THE WILEY BLACKWELL COMPANION TO MEDICAL SOCIOLOGY

WILEY BLACKWELL COMPANIONS TO SOCIOLOGY

The Wiley Blackwell Companions to Sociology provide introductions to emerging topics and theoretical orientations in sociology as well as presenting the scope and quality of the discipline as it is currently configured. Essays in the Companions tackle broad themes or central puzzles within the field and are authored by key scholars who have spent considerable time in research and reflection on the questions and controversies that have activated interest in their area. This authoritative series will interest those studying sociology at advanced undergraduate or graduate level as well as scholars in the social sciences and informed readers in applied disciplines.

The Wiley Blackwell Companion to Medical SociologyEdited by William C. Cockerham

The Wiley Blackwell Companion to Sociology, Second EditionEdited by George Ritzer, and Wendy Wiedenhoft Murphy

The Wiley Blackwell Companion to Social Movements, Second EditionEdited by David A. Snow, Sarah A. Soule, Hanspeter Kriesi, and Holly J. McCammon

The Wiley Blackwell Companion to the Sociology of FamiliesEdited by Judith Treas, Jacqueline Scott, and Martin Richards

The New Blackwell Companion to the Sociology of ReligionEdited by Bryan S. Turner

The New Blackwell Companion to Social TheoryEdited by Bryan S. Turner

The Wiley-Blackwell Companion to Political SociologyEdited by Edwin Amenta, Kate Nash, and Alan Scott

The Blackwell Companion to the Sociology of CultureEdited by Mark Jacobs and Nancy Hanrahan

The Wiley-Blackwell Companion to Major Social TheoristsEdited by George Ritzer & Jeffrey Stepnisky

The Blackwell Companion to Major Contemporary Social TheoristsEdited by George Ritzer

The Blackwell Companion to CriminologyEdited by Colin Sumner

The Blackwell Companion to Social InequalitiesEdited by Mary Romero and Eric Margolis

The Blackwell Companion to Law and SocietyEdited by Austin Sarat

The Blackwell Companion to Major Classical Social TheoristsEdited by George Ritzer

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The Blackwell Companion to GlobalizationEdited by George Ritzer

The New Blackwell Companion to the CityEdited by Gary Bridge and Sophie Watson

THE WILEY BLACKWELL COMPANION TO

Medical Sociology

EDITED BY

WILLIAM C. COCKERHAM

This edition first published 2021© 2021 John Wiley & Sons Ltd.

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Library of Congress Cataloging-in-Publication DataNames: Cockerham, William C., editor. Title: The Wiley Blackwell companion to medical sociology / edited by William C. Cockerham. Description: Hoboken, NJ : John Wiley & Sons, [2021] | Series: Wiley Blackwell companions to sociology | Includes bibliographical references and index. Identifiers: LCCN 2020043079 (print) | LCCN 2020043080 (ebook) | ISBN 9781119633754 (hardback) | ISBN 9781119637585 (paperback) | ISBN 9781119633785 (pdf) | ISBN 9781119633761 (epub) | ISBN 9781119633808 (ebook) Subjects: LCSH: Social medicine. Classification: LCC RA418 .W445 2021 (print) | LCC RA418 (ebook) | DDC 362.1—dc23 LC record available at https://lccn.loc.gov/2020043079LC ebook record available at https://lccn.loc.gov/2020043080

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Contents

List of Contributors viiiPreface xix

PART I INTRODUCTION 1

1 Medical Sociology and Its Changing Subfields 3Terrence D. Hill, William C. Cockerham, Jane D. Mcleod, and Frederic W. Hafferty

2 Medical Sociology and Sociological Theory 22William C. Cockerham and Graham Scambler

3 Research Methods in Medical Sociology 45Joseph D. Wolfe, Shawn Bauldry, and Cindy L. Cain

4 Health and Culture in the Global Context 62Stella Quah

5 Bioethics: A Study in Sociology 82Kristina Orfali and Raymond de Vries

PART II THEORETICAL APPROACHES 103

6 The Sociology of the Body 105Sarah Nettleton

7 Biomedicalization Revisited 125Adele E. Clarke, Melanie Jeske, Laura Mamo, and Janet K. Shim

8 Health Lifestyles: Bringing Structure Back 150William C. Cockerham

9 The Life Course Perspective 171Kim M. Shuey and Andrea E. Willson

vi CONTENTS

10 Social Capital and Health 192Lijun Song and Yvonne Chen

PART III HEALTH AND SOCIAL INEQUALITY 215

11 Health and Social Class 217Jarron M. Saint Onge and Patrick M. Krueger

12 Health and Gender 237Ellen Annandale

13 Health, Ethnicity, and Race 258Hannah Bradby and James Y. Nazroo

14 African American Health 279Christy L. Erving and Lacee A. Satcher

15 Latinos and Equity in Health Care Access in the US 303Ronald J. Angel and Jacqueline L. Angel

16 Social Policies and Health Inequalities 322Amélie Quesnel-Vallée, Jaunathan Bilodeau, and Kaitlin Conway

PART IV HEALTH AND SOCIAL RELATIONSHIPS 347

17 Health and the Family 349Mieke Beth Thomeer and Kirsten Ostergren Clark

18 Health and Religion 370Ellen Idler

19 Migration and Health 389Elyas Bakhtiari

20 Mental Health 410Teresa L. Scheid

PART V HEALTH AND DISEASE 431

21 Emerging Infectious Diseases 433Ron Barrett

22 Beyond the Lost Self: Old Insights and New Horizons in the Sociology of Chronic Illness 447Alexandra C. H. Nowakowski

CONTENTS vii

PART VI HEALTH CARE DELIVERY 471

23 Health Professions and Occupations 473Jason Adam Wasserman and Brian Philip Hinote

24 Doctor–Patient Relationship 495Hyeyoung Oh Nelson

25 Complementary and Alternative Medicine 516Eeva Sointu

26 American Health Care System: Reforms for Access, Outcomes, and Cost Amid Legal, Legislative, and Political Disputes 537Bernice A. Pescosolido and Carol A. Boyer

27 The British Healthcare System 556Jonathan Gabe

28 The Chinese Health Care System 572Lei Jin and Chenyu Ye

Author Index 590Subject Index 605

List of Contributors

Ronald J. Angel is Professor of Sociology at the University of Texas at Austin. He received his PhD in Sociology from the University of Wisconsin Madison in 1981. His research focuses on comparative welfare systems, retirement, and health care access and use among Hispanics and other minority populations. His work, which has been published in numerous books and journal articles, demonstrates the com-plex interaction of socioeconomic status, cultural and other social factors in deter-mining individuals’ and communities’ opportunities for social advancement and exposure to health risks. Angel is currently working on a project focused on the role of the non-governmental sector in advocacy for and care delivery to older indi-viduals in Mexico. The work appears in a book entitled When Strangers Become Family: The Role of Civil Society in Addressing the Needs of Aging Populations (Routledge 2020). This is part of a larger project on the role of civil society organi-zations in rapidly aging nations.

Jacqueline L. Angel is Professor of Public Affairs and Sociology and a Faculty Affiliate at the Population Research Center at The University of Texas at Austin. Her research examines health and retirement issues in the US, with a focus on older minorities, immigration processes, the impact of social policy on the Hispanic population and Mexican-American families. She is involved in several NIH/NIA projects, including a longitudinal study of older Mexican Americans (H-EPESE) since its inception in 1992 and for the past two decades a Conference Series on Aging in the Americas. Angel is author/coauthor/co-editor of numerous publications. This includes books such as The Politics of a Majority-Minority Nation: Aging, Diversity and Immigra-tion (2019) and Latinos in an Aging World (2015). Major papers include “Institu-tional Context of Family Eldercare in Mexico and the United States” (2016) and “Medicaid Use among Older Low-Income Medicare Enrollees in California and Texas: A Tale of Two States” (2019).

Ellen Annandale is Professor of Sociology at the University of York, UK, where she was Head of Department between 2013 and 2017. She was Editor-in-Chief of the journal Social Science & Medicine between 2004 and 2012, a past Vice-President of the European Sociological Association (ESA) and is coordinator of ESA’s Research Network 16 (Sociology of Health and Illness). She is Chair of the Trustees of the

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Foundation for the Sociology of Health and Illness. Ellen has a long-standing interest in gender and health, particularly as it concerns feminist and gender theory, health inequalities, and the sociology of reproduction and childbirth. She is the author and editor of several books in this field, including Women’s Health and Social Change (Routledge 2009) and, with Ellen Kuhlmann, The Palgrave Handbook of Gender and Healthcare (Palgrave 2012). She is currently working with colleagues on the research project Interactional Practices of Decision-making During Childbirth in Maternity Units funded by the UK’s National Institute of Health Research.

Elyas Bakhtiari is Assistant Professor in the Department of Sociology at the College of William & Mary. His research examines how institutionalized social inequalities and boundary formation processes shape patterns of health outcomes and health dis-parities, particularly for racial and ethnic minorities and international migrants. His work relies on historical and cross-national comparison to understand the formation of health disparities, with current projects focusing on European migration to the US in the early twentieth century and Middle Eastern migrant health after September 11, 2001. His work has been published in the Journal of Health and Social Behavior, Social Science & Medicine, American Behavioral Scientist, Socius, and other outlets.

Ron Barrett is Associate Professor of Anthropology at Macalester College. His research focuses on the social determinants of infectious diseases and the anthropology of death and dying. His first book, Aghor Medicine (University of California Press), is an ethnography of religious healing and the stigma of leprosy in northern India. It was awarded the Wellcome Medal by the Royal Anthropological Institute. He also co-authored An Unnatural History of Emerging Infections (Oxford University Press) with George Armelagos, which explores the human determinants of disease in three transition periods occurring in the Neolithic, the Industrial Revolution, and today. Professor Barrett is also a former registered nurse with clinical experience in neuro-intensive care, brain injury rehabilitation, and hospice.

Shawn Bauldry is Associate Professor of Sociology at Purdue University. His inter-ests in medical sociology include the interrelationship between education and health over the life course and across generations, the evolution of health lifestyles over the life course, and disparities in mental health and mental health care utilization. In addition, he works in the area of applied statistics with a focus on structural equation modeling and models for categorical data. His work has appeared in the Journal of Health and Social Behavior, Social Science & Medicine, Sociological Methodology, and Sociological Methods & Research among others.

Jaunathan Bilodeau is a postdoctoral researcher at the Department of Sociology at McGill University in Montreal, Canada. His work focuses on the relationship between work-family conflict and mental health, as well as the structural determi-nants of health inequalities such as gender and social policies. He recently pub-lished in Stress & Health, Social Science & Medicine and Annals of Work Exposure and Health.

Carol A. Boyer is former Associate Director of the Institute for Health, Health Care Policy and Aging Research and graduate faculty in the Department of Sociology at Rutgers University. She has devoted her career to health services research and

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policy and interdisciplinary studies informed by clinical experience in acute-care and emergency settings. With over 30 years’ experience in mental health services research focusing on populations with severe mental illnesses and their medical co-morbidi-ties, her studies addressed access, utilization, stigma, quality of life and the content and outcomes of treatment and services provided to individuals with a diagnosis of schizophrenia, psychosocial interventions and strategies to enhance adherence with antipsychotic medications and linking individuals successfully to home and community services. Her research informed developing and implementing training programs including both didactic and experiential learning components.

Hannah Bradby is Professor at the Sociology Department, Uppsala University, Swe-den since 2013, having previously held a senior lectureship at the University of War-wick, UK. Her research interrogates the links between identity, structure and health with particular reference to racism, ethnicity and religion. She is Field Chief Editor for Frontiers in Sociology and blogs regularly at Cost of Living.

Cindy L. Cain is Assistant Professor of Sociology at the University of Alabama at Bir-mingham. Her interests in medical sociology include changes within the healthcare system, the experiences of healthcare workers, and care for vulnerable older adults. In addition, she specializes in qualitative and mixed methods approaches and is espe-cially interested in how we can better integrate different methods. Her work has ap-peared in the Journal of Health and Social Behavior, Sociology of Health & Illness, Journal of Contemporary Ethnography, The Gerontologist, and other journals.

Yvonne Chen is a PhD student in the Department of Sociology at Vanderbilt Univer-sity. Her major research interests center on race and ethnicity, mental health, social stratification, and social networks. Her work has appeared in Sociology of Race and Ethnicity.

Kirsten Ostergren Clark is a PhD candidate in medical sociology in the Department of Sociology at the University of Alabama at Birmingham. Her research interests are developmental disabilities, masculinity and fatherhood, and religion and health. She earned a Master of Social Work degree from the University of South Carolina and spent several years supervising group homes for individuals with developmental dis-abilities and working as a renal social worker in dialysis clinics. Her dissertation is a qualitative project involving fatherhood and developmental disabilities.

Adele E. Clarke is Professor Emerita of Sociology and History of Health Sciences at the University of California at San Francisco. Her books include Disciplining Reproduction: Modernity, American Life Sciences, and “Problems of Sex” (1998, Fleck Award, Society for Social Studies of Science; and Basker Award, Society for Medical Anthropology), Situational Analysis: Grounded Theory after the Postmodern Turn (2005, Cooley Award, Society for the Study of Symbolic Interaction), co- edited The Right Tools for the Job in Twentieth Century Life Sciences (1992), W omen’s Health: Differences and Complexities (1997), Revisioning Women, Health, and Healing (1999), Biomedicalization: Technoscience, Health, and Illness in the US (2010), Situational Analysis in Practice (2015), and co-authored Situational Analysis: Grounded Theory After the Interpretive Turn (2018). She received the Bernal Prize (Society for Social Studies of Science, 2012), the Reeder Award (Medical Sociology

LIST Of CONTrIBuTOrS xi

Section, ASA, 2015), and sessions in her honor at American Anthropological Association (2012) and Pacific Sociological Association (2019) meetings.

William C. Cockerham is Distinguished Professor of Sociology and Chair Emeritus at the University of Alabama at Birmingham and Research Scholar of Sociology at the College of William & Mary. He is past president of the Research Committee on Health Sociology of the International Sociological Association and author or editor of several books and articles on medical sociology. Additionally, he is Deputy Editor of the Journal of Health and Social Behavior and previously served on the editorial boards of the American Sociological Review, Society and Mental Health, and other journals. He also has held editorial positions for several encyclopedias, including Ed-itor-in-Chief of the Wiley Blackwell Encyclopedia of Health, Illness, Behavior, and Society (Wiley Blackwell 2014) and Associate Editor-in-Chief of the International Encyclopedia of Public Health, 2nd ed. (Academic Press 2017). His most recent books include Social Causes of Health and Disease, 3rd ed. (Polity 2021), Sociological The-ories of Health and Illness (Routledge 2021), Sociology of Mental Disorder, 11th ed. (Routledge 2021), and Medical Sociology, 15th ed. (Routledge 2021).

Kaitlin Conway is a PhD student in Sociology at McGill University, Canada, under the supervision of Dr. Amélie Quesnel Vallée. Her research focuses on the life course health inequalities of marginalized populations in Canada and the US. Prior to beginning her PhD, Kaitlin worked in the non-profit sector in both research and program monitoring capacities, both with a focus on global health. She holds a Master of Science in Global Health from King’s College London and an Honours Bachelor of Arts in International Development from McGill University.

Raymond De Vries is Associate Director of the Center for Bioethics and Social Sci-ences in Medicine, University of Michigan, visiting professor at the School for Pub-lic Health and Primary Care, University of Maastricht (Netherlands), and a fellow at the Hastings Center. He is a medical sociologist with broad experience in the study of the practice and profession of bioethics and the social and cultural influ-ences on the organization of maternity care systems. He is the author of A Pleasing Birth: Midwifery and Maternity Care in the Netherlands (Temple University Press 2005), and co-editor of Birth by Design: Pregnancy, Maternity Care and Midwifery in North America and Europe (Routledge 2001), The View from Here: Bioethics and the Social Sciences (Blackwell 2007), Qualitative Methods in Health Research (Sage 2010), and co-edited special issues of Medicine, Health Care, and Philosophy (2008), Social Science and Medicine (2013), Journal of Clinical Ethics (2013), and the AMA Journal of Ethics (2019).

Christy L. Erving is Assistant Professor of sociology at Vanderbilt University. Using theories, concepts, and perspectives from several research areas, her program of research employs quantitative methods to clarify and explain social status distinc-tions in health. Her primary research areas explore: (1) how race, ethnicity, gender, and immigrant status intersect to produce health differentials, (2) the relationship between physical and mental health, (3) psychosocial determinants of Black wom-en’s health, and (4) the Black–White mental health paradox. In 2014–16, she was a post-doctoral fellow in the Robert Wood Johnson Foundation Health & Society

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Scholars Program at University of Wisconsin, Madison. She completed a PhD and MA in Sociology at Indiana University-Bloomington, and received a BA in Sociol-ogy and Hispanic Studies from Rice University. Her research has been funded by the American Sociological Association, Ford Foundation, and Robert Wood Johnson Foundation.

Jonathan Gabe is Emeritus Professor of Sociology at Royal Holloway, University of London, UK. His research interests include pharmaceuticals, chronic illness, health professions, and health policy. He has edited or written 14 books (and 2 second edi-tions) and published his research in journals such as Health, Health, Risk & Society, Health Sociology Review, Social Science & Medicine, Sociological Review, Sociol-ogy, Sociology Compass, and Sociology of Health & Illness. He is a past editor of the international journal Sociology of Health & Illness and a past chair of the European Sociological Association RN16, Sociology of Health and Illness. He is also a past President of the International Sociological Association RC15 Sociology of Health and a Fellow of the UK Academy of Social Sciences.

Frederic W. Hafferty is Professor of Medical Education, Associate Director of the Program for Professionalism & Values, and Associate Dean for Professionalism, College of Medicine at the Mayo Clinic in Rochester, Minnesota. He received his undergraduate degree in Social Relations from Harvard in 1969 and his PhD in Medical Sociology from Yale in 1976. He is past chair of the Medical Sociology Section of the American Sociological Association and currently sits on the American Board of Medical Specialties (ABMS) standing committee on Ethics and Profes-sionalism, ABMS Professionalism Task Force, ABMS Stakeholder Council, and on the editorial board of Academic Medicine. He is the author of several books and a variety of academic papers that apply sociological frameworks to disability studies and issues of medical education, culture, and professionalism.

Terrence D. Hill is Associate Professor in the Department of Sociology at the Uni-versity of Texas at San Antonio. His research examines social inequalities in health and human suffering. He is especially interested in the effects of religious involve-ment, neighborhood context, social relationships, and socioeconomic status. To date, he has published over 100 peer-reviewed journal articles and book chapters. His work appears in a range of journals, including the Journal of Health and Social Behavior, Social Science & Medicine, The Journals of Gerontology, The Gerontol-ogist, American Journal of Public Health, Labour Economics, and Social Work. He has also published chapters in the Handbook of Sociology of Aging, Annual Review of Gerontology and Geriatrics, the Handbook of the Sociology of Mental Health, and the Handbook on Religion and Society. According to Google Scholar, his pub-lished work has been cited across a range of disciplines over 5,000 times.

Brian P. Hinote is Professor, Associate Vice Provost for Data Analytics & Student Success, and Chief Online Learning Officer at Middle Tennessee State University. In addition to clinical and research experience in areas as diverse as pediatrics, neurol-ogy, and cell biology, his interdisciplinary work appears in multiple books and peer-reviewed journals in social science, nursing, and medicine. His most recent work focuses on the various ways that social and behavioral science perspectives intersect

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and inform health care delivery and policy, clinical practice, and the work of various health professions. This line of inquiry culminates in his latest book project, Social & Behavioral Science for Health Professionals (Rowman & Littlefield 2020).

Ellen Idler is the Samuel Candler Dobbs Professor of Sociology, and Director of Emory’s Religion and Public Health Collaborative, with additional Emory appoint-ments at the Rollins School of Public Health, the Center for Ethics, the Graduate Division of Religion, and the Division of Geriatrics and Gerontology at the School of Medicine. Dr. Idler is a Fellow and past Chair of the Behavioral and Social Sci-ences Section of the Gerontological Society of America, and she served as Chair of the American Sociological Association’s Section on Aging and the Life Course. She studies the influence of attitudes, beliefs, and social connections on health, includ-ing the effect of self-ratings of health on mortality and disability, and the impact of religious participation on health and the timing of death among the elderly. Her research papers have been cited over 20,000 times. She is an Academic Editor for PLoS One and serves on the editorial boards of the Journal of Gerontology: Social Sciences; Innovation in Aging; and Palliative and Social Care.

Melanie Jeske is a doctoral candidate in sociology at the University of California at San Francisco. Situated at the intersection of medical sociology and science and tech-nology studies, her research explores the social, political and ethical dimensions of knowledge systems, emergent biotechnologies, and biomedical expertise. Her disser-tation research explores the politics and values of translational medicine, and goals of commercialization in biomedical research. Melanie’s research has been published in journals including BioSocieties, Social Science & Medicine, and Engaging Science, Technology, and Society.

Lei Jin is Associate Professor at the Department of Sociology and Jockey Club School of Public Health and Primary Care at the Chinese University of Hong Kong. She received her PhD at the University of Chicago and was a Robert Wood Johnson post-doctoral fellow in the Health Policy Program at Harvard University. Her research interests include social disparities in health and well-being, health lifestyle, health-care policy and healthcare professions. Her work has appeared in prestigious inter-national journals such as Demography, Social Science Research, Social Science & Medicine, and the American Behavioral Scientist. Professor Jin’s current projects examine the following topics: (1) social disparities in health lifestyle in transitional China; (2) psychological well-being and power perception in different social and political contexts across the world; and (3) professionalization and professionalism among physicians in China’s public hospitals.

Patrick M. Krueger is Associate Professor in Health & Behavioral Sciences at the University of Colorado Denver, and research faculty at the Population Program at the University of Colorado Boulder. His research focuses on race/ethnic and socio-economic disparities in health, health behaviors, and mortality. His current hobby is reciting pi backward.

Laura Mamo (PhD Sociology) is Professor of Public Health at San Francisco State University. Her research focuses on the technoscientific, biomedical, and social and

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cultural dimensions of health inequalities largely in the US. She is the author of Queering Reproduction: Achieving Pregnancy in the Age of Technoscience (Duke University Press 2007); co-editor of Biomedicalization: Technoscience, Health, and Illness in the US (Duke University Press 2010); and co-author of Living Green: Com-munities That Sustain (New Society Press 2009). She is also a founding member of the Beyond Bullying Project, a multi-media and ethnographic project studying the circulation of sexuality at school. Her research has received funding from the National Science Foundation, the Ford Foundation, the Robert Wood Johnson Foundation, the Canadian Institutes of Health Research and the US National Institutes of Health.

Jane D. McLeod is Provost Professor and Chair of the Department of Sociology at Indiana University. Her research traverses social psychology, medical sociology, soci-ology of mental health, stratification, and the life course. She is currently working on projects concerned with the social psychology of inequality, the college experiences of youth on the autism spectrum, and mental health inequalities.

James Nazroo is Professor of Sociology at the University of Manchester, UK, where he is Deputy Director (formerly founding Director) of the Centre on Dynamics of Ethnicity. His research focuses on inequality, social justice and stratification in rela-tion to ethnicity and aging. His research on ethnic inequalities has spanned more than twenty-five years and demonstrates how health and underlying socioeconomic inequalities are shaped by racism.

Hyeyoung Oh Nelson is Visiting Assistant Professor in the Department of Health and Behavioral Sciences at the University of Colorado-Denver. She is a medical sociologist and qualitative researcher. Her research interests include the medical profession, health care organizations, the doctor-patient relationship, racial health disparities, and maternal health. Her work has been published in the Journal of Health and Social Behavior, Sociology of Health & Illness, and Qualitative Health Research.

Sarah Nettleton is Professor of Sociology in the Department of Sociology, University of York, UK. Over three decades her research has focused on embodiment, experi-ences of illness, health promotion, recovery, sleep and more lately architecture in the context of health and social care. She is author of the textbook Sociology of Health and Illness, 4th edition (Polity 2020).

Alexandra “Xan” Nowakowski is Assistant Professor at Florida State University College of Medicine. They are a medical sociologist and program evaluator focused on health equity in aging with chronic disease. Currently they evaluate the Florida Asthma and REACH Geriatrics programs. They have published in numerous jour-nals, including the Sociology of Health & Illness, Symbolic Interaction, and Teaching Sociology plus interdisciplinary sociomedical journals. They have served on editorial boards for Inquiry, The Qualitative Report, and Sociological Spectrum. Their books include the edited volume Negotiating the Emotional Challenges of Deeply Personal Research in Health (Routledge 2017) and the social fiction novel Other People’s Oysters (Brill 2018). They also edit the Health and Aging in the Margins series (Rowman & Littlefield) and the Write Where It Hurts trauma informed scholarship project. Dr. Nowakowski is agender, which informs their intersectional scholarship on chronic illness, and uses they/them pronouns.

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Kristina Orfali is Professor of Bioethics and a Fellow of the Institute for Social and Economic Research & Policy at Columbia University. She is a sociologist with broad cross-cultural experience in the study of the practice of bioethics and clinical ethics. She has published work on clinician and family decision making and on neonatal ethics; she is the co-editor of special issues of Sociology of Health & Illness (2007), Social Science & Medicine (2013) and of several books: Who is my Genetic Parent? Assisted Reproduction and Donor Anonymity: A Cross-Cultural Perspective (2012), Families and End of Life Treatment. An International Perspective (2013), The Female Body: A Journey through Law, Culture and Medicine (2014), Reproductive Technol-ogy and Changing Perceptions of Parenthood around the World (2014), Protecting the Human Body: Legal and Bioethical Perspectives around the World (2016), and The Reality of Human Dignity in Bioethics and Law: Comparative Perspectives (2018).

Bernice Pescosolido is Distinguished and Chancellor’s Professor of Sociology at In-diana University, Founding Director of the Indiana Consortium for Mental Health Services Research (ICMHSR) and was Founding Co-Director of the Indiana Univer-sity Network Science Institute (IUNI). Her research focuses on four areas – stigma, health care use, suicide, and social networks – primarily looking at mental illness and substance abuse and the role that social and organizational networks play in people’s responses to problems. Trained as a medical sociologist at Yale University, her research has been published in sociology, anthropology, public health, and psy-chiatric journals and has been supported by the National Institute of Mental Health, the Fogarty International Center, the National Institute of Drug Abuse, the MacAr-thur Foundation, the Robert Wood Johnson Foundation, and the National Science Foundation, among others. She has served as the Vice President of the American Sociological Association, and has received several career, teaching, and mentor-ing awards in sociology and public health, including the NARSAD Distinguished Investigator Award and the Wilbur Lucius Cross Medal from Yale. In 2016, she was elected to the National Academy of Medicine.

Stella R. Quah is Adjunct Professor, Health Services and Systems Research, Duke-NUS Medical School, National University of Singapore. Prior to joining Duke-NUS in July 2009, she was Professor of Sociology at the National University of Singapore (NUS) where she was a faculty member from 1977 to 2009; and Research Sociol-ogist at the Department of Social Medicine and Public Health from 1973 to 1975. In addition to her consultancy work, Stella Quah is also member of several Institu-tional Review Boards. Among her most recent publications on sociology of health and social epidemiology are the International Encyclopedia of Public Health, 2nd Ed., Editor-in-Chief (Elsevier 2017); and Section Editor of Epidemiology and Public Health, Elsevier Reference Module in Biomedical Sciences (since 2014). Her pub-lished research on family sociology includes the Routledge Handbook of Families in Asia (Routledge 2015); and Families in Asia – Home and Kin (Routledge 2009) among others. Her full list of publications by theme is available at https://www. stellarquah.website.

Amélie Quesnel-Vallée is the 2019–20 recipient of the Fulbright Canada Distinguished Chair in Quebec Studies, SUNY Plattsburgh. She is Professor at McGill University in Montreal where she holds the Canada Research Chair in Policies and Health

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Inequalities and is jointly appointed across the faculties of Arts (Sociology) and Medicine (Epidemiology). She is the founding Director of the McGill Observatory on Health and Social Services Reforms. Her research examines the contribution of policies to social inequalities in health over the life course. It has appeared in journals such as The Lancet, the International Journal of Epidemiology, and Social Science & Medicine and was recognized through several international professional associa-tions’ awards, including from the American Sociological Association, the Population Association of America, and the American Public Health Association. Committed to furthering public understanding of science, she is frequently sought by the media such as National Public Radio, the New York Times, and Business Week.

Jarron M. Saint Onge is Associate Professor in Sociology at the University of Kansas and associate professor of Population Health at the University of Kansas Medi-cal Center. His research focuses on social determinants of health disparities, with specific interests in health lifestyles and neighborhood contexts.

Lacee A. Satcher is a PhD Candidate in the Department of Sociology at Vanderbilt University. She received her BA in Psychology from Tougaloo College in 2013, MA in Sociology from Jackson State University in 2015, and MA in Sociology from Vanderbilt University in 2017. Her research interests include race, health, place and inequality, social psychology of health and inequality, health policy, environmental justice, and urban sociology. Her recent research focuses on the race-environment-health connection in the urban American South, specifically how various individual social identities/social locations structure our relations with and within space and place to shape health outcomes and health experiences.

Graham Scambler is Emeritus Professor of Sociology at University College London and Visiting Professor of Sociology at Surrey University, UK. He has published exten-sively in social theory and the sociology of health. Specific foci of his work have been the sociologies of stigma and health inequalities. Recent books include: Sociology, Health and the Fractured Society: A Critical Realist Account (Routledge 2018), which was awarded the Cheryl Frank Memorial Prize; A Sociology of Shame and Blame: Insiders Versus Outsiders (Palgrave 2020); and Communal Forms: A Socio-logical Exploration of the Concept of Community (with Aksel Tjora) (Routledge 2020). He is a Fellow of the Academy of Social Sciences, UK.

Teresa L. Scheid is Professor of Sociology at the University of North Carolina at Charlotte with joint appointments in Public Policy and Health Services Research. She is senior editor (with Eric Wright) of the Handbook for the Study of Mental Health: Social Contexts, Theories, and Systems, 3rd Ed. (Cambridge University Press 2017). She has published widely on the organization and delivery of mental health services and the work of mental health workers that resulted in her 2004 book Tie a Knot and Hang On: Delivering Mental Health Care in a Turbulent Environment. Her most recent books are Comprehensive Care for HIV/AIDS: Community-Based Strategies (Routledge 2015), Reducing Race Differences in Direct-to-Consumer Pharmaceutical Advertising: The Case for Regulation with Stephany De Scisciolo (Lexington 2018), and a forthcoming book with Megan S. Smith titled Ties That Enable: Community Solidarity for Adults Living with Serious Mental Illness to be published by Rutgers University Press.

LIST Of CONTrIBuTOrS xvii

Janet K. Shim is Professor of Sociology in the Department of Social and Behavioral Sciences at the University of California at San Francisco. Her current program of research focuses on two areas: the sociological analysis of health sciences, particularly how they understand social difference and health inequality, and the study of health-care interactions and how they produce unequal outcomes. Her work has been funded by the US National Institutes of Health and the National Science Foundation. She is a co-editor of Biomedicalization: Technoscience, Health, and Illness in the US (Duke University Press 2010) and the author of Heart-Sick: The Politics of Risk, Inequality, and Heart Disease (New York University Press 2014). Her articles have appeared in journals such as American Sociological Review, Journal of Health and Social Behavior, Medical Anthropology Quarterly, Science, Technology & Human Values, Social Science & Medicine, Social Studies of Science, and Sociology of Health & Illness.

Kim Shuey is Associate Professor of Sociology at the University of Western On-tario in Canada. Her research interests focus on life course sociology, and work and health. She has published in Work and Occupations, Advances in Life Course Research, and the American Journal of Sociology, among other venues.

Eeva Sointu is Senior Lecturer in Sociology at York St. John University, UK. She is the author of Theorizing Complementary and Alternative Medicines: Wellbeing, Self, Class, Gender (Palgrave Macmillan 2012). She studies configurations of power, legit-imacy and meaning in the domains of health, well-being and medicine, and concep-tualizes social identities and values as central to understanding medical work, health seeking, and the ways in which health practices are represented.

Lijun Song is Associate Professor in the Department of Sociology and the Center for Medicine, Health and Society at Vanderbilt University. Her major research interests include social networks and social capital, medical sociology and mental health, social psychology, social stratification, marriage and family, and comparative his-torical sociology. Her publications have appeared in journals such as Social Forces, Journal of Health and Social Behavior, Society and Mental Health, Social Psychology Quarterly, Social Science & Medicine, Social Networks, Sociological Perspectives, American Behavioral Scientist, Chinese Sociological Review, and Research in the Sociology of Work.

Mieke Beth Thomeer is Associate Professor of Sociology at the University of Ala-bama at Birmingham. Her research interests include aging, family, health, gender, and sexuality. In her research, she addresses questions about how family relation-ships influence and are influenced by physical and mental health, with particular attention to gender. She uses both qualitative and quantitative methods, with spe-cial emphasis on dyadic methods. Her research has been published in the American Journal of Public Health, Journal of Marriage and Family, Journal of Gerontology, Social Science & Medicine, Journal of Health and Social Behavior, and other jour-nals. She currently serves as Deputy Editor for the Journal of Marriage and Family, on the editorial boards of several journals, and is Teaching Committee Chair for the American Sociological Association’s Medical Sociology Section.

Jason Adam Wasserman is Associate Professor of Foundational Medical Studies at Oakland University William Beaumont School of Medicine, where he also holds

xviii LIST Of CONTrIBuTOrS

an appointment in Pediatrics, is the course director for the Medical Humanities and Clinical Bioethics curriculum, serves as Faculty Advisor on Professionalism, and conduct ethics consultations for area hospitals. His first book, At Home on the Street (Lynne Rienner Publishers 2010) addressed the issue of homelessness, while his current scholarly work focuses on clinical bioethics as well as integrating social science into clinical medicine. The second edition of his book Social and Behavioral Science for Health Professionals (with Brian Hinote) was published in 2020 by Row-man and Littlefield. He has authored numerous articles in journals such as Social Science & Medicine, American Journal of Bioethics, Hastings Center Report, Mayo Clinic Proceedings, JAMA-Pediatrics, Journal of Clinical Ethics, Journal of Preven-tive Medicine, and The New England Journal of Medicine.

Andrea Willson is Associate Professor of Sociology at the University of Western On-tario in Canada. Her research focuses the investigation of health inequality over the life course and its transmission across generations. She is Principal Investigator (K. Shuey, co-investigator) of a grant from the Canadian Social Sciences and Human-ities Research Council to investigate family context and the intergenerational per-sistence of health inequality. Her work has appeared in Journal of Health and Social Behavior, International Sociology, and the American Journal of Sociology.

Joseph D. Wolfe is Associate Professor of Sociology at University of Alabama at Birmingham. His interests include studying health disparities across periods of social change, multigenerational socioeconomic resources and longevity, and measurement of social hierarchies related to US health inequalities. His most recent research decomposes wealth into its multiple sources, such as housing and financial wealth, and then examines their relationships to mental and physical health among adults entering later midlife. His work has appeared in the Journal of Health and Social Behavior, Social Forces, Research on Aging, Obesity, and several other social sci-ence journals.

Chenyu Ye is a PhD candidate in the Department of Sociology at the Chinese University of Hong Kong. She completed her undergraduate studies at Sun Yat-sen University in Guangzhou, China. Her main research interests lie in the areas of med-ical sociology, sociology of professions, health policy, and family and marriage.

Preface

The Wiley Blackwell Companion to Medical Sociology is a follow-up to two earlier volumes of this book and the latest work currently in Wiley Blackwell’s Companion series. The goal is to bring together leading scholars in medical sociology to provide discussion of the most important issues and review the current research in the field. This edition follows this practice by providing chapters on health-related topics of significant interest. The contributors are from Canada, China, Singapore, Sweden, the UK, and the US, who were carefully selected to write chapters on topics in which they were recognized experts.

As will be seen in several chapters, this book was organized and written during the 2019–20 COVID-19 global pandemic. Consequently, many of these chapters take the effects of COVID-19 into account. One chapter (Chapter 21) on newly emerg-ing diseases by Ron Barrett (Macalester College), a recipient of the Wellcome Medal from the Royal Anthropological Institute in the UK, focuses directly on COVID-19 with an authoritative account of the pandemic. Part I of this volume begins with a chapter by Terrence Hill (Texas-San Antonio), myself, Jane McLeod (Indiana Univer-sity), and Fred Hafferty (Mayo Clinic). It analyzes how medical sociology’s former subfields of sociology in medicine and the sociology of medicine have changed as its subject matter has enlarged and expanded well beyond these two initial categories. Each of these co-authors addresses a particular area of contemporary research. Hill is one of the most prolific scholars in medical sociology, McLeod is Provost Profes-sor and Chair of the Department of Sociology at Indiana University and recipient of both the James R. Greenley and Leonard I. Pearlin awards for distinguished contri-butions to the Sociology of Mental Health, and Hafferty is a past chair of the Med-ical Sociology Section of the American Sociological Association who is currently at the College of Medicine at Mayo Clinic in Rochester, Minnesota. He has spent his career as a sociologist working in medical institutions.

Next, I join Graham Scambler (University College London and Surrey University, UK) to provide an overview of sociological theory in medical sociology. Scambler is a Fellow of the Academy of Social Sciences, UK, and editor emeritus of the journal Social Theory & Health. Medical sociology’s evolution from an applied and atheoretical field to a subdiscipline that not only draws from theory in sociology but contributes to it is noted. Current theories in the field are reviewed.

xx PrEfACE

Chapter 3 focuses on research methods, which is a new yet important topic for this volume. This chapter is written by Joseph Wolfe (University of Alabama at Birmingham), Shawn Bauldry (Purdue University), and Cindy Cain (University of Alabama at Birmingham) – each of whom is an experienced and well-regarded methodologist. Next is Chapter 4 on the important relationship between culture and health in a global context. Stella Quah of the Duke-NUS Medical School in Singa-pore writes this chapter. She is past chair of the International Sociological Association (ISA) Research Council, past president of the ISA Research Committee on Health Sociology, and editor-in-chief of the 2nd edition of the International Encyclopedia of Public Health. Altogether, four past presidents of ISA’s Research Committee on Health Sociology are authors of chapters in this volume (Cockerham, Gabe, Quah, and Quesnel-Vallée). The remaining introductory chapter is on bioethics by Kris-tina Orfali (Columbia University) and Raymond De Vries (University of Michigan). Orfali is a Fellow of the Institute for Social and Economic Research & Policy at Columbia and DeVries is Associate Director of the Center for Bioethics and Social Sciences in Medicine at Michigan,

The section (Part II) on theoretical approaches in medical sociology follows. Sarah Nettleton (University of York, UK) provides an update of research on the sociology of the body. Nettleton is a former senior editor of the journal Social Science & Medicine. Adele Clarke of the University of California Medical Center at San Francisco and her colleagues at U.C. San Francisco, Melanie Jeske, and Ja-net Shim, along with Laura Mamo at San Francisco State University reexamine biomedicalization theory in Chapter 7 on a return visit to the theory decades later. Clarke, the leading proponent of biomedicalization theory has received numerous prizes and awards from professional organizations, including the Medical Sociol-ogy Section of the American Sociological Association and the Societies for Medical Anthropology, the Study of Social Sciences, and the Study of Symbolic Interaction. Next (Chapter 8) is an update of health lifestyle theory by the editor with a focus on the significance of social structures in influencing the health-related behavior of individuals. This chapter is followed by a new chapter on life course theory by An-drea Willson and Kim Shuey of the University of Western Ontario in Canada. They have published substantial work in this area. Chapter 10 takes the next journey into theory with a chapter by Lijun Song and Yvonne Chin (Vanderbilt University) on social capital and health. Song is a former student of Nan Lin, a major figure in social capital theory who co-authored a chapter on social capital with her in earlier versions of this book.

Part III addresses health and social inequality, which is a focus of several studies in medical sociology. The section begins with a topic of major importance for med-ical sociologists, that of health and social class, by two experienced medical soci-ologists, Jarron Saint Onge (University of Kansas) and Patrick Krueger (University of Colorado-Denver). Next is Chapter 12 on health and gender by Ellen Annan-dale ( University of York, UK). She is a former editor-in-chief of Social Science & Medicine and past vice-president of the European Sociological Association and the International Sociological Association’s Research Committee on Health Sociology. Chapter 13 presents a European view of health, ethnicity, and race by two noted researchers in this area, Hannah Brady (Uppsala University, Sweden) and James Nazroo (University of Manchester, UK). A European perspective is often missing

PrEfACE xxi

from similar accounts by American medical sociologists, and this chapter fills that void. Turning, however, to the US, Christy Erving and Lacee Satcher (Vanderbilt Uni-versity) examine African American health, while senior scholars Ronald and Jaque-line Angel (University of Texas-Austin) look at Latinos and equity in access to health care. Both chapters are especially relevant topics today in the US. The concluding chapter in this section is on social policy and health inequality by Amélie Quesnel-Vallée, Jaunathan Bilodeau, and Kaitlin Conway of McGill University in Canada. Quesnel-Vallée holds the Canada Research Chair in Policies and Health Inequal-ities at McGill, is past president of International Sociological Association’s Research Committee on Health Sociology, and has received awards from the American Socio-logical Association, the American Public Health Association, and the Population Health Association of America.

In Part IV, the emphasis is on health and various types of social relationships. Chapter 17 is on health and family, which is a new but highly significant topic for this volume. It is written by Mieke Thomeer and Kirsten Ostergren Clark of the University of Alabama at Birmingham. Thomeer is Deputy Editor of the Journal of Marriage and Family, on the editorial board of the Journal of Health and Social Behavior, and is Teaching Committee Chair for the American Sociological Associa-tion’s Medical Sociology Section. Chapter 18 is an updated chapter on health and religion by the well-known scholar Ellen Idler (Emory University). She is the Samuel Candler Dobbs Professor of Sociology at Emory and Director of the Religion and Public Health Collaborative. She also is a Fellow and past chair of the Behavioral and Social Sciences Section of the Gerontological Society of America and the American Sociological Association’s Section on Aging and the Life Course.

Next is a chapter (Chapter 19) on health and migration by a new scholar Elyas Bakhtiari (College of William & Mary) that investigates the increasingly important topic of the health of migrants by an expert on this topic. The section concludes with a chapter on another new subject for this volume, that of mental health, by Teresa Scheid (University of North Carolina-Charlotte). She is a well-known researcher in the sociology of mental health and a senior editor with Eric Wright of the third edition of the Handbook for the Study of Mental Health: Social Contexts, Theories, and Systems.

Part V contains two chapters on health and disease. One is by Barrett on emerg-ing infectious diseases described earlier in this preface for its emphasis on COV-ID-19 and the other (Chapter 22) by Alexandra C. H. Nowakowski (Florida State University College of Medicine) is on chronic illness. As someone who has experi-enced a chronic illness over her life course, Nowakowski brings an insightful and personal view to this chapter.

The final section is Part VI on health care delivery. It begins with a chapter by rising scholars Jason Adam Wasserman (Oakland University Beaumont School of Medicine) and Brian Hinote (Middle Tennessee State University) on health pro-fessions and occupations. Hinote and Wasserman are co-authors of Social and Behavioral Science for Health Professionals. Another rising scholar is Hyeyoung Oh Nelson (University of Colorado-Denver), who analyzes the doctor-patient relation-ship in Chapter 24. Eeva Sointu (York St. John University, UK), who has extensively researched complementary and alternative forms of medicine, provides a chapter (Chapter 25) on that topic.

xxii PrEfACE

Part VI concludes with chapters on the health care systems of the US, the UK, and China – three important countries in health affairs. Chapter 26 is by Bernice Pesco-solido (Indiana University) and Carol Boyer (Rutgers University), who contribute a chapter on the American health care delivery system. The chapter explores the current vortex of health care reforms, problems of access, and costs pertinent to the ongoing legal, legislative, and political disputes taking place in American society. Pes-cosolido is Distinguished and Chancellor’s Professor of Sociology at Indiana Univer-sity and Founding Director of the Indiana Consortium for Mental Health Services Research (ICMHSR). She has served as Vice President of the American Sociological Association, received several awards in sociology and public health, and elected to the National Academy of Medicine. Boyer has had a distinguished career at Rutgers where she is former Associate Director of the Institute for Health, Health Care Policy and Aging Research, and a well-known medical sociologist.

Chapter 27 on the British health care system by Jonathan Gabe (Royal Holloway, University of London, UK) is next, and he brings us up-to-date on that country’s national health service and health issues. A noted scholar, he is a former editor of the journal Sociology of Health & Illness, past chair of the European Sociological As-sociation’s Research Network on the Sociology of Health and Illness, past president of the International Sociological Association’s Research Committee on Health Soci-ology, and a Fellow of the Academy of Social Sciences in the UK. The book con-cludes with Chapter 28 on the Chinese health care delivery system by Lei Jin and Chenyu Ye of the Chinese University of Hong Kong. This chapter was written in difficult circumstances as Hong Kong was undergoing political protests at the time, and the Chinese University’s campus was closed because of COVID-19. Nonethe-less, they contribute an excellent chapter on China, including efforts to cope with the pandemic.

Finally, I would like to thank the efforts of several people at Wiley Blackwell in Oxford who had an important role in the development and publication of this book. These include Justin Vaughan, Charlie Hamlyn, Richard Samson, Merryl Le Roux, and Clelia Petracca. Katie McIntyre at Birmingham-Southern College worked on the index. The first volume of this book originated in a conversation with Justin in a bar in New York City one warm and pleasant afternoon during a long-ago American Sociological Association meeting. This version continues the venture. And thanks again to my wife, Cynthia, for her loving support.

William C. CockerhamWilliamsburg, Virginia

Part IIntroduction

The Wiley Blackwell Companion to Medical Sociology, First Edition. Edited by William C. Cockerham. © 2021 John Wiley & Sons Ltd. Published 2021 by John Wiley & Sons Ltd.

1Medical Sociology and Its

Changing Subfields

Terrence D. Hill, William C. Cockerham, Jane D. Mcleod, and Frederic W. Hafferty

The sociological study of health, illness, and healing systems in the US has expanded substantively and deepened theoretically over the past half century. While work in this area once fit under the single moniker of “Medical Sociology,” we now use a range of alternative labels (e.g. Sociology of Medicine, Sociology of Health and Illness, Sociology of Health, Illness, and Healing, Sociology of Health, Health Soci-ology) and definitions to describe the field. Some definitions highlight topic areas:

“Medical sociology is the study of health care as it is institutionalized in a society, and of health, or illness, and its relationship to social factors” (Ruderman 1981: 927).

“The sociology of health and illness studies such issues as how social and cultural factors influence health and people’s perceptions of health and healing, and how healing is done in different societies” (Freund et al. 2003: 2)

“Medical sociology focuses on the social causes and consequences of health and illness” (Cockerham 2017: 4).

Others emphasize different aspects of the sociological perspective:

“Medical Sociology is the subfield which applies the perspectives, conceptualizations, theories, and methodologies of sociology to phenomena having to do with human health and disease. As a specialization, medical sociology encompasses a body of knowledge which places health and disease in a social, cultural, and behavioral con-text” (Committee on Certification in Medical Sociology 1986).

4 HILL, COCKErHAM, MCLEOD, AND HAffErTY

“The most important tasks of medical sociology are to demonstrate and emphasize the important influence of cultural, social-structural, and institutional forces on health, healing, and illness…” (Weiss and Lonnquist 2016: 11).

“An approach that emphasizes using the area of health, illness, and health care to answer research questions of interest to sociologists in general. This approach often requires researchers to raise questions that could challenge medical views of the world and power relationships within the health care world” (Weitz 2017: 346).

The many labels and definitions that have been offered suggest a lack of consensus on defining medical sociology’s substantive scope and its most significant contribu-tions to knowledge. Some suggest that it is “hard to find a comprehensible statement of what… medical sociology is” (Chaiklin 2011: 585). Others describe the field as a “loosely connected network of disparate subgroups” (Veenstra 2002: 748). This state of the field raises several fundamental questions. How can we characterize our field in a general and consistent manner? What are our contemporary disciplinary boundaries? What are our major subfields? In other words, who are we now, and what do we do?

In this chapter, we propose a disciplinary structure for medical sociology that attempts to answer these questions. By “disciplinary structure,” we mean a repre-sentative model of our major subfields as defined by topic areas, theoretical orien-tations, and significant contributions to the study of health. All sciences invariably reflect on these important issues and, in doing so, define their scientific orientation and boundaries in relation to other sciences, including, for example, medical sociol-ogy (Bloom 1986; Gold 1977; Petersdorf and Feinstein 1980; Straus 1957), medical anthropology (Saillant and Genest 2007), health psychology (Baum et al. 2011), and health economics (Pauly et al. 2012). Explicit disciplinary structures are one way to set disciplinary boundaries, mark accomplishments, and direct future efforts toward a cumulative science. Substantive topics and concepts alone are too granular to signify a field’s major organizing principles. As Zerubavel (1991) once pointed out, things become meaningful only when placed into categories, and the “islands of meaning” that are created in this process explain what matters to a particular social world (or in this case, medical sociology) and help to determine the nature of its social order (or field of knowledge). In short, it is through the process of classification that we establish our boundaries and identity and, by extension, dis-tinguish ourselves from other fields within sociology and other disciplines concerned with health.

The identification of a disciplinary structure was once integral to the development of the field, as evidenced in Straus’s (1957) classic distinction between the sociol-ogy of medicine and sociology in medicine. Six decades have passed since Straus offered his structure, and we believe it is time to consider a more contemporary scheme that acknowledges the expansion of our subject matter, the broadening of theoretical influences, and the resultant complexity. Our primary aim here is to stimulate a forward-looking conversation among medical sociologists by review-ing previous conceptualizations and proposing a new model to serve as a basis for discussion. Our model classifies medical sociology in terms of its major subfields as

MEDICAL SOCIOLOGY AND ITS CHANGING SuBfIELDS 5

defined by substantive topics, theoretical orientations, and scientific contributions. We review the unique contributions of each subfield while recognizing an underly-ing unity driven by common training in sociological theory and methods. We end with several recommendations for a more refined and directed conceptualization of the field.

There are several reasons why we should be having these discussions. When we define our major subfields and contributions to the study of health, we (1) claim our independence from other health sciences (e.g. medicine), (2) maintain our status in the marketplace of health research (e.g. as health psychologists and public health researchers publish more and more on socioeconomic inequalities), and (3) develop as a cumulative science through a formal recognition of the expansion of our field’s purview. Before Straus (1957), for example, some questioned whether sociology should be considered a “third branch to medicine” (Boulton 2017: 242). When we stop reflecting and leave our subfields undefined, we lose track of our major con-tributions across generations of medical sociologists and in the broader interdis-ciplinary field of health research, leaving scholars from other health sciences (e.g. public health) unable to identify them. We also create intellectual vacuums for less fruitful discussions. For example, when we stopped discussing subfields in the late 1980s, we began the great “moniker debate” over whether to continue using the term “medical sociology” or to rename ourselves something else to be more inclusive of work related more to health than medicine. Instead of taking up that debate, we intend to redirect the conversation to how best to represent our disciplinary struc-ture. Ultimately, we believe that focusing more on our major subfields and contribu-tions to sociology and the broader study of health will support more productive and substantive conversations about what medical sociology has to offer.

Previous Subfield Models

The establishment of subfields within medical sociology was a major advance in its early development. In the 1950s, Straus (1957) proposed a two-subfield struc-ture that included the sociology of medicine and sociology in medicine. These sub-fields were important because they (1) organized studies depending on the extent to which they served the interests of sociology vs. medicine and (2) sought to highlight the unique contributions of sociology to the study of health, illness, and medical practice. In the 1980s, Petersdorf and Feinstein (1980) suggested a more elaborate six-subfield model that was still based on sociology’s stance vis-à-vis professional medicine, including sociology in medicine, sociology of medicine, sociology for med-icine, sociology from medicine, sociology at medicine, and sociology around med-icine. Still others advocated for a sociology with medicine (Bury 1986; Horobin 1985; Levine 1987). Although elaborations on Straus’ original model never really took hold (Cockerham 1983; Hollingshead 1973; Ruderman 1981; Straus 1999; Wardwell 1982), we argue that, after decades of scholarship, the two-subfield model no longer adequately represents our contemporary disciplinary structure or our con-tributions to the study of health. For example, many medical sociologists no longer define themselves primarily in relation to medicine (whether critical of, or allied

6 HILL, COCKErHAM, MCLEOD, AND HAffErTY

with it), and areas of inquiry that have distinct sociological identities have become more prominent (e.g. social epidemiology). For these reasons, we take Straus’ (1957) original concerns with disciplinary structure in a new direction by defining subfields that are distinguished by substantive topics, theoretical orientations, and contribu-tions to the interdisciplinary study of health.

Handbooks and textbooks typically divide the field substantively. For example, the third edition of the Handbook of Medical Sociology (Freeman, Levine, and Reeder 1979) was organized into five parts: “Health and Illness,” “Health Care Pro-viders,” “Individual and Organizational Behavior,” “Health Policy Dimensions,” and “Methods and Status in Medical Sociology.” The most recent sixth edition of the Handbook of Medical Sociology (Bird et al. 2010) adopted a different set of three organizational categories: “Social Contexts and Health Disparities,” “Health Tra-jectories and Experiences,” and “Health-Care Organization, Delivery, and Impact.” The Handbook of Health, Illness, and Healing (Pescosolido et al. 2011) offered yet another distinct seven-part scheme: “Rethinking Connecting Sociology’s Role in Health, Illness, and Healing,” “Connecting Communities,” “Connecting to Med-icine: The Profession and Its Organizations,” “Connecting to the People: The Pub-lic as Patient and Powerful Force,” “Connecting Personal & Cultural Systems,” “Connecting to Dynamics: The Health and Illness Career,” and “Connecting to the Individual and the Body.”

When we turn to important textbooks, we find four major sections in Cockerham (2017) (Health and Illness, Seeking Health Care, Providing Health Care, and Health Care Delivery Systems) and four major sections in Weitz (2017) (Social Factors and Illness, The Meaning and Experience of Illness, Health Care Systems, Settings, and Technologies, and Health Care, Health Research, and Bioethics). In Weiss and Lon-nquist (2016), we see a more complex structure with no major sections or organiza-tional schemes. Although these formats are effective for textbook presentations of the literature, they are more a collection of topics than major subfields that might organize the field.

One of the challenges we face is defining our field’s substantive scope and its most significant contributions to knowledge in a way that is contemporary, com-prehensive, and efficient. Although Straus’ (1957) original model was efficient, it no longer adequately represents the field. The organizational schemes of books are more contemporary, but their structures are inefficient in the sense that the cate-gories are numerous and inconsistent across volumes. The compromise we propose is a modest elaboration on Straus (1957) that reflects contemporary developments in the field.

A New Four Subfield Model

Building on previous conceptualizations, Figure 1.1 identifies and describes four major subfields of medical sociology: (1) Social Epidemiology, (2) Social Psychol-ogy of Health and Illness, (3) Sociology of Medicine, and (4) Sociology in Medicine. These subfields are intended to represent the field according to substance, theory, and contributions to knowledge.

MEDICAL SOCIOLOgY AND ITS CHANgINg SubFIELDS 7

According to the ASA Committee on Certification in Medical Sociology (1986), our subject matter includes “descriptions and explanations or theories relating to the distribution of diseases among various population groups; the behaviors or actions taken by individuals to maintain, enhance, or restore health or cope with illness, disease, or disability; people’s attitudes, and beliefs about health, disease, disability and medical care providers and organizations; medical occupations or professions and the organization, financing, and delivery of medical care services; medicine as a social institution and its relationship to other social institutions; cultural values and societal responses with respect to health, illness, and disability; and the role of social factors in the etiology of disease, especially functional and emotion-related.”

Our proposed subfields are intended to capture this broad range of topics, but not to be mutually exclusive or exhaustive. We fully acknowledge that some researchers may identify with more than one subfield. We believe that the diversity of research conducted in our field has and will continue to challenge the representativeness of our proposed disciplinary structure. With this in mind, our aim is not to find a per-fect representation of the field or to dismiss other organizational schemes. Instead, our aim is to create a representative structure so that we can see the scope of our field more clearly. What does sociology contribute to the study of health and medicine? We argue that our subfield model answers this question in a clear way that better reflects where we are today.

Social Epidemiology

Focuses on the social distribution and social causes of health-related

outcomes and behaviors.

Emphasizes social structure and

material conditions.

Social Psychology of Health and Illness

Focuses on social psychological

processes, especially those that mediate and

moderate the social causes and social consequences of

health-related outcomes and

behaviors.Emphasizes culture

and meaning.

Sociology ofMedicine

Focuses on issues linked with health care delivery and

health care experiences, medical

knowledge, and health social movements,

including social inequality, social institutions, and

health policy/law, often employing a critical theoretical

perspective. Emphasizes

institutions of medicine.

Sociology in Medicine

Focuses on issues within institutions of medicine, including medical treatment,health professions,

and the marketing ofhealth care.

Emphasizes appliedresearch questions.

MEDICAL SOCIOLOGY

Figure 1.1 Major Subfields of Medical Sociology.

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