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Health And Illness Essay, Research Paper
Definitions of health and illness are very complex, in that there are cultural differences in how societies classify what are health and illness, the causes and the treatment. However because disease occurs in patterns it is thought that the conditions that determine health chances are social conditions. The way we think about health and illness is socially constructed as we are used to accepting the views of the medical profession. In modern medicine our bodies are seen as machines and doctors as mechanics, however studies by sociologists show that there is a range of environmental, political and behavioural factors that contribute to the construction of health and illness. In societies what appears to be abnormal or unacceptable is often labelled as disease, conflicts arise because what accounts for illness differs from place to place and from time to time. Numerous studies also show that a person s social class strongly affects health and longevity, and that poverty and social class are the most important factors determining health. The lower ones social rank the more prone one is to early death. Beliefs about gender also influence attitudes to health and illness, as what is natural becomes medicalised when women s natural reproductive cycles and childbirth are often treated as disease
The Black report published in the 1980s showed that there was a pattern to the wealth and health experienced by the different social classes, based on occupation the report showed health inequality and suggested that professionals fare better than managers, managers fare better than skilled workers and so on down the line. However there are also theories that try explaining the results of the Black report, suggesting that the system of health care is not such an important factor as other life circumstances that affect the health of different classes. The artefact theory suggests that the use of surveys for statistics is inaccurate because it fails to take into consideration the clinical iceberg where it is unknown how many people suffer illness as they don t always report it also most health care happens in the home usually women treating symptoms by self care, in the case of postal surveys not everyone will respond and women often fill in forms for other family members. It is also unreliable because the figures relate to males of working age and not females and older and younger people and the statistics change all the time. However another study known as the Whitehall study gave evidence that there is a real relationship between social class and health outcome.
When different grades of workers was compared, those in the lowest grade had 3.6 times greater risk of dying from heart disease than those in the highest grade (Marsh, p473.)
The other explanation considered by the Black report accepted the relationship between social class and health, the social selection explanation theorises that it is not social class that affects heath but health that affects social class, people who suffer poor health stay at the bottom of the occupational scale because they are not healthy enough to make any progress, and that it is not the lower class which actually causes their poor health but rather people who are ill tend to take time off school and work so their chances of succeeding are less likely than someone who is healthy and is rarely absent from school or work .
The cultural or individualist theory suggests that there is something about the culture of the lower classes that is unhealthy; they tend to smoke and drink more and it is attitude not income at fault so individuals are to blame for not looking after their health.
The individualist theory thus suggests that the lower social classes have poorer health because, through choice or ignorance, they adopt unhealthy behaviour (Harvey p94)
The materialistic theory believes that conditions such as poverty or homelessness are a direct cause of mortality.
Despite the existence in Britain of a National Health Service there are still vast social divisions of health outcomes, Social class divisions in mortality and morbidity are probably the result of material factors. (Marsh.p480)
The health and illness that affect the social classes is often influenced by their environment for instance the child mortality rate of the lower classes can be caused by living in poverty, damp housing, low income, inadequate diet, through unemployment, all the issues which contribute to stress and depression as the lower class is caught in an never ending circle where each problem contributes to another and so lifestyles tend to stay the same. This diminishes hope and limits choices causing a threat to health. The lower classes also have the worst facilities of health care. Doctors and specialists who are able to choose the areas they work will more often choose middleclass areas where they will have the advantage of better staff and equipment. Hillary Graham s work on women and smoking suggested that smoking might help women in poverty to cope because it is a method of relaxation, her way of having a break from the main interaction with small children.
Our ideas in society tend to construct gender differences in health problems, there appears to be some evidence that men take more risks than women such as dangerous sports and violent activities and hazardous occupations, also women tend to consult doctors more often but yet statistics suggest women have more ill health, but this could be because women in their socially produced gender roles are seen as more acceptable to show weakness and seek medical help. Women s lives are more often medicalised than men, in childbirth, reproduction and mental health women are more likely to be given prescriptions for anti-depressants or tranquillizers, men however are more likely to have alcohol related problems, a more socially acceptable response to stress than it is for women. Peter Sedgwick found that:
About 10% of all GPs prescriptions and 20% of annual expenditure goes on tranquillisers, anti- depressants or hypnotic drugs, mainly for women (class handout)
A woman s role is often looking after everyone in the family and because she tends to carry an added burden of stress with an attitude of having to soldier on with her responsibilities she may be prone to physical and mental disorders. As victims of social and economic circumstances women tend to suffer from what is known as housewife syndrome . The isolation and constant decision making involved in housework are very stressful as is the responsibilities of looking after young children.In addition there are certain illness s that women suffer from because of their biology because women live longer they tend to suffer from degenerative disorders.
There is substantial evidence that illness is socially constructed through the medical professions interventation in creation of iatragenic diseases, in many cases the treatment causes more damage than the illness ever would for example the thalidomide drug where the effects on the unborn children greatly outweighed the advantages to the pregnant women. People suffering from depression are often given tranquillisers this in turn can cause addiction. There is also much evidence to suggest that there are many unpleasant side effects to the contraceptive pill as it can cause cancer or thrombosis and intra uterine devices can cause all sorts of infections, however they continue to be used by the majority of women, as there is little choice of other methods of birth control.
Health and illness are socially constructed by the environment, technological changes over time have brought improvements in sanitary systems ending the risks of major epidemics, however this industrialised engineering has also brought about high levels of dangerous chemicals with the result that the major killers in modern industrial societies are heart diseases and cancers.
The idea that disease emanates from an individuals relationship with his environment was part of Greek medical orthodoxy and, as anthropologists have discovered, is a quite common concept in other cultures (Gomm p248)
Medical matters are often socially constructed through the beliefs of the medical profession and their power to control the behaviour of society, this happens when alcoholism, smoking or obesity are seen as unacceptable and so are labelled as disease which society finds easier to accept. Treatments are then created to try to cure the behaviour of the individual. In the 19th century women who didn t conform to the stereotyped female role were often regarded as suffering from a disease. This is where the power of the medical profession can be clearly seen.
From a sociological point of view, there is no objective definition of illness; instead it is necessary to ask whose interest, and with what purpose in mind, illness is socially defined by different people (Gomm p.250)
High levels of illness are seen as a threat to society thus the medical profession serves to ensure the satisfactory performance of social roles yet the major effect of the intervention of the medical profession actually increases the numbers of people diagnosed as sick. The large drug companies which are the most profitable in the world help shape the pattern of medicine, drugs are made to produce profit therefore there is a relationship between doctors and drug companies designed to maximise the sale of drugs.
The elderly in society are also often diagnosed as sick because they are most vulnerable to illness; a large number of the elderly are in hospitals not because they are sick but because there is no one to look after them at home and also because health and welfare services fail to provide enough care in the community.
The social construction of health and illness is a complex interaction of gender, class, age and other social characteristics, still vast social divisions of health outcomes, social class divisions in mortality and morbidity are probably the result of material factors, what is defined as disease often occurs in patterns which are best understood sociologically. Evidence from medical historians conclude that medical intervention has been less important in promoting health than have other social and economic factors, The improvement in life expectancy over the years is because epidemic diseases were reduced with improved sanitary conditions, looked at in this perspective, modern medicine has been less important than changes in environments. It would appear that there is something much bigger going on with the career interests of the doctors and the commercial interests of the drug companies
Bibliography And References
Brennan, M. (1998) Choosing Ill Health . Sociology Review, Class Handout.
Donovan, K. (1993) Blame It On The Hormones: The Irish Times Newspaper, Oct.7th.
Gomm, R. Social Science And Medicine: Perspectives On Society , Class Handout.
Graham, H. (1987) Women Health And Illness , Social Studies Review, Class Handout.
Harvey, L. and Mac Donald, M. (1993) Doing Sociology: A Practible Introduction, Hampshire, and Macmillan Press.
Marsh, I. (2000). Sociology: Making Sense Of Society London, Peason Education 2nd edn
Matlin, W.M The Psychology Of Women Class Handout.
Meridith, Tax. (1970) Women And Her Mind: The Society Of Daily Life Quoted In S. Rowbottom, Women s Consciousness, Mans World Penguin. 1973.
Mihill, C. (1995) Poor Suffer More Illness Than Rich The Guardian Newspaper, Oct 24th.
O Donnell, M. and Garrod, J. (1990) Sociology In Practice UK. Nelson Ltd.
Rubinstein, D. (1986) Lunatic Or Heroine? New Society, Class Handout.
Waddington, I. (1989) Inequalities In Health Social Studies Review, Class Handout.
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