The Social Origins of Illness and Health

In his book “Second Opinion : an introduction to health sociology” John Germov has explained how sociology should be used to understand illness and health. He talks about how we are living in an age of health obsession. Where people all over the world are being bombarded with messages from fitness gurus, health professionals and health authorities. He points out how everyone is being urged to take responsibility for their health. He uses sociology in understanding the social patterns of illness and health from different social statuses and non-indigenous and indigenous populations (Nettleton, 2013). He provides a second opinion to the conventional definition of “illness” derived from psychological and biological explanations by looking into the social origins of illness and health. He stresses how social origins can be clearly observed when we make a comparison in the life expectancy figures of different countries. Through the data made available by UNDP for the year 2013 he shows how least developed countries have life expectancy of twenty years less than in comparison to developed countries like Australia. Japan has the highest life expectancy and Australia comes second. But these figures also prove that lowest socio-economic groups in any country experience lesser life expectancy than in comparison to higher socio-economic groups. In Australia the indigenous population have life expectancy of  twelve years less than in comparison to the national average (Lawson, & Bauman, 2001).

Charles Wright Mills coined a term “sociological imagination” which stands for the link that the people make between public troubles and personal troubles. He showed how problems when faced in a group have a common cause and can be dealt by a collective action. Evan Willis an Australian sociologist suggested that sociological imagination can be divided into four parts that are the historical factors that is about the past and its influences on present, cultural factors that is about how culture affects the people’s lives, structural factors that is how social organizations affect people’s lives and lastly critical factors is about improving our social environment. This template helps in understanding how to analyze in a sociological way (Cockerman, 2013).. This template helps with simplifying the sociological analysis process. We are all social creatures and we project our environment in how we dress and how we interact (Willis, 2011). . Our institutions, our social structures and customs all influence us (López, & Scott,2000).. So the question arises are we the sole person who is responsible for our actions? Yet to what extend we can be called the product of the society? Well the answers to these questions are not simple and are always on debate. We are all born in a world not of our making and our thoughts and actions are influence and shaped by our surroundings. But we are no “PUPPETS” we are all self-aware and can act and think individually. John Germov discusses about two models in the book the social health model and biomedical model. Biomedical model assumes that each disease has a cause that affects the body in a predictable way. This model sees the body as a machine but this model is under criticism as it underestimates the complexity of illness and health (Engel, 1977).  . On the other hand the social model of health links public health concerns  (clean water and air, occupational safety and safe food) to social, behavioral and economic factors. As this model is assuming that health is a social responsibility(Gabe, & Monaghan, 2013). We can easily conclude that in order to understand the complexity of illness and health we need to move beyond these models and beliefs. As sociology teaches us the links between the social context and individual’s experiences is enabling us to see that health issues are also social issues. (Rayner, & Lang,2012).      

Different Health Models

Anne McMurray book titled Community Health and Wellness: A socio-ecological approach “The community of the twenty first century” is about considering the effect of surroundings on your health. The examples she represents in the book illustrate that health is a socioecological construct. (Blaxter, 2010). Being healthy and taking healthy choices is a function of attitudes. These attitudes in turn are a product of environmental, biological and social influences we have in our lives. She explains how in a community the lives of individuals is interwoven in a common geographical space. Therefore the interactions in this common geographical space whether it is between social groups, families and community members are all “ecological”. These ecological exchanges can create enhancements as well as constraints in a community as well as personal health. One example would be of the contaminants that we are exposed to in our physical environment (Bascom et al.,1996). The risk that we take in our social environment as our workplaces, schools and even our neighborhood. WHO defines health as the state of complete social, mental and physical wellbeing and not only the absence of a disease. In a broad view wellness and health is socioecological at the environmental, group and personal level. But health is not experienced as an ideal way as described in the definition above. Community is seen as strengthening and building health capacity. She explains how potential and balance are two elements of healthiness. Communities who balance the barriers to health such as poverty, lack of education and unemployment and encourage the use of medical facilities, sporting facilities are termed healthy. In her book she focuses on the determinants of wellness and health. She explains how material wealth is important for being healthy. As socioeconomic factors that are made available due to availability of wealth include clean air, water, and better working conditions that in turn promotes the availability of range healthy choices and services. She found out that the main determinants of health are biological factors such as genetic and hereditary factors. Physical and social environment that includes economic, cultural factors are also determinants of health. The combination of these factors interact with the choices that we make i(Hertzman, 2001). Concepts of health are deeply imbedded in values and norms that the person beliefs in. Some researchers even believe that biological factors are shaped by environment and conditions around a person.

She explains how in a healthy community sustainability is the goal. There are various levels of sustainability that can be achieved through valuing diversity and through conserving physical and personal resources. Through this she highlights how a healthy community cannot be made only be availability of health services but through the care and sharing of the community. In order to understand the community health the concept of empowerment should be understood as well. This empowerment in a community occurs when individuals in the community have influence on events and their outcomes(Fawcett et al., 1995). This is explained how a person who knows his needs would make sure to access the resources to meet the needs. Therefore to ensure the health of a community, empowerment of a community is needed which can be done through encouraging group participation and by promoting health education(Whitehead, 2001). Thus we can easily denote that development of the community health is dependent on the acceptance of the notion that health is socioecological construct.

The Socioecological Approach to Determining Wellness and Health

Neil Thompson in his book “Promoting Equality: Working with Diversity and Difference” he wrote how western societies are being characterized by inequality. Inequality is not from the cause of the actions of one minority like “male chauvinists” for sexism. He discusses how professions have traditional approaches that pay no attention to oppression, discrimination and inequality and are source of practices that devalued, disempowered and alienate people. He even argues that inequality have now become an inevitable part of the professions in our society. Illness according to him in ageism and disablism is a disempowering and oppressive consequence. People with disabilities and older people often find themselves under pervasiveness and dominance of the medical profession. The power relation that is formed where the health professional is in favor and disabled person is facing detrimental consequences. He writes about social construction of dependency where social and health welfare assume a level of dependency that is higher than in actuality. The primary ethos is about care rather than being of empowerment. This proves that care is seen as power and if you resist power you are actually refusing care. He does accept that while some inequality in some professions is unavoidable but the abuse of power in the health sector is widespread. The use of this deliberate power in this sector is harming and exploiting others. He points out the violent episodes the people face while going through private or public health services. He quotes episodes where people say that during the treatment they were profoundly affected and had an idea about their body being a “political surface”. This referred to they felt that as if there body had no organs. This affects their recovery and haunts them in future. This medical dominance in the treatment and power abuse by the health professionals is a disempowering and stigmatizing experience for the patients. According to him the violence is intense when power is exercised in complex organizations such as hospitals and other healthcare institutions. He especially focuses on mental illness as being caused by unequal struggle in power relations in the complex social system. The violence is not limited to the patient but can also be a result of staff bullying, unfairly treating and harassing each other. Therefore it is crucial that in a health setting individuals are treated with dignity and respect rather than being subjected to power and inequality.

Conclusion:-

From all the three readings we can note that health is not a sole responsibility of an individual but is also dependent on surroundings and environment. All the three books are presenting content and data that supports that health is a sociological construct. In his book “Second Opinion : an introduction to health sociology” John Germov has explained how sociology should be used to understand illness and health. He explains how lowest socio-economic groups in any country experience lesser life expectancy than in comparison to higher socio-economic groups. He stresses on the fact that we are all social creatures and we project our environment in how we dress and how we interact. Anne McMurray book titled Community Health and Wellness: A socio-ecological approach “The community of the twenty first century” is about considering the effect of surroundings on your health. She suggested that community plays a crucial role in an individual health. Therefore for a healthy community, education and group participation should be encouraged. Neil Thompson in his book “Promoting Equality: Working with Diversity and Difference” highlight the use of deliberate power in the healthcare sector. Where he has quotes of people who felt stigmatized and disrespected by health professionals when they were being treated. So the surroundings where people should feel safe and care for, are the ones where people are feeling judged and disrespected by professionals that should have cared for them. This shows there is a need for ensuring that professional practice should not amplify the inequality the disadvantaged social groups experience. The reality of discrimination includes its roots in politics, psychology, economics and sociology. Consequently if the people are not aware of ideology they unwittingly reinforce power relations.

References

Bascom, R., Bromberg, P., Costa, D., Devlin, R., Dockery, D., Frampton, M., Lambert, W., Samet, J., Speizer, F. and Utell, M. (1996). Health effects of outdoor air pollution. American Journal of Respiratory and Critical Care Medicine, 152(2), pp.477-498.

https://www.ncbi.nlm.nih.gov/pubmed/8542133

Blaxter, M. (2010). Health. 2nd ed. Cambridge: Polity Press.

https://www.polity.co.uk/chs/pdf/Contemporary_Health_Studies_sample_chapter1.pdf

Cockerman, W.C. (2013). Social Causes of Health and Disease . 2nd edn.  Polity Press, Cambridge.

https://www3.nd.edu/~jwarlick/documents/Cockerham.pdf

Engel, G.L. (1977).  ‘The need for a new medical model: a challenge for biomedicine’. Science . vol. 196, no. 4286, pp. 129–36.

https://www.drannejensen.com/PDF/publications/The%20need%20for%20a%20new%20medical%20model%20-%20A%20challenge%20for%20biomedicine.pdf

Fawcett, S., Paine-Andrews, A., Francisco, V., Schultz, J., Richter, K., Lewis, R., Williams, E., Harris, K., Berkley, J., Fisher, J. and Lopez, C. (1995). Using empowerment theory in collaborative partnerships for community health and development. American Journal of Community Psychology, 23(5), pp.677-697.

https://www.ncbi.nlm.nih.gov/pubmed/8851345

Lawson, J.S. & Bauman, A.E. 2001, Public Health Australia: An Introduction , McGraw-Hill, Sydney.

https://books.google.de/books?id=wzS2CgAAQBAJ&pg=PA22&lpg=PA22&dq=Public+Health+Australia:+An+Introduction+,+McGraw-Hill,+Sydney.&source=bl&ots=nCJqUyvp7K&sig=2r3qURQCECWpevsuowwq2HCUhN8&hl=en&sa=X&ved=0ahUKEwjzhoDr34_TAhWENJoKHZb8B80Q6AEIMTAE#v=onepage&q=Public%20Health%20Australia%3A%20An%20Introduction%20%2C%20McGraw-Hill%2C%20Sydney.&f=false

López, J. & Scott, J. (2000). Social Structure , Open University Press, Buckingham.

https://humannetwork.wikia.com/wiki/Social_structure

Gabe, J. & Monaghan, L. (2013) Key Concepts in Medical Sociology . 2nd edn, Sage: London.

Hertzman, C. (2001). Health and Human Society. American Scientist, 89(6), p.538.

https://www.americanscientist.org/issues/num2/health-and-human-society/1

Lawson, J.S. & Bauman, A.E. (2001). Public Health Australia: An Introduction . McGraw-Hill, Sydney.

Rayner, G. and Lang, T. (2012). Ecological Public Health. 1st ed. Hoboken: Taylor & Francis.

https://public-health.medunigraz.at/archiv/artikel/Artikel%202012/2012_BMJ_Ecological%20public%20health_the%2021st%20century%E2%80%99s%20big%20idea.pdf

Nettleton, S. 2013, The Sociology of Health and Illness , 3rd edn, Polity Press, Cambridge

Whitehead, D. (2001). Health education, behavioural change and social psychology: nursing’s contribution to health promotion?. Journal of Advanced Nursing, 34(6), pp.822-832.

https://www.ncbi.nlm.nih.gov/pubmed/11422553

Willis, E. (2011). The Sociological Quest: An Introduction to the Study of Social Life. 5th ed. Sydney: Allen & Unwin.

www.sijakovic.com/wp-content/uploads/2012/06/The-Sociological-Quest.doc