Sociological and Biological Constructs of Health

CONTENTS

1. Introduction————————————————————————1

Section 1

2. Definition of health and illness————————————————-2

3. Evaluate Sociological and biological constructs of health——————3

Section 2

4. Structural patterns in inequality in modern Britain————————-4

5. Evaluation of unequal distribution of illness——————————–5

Section 3

6. Factors that reduce the freedom of health care —————————-6

7. Structures of healthcare service that might affect individuals———–7

Section 4

8. Conclusion———————————————————————8

Section 5

9. Reference———————————————————————-9

Introduction

This report aims to understand and analyse the different definitions of health and illness in different perspectives, evaluate them and identify structural patterns in inequality in Modern Britain.

It also evaluates unequal distribution of illness from different perspectives among different groups. It identifies problems that might occur in accessing health care among different groups in modern Britain.

Finally it evaluates changes in healthcare services and the structures, and how this might affect different groups in the society.

DIFINING HEALTH AND ILLNESS

The speech “Beauty lies in the eyes of the beholder,” can be used to define my own version of health and illness as to what our views are about health and illness. For example I view health as been strong and healthy enough to carry out my daily chores, on the contrary inability to achieve it will be blamed on my physical health. So how do people view health and illness?

World health organisation (1946) defines health as the mental and physical wellbeing. On the other hand illness will be the defined as lack of mental and physical wellbeing.

The biopsychosocial model view health and illness as the interaction between biomedical, social and psychological factors. Biomedical refers to genetic factors such as inherited conditions and physiological changes of individuals, psychologically how we manifest our feelings and thought and socially how we socialise and communicate with persons and group of persons in the society as a whole. The interaction with all of these factors, coupled with cultural differences among different groups of people in Britain will influence the way we view health and illnesses.

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Holistic model view health and illness by taking into account the whole person, which includes the person’s body, spirit and mind. This mode is much more individualised to the person involved and rarely take into account wider picture and the social and environmental factors that might possibly influence health and illness across various cultures.

Biomedical models defines health and illness by using scientific measure to determine if a person is ill or not, as they believe that illness is caused by physical factors, such as physiological changes in the body and inherited genes, in case of mental health causes might be referred to neurotransmitters defect, biochemistry which might be linked to high increase of dopamine to the frontal cortex of the brain and so on. As such blood test, analysis and series of test are carried out to identify the causes and this may enable them to classify the illness and provide appropriate treatment through the use of drugs to control or cure the condition. Biomedical model view human body as a machine, in real sense machines do develop a mechanical fault and will require fixing up. This is how biomedical model view the body, at a point it might break down and require fixing up through surgery or drugs.

Sociological model believes that health and illness are caused by factors outside of the physiological changes in the body. This model attributes causes of ill health to poverty and inequality, socio standard of behaviour and communication in the society. Sociological model view health to be socially constructed in the society to control people. They also believe that different factors such as psychological, political, social, economic, biological, and culture and environment influenced the way people view health in the society.

Health is not an easy term to define. For some it encompasses mental health, for others physical and mental health are compartmentalized.

A perception of health or mental health is not only defined within the medical context, but it is also defined by the patient within a sociocultural context that includes family and social network as well as a wide selection of potential providers. Such definitions may vary from one culture to another, Warwick-Boot (2012).

Biomedical models does have some advantages as it enable the medical team to carry out series of medical test to find out any physiological changes. However, scientifically, there has been no expansion of drug innovation, old drugs have been manufactured under different names doing the same thing as previous drugs. This raise concern if these drug manufacturers are neutral to the medical teams. Areas with major health concerns and needs are been neglected and drugs budget have been dramatically reduced due to the poverty conditions of these groups for the fact that they might not make a lot of profit, this refers to the medical professionals as iatrogenesis meaning they are the cause of health problems.

The benefit of Sociological model is that it takes into account the factors outside of the physiological changes in the body such as psychological, political, social, economic, biological, culture and environment when viewing health and illness. The down side to it is that way cultures and different groups view health and illness changes over time. For example once homosexuality was viewed as illness and now it is normal in a society.

Section 2

Ethnicity

According to M. Senior, B Viveash (1998) refers to ethnicity as a way of life, behaviour that one acts on to make a sense of their cultural identity in a particular group in the society as a whole. Movement in and out of Britain have made Britain into more diversified cultural society today, to those who preserved it. Though several ethnic minorities are small, but in some cases there are larger ones in some demographic region like Brent in London. This makes it more obvious for a particular health need to be cared for in an area where ethnic groups are concentrated in.

The biological model often refers to the features which makes up the physical look of a person such as their skin colour to classify them into a group. Why the sociologists distinguishes people according to their ethnic groups.

The artefact explanations strongly believe that there are specific health and illnesses associated within different ethnic groups.

The sociologists have great concern in understanding why some certain health and illnesses are associated with different ethnic groups. Such as Afro-Caribbean linked with high rate of sickle cell anaemia an inherited blood disorder, why the White European have a high rate of haemophilia a disorder that prevents the clotting of blood and might cause someone to bleed to death if quick medical emergency intervention is not carried out on time. Also Asians are associated with high rate of heart diseases and so forth.

It is important to examine the way ethnic groups have distributed themselves in the demographic regions of Britain to enable us to account for their numbers in a particular area, whether they are minor or large such as ethnic group in Brent in London, understand some health related issues associated with these specific groups and outline the health care needs of the majority of the local people in the society.

Health inequalities exist among different groups. In this case among ethnic groups.

Ethnicity and Culture

According to Public Health Action Support (2011) there is evidence of documentation within ethnic inequalities in health outcomes in the UK. There are difficulties with the approach and measurement of ethnicity as to what the causes might be as outlined below.

• Ethnicity is regarded as a fluid concept, because it entails different meanings within different contexts. For example, an individual from Pakistan might consider himself as a Pakistani when filling out a form in the UK surveys, when filling out a form in the US might consider himself Asian. The definition of ethnicity is influenced by historical value and the current social and political context (Bradby, 2003).
• As definitions of ethnicity changes classifications such as race, skin colour, language, religion, nationality, country of origin, and culture do not change. These have limitations and implications in accessing health. Often reason for research are not clearly stated. Bhopal (1997) claims that ethnicity is a euphemism for race. Review of the literature, Comstock and colleagues (2004) found that researchers failed to differentiate between the concepts of race and ethnicity.
• Reliability and validity of measurements of ethnicity are huge concern to the society as a whole. Assigned ethnic identities may not match individual identities which threatens the validity of the research. Comparisons over time cannot reflect mixed ethnic identities. Finally classifying people as black, white, or Asian may mask differences associated between different groups of people. Ellison (2005).

For the fact Ethnicity is not written on UK death certificates, and mortality data uses country of birth as a proxy, this systems fail to recognise ethnic minorities that are born in the UK.

Findings on ethnic inequalities in mortality (Kelly & Nazroo, 2008):

• Caribbean’s born in the UK have high rates of mortality from stroke. Men born in the Caribbean have low rates of mortality from coronary heart disease.

• Born in West/South Africa you may have high mortality rates from stroke, but low mortality rates from coronary heart disease.

• If born in South Asia you may have high mortality rates form coronary heart disease and stroke.

• Non-white individuals may have low mortality rates from respiratory disease and lung cancer, but high mortality rates of diabetes.

Table 1: Analyses the rates of mortality by country of origin, England and Wales, 1989-1992.

Source: Wild and McKeigue (1997:705) in Bartly (2004)

Explanations for ethnic inequalities in health include:

• Biased results of statistical artefact.
• Illness are blamed on migrationprocess (change of environment).
• Genetic and biological differencesbetween ethnic groups may be a factor.
• It is associated with different culture and health behaviours.
• Poverty
• Experiences of various forms of racial abuse leads to health problems.
• Unequal treatment by the health care system in Britain.

Ethnic inequalities in health care access still persist in NHS. The inverse care law, first described by Julian Tudor Hart in 1971, states: The availability of good medical care tends to vary inversely with the need for it in the population

served.

Goddard and Smith (2001) outline reasons for variations in access to health care:

Availability:Some health care services may not be available to some population groups, or clinicians may have different propensities to offer treatment to patients from different population groups, even where they have

identical needs.

Quality: The quality of services offered to patients may vary between population groups.

Costs:The health care services may impose costs (financial or otherwise) which vary between population groups.

Information:The health care organisations may fail to ensure that all population groups are equally aware of the services available.

The sociological perspectives to illness varies. The functionalism expects a large population to have division of labour as no one is self -sufficient to ensure that the society functions in an orderly manner. They also encourage people to seek and comply with medical advice for speedy recovery so as to return back to work. They understands people have to work, and people do not claim to be ill deliberately and as such should not be punished. This perspective do aim to protect workers from been abused or punished by their employer due to ill health, however they do overstate the importance of the doctors who have the power to make or break a patient which leads to lots of medical errors referred to as iatrogenesis. There could also be dependency on drugs to force people back to work.

Marxism examine the economic systems of the capitalist society that shapes the society as a whole. As such the society is divided into two social groups which are the bourgeoisie and the proletariat. Bourgeoisie the private property owners and those that owns the means of production and create bogus profit are believed to have greater influences in the rules of the society. Why the proletariat (labourers), those who work for the bourgeoisie are been manipulated to believe that they are in a fair system. Marxism ideology encourages us to question the motives of the doctors as they intend to serve the rich people of the society. Due to the need to access healthcare and it is made available to the proletariat they have been made to believe that illness is a personal issue rather than socially constructed. Marxism does not acknowledge the the interaction between doctors patient and also they ignore the sickness and employment benefit offered by the capitalist states.

Feminism views thinks men dominate the medical professions and make decisions about a woman’s body which affects women. They also feel that lack of understanding of a natural process of childbirth have been labelled to be a medical condition. Exhaustion from a new role as a mum, have also been labelled as depression. They also think why are women contraception over emphasized? And men left out. This explains the inequality and the patriarchy world we are in today.

The interactionist views are that individuals attaches meaning to their own behaviour as well as others they also feel illness differ from person one person to person, even when they are diagnosed with the same condition. They are not always in compliance with the medical team that is why a dialogue is needed for mutual agreement between the doctor and the patient. Sometimes the doctors do not come to terms with a patient if they complain of a particular illness, and sometimes doctors label people with illness which affect the psyche of people’s mind and then making them psychosomatic by acting out those symptoms.

If we look at post natal depression as an illness diagnosed by a medical team from all of this prospective we can see that the functionist view conforms to this by giving the medical team the power to label this individual, which results to administration of drugs that eventually will become tranquillizers which leads to dependency with much more side effects. From the Marxism point of view people will be brainwashed to accept the fact that they are suffering from this illness due to their personal physiological changes rather than socially constructed issues of the society as a whole. The feminist does not see post natal depression as an illness, rather they feel it is a natural process for a woman to become sore after the birth of a baby as they may have had episiotomy, sore breast, sleepless nights for caring for a new born, instead of labelling it and interrupting a natural process by medication, they feel the patriarchy medical team should understand things better from a woman’s point of view. Finally post natal depression may be viewed as labelling an individual which into may utter their psyche and may begin to manifest the symptoms, they feel labelling someone may actually make them worse off.

Can you think of human behaviours or conditions that have recently been mediatised?

Think about what makes a person disabled? Write down some physical symptoms and then discuss how these can be ‘enabled’ in our society

Section 3

Definitions of Health, Illness and Sickness

http://nccc.georgetown.edu/body_mind_spirit/definitions_health_sickness.html

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Warwick

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Michael Senior with Bruce V

Health Knowledge

Inequalities in the distribution of health and health care

http://www.healthknowledge.org.uk/public-health-textbook/medical-sociology-policy-economics/4c-equality-equity-policy/inequalities-distribution. Public Health Action Support 2011