Download 6. Sociology of labor and education

6. Sociology of labor and education:
Medical Sociology
 Some have argued that medical sociology should be
thought of as a loosely connected network of disparate
subgroups rather than as a single discipline. Many
medical sociologists tend to argue against certain axioms
in the biomedical model of health and illness. They reject
the reductivist approach of biomedicine, which claims
that health and disease are natural phenomena that exist
in the individual body rather than in the interaction of the
individual and the social world; they reject the doctrine
of specific etiology, the vision that disease can be
induced by introducing a single specific factor into a
healthy animal; and they reject biomedicine's claim to
scientific neutrality.

Like sociology in general, subgroups within medical sociology vary
according to dichotomies such as human agency versus social
structure, conflict versus consensus, and idealism versus realism.
Subgroups also vary according to subject matter, thus the sociology
of medicine can be distinguished from the sociology of health and
illness, the sociology of healers, and the sociology of the health care
system. Medical sociologists also distinguish between the sociology
of health, the study of health, illness, and health care to further
sociological theory; and sociology in health, the use of sociological
insights to complement biomedicine's objectives and priorities.
There are four often interrelated areas of research in medical
sociology: the social production of health and illness, the social
construction of health and illness, postmodern perspectives on
health and illness, and the study of the health care system and its
constituent parts.
 Research in the social production of health and illness
tends to explore variations in biomedical indicators of
health such as self-reported health status and morbidity
or mortality statistics. Social epidemiology shows that
the distribution of disease is related to the structure of
social inequalities (i.e., to occupational class,
socioeconomic status, gender, marital status, age,
ethnicity, area of residence, housing, family structure,
and employment status), although it does little to
explain these microlevel relationships.
 The political economy perspective incorporates a broader political
and economic framework, arguing that relations of domination
within patriarchal capitalism create conditions of deprivation within
which some people must struggle to maintain health. It claims that
there is a contradiction between the pursuit of health and the
pursuit of profit. It notes the large differentials in health found
among social classes, sometimes pointing to unhealthy work
environments of the lower classes as an explanation, and also notes
the strong relationship found among Western countries between
aggregate health and degree of income inequality. This perspective
has been criticized, however, for failing to recognize the substantial
health gains that have accompanied capitalist development and for
proposing a scenario with little opportunity for intervention or
change.
 Social relations (such as social support for individuals and social
capital or social cohesion for communities) have been investigated
as determinants of the health of individuals and communities. There
is also strong empirical support for the importance of lifestyle
practices and behaviors embedded in social environments and
cultural contexts. On a global scale, some authors argue that
capitalist imperialism influences the presence and distribution of
illness in developing nations, through the transfer of modern
medicine, industry, and technology from the West, which is
motivated in part by profit-driven pharmaceutical companies, for
example. Finally, some authors investigate the role of Western
medicine in creating as well as preventing illness. They argue that
improvements in health have come mainly from nonmedical factors,
and that medicine reproduces the legitimacy of the dominant social
order by serving as a means of social control.
 Social construction research views illness behaviors and
the experience of health and illness as social states.
Interactionist theory argues that people bestow meaning
on their interactions with othershat selves are emergent
and socially constructed. An early sociological
contribution was the distinction between disease (an
objective state), illness (the subjective experience of
disorder), and sickness (the social state associated with
being ill). Talcott Parsons's sick role, a social role with
certain rights and obligations for those so labeled, shows
the power of medicine to define illness and shows that
illness is a form of social deviance. Subsequent work has
introduced core sociological concepts such as deviance,
labeling, career, medicalization, socialization, self, and
identity to the field. Interactionist approaches have been
criticized for neglecting the hard realities of power and
politics and for their cognitivist bias, sharply separating
 Postmodernist thought rejects binary oppositions,
instead focusing on a shifting reality with multiple truths.
Foucauldian social constructionism of claims that
diseases are fabrications of powerful discourses wherein
individuals explore the boundaries of their self-identity,
engaging in the endless task of self-transformation.
Others argue that the body is a liquid commodity, an
object of circulating capital, in a new world of
hyperreality filled with new forms of technology. The
sociology of the body stresses the re-entrance of the
physical body within sociological discourse, exploring
how socially structured physiology affects social
behavior and vice versa. These perspectives are criticized
for their lack of an ethic, extreme relativism and
abstraction, and lack of attention to the greater political
 Some micro-level concerns when studying the
health care system are entry into and
experience with the health care system and
patient-practitioner relationships, which have
shifted focus from the provider's interest in
compliance to a power-based perspective.
Some argue that medicalization (providers
defining needs) impinges on patient
autonomy and acts as a form of social control
directing deviance into controllable channels.
Others explore the behaviors of providers, the
management of uncertainty in practice, and
implicit theories of professional knowledge.

A prevailing theme at the meso-level, the interactional region between the faceto-face encounter and the wider social structure, is medical dominance, the
power of medicine to define matters in its own interests, applied to the study of
professions, occupations, hospitals, and medical schools, for example. Some have
studied the adoption of a cloak of competence in the socialization of medical
students.
 Community involvement in planning and decision makinghe
democratization of medical careeceived attention in the late
1990s. Finally, some macro-level concerns are the role of
multinational pharmaceutical companies in shaping the nature of
health care and the reasons for and historical development of
health insurance.
Bibliography

Annandale, E. (1998). The Sociology of Health and Medicine: A Critical Introduction. Malden, MA:
Polity Press.

Evans, R. G.; Barer, M. L.; and Marmor, T. R., eds. (1994). Why Are Some People Healthy and
Others Not? The Determinants of Health of Populations. New York: Aldine de Gruyter.

Freidson, E. (1970). Professional Dominance: The Social Structure of Medical Care. New York:
Atherton Press. Illich, I. (1976). Limits to Medicine. Toronto: McClelland and Stewart.

Martin, E. (1987). The Woman in the Body. Boston: Beacon Press.

McKeown, T. (1976). The Role of Medicine: Dream, Mirage or Nemesis? London: Nutfield
Provincial Hospitals Trust.

Parsons, T. (1951). The Social System. Glencoe, IL: Free Press.

Starr, P. (1982). The Social Transformation of American Medicine. New York: Basic Books.

Veenstra, G. (2000). "Social Capital, SES and Health: An Individual-level Analysis." Social Science
and Medicine 50:61929.

Wilkinson, R. G. (1997). Unhealthy Societies: The Afflictions of Inequality. New York: Routledge.

Source: Encyclopedia of Public Health, ©2002 Gale Cengage. All Rights Reserved.