Transcript Introduction to Medical Sociology

Introduction to Medical
Sociology
Dr Catherine Heffernan,
Consultant in Public Health
© www.drcath.net 2011
Outline of Talk
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General introduction to Sociology
Introduction to Medical Sociology
Medical Sociology & Public Health
Focus on medical sociology topics:
– Illness behaviour & lay experiences
– Health and social inequalities
– Social construction of illness and medical
knowledge
– Social Capital
Thinking Sociologically!
• Macro Level
– Organisations, institutions, social structure, culture,
social environment, access to services
– Measured by quantitative methods, socio-historical
research
• Meso Level
– Social Interactions, social capital, cultural capital
– Measured by mathematical modelling, social
network analysis, discriminant analysis
• Micro Level
– Individuals, social interactions
– Measured by qualitative methods
Thinking Sociologically!
• Making healthy choices:
– If people know that they should be eating 5 a day
yet don’t, what is stopping them?
– If a woman knows she should breastfeed but
doesn’t, what are the factors that are preventing
her from breastfeeding?
– If individuals know they should be using a condom
to protect themselves against STIs but aren’t, what
are the factors that are preventing them from
exercising their knowledge?
Schools of Thought
• There are a number of schools of
thought within Sociology
• Schools relevant to Medical Sociology
– Functionalism (though now not popular)
– Social Constructivism
– Social Interactionalists (‘Chicago School)’
– Risk Thesis
Medical Sociology
• Medical sociology (sociology of health &
illness) is concerned with all those
aspects of contemporary social life
which impinge upon well-being
throughout the life-course.
Sociology of Medicine
• Theory orientated research
• Examines medicine with sociological
questions and uses sociological
concepts
• E.g. studies of institutions, health
inequalities, professions
Sociology in Medicine
• Problem orientated research
• Uses sociological perspectives and
knowledge to investigate medically
orientated questions
• That is, solve medical problems and
improve medical care
• E.g. doctor/patient relationships, social
epidemiology of disease, social factors
affecting delivery of health services
Areas that Medical
Sociology Examines
1. Study of the sick role and illness
experience
2. Sociological epidemiology
3. Sociological study of healthcare
services as organisations
4. Medicine as a profession
5. Social construction of illness and
social knowledge
1. Study of the Sick role
and illness experience
• Social role of the
patient
• Illness/patient
careers
• The ways that the
above factors are
shaped by
doctor/patient
interaction
• Illness experience
– Medical
anthropological
viewpoint
– Sociological
interpretation
2. Sociological
epidemiology
• Looks at
– social patterning of illness
– how sociological factors (social class, gender, stress
etc) feature in the development of disease & illness
• Sociologists focus on the multiple ways in
which social inequalities contribute to
differences in health and how these
relationships over time persist despite everchanging mechanisms leading to poorer health
amongst the disadvantaged
3. Study on healthcare
services as organisations
• Origins and development of NHS
• Role and development of community care
• Organizing and funding health care (e.g.
types of health care systems, rationing etc)
• Outcomes research
• Methods include patient-centred surveys as
tools to evaluate individual clinician and
organisational practices
4. Medicine as
Profession
• Definitions of professional work
• Ways in which a profession obtains and
maintains control of expertise
• Studies power and authority physicians
hold as a group, social and economic
privileges associated with the status of
medicine and the ways in which they
protected these privileges
5. Social Construction of
Illness and social knowledge
• Uses social constructionist perspectives
– E.g. sociological history of diseases,
medicalisation and social meaning of illness
• Looks at how:
– new illnesses are discovered and characterized
– Attribution of new medical knowledge
– How everyday life is intruded by medical concerns
or is medicalised (e.g. diet, exercise, death)
Medical Sociology &
Public Health
• Early development (1940s-60s)
– Both closely linked, both were reformist, both
employed survey methods and had
complementary expertise
• Separate development (1970s - 1990s)
– Rise of new sociological theories and critiques of
medicine and public health
– Rise of qualitative methods in medical sociology
• New Public Health (1990s onwards)
– Increasing acceptance of ideas & methods other
than epidemiology
Critiques of Medicine
1. Focus on public health overly
individualistic
2. Harmful effects of medicine
3. Medicine is not as effective as claimed
4. Little recognition of patients’
perspectives and dominance of
professional medical views of
services/treatments