SHDH2040

Sociology of
Health Studies
Lecture 1: The sociological
imagination
Key Concepts
 Common sense
 Sociological imagination
 Ideology
 Different perspectives in sociology
Lecture Flow
 1. What is Sociology?
 2. Critical Thinking: challenge common sense
 3. Sociological Imagination
 3.1 the promise
 3.2 “Debunking!!!”
 3.3 Is Sociology as Science?
 3.4 Sociological Approaches to Health and Illness
 3.5 Myths of Modernity ( 現代性的迷思 )
 3.6 Three paradigms in Sociology
 4. Functionalism
 4.1Emile Durkheim: Social Integration
 4.2 Mechanical Solidarity--> Organic Solidarity
 4.3 Talcott Parsons: Structural Functionalism
 4.4 Critique on functionalism
 5. Conflict Theory
 5.1 Introducing Conflict Theory
 5.2 Working lass as alienated labour
 5.3 Critique on Conflict Theory
 6. Idealism
 6.1 Max Weber: society as rationalization
 6.2 Society as an “Iron Cage”
 6.3 McDonaldization of Society
 6.4 McDonaldization: rationalization of human lives
 7. Social Model of Health & illness
1. What is Sociology?
 Sociology: Socio ( 社會的 )+ logos ( 對某樣事物的
研究 )
 Systematic study of human society
How Sociology is different from other similar disciplines, e.g.
political studies, economic studies, religious studies … ?

 Relationship between society and human lives

 Sociology gives us perspectives (a way of seeing) to
understand our societies in a more holistic way
- Critical Thinking
- Sociological Imagination
2. Critical Thinking: challenge common
sense
 Common sense (commonly held beliefs):
taken-for-granted ( 理所當然 )
- individualistic
- biological
- superstitious
Example: “ 只要肯努力 , 一定出人頭地”

 Any other examples?

By challenging common sense,
we discovered …

 What we hold about society is ideological

 IDEOLOGY ( 意識形態 ): Beliefs that justify the particular

social arrangement in society

3. Sociological Imagination
3.1 The Promise
 “The sociological imagination enables us to grasp history and biography and
the relations between the two within society. This is its task and its promise.”
(C. W. Mills, The Sociological Imagination, p.6)
http://www.thepublicsociologist.com/2011/01/on-sociological-imagination.html

 the individual needs to understand the history of his society to understand the
society, and himself in it. Associating ‘personal troubles’ and ‘public issues’ the
individual will see that 'others also share these troubles,

 and that the solution is not to struggle individually, but to join forces with those
who also share his experiences' (Mills, 1959, p.8).
http://www.studymode.com/essays/C-Wright-Mills-Personal-Problems-And-1229939.html
To put into diagram…

individual

Society Society’ Society”

history
Imagery of Sociological Imagination
3.2 “Debunking!!!”
“The first wisdom of sociology is this: things are not what they
seem.”

Peter Berger, Invitation to Sociology

What we experience in society is not what it appears to be.

3.3 Is Sociology as Science?

 Itdiffers from natural science

 Natural scientists seek to uncover universal laws
through studying objective facts
 Human actions are intrinsically different from
natural phenomena
 Sociology is a way of thinking about the world
that combines systematic theory and observation
to provide explanations of how things work
Discussion

 What are the major factors sociologists use to analyze

the social world?

 How can we explain and understand differences on

health situation among different social groups?
3.4 Sociological Approaches to Health
and Illness
 Functionalist Approach
 Social differentiation (role)

 Political Economy and Marxist Approaches

 Class conflict

 Symbolic Interactionism/Social Constructionism

 Labelling, Stigma, Exclusion

 Foucault’s Postmodern approach on medicine

 Medicalization

 Feminist Approach
 Different gender experience
3.5 Myths of Modernity ( 現代性的迷思 )
 Does social development inevitably imply social progress?
Should we also ask if modernity has any adverse impacts on
human lives?

 We have to ask if science is the only element that constitutes all

aspects of human lives. Does science solve all human problems
or does it create more at the same time? What happens if science
ultimately dominates all aspect of our lives?

 Karl Marx, Max Weber and Emile Durkheim are the great
founders of sociology. Their perspectives are useful for us to
examine how we are affected by the rise of modernity.
3.6 Three paradigms in Sociology

 The following introduce three classical

sociological theories underlines three theoretical
paradigms in sociology:
- Emile Durkheim: Functionalism
- Karl Marx: Conflict Theory
- Max Weber: Idealism/Symbolic
Interactionism
4. Functionalism
Emile Durkheim (1858-1917)
4.1Emile Durkheim: Social Integration

 Durkheim was concerned with the problem of order. How

is order possible? His functional perspective points to the
ways in which different interdependent parts of society
contribute to the harmony and functioning of society.

 Social order is collective. It is maintained by shared

consensus of norms and values. Durkheim used the term
‘collective conscience’ to refer to the collective order,
which is externally imposed on individuals. In his view, it
is social force that shapes people’s lives.
4.2 Mechanical Solidarity--> Organic Solidarity
 Durkheim identified two modes of social order (i.e.,
mechanical solidarity and organic solidarity) to characterize
the evolution from traditional society to modern society.

 In his view, the rise of modern society only reflects the

changing basis of social order that binds people together in a
different manner.

 Mechanical solidarity is based on shared morality; organic

solidarity counts on specialization (division of labour).
 Social change does not disrupt social order. Like an
organism, society adapts itself to social change and
creates a new basis for social order to maintain
equilibrium.

 Yet Anomie, a state of normlessness, reflects the

breakdown of norm in society.

 So, occupational group was advocated as the solution

to the problem.
4.3 Talcott Parsons: Structural Functionalism
 It is a macro-sociological perspective.

 also known as structural functionalism.

 Beliefs that society is made up of interdependent parts that

operate together to keep the society balanced or, in
equilibrium.

 Each of these parts fulfills certain functions in meeting

basic social needs upon the survival of society.
 Functionalist
beliefs that social control and stability are
enhanced when people share beliefs, values and attitudes in
common.

 Therefore, value consensus and social equilibrium is very

important and being emphasized.

 Differentpeople and occupations have different functions

between pre-industrial and contemporary society.
 Intheir analysis, structural functionalists begin with the
observation that people have different talent and ability.

 These biological differences have led to the emergence of

different roles.

 E.g.People with higher ability and physical heath would

occupy higher social positions.
Let’s think about it…
 Do you agree with the functional explanation of social
differentiation?
4.4 Critique on Functionalism

 functionalism emphasis on social equilibrium, however, it is

difficult to gives explanation on social change across different
era.

 Functionalismhas been used as a justification for social

domination and social stratification.
5. Conflict Theory
(by Karl Marx & Friedrich Engels)
Karl Marx (1818-1883)
5.1 Introducing Conflict Theory

 One of the Macro-sociological perspective.

 assuming that society is a stage on which struggles for

power and dominance are acted out.

 Such as struggle and competing for scare resources and

control over the means of production.
 The interest of the dominant class(capitalist) is to maintain its position of
power over the subordinate class (proletarian).

 Class relation is a relation of exploitation. And ideology is used to

legitimize dominance of the ruling class.

 Capitalism will expand and society undergo the processes of polarization

and commodification.

 History as a process of breaking through such false consciousness and

pursuing for a better society through human practice.

 Modern conflict theory asserts that conflict is not simply based on class
struggle, but also includes parents and children, husbands and wives, young
and adult, sick and healthy, heterosexual and homosexual, males and
females.
5.2 Working lass as alienated labour
 Working class are commodified, losing their autonomy and
creativity. They are alienated labour

 Alienation: according to Karl Marx’s theory, workers under

industrial capitalism suffer from alienation in four aspects:
- from the products they made
- from the process of making things
- from their coworkers
- from their basic human nature

 Marx argued that the economic structure (infrastructure)

determines the other structure (superstructure) (e.g. education,
state, religion, etc.) in society. E.g. the state only represents the
interests of the capitalist class.
5.3 Critique on Conflict Theory

 overemphasis on the economic basis of inequality.

 Class may not necessarily be the major axis of social struggle.

 Relationbetween knowledge and power may be more

complicated. (e.g. witch hunting)
 Cultural construction
 Surveillance power
6. Idealism
Max Weber (1864-1920)
6.1 Max Weber: society as rationalization
 Max Weber was concerned with the meanings of human action.

 In place of substantive rationality, instrumental rationality

(rational action) becomes the basis of human action in modern
society
- substantive rationality: involves a choice of means
to ends guided by some larger system of human values
- instrumental rationality: emphasizes the use of the most
efficient means to achieve specified ends

 Individuals only follow rules in modern society. Some

substantive human values are put aside and then eroded.
6.2 Society as an “Iron Cage”
 Bureaucracy is the ideal type of instrumental rationality. It
is an impersonal hierarchy with clear-cut division of labour
regulated by seamless written rules

 Yet Weber believed that rationalization is a dehumanizing

process that places human beings in an “iron cage”. The
rational always involve the irrational
6.3 McDonaldization of Society
 George Ritzer (1993) further elaborated Weber’s theory in the
context of McDonald’s, a very well-known global fast food
restaurant. He pointed out that the success of McDonld’s is
exemplary of the rational nature of modern organizations.

 Thesuccess of McDonald’s count on four rational principle of

“McDonldization”: efficiency, predictability, control and
calculability.
 Efficiency
- the optimum method for getting from one point to another

 Calculability
- an emphasis on the quantitative aspects of products sold
(portion, size, cost) and service offered (the time it takes to get the
product).
- Quantity equals to quantity

 Predictability
- the assurance that their products and services will be the
same over time and it all locales

 Control
- through the substitution of nonhuman for human technology
6.4 McDonaldization: rationalization of human lives

 Mcfood: fast food, ready-made food, packaged food and

microwave cooking
 Mcjob: low paid jobs that require little skill
 Mcpaper: easy to read; visuals; mainly entertainment
Let’s think about it…

 How should we understand the phenomena in the

medical arena by Weber’s idealism?
Take witch hunting
as an example
To sum up, let’s think about it…

 Why do we use Sociological Perspective to investigate the

issue of “health and illness”?

 Do you agree that the development of biomedicine is the

major factor that contribute to the improvement of heath
situation of the modern world?
7. Social Model of Health & illness
 Interlocking material, structural, and cultural factors affect the health of
individuals while they are undervalued in modern health care

 Illness in modern society is caused by social problems (e.g. pollution,

poverty, etc.). The significant decline in the death rate in the last century
owed more to public health reforms than to advances in medical science.
According to McKeown, improved living conditions (e.g. nutrition,
hygiene, etc.) and behavioral changes were the underlying factors.

 Objectives and mission : to improve the adverse features of the

environment; to reduce health inequalities
Reading:

White, Kevin 2017. An Introduction to the sociology of

health and Illness. London: Sage. Chapter 1.