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The social construction of Health and Illness
In what ways can it be claimed that health and illness are socially constructed? Refer to sociological theory in your response, and give examples from everyday life.
This assignment reviews the theory of social constructivism and its significance to Today’s social construction of Health and Illness , and how health and Illness are perceived and interpreted by society . This paper will explore different aspects to the social constructionist debate, on the two of the most important aspect such as “problematisation” , but mostly focusing on “medicalisation”. It will explore the macro-social factors, cultural aspects,the socio-economic conditions that could possibly be some of the fundamental aspects of the construction of both Health and Illness.It will also focus on analyzing the terminology and the etymology of the words and how it changed its meaning historically.
The social construction of Health and Illness
A social vision of medicine seems to move attention to the promotion and information of health, on the social, cultural, political and economic health in terms of factors and variables in relation to each other without forgetting that the center is the individual. It is in this perspective that relational sociology intends to look at health in a post-modern reality in where the values appear to move continuously toward individualism systemic, a need for efficiency, a multiplication of the roles of the social actor.
I would like to start this assignment with an example of what social construction of health is. From the Iconic contents of the Iliad and the Odyssey, we can understand the significant knowledge of the Epoch on the ancient pathologies. Omer describes the fractures of the Femur, with very medicalised terms very accurate detail but most importantly he uses a very significant metaphor to describe the state of health as the joy and strive of Ulysses as soon as he spot a land like the recovery from an Illness.
Ulysses is a mature man , a man that suffered a lot but most significantly a man that depended on travelling , we can relate to Ulysses in our Modern and contemporary lives.
Ulysses comes back to not go back , so he doesn’t get recognized and not to recognize. The Return of Ulysses is the Journey , not his landing, like this the individual looks and strives for health as a definitive experience inasmuch as health doesn’t seem to be an ideal state but rather a construction, of a reality .
“The sociology of knowledge must concern itself with whatever passes for “knowledgeâ€Ÿ in a society, regardless of the ultimate validity or invalidity (by whatever criteria) of such “knowledge”. (Berger, P. L. and T. Luckmann ,1971.pp. 15), “To understand the state of the socially constructed universe at any given time, or its change over time, one must understand the social organization that permits the definers to do their defining. Put a little crudely, it is essential to keep pushing questions about the historically available conceptualizations of reality from the abstract “What?â€Ÿ to the socially concrete “Says who?â€Ÿ (Berger, P. L. and T. Luckmann ,1966),
The social constructionist debate is one of the most important in social science analyses of health and illness. It is part of a critical approach to biomedicine and biomedical knowledge that emerged in the 1970s. Many of the assumptions and values of the medical profession and biomedicine were challenged and criticised for being consistent with the patriarchal and capitalist structures of the society in which they were located.
From this emerged an anti-psychiatry movement which argued that much of what was labelled a mental illness was simply a social construction created by psychiatrists who acted as powerful agents of social control.
Diagnosing someone as schizophrenic for example, enabled psychiatrists to declare that person unfit to participate fully in social life. Diagnostic categories were called into question and the application of medical knowledge was seen as being political and not just a technically neutral act.
These ideas in the social constructionist debate have been applied to question the assumptions on which biomedicine’s autonomous and extremely powerful position in society is based.
There are several different aspects to the social constructionist debate, two of the most important are “problematisation” and “medicalisation”.
This approach states that diseases are not simply real but are products of social reasoning and social practices. Calling a set of symptoms “bronchitis” does not mean that a discrete disease exits as an entity independent of social context.
That is how medical science at a given place and time with the aid of laboratory tests and theories has come to define it. Someone with bronchitis will experience pain and suffering but the interpretation of it will vary between time and place.
In this sense then the idea of medical discoveries is misleading. There are no fixed realities of the human body waiting to be discovered. There are fabrications or inventions by biomedicine which implies that the disease was established through certain investigations which confirmed its reality.
It is indirectly related to social constructionism – it does not question the basis of medical knowledge as such but challenges its application. It draws attention to the fact that medicine operates as a powerful institution of social control. It does this by claiming expertise about matters of life which had previously not been regarded as medical matters e.g. ageing, childbirth, alcohol consumption and childhood behaviour.
Social construction of Health and Illness
Health does not qualify as a given, but a map and a construct generated by coordinating various points of view. As disease, health is a model, socially constructed, to interpret reality. So health, can be configured as an event, that the individual can use to interpret the world and relationships with the society in which he lives: a repertoire of signs that the social actor can use to interpret the social order.
So the disenchantment of the world, a result of erosion of traditional paradigms, leaves the individual alone, only to represent themselves in different roles in which he is called by many of the company.
The definition of health and the promotion of health itself exceeds the model, so to speak, ideal health, what which is constituted as the absence of disease: health becomes a condition which has an almost unconscious, seems coincide with the flow of life.
The disease, as agent that interferes with this flow, it seems revealing it as a lost condition. This model of the relationship between health and disease seems be that prevailing paradigms in medical and health facilities.
The logic seems to characterize the medical paradigms seems develop according to a complex system of different modes:
- The first mode is the linear one in which a given injury causes a disease condition and treatment become a system in place to repair the damage had.
- The second way is the individualistic : health and disease are determined by absence / presence of resources in the individual and care form interventions directed exclusively to the individual.
- The Last is the a-historical: it ignores the interaction of the individual with his environment, its culture, its history, its social condition.
In this direction, macro-social factors, cultural differences, events external and extreme, the socio-economic conditions, the lack of a adequate social support, the relational environment against, are all, factors totally or relatively independent of the characteristics biological or psychological of an individual. (Canguilhem, 1988; Stern, 1927; White, 1991a; Zinsser, 1935).
The micro-social contexts and macro-social have a crucial role in the onset and evolution health status of individuals.
The networks of relationships can foster the creation of informal mechanisms of protection against disease and old age or, through the stimulation of collective action, can improve the efficiency and effectiveness of the provision of certain services by the public sector.
Kleinman (1980) has proposed a distinction between etymologies: disease, which refers to abnormalities in the structure or operation of organs and systems, and that is the domain of the biomedical model; illness, which is refers to the individual perception of a state that has a negative connotation and that includes, but is not limited to disease; sickness, indicating the events that can become disease or illness.
The term illness should refer to the direct experience of sick, the experience of the disease, while the disease is indicated conceptualization of the disease by the physician. Therefore, there is a difference between being sick and having a disease, a difference that in the German language is perceived as Erkrankung and Krankheit, needed to introduce a further term, sickness, indicating the perception of the disease by part of the social non-medical.
Precisely in this perspective Young (2004 ,p.26), exploring the social construction of the disease, proposed the further specification by the term sickness, which does not seem to be simply an ambiguous term that defines the was among the biological damage and the subjective perception of the damage.
The disease-sickness is to be understood as in fact the process through which, in conduct of concern and biological symptoms, is given a meaning socially recognizable and, therefore, acceptable.
Every culture has, according to Young (2004), the rules for “transforming” signs of the body in the symptoms, to connect the symptoms in a model etiological and intervention.
The disease-sickness, then, seems to be a process for socializing disease and disease-illness. The same set of signs, for example, can match, and different types of diagnosis and therapy. Is the causative dominant model in that society that “decides” what kind of disease the individual has and what will be the appropriate therapy.
The disease-sickness, also determines the size of individual of the disease. But it is society that determines which symptoms pay attention, when it is legitimate to feel bad and when it is not.
The role of Medicalisation
Medicine constructs or redefines aspects of ‘normal’ or accepted everyday life as medical problems. Professionals tend to offer technological or biomedical solutions to what are inherently ‘normal’ aspects of everyday life or social problems. Medicine has become a major institution of social control and this has been related to an increasing complex and bureaucratic system which encourages a greater reliance on experts.
High-tech modern medicine has become increasingly dangerous to the population’s health by:
- reducing their autonomy and their ability to cope with their problems;
- making them dependent on the medical profession;
- damaging their health by the side effects of drugs and surgical interventions;
The medical system operates in close relationship with the manufacturers of pharmaceuticals and medical equipment, and this relationship is not necessarily in the patient’s interest. (Illich, I. 1977)
Inherent in the medicalization thesis are Marxist and Phenomological approaches to health and illness. This thesis considers definitions of illness to be products of social interactions or negotiations which are unequal because people do not have equal influence on the social construction of reality. Medical professionals are more able to define what counts as sickness than ordinary people. Medical professionals, therefore, have great scope for social regulation because if matters have to be defined as medical concerns, then health professionals have the authority to monitor, intervene and pass judgements upon them.
A common construction of the cause of disease portrayed in our culture , especially the idea that lifestyles are freely chosen , individualizes and obscures the way in which disease is socially produced.
The conceptualization of medicine as the application of ‘objective’,‘scientific’ knowledge to a purely biological body, obscures how diseases are produced in structures of inequality that are social that are mainly based on class, gender, or ethnicity.
At the centre of all sociological accounts of medicine is the argument that medical knowledge performs social functions independently of whether it cures and heals. Medical knowledge and practices are social accomplishments, and not the inevitable outcome of science or nature.
The sociological perspective on medicine seems focus its attention to the information and promotion of health, on the cultural, social, economic and political health in terms of factors and variables in relation to each other without excluding that the center is the individual. It is in this perspective that relational sociology intends to look at health in a post-modern reality in where the values appear to move continuously toward individualism systemic. The micro-social contexts and macro-social have a crucial role in the onset and evolution health status of individuals.
Albrecht, Gary L., Fitzpatrick, Ray and Scrimshaw,Susan C. (eds) (2000) Handbook of Social Studies in Health and Medicine. London: Sage
Berger, P. L. and T. Luckmann (1966),The Social Construction of Reality: A Treatise in the Sociology of Knowledge, Garden City, NY: Anchor
Conrad, P. (ed.) (2001) The Sociology of Health and Illness: Critical Perspectives. New York:
Conrad, P. and Barker, K. (2010) ‘The social Construction of Illness: Key insights and policy implications’ Journal of Health and Social Behaviour 51(S) 67-79
Dausset J., La medicine predictive et son ethique, in Pathologie et Biologie, 1997, pp. 199-204.
Freund, P. and McGuire, M. (1999) Health, Illness and the Social Body. Engelwood Cliffs,NJ: Prentice Hall.
Illich, I. (1977). Limits to medicine: Medical nemesis: the Exploration of health. NY: Penguin
Young,J.T. (2004) ,”Illness Behaviour : A Selective Review and Synthesis”, Sociology of Health and Illness,26,1:1-31
White, Kevin (2002).White, Kevin (2002). An introduction to the sociology of health and illness. SAGE. p. 42. SAGE. p.42.
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