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Sociological Perspectives on Society and Health Aim: To describe functionalist, conflict and social interactionist perspectives applied to health Functionalism (Durkheim 1858-1917) • Functionalists focus upon the apparent consensus with appears to exist among members of any society. This consensus also explains, supposedly, the nature of the social institutions which assist social reproduction. Functionalists adopt a perspective on society like the one the biologist may take towards the body. Each organ has its function. Change comes from outside the system. Conflict sociological perspective (Marx 1818-83) • Before all else people must survive • The structures of economic production predominantly explain the social structures • In the book ‘Capital’ Marx traced the European development of capitalist, factory based, relations of production from earlier, feudal production - based on living off the land. Class struggle as ‘the motor of history’ • The development of capitalism involved the move of people from rural areas to urban areas to sell their ability to work • Marx defined class as a relationship to the means of production. The capitalist owns land and capital (money invested to make more money) and workers sell their ability to work • This master and servant relationship is seen as essentially antagonistic, as workers are replaced by machines invented to cheapen production. Functionalist and conflict based sociological perspectives Functionalists emphasize social consensus and social persistence through social reproduction. Social class is defined on a social ladder. • Conflict theorists emphasize pursuit of vested interested by groups with opposing material interests. Social class is defined as a relationship to production which will bring about an international capitalist system as the employers seek more profits through cheapening production and broadening markets. Society from a social interactionist perspective (Life after Freud?) • Social interactionists differ from functionalist and conflict sociologists who often look at the ‘big picture’. Their focus is on the apparent perceptions people have and the related choices they make, often in micro social climates. • Social interactionists see human behavior as the product of what people ‘feel’ is going on around them. They are not most interested in events and their apparent causes, but in the meaning or interpretation that individuals place on events. The march of world history in the 20th century • Socialist revolutions by followers of Marx in Russia in 1918, China in 1949 • Two world wars in Europe and the failed and racist experiment with Fascism • Establishment of the United Nations but then the Cold War arms build-up • Fall of the Berlin Wall, beginning of nuclear disarmament and of a new, international world order based on the market and the control of bad outcomes by a democratic government Functionalist theory applied to health (examples) • Talcott Parsons(1951) argued that people can only escape the stresses of social expectations through illness or crime. • Four elements of ‘the sick role’ are (1) the absence of responsibility of the individual for his or her condition; (2) Exemption from normal task and role obligations; (3) one should want to get well; (4) The obligation to seek out competent help Conflict perspectives applied to health • In the 19th century Engels pointed out how the health of workers and children was destroyed by the combination of factory conditions and poverty Today, people in the wealthiest countries have the best health (although the US performs comparatively poorly) • Argument about mental health (Is it being increasingly defined by the interests of drug companies and doctors who prescribe pills?) Foucault’s Perspective on the body • Foucault argued that the body is the ultimate site of political and ideological control, surveillance and regulation carried out by government and professional groups. He saw the historical development of science and the power of professional interests as growing together. He viewed sick or deviant others as being treated primarily as objects for classification in the personal advance of those with powerful, vested interests. The weak are subjects of discourse. Social interactionist theory applied to health • Goffman pointed out the difference between social status symbols and social stigma symbols. The latter may include physical deformities, perceived abnormalities or blemishes of character (addiction, mental disorder or imprisonment) and tribally allocated stigmas related to ethnicity or religion. • He talked about the treatment and the feelings of people experiencing social stigma, such as patients in mental hospitals. The United Nations and International Human Rights • 1948 - Universal Declaration of Human Rights • All human beings are born equal in dignity and rights ‘without distinction of any kind such as race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status’. • Wars and oppression continued regardless, but to a lesser extent The foundation of antidiscrimination legislation • The establishment of the United Nations (UN) after World War 2 and the adoption of the Universal Declaration of Human Rights begins an official global process to develop the view that all people are born equal and with ‘inalienable’ rights. • National and state laws also indicate that citizens have responsibilities. How should rights and responsibilities be related? Aust. Anti-Discrimination Acts • It is illegal to discriminate on the basis of: • Sex, pregnancy, marital status • Race, colour, nationality, ethnic or ethnoreligious background • Physical or intellectual disability • Homosexuality (actual or presumed) (Globally the poor may experience the worst discrimination if they do not have access to goods and services. This affects their health) At the personal level • An Australian disability awareness package suggests to any person with a disability: • Tell the other person if any form of assistance is required • Let people know what you wish to do yourself • Don’t let people treat you as an invalid • Do not assume that others know and understand your disability At the personal level • Ask a person who you think may have a disability if help is required, but do not insist and do not assist without asking • If you are unsure of how to behave – ask the person. Accept the fact that disability exists (from your perception). Don’t try to pretend it isn’t there. • Regard and treat the person as healthy (or should that be as an equal or ‘with respect’?) • Be aware of the environment and how it may present difficulties. Conclusion • Understand the difference between a consensus, conflict or social interactionist view and think about what kind of perspective any researcher seems to be taking when they describe events. • Any theoretical perspective should be grounded in research of specific conditions. This should attempt to be as scientific and objective as possible.