Sociology of Health and Illness

The state of our health is very important to us, we spend a lot of time and money on trying to stay healthy, but what do we mean by "Health"? The world Health Organisation (WHO) describes health as "a state of complete physical, mental and social well-being which is more than just the absence of disease.

When we think of health and illness, there is a general conception that it involves health habits such as exercise and eating the right food, as well as institutions such as hospitals and doctors. In Western societies it is commonly accepted that if we are ill it is a result of an infectious disease that can be cured by modern medicine, or is a result of genetics or lifestyle choices. Sociologists propose a different cause. They examine patterns within society, and they seek social rather than biological answers and suggest that the differences in health and illness between different groups within society are influenced by social, economic, cultural and political factors. It is from these observations that sociologists have concluded, health is unevenly distributed in a systematic way.

Social class has always been a fundamental concept in medical sociology, demonstrating its empirical value for the understanding of 'health chances ' for the individual ever since the early years of this century when Stevenson constructed a classification based on father 's occupation for the purpose of analysing infant mortality in England and Wales. In the past, however, medical sociologists have been criticised for an atheoretical use of class. Medical sociology, and especially the 'inequality in health ' debate, have thus been criticised as being isolated from developments in wider sociology. (Fitzpatrick, 2004, 199-202) The objective of this paper, however, is to document how this is changing. It is argued that, currently, medical sociology is both taking note of contemporary theory of class and contributing to it. This is occurring largely through an attempt to incorporate the concept of time. Health is a characteristic where time cannot be ignored: the sociology of health is concerned with birth and death, ageing and the life course, becoming ill and getting better, moving through both personal and historical trajectories. Health is neither simply a characteristic of the individual nor an event, but their meeting as they come together in biography. Thus health is a topic which adds in a special way to both structure and action as they are conceived of in the theory of class.

This observation has been linked to class, gender, race, ethnicity and geographical location, in understanding why certain groups experience significantly different rates of illness. The sociology of health and illness is concerned with the social origins of and influences on disease, rather than the professional interests of medicine that examine health and illness from its biological development and regards illness as a malfunction of the human body. (Wilkinson, 1999, 391-412) The social theory of health and illness is critical of the medical model and treats concepts of health and illness as highly problematic and political. It also gives special attention to how patients experience and express their distress when ill, but is critical of the ideal of the so-called 'sick roles '. It argues that modern societies are primarily concerned with illness because of the emphasis that the medical professions have placed on it. Finally, the social approach has been critical of the medicalisation of social problems, such as lifestyle illness, like stress (Abercrombie, Hill, 2001, p. 337).

Our ideas about what health and illness are have been shaped by the influence of contemporary medicine. It has been given high priority by British society with many industries being built around it whose main goals are not only health but also profit. However health and illness is far more than just medicine and medical treatments. Health and illness is closely linked to social structures and economic forces that go a long way to determining our health and our access to health resources. (Drever, 2001, 93-100) Health is linked inversely to income, with the poor generally suffering from worse health and limited health care as compared with the wealthier who tend to have better health and far greater access to health care.( Mensah, 2002, 1-7) Deficiency diseases such as Rickets and Scurvy are caused due to a lack of certain vitamins or minerals in the diet. Self-Inflicted diseases such as Lung Cancer, Alcohol Abuse, Anorexia and Bulimia are caused by people 's lifestyles, environment and maybe lack of education and awareness.( Smith, 1999, 10-12)We are concerned with infectious diseases, sexually transmitted diseases and lifestyle diseases. All the diseases that fit under one of the above titles can be reduced or even eradicated, if humans change their attitudes and behaviours towards them. Below is a list of some of the diseases that humans pass on to one another or threw lifestyle:•Impetigo Alcohol Abuse•Gonorrhea Drug Abuse•Syphilis Food Poisoning•Influenza Chickenpox•Measles Polio•Diet Herpes•Tuberculosis Heart Disease•HIV/AIDS Colds•Cholera Chlamydia•Lung Cancer Cold Sores•Illegal Drugs Hepatitis•Glandular Fever Impetigo•Skin Cancer ScabiesSome of the diseases listed above are more fatal than others, but they all affect our health one way or another. In third world countries the number of infected is the highest, this may be due to the lack of sex, health education, poverty and living conditions. (Mili, 2003, 160-66)In the U.K we are still contracting HIV/AIDS, why is this? We all have access to free protection (condoms), and we have all been educated to the risks and dangers of HIV/AIDS threw some sort of media form. But still we continue to spread the disease, could this be cause our attitudes towards it is "it won 't happen to me" or have we a lack of self respect? Many non-infectious diseases are a result of the lifestyle people are either forced or choose to lead, for example: the diet they eat, to smoke or not to smoke, or to use illegal drugs or not. Theses diseases are self-inflicted as they are well within our control. Some factors to why we inflict theses diseases upon ourselves may be a lack of awareness, addiction, social class also living conditions.( Davey, 1997, 547-52)There have been extensive changes in the world of production, with the decline in manufacturing industry. The middle classes have not only increased in size, in both absolute and relative terms, but have also become more differentiated. There has been a shrinkage of the wage labour society, through extended education, earlier retirement, shorter hours, and the development of part-time, shared, and contract work. The boundaries between work and non-work become more fluid, with flexible forms of employment and domestic and wage labour less clearly separated. There is a shortening of the proportion of the lifespan spent in work. Rising living standards, a decline in the influence of traditional institutions, and the erosion of traditional status orders, have all been implicated in the changing meaning of class. (Davey, 1998, 934-39)These practical problems of applying RG Social Class, and doubts about the continuing validity of the system, have caused increasing unease about using class as an explanatory variable in health. In the field of inequality of health, for instance, class continues, despite all the problems noted above, to be a useful descriptive variable, but it offers little to explanation, to the identification of the factors which cause social variation. There is no clarity about what RG Social Class actually measures, or with what accuracy. (Davey, 1994, 131-44) The basis is officially described as level of occupational skill, implicitly presumed to be associated with both a material, economic dimension and a status dimension. The conflation has been criticised by Weberians and Marxists alike. In fact, rather little attention has been paid by theoretical sociologists to mapping either changing rewards or shifting prestige in RG classes over time, since in the wider sociological arena it is preferred to dismiss the simple RGSC I-V altogether. It is only medical sociology which has remained to some extent tied to the system because of its use for census and mortality data. (Eyler, 2002, 23-30)Emotions lie at the juncture of a number of classical and contemporary debates in sociology including the micro-macro divide, positivism versus anti-positivism, quantitative versus quantitative, prediction versus description, managing versus accounting for emotions, and biosocial versus social constructionist perspectives. (Hill, 2001, 329-36) Temptation to overstretch their explanatory frames of reference (i.e. move to the other extreme of the organic-social spectrum). Indeed, a purely constructionist perspective in the sociology of emotions, as Armstrong, rightly argues: ignores biological process and presents a disembodied view of human emotions. The relationship between body and emotions are not resolved by ignoring the body 's relevance or by viewing emotions simply as cognitive products ' (1995:404). 'Going beyond ' the biological, in short, does not mean ignoring it altogether. Rather, it necessitates a more intricate model than organismic theorists or social constructionists propose of how social and cognitive influences 'join ' physiological ones in the genesis of human emotions.( Higgs, 1998,45-50)Emotions are embodied experiences; ones which radiate through the body as a lived structure of on-going experience and centrally involve self-feelings which constitute the inner core of emotionality. For individuals to understand their own lived emotions, they must experience them socially and reflectively. It is here at the intersection between emotions as embodied experiences, their socially faceted nature, and their links with feelings of selfhood and personal identity, that a truly sociological perspective and understanding of emotions can most fruitfully be forged. (Bury, 2002, 167-82) Building on these insights, Emotions are best seen as complexes rather than things; ones which are multi- rather than uni-dimensional in their composition. (Blane, 1993, 1-15) Emotions, he suggests, arise within social relationships, yet display a corporeal embodied aspect as well as a socio-cultural one; something which, in turn, is linked to techniques of the body learned within a social habitus.

The pursuit of health has become an important activity, especially for the American middle class. Millions of people have become concerned about their health and have changed their behaviour in order to protect or improve it. Millions more continue to act as always or with minor changes but now with awareness that such behaviour puts them 'at risk '. In either case, health has become an important topic in everyday conversation, reflecting an extraordinary expansion of medical, political, and educative discourses about health hazards and ways to protect individuals and populations against them. There are several kinds of health discourse. Health promotion means the set of discourses and practices concerned with individual behaviours, attitudes, dispositions or lifestyle choices said to affect health. Protecting and improving individual health appear to be prototypical acts of practical reason and personal responsibility-a matter of common sense. The appearance is based on the assumption that, given accurate medical information about hazards to health and naturally desiring to live a long life free from debilitating disease, the rational person will act to avoid unnecessary dangers and adopt healthy behaviours. Yet, there is a parallel appearance. No matter how much or how little is undertaken in the name of health, we all know that the attempt falls short. Health promotion is an imperfect practice, an experience of conflicting urges and varied outcomes. Few of us live consistently healthy lifestyles and those who approach that ideal seem to be engaged in an unhealthy obsession. In short, we are both ambivalent and inconsistent in following the rules of health.

ReferencesArmstrong, D., 1995 'the rise of surveillance medicine ', Sociology of Health & Illness, vol. 17, no. 3, pp. 393-404Blane, D., Davey Smith, G. and Bartley, M. (1993) Social selection: what does it contribute to social class differences in health? Sociology of Health and Illness, 15, 1-15.

Bury, M.R. (2002) Chronic illness as biographical disruption. Sociology of Health and Illness, 4, 2, 167-82.

Davey Smith, G., Blane, D. and Bartley, M. (1994) Explanations for socio-economic differentials in mortality: evidence from Britain and elsewhere. European Journal of Public Health, 4, 131-44.

Davey Smith, G., Hart, C., Blane, D., Gillis, C. and Hawthorne, V. (1997) Lifetime socioeconomic position and mortality: prospective observational study. British Medical Journal, 314, 547-52.

Davey Smith, G., Neaton, J.D., Wentworth, D. and Stamler, R. (1998) Mortality differences between black and white men in the USA: contribution of income and other risk factors among men screened for the MRFIT. Lancet, 351, 934-9.

Drever, F. and Whitehead, M. (2001) Health Inequalities. London: HMSO. 93-100Eyler, J. (2002) William Farr and Victorian Social Medicine. Baltimore: Johns Hopkins University Press. 23-30Fitzpatrick, R., Hinton, J., Newman, S., Scambler, G. and Thompson, J. (2004) The Experience of Illness. London: Tavistock. 199-202Higgs, P. and Scambler, G. (1998) Explaining health inequalities: how useful are concepts of social class? In Higgs, P. and Scambler, G. (eds) Modernity, Medicine and Health. London: Routledge. 45-50Hill, Turner, Abercrombie, 2001. The Penguin Dictionary of Health Sociology Fourth Edition, Penguin Books, London, 329-336.

Mensah GA. 2002. Eliminating health disparities: the time for action is now. Winter;12(1):3-7.

Mili F, Helmick CG, Moriarty DG. 2003. Health related quality of life among adults: analysis of data from the Behavioural Risk Factor Surveillance System, UK, 160-6.

Smith, F. B. (1999) The People 's Health: 1830-1910. London: Croom Helm. 10-12Wilkinson R. Income distribution and mortality: a "natural" experiment. Sociology of Health and Illness 1999;12 :391-412.

References: rmstrong, D., 1995 'the rise of surveillance medicine ', Sociology of Health & Illness, vol. 17, no. 3, pp. 393-404Blane, D., Davey Smith, G. and Bartley, M. (1993) Social selection: what does it contribute to social class differences in health? Sociology of Health and Illness, 15, 1-15. Bury, M.R. (2002) Chronic illness as biographical disruption. Sociology of Health and Illness, 4, 2, 167-82. Davey Smith, G., Blane, D. and Bartley, M. (1994) Explanations for socio-economic differentials in mortality: evidence from Britain and elsewhere. European Journal of Public Health, 4, 131-44. Davey Smith, G., Hart, C., Blane, D., Gillis, C. and Hawthorne, V. (1997) Lifetime socioeconomic position and mortality: prospective observational study. British Medical Journal, 314, 547-52. Davey Smith, G., Neaton, J.D., Wentworth, D. and Stamler, R. (1998) Mortality differences between black and white men in the USA: contribution of income and other risk factors among men screened for the MRFIT. Lancet, 351, 934-9. Drever, F. and Whitehead, M. (2001) Health Inequalities. London: HMSO. 93-100Eyler, J. (2002) William Farr and Victorian Social Medicine. Baltimore: Johns Hopkins University Press. 23-30Fitzpatrick, R., Hinton, J., Newman, S., Scambler, G. and Thompson, J. (2004) The Experience of Illness. London: Tavistock. 199-202Higgs, P. and Scambler, G. (1998) Explaining health inequalities: how useful are concepts of social class? In Higgs, P. and Scambler, G. (eds) Modernity, Medicine and Health. London: Routledge. 45-50Hill, Turner, Abercrombie, 2001. The Penguin Dictionary of Health Sociology Fourth Edition, Penguin Books, London, 329-336. Mensah GA. 2002. Eliminating health disparities: the time for action is now. Winter;12(1):3-7. Mili F, Helmick CG, Moriarty DG. 2003. Health related quality of life among adults: analysis of data from the Behavioural Risk Factor Surveillance System, UK, 160-6. Smith, F. B. (1999) The People 's Health: 1830-1910. London: Croom Helm. 10-12Wilkinson R. Income distribution and mortality: a "natural" experiment. Sociology of Health and Illness 1999;12 :391-412.