Basic Sociology Concepts for Pharmacy

• Sociology for Pharmacy compiled by AIREEN MAY E. SOGUILON, RPh, ClinPharm, MSPharm

Basic Sociological Concepts

• Agency is an undetermined voluntary action by an individual
• Norm is a shared and expected social behaviour
• Social role involves expected actions associated with particular social positions
• Social Structure involves recurring patterns of interrelationship between individuals or groups
• Socialization is the acquisition and internalizing the norms and values of a particular group
• Society is a configuration of cohesive social relationships within a particular group
• Sociology is the observation and analysis of societies

Sociology

• Sociology is an academic discipline using wide range of research methods to study society and social behaviour or social actions

Social Action

• Social action is complex
• The complexity of the social world, and behaviour within it, shouldn't be unraveled by simply applying 'common-sense' understandings
• Bauman (1997) identified differences between Common Sense and Sociology:
• Sociological propositions aren't founded on beliefs, but on corroborative evidence compared to common sense
• Sociology accounts from the individual perspective - recognizing the link between individual accounts and social processes of which individuals may be unaware compared to common sense
• Sociology understands our actions due to our interdependency with our fellow members in the society compared to common sense
• Sociology scrutinizes the familiar in order to understand how common sense is as it is compared to common sense of 'things are as they are' and 'people are as they are'

Sociological Perspectives and Their Applications to Pharmacy

• Sociology in pharmacy studies how social factors influence health behaviours, patient-practitioner relationships, and healthcare delivery
• Understanding these dynamics is vital for pharmacists to effectively address patient needs and improve health outcomes
• Subject matter of pharmacy is diverse and diffuse, its focus being on people and society
• There are many different approaches or perspectives
• Perspectives seek to understand how social structures interact with individual behaviours, and these vary in terms of their level of analysis
• A sociological perspective is orientated towards
• Micro-level issues - actions and beliefs of individuals
• Macro-level issues - pertains to the way in which the 'structures' of society are organized, asking how education or health care systems and economic systems function

Turner (1995) 3 Levels of Analysis

• Individual Level - Lay knowledge of health, illness, experience with Interpretive approaches
• Social Level - Cultural categories of sickness and Structural-functionalism- sociology of roles, norms, and deviance
• Societal - Health care systems with a Conflict of perspectives, e.g. political economy

Individual Level

• Sociologists examine people's accounts of their experiences of illness and how they maintain their health
• Illuminate aspects of everyday life from the perspective of the individual
• Analysis towards ‘interpretive perspective' - they interpret how people makes sense of, and give meaning to, their lives or actions
• Focus on how people interact at a face-to-face level
• Social circumstance equals physical symptoms
• 'Meaning' - the way people male sense of what is happening to them

Social Level

• 'Social perspectives' examine what society regards as sickness, illness, or disease
• Disease category is not simply a reflection of biophysical processes within the body but are also the result of social considerations
• Homosexuality, for example, was once considered a sickness that can be treated and a result of physiological dysfunctions
• Medicine is one of the most powerful social institutions
• 'sick role' Involves obligations to get well and to seek expert help
• Illness and disease prevent society from functioning effectively, so health professionals help them to get better

Societal Level

• Highlights 'conflict' rather than cohesion
• 'Conflict' perspective - Differential power and economic rewards are given to those in social authority which lead to social tension and conflict, social order then happens through coercion rather than in consensus
• 'Political economy approach' argues that socio-economic factors create and produce illness
• Medicalisation is a sociological concept which refers to the ways in which more and more everyday life matters come to be dealt with by bio-medicine

Key Theories

• 19th century sociological theorists Durkheim, Marx and Weber are regarded as the ‘founding fathers' of sociology
• The French revolution of 1789 and the European-wide industrial revolution were historical revolutions that were instrumental in the emergence of sociology as a discipline
• Rapid social transformation led to the development of systematic enquiries into how society could undergo such change

Industrial Revolution

• Increasing the production of goods and services, which changed the way of life

Emile Durkheim (1858-1917)

• Researched how social order is maintained and cohesive social relations are established
• 'Social facts' - forces such as shared belief systems, which operated on individuals on a coercive way
• The functions of pharmacists include contributing to legitimating an individual's sickness, by diagnosing illness, supplying medication and referral to a general practitioner by expediting people's 'flight into health' and helping to ensure that prescribed medicines are taken in accordance with the prescriber's wishes, pharmacists ensure people overcome their sickness and return to their regular productive activities, thus maintaining the social order

Karl Marx (1818-83)

• Focused on the Marxist perspective and the theory of capitalist society
• People express themselves productively
• There has always an element of exploitation in which one group (the ruling class) seeks to take advantage of other groups (the working class)
• Medicines are internationally traded commodity
• Pharmacist's role promotes drug consumption serves the interests of the large pharmaceutical manufacturing corporations rather than the general population
• Pharmaceutical companies define ‘health problems' to which their product is the 'answer'

Max Weber (1864-1920)

• Theory of rationalisation within industrial societies
• Bureaucracy was the classic form of rationalisation,
• Industrialized world - epitome of modernization, as the social order depends for its smooth existence on the technical efficiency
• Resigning ourselves to a world ordered by bureaucracy, creating an ‘iron cage' from which we cannot escape may be necessary
• Community pharmacies increasingly function as part of large bureaucratic structures as multiple chains of pharmacies and in-store supermarket pharmacies proliferate
• Bureaucracies seek to enhance productivity and profits by instituting rationalized and routinized processes

Modernity

• Key to the modernist approach is the assumption that different forms of knowledge exist and are hierarchical
• At the very pinnacle is SCIENTIFIC KNOWLEDGE, GENERATED BY SCIENCE while common-sense knowledge or knowledge based on experience alone is relegated as being either self-evident or subjective knowledge being less valid

Post-Modernity

• Maintains objective knowledge, such as generated through scientific enquiry
• 'Knowledge' and 'PHARMACOGNOSY' is socially constructed rather than passively discovered,
• Represents nature
• Now - possible to know the medicinal properties of plants by other than scientific trails and experimentation,- experiencing the medicinal properties of essential oils

Scientific knowledge, Medicines use and the Dilemmas of choice

• Revolutions in drug therapy has lead to availability of powerful medications over the counter from community pharmacies
• Public access to medicines exists via both OTC and prescribed routes
• Individuals are involved in managing and assessing health-related risks
• We are increasingly made aware of the prevalence of risks
• We are expected to assess and manage such risks ourselves by 'doing our bit'

Pharmacy in Contemporary Society

• Social dimensions of health and illness, together with the application of their specialist knowledge of drugs and drug therapy, will ensure that the advice and/or treatment offered by pharmacists is appropriate to an individual patient's particular needs
• Sociological perspective applied to pharmacy provides an insight into an individual's responses to illness and medication use through appreciation of health beliefs which are shaped by the social context
• COLLECTIVE BELIEF, VALUES, and ATTITUDES account for the motivations and constraints that influence their use, misuse, and non-use of medicines and health care services