The aims of the task are to describe the terms health and illness. Too outline biological, and sociological, perceptions of health and illness. Also too describe various patterns of health inequalities within society, and to evaluate the different perspectives of health and illness with in society. The booklet will also provide a brief analysis of two different approaches to the study of mental health and illness within society.
According to the World Health Organisation "health is a complete physical, mental and social wellbeing and not merely the absence of disease and infirmity"(The W.H.O). Illness is poor health resulting from disease of body or mind, sickness or a disease, (www.thefreedictionary.com/illness). Many factors combine together to affect the health and well-being of individuals and communities.Â Whether people are healthy or not is determined by their circumstances and environment. Factors such as where we live, the environment we live in, genetics, diseases, employment and income, education, and relationships with friends and family all have considerable impacts on health and well-being, whereas the more commonly considered factors such as access and use of health care services often have less of an impact.Â
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Sociologists and specialists in social epidemiology are scientists who study the distribution and incidences of disease and illness within the population. They attempt to explain the link between health and variables such as social class, gender, race, age and geography.
The biomedical model is the most dominant theory in Modern Western medicine of health and illness, held by many official health practitioners such as doctors, consultants, and surgeons has been labelled the 'biomedical approach model'. The biomedical model presumes that illness is always due to abnormalities in the body's workings. It is the basis of modern Western medical practice. It works on the theory that if a part of the body goes wrong it should be fixed or replaced, in the same way that a machine would be repaired. It is a reductionist view of illness. This means that it takes the simplest possible cause of the illness and applies the simplest cure. It's unlike other models such as the social model as that looks to other factors and focuses on them, such as culture, and social aspects. The biomedical model is used, to bring down the number of morbidity and premature mortality deaths. This model is where we look at the parts of the body that might work together to make sure we have good health. This model focuses on the actual person, rather than the social and emotional process of the individual. The aim of it is to identify people who are at risk from a disease. It focuses on the treatment rather than the prevention.http://cnx.org/content/m13589/latest/Graphic1.png
Sociological perception believes that health is a state of complete wellbeing, physical, mental, and emotional. It emphasizes the importance of being more than disease free, and recognises that a healthy body depends upon a healthy environment and a stable mind. This sociological view, points out that society plays a role in sickness and assumes that, a functioning society depends upon healthy people and upon controlling illness. In contrast to the biomedical model, which pictures illness as a mechanical malfunction, Parsons described the sick role as a temporary, medically sanctioned form of deviant behaviour (Parson, 1950). Parsons used ideas from Freud's psychoanalytic theories, the idea that a sick person has conflicting drives both to recover from the illness and to continue to enjoy the 'secondary gains' of attention and to be exempt from normal duties. Parsons also used functionalism to explain the social role of sickness by examining the use of the sick role mechanism. In order to be excused from a person's usual duties and to be considered not to be responsible for their condition, the sick person is expected to seek professional advice and to adhere to treatments in order to get well.
Marxist, believe doctors act as agents of social control, to keep the workforce healthy, a healthy workforce is a productive workforce. Doctors indirectly work for the capitalists, as their job is to get people back to work as quickly as possible. Ethnic, Materialistic and structural explanation argues, that heart problems amongst minority ethnic groups must be seen as a result of ill-health, caused by low incomes and poor working conditions. Groups from Pakistan and Bangladesh are more likely to live in poorer housing conditions, unlike the Indians and Chinese who are more likely to be middle class, and generally suffer from fewer health problems, than other Asian groups. http://www.sasi.group.shef.ac.uk/maps/nsdivide/north-south_divide_UK_no_labels_blue_red_small.jpg
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In the UK the chances of becoming sick or even dying are directly linked to several factors, these include, social class, gender, age and ethnicity. The higher the social class, the healthier a person will be. People with a higher class status are less likely to die of heart disease, stroke or lung cancer. (Acheson report 1998) clearly shows a health gap between classes. People living in the North of the UK are less healthy than those from the South. (Shaw et al) found that the infant mortality rates were twice as high in the North, and also found that four times as many households with children are living in poverty. There are also nearly three times as many people in the North living with long term illnesses than those from the South. This is referred to as the North/South divide, and is linked to such things as social class and ethnicity. The working class and the minority ethnic groups are more likely to live in poorer areas, than the white middle class who live in suburbs and rural areas. People living in these richer areas tend to be healthier due to better air quality, more exercise space and a less hazardous environment.
Parsons sick role model has been an influential theory, which reveals clearly how an ill person is an integral part of a larger society context. There are however a number of weaknesses that have been collected against it. Some argue that the sick role is unable to capture the experience of illness, and that it cannot be applied globally, for example the sick role theory does not account for instance, when doctors and patients disagree about a diagnosis, or they have conflicting interests. The sick role does not work for people who have suffered with chronic illness and symptoms for years, and have been misdiagnosed repeatedly. These people are denied the sick role until a clear diagnosis of their condition is made. Other factors such as race, class and gender can affect whether the sick role is granted. The realities of health and illness are more complex than the sick role suggests. The sick role is useful in understanding acute illness, but it is less useful however in the case of chronic illness.
Marxism is a structural theory that studies sociology as a whole. Marxists are critical of capitalist societies which they see as a society of two parts. The first component of society is the economic base, (infrastructure). The second component is the superstructure, which includes major agencies of social control such as education, medicine and religion. Marxists theory is concerned with the way in which the dominant economic structure of society determines inequality and power, as well as shaping the relations upon which the major social institutions are built. Medicine is a social institution, and in capitalist societies, it is shaped by the capitalist interests. Navarro (1985) said there are four parts to defining medicine as a capitalist. He believes that medicine has become a market commodity, increasingly specialised and hierarchical. He believes that medicine has now become an extensive wage labour force, increasingly profitable for two dominant capital interests (the financial sector and the corporate sector). The last point states that medicine, is as organised as the national health care system this does not mean it is free from capitalist influence. Marxist claims that health problems are closely tied to unhealthy and stressful work environments. Rather than seeing health problems as the result of individual weakness, they should be seen in terms of the unequal social structure and class disadvantage that are reproduced under capitalism. Patterns of mortality and morbidity are closely related to occupation especially in the case of the industrial working class, for example industrial carcinogens (asbestos, metals and chemicals) are responsible for over 10% of all male cancers. Critics have found weaknesses in the Marxist views, as it focuses more on its inadequacies than its practise of locating medicine firmly within capitalism. The critics believe they should pay more attention to the dynamics of the medical process, the experience of illness and the state of being a patient. http://www.dreamstime.com/medicine-and-health-icons-set-6-part-1--thumb401393.jpg
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There are two different approaches regarding mental illness, these are social realism and social construction. Social realism is a term used to describe the approaches of sociologists who, accept there are a distinctive set of abnormal behaviour, which cause distress to individuals and to those around them. These forms of abnormal behaviour are classified as mental illness. Social construction has been very influential in sociological approaches to mental health, and start from the argument that what is considered normal varies, over time and from society to society. For example, over the last two hundred years in Britain, alcohol consumption has been seen variously as normal, as morally wrong and even illegal, as a sign of being mentally ill and as a part of religious rituals.
Labelling theory rests firmly upon a social contructionist definition of mental health. According to Scheff (1966), whether someone becomes labelled or not is determined by the benefits that others might gain by labelling the person "mentally ill". Those people who become a nuisance, or who prevent other from doing something they want to do, are far more likely to be defined as being mentally ill, than those who pose no threat or inconvenience, and may be ignored. The labelling perspective on mental illness has not gone unchallenged. According to Gove (1982), labelling may help explain some of the responses of others to the mentally ill, but it cannot explain the causes of the illness. http://mental.buu.ac.th/images/logohand_MentalHealth.JPG
Structuralist perspectives on mental health are closely tied to the social realist definition of mental health. These approaches accept the reality of mental health and set out to discover what factors in society might cause illness. There is clear evidence of mental health differences between social groups. When looking at which group is most likely to suffer from high rates of mental illness, the poorest and the most excluded are hugely excessive. A government study (2004) found that children from the poorest backgrounds were three times more likely to have conduct orders than those whose parents were in professional occupations.
Mental illness has been with us since the beginning of time. There are many types of mental illness and they vary in severity and duration. There are also many sociological arguments over the very definition of the term and how to explain the differences in mental illness within society.