INTRODUCTION TO MEDICAL SOCIOLOGY FOR BIOMEDICAL STUDENTS

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INTRODUCTION TO MEDICAL SOCIOLOGY FOR BIOMEDICAL
STUDENTS

• Kai-Lit Phua, PhD FLMI
• Associate Professor
• School of Medicine Health Sciences
• Monash University Malaysia Campus

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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.

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Lecture notes

• http//phuakl.tripod.com/phuakl1.html
• Click on Medical Sociology A or
• Medical Sociology B

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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

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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

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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

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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 Starrs book called
  The Social Transformation of American Medicine
  which predicted erosion of this dominance with
  the rise of corporate medicine

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Sociology in Medicine

• This approach focuses on applications and solving
  problems using sociological knowledge
• An example would be David Mechanics studies of
  illness behaviour
• Another example would be studies of adherence
  (compliance)

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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

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Ethnicity (race) Health

• How does membership in a particular ethnic group
  affect ones 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

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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
• Marmots 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

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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

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Age Health

• The life cycle and health
• Before birth (fetus)
• Infant
• Child
• Teenager
• Young adulthood
• Middle adulthood
• Old age

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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

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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

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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

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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.
  Jehovahs Witness and blood transfusion

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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

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THE END

• THANK YOU