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Throughout society there are many different sociological approaches to health and ill health. Within society there are many different perspectives towards whom the responsibility for health falls upon and also what defines people as ill? Your health is defined by the general condition of your body and mind. An illness is defined by an impairment of normal physical or mental function. To help explain the different sociological approaches to health and ill health I will be referring to the case study of Aziz and Tamsela.
Aziz and Tamsela have four young children; Tamsela’s elderly parents also live with them in their three bedroomed houses in a deprived and depressing area of London. Their house is in desperate need of repair; it is damp and due to this is very expensive to heat in the winter months. Aziz and Tamsela are both currently unemployed. The family also has very ill health; during the winter the children generally seem to have constant colds.
On top of this Tamsela suffers from asthma and her father has bronchitis; also Tamsela’s mother is depressed and has been prescribed drugs to help her condition.
One of the first sociological approaches to health and ill health involves the functionalist approach. The functionalists approach is derived from the work of Talcott Parsons. Using the traditional functionalists approach he described how for society to function effectively that its members need to healthy. Parsons defined illness as a form of deviance and that ill members of society were still performing a social role, the sick role.
In his view if people declared themselves as ill specific rights and responsibilities come with this new role. Functionalists believe that the rights associated with the sick role are; to be exempt from normal social obligations, for example, to go to school, college or work and from meeting normal family obligations, also to be cared for.
Parsons saw it as one of the key functions of the family to care for the sick and other dependant members of the family group. The individual also has responsibilities that are involved in the sick role; taking all reasonable steps to get better and seeking to resume their normal place in society as soon as possible and to cooperate with medical professionals, particularly doctors and their staff. Functionalists view that illness has social consequences; the ill cannot work and need to be cared for.
They believe that where ever possible illness must be quickly dealt with in order for society to function effectively. In the instance of Aziz and Tamsela, the functionalists view contradicts their situation as they are in ill health and are not working; therefore they are stopping the effective function of society. In order to comply with the functionalists view they would need to seek help themselves and ensure their return to health in order to be able to start working and contributing to society as in their current situation they are draining society.
Another approach to health and ill health would be the Marxists approach. Marxists believe that the definitions of health and illness and the health and social care system provided are in place to serve the interests of the more powerful dominant classes. Doctors are seen as agents who ensure that people go back to work as soon as possible, working in the interests of their employers rather than working in the patient’s best interests. Their job is to ensure that the employer has a healthy workforce. However the government still allow these companies to make money from the products that effectively cause ill health such as tobacco and junk food.
Factories and firms also continue to produce toxic waste and large amounts of pollution which can also cause ill health. Marxists regard levels of ill health to be linked to the differences in social class, for example there is a higher level of illness and lower life expectancy in areas of poverty, high unemployment and environmental pollution. Marxists believe that the government do not consider enough the reasons for ill health; they believe that rather than treating patients each time they become ill that the government should look into the reasons they are continually becoming ill.
With people needing to be treated by the NHS constantly this costs the government lots of money which the Marxist believe is funded by the most advantaged in society. The case study of Aziz and Tamsela supports this, as they live in a deprived area of London, in a damp house, they live in poverty and all have ill health, therefore supporting the Marxists view. Their care and ill health is costing society, however if they lived in a better area in a better house they may not become ill as often and may be able to recover and work. In this case the action would be to make sure they are fit and well unable to return to work and benefit their employer however a bigger solution would involve seeking a long term problem to their illnesses.
Another approach to be considered is the interactionalist or social action approach. Interactionism is more concerned with the issues of health and illness. They look at; the process which lead a person to define themselves as ill, people with the same complaint vary with symptoms and also vary as to whether they will seek professional help. Also the interaction between the professionals and the patient in agreeing how ill they are and also the discussion between the professional and the patient about the impact of their illness and how much their illness limits them.
They also consider the impact of illness on people self-image and their relationships if they are labelled as ill. Interactionists do not look at the structures and institutions or the reasons people become ill but the complex relationships between people, their friends and family and their links with the professional services. They believe that these relationships have as much influence as medical diagnosis on whether a person declares themselves as ill. In relation the Aziz and Tamsela, it is possible that they declare themselves as ill and declare their children as ill as their parents both suffer from serious illnesses.
Lastly the feminist approach focuses on the male domination in society and medical professions and how this affects the health and social care system. They are particularly concerned with the way in which pregnancy and child birth are perceived as medical issues rather than a natural process. Another issue they have been trying to combat is the issue that the medical profession and the related pharmaceutical industries have given low priority to developing a male contraceptive pill, leaving most contraceptive methods only available to women. Their main focus is the fact that many women suffer from mental illnesses such as anxiety and depression. Feminists see this as a result of their exploited position in society and family unit.
They argue that because women now also have the pressure and expectation of working however they also still have the responsibility of running a family, this causes them great stress due to a lot of pressure from society and their families. Feminists believe that any medical issue should be treated with medicines. In regards to the case study this approach does not have a very strong link as Tamsela does not work and neither does her husband. However due to the extra pressure of her parents living with her she will feel more stressed having to care for them, she is also dealing with extra pressure as her husband does not work and there is no money coming in to the family.
Health can be defined in a negative or positive concept. A positive concept looks at health as a state of complete physical, mental, spiritual and social wellbeing. Whereas a negative concept of health is that health is merely the absence of disease. In the health and social care sector, care professionals usually adapt the holistic approach.
The holistic approach addresses the needs of the whole person including their, intellectual, spiritual, social, emotional, mental and physical health. Mildred Blaxter (1990) interviewed 10,000 people in a large scale study. From this she defined three standards of peoples understanding of health and wellbeing; a positive definition, regarding health as feeling fit and well. A negative definition regarding health as being free from pain and discomfort and also a functional definition, regarding health in terms of being able to perform certain day to day tasks.
Models of Health
There are also two models regarding health, the biomedical model and Socio-medical model. The Biomedical model has dominated western industrialised societies since the nineteenth century. This view of health underpins the policies of the current health system in the UK. In this model health is regarded as the absence of disease and that intervention from health professionals is necessary in the time of illness. The main purpose of the health service is to cure disease and to use scientifically tested methods to address diagnosed illnesses. In this model little regard is given to the social and environmental factors that may have caused ill health, it mainly focuses on the individual.
The Biomedical model focuses mainly on the individual and finding a cure for them, it is a limitation of this model as it does not take into account the factors causing ill health and also the implications on the rest of society. Another limitation is that the biomedical model regards health as being simply the absence of disease which does not consider a patients mental, social, spiritual, emotional, intellectual or physical health, which could lead to a person becoming unhealthy in different terms.
However an advantage of this is that because the main focus of the model is disease, this would show that it is the health care professionals such as doctors whom are in control of a patient’s condition, meaning less confusion or interference from others such as management or other health care workers. This is links in with the inter-actionists sociological approach to health and illness as they focus on the relationship between the health professional and the individual and how this affects the person’s health and the decisions made about their health.
The biomedical model also sits well with the functionalists approach to health and social care. Functionalists view illness as dysfunctional for society, as if people are ill they can’t make their normal contributions to society and are exempt from their usual social responsibilities, effectively stopping it from running smoothly. They then have the responsibility to co-operate with health care professionals and should take all reasonable steps to get better.
Whereas the Socio-medical focuses on the social factors that contribute to health and wellbeing. Research shows that life expectancy rose and death rates fell especially infant mortality rates with improvements in sanitation and the provision of clean water, the building of new council houses and general improved standards of living. This began during the late nineteenth century and early twentieth century. However the NHS was not introduced until 1948 which meant free personal health care.
This goes to show that social and environmental factors are a significant source of disease and that the causes and effects of ill health are not solely surrounding the individual. However as the Socio-medical model focuses on the environmental and social affecting factors, this can take time to find a cause of illness which would mean that until a cure or solution was found each patient would need to treated individual so that their illness was kept under control. This could also be seen as strength of the Socio-medical model because even though it may take time to find a solution to the problem or reasons for an illness, if a solution was found it can mean long term solutions and also the prevention of the illness in future.
However unlike the biomedical model the socio-medical model does not fit at all with the functionalists perspective towards health and illness but fits better with the Marxists view of health and illness, Marxists would explain the shorter life expectancy and the higher rates of ill-health among the poor as a consequence of the inequalities in society and the poor life circumstances of those in poverty.
They would argue that the poor are more likely to have an inadequate diet and live in damp houses, in deprived areas where unemployment and environmental pollution are higher making them more vulnerable to illness and that the higher groups in society such as politicians and the owners of the industries are not willing to help and make changes to help protect the poor from ill-health and disease.
Overall both models of health are very different the biomedical model focuses on curing the individual each time where as the socio-medical model looks at the causes of the illnesses including the society we live in and the environment and looks for a longer term solutions. Effectively both models are useful and possibly if put together could be more effective in solving the problems regarding health and illness throughout society.
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