SOC 6022 - Sociology of Health and Illness
[DRAFT SYLLABUS – updated NOV. 2015]
Winter 2016
Tuesday, 12:10-2:00, RM 40
Instructor: Markus Schafer
Phone: 416.946.5900
Email: markus.schafer@utoronto.ca
Office: 725 Spadina, rm. 374
Description:
Sociology of Health and Illness is an overview of research in medical sociology. We will cover
the conceptualization and measurement of health, the social distribution of health, sociological
approaches to understanding health-related processes and outcomes, organizational dynamics
of health care and medical treatment, and issues related to health care reform in cross-national
perspective. The course surveys a wide range of topics and includes both classic research and
exemplary recent scholarship. Learning will be facilitated by class discussion and the process of
original research culminating in a presentation and a paper.
Modes of evaluation and distribution of marks:






Class participation (10%)
Presentation and discussion leadership (15%)
Reflection memos (15%)
Final paper (40%)
Peer-review exercise for final paper (10%)
Presentation of work in progress (10%)
Weekly class participation:
Students are expected to complete each week’s reading and to actively contribute to class
discussion. An overall assessment (10% of course total) will reflect weekly participation.
Presentations and discussion leadership:
Each week, a different group (most likely 2-3 students) will make a presentation and lead the
discussion. With 10 weeks of reading, each student can expect to be a discussion co-leader
several times during the semester. The presentations should include a synthesis and summary of
the week’s reading: (1) what are the key research question(s) or issues that arise in the
readings?; (2) what are the core conceptual or theoretical perspective(s)?; (3) what are the
methodologies used?; (4) what are the key findings and/or arguments of the readings?; and (5)
what are some critical insights or reflections that would be useful for class discussion and
debate? These presentations will set the tone for our class discussion and should use
1
presentation software to help everyone follow along. Evaluations will be based on how well you
cover the five points above, your effectiveness at presenting the content, and your capacity to
lead the class in discussion.
Presentation reflection memos
For weeks in which you are a discussion leader, you write a brief memo that summarizes the key
ideas in your presentation, but also reflects on how your understanding of the content was
expanded and refined through the class discussion. For example, you may describe how the
comments of your colleagues helped clarify or challenge your initial insights. Memos should be
handed in the following week of class and should be no more than 2 double-spaced pages.
Final paper
By semester’s end, students will complete a paper related to the sociology of health and illness.
This paper can take several forms: (a) an original empirical analysis using qualitative or
quantitative data; (b) a proposal for a research study which outlines a specific research question
as informed by relevant literature, describes, in detail, the data needed to conduct such a study,
and anticipates the expected outcomes and likely complexities of carrying out the research; or
(c) a theoretical article which attempts to re-conceptualize some aspect of our current
understanding or forge new directions for research in the sociology of health and illness. More
details on final paper will be forthcoming. Whatever option students select, the final paper
should be between 6,500 and 10,000 words and must follow ASA formatting.
The paper will be completed in two stages. First, students will submit a draft of their paper on
March 29. This draft may be rough, but it must represent the core argument well enough to be
read and critiqued by classmates. Your colleagues will serve as “peer reviewers”, treating your
paper as though it was a standard journal article submission and offering feedback akin to a
journal referee (more details on this peer review process to come). Second, students will hand in
a final paper which involves a response to peer review comments. Specifically, you will submit
with your final paper a memo that articulates the major points of concern raised by reviewers,
including a description of how you responded to their comments and/or a rebuttal to their
critiques. The final paper is due by 5:00 pm on April 15.
Peer review exercise
In this course, you will serve as peer reviewer of your colleagues’ work. Specifically, you will
receive a rough draft copy of another student’s paper (see above), randomly selected from the
submissions due on March 29. You will have one week to conduct a formal peer review
evaluation of the paper, following the instructions of leading journals in the field (e.g., Journal
of Health and Social Behavior; Social Science & Medicine). The peer review is due the final
week of class (April 5), and more details will be forthcoming. The goal of this exercise is twofold.
First, giving and receiving feedback will help everyone’s work improve and should result in
better final papers. Second, we will seek to simulate the journal submission/peer review process
as a mode of professional socialization. To that end, we will spend some time throughout the
semester talking about the peer review process and discussing best practices for this aspect of
the academic life.
2
Presentation of work in progress
On March 15, you will present your work in progress related to the final paper assignment.
Presentations should be 6 minutes in length and allow 5-10 minutes for question and answer
time. More details on presentations will follow.
COURSE SCHEDULE
DATE
TOPIC
[WEEK 1] January 12
Introduction and Salutations
Optional Readings:



I.
Hankin, Janet R. and Eric Wright. 2010. “Reflections on Fifty Years of Medical Sociology.”
Journal of Health and Social Behavior 51:10-15.
Pescosolido, Bernice A. 2011. “Taking ‘The Promise’ Seriously: Medical Sociology’s Role in
Health, Illness, and Healing in a Time of Social Change.” Pp. 3-20 in Handbook of the
Sociology of Health, Illness, and Healing: Blueprint for the 21st Century, edited by B.A.
Pescosolido, J.K. Martin, J.D. McLeod, and A. Rogers. New York: Springer.
Timmermans, Stefan and Steven Haas. 2008. “Towards a Sociology of Disease.” Sociology
of Health & Illness 30:659-676.
Social Context and the Distribution of Health Outcomes and Risks
[WEEK 2] January 19
The persistence of socioeconomic health disparities
Required Readings:




Link, Bruce G., and Jo Phelan. 1995. “Social Conditions as Fundamental Causes of
Disease.” Journal of Health and Social Behavior 35:80–94.
Phelan, J. C., Link, B. G., Diez-Roux, A., Kawachi, I., & Levin, B. 2004. “‘Fundamental
Causes of Social Inequalities in Mortality: A Test of the Theory.” Journal of Health and
Social Behavior 45:265-285.
Lutfey, Karen and Jeremy Freese. 2005. “Toward Some Fundamentals of Fundamental
Causality: Socioeconomic Status and Health in the Routine Clinic Visit.” American Journal
of Sociology 110:1326-1372.
Freese, Jeremy and Karen Lutfey. 2010 “Fundamental Causality: Challenges of an
Animating Concept for Medical Sociology.” Pp. 67-81 in Handbook of the Sociology of
3
Health, Illness, and Healing: Blueprint for the 21st Century, edited by B. Pescosolido, J.
Martin, J. McLeod, and A. Rogers. New York: Springer.
Mackenbach, Johan P. 2012. “The Persistence of Health Inequalities in Modern Welfare
States: The Explanation of a Paradox.” Social Science & Medicine 75:761-769.

[WEEK 3] January 26
Gender health inequalities
Required Readings:

Bird, Chloe E., and Patricia P. Rieker. 1999. “Gender Matters: An Integrated Model for
Understanding Men’s and Women’s Health.” Social Science & Medicine 48:745–755.
Williams, Kristi and Debra Umberson. 2004. “Marital Status, Marital Transitions, and
Health: A Gendered Life Course Perspective.” Journal of Health and Social Behavior
45(1):81-98.
Schnittker, Jason. 2007. “Working More and Feeling Better: Women's Health,
Employment, and Family Life, 1974-2004.” American Sociological Review 72:221-238.
Courtenay, Will H. 2000. “Constructions of Masculinity and their Influence on Men’s WellBeing: A Theory of Gender and Health.” Social Science & Medicine 50:1385-1401.



[WEEK 4] February 2
Life course dynamics of health inequality
Required Readings:




Willson, Andrea E., Kim M. Shuey, and Glen H. Elder. 2007. “Cumulative Advantage
Processes as Mechanisms of Inequality in Life Course Health.” American Journal of
Sociology 112:1886–1924.
Wheaton, Blair and Philippa Clarke. 2003. “Space Meets Time: Integrating Temporal
and Contextual Influences on Mental Health in Early Adulthood.” American Sociological
Review 68:680-706.
Pudrovska, Tetyana, Deborah Carr, Michael McFarland, and Caitlyn Collins. 2013.
“Higher-Status Occupations and Breast Cancer: A Life-Course Stress Approach.” Social
Science & Medicine 89:53-61.
Haas, Steven A. 2006. “Health Selection and the Process of Social Stratification: The
Effect of Childhood Health on Socioeconomic Attainment.” Journal of Health and Social
Behavior 47:339–354.
[WEEK 5] February 9
Social relationships and health
Required Readings:

Berkman, Lisa F., Thomas Glass, Ian Brissette, and Teresa E. Seeman. 2000. “From
Social Integration to Health: Durkheim in the New Millennium.” Social Science &
4



Medicine 51:843-857.
Elwert, Felix and Nicholas A. Christakis. 2006. “Widowhood and Race.” American
Sociological Review 71:16-41.
Kreager, Derek A., and Dana L. Haynie. 2011. “Dangerous Liaisons? Dating and Drinking
Diffusion in Adolescent Peer Networks.” American Sociological Review 76:737–763.
Christakis, Nicholas A, and James H Fowler. 2007. “The Spread of Obesity in a Large
Social Network over 32 Years.” The New England Journal of Medicine 357:370–379.
READING WEEK; NO CLASS FEBRUARY 16
[WEEK 6] February 23
Health lifestyles and cultural perspectives on health
inequality
Required Readings:




II.
Cockerham, William C., Thomas Abel, and Günther Lüschen. 1993. “Max Weber,
Formal Rationality, and Health Lifestyles.” Sociological Quarterly 34:413–425.
Cockerham, William C., M. Christine Snead, and Derek F. DeWaal. 2002. “Health
Lifestyles in Russia and the Socialist Heritage.” Journal of Health and Social Behavior
43:42–55.
Pampel, Fred C. 2011. “Does Reading Keep You Thin? Leisure Activities, Cultural Tastes,
and Body Weight in Comparative Perspective.” Sociology of Health & Illness 34:396–
411.
Katainen, Anu. 2010. “Social Class Differences in the Accounts of Smoking – Striving for
Distinction?” Sociology of Health & Illness 32:1087–1101.
Stigma
[WEEK 7] March 1
Stigma and labelling theories
Required Readings:


Link, Bruce G., Francis T. Cullen, Elmer Struening, Patrick E. Shrout, and Bruce P.
Dohrenwend. 1989. “A Modified Labeling Theory Approach to Mental Disorders: An
Empirical Assessment.” American Sociological Review 54:400–423.
Fife, Betsy L. and Eric R Wright. 2000. “The Dimensionality of Stigma: A Comparison of
Its Impact on the Self of Persons with HIV/AIDS and Cancer.” Journal of Health and
Social Behavior 41:50-67.
5


III.
DeJong, Willaim. 1980. “The Stigma of Obesity: The Consequences of Naive
Assumptions Concerning the Causes of Physical Deviance.” Journal of Health and Social
Behavior 21:75–87.
Yang, Lawrence Hsin, Arthur Kleinman, Bruce G. Link, Jo C. Phelan, Sing Lee, and
Byron Good. 2007. “Culture and Stigma: Adding Moral Experience to Stigma Theory.”
Social Science & Medicine 64:1524–1535.
Medicalization
[WEEK 8] March 8
Conceptualizing medicalization; two illustrative cases:
obesity and mental illness
Required Readings:




Ballard, Karen, and Mary Ann Elston. 2005. “Medicalisation: A Multi-dimensional
Concept.” Social Theory & Health 3:228–241.
Conrad, Peter. 2005. “The Shifting Engines of Medicalization.” Journal of Health and
Social Behavior 46:3–14.
Monaghan, Lee F. 2005. “A Critical Take on the Obesity Debate.” Social Theory & Health
3, no. 4: 302–314.
Horwitz, Allan V. 2002. Creating Mental Illness. Chicago: University of Chicago Press.
(Selected Chapters: Introduction, 1-4, Conclusion)
[WEEK 9] March 15
IV.
PRESENTATIONS—WORKS IN PROGRESS
Social Factors and the Practice of Medicine
[WEEK 10] March 22
Diagnosis; the clinical encounter
Required Readings:



Jutel, Annemarie. “Sociology of Diagnosis: a Preliminary Review.” Sociology of Health &
Illness 31, no. 2 (2009): 278–299.
Liu, Ka-Yuet, Marissa King, and Peter S. Bearman. “Social Influence and the Autism
Epidemic.” American Journal of Sociology 115, no. 5 (March 2010): 1387–1434.
Werner, Anne, and Kirsti Malterud. 2003. “It Is Hard Work Behaving as a Credible
Patient: Encounters Between Women with Chronic Pain and Their Doctors.” Social
Science & Medicine 57:1409–1419.
6

Mik-Meyer, Nanna and Anne R. Obling. 2012. “The Negotiation of the Sick Role: General
Practitioners’ Classification of Patients with Medically Unexplained Symptoms.”
Sociology of Health & Illness 34:1025-1038.
[WEEK 11] March 29
Organizational perspectives on medicine and healing
Required Reading:

Chambliss, Daniel F. 1996. Beyond Caring: Hospitals, Nurses, and the Social
Organization of Ethics. Chicago: University of Chicago Press.
DRAFT OF RESEARCH PAPER DUE
[WEEK 12] April 5
Comparative health policy and reform
Required Readings:
(all from special issue of Current Sociology, July 2012)








Kuhlmann, Ellen, and Ellen Annandale. 2012. “Researching Transformations in
Healthcare Services and Policy in International Perspective: An Introduction.” Current
Sociology 60:401–414.
Lin, Vivian. 2012. “Transformations in the Healthcare System in China.” Current
Sociology 60:427–440.
McDonald, Ruth. 2012. “Restratification Revisited: The Changing Landscape of Primary
Medical Care in England and California.” Current Sociology 60:441–455.
Agartan, Tuba I. 2012. “Marketization and Universalism: Crafting the Right Balance in
the Turkish Healthcare System.” Current Sociology 60:456–471.
Pavolini, Emmanuele, and Giovanna Vicarelli. 2012. “Is Decentralization Good for Your
Health? Transformations in the Italian NHS.” Current Sociology 60:472–488.
Reibling, Nadine, and Claus Wendt. 2012. “Gatekeeping and Provider Choice in OECD
Healthcare Systems.” Current Sociology 60:489–505.
Kuhlmann, Ellen, and Ellen Annandale. 2012. “Mainstreaming Gender into Healthcare:
A Scoping Exercise into Policy Transfer in England and Germany.” Current Sociology
60:551–568.
Burau, Viola. 2012. “Transforming Health Policy and Services: Challenges for
Comparative Research.” Current Sociology 60:569–578.
Optional readings:
Muntaner, Carles, Carme Borrell, Edwin Ng, Haejoo Chung, Albert Espelt, Maica RodriguezSanz, Joan Benach, and Patricia O’Campo. 2011. “Politics, Welfare Regimes, and
7
Population Health: Controversies and Evidence.” Sociology of Health & Illness 33:946–
964.
PEER REVIEW EXERCISE DUE
8