, but our belief in them
means that we expect to be perfectly healthy all the
time, and so the doctors have given us unrealistic
expectations of health, which means that when we suffer
we feel it much more than generations before us
because they did not have those expectations.
Talcott Parsons’ Theory:
The Sick Role
• Parsons said that society applies ‘rules’ to people
who are ill.
• The sick person AND the society have obligations:
• Sick Person: To seek appropriate medical help AND
to want to get better.
• Society: To excuse the sick person from normal
social roles (eg worker, mother etc) AND to not hold
the patient responsible for their condition AND for
the sick person to be taken care of
• These obligations must be fulfilled for the person to
be allowed to be in the ‘sick role’.
Talcott Parsons’ Theory:
The Sick Role
The sick role is a
functionalist theory
If this person is sick
then they cannot put
into society in the way
they usually do.
Society
But they can receive
from society in the
same way.
The sick role is
therefore seen as a
deviant role.
A functionalist would want the sick
person to get better so they can
start contributing to society again.
Talcott Parsons’ Theory:
The Sick Role
• If you were the
person in the sick
role, what roles
would YOU be
exempt from?
• What would you
be excused from
having to do?
Society
Analysing The Sick Role
Lets go back to the obligations of the sick
person: To seek appropriate medical help
AND to want to get better.
How many people don’t seek medical help?
What reasons do they have?
Do sick people always want to get better?
Describe situations when they don’t.
Analysing The Sick Role
Lets go back to the obligations of the society:
To excuse the sick person from normal social roles
AND to not hold the sick person responsible for their
condition.
Are people always excused from
their normal social roles?
List situations when they are not.
Does society always not hold the
person responsible for their
condition?
List situations when they are.
Concepts of Health
• Negative concept of health: The absence
of disease or illness. (Related to the
Medical Model of Health)
• Positive concept of health: A state of well
being.
• World Health Organisation Definition:
A state of complete physical, mental and
social well being, not merely the absence
of disease or infirmity (WHO 1946)