Sociology 1: sociology of health and illness
Major political and social issue at the moment:
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Problems of staffing medical services
The 2 systems of health care: divide between public and private
Centralisation and rationalisation of facilities (eg Tullamore; Monaghan)
Use of human organs in research/foetal tissue &c
Issues related to lifestyle: smoking, drinking, vehicle accidents, suicide
Food safety issues: BSE/CJD, e coli. Obesity
Health issues on TV: ER, Peak Practice . . .
Again: CW Mills link b/w private troubles and public issues
Sociologists have long had an interest in health issues: eg Durkheim’s interest in Suicide
Aspects of medical sociology:
 Epidemiology – looks at the incidence and prevalence of disease (MGilmore)
 The sick role – from functionalist sociology (19c women)
 Doctor/patient relationship – from interactionist sociology
 Inequalities in health status – conflict/feminist perspectives
 Critique of the biomedical model – especially from feminist/postmodern perspectives
 Sociology of the body; sociology of food and eating, sport & leisure &c
Social research does have an impact on delivery of health services: eg research into
experience of pain  provision of drugs; images of the body  delivery of health promotion
strategies around obesity and diet
The critique of the biomedical model
Biomedical model of health: cause & effect & treatment
Scientific vs folk medicine
Power of discourse: exclusion of other discourses
Eg ‘witches’, wise women, herbalists, alternative medicine
Some may enter: eg chiropractic, acupuncture, homeopathy
Supported by health insurance and other institutional structures (eg education cf ITS and alt.
med)
ALL knowledge socially constructed (cf AIDS example in Macionis & Plummer p553)
Medical practices similarly socially constructyed: Viagra vs diarrhoea
Process of medicalisation: eg alcoholism; ADHD – others?
Biomedical model individualistic: eg women’s health policy focus on individual smoking
habits and diet: not on tobacco or food industries, or other issues like H&S at work or poverty
Also pointed out that biomedical model can lead to iatrogenesis: estimated that in US 80k
people are ‘killed by doctors’ every year: twice those killed in car accidents
Alternative: ‘holism’
Incorporates social, economic, environmental, spiritual apects of life
WHO definition of health:
Health is a state of complete physical, mental, and social well-being and not merely
the absence of disease or infirmity.
Idealistic? Problems?
To shift to holistic model: implications for health institutions, research, policies and practices
Question of surveillance (Foucault Birth of the Clinic): may be extended by an holistic
approach?
Inequalities in health care
Defining health? - very difficult
Eg what are obesity? Hyperactivity? Depression?
Even more ‘objective’ conditions are difficult to define – eg HIV
AIDS itself an excellent example of changing definitions
Measuring health then also very difficult
Concept of ‘health status’:
- Rates of morbidity and mortality
- Prevalence of good/bad health practices
- Rates of specific illnesses (eg TB)
- Prevalence of symptoms of well-being
Expert knowldege or self-reporting
‘objective’ indictors used internationally:
- death rates
- life expectancy
- availability of health services (how measured?) (hospital beds eg)
Ireland has little such objective data
[show stats: life expectancy; causes of death]
Next lecture (after placement) – inequalities in health care (essay topic) patterns of illness and
health within Ireland and other societies and how related to other social factors