Introduction to Sociology | Hunter CollegeJessie Daniels, PhD

Sociology of Health & Medicine

Today

• Key Questions: – Why are some people healthy & others not?

– How is diagnosis a form of social control?

– How are health & morality linked?

• Key Concepts: – Structural Determinants of Health

– Structural Violence

– Medicalization

– Healthism

<why are some healthy & others

not?>

is it because some ‘lead good lives’ &

others do not?

is it because some ‘lead good lives’ &

others do not?

what is the single best predictor of

someone’s overall health?

zip code

10028 or 10035

Health of those living in 10028

• Life expectancy: 80 yrs

• Low rates of childhood asthma

• Low mortality for heart disease and cancer

Health of those living in 10035

• Life expectancy: 70 yrs

• High rates of childhood asthma

• Higher rates of mortality from cancer and heart disease

Boston: % of adults with diabetes by T stop

how do we explain this?

Health is (mostly) structural

Zip Code is a proxy measure for structure

Poorer neighborhoods, more exposure

Structural factors that damage health

Structural factors that damage health

Structural Determinants of Health

why are the same groups damaged?

Structural violence: systematic ways

in which social structures harm or

otherwise disadvantage individuals.

“Structural violence is one way of describing

social arrangements that put individuals and

populations in harm’s way… The

arrangements are structural because they are

embedded in the political and economic

organization of our social world; they are

violent because they cause injury to people …

neither culture nor pure individual will is at

fault; rather, historically given (and often

economically driven) processes and forces

conspire to constrain individual agency.” ~ Dr. Paul Farmer

Sample question: The people of

Flint, Michigan have not had clean

water for over three years. High

levels of lead in the water are

correlated with high rates of school

suspension. How is this a form of

structural violence?

Possible answer: The water crisis

in Flint, Michigan is a form of

structural violence because the

causes are embedded in the political

and economic organization of our

social world. It is violent because it is

causing injury to people.

<how is diagnosis a form of social control?>

medicalization

medicalization: a process by which

normal human conditions and

problems become defined and

treated

as medical conditions

a few historical examples

“drapetomania”

“drapetomania”: a mental illness

that cause enslaved people to have

an uncontrollable desire to run away

from captivity (1851)

“hysteria”

“nervous exhaustion and

extreme excitability”

“the rest cure”

medicalization is a type of labeling

Labeling Theory

• Everyone labels

• Those with power are able to label someone and make others accept that label

• Labeling can lead to self-fulfilling prophecy

• If the label is especially damaging, it can become a ‘master status’

medicalization is a form of

social control

medicalization is most effective on

those with little social power

does medicalization still

happen?

yes

Four Agents of Medicalization

• Medical professionals (diagnosis, prescriptions)

• Patients (response to ads, requests for diagnosis and prescriptions)

• Corporations(advertising, marketing to MDs)

• Social norms(support for ‘the sick role,’ sanctions for resisting diagnosis)

During 1960s, sharp increase in

diagnosis of African Americans –

particularly men – as schizophrenic

after DSM-11 added “hostility” and

“aggression” as symptoms

diagnosis exerts social control through labeling

medicalization permeates our culture

it’s not just corporations

we actively engage in

medicalization

women’s bodies are “policed” &

we “police” ourselves through

medicalization

Sample question: There are some

who suggest that small breasts are a

medical condition that require

surgery to fix. How is this a form of

medicalization?

Possible answer: Labeling

someone who has small breasts as

“unwell” or “having a condition” is a

form of medicalization because it

takes a normal human conditions

and defines it as a medical condition

in need of treatment.

<how are health & morality linked?>

Healthism: a preoccupation with

personal health as the primary focus

or goal, which is to be attained

primarily through the modification of

individual life styles

they argue as “better health”

is one of those ruling ideas

Healthism: a key strategy of neoliberalism

(recall neoliberalism is a form of capitalism

that says the ‘marketplace’ is the best way

to distribute social goods)

if we are busy policing our bodies and

modifying our individual behavior,

then we have no time for addressing the real,

structural factors that are actually damaging to

health, like poverty or housing or clean water.

the fact is investment structural factors is the

most important intervention for improving

health

Sample question: Recently,

Congressman Brooks (R-AL) said

that “people who live good lives don’t

have pre-existing conditions.” How

are they an example of ‘healthism’?

How are his comments an example

of ‘the ruling ideas’?

Possible answers: Rep. Brooks’

comments are an example of healthism

because they suggest that health is entirely

the result of individual choices. His

comments are also an example of the idea

that ‘the ruling ideas,’ in this case ‘better

health,’ serve the interests of those in

power. In this instance, a wealthy member

of Congress is trying to deny access to

health care for everyone else, and his ideas

serve to justify that action.

What should you do before next class?

1. Be sure you’ve read Ch. 19, “Health & Medicine” in your text.

2. Print out your Video Worksheet for the film on Thursday.3. Brush up on current events for final exam. Check #SOC101

hashtag on Twitter.