The Sociology of Illness - Case Study Example

Introduction In recent years, society has become increasingly aware of health issues, as people who are healthy are often judged much more positivelythan those who do not have health, as “the general sense, feeling or judgement of mankind [sic] or a community” (Lindsay, 2003, 1) has a great deal to do with health. This is because health is something that defines who a person is and where he or she fits into society. Much of this judgment comes about because of our lay beliefs on illness and what it means, since people naturally attempt to make sense of illness. This is difficult to grasp, however, because there are so many different definitions of what it means to be healthy. What may be considered healthy for an elderly person would not be considered healthy for a 25-year old, so there is no clear-cut definition of health that pertains to everyone. Also, one person might look ill while being perfectly healthy, when at the same time another person could have HIV and not even be aware of it. In addition, there are differing views on the causation of illness. Often times, someone who suffers from an illness will feel a sense of embarrassment for contracting the disease, even though it was through no fault of that person because “way of life and characteristics of an individual” (Bury, 1997, P. 29) are often cited as reasons why a person becomes ill. This is unfair because this embarrassment often leads to the person not getting the help that he or she needs. There are also differences in attitudes between social classes, as poor people are often associated with lacking cleanliness, which laypersons would assume makes them more susceptible to disease. The knowledge gap between the medical community and laypersons is directly responsible for people’s attitudes towards those who are ill. Health The official definition of health was made by the World Health Organization in 1974 and it reads, “Health is not merely the absence of disease, but the state of complete physical, mental, spiritual and social well-being”. This means that in order to be healthy, one must be exactly where he or she wants to be in life. If someone lacks a healthy social life, then he or she cannot be considered completely healthy. This is a different manner of looking at health than is the norm, since we normally view health as something that is visible. Also, someone who is perfectly healthy physically could have serious psychological problems that are not visible, but are constantly affecting the person. Spiritual health means that the person must be at peace with the world, which is a very rare quality, so it could be argued that most of society is unhealthy in that manner. Another ideology was placed forward by Helman in 2000 concluded that the “traditional classification of illness can be divided into four classes: natural, supernatural, personal and social” (found in Ember et al., 2004, 733). None of these illnesses is looked down upon as much as physical health, however, even though physical health is not always the fault of the person who is sick. There is also the attitude present that “disease… is something an organ has; illness is something a man sic has” (Cassell, 1976, P. 42). This means that illnesses are often reflected upon the individual because that is where they are visible. There is also “the assumption that illness is postulated as consisting of distinct and discrete clinical states, each with specific pathological manifestations and each caused by a different agent,” (Koch, 1890, in Blaxter, 1990, 4) which means that illness must be caused by something because it does not just appear for no reason. This is once again something that is placed upon the character of the individual who is suffering from the illness. Lay Health Beliefs Lay health beliefs vary from person to person and society to society, which makes it very difficult to define. Therefore, these beliefs are simply a person’s understanding of health and the actions that pertain to health. This occurs because people feel the need to understand why illness is a part of our lives. A study was conducted and there are “three main forms of representations of health are identified in the study, health-in-a-vacuum, reserve of health, and health as equilibrium” (Bury, 1997, P. 30). Health-in-a-vacuum means that the person is physically healthy, but is completely unaware about is or her own body. This means that the person takes his or her health for granted. Reserve of health “draws on notions of constitution and temperament, but also suggests way in which it can be improved“ (Bury, 1997, P. 30). People assume that there must be some reason why people are ill, whether it be punishment from God or the person simply not taking care of him or her self. Some of these beliefs do come from medical information, as some diseases can only be contracted in certain manners. An example of this is a sexually transmitted disease, as these illnesses involve sexual activity with an infected partner. Others, however, do not necessarily come from one particular place, which can lead to contradictions when speaking of these diseases. This can also lead to misunderstandings about how a person acquired a disease, which can lead to serious tension. These beliefs about disease are often linked to a person’s social identity because this identity dictates how people are thought of in society, as “illness is seen as principally a problem of the individual, and psychological variables such as depression or locus of control are viewed as essentially personal characteristics“ (Yardley 1997, P. 7). An example of this how a person who has HIV will be treated. When someone who holds a respected position in society contracts the disease, such as basketball player Magic Johnson, the rest of society will assume that the person who gave him the disease was at fault. If someone who lives on the streets contracts the disease, however, society will assume that it was from sharing a needle with an infected person and he or she will be judged much more negatively. These judgments are also based on the person’s personal biography, as his or her past will be looked at when making a judgment on how he or she became ill. Much of this is placed in a cultural context, however, as different attitudes and behaviours are respected in different cultures. These beliefs are so ingrained in society that they will probably never go away because society is comfortable with its beliefs on illness, while leaving the real knowledge up to healthcare professionals. Knowledge Currently, the health profession has nearly all of the knowledge about illness and the public is only allowed to know what they wish for it to know. This is because they believe that this is necessary in order to keep social order, as “the social representations of illness and health could be studied in their own right, particularly as they were drawn upon by individuals in specific social contexts” (Bury, 1997, P. 29). Recent studies have shown that there is a significant knowledge gap between lay knowledge and scientific knowledge and also a blurring of the boundaries between them. One of the most common misconceptions is, once again, that way of life can be used as a reason for any illness. This is the belief that the sources of illness lay within a person and are not necessarily something that a person simply contracts accidentally or by chance. A British study by Blaxter suggests that many women believe that illness comes from a variety of internal and external factors. The internal factors are things like not receiving the proper love from one’s family or unneeded stress being placed on the person, while external factors are things like germs and viruses. This ideology means that these people believe that a person has a better chance of becoming ill if he or she does not have a supportive family. The medical community would surely not support this, but since the idea is present in society, it is possible to see how someone might be embarrassed to admit an illness around people who hold these beliefs. The idea that germs are responsible for these illnesses is also an embarrassment to some, because it implies that the person does not keep his or her house clean and that is why the person is ill, since “from a behavioural perspective, health and illness in general, not just the specific diseases suggested by proponents of the psychosomatic medicine, are influenced by a diversity of factors that are psychological, social, environmental, as well as biological in nature“ (Merluzzi 1999, P. 7) . A similar study also found a division in the ideologies of women based on their social standing, as women who had material constraints and were forced to work had different beliefs than women who were not faced with these financial problems. A study that was conducted in South Wales among working class women had a similar result, as these women believed that germs caused nearly all disease, as they held “the idea that illness is primarily ‘self-inflicted’ and has behavioural causes“ and that “the view that the major causes are structural and located in the environment“ (Radley, 1996, 124). They also had specific diseases that they believed these germs caused, so it was not simply just a generic illness. This study also included a moral dilemma, as the women believed that a person’s lifestyle had a great deal to do with his or her health. Those who do not look after themselves are more likely to become ill, as are those who take unnecessary risks. This could include engaging in unprotected sex or eating foods that have had their shelf life expire. For socially disadvantaged families, these beliefs are a little different, as they see the world in a much different manner. These families did not have any positive ideas about health, choosing to simply state that health is the absence of illness because it allowed them to carry out their expected roles. They did not believe that their social standing was representative of their health and, therefore, they were content with their physical health because it allows for them to carry out their day-to-day activities. This leads to people in these lower classes not participating in any preventative health programs. It also leads to them tolerating minor illnesses without getting treatment or considering themselves unhealthy because “physicians diagnose and treat diseases,” (Eisenberg, 1977, P. 11) but not minor illnesses. This is entirely because of their lack of focus on health as a positive entity because health is seen as a neutral thing when it is good and as a negative thing when it is bad. It can also be noted that those who are in lower social standing will often blame themselves for their health problems and ignore this disadvantage that they have been presented. Blaxter’s analysis also focuses on illness in more functional terms, as it makes the distinction between serious illness and normal illness. In addition, things like menopause and child-bearing are not considered illnesses, but are rather simply unpleasant facts that must be dealt with, despite their negative impact on one’s health. Blaxter believes that the women who were surveyed about illness were bound up in their own personal identities and that their answers reflect a great deal about their own identities. For example, by placing negative values with being ill, it deflects this negativity away from themselves and places it upon the ill person. They can then say that their family must be running very smoothly because no one in the family is ill or that the house must be free of germs because of the family’s good health. By pointing out the negatives of others, it makes them feel better about their own identities, so this could be why they have these attitudes about illness. He also pointed out that “the traditional approaches of epidemiology have become more complex mostly because many of the health problems are degenerative and chronic; there is now recognition that most diseases have multiple and interactive causes” (Blaxter, 1990, P. 4). This knowledge, however, is “one’s own responsibility not only at the superficial level of quickly-offered survey responses, but also at a deeper level of claiming responsibility for one’s own identity” (Radley, 1996, P. 141). Conclusion The sociology of illness is a complex one because it takes different social classes into account and the beliefs that people have about those social classes. There is a lay ideology present that people in lower social classes are more prone to disease because they do not live in as clean of an environment. This is something that society has created about the causation of disease and it has left those who suffer from an illness with negative connotations surrounding themselves, through no fault of their own. The knowledge gap between the medical community and laypersons is extreme and it is directly responsible for peoples’ attitudes towards illness. Works Cited Blaxter, M. (1990). Health and Lifestyles. London: Routledge Bury, Michael. (1997). "The Emergence of Health Beliefs in Medical Sociology". Health Beliefs and Knowledge. PP. 29-37. Eisenberg, L. (1977) Disease and Illness: Distinctions Between professional and Popular Ideas of Sickness. Culture, Medicine and Psychiatry, 1: 9-23 Ember, C., Ember, M. (2004) Encyclopedia of Medical Anthropology: Health and Illness in the World’s Cultures. New York: Springer Verlag Lindsay, C. (2003) Rival Truths: Common Sense and Social Psychological Explanations in Health and Illness. New York: Psychology Press Merluzzi, T., White, R., Whitman, T. (1999). Life-Span Perspectives on Health and Illness. Mahwah, NJ: Lawrence Erlbaum Associates Radley, A. (1996). Worlds of Illness: Biographical and Cultural Perspectives on Health and Disease. New York: Routledge Yardley, L. (1997) Material Discourses of Health and Illness. London: Routledge Read More