INTRODUCTION TO
MEDICAL SOCIOLOGY
FOR BIOMEDICAL
STUDENTS
Kai-Lit Phua, PhD FLMI
Associate Professor
School of Medicine & Health Sciences
Monash University Malaysia Campus
Biographical details
Kai-Lit Phua received his BA (cum laude) in Public Health
& Population Studies from the University of Rochester
and his PhD in Sociology from Johns Hopkins University.
He also holds professional qualifications from the
insurance industry.
Prior to joining academia, he worked as a research
statistician for the Maryland Department of Health and
Mental Hygiene and for the Managed Care Department
of a leading insurance company in Singapore.
He was awarded an Asian Public Intellectual Senior
Fellowship by the Nippon Foundation in 2003.
Lecture notes:
http://phuakl.tripod.com/phuakl1.html
Click on Medical Sociology A or
Medical Sociology B
Learning Objectives

To gain an understanding of sociology as a social
science discipline

To appreciate the usefulness of sociology in
solving biomedical and public health problems

To be introduced to a number of major
sociological/epidemiological variables
What is “Sociology”?

Sociology is one of the social sciences

Sociologists study human societies, human
behaviour in groups, and how individual
behaviour is shaped by social institutions and
socio-economic forces

Examples of social institutions: family, school,
religion, legal system

Historically, sociology is associated with the
challenge of responding to social problems
arising from industrialisation and urbanisation in
W. Europe
What is “Medical Sociology”?
A better term for it is “Sociology of Health
and Illness”
 Using the sociological way of thinking to
study or solve biomedical/public health
problems

1. Sociology of medicine
2. Sociology in medicine
Sociology of Medicine

This approach focuses on theory and concepts

An example would be the famous book by Eliot
Freidson called “Professional Dominance” i.e. a
study of why and how doctors are dominant in
the health professions and health institutions

Another example would be Paul Starr’s book
called “The Social Transformation of American
Medicine” which predicted erosion of this
dominance with the rise of corporate medicine
Sociology in Medicine

This approach focuses on applications and
solving problems using sociological
knowledge

An example would be David Mechanic’s
studies of “illness behaviour”

Another example would be studies of
“adherence” (“compliance”)
Major Sociological Concepts
Useful to Biomedical Students
Ethnicity (“race”)
Class (social class)
Gender (“sex”)
Age
Region (geographical location)
Education (educational attainment)
Marital status
Religion
Other e.g. sexuality/sexual orientation
Ethnicity (“race”) & Health

How does membership in a particular ethnic
group affect one’s health? Example: health of
indigenous peoples and ethnic minorities

Measuring health at the population level:
Morbidity (sickness) rates
Disability rates
Mortality (deaths) rates
Life expectancy
Culture, health and disease e.g. nutrition
patterns, other health-related behaviour
 Culture-bound illnesses

Class (social class) & Health

Social class differences in health (the “social
class gradient in health”) :
People in the lower classes tend to have poorer
health than people in the upper classes
Marmot’s “Whitehall studies” of British civil
servants document the existence of a health
gradient by civil service rank
Note: Sometimes, “SES” (Socio Economic Status)
is used instead of “Class”
Gender (“sex”) & Health
Gender versus biological sex
 Gender, socialisation and health







Cervical cancer – related to biological sex
Lung cancer
Substance abuse (tobacco, alcohol, illegal drugs)
Sexually-transmitted infections (STIs) e.g.
HIV/AIDS
Injuries from risk-taking behaviour
Body image and eating disorders
Age & Health

The life cycle and health:
Before birth (fetus)
Infant
Child
Teenager
Young adulthood
Middle adulthood
Old age
Region & Health

Geographical location and health:
Rural versus Urban
Urban slums versus Desirable urban areas
Poor country versus rich country
Physical characteristics/weather of region
Education & Health

Educational level and health:

Less educated people tend to have poorer
health than better educated people

Female education is associated with lower
infant mortality rate
Marital Status & Health

Marital status and health:
Marriage is good for mental health (for
most people)
 People living alone (single people, the
widowed, elderly living by themselves)
tend to have poorer health

Religion & Health

Religious values and health:
Religious beliefs can affect health-related
behaviour e.g. diet, smoking, drinking,
sexuality, seeing the doctor (including the
psychiatrist) and seeking medical care e.g.
Jehovah’s Witness and blood transfusion
Other concepts
(more advanced)

Medicalisation:
What used to be a social problem gets redefined
as a “medical problem” to be treated by doctors
and other health professionals e.g. alcoholism,
domestic violence, compulsive gambling

Demedicalisation:
An example would be homosexuality no longer
being classified as a mental disorder by the
American Psychiatric Association in the 1970s
THE END
THANK YOU