Download Department of Sociology

Department of Sociology
Rhodes University
Honours 2016
2nd Term
Sociology of Health and Illness
Lecturer: Janet Chisaka
Course Description
The sociology of health, illness and healthcare has changed drastically over the past few decades. It
began mainly by sociologists who worked closely with doctors, and who took for granted doctors’
assumptions about health and healthcare. Thus early medical sociologists, such as Talcott Parsons,
primarily asked questions that doctors deemed important. However, by the 1970s, the field had
begun shifting toward a very different set of questions. Some of these questions challenged the
doctors’ assumptions and others focused on the issues that were beyond most doctors’ areas of
interest or expertise, such as the effects of poverty on health or how individuals develop meaningful
lives despite chronic illness.
The course aims to provide you with a thorough grounding in the sociology of health, illness and
healthcare (focus on RSA health policy and healthcare), including critical sociological perspectives
on medicine, health and society; the changing nature and status of professional power and
dominance; illness experience and patient-professional relations in medicine and healthcare.
Sociological explanations of health and illness move beyond individual explanations, towards a
social analysis of these phenomena including a critique of healthcare. Our sociological focus is in
no way denying the many advantages and successes of medical knowledge and healthcare.
Course Requirements & Assignments
Attendance of all seminars is compulsory. There will be two seminars a week, on Monday and
Wednesday from 9am to 12.30pm in the Steve Biko Seminar room. I will lead the Monday seminar,
but you are expected to actively participate (reading before a seminar is a must). For the Wednesday
seminar you must e-mail me ([email protected]) a 2-3 page written discussion based on the week’s
key readings and set question (see seminar guide below). The email deadline is Tuesday 04.30pm.
These weekly submissions will collectively count 30% towards the in-Term course mark, and late
submissions will not be assigned a mark, but feedback will be provided. You will each do a
presentation (counts 20% of the in-Term course mark) on a theme drawn from the seminar topics. A
long essay (8-10 pages) is due on 27nd May. You are encouraged to formulate your own question or
you can choose one of the seminar questions. The essay counts 50% of the in-Term course mark.
A three hour exam will be written in June. The in-Term mark counts 40% and the June exam 60%
of the entire course mark.
Success in this course, like others, is dependent on your active engagement with the course, and
reading beyond prescribed material. Given that health, illness and healthcare are issues that you can
all relate to, you are encouraged to reflect on and incorporate your understanding and experience of
these phenomena in your assignments. You should incorporate media accounts, especially those on
South African healthcare.
SEMINARS
Week 1: Sociological perspectives on health, illness and healthcare
This week’s seminars provide a brief historical and theoretical discussion on western medicine
Readings
Annandale, E. 1998. The sociology of health and medicine: a critical introduction. Malden:
Blackwell Publishers Inc.
Foucault, M. 1975. The birth of the clinic: an archaeology of medical perception. New York:
Vintage Books.
Foucault, M. 1979. Discipline and punish: the birth of the prison. Harmondsworth, Middlesex:
Penguin.
Illich, I.1976. Medical nemesis: the expropriation of health. New York: Bantam.
Kelleher, D., Gabe, J. & Williams G. 1994. Challenging medicine. London: Routledge.
Kuhlmann, E. & Annandale, E. 2010. The Palgrave handbook of gender and healthcare.
Basingstoke: Palgrave Macmillan.
Navarro, V. 1979. Imperialism, health and medicine. New York: Baywood.
- 1986. Crisis, health, and medicine: a social critique. New York: Tavistock.
- 2004. The political and social contexts of health. New York: Baywood.
- 2007. Neoliberalism, globalization and inequalities: consequences for health and
quality of life. New York: Baywood.
- 2009. What we mean by social determinants of health. International Journal of Health
Services. Volume 39 (3) 423-441.
Nettleton, S. 1995. 1st Edition. The sociology of health and illness. Cambridge: Polity Press.
Nettleton, S. 2013. 3rd Edition. The sociology of health and illness. Cambridge: Polity Press.
Netttleton, S. & Gustafsson, U. (eds.) 2002. The sociology of health and illness reader.
Cambridge: Polity Press.
Parsons, T. 1951. The social system. Glencoe, Illinois: Free Press.
Scambler, G. (ed). 1987. Sociological theory and medical sociology. New York: Tavistock.
Strong, P. M. 2006. Sociology and medicine. Hampshire: Ashgate Publishing Limited.
Weitz, R. 2004. Sociology of health, illness, and health care: a critical approach. Belmont,
California: Wadsworth/Thomson.
Question:
The sociological perspective sets sociologists apart from other health and social researchers. This
perspective focuses on explaining social patterns rather than individual behaviour and on
identifying and resolving public issues rather than personal problems. In your view, what
sociological perspective/s can be used to understand health, illness and healthcare?
Week 2: Medical profession
Readings:
Conrad, P. 1979. Types of medical social control. Sociology of Health and Illness Vol. 1 (1) 1-11.
Conrad, P. 1992. Medicalization and social control. Annual Review of Sociology Volume 18 (1)
209-232.
Conrad, P. 2005. The shifting engines of medicalization. Journal of Health & Social Behavior
Volume 46 (1) 3-14.
Freidson, E. 1993. How dominant are the professions? In F. Hafferty & J. McKinlay (eds). The
changing medical profession: an international perspective. New York: Oxford University
Press.
Lupton, D. 1997. Doctors on the medical profession. Sociology of Health & Illness Volume 19 (4)
480-497.
Lupton, D. 1997. Foucault and the medicalisation critique. In A. Petersen & R. Bunton (Eds.).
Foucault: health and medicine. London: Routledge.
Ritzer, 1975. Professionalization, bureaucratization and rationalization: the views of Max
Weber. Social Forces Volume 53 (4) 627-634.
Zola, I. K. 1972. Medicine as an institution of social control. Sociological Review Volume 20 (4)
487-504.
Question:
Why is the medical profession dominant in capitalist societies?
Week 3: The changing medical profession
Readings
Armstrong, D. 1990. Medicine as a profession: times of change. British Medical Journal Volume
301:691-3.
Elston, M. A. 1991. The politics of professional power: medicine in a changing health service. In J.
Gabe, M. Calnan & M. Bury (eds.). The sociology of the health service. London: Routledge.
Frenk, J. & Durá-Arenas, L. 1993. The medical profession and the state. In F. W. Hafferty & J. B.
McKinlay. The changing medical profession: an international perspective. New York:
Oxford University Press.
Hafferty, F. W. & McKinlay J. B. 1993. The changing medical profession: an international
perspective. New York: Oxford University Press.
McKinlay, J. B. & Marceau, L. D. 2002. The end of the golden age of doctoring. International
Journal of Health Services. Volume 32 (2) 379-416.
Question
Do you agree with McKinlay & Marceau’s claim that we have come to the “end of the golden age
of doctoring”?
Week 4: Medicine and social justice
Readings:
Anand, S. 2004. The concern for equity in health. In S. Anand, F. Peter & A. Sen (eds.). Public
health, ethics, and equity. Oxford: University of Oxford Press.
Anand, S., Peter, F. & Sen, A. 2004. Public health, ethics, and equity. Oxford: University of
Oxford Press.
Baumrin, B. 2002. Why there is no right to health care. In R. Rhodes, M. Battin & A. Silvers
(eds). Medicine and social justice: essays on the distribution of health care. New York:
Oxford University Press.
Daniels, N. 1985. Just health care: studies in philosophy and health policy. Cambridge: Cambridge
University Press.
Daniels, N. 2002. Justice, health, and health care. In R. Rhodes, M. P. Battin & A. Silvers (eds.).
Medicine and social justice: essays on the distribution of health care. New York: Oxford
University Press, Inc.
Daniels, N., Kennedy, B. & Kawachi, I. 2004. Health and inequality, or, why justice is good for
our health. In S. Anand, F. Peter & A. Sen (eds.). Public health, ethics, and equity. Oxford:
University of Oxford Press.
Rawls, J. 1999. A theory of justice. Cambridge, Massachusetts: Belknap Press of Harvard
University Press.
Rispel, L. & Setswe, G. 2007. Stewardship: protecting the public’s health. South African Health
Review 3-17.
Wilkinson, R. & Pickett, K. 2009. The spirit level: why greater equality makes societies stronger.
New York: Bloomsbury Press.
Wilkinson, R.G. 2005. The impact of inequality: how to make sick societies healthier. London:
Routledge.
Question:
Baumrin (2002) claims that the right to health care does not exist because there is no reciprocal
‘duty’ (for example, the South African Department of Health is ‘duty’ bound by the Constitution to
provide health care to all RSA citizens). Do you agree? Why or why not?

If yes: Are all duties obtainable or possible?

If no: What are some of its flaws? Can a right exist without a ‘duty’
Week 5: Illness experience
This week’s seminars will largely draw on illness experience in the media (or personal accounts),
and the sociological approaches discussed in the first week will be used to analyse these illness
narratives.
Readings:
Bury, M. 1982. Chronic illness as biographical disruption. Sociology of Health and Illness,
Volume 4 (2) 167-182.
Charmaz, K. 1983. Loss of self: a fundamental form of suffering in the chronically ill. Sociology of
Health and Illness. Volume 5 (2) 168-197.
Charmaz, K. 2000. Experiencing chronic illness. In Albrecht, G. L., Fitzpatrick, R. &
Scrimshaw, C. (eds). The handbook of social studies in health and medicine. London: Sage
Publications Ltd.
Chisaka, J. K. C. & Coetzee, J. K. 2009. Biographical disruption, HIV/AIDS and
Chronic poverty. Acta Academica, Volume 41 (2) 109-131.
Parsons, T. 1951. The social system. Glencoe, Illinois: Free Press (His ‘sick role’ thesis).
Szasz, T. 1957. Pain and pleasure. New York: Basic Books.
Williams, G. & Popay, J. 1994. Lay knowledge and the privilege of experience. In J. Gabe, D.
Kelleher & G. Williams. Challenging medicine. London: Routledge.
Assignment:
Critically compare two illness narratives based on one or two of the following differences – gender,
class, ethnicity, country (developed/developing), rural/urban, educated/uneducated or any marker of
your choice.
Week 6: Health policy and healthcare in South Africa
Readings:
African National Congress. 1994a. Policy document: A national health plan for South Africa.
www.anc.org.za/show.php?id=257
Baker, P. A. 2010. From apartheid to neoliberalism: health equity in post-apartheid South Africa.
International Journal of Health Services. Volume 40 (1) 79-95.
Coovadia, H. Jewkes, R., Barron, P., Sanders, D. & McIntyre, D. 2009. The health and health
system of South Africa: historical roots of current public health challenges. Lancet Volume
374 (9692) 813-817.
Doherty, J., McIntyre, D. & Gilson, L. 2000. Social health insurance. South African Health
Review 169-181.
Engelbrecht, B. & Crisp, N. 2010. Improving performance of the health system: perspective ona
national health insurance. South African Health Review 195-204.
Evans, M. & Shisana, O. 2012. Gender differences in public perceptions on National Health
Insurance. The South African Medical Journal Volume 102 (12).
Møller, V. (ed) 2007. Quality of life in South Africa ten years into democracy. Dordrecht:
Springer.
Padayachee, T., Seunanden, T., Ogunmefun, C., Morley, P., Zide, B. Mureithi, L., van Schaik, N. &
English, R. 2013. Documenting good practices in the public health sector of South Africa:
from policy to practice. Durban: Health Systems Trust.
Reynolds, L. 2013. Healthcare that is accessible to all is the foundation on which an equitable
and efficient system must be built. http://mg.co.za/article/2013-05-17-00-comment-freehealthcare-is-a-human-right
Ruiters, G. & van Niekerk, R. Universal health care in southern Africa: policy contestation in health
system reform in South Africa and Zimbabwe. Scottsville: University of KwaZulu –Natal
Press.
South African Medical Association. January, 2012. Submission of comments on the NHI green
paper.
http://www.samedical.org/assets/files/nhigreenpaper/SAMA%20NHI%20submission.pdf
Urbach, J. 2012. A wealthier SA will be a healthier SA.
http://www.freemarketfoundation.com/issues/a-wealthier-sa-will-be-a-healthier-sa
van den Heever, A. 2011. Evaluation of the green paper on NHI.
http://www.hsf.org.za/siteworkspace/gp-review-alexvdh-dec2011-vf-1.pdf
Wadee, H. & Khan, F. 2007. Human resources for health. South African Health Review 141-149
Assignment:
Critically discuss the pros and cons of the current health policy in South Africa.