The Sociology of Health: 33 Mark Essay Plans
1.
Outline and evaluate Marxist views on the role of medical
professionals in society [33]
Introduction: What are the two opposing views on the roles of medical professionals in society? (1-2
lines); Which side of the argument are the Marxists on – and briefly why? (1 line)
1.
The Marxist View (1-2 Paragraphs)
-Describe how the medical profession benefits capitalism and the bourgeoisie (according to Navarro)
-Briefly elaborate on this, specifying how it specifically benefits pharmaceutical corporations, private
doctors and business leaders.
-You could (very briefly) use an example from the US Healthcare system (as we saw in the movie
‘Sicko’ to back this up)
-Describe the view that the medical profession has an ideological control over health and how the
biomedical model gives power to professionals (this view is supported by both Foucault and Illich)
2.
The Weberian View (1 short paragraph)
-Very briefly describe how the Weberian view supports the Marxist view in claiming that medical
professionals work to maintain their high power, status and pay (rather than for the good of
patients).
3.
The Functionalist View and further evaluation (1 paragraph)
-Very briefly describe how the functionalist view is completely opposite to the Marxist view (they
believe the medical profession exists for the benefit of the whole of society and deserves high
status/pay)…
-Include further evaluate of the Marxist view(s) e.g.: Do the views apply in the UK where healthcare
is free for everyone? They assume we always do what our doctors tell us, but we don’t!; they
assume the dominance of the biomedical model, but the social model is becoming more influential
in many societies…
Evaluation (1-2 lines): Based on what you have written, which of the opposing views is the most
convincing? Does the Marxist view hold up in the contemporary UK?
***
2.
Outline and evaluate feminist views on the role of medical
professionals in society [33]
Introduction: What are the two main opposing views on the roles of medical professionals in
society? (1-2 lines); how is the Feminist view slightly different to these (e.g. it is focused on arguing
that the medical profession is male dominated and therefore serves patriarchal interests…)
2-3 Paragraphs including some – or all – of the following:
-Prior to the Medical Registration Act, women were the main healthcare providers; now they are
reduced to ‘helpers’ in a male dominated profession (Doyal)…most of the areas of healthcare that
are female dominated are less well paid (e.g. nurses, midwives)
-Contraception is treated as a ‘female problem’; it is marketed at women, and contraception that is
for women tends to have far more health risks than that aimed at men
-Conditions that effect women have been either over-medicalised (e.g. childbirth, pregnancy)
according to Oakley – or neglected and under-researched (e.g. menopause, menstruation)
-Historically, the medical profession has been used to control women (e.g. diagnosis of hysteria
coinciding with the Women’s Movement; unmarried mothers labelled as mentally ill etc.)
Evaluation Paragraph:
-Medicine does harm to men as well as women (e.g. relative lack of awareness historically for
conditions affecting only men, such as testicular cancer)
-Other views (e.g. Marxism, Illich, Foucault) suggest that the medical profession does not just work
against women, but against everyone (except for the rich and medical professions themselves)…
Conclusion: Based on what you’ve written, do you think the feminists have a point? To what extent
is the medical profession male dominated and discriminatory towards women?
***
3.
Outline and evaluate cultural explanations of patterns of ill
health [33]
Introduction: Outline what are meant by ‘cultural’ explanations (e.g. the view that differences and
inequalities in health and illness might be linked to the different culture and behaviours of particular
groups in society). Explain that the patterns of ill health you will be discussing are gender, ethnicity
and class.
Paragraph 1: Culture & Gender
Discuss some/all of the following:

The norms of hegemonic masculinity encourage behaviours harmful for health in men (give
examples)




Higher rates of social isolation (Perren et al) and alcoholism/drug addiction (Taylor et al) may
explain why suicide is the main killer of men under 50.
Within UK culture, females are socialised to be more aware of health issues and of their own
bodies…
…Though media pressure on women as a result of this may lead to higher rates of eating
disorders among them.
It is more socially acceptable for women to define themselves as ill (Seligman – ‘learned
helplessness’ – means women accept sickness as part of their lives); men on the other hand
are less likely to be aware of health issues and so less likely to seek medical help (ref: The
Parris study).
Paragraph 2: Culture & Ethnicity
Discuss the following:


Different ethnic groups have different smoking rates; culture and gender are both influences
here (e.g. Bangladeshi women have the lowest rates of smoking in the UK)
Culture also influences diet e.g. the use of ghee in some Asian cooking; some cultures and
religious beliefs (e.g. Sikhism) promote a vegetarian diet etc.
Paragraph 3: Culture & Class
Discuss the following:


Working class people have higher rates of smoking and drinking, poorer diets and do less
exercise than members of the higher social classes…
Some theorists e.g. Willis have argued that the working class have their own culture, of
which fatalism and immediate gratification are a part – this might lead them towards
lifestyle choices that are harmful to their health.
Evaluation:


What problems are there with relying on cultural explanations (e.g. they can be too general,
such as classifying all ‘Asians’ or ‘Working Class People’ as single groups)?
Identify and very briefly describe at least one other type of explanation (e.g. biological,
structural) as an alternative.
Conclusion:
2-3 Lines: Based on what you’ve written, do you think cultural explanations have an
influence on patterns on health/illness?
***
4.
Outline and evaluate interactionist explanations of mental
illness [33]
5.
Outline and evaluate the view that medical professionals play
a positive role in society [33]
Introduction: What are the two opposing views on the roles of medical professionals in society? (1-2
lines); Which perspectives are on each side of the view and – very briefly – what do each believe? (23 lines)
Paragraph 1: Functionalism – They Believe medical professionals play a positive role because…
-Describe Parson’s ‘Sick Role’…what is it and why does it mean that medical professionals must be a
positive force?Functionalists believe that people should – and do – trust their doctors and describe
why this is (e.g. doctors are always well trained, have lots of knowledge, swear a Hippocratic Oath
etc).
- Make some evaluative points about this view (e.g. it assumes we trust our doctors; most symptoms
never get reported to doctors; many conditions cannot be cured/treated so the ‘sick role’ can’t apply
to them…)
Paragraph 2: Weberianism – They believe medical professionals are focused on themselves rather
than on society…
- They want to protect their high status/pay so they have created a sector that only a few can enter
and everyone else is excluded…
- They maintain occupational dominance (Turner) by forcing other healthcare providers out or
reducing them to subordinate positions…
- They maintain a monopoly on truth and used medical terminology to keep their patients
mystified…
Paragraph 3: Marxism (include all/some of the following)
-Describe how the medical profession benefits capitalism and the bourgeoisie (according to Navarro)
-Briefly elaborate on this, specifying how it specifically benefits pharmaceutical corporations, private
doctors and business leaders.
-You could (very briefly) use an example from the US Healthcare system (as we saw in the movie
‘Sicko’ to back this up)
-Describe the view that the medical profession has an ideological control over health and how the
biomedical model gives power to professionals (this view is supported by both Foucault and Illich…).
Paragraph 4: Other Views
Very briefly describe some other views e.g. you could briefly outline the overall feminist view
(medical professionals are mostly male; the medical profession works against women) or outline
Illich’s concept of iatrogenesis or Foucault’s views on medical discourse.
Conclusion: Based on what you’ve written, which view is the strongest or most convincing? Is there
any further evidence/examples that might sway you in favour of one or none?
***
6. Outline and evaluate the view that social class inequalities in
health are a result of structural factors [33]
Introduction (1 paragraph): Briefly outline some of the evidence for social class inequalities (e.g.
people of lower social class backgrounds have more sickness, lower life expectancies, higher rates of
infant mortality etc). Explain what is meant by ‘structural factors’ (e.g. explaining inequality through
the way society is structured, especially the living and working conditions of its members).
Paragraphs 1-3: Structural Factors & Class
Explain and evaluate most of the following:







Accident rates are higher amongst those in manual labour.
Those who live in poorer housing have higher rates of respiratory diseases (Martin et al,
1987)
The material effects of unemployment are significant, leading to stress, disruption and
behavioural patterns that damage health (Morris et al, 1994)
Lobstein (1995) found that healthy food cost less in affluent parts of London than it did in
poorer areas.
The Whitehall study by Marmot which identified workplace stress, as a result of lack of
control at work, with higher death rates in lower classes.
The Multiple Disadvantages faced by poorer people in society, linked to where they lived
and their social environment (the Glasgow study is an example of this)
Tudor Hart’s Inverse Care Law (areas that need the most healthcare have the least access to
it).
Further Evaluation (1 Paragraph):


Identify and briefly explain at least one alternative type of explanation for class inequalities
in health (e.g. cultural, artefact, social selection).
Identify the extraneous factors that make it difficult to claim that social class is the main
cause of inequality (e.g. gender and ethnicity might be more influential).
Conclusion: Based on what you have written, do you think social class inequality in health can be
blamed on structural factors and why/why not? (2-3 lines)
***
7.
Outline and evaluate sociological explanations of mental illness [33]
Introduction: Briefly explain that there are many different explanations of mental illness in
sociology. You could briefly outline the main views as follows:


Structural views (e.g. Marxism, Feminism) look for the causes of mental illness within
society.
Interactionists believe that mental illness is a social construction and is not a real thing.
You can then explain that your essay will mainly be focused on these interactionist views…
Paragraphs 1-3: Interactionism and Mental Illness
You should include all/most of the following:





Scheff claims there is no such thing as mental illness; just behaviour that doesn’t make sense
to others. He believes we learn a stereotyped view of mental illness as children and this is
reinforced throughout our lives (e.g. by the media – give an example or two here)
What is considered mental illness in one society, time or context is not in another (give
examples e.g. slaves who escaped their owners in the Southern USA were historically
considered to be mentally ill; a man who claims to be a representative of God might be
diagnosed as mentally ill in one society, but worshipped by another society; a man who
shouts at people in the high street might be considered mentally ill but a man who shouts at
a football match is normal) – this all suggests mental illness is socially constructed.
Foucault says that the language we use to talk about mental “illness” has made us think of it
in the same way we think about physical illnesses, even though the two things are
completely different. Foucault believes if we didn’t used words like “illness” we would see
that there is no such thing as mental illness, just unusual behaviour.
Both Foucault and Szasz give examples of how mental illness has been used to control
people throughout history (e.g. an excuse to lock people away – i.e. unmarried mothers,
dissidents in Communist Russia)
Labelling theorists like Becker and Goffman believe that ‘mental illness’ is a label given to
people; once they are labelled, it becomes a master status that affects everything they do.
Goffman looked at how mental institutions taught people to be mentally ill, rather than
cured them – and the power of the ‘mental patient’ label. Rosenhan’s study reinforced this.
Conclusion: Based on what you’ve written, have you shown that mental illness is a real thing or not?
Conclude also by adding the Social Realist view, which completely disagrees with the Interactionist
view, as Realists believe mental illness is a real issue that has a serious impact of people’s lives and
requires treatment.
***
8.
Outline and evaluate the Weberian view that the medical professional
exists to serve its own interests [33]
Introduction: What are the two opposing views on the roles of medical professionals in society? (1-2
lines); Which perspectives are on each side of the view and – very briefly – what do each believe? (23 lines). Make it very clear which side the Weberians are on.
Paragraph 1-2: Weberianism – They believe medical professionals are focused on themselves
rather than on society…
- They want to protect their high status/pay so they have created a sector that only a few can enter
and everyone else is excluded…
- They maintain occupational dominance (Turner) by forcing other healthcare providers out or
reducing them to subordinate positions…
- Freidson adds that they have created a system of social closure; the medical profession is not
accessible to ‘outsiders’…Millerson shows the ‘techniques’ that medical professionals use to
maintain their position (e.g. theoretical knowledge; level of training; codes of conduct); only people
who train, learn and subscribe to exactly the same things can call themselves ‘medical
professionals’…
- They maintain a monopoly on truth and used medical terminology to keep their patients
mystified…
Paragraph 3: Evaluation of Weberian views
-
Reliant on the biomedical model (medical professionals would not have all this power/status
in societies where the social model/preventative medicine become more dominant)
Alternative medicine is growing in popularity in the UK
‘Paramedical’ professions (e.g. nursing, midwifery, pharmacists) are becoming more
professionalised (e.g. have more powers, status and training) than before, which threatens
the dominance of doctors.
Paragraph 4: Functionalism
Briefly outline the functionalist view, just to show how it completely disagrees with the Weberian
view: The main point is that Functionalists believe that medicial professionals serve an essential
function in society and therefore deserve high pay/status etc. and that they always work for the
benefit of their patients, not for themselves.
Conclusion: Based on what you’ve written, do you think the Weberian view is convincing?
***
9.
Outline and evaluate cultural explanations for patterns of ill health
related to gender [33]
Introduction: Very briefly describe the patterns of health related to gender, perhaps with some
evidence (statistically: men die quicker, but women are sicker). Then explain what is meant by a
‘cultural explanation’ (links patterns of ill health to the culture of a society ).
Paragraphs 1-3:
Outline and evaluate most of the following:
-
-
-
-
The norms/roles of hegemonic masculinity may encourage behaviour that is dangerous to
the health of males
Suicide is the most common cause of death in young men (Perren et al suggest this is
because males are more likely to be socially isolated; Taylor & Field suggest that it may be
because men are more likely to be addicted to drugs or alcohol)
Women are socialised to be more aware of their health than men (because femininity is
defined by the body)…It is more socially acceptable for women to define themselves as ‘sick’
than men (Seligman called this ‘learned helplessness’ – women learn that being ‘sick’ is part
of their identity as women, so accept it)…
…Men on the other hand are less aware of their health, so less likely to seek medical
attention (e.g. a study by Parris that showed men had very little knowledge about prostate
cancer)
Women are more likely to suffer from eating disorders than men (e.g. through pressure
from the mass media on how to look)
Paragraph 4: Briefly offer/describe at least one OTHER explanation for patterns of ill health by
gender (e.g. structural, biological, artefact)…for example, you could suggest that these patterns of ill
health by gender are just due to the biological differences between men and women (e.g. genetic
resistance to heart disease among women; women have to go to the doctor more often as many
conditions only affect them – menopause, menstruation etc)…
Conclusion: Based on what you’ve written, do you think the culture of a society has a significant
impact on patterns of health/illness or are there other more convincing explanations.
***
10. Outline and evaluate artefact explanations for patterns of ill health
[33]
Introduction: Briefly explain that in there are clear patterns of ill health in the UK by gender, class
and ethnicity. Then explain what is meant by an ‘artefact explanation’ (e.g. flaws in the
statistics/data, or in the method by which the statistics/data was collected…these explanations
suggest that patterns of ill health are just a product of bad statistics/data).
Paragraph 1: Artefact explanations for gender and ill health
The morbidity statistics for patterns of ill health by gender are not valid because (explain the
following):
-
Women are more likely to self-report as ill than men
Men are more likely to over-rate their symptoms than women (Macintyre)
Women are more likely to make medical appointments on behalf of others (e.g. young
children)
-
Biological factors mean women may have to visit the doctor more than men, but for
conditions that are not ‘illness’ (e.g. menopause, menstruation, pregnancy)
Paragraph 2: Artefact explanations for ethnicity and ill health
-
-
Statistical evidence shows that some ethnic minorities have lower life expectancies and
higher rates of sickness than others…
…However, most sociologists believe that this is misleading and that structural factors are
much more significant (e.g. some ethnic minorities more likely to be homeless, more likely
to be in low paid jobs or unemployed, more likely to suffer racism/discrimination at work)
Many statistics are too generalised (e.g. classing ‘Asians’ as a single ethnic group)
Paragraph 3: Artefact explanations for class and ill health
-
Critics point out that statistics linking health to social class tend to focus on extremes (e.g.
comparing the highest and the lowest social classes, but ignoring everything in between)
Those that use artefact explanations often claim that patterns of ill health by class are not
valid because of the above – they are just a product of statistics…
…However, there is little support for this view in Sociology.
Conclusion: Artefact explanations suggest that inequalities are not necessarily real, but are a
product of bad data. Based on what you’ve written, do you think this is convincing?
***
11.
Outline and evaluate structural explanations for mental illness [33]
Introduction: Structural explanations for mental illness look for the causes of mental illness
in the way society is structured, and particularly in the living/working conditions of
members of society. In the contemporary UK, some groups are more likely to be diagnosed
as mentally ill than others (specifically white women, black males and people of lower social
class backgrounds). Can these patterns be explained structurally?
Paragraph 1: Mental Illness & Gender – Structural Explanations
According to Rogers & Pilgrim, Women’s lives are more stressful than men’s because
1.
2.
3.
4.
Of their role as carers
Of the lack of structure in domestic roles
Of their lack of time to reflect over emotional difficulties
Of their lack of privacy
Women are also more likely to experience worse pay, worse working conditions and poverty
than men (add more detail to the above where possible).
Paragraph 2: Mental Illness & Ethnicity – Structural Explanations
The lives of some ethnic minorities (including black people) are more stressful than others
because:
- A majority of ‘homeless households’ are ethnic minority (a study by Lissauer et al showed
how this can cause stress, depression etc)
-They are also more likely experience worse pay, worse working conditions and poverty
than other ethnic groups (add more detail to the above where possible).
Paragraph 3: Mental Illness & Class – Structural Explanations
-
Rogers & Pilgrim (2005) agreed that poorer people are significantly more likely to
experience mental health problems.
Stansfield et al (2003) found that work is the main factor in depressive symptoms in
men: Both lack of employment and inadequate employment.
Ross et al (2001) believed that bad neighbourhoods were a key influence on mental
health.
Reading & Reynolds (2001) found that anxiety about debt was the best predictor of
depressive symptoms in families.
The Whitehall Studies by Marmot also showed how lower social classes experience
more stress than higher classes due to a lack of control over work
Conclusion: Based on what you’ve written, do you think structural explanations are there
convincing? Might biological or cultural explanations be more convincing? (You could very
briefly offer a couple of examples of alternative explanations).
12. Outline and evaluate sociological patterns of ill health related to
ethnicity [33]
Introduction: (1 Paragraph) Describe patterns of ill-health related to ethnicity e.g. most ethnic
minority groups in the UK have higher mortality rates, higher infant mortality rates….African
Caribbean people are more likely to die of stroke or be diagnosed with psychotic illnesses…Asian
groups have higher rates of heart disease. Are these patterns signs of inequality or difference?
Paragraph 1: Biological Explanations
Patterns of ill health could be explained by biological differences between ethnic groups; some
groups are biologically more prone to certain illnesses than others (e.g. sickle-cell anaemia in black
people)…However, this explanation only works for a few illnesses and lifestyle is more important in
determining whether symptoms ever appear, even in people with a genetic disposition to an illness
(e.g. Zubin & Spring’s study of schizophrenis).
Paragraph 2: Cultural Explanations
Discuss and evaluate (with examples) things like:


Diet
Smoking/drinking rates
Explain how cultural/religious beliefs of some ethnic groups might lead them to make certain
lifestyle choices (e.g. some religions might forbid drinking/drugs/smoking or the eating of certain
meats) and how this could impact health.
Paragraph 3: Structural Explanations
Discuss and evaluate (with examples) things like:



In the UK, some ethnic minorities are more likely to be higher social classes than others (e.g.
Indian/Chinese people more likely to be Class 1; Pakistani/Bangladeshi people more likely to
be lowest social classes).
Some ethnic minorities more likely to be in hazardous, risky work so suffer more accidents
etc. (Amin); also more likely to be unemployed/in poverty, which causes stress, depression
etc.
Ethnic minorities more likely to live in ‘homeless households’, which can cause health
problems (see Lissauer et al)
Paragraph 3: Racism/Discrimination

Some ethnic minorities more likely than others to experience racial
harassment/discrimination; this can have a negative effect on health (e.g. cause stress,
depression, social isolation).
Conclusion: Based on what you’ve written, do you think ill health is related to ethnicity? You could
point out some problems with the data (e.g. statistics often treat Asian people as one group, despite
this referring to a wide range of ethnic groups).
***
13. Outline and evaluate sociological views on the role of medical
professionals in society [33]
Basically, exactly the same answer here as question 5 (above)!
***
14.
Outline and evaluate the view that disability is socially constructed [33]
Introduction: Briefly define ‘disability’ and explain what is meant by ‘social construction’ (3-4 lines
total).
Disability is socially constructed (2-3 paragraphs):
Discuss (with examples, explanations and evaluation where possible) some/all of the following:

This view is promoted by the social model of health





Suggests disability is not created by impairment, it is created by society
Mike Oliver claimed the inability of the social environment to cope with impairments makes
people disabled (he gave the example of public transport)
Davie argued that disability is created by both the way society’s institutions operate and by
the attitudes and beliefs held in society about disabled people, which causes stigma.
Social stigma can restrict opportunities for disabled people.
The biomedical model is dominant in British society and this considers disabled people to be
‘problems’ that need ‘fixing’, care or treatment. It does not consider the social barriers.
Evaluation/Other Views (1 paragraph)


The social model of disability has been increasingly accepted in the UK and the rights and
opportunities of disabled people are protected and enforced by legislation (e.g. the
Disability Discrimination Act, the Equality Act) – so some of the above is now outdated.
However, there are still some disabilities and impairments that will always mean that the
individuals who have them cannot fully participate in society, no matter what changes are
made to society (e.g. someone with a profound mental impairment may not be able to
participate in many social activities)
Conclusion: (1-2 lines) Based on what you’ve written above, is disability socially constructed or is it
entirely a physical ‘problem’ as the biomedical model might suggest.
***
15. Outline and evaluate the biomedical model for understanding health
and illness [33]
Introduction: Very briefly describe what the biomedical model is (e.g. it is the dominant way of
understanding health and illness in many Western societies, including the UK).
Paragraph 1 (could even be 2 paragraphs): The assumptions of the biomedical model
Briefly describe the assumptions of the biomedical model e.g.




Health is biomedical normality (being healthy is when everything in the body is functioning
normally)
The cause for illness/disease can always be identified and categorised…
…But identification and classification can only be done by trained professionals – NOT laypeople (non-professionals)
Once a disease/illness has been identified and classified, it can be treated and cured
Paragraph 2: Strengths of the biomedical model


It never assumes ‘nothing can be done’ – it encourages research into illness and, as a result
of this research, many successful treatments have been developed (give some examples)
It is based on scientific understanding
Paragraph 3: Weaknesses of the biomedical model
Supporters of the social model of health argued that the biomedical model:




Focuses too much on treatment rather than prevention
Ignores the social factors than can cause illness (e.g. diet, lifestyle, environment)…McKeown
argued that these factors have been much more influential in getting rid of infectious
diseases than medicine has
Gives too much power to medical professionals…
…Ivan Illich believes that, with this power, medical professionals can do more harm than
good (describe Iatrogenesis)
Conclusion: Based on what you’ve written, is the biomedical model the best way to understanding
and manage health and illness (you should probably conclude that it works best alongside the social
model)…