An Introduction To The Sociology Of Health And Illness

[Kum Verna]

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In the last decades we have seen a growing interest in research into children's own experiences and understandings of health and illness. This development, we would argue, is much stimulated by the sociology of childhood which has drawn our attention to how children as a social group are placed and perceived within the structure of society, and within inter-generational relations, as well as how children are social agents and co-constructors of their social world. Drawing on this tradition, we here address some cross-cutting themes that we think are important to further the study of child health: situating children within health policy, drawing attention to practices around children's health and well-being and a focus on children as health actors. The paper contributes to a critical analysis of child health policy and notions of child health and normality, pointing to theoretical and empirical research potential for the sociology of children's health and illness.

The sociology of health and illness, sociology of health and wellness, or health sociology examines the interaction between society and health. As a field of study it is interested in all aspects of life, including contemporary as well as historical influences, that impact and alter our health and wellbeing.[1][2]

It establishes that, from our births to our deaths, social processes interweave and influence our health and wellbeing. These influences could be where we were brought up, how illness is understood and framed by immediate community members, or the impact that technology has with our health. As such, it outlines that both our health and the medical science that engages it are social constructs; that our way of knowing illness, wellbeing, and our interactions with them are socially interpreted.[3][4]

Health sociology uses this insight to critique long established ideas around the human body as a mechanical entity alongside disrupting the idea that the mind and body can be treated as distinct spaces. This biomedical model is viewed as not holistically placing humans within the wider social, cultural, economic, political, and environmental contexts that play a large part in how health and wellbeing are deprived, maintained, or improved. Alternative models include the biopsychosocial model[5][6] that aims to incorporate these elements alongside the psychological aspect of the mind.

This field of research acts as a broad school overlapping with areas like the sociology of medicine, sociology of the body, sociology of disease[7] to wider sociologies like that of the family or education as they contribute insights from their distinct focuses on the life-course of our health and wellness.[8]

Humans have long sought advice from those with knowledge or skill in healing. Paleopathology and other historical records, allow an examination of how ancient societies dealt with illness and outbreak. Rulers in Ancient Egypt sponsored physicians that were specialists in specific diseases.[12] Imhotep was the first medical doctor known by name. An Egyptian who lived around 2650 B.C., he was an adviser to King Zoser at a time when Egyptians were making progress in medicine. Among his contributions to medicine was a textbook on the treatment of wounds, broken bones, and even tumors.[13]

Stopping the spread of infectious disease was of utmost importance for maintaining a healthy society.[12] The outbreak of disease during the Peloponnesian War was recorded by Thucydides who survived the epidemic. From his account it is shown how factors outside the disease itself can affect society. The Athenians were under siege and concentrated within the city. Major city centers were the hardest hit.[14] This made the outbreak even more deadly and with probable food shortages the fate of Athens was inevitable.[14] Approximately 25% of the population died of the disease.[14] Thucydides stated that the epidemic "carried away all alike". The disease attacked people of different ages, sexes and nationalities.[14]

Ancient medical systems stressed the importance of reducing illness through divination and ritual.[12] Other codes of behavior and dietary protocols were widespread in the ancient world.[12] During the Zhou Dynasty in China, doctors suggested exercise, meditation and temperance to preserve one's health.[12] The Chinese closely link health with spiritual well-being. Health regimes in ancient India focused on oral health as the best method for a healthy life.[12] The Talmudic code created rules for health which stressed ritual cleanliness, connected disease with certain animals and created diets.[12] Other examples include the Mosaic Code and Roman baths and aqueducts.[12]

Those that were most concerned with health, sanitation and illness in the ancient world were those in the elite class.[12] Good health was thought to reduce the risk of spiritual defilement and therefore enhanced the social status of the ruling class who saw themselves as the beacon of civilization.[12] During the late Roman Period, sanitation for the lower classes was a concern for the leisured class.[12] Those that had the means would donate to charities that focused on the health of non-elites.[12] After the decline of the Roman Empire, physicians and concern with public health disappeared except in the largest cities.[12] Health and public doctors remained in the Byzantine Empire.[12] Focusing on preventing the spread of diseases such as small pox lead to a smaller mortality rate in much of the western world.[12] Other factors that allowed the modern rise in population include: better nutrition and environmental reforms (such as getting clean water supplies).[12]

The present day sense of health being a public concern for the state began in the Middle Ages.[15] A few state interventions include maintaining clean towns, enforcing quarantines during epidemics and supervising sewer systems.[15] Private corporations also played a role in public health. The funding for research and the institutions for them to work were funded by governments and private firms.[15] Epidemics were the cause of most government interventions. The early goal of public health was reactionary whereas the modern goal is to prevent disease before it becomes a problem.[15] Despite the overall improvement of world health, there still has not been any decrease in the health gap between the affluent and the impoverished.[16] Today, society is more likely to blame health issues on the individual rather than society as a whole. This was the prevailing view in the late 20th century.[16] In the 1980s the Black Report, published in the United Kingdom, went against this view and argued that the true root of the problem was material deprivation.[16] This report proposed a comprehensive anti-poverty strategy to address these issues.[16] Since this did not parallel the views of the Conservative government, it did not go into action immediately.[16] The Conservative government was criticized by the Labour Party for not implementing the suggestions that the Black Report listed.[16] This criticism gave the Black Report the exposure it needed and its arguments were considered a valid explanation for health inequality.[16] There is also a debate over whether poverty causes ill-health or if ill-health causes poverty.[16] Arguments by the National Health Service gave considerable emphasis to poverty and lack of access to health care. It has also been found that heredity has more of a bearing on health than social environment, but research has also proved that there is indeed a positive correlation between socioeconomic inequalities and illness.[16]

The Sociology of Health and Illness focuses on three areas: the conceptualization, the study of measurement and social distribution, and the justification of patterns in health and illness. By looking at these things researchers can look at different diseases through a sociological lens. The prevalence and response to different diseases varies by culture.[17] By looking at bad health, researchers can see if health affects different social regulations or controls. When measuring the distribution of health and illness, it is useful to look at official statistics and community surveys. Official statistics make it possible to look at people who have been treated. It shows that they are both willing and able to use health services. It also sheds light on the infected person's view of their illness. On the other hand, community surveys look at people's rating of their health. Then looking at the relation of clinically defined illness and self reports and find that there is often a discrepancy.

A great deal of the time, mortality statistics take the place of the morbidity statistics because in many developed societies where people typically die from degenerative conditions, the age in which they die sheds more light on their life-time health. This produces many limitations when looking at the pattern of sickness, but sociologists try to look at various data to analyze the distribution better. Normally, developing societies have lower life expectancies in comparison to developed countries. They have also found correlations between mortality and sex and age. Very young and old people are more susceptible to sickness and death. On average women typically live longer than men, although women are more likely to have bad health.[17]

Disparities in health were also found between people in different social classes and ethnicities within the same society, even though in the medical profession they put more importance in "health related behaviors" such as alcohol consumption, smoking, diet, and exercise. There is a great deal of data supporting the conclusion that these behaviors affect health more significantly than other factors.[17] Sociologists think that it is more helpful to look at health and illness through a broad lens. Sociologists agree that alcohol consumption, smoking, diet, and exercise are important issues, but they also see the importance of analyzing the cultural factors that affect these patterns. Sociologists also look at the effects that the productive process has on health and illness. While also looking at things such as industrial pollution, environmental pollution, accidents at work, and stress-related diseases.[17]

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