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Health is the general condition of a person in all aspects of life. It can be seen as the level of functional and or metabolic efficiency of an organism, often implicitly human. According to World Health Organization (WHO), health is ‘a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity’- (WHO 1986). It can be defined as the absence of disease, a state of health unless symptoms emerge that demonstrates a deviance from normality.
Mechanic and Volkhart (1961) define illness behaviour as ‘ the way in which symptoms are perceived, evaluated and acted upon by a person who recognizes some pain, discomfort or other signs of malfunction’. Coe, (1979) asserts that illness is a subjective phenomenon. Individuals perceive themselves as not feeling well and hence may deviate from usual normal behaviour. According to him, “the individual may feel sick without a disease being present, (or he/she may not experience illness even though a disease is present). Two persons with the same clinical symptoms may act altogether differently in degree and kind of concern expressed, and whether and how they search for treatment”
Foster and Anderson (1979) posit that the state of illness comes with a time sequence. “There is the beginning, an awareness of the first faint symptoms, there is a progression, the social and psychological progresses that occur, and there is a termination, through recovery or death. At many points during the course of illness, medical and social decisions must be made, roles adjusted and attitudes changed to confirm to the reality of the situations”. Medical sociologist believes that illness behavior is to a large extent influenced by the individual’s social class, ethnic background and culture of orientation.
The definition of health and illness polarizes between those that rely upon objectives, scientific criteria at one extreme, and awareness, at the other. It has generated divergent views and understanding which is reflected in the academic debates about the nature of health and illness.
Traditional Medical View
The traditional medical view is that there is such a thing as a normal functioning of the body, which has a limited degree of variation. When operating within the normal boundaries of these variations, a person can be defined as healthy, and when they are outside these normal boundaries, they are ill or there organs are diseased. Health can be defined within this framework as the absence of disease. It assumes a state of health unless symptoms emerge that demonstrate a deviance from normality.
The Positivist Approach
The positivist approach accepts the concept of disease, but, brings out a much broader social element into the definition, suggesting that health is not just a physical state, but also a wider sense of well-being, closely linked to our social surroundings.
While the Lay Models of Health perspective emerged to use the functional definition by arguing that health can be defined as the ability to perform normal daily activities (Haralambos and Holborn 2008:280-1). The functionalist approach to the sociology of health and illness derives from the work of Talcott Parsons. He explored the relationship between illness and social control. Parson (1951) put forward one of the most famous concept in the sociology of health and illness: the sick role. This is the role assumed by an individual who excuses him or her from the normal behaviour because he is sick due to injury or incapacitation. He/she then seeks compassion from colleges, friend and family members and is no longer able to carry out normal activities. The sick person has the right to be exempted from normal social obligations, such as attending employment, or fully engaging in family activities. More so, sickness is something that no person can do anything about and for which the sick should not be blamed -they therefore have the right to be looked after by others.
However the obligation of the sick role entails that the sick person must accept that he/she is in a situation that is undesirable and should seek to get well a soon as possible. The sick person must seek professional help and cooperate with the medical profession to get better.
To the functionalist, illness has positive adaptive function which only a critical analysis can bring out. Dysfunctionally, disease and illness are destructive of human organism attacking cells and tissues thus reducing organism’s adjustment. It brings loss resources for the individual and his/her group and can engender role problems as one individual or some people are put off temporally or permanently. On manifest, illness serves to forewarn the individual about the possible collapse of his/her physical structure and to effect repair. It makes the individual, his/her group or society to mobilize for such and similar occurrence, and for the group or society to train members for multiple roles incase of incapacitation of some people.
On the latent functions, illness relieves the victim of unbearable pressure, mainly from relatives and dependants. It is used to gain attention and also maybe a device to expiate sinful feelings.
The Work of Foucault
A Foucaultian perspective drives social constructionalism much further on, right to the heart of the natural or biological, arguing that what we know as disease are themselves fabrications of powerful discourses, rather than discoveries of ‘truths’ about the body and its interaction with the social world (Bury 1986)
The corpus of his major work from the 1960s to the 1980s is an attempt to write a new history of the subject as constituted through historically located disciplinary powers. Foucault’s starting position is the configuration of knowledge or episteme which constitutes particular subjects during specific historical periods. For Foucault (1973) sociology was deeply implicated in the very episteme which had given rise to medicine. The discipline of medicine provided the tool whereby subjectivity could be experienced and enforced.
Contemporary sociology is not against medicine or professional practice, but rather seeks to problematize the taken- for- granted categories or reality within which they operate and deploy power/knowledge. The relationship between sociology and medicine and practices has always had a major impact on the field of the sociology of health and illness. His work went further to review the changing relationship before moving on to discuss some key characteristic of a sociological account for modern medicine and the social functions of medical knowledge. Although it is inappropriate to label Foucaults work postmodern it has been an important influences upon postmodernists.
This approach allows the analysis of the fabrication of ‘health’, illness and “patient” subjectivity and the effect of the inscription on the body. It is suggested that health care professionals need to be more reflexive about their own knowledge claims and to resist the discursive practices which disempower and reduce choice.
There is sustained application of post-modernist ideas to the sociology of health and medicine, although there is certainly an interest among many to explore their relevance for the field. The objective of sociologists of postmodernity is to understand the nature of contemporary postmodern society. As a result of developments in medicine, the overall increase in levels of health, have created the belief that most people will live long healthy lives. “There is an increasing emphasis on ‘life planning’ and ‘self-identity’â€¦.as the constraints of life-threatening diseases early death and insecurity have given way to a more predictable life course” – Bury (1997). The experience of chronic illness therefore threatens much of what has come to be accepted as normal in contemporary society. Bury(1982) argued that chronic illness constitutes a major disruptive force in people lives undermining the taken-for-granted assumptions they had about the world and their place in it and forcing them to review their lives their own bodies and their own identities. He called this process biographical disruption. Narrative reconstruction is used by people to create a sense of coherence and order-why they got the disease.
Symbolic interactionism has probably been the most influential theoretical approach in the sociology of health and illness with studies focusing on the processes involved in people arriving at the decision to seek professional help, the interaction between the ill person and the medical professional in arriving at a definition of the illness and the impact on the person of being labeled as ill. This perspective rejects the notion that illness is a direct result of some form of disease instead they perceive it as a form of social deviance. What constitutes illness is a result of social definitions.
Mechanic (1968) defines illness behaviour as the way in which symptoms are perceived evaluated and acted upon by a person who recognizes some pain discomfort and other signs of organic malfunction.
Feminist Approach to Health
These can include liberal feminism, socialist feminism and radical feminism. Divisions are apparent in the theoretical debates on feminism within the sociology of health and illness.
All of them focuses in particular on inequalities of health between male and female and has sought explanations for these differences within the different role and economic positions of men and women. It tends to sought equality of numbers of men and women in the higher status medical professions and research has been undertaken to demonstrate the smaller number of women who occupy senior medical position and also the way in which nursing is regarded as lower-status, female profession. It also points to the lack of power that women have in their relations with the medical profession and demands a greater say in women’s health particularly in childbirth and conception.
Soialist feminist emphasizes that it is not possible to change the role of males and females within a capitalist patriarchal society as liberal feminist seek to do.
Health and illness in contemporary societies has been subjected of discuss from centuries back. Contemporary medicine includes unofficial, unorthodox, holistic and non conventional – reflects both the range of models of health which underlie these differing medicines and the ability of the more powerful biomedical profession to have them defined as somehow subservient to (complementary) or less proven (alternative than biomedicine.
Although there is general acceptance of the importance of social explanation in helping to understand health and illness within sociology, there is little consensus as to the exact mechanism which links social class, gender, ethnicity, and geography to different level of health – with the explanations ranging from those which stresses the wider economic structure of society, to those which stress the individual life style choice.
Finally the conceptualization of health and illness in contemporary society has brought out the idea that there are areas of knowledge which are natural and can only be understood through a sociological and physiological framework.
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