what does it mean to say that illness is a social construction and a moral status

What you lot'll larn to do: describe the social construction of health and the theoretical perspectives on health and medicine

Medical sociology is the systematic study of how humans manage bug of wellness and affliction, disease and disorders, and healthcare for both the sick and the healthy. In this section, yous'll larn virtually the importance of medical practices and how the social construction of wellness explains how society both shapes medical ideas and is shaped by them.

Learning outcomes

• Explain the cultural significance and social construction of health
• Apply functionalist, disharmonize theorist, and symbolic interactionist perspectives to wellness bug

The Cultural Significance of Wellness

If sociology is the systematic written report of human behavior in society, medical sociology is the systematic study of how humans manage issues of health and disease, disease and disorders, and healthcare for both the sick and the healthy. Medical sociologists report the physical, mental, and social components of health and illness. Major topics for medical sociologists include the doc/patient relationship and power dynamics inside the human relationship, the construction and socioeconomics of healthcare, unequal access to healthcare (what is oftentimes referred to as health inequality), and how culture impacts attitudes toward specific diseases, conditions, and health.

The social construction of wellness is a major research topic within medical sociology. At first glance, the concept of a social construction of health does non seem to make sense. After all, if disease is a measurable, physiological problem, and so there can be no question of socially constructing disease, right? Well, it's not that elementary. The idea of the social construction of health emphasizes the socio-cultural aspects of the discipline'due south approach to physical, objectively definable phenomena. Sociologists Peter Conrad and Kristin Barker (2010) offer a comprehensive framework for understanding the major findings of the last 50 years of development in this concept. Their summary categorizes the findings in the field nether 3 subheadings: the cultural meaning of affliction, the social construction of the disease experience, and the social construction of medical cognition.

The Cultural Significant of Illness

Many medical sociologists contend that illnesses have both a biological and an experiential component, and that these components be independently of and external to each other. Our culture, not our biological science, dictates which illnesses are stigmatized and which are not, which are considered disabilities and which are not, and which are deemed contestable (pregnant some medical professionals may notice the existence of this ailment questionable) as opposed to definitive (illnesses that are unquestionably recognized in the medical profession) in the medical field (Conrad and Barker 2010).

For instance, sociologist Erving Goffman (1963) described how social stigmas hinder individuals from fully integrating into society. In essence, Goffman (1963) suggests nosotros might view illness as a stigma that tin can push button others to view the ill individual in an undesirable way. The stigmatization of illness often has the greatest issue on the patient and the kind of care they receive. Many contend that our order and even our healthcare institutions discriminate against certain diseases—similar mental disorders, AIDS, venereal diseases, and peel disorders (Sartorius 2007). Facilities for these diseases may exist sub-par relative to facilities aimed at addressing and alleviating other weather; they may be segregated from other healthcare areas or relegated to a poorer environment. The stigma attached to a specific status may keep people from seeking assist for such conditions, consequently existence detrimental to the private's and society'due south well-being.

Contested illnesses are those that are questioned or questionable by a fraction of medical professionals. Disorders similar fibromyalgia or chronic fatigue syndrome may be either true, objective, and tangible illnesses or, every bit argued by some medical professionals, may be only in patients' heads. This dynamic tin affect how a patient seeks handling and what kind of treatment they receive.

Effort Information technology

The Sick Part

Sick role is a term used in medical sociology regarding sickness and the rights and obligations of the affected. Information technology is a concept created by the American sociologist Talcott Parsons in 1951. Parsons argued that the best fashion to sympathize illness sociologically is to view it as a form of deviance that disturbs the social performance of society. The full general idea is that the individual who has fallen ill is not but physically sick, but now adheres to the specifically patterned social role of existence sick. "Being Sick" is not merely a "condition"; it contains inside itself customary rights and obligations based on the social norms that environs it, and therefore plays a part in everyday, normative interactions.

Parsons' theory outlined 2 rights of a sick person along with 2 obligations. The ill person's rights are: beingness exempt from normal social roles, and not being responsible for their status. Conversely, the sick person's obligations include trying to get well and cooperating with medical professionals.

The Social Construction of the Affliction Experience

The idea of the social construction of the illness experience is based on the concept of reality every bit a social construction. In other words, there is no objective reality; in that location are only individual perceptions of information technology, which are always relative and involve a process of construction. The social construction of the illness experience addresses the mode some patients command the fashion in which they reveal their diseases, and the lifestyle adaptations patients develop to cope with their illnesses.

Figure ane.The Mosby pain rating calibration helps health care providers appraise an individual's level of pain. What might a symbolic interactionist observe almost this method? (Photograph courtesy of wrestlingentropy/flickr)

In terms of constructing the illness experience, culture and individual personality both play a pregnant role. For some people, a long-term illness can have the upshot of making their world smaller, leading to a life that is more defined by the disease than past annihilation else. Their disease becomes their mark, or their focal condition. For others, illness can be a risk for discovery, for re-imagining a new self (Conrad and Barker 2007). Culture plays a substantial role in how an private experiences illness. Widespread diseases similar AIDS or breast cancer take specific cultural markers that have changed over the years and that govern how individuals—and society—view both the condition and the private directly afflicted past the condition.

Today, many institutions of wellness acknowledge the degree to which individual perceptions shape the nature of health and illness. Regarding concrete activity, for instance, the Centers for Disease Control (CDC) recommends that individuals utilize a standard level of exertion to assess their physical activeness. This Rating of Perceived Exertion (RPE) gives a more than complete view of an individual'southward actual exertion level, since heart rate or pulse measurements may be affected by medication or other factors(Centers for Illness Control 2011). Similarly, many medical professionals utilise a comparable, somewhat universal scale for perceived hurting to help determine pain management strategies.

Sentinel It

Watch this video to learn more about the ill part and ways that gild influences health. Look for examples of how wellness, illness, and illness are socially synthetic.

The Social Construction of Medical Noesis

Conrad and Barker show how medical knowledge is socially constructed; that is, information technology can both reverberate and reproduce inequalities in gender, class, race, and ethnicity. Conrad and Barker (2011) utilize the example of the social structure of women'due south health and how medical cognition has changed significantly in the class of a few generations. For instance, in the early nineteenth century, pregnant women were discouraged from driving or dancing for fearfulness of harming the unborn kid, much as they are discouraged, with more than valid and show-based reason, from smoking or drinking alcohol today.

Has Breast Cancer Awareness Gone As well Far?

Figure 2.Pinkish ribbons are a ubiquitous reminder of breast cancer. But do pink ribbon chocolates do anything to eradicate the disease? (Photo courtesy of wishuponacupcake/Wikimedia Eatables)

Every October, the world turns pink. Football and baseball players vesture pinkish accessories. Skyscrapers and big public buildings are lit with pinkish lights at nighttime. Shoppers can cull from a huge array of pink products. In 2014, people wanting to support the fight against breast cancer could buy whatever of the following pinkish products: KitchenAid mixers, Primary Lock padlocks and wheel chains, Wilson tennis rackets, Fiat cars, and Smith & Wesson handguns. You read that correctly. The goal of all these pink products is to raise awareness and coin for breast cancer. All the same, the relentless creep of pink has many people wondering if the pink marketing juggernaut has gone likewise far.

Pink has been associated with breast cancer since 1991, when the Susan 1000. Komen Foundation handed out pink ribbons at its 1991 Race for the Cure event. Since then, the pink ribbon has appeared on countless products, and then by extension, the color pink has come to represent support for a cure of the disease. No one tin can contend about the Susan G. Komen Foundation's mission—to find a cure for breast cancer—or the fact that the group has raised millions of dollars for inquiry and care. Nonetheless, some people question if, or how much, all these products really assistance in the fight against breast cancer (Begos 2011).

The advocacy group Breast Cancer Action (BCA) position themselves every bit watchdogs of other agencies fighting breast cancer. They have no funding from entities, like those in the pharmaceutical industry, with potential turn a profit connections to this health industry. They've adult a trademarked "Think Before Yous Pink" campaign to provoke consumer questioning of the end contributions fabricated to breast cancer by companies hawking pink wares. They do not advise against "pink" purchases; they just want consumers to be informed about how much money is involved, where it comes from, and where it will become. For instance, what percentage of each purchase goes to breast cancer causes? BCA does not gauge how much is enough, only information technology informs customers and so encourages them to consider whether they experience the corporeality is enough (Think Before You Pink 2012).

BCA besides suggests that consumers brand sure that the production they are buying does not actually contribute to breast cancer, a phenomenon they call "pinkwashing." This issue fabricated national headlines in 2010, when the Susan G. Komen Foundation partnered with Kentucky Fried Craven (KFC) on a promotion called "Buckets for the Cure." For every bucket of grilled or regular fried chicken, KFC would donate fifty cents to the Komen Foundation, with the goal of reaching eight million dollars: the largest unmarried donation received by the foundation. Nevertheless, some critics saw the partnership every bit an unholy alliance. College body fat and eating fatty foods has been linked to increased cancer risks, and detractors, including BCA, chosen the Komen Foundation out on this apparent contradiction. Komen's response was that the programme did a great bargain to raise sensation in low-income communities, where Komen previously had piffling outreach (Hutchison 2010), therefore justifying their seemingly contradictory goals.

What do you think? Are fundraising and sensation important plenty to trump problems of wellness? What other examples of "pinkwashing" can you call back of?

Further Research

Visit the Humanology Project website, which works to shift common perceptions and misconceptions almost illnesses.

Think It Over

• Selection a mutual affliction and describe which parts of it are medically synthetic, and which parts are socially constructed.
• What diseases are the most stigmatized? Which are the least? Is this unlike in dissimilar cultures or social classes?

Theoretical Perspectives on Wellness and Medicine

Each of the 3 major sociological theoretical perspectives arroyo the topics of health, illness, and medicine differently. You lot may prefer merely ane of the theories that follow, or you may find that combining theories and perspectives provides a fuller and more than accurate picture of how nosotros experience and understand wellness and wellness.

Functionalism

According to the functionalist perspective, health is vital to the stability of the society, and therefore sickness is a sanctioned form of deviance. Talcott Parsons (1951) was the first to discuss this in terms of the sick role : patterns of expectations that define appropriate behavior for the sick and for those who accept care of them.

According to Parsons, the sick person has a specific function with both rights and responsibilities. To start with, they have non called to be sick and should not be treated equally responsible for their condition. The sick person also has the correct of being exempt from normal social roles; they are non required to fulfill the obligation of a well person and tin avert normal responsibilities without censure. However, this exemption is temporary and relative to the severity of the illness. The exemption besides requires legitimization by a physician; that is, a physician must certify that the disease is genuine.

The responsibility of the sick person is twofold: to attempt to get well and to seek technically competent aid from a physician. If the sick person stays ill longer than is appropriate (malingers), they may be stigmatized.

Parsons argues that since the ill are unable to fulfill their normal societal roles, their sickness weakens the gild. Therefore, it is sometimes necessary for various forms of social control to bring the behavior of a sick person dorsum in line with normal expectations. In this model, doctors serve as gatekeepers, deciding who is healthy and who is ill—a relationship in which the md has all the ability. Moreover, medical providers function as dispensers of resources for the healing of the sick. But is it appropriate to let doctors so broad discretion in deciding who is and is non sick? And what near people who are ill, but are unwilling to leave their positions for any number of reasons? (e.g., personal/social obligations, financial need, or lack of insurance)

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Disharmonize Perspective

Theorists using the disharmonize perspective advise that issues with the healthcare system, as with most other social problems, are rooted in backer social club. According to conflict theorists, capitalism and the pursuit of turn a profit lead to the commodification of health: the changing of something non more often than not idea of every bit an abstract object into something that can be bought and sold in a marketplace in order to create profit for someone somewhere. In this view, people with money and ability—the dominant grouping—are the ones who make decisions about how the healthcare system will be run. They therefore control the degree to which the individuals and groups without political and economic ability will remain subordinate. This creates strife within the larger healthcare system and also results in personal health disparities between the dominant and subordinate groups. The inequality that is seen in other spheres and institutions is pervasive in healthcare access, farther accumulating disadvantage to already subordinate groups.

Alongside the health disparities created by class inequalities, in that location are a number of health inequalities created by racism, sexism, ageism, and LGBTQ+ discrimination. When health is a article, the poor are more likely to experience affliction caused past inadequate diet, to live and piece of work in unhealthy environments, and are less likely to claiming the system or its authorization. In the United States, a disproportionate number of racial minorities also have less economic power, and so they comport a great deal of the burden of poor health. Information technology is not but the poor who endure from the conflict between dominant and subordinate groups. For many years, and only until very recently, homosexual couples had been denied spousal benefits, either in the form of health insurance or in terms of medical responsibility. Further calculation to the upshot, doctors hold a asymmetric amount of power in the doctor/patient relationship, which provides them with extensive social and economical benefits.

Discrimination is often the result of stigma towards specific groups or medical conditions. This stigma is rooted in the perception of an undesirable condition or attribute. Accept HIV/AIDS, for example. Because of their illness, individuals with HIV/AIDS have lost jobs, been denied educational opportunities, been kicked out of their homes, or have been mistreated (or non treated at all) by the healthcare system.^[i] Most importantly, because of the stigma attached to the affliction, individuals take foregone medical assistance and have passed abroad as a consequence. Legal protections take been put in place, notwithstanding the stigma and bigotry remain prevalent. Until nosotros de-stigmatize the condition itself, and despite the implementation of policy, individual acts of discrimination will likely keep. HIV continues to exist an epidemic in parts of Africa, non necessarily because of stigma, but considering of the lack of available treatment resources.

scout it

This first video clip gives some examples of means that those with HIV are discriminated confronting, fifty-fifty inside the medical community. The 2nd clip shares the story of Joe and his experiences dealing with the stigma of being HIV positive.

While conflict theorists are right to bespeak out certain inequalities in the healthcare organisation, and their critiques have propelled equity-driven policy, they practice not give enough credit to medical advances that would not take been made without an economic structure to support and reward researchers, a structure that has typically been dependent on profitability. While this market solutions model has indeed provided many advances, a conflict theorist would likely reply that greater country-sponsored investment–with better public health outcomes as the goal–could also effect the same evolutions in treatment. Likewise at consequence for conflict theorists and their critics is the degree to which the hard-won medical expertise possessed by doctors and not patients might render a truly mutual understanding elusive.

Symbolic Interactionism

According to theorists working in this perspective, wellness and disease are both socially synthetic. Every bit we discussed in the commencement of the module, interactionists focus on the specific meanings and causes people aspect to illness. The term medicalization of deviance refers to the process that changes "bad" behavior into "sick" behavior. A related procedure is demedicalization , in which "sick" behavior is normalized again. Medicalization and demedicalization impact who responds to the patient, how people respond to the patient, and how people view the personal responsibility of the patient (Conrad and Schneider 1992). Under this perspective, every bit our perception of a condition changes, and then practice the social consequences of that condition.

Figure 3.In this engraving from the nineteenth century, "King Alcohol" is shown with a skeleton on a barrel of alcohol. The words "poverty," "misery," "crime," and "decease" hang in the air behind him. (Photo courtesy of the Library of Congress/Wikimedia Commons)

An case of medicalization is illustrated past the history of how our society views booze and alcoholism. During the nineteenth century, those who drank besides much were considered bad, lazy people. They were called drunks, and it was not uncommon for them to exist arrested or run out of a boondocks. Drunks were not treated in a sympathetic way because, at that fourth dimension, information technology was thought that it was their own fault that they could not finish drinking. During the latter half of the twentieth century, however, people who drank likewise much were increasingly defined as alcoholics: people with a illness or a genetic predisposition to addiction who were not responsible for their drinking. With alcoholism divers as a disease and not a personal choice, alcoholics came to be viewed with more compassion and understanding. Thus, "badness" was transformed into "sickness."

At that place are numerous examples of demedicalization in history as well. During the Civil State of war era, slaves who frequently ran away from their owners were diagnosed with a mental disorder called drapetomania. This has since been reinterpreted, unsurprisingly, as a completely advisable response to existence enslaved. A more recent instance is homosexuality, which was labeled a mental disorder or a sexual orientation disturbance by the American Psychological Clan until 1973.

While interactionism does acknowledge the subjective nature of diagnosis, it is important to remember who most benefits when a behavior becomes defined as illness or status. Pharmaceutical companies make billions treating illnesses such as fatigue, insomnia, and hyperactivity that may non really be illnesses in demand of treatment.

Watch It

Lookout this video to review and come across examples of how each of these key paradigms views medicine.

Remember Information technology Over

• Which theoretical perspective do you call up best explains the folklore of health? Why?
• What examples of medicalization and demedicalization can you think of?

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glossary

commodification:

the changing of something non generally idea of as a commodity into something that tin can be bought and sold in a market

contested illnesses:

illnesses that are questioned or considered questionable by some medical professionals

demedicalization:

the social process that normalizes "sick" behavior

legitimation:

the act of a physician certifying that an affliction is genuine

medicalization of deviance:

the process that changes "bad" behavior into "sick" beliefs

medical sociology:

the systematic study of how humans manage issues of health and illness, illness and disorders, and healthcare for both the sick and the good for you

sick role:

the pattern of expectations that ascertain appropriate behavior for the ill and for those who take intendance of them

stigmatization of illness:

illnesses that are discriminated against and whose sufferers are looked down upon or even shunned past society

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Source: https://courses.lumenlearning.com/wmopen-introtosociology/chapter/the-social-construction-of-health/

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