Sociology and Health: Theories and Exclusion

Exclusion

• Individuals and groups experience economic vulnerability and social isolation leading to limited or no access to socioeconomic services and well-being
• Life expectancies in 1990, 2010 and 2017 varied between countries:
  • Australia: 77 (1990), 82 (2010), 82.4 (2017)
  • Mozambique: 43 (1990), 52 (2010), 59 (2017)
  • Spain: 77 (1990), 82 (2010), 83 (2017)
  • South Africa: 62 (1990), 58 (2010), 63.5 (2017)
  • United Kingdom: 76 (1990), 80 (2010), 81 (2017)
  • Zimbabwe: 61 (1990), 51 (2010), 61 (2017)
  • Germany: 75 (1990), 80 (2010), 81 (2017)
  • Nigeria: 46 (1990), 51 (2010), 54 (2017)

Sociological Theories on Health and Illness: Functionalism, Interactionism, Marxism and Feminism

• Various sociological theories approach health and illness
• Functionalism focuses on the functionality of health
• Interactionism focuses on relationships and how individuals negotiate health meanings
• Marxism focuses on how a capitalist system benefits the dominant group
• Feminism considers the unique experiences and challenges faced by women in relation to health

Functionalist Perspective on Health

• Health is seen as an individual's ability to contribute to society
• Illness is viewed as a deviation from societal norms
• Socialization ensures individuals learn to function effectively and create harmony in society
• Different roles learned contribute to social stability and cooperation

Talcott Parson’s 1951 The Sick Role

• Health and sickness are social concepts
• Illness is considered a deviation from societal norms
• Sickness destabilizes functions in society and is treated as a threat, leading to social control

Sick Role in Functionalism

• A sick person is seen as unproductive
• They cannot fulfill their societal roles
• Deviance necessitates control, which aligns with the approach of the medical profession

Functionalist Perspective of Health and Illness

• Health is defined as the absence of illness
• This view doesn't acknowledge a holistic understanding of health

Criticisms of the Functionalist Perspective

• Ignores the differential experiences with health and illness based on class, gender, and ethnicity
• Disregards historical differences in healthcare development
• Idealizes a specific patient-doctor relationship
• The sick role can become illegitimate despite medical diagnosis: for example, societal judgment of HIV-AIDS victims, denying rights

The Interactionist Perspective

• Emphasizes human social interactions and the social meaning of illness
• Centers on how individuals perceive themselves when experiencing illness and how that shapes their interactions

Stigma

• Coined by Goffman in 1963, stigma is a social process involving exclusion, rejection, blame, or devaluation.
• It arises from social judgments regarding a person or a group based on experiences, perceptions, or anticipated reactions to an illness.
• Stigma can be applied to individuals who are perceived as deviant from social norms.

Stigma and Illness

• Goffman argues that illness can lead to stigma, impacting individual identity.
• Judgements about illness reflect social values and are not neutral.
• Stigma can result from physical differences and social stereotyping.

Susan Sontag (1991)

• Treating illness as evil demoralizes patients and hinders recovery.

Stigma and HIV-AIDS

• Undermines efforts to address the pandemic:
  • Prevents people from getting tested due to negative stigma
  • Hinders care seeking after diagnosis due to denial
  • Prevents quality care due to discrimination against HIV positive individuals

The Interactionist Perspective on Illness and Identity

• Social identities arising from illness shape how individuals react and approach their illness.

Critique of Interactionism

• Provides valuable insights into how health and illness are socially constructed.
• Explores the micro and social aspects, but neglects the macro-sociological perspective.
• While some aspects of the view overlap with institutional perspectives (Foucault's work on institutions and Goffman's on asylums), further exploration is needed.

The Marxist Perspective on Health

• Focuses on the structure of the capitalist system, where the dominant group benefits and the working class sees limited gains.
• Highlights how health systems within a capitalist structure may not serve the interests of the working class.