ASSIGNMENT

NAME: KRITIKA GUPTA

COLLEGE ROLL NO.: 22527073
COURSE: BA (HONS.) POLITICAL SCIENCE
PAPER NAME: SOCIOLOGY OF PUBLIC HEALTH (G.E.)
SEMESTER: FOURTH (4th)
SUBMITTED TO: MR. AKHILESH PATHAK

INTRODUCTION

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 Sociology as a discipline developed from theoretical writings of the
nineteenth century and the first half of the twentieth century. The
predominant theories stem from the work of Karl Marx, Emile Durkheim,
Max Weber, Talcott Parsons, Robert Merton, and James Coleman. The
influence of this rich theoretical foundation has manifested itself in
major debates over the role of sociology as a science. European and
American perspectives on sociology as a science differ, with the
American perspective favoring sociology as a scientific discipline and
emphasizing a more quantitative methodological approach than the
European approach.

PUBLIC HEATH SOCIOLOGY AS A BEHAVIORAL SCIENCE

Behavioral Science is a branch of science (such as psychology, sociology, or
anthropology) that deals primarily with human action and often seeks to
generalize about human behavior in society.
Many public health challenges – including preventable diseases,
smoking, and mental ill-health – are more often behavioral and
sociological than medical. The reason behind this is that they often arise
from behaviors that are underpinned by social and structural
determinants.

For example, obesity and Type 2 diabetes often arise as a result of the
poor diets that we have, which are influenced by the obesogenic
environment that we live in. Although these behavioral and social factors
are often the leading influences on our health outcomes, they attract
only a fraction of the attention or resources that go into clinical
treatment.

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 Other examples that illustrate Public health sociology as a
part of behavioral sciences;
Sociology is a science that looks at human behavior in groups. Sociologists
maintain objectivity, perspective, and imagination,
Sociologists use scientific method to study politics, race, culture,
socioeconomic issues,
All interacting with each other in social settings causes group behavior,
Sociology uses different questions about human behavior.
Example; Why health or illness is promoted or complicated by the type of
food we eat.
 Sociology helps to understand why people are refusing to use certain
kinds of health facilities
 Sociology studies man as behaving individual
 Sociology studies the nature and characteristics of individuals in
society
 Systematic analysis and investigation of human behavior through the
study of past, controlled, and naturalistic observation
 Sociology analyses the influences of economic, political,
technological, cultural, and other forces and factors on individuals and
their lives.
Therefore, Public Health Sociology, or simply sociology is a science. As it
uses the scientific method of research and data collection. Sociological
methods are both qualitative and quantitative methods.

Most of the Sociological investigations are related to the behavior of

men in groups.

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For Example; The socioeconomic status of a group is affected by
complex components such as education and occupation that are part of
the total life course of individuals within the group.

To sum up, in sociological approaches to public health, the role of social

and behavioral factors in health and illness is central. Thus, Public Health
sociology is a part of behavioral science.

KEY CONCEPTS IN SOCIOLOGY

Several key concepts in sociology relate to its role in public health.

Foremost is the emphasis on society rather than the individual. The
individual is viewed as an actor within larger social processes. This
distinguishes the field from psychology. The emphasis is on units of
analysis at the collective level, such as the family, the group, the
neighborhood, the city, the organization, the state, and the world. Of
key importance is how the social fabric, or social structure, is maintained,
and how social processes, such as conflict and resolution, relate to the
maintenance and change of social structures. A sociologist studies
processes that create, maintain, and sustain a social system, such as a
health care system in a particular country. The scientific component of
this study would be the concern with the processes regulating and
shaping the health care system. Sociology assumes that social structure
and social processes are very complex. Therefore its methodology is
appropriately complex and often, particularly in American sociology,
dominated by multivariate statistical analysis methods. The advent of
the computer in the second half of the twentieth century presented the

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field with the opportunity to work with very large bodies of data and
complex variables.

MEDICAL SOCIOLOGY

Earlier social theorists, such as those noted above, did write on subjects
of concern to medicine, health, and illness, but medical sociology, as a
subdiscipline of sociology, developed in the post-World War II period.
Early debates in medical sociology were concerned with the role of
sociology as it relates to medicine: Should the field be critical and
analytical, concerning itself with the sociology of medicine (i.e.,
examining how medicine works); or should it be largely applied, focusing
on sociology as a handmaiden for medicine? Like many such formative
debates, there could be no conclusive answer. However, the field has
developed into two groups: those (largely within academic settings)
which focus on the sociology of medicine; and those (primarily in schools
of public health and governmental institutions) which focus on the
application of sociology to medicine. Later debates related to whether
the focus should be on health sociology or medical sociology. This
debate has moved the field to a broader, more ecological, view of
medicine and health.

SOCIOLOGY IN PUBLIC HEALTH

Public health has been and remains a very applied field. It is also
characterized by a population-based approach to health, and statistical
methods are deemed the appropriate underlying method for the field. It
is viewed as a science that seeks to intervene, control, and prevent large-

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scale processes that negatively affect the public's health. By these
criteria, there is a strong logical fit of sociological principles and practices
within public health. Nonetheless, sociology has not been the key social
science discipline in public health. That position has gone to psychology,
where the emphasis on individual behavior resonates more with a
biomedical model. Despite this, many of the primary concerns of
present-day public health, with large-scale variables such as social
capital, social inequality, social status, and healthcare organization and
financing, remain topics best suited to the sociological perspective and
methodology. The emphasis on public health is thus shifting toward a
sociological perspective.

SOCIOLOGICAL METHODS IN PUBLIC HEALTH

Methodological concerns are critical to sociological research. The great

debate in sociology has been on the relative merits and role of
quantitative versus qualitative approaches. Both approaches are widely
used and play a critical role in public health. Sociology has long
recognized that the social world comprises both an objective and a
subjective reality. For example, the objective reality of having cancer is
accompanied by the subjective reality of the experience of cancer by the
patient, and the patient's family and friends. Both realities are relevant
to the sociological approach. The subjective, qualitative approach is
generally discussed in the theory and methods concerned with illness
behavior, but qualitative approaches are equally applicable to the
understanding of social policy, world systems, and areas of sociology
where statistical measurement is difficult or less relevant.

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Within public health, surveillance is seen as a key approach to describing
the distribution and dynamics of disease. In sociological approaches to
public health, the role of social and behavioral factors in health and
illness is central. Survey methodology has occupied a central place in
sociological research since the middle of the twentieth century. The
concern has been with the collection, management, analysis,
interpretation, and use of large quantities of data obtained by direct
interviews with respondents. Social surveys are characterized by large
random samples, complicated questionnaires, and the use of
multivariate statistics for analysis. By their very nature, most sociological
variables are complex to measure and analyze. For example, the
assessment of the socioeconomic status of an individual requires the
accurate measurement of several variables that sit within a larger social
context. Socioeconomic status (SES) is regarded as a product of several
components, including income, residence, education, and occupation.
Determining the relative weight of each of these components is a major
analytical problem. Thus, when considering the role of socioeconomic
status on health care outcomes, there is no easy answer to what
mechanism works to determine the observed relationship between SES
and health.

WHAT IS THE SOCIAL CONSTRUCTION OF HEALTH?

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The social construction of health is an important research topic in the
sociology of health. It states that many aspects of health and illness are
socially constructed. The topic was introduced by Conrad and Barker
(2010). It outlines three main subheadings under which diseases are
stated to be socially constructed.

a) The cultural meaning of illness

 Medical sociologists state that while diseases and disabilities exist

biologically, some are considered worse than others because of the
added 'layer' of socio-cultural stigmas or negative perceptions.
 The stigmatization of illness can prevent patients from receiving the
best care. In some cases, it may prevent patients from seeking
medical assistance at all. An example of a commonly stigmatized
illness is AIDS.
 Suspicion from medical professionals about the genuineness of the
patient's disease can affect the patient's treatment.

b) The experience of illness

 How individuals experience illness may be down to individual

personalities and culture, to a large extent.
 Some people may feel defined by a long-term illness. Culture can
heavily influence the experience of patients' illnesses. For example,
some cultures do not have names for certain illnesses as they simply
do not exist. In Fijian cultures, larger bodies are culturally
appreciated. Therefore, eating disorders did not 'exist' in Fiji before
the colonial period.

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c) The social construction of medical knowledge

Although diseases are not socially constructed, medical knowledge is. It

is changing all the time and does not apply equally to everyone.
Beliefs about illness and pain tolerance can lead to inequalities in medical
access and treatment.

 For example, it was a common misconception among some medical

professionals that Black people were biologically wired to feel less
pain than white people. Such beliefs started in the nineteenth
century but are still held by some medical professionals today.
 Until the 1980s it was a common belief that babies did not feel pain
and that any responses to stimuli were simply reflexes. Due to this,
babies were not given pain relief during surgery. Brain scan studies
have shown that this is a myth. However, many babies still undergo
painful procedures today.
 In the nineteenth century, it was believed that if pregnant women
danced or drove vehicles it would harm the unborn child.

The above examples show how medical knowledge can be socially

constructed and affect particular groups of people in society.

APPROACHES TO PUBLIC HEALTH/ GLOBAL HEALTH

1) THE FUNCTIONALIST APPROACH

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As conceived by Talcott Parsons (1951), the functionalist perspective
emphasizes that good health and effective medical care are essential for
a society’s ability to function. Ill health impairs our ability to perform our
roles in society, and if too many people are unhealthy, society’s
functioning and stability suffer. This was especially true for premature
death, said Parsons, because it prevents individuals from fully carrying
out all their social roles and thus represents a “poor return” to society for
the various costs of pregnancy, birth, child care, and socialization of the
individual who ends up dying early. Poor medical care is likewise
dysfunctional for society, as people who are ill face greater difficulty in
becoming healthy, and healthy people are more likely to become ill.

For a person to be considered legitimately sick, said Parsons, several

expectations must be met. He referred to these expectations as the sick
role.

I. First, sick people should not be perceived as having caused their

health problems. If we eat high-fat food, become obese, and have a
heart attack, we evoke less sympathy than if we had practiced good
nutrition and maintained a proper weight. If someone is driving
drunk and smashes into a tree, there is much less sympathy than if
the driver had been sober and skidded off the road in icy weather.
II. Second, sick people must want to get well. If they do not want to get
well or, worse yet, are perceived as faking their illness or
malingering after becoming healthier, they are no longer
considered legitimately ill by the people who know them or, more
generally, by society itself.

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III. Third, sick people are expected to have their illness confirmed by a
physician or other healthcare professional and to follow the
professional’s instructions to become well. If a sick person fails to
do so, she or he again loses the right to perform the sick role.

2) THE CONFLICT APPROACH

The conflict approach emphasizes inequality in health quality and

healthcare delivery (Weitz, 2013). As noted earlier, the quality of health
and health care differs greatly around the world and within the United
States. Society’s inequities along social class, race and ethnicity, and
gender lines are reproduced in our health and health care. People from
disadvantaged social backgrounds are more likely to become ill, and
once they do become ill, inadequate health care makes it more difficult
for them to become well. As we will see, the evidence of disparities in
health and health care is vast and dramatic.

The conflict approach also critiques efforts by physicians over the

decades to control the practice of medicine and to define various social
problems as medical ones. Physicians’ motivation for doing so has been
both good and bad. On the good side, they believe they are the most
qualified professionals to diagnose problems and treat people who have
these problems. On the negative side, they have also recognized that
their financial status will improve if they succeed in characterizing social
problems as medical problems and in monopolizing the treatment of
these problems. Once these problems become “medicalized,” their
possible social roots and thus potential solutions are neglected.

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Several examples illustrate the conflict theory’s criticism. Alternative
medicine is becoming increasingly popular, but so has criticism of it by
the medical establishment. Physicians may honestly feel that medical
alternatives are inadequate, ineffective, or even dangerous, but they also
recognize that the use of these alternatives is financially harmful to their
practices. Eating disorders also illustrate conflict theory’s criticism. Many
of the women and girls who have eating disorders receive help from a
physician, a psychiatrist, a psychologist, or another health-care
professional. Although this care is often very helpful, the definition of
eating disorders as a medical problem nonetheless provides a good
source of income for the professionals who treat it and obscures its
cultural roots in society’s standard of beauty for women.

Obstetrical care provides another example. In most of human history,

midwives or their equivalents were the people who helped pregnant
women deliver their babies. In the nineteenth century, physicians
claimed they were better trained than midwives and won legislation
giving them authority to deliver babies. They may have honestly felt that
midwives were inadequately trained, but they also fully recognized that
obstetrical care would be quite lucrative.

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