HEALTH (ILLNESS AND MEDICINE) AND SOCIETY

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HEALTH (ILLNESS AND MEDICINE)AND SOCIETY
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Medicine as a Cultural System

• all human groups develop some set of beliefs,
  patterns of thought, perceptions consistent with
  their cultural systems for defining
  conceptualizing disease
• all societies have medical practices and beliefs
  based on theories of diseases disease causation
  with an internal logic of their own, and should
  not be dismissed as bizarre, esoteric, illogical,
  irrational bits and pieces of belief practice
  in exotic cultures

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Medicine as a Social System

• all human groups develop methods allocate roles
  congruent with their resources structures for
  coping with or responding to disease
• norms governing choices and evaluations of
  treatment - the types of treatment they believe
  in, and to whom they turn if they do become ill
• social statuses, roles, power relationships
• patients healers - basic components of health
  care system
• embedded in specific configurations of cultural
  meaning and other social relationships
• interaction settings - clinic, hospital, with
  healer, family, society-at-large
• institutions related to health and healing

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Sociology of health medicine

• Focus on medicine
• Social aspects of medicine, health, disease
• Social factors shaping medicine
• Social structure
• Social labelling social control
• Sick role
• Patient-doctor relationship
• Disease-illness distinction
• Medicalization

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The social production of health

• Shift from disease focus of medicine
• Shift from focus on medicine
• Same emphasis on power, inequality, social
  relationships/organization/structure
• Social characteristics play a predominant role in
  determining sickness and health status
• Occupation related to health
• Social position class, ethnicity, gender, age
• disease feelings of sickness not determined
  solely by underlying biology

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Society and health

• Social relations of sickness which produce forms
  and distributions of sickness in society
• Sickness is the process through which worrisome
  behavioral and biological signs, particularly
  ones originating with disease, are given socially
  recognizable meanings resulting in socially
  significant outcomes
• Sickness is a process for socializing disease and
  illness
• The social order is embedded in medical beliefs

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Society and health

• choices forms of medical interventions
  transactions are determined by sickness (not
  illness or disease)
• Medicine continues to divorce disease from its
  social relations of production
• Ignoring power differentials that originate and
  reside in arrangements between social groups and
  classes
• Symbols of healing are equated with power
• Medicine is an ideological practice

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SOCIAL FORCES AND PROCESSES EMBODIED AS
BIOLOGICAL EVENTSTHE CRITICAL PERSPECTIVE

• Paul Farmer
• Inequality itself constitutes our modern plague
  inequality is a pathogenic force
• Social inequalities often determine both the
  distribution of modern plagues and clinical
  outcomes among the afflicted

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Critical Theory, Social Structure, Medicine

• Questions about the neutrality/objectivity of
  medicine, use of technology, science
• Ideology -- a system of shared beliefs that
  legitimize particular behavioral norms values
  at the same time they claim appear to be based
  on empirical truths
• ideologies transform power (potential influence)
  into authority (legitimate control)

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Life Expectancy Ethnicity in the US
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Canada, Health, Inequalities
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Non-Medical Determinants of Health

• In First Nations communities only 56.9 of homes
  were considered adequate in 1999--00.
• 33.6 of First Nations communities had at least
  90 of their homes connected to a community
  sewage disposal system.
• In 1999, 65 First Nations and Inuit communities
  were under a boil water advisory for varying
  lengths of time--an average of 183 days of boil
  water advisories per affected community.
• Many communicable diseases such as giardiasis and
  shigellosis (both acute infectious diseases
  characterized by diarrhea, fever and nausea) can
  be traced to poor water quality

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Cultural Capital Health
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World-Wide Health Inequalities
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WORLD SYSTEMS
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World Systems (I. Wallerstein)

• A world-system is a social system
• one that has boundaries, structures, member
  groups, rules of legitimation, and coherence.
• made up of the conflicting forces which hold it
  together by tension and tear it apart as each
  group seeks eternally to remold it to its
  advantage.
• a life-span over which its characteristics change
  in some respects and remain stable in others.
• its structures -- at different times strong or
  weak in terms of the internal logic of its
  functioning.

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Health and society

• Relational
• comparing the health status of different
  population groups within
• social, economic and environmental conditions and
  marked disparities among population groups
• To see health in its social context is to look
  beyond the limits of medicine as we know it, to a
  much wider set of questions that engage social,
  cultural, political and moral aspects of human
  experience
• the ways in which globalizing economies shape
  both illness and health care
• the role played by social forces and cultural
  change in shaping individual well-being.
• Process meaning and action