Health, Illness, Disability and the Body

This section explores the topic of Health in relation to A-Level Sociology. The page explains: The social construction of health, Illness, disability, and the body, models of health and illness, the distribution of health chances, the nature and distribution of mental illness, the role of medicine and the globalised health industry.

The Social Construction of Health, Illness, Disability and the Body

Sociologists argue that health, illness, disability, and perceptions of the body are socially constructed, meaning they are shaped by social, cultural, and historical factors, rather than being purely biological.

Health and Illness as Social Constructs: Definitions of health and illness vary across cultures and time periods. What is considered "healthy" or "ill" is influenced by social expectations. For example, being overweight may be seen as unhealthy in some societies but a sign of wealth or fertility in others. Medicalisation (Illich) refers to the process by which non-medical problems become defined and treated as medical issues, such as childbirth or ageing.

Disability as a Social Construct: The social model of disability argues that disability is not simply a biological condition but a product of societal barriers (e.g., inaccessible buildings, negative attitudes) that restrict individuals’ participation. In contrast, the medical model of disability focuses on the individual's physical impairments and sees them as the primary problem to be fixed.

The Body: Sociologists like Foucault examine how society exerts control over the body through surveillance and discipline. The body becomes a site of power relations, where norms around appearance, fitness, and health are socially regulated. Postmodernist perspectives, such as those from Baudrillard, highlight how bodies are increasingly commodified in a consumer society, with individuals constructing their identity through body modifications like plastic surgery or tattoos.

Models of Health and Illness

Different models explain how health and illness are understood and treated:

Biomedical Model: The dominant model in Western medicine, this views illness as a result of biological factors such as pathogens, genetics, or injury. It focuses on diagnosis and treatment through scientific methods. While effective in treating many diseases, critics argue that it overlooks social and environmental causes of ill-health.

Social Model of Health: This model emphasises the social, economic, and environmental factors that contribute to health. It considers how issues such as poverty, housing, and education impact well-being. For example, poor housing conditions may lead to respiratory illnesses, while unemployment may contribute to mental health issues.

Holistic Model: Views health as a complete state of physical, mental, and social well-being, not just the absence of disease. This model encourages a more integrated approach to health care, considering lifestyle, emotional health, and social connections.

The Unequal Social Distribution of Health Chances in the UK

Health chances in the UK are unevenly distributed along lines of social class, gender, ethnicity, and region.

Social Class:

Studies consistently show that working-class individuals have worse health outcomes compared to middle and upper classes. This is due to material deprivation, poor living conditions, restricted access to green spaces for exercise and more dangerous working environments. Wilkinson and Pickett argue that income inequality within societies leads to poorer health for those at the bottom.

Cultural explanations also suggest that working-class people may engage in more risky health behaviours (e.g., smoking, poor diet) due to stress or lack of access to health education.

Gender:

Women generally live longer than men but suffer more from chronic illnesses. This has been linked to gender roles, with women more likely to seek medical help but also more likely to experience conditions like depression and anxiety due to social pressures, such as balancing work and family life.

Men, on the other hand, are less likely to visit doctors and may engage in more risky behaviours like heavy drinking, which contributes to higher rates of heart disease and cancer. Connell's concept of hegemonic masculinity suggests that traditional male roles discourage men from showing weakness or vulnerability.

Ethnicity:

Ethnic minority groups in the UK face disparities in health outcomes. For instance, Black Caribbean and South Asian populations have higher rates of diabetes and heart disease. Much of this can be explained by genetic factors, but some of it is due to institutional racism, poorer access to health services, and socio-economic deprivation.

Cultural factors, such as diet and attitudes towards healthcare, may also contribute to these differences. Additionally, ethnic minorities are more likely to live in deprived areas, exacerbating health inequalities.

Region:

There is a marked North-South divide in health outcomes in the UK. Regions in the North tend to have lower life expectancy and higher rates of illness compared to the more affluent South. This is linked to industrial decline in northern areas, leading to unemployment, poverty, and poorer health services.

Inequalities in the Provision of, and Access to, Health Care

Access to health care in the UK is unequal, despite the NHS aiming to provide free healthcare for all.

Social Class: Middle-class individuals tend to have better access to healthcare, as they can afford private treatment or live in areas with better NHS services. Working-class individuals may face longer waiting times, lack of resources, and poorer-quality care. Marxist perspectives argue that healthcare is another means through which class inequalities are maintained.

Ethnicity: Ethnic minorities may experience difficulties accessing healthcare due to language barriers, lack of cultural understanding by healthcare professionals, or discrimination. Studies show that some minority groups are less likely to receive early diagnoses for conditions like cancer.

Gender: Women are more likely to use health services but may face challenges such as being dismissed as "hysterical" or "overly emotional" when reporting symptoms. Men, by contrast, are less likely to seek help, contributing to worse health outcomes.

Region: Access to healthcare varies by region, with urban areas generally having better facilities and more specialised services than rural areas. This can create significant barriers for people living in remote regions, where transport and availability of services are limited.

The Nature and Social Distribution of Mental Illness

Mental illness is also socially distributed and shaped by various social factors:

Social Class: Working-class individuals are more likely to suffer from mental health issues such as depression and anxiety, due to higher levels of stress from financial insecurity, unemployment, and poor living conditions. Marxist perspectives suggest that capitalism creates conditions of alienation and exploitation, which negatively impact mental health.

Gender: Women are more likely to be diagnosed with common mental health conditions like depression, anxiety, and eating disorders. Feminists argue that this is due to the pressures of balancing traditional gender roles, such as caregiving responsibilities and paid work. Men, on the other hand, are more likely to suffer from substance abuse and have higher rates of suicide.

Ethnicity: Ethnic minority groups often experience higher rates of mental health issues, such as schizophrenia. However, there are concerns that these groups are more likely to be overdiagnosed or misdiagnosed due to cultural bias in mental health assessments. Structural racism and marginalisation are key factors contributing to poorer mental health among ethnic minorities.

Region: People living in deprived areas are more likely to experience mental health problems due to higher levels of poverty, unemployment, and social isolation.

The Role of Medicine, the Health Professions, and the Globalised Health Industry

Role of Medicine: Medicine is not just about treating illness but also plays a key role in maintaining social control. Foucault argued that the medical profession exerts power by defining what is normal and abnormal, thus controlling individuals' bodies. The medical profession also reinforces societal norms, such as gender roles or expectations around ageing.

Health Professions: Doctors and other health professionals hold significant authority in society. The functionalists argue that they perform an essential role in maintaining societal well-being. However, Marxists and feminists argue that the health profession reinforces class and gender inequalities. For example, middle-class men dominate high-status roles within medicine, while women are often found in lower-paid, less prestigious healthcare jobs.

Globalised Health Industry: Globalisation has impacted the health industry in various ways. The increasing flow of goods, people, and information has led to the spread of both diseases (e.g., pandemics like COVID-19) and medical knowledge. The global health industry has also become increasingly privatised, with pharmaceutical companies and private healthcare providers playing a large role in shaping health policy and access to care. McDonaldization of healthcare refers to the standardisation and efficiency-driven practices seen in healthcare globally, often criticised for prioritising profit over patient care.

Summary

Health, illness, disability, and the body are socially constructed concepts that vary across time and cultures.

Health chances are unevenly distributed by social class, gender, ethnicity, and region, with significant inequalities in access to healthcare.

Mental illness is similarly affected by social factors, with working-class, ethnic minority, and marginalised groups experiencing higher rates of mental health problems.

Medicine and the health professions hold significant power in defining and controlling health, while the globalised health industry continues to reshape healthcare access and practices worldwide.