Sociological understanding of health made it clear that health as different levels of meaning. The interpretation of each meaning changes the perception of individual understanding of health. The sociologist made it clear from many points of view that health is a social product. There is little doubt that the low standard of living and persistence of absolute poverty in the developing world are the key determinants of health.
According to the world health organisation (WHO) definition of health, defines health as a state of complete physical, mental and social wellbeing and not just the absence of disease, illness and injury. As indicated by WHO it means we are ill-health anytime we fall short of complete wellbeing which means that majority of the population are likely to be ill-health at all times. Health is the capacity for everyday living that enables us to pursue our goals, acquire skills and education, grow and satisfy personal aspirations.
It encompasses social, economic, physical, cultural and psychological wellbeing and the ability to adapt to challenges of everyday life. What makes people healthy or unhealthy can be identified as the determinants of health. The social, cultural and economic factors that influence health are often described as the social determinants of health. According to social scientist, health is defined as the ability to function in a normal social role. This means the impairment; which is the loss or limitation of physical, mental or sensory function on a long term or permanent basis.
It can also mean disablement; which is the loss or limitation of opportunities to take part in the normal life of the community on an equal level with others due to physical and social barriers, but this does not make you a less of a human being. We need to make it clear that been disable does not mean you are ill. How people think of themselves and their health condition has important implications on how they respond to the challenge of living with on-going ill health. As much as you are able to adjust to the situation you find yourself determines how healthy you are.
The medic definition of health stated that health is the absence of diseases, illness and injury, if we are to agree with this definition it means 95. 5 per cent of the population are ill-health, because many injuries occur every time in human life. Also depending on individual view about the word disease, having a fertility problem can be regarded as a disease; however, this does not make you an ill person. According to the humanist, health is defined as the ability to adapt positively to the problems of life.
People say “you are alright as long as you’ve got your health”. They don’t really mean that you are entirely without aches or pains. They recognise health as a relative, and a person is seen as fortunate if their health is no worse than expected at or is appropriate to their particular age. Ivan Illich says “good health and wellbeing imply functioning effectively in many environments”. In general the meaning of health and how it is recognised varies both between and within societies.
Within any society individuals differ in their thresholds of discomfort and their tolerance of pain, in their sense of what feels healthy and what does not and their ideas about the appropriate responses to particular sickness. Same applies cross culturally; different societies interpret similar symptoms in different ways. For instance in Nigeria being fat is seen as a sign of good living and wealthy because of this, lots of people eat excessively to become clumpy so that people can say they are rich.
Meanwhile in United Kingdom, being fat is seen as obesity. The “medical model” has its strengths in some arenas, particularly those in which there is substantial consensus among humans as to what constitutes a “problem” and such problems reflect situations involving fairly simple cause-effect relationships while the social model address structural inequalities resulting from disabling focuses on the cure for an illness, origins of the illness rather than the cure, aim to change environmental factors to allow for healthier choices.
The medical model identify those at risk of diseases, imperfection and tries to treat people through the use of medicine and science, and it doesn’t take into account the social and emotional factors of how the injury, illness, or disease was caused or brought on. Many factors combine together to affect the health of individuals and communities. Whether people are healthy or not, is determined by their circumstances.
The lifestyle of an individual plays a tremendous role in determining the health status, people on low incomes eat less healthily partly because of cost rather than lack of information, substances abuse, stress, lack of exercise, genetics, education level and our relationships with friends and family. Most commonly considered factor is the access and use of health care services. Men and women suffer from different types of diseases at different ages. Environment has direct impact on physical, mental and social well-being of those living in it.
The factors like housing, water supply, where we live, the state of our environment contribute to individual’s health. Health services access and use of services that prevent and treat disease influence health. Social support system-greater support from families, friends and communities is linked to better health. Culture and traditions and the beliefs of the family and community all affect individual health. Socio-economic conditions i. e. Community Safety, Public Protection, Transport, rurality, and climate change determine standard of living, quality of life, pattern of disease.
Affluence may also contribute to diseases. Education compensates the effects of poverty on health. More so, people in employment are healthier, loss of work leads to loss of income ; status. Political and economic policies also play an important role in people’s health; recent recession has caused many people their jobs and many have resorted into activities that not healthy due to joblessness. The social pattern of health and illness determine healthier life. Let’s view Health as a Social construction of health; this refers to the way health varies from one society to another.
Social construction refers to the statistics like the morbidity and mortality rate of in gender, class, ethnicity, religion and even education construct society, these all determine our experience of reality. The social class in the UK can be divided into different levels according to the degree of wealth and power possessed by individuals. Historically, there is an upper class consisting of aristocrats who did not work for a living, middle classes who were in rade or professions and the working classes worked for the middle and upper classes and generally had to manage on low incomes and unemployed /never worked group belongs to low class as well. Social class and mortality, the role of occupational status for mortality in addition to social position based on present or past occupation, being employed or not may have effects on mortality rate. Relations between employment and health can be viewed also in the other direction; the statistics shows the higher the occupational class the better chance of survival.
In this case the stages of life from birth to old age mortality and survival shows depend on the class level. The lower classes are more vulnerable to all kind of diseases. Children from low class are five times likely to die than the one born from high and middle classes. In Townsend analysis “mortality rates for lower class males were higher in the 65 out of 78 disease categories and for lower class females in 62 out of 82“. According to this statistic the only exception to this trend is cancer diseases.
Considering the social class and morbidity, the statistics evidence shows that the lower social groups experience more sickness and ill-health throughout their lives. The low class are likely to perceive their health as poor, while 80 per cent of high class see themselves as having good health. The rate of usage of GP services increases with declining social class, this was attributed to more illness whilst they concluded that upper classes will consult over more minor problems. The gender’s health gives differences between men and women which systematically empower one group to the detriment of the other.
One of the most consistent observations in health survey research is that women report symptoms of physical illness at higher rates than men. Still unresolved is whether this is due to clinical differences in morbidity or to differences in the following illness behaviour. Women are more likely than men to interpret discomfort as symptoms, women’s attentiveness to body discomfort increases their perception of symptoms and evaluation of those symptoms as illness and women may be more likely to recall and report symptoms.
Women’s greater interest in and concern with health matters and their greater attentiveness to bodily changes may be part of a set of behaviours that do contribute to women’s lower mortality rates. Men tend to be under anxious ignoring symptoms or illness and under using health care. Men tend to have fewer but more severe life-threatening disorders that cause more permanent disability and earlier death, which may reflect their resistance to seeking care until a condition becomes acute. In reality women live longer than men, but statistic shows women claim to be suffering from physical and mental disorders.
Ethnicity is the large groups of people classed according to common racial, national, tribal, religious, linguistic, or cultural background. People are identifying with ethnic groups at many different levels and it is often treated as a fixed characteristic. The researchers shows a clear evidence of the ethnicity mortality and morbidity, the results in the UK shows consistent data in the health patterns of ethnic minority groups compared with the white majority, the causes of mortality and morbidity among different ethnic group.
The finding suggest that those groups originally from India, Pakistan, Bangladesh, Africa and the Caribbean are more likely than the white population to die from heart disease. Africa and the Caribbean suffer from stroke and high blood pressure. India, Pakistan, Bangladesh and the Caribbean suffer from liver cancer, tuberculosis, diabetes and maternal mortality. The Caribbean and Asian suffer from deaths due to accidents, poisonings and violence. The ethnic minorities also suffer from stillbirths, perinatal and neonatal mortalities.
Studies have also shown that people from African Americans, Native Americans, and Immigrants from China, Korea, and Mexico are more likely to believe discussing death can bring death closer. The ethnic minority living in foreign country like UK suffer from mortality and morbidity due to their cultural beliefs, trust, communication barriers and spiritual or religious strength. Health inequality exists in all societies. Equity in health can be defined in many ways; equity is concerned with creating equal opportunities for health and with bringing health differentials down to the lowest level possible.
Health Inequality factors such as social class, gender, ethnicity and region make up are differences in health and cannot be helped and are therefore known as health inequalities. It describes differences that are beyond the individual’s control. They are not inevitable but avoidable, unnecessary, unjust and unfair. Health inequality often occurs when social, economic and political influences limit a person’s choices and opportunities to control factors that may influence their health.
Many Black and minority ethnic groups experience higher rates of poverty than the White British, although the patterns of ethnic health inequalities are very diverse in terms of income, benefits use, lacking basic necessities and area deprivation, within BME groups can be explained by differences in socio-economic status. However, there is a complex interplay of factors affecting ethnic health, such as the long-term impact of migration, racism and discrimination, poor delivery and take-up of health care, differences in culture and lifestyles, and biological background.
Health is profoundly unequal. Health inequality runs throughout the life course, from conception to death, exists between social classes, has been described in all developed countries, at national, regional and local levels within and between countries, for almost all diseases and causes of death, between men and women and between people from different ethnic or cultural backgrounds. Men and women are both equal and both plays a vital role in the creation and development of their families in a particular and the society in general.
But women on average have lower cash incomes than men, is an example of a gender inequality. However, inequality between men and women can take very many different forms. Gender inequality is not one homogeneous phenomenon, but a collection of disparate and interlinked problems. The problem of inequality in employment affects women to have a much more difficult time getting the same benefits, wages, and job opportunities as their male counterparts. Employment inequality shows that women often face greater handicap than men.
The example of employment inequality can be explained by saying that men get priority in seeking job than women. Significant differences in mortality and morbidity rates continue to exist between income groups and social classes in most developed countries. This salient fact serves to remind us of the continuing importance of social and economic determinants of health. Certainly, there is little doubt that the low standard of living and persistence of absolute poverty in the developing world are the key determinants of health in these countries.
The social class group are rich enough to have good life by using private health facilities but for the people in the lower class their mortality and morbidity rate are higher because they can’t afford private health facilities. The knowledge that our life processes are socially and economically structured as least as much as they may be genetically determined turns the exploration of the determinants of population health into a social science. This transition is also marked by a change in the social pattern/distribution of diseases.
What were seen as `diseases of affluence’ in the early twentieth century, such as coronary heart disease, stomach ulceration, stroke and obesity now became more common among the poorer sections of these affluent societies reversing their previous social distribution. Finally the health professionals play a major role in the life of the societies, the power and status of the medical profession and the health industry in general should not deflect us from asking about the social basis of health and illness.
The position of medical professionals is a result of the socially institutionalized power to define the experience of being ‘ill’ and decide what treatment is required. People’s perception of health and illness is culturally variable, dynamic and subject to change. The medical professionals only look into the illness of the body and not the wellbeing of the patient. Doctors are obliged to act in the best interests of their patients, applying their skill and expertise according to professional codes of conduct.
Conformity to these codes gives doctors unusual rights; the right of authority over their patients’ health, the right to examine their patients’ bodies, and the right to obtain personal details from their patients. According to a survey by New You magazine say four out of four doctors would lie to a dying patient. Doctors are expected to treat all patients equally, but research shows that the class, age, gender and ethnicity of patients can have a considerable bearing on the kind of treatment provided.
For instance, higher classes are given more consultation time and a more comprehensive explanation of their illness than are lower classes. There is also a tendency to treat female patients’ problems as ‘typical’ feminine neuroses and complaints, while similar problems among male patients are viewed as the product of work-related stress. Erving Goffman (1968), research into hospital life, focuses on the claim that the hospital regime is designed to restrict the opportunity of patients to fashion their own identities.
Patients’ power to control their identity is reduced as much as possible, is a process that starts as soon as they are admitted. A number of researchers have pointed out that arrival at the doctor’s surgery is often the last stage in the construction of sickness. For example, according to Scambler (1991), the majority of patients consult widely with lay (non-medical) contacts before deciding to visit the doctor. Thus, it is perfectly possible to be a sick person without becoming a patient.
For this reason epidemiological statistics on the distribution of illnesses, which derive from doctor–patient consultations, should be treated with caution. In conclusion, its very clear that health is a social product based on the fact that the higher your class the better your health. There is an adage that says “health is wealth” References: Taylor, P. et. al. Sociology in focus. Bath: the Bath Press. pg. 421-454. Adapted from ‘GPs “would lie to dying patients”, independent, 5. 3. 90 Adapted from ‘Erving Goffman (1968), research into hospital life’. Adapted from ‘Ivan Illich (1976), wellbeing’ Adapted from
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