MA Sociology Paper‐XI SOCIOLOGY OF HEALTH Author Suvashree Behera Sociology of Health Unit‐I: Sociology of Health: its aim & scope, Contribution of Sociology to Health, Definition of Health & Illness‐ Four Dimensions of Health and Evolution of Social medicine in India . Unit‐I 1.0. Objectives of the Unit 1.1. Sociology of Health: an introduction 1.2. Aim and Scope 1.2.1 The social basis of health, illness and medicine 1.2.1.1 Bio‐chemical model versus Holistic approach 1.2.1.2 The relationship between society and individual 1.2.1.3 Class and health inequalities 1.2.1.4 Ethnicity, race and health 1.2.1.5 Gender and health 1.2.2 Mental health 1.2.2.1 Mental illness 1.2.2.2 Stigma 1.2.2.3 Ethnicity and mental health 1.2.2.4 Gender and mental health 1.3 Theoretical approaches 1.4 Contribution of sociology to health 1.4.1 Health promotion and sociology 1.4.2 Mental health roots 1.4.3 Some Contributions of Medical Sociology 1.4.4 Medical education 1.4.5 Medical sociology and physicians 1.4.6 Some of other major contributions of the sociology of health and illness 1.5 The Future of Medical Sociology 1.6 Definition of Health & Illness 1.6.1 Health: a global survey 1.6.1.1 Health in history 1.6.1.2 Health in low‐income countries 1.6.1.3 Health in high‐income countries 1.6.2 Current inequalities in health 1.6.3 Sociological Perspective on Health 1.6.4 The determinants of health 1.6.5 Policies to improve health 1.7 Four Dimensions of Health 1.8 Evolution of Social medicine in India 1.8.1 What is Social Medicine? Meaning and scope 1.8.2 Genesis and evolution of social medicine 1.8.3: Development of preventive and social medicine 1.8.4 Challenges 1.9. Summary 1.10. Key words 1.11. Further Readings 1.0.Objectives of the Unit: The main objective of this unit is to inform the readers about the basic idea on Health Sociology. After the completion of studying this unit the students will gain some fundamental knowledge on the following topics: Meaning, aim, objectives and scope of Health Sociology. Major theoretical approaches to health sociology. The concept of health and illness and different social determinates of health and illness. Major contributions of health sociology. Social Medicine‐ Its Evolution and development. 1.1 Sociology of Health: an introduction Over the last decade the promotion of health has become a central feature of health policy at local, national and international levels, forming part of global health initiatives such as those endorsed by the World Health Organization. At the same time a concern with ‘healthy living’ has become a preoccupation for many people. The Sociology of Health Promotion responds by offering the first critical sociological account of these developments and locates them within a set of wider socio‐cultural changes associated with late modernism. The Sociology of Health offers analyses of contemporary public health policy, lifestyle, consumption, risk and health. It also examines socio‐political critiques of health promotion and reflects upon their implications for policy and practice, the impact of both morbidity on social life and social life on morbidity. Diseases and conditions once attributed mainly to genetic predispositions are increasingly being looked at under a more global microscope with factors such as family, education, religion and economic standing all playing key roles in understanding the issue at hand. The history of HIV/Aids illustrates a prime example of how sociological factors affect health. The disease is thought to have originated in Sub‐Saharan Africa, where 69% of the world’s HIV/Aids cases currently exist, making heritage an important component to consider. However, there are even more sociological circumstances that contribute to the plethora of HIV/Aids victims in this area of the world. Female genital mutilation, an unfortunate cultural norm in parts of Africa, is conducive to the exchange of blood during sexual intercourse. Additionally, interference by religious activists often prevents any hope for promoting safe‐sex campaigns. Even major political figures in Africa have been known to cling strongly to AIDS‐denialist claims. This ignorant standpoint places a society that is already intensely prone to contracting the disease in an even more uneducated position. The positive side to discovering the influence of sociological factors on disease is that it provides us with further insight to humanity’s core issues and obstacles. When not adequately paid attention to, however, knowledge can be a double‐edged sword. For instance, when HIV/Aids first emerged in the US in the 1980s, it was feared but also believed to solely infect the homosexual and/or African American communities. Though these groups do often dominate statistics, HIV/Aids have actually been on the rise significantly in heterosexual females as of late. So, though the stigma and fear of HIV/Aids still exists in the US, the invention of new medicines and the spotlight on stereotypical victims sometimes make it not as prominent a concern as it should be for others who could still be infected. As we progress as a society, it is vital that we fully acknowledge potential health risks and make a joint effort to share and spread preventative knowledge. Health is a state of complete well‐being: physical, mental, and emotional. This definition emphasizes the importance of being more than disease free, and recognizes that a healthy body depends upon a healthy environment and a stable mind. Medicine is the social institution that diagnoses, treats, and prevents disease. To accomplish these tasks, medicine depends upon most other sciences—including life and earth sciences, chemistry, physics, and engineering. Preventive medicine is a more recent approach to medicine, which emphasizes health habits that prevent disease, including eating a healthier diet, getting adequate exercise etc. The sociology of health and illness studies the interaction between society and health. In particular, sociologists examine how social life impacts morbidity and mortality rates and how morbidity and mortality rates impact society. This discipline also looks at health and illness in relation to social institutions such as the family, work, school, and religion as well as the causes of disease and illness, reasons for seeking particular types of care, and patient compliance and noncompliance. Health, or lack of health, was once merely attributed to biological or natural conditions. Sociologists have demonstrated that the spread of diseases is heavily influenced by the socioeconomic status of individuals, ethnic traditions or beliefs, and other cultural factors. Where medical research might gather statistics on a disease, a sociological perspective of an illness would provide insight on what external factors caused the demographics that contracted the disease to become ill. The sociology of health and illness requires a global approach of analysis because the influence of societal factors varies throughout the world. Diseases are examined and compared based on the traditional medicine, economics, religion, and culture that are specific to each region. For example, HIV/AIDS serves as a common basis of comparison among regions. While it is extremely problematic in certain areas, in others it has affected a relatively small percentage of the population. Sociological factors can help to explain why these discrepancies exist. Moreover, there are obvious differences in patterns of health and illness across societies, over time, and within particular society types. There has historically been a long‐term decline in mortality within industrialized societies, and on average, life‐expectancies are considerably higher in developed, rather than developing or undeveloped, societies. Patterns of global change in health care systems make it more imperative than ever to research and comprehend the sociology of health and illness. Continuous changes in economy, therapy, technology and insurance can affect the way individual communities view and respond to the medical care available. These rapid fluctuations cause the issue of health and illness within social life to be very dynamic in definition. Advancing information is vital because as patterns evolve, the study of the sociology of health and illness constantly needs to be updated. 1.2 Aim and Scope: 1.2.1 The social basis of health, illness and medicine 1.2.1.1 Bio‐chemical model versus Holistic approach Health and illness are, surely, simply biological descriptions of the state of our bodies. When we’re ill, we’re ill. A more refined version of this common‐sense view underlies the long‐standing biomedical model of disease, which is based on the following assumptions: Disease is an organic condition: non‐organic factors associated with the human mind are considered unimportant or are ignored altogether in the search for biological causes of pathological symptoms. Disease is a temporary organic state that can be eradicated – cured – by medical intervention. Disease is experienced by a sick individual, who then becomes the object of treatment. Disease is treated after the symptoms appear – the application of medicine is a reactive healing process. Disease is treated in a medical environment – a surgery or a hospital – away from the site where the symptoms first appeared. This model has dominated medical practice because it has been seen to work. It is based on a technically powerful science that has made a massive contribution to key areas of health (for example, vaccination). The anatomical and neurophysiologic structures of the body have been mapped out, and the genetic mapping of the body is being undertaken through the Human Genome Project. The search for the fundamental – that is, genetic – basis of human pathology is on, whether the target is cancer, AIDS or Alzheimer’s disease.