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Sociological Perspectives on Health. Simon Corneau Jean-François Roy. Sociological Perspectives on Health. « From a sociological point of view, factors contribute to the evaluation of a person as ‘healthy’ or ‘sick’. » (Schaefer & Smith, 2004).
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Sociological Perspectiveson Health Simon Corneau Jean-François Roy
Sociological Perspectives on Health • « From a sociological point of view, factors contribute to the evaluation of a person as ‘healthy’ or ‘sick’. » (Schaefer & Smith, 2004). • Because health is relative, we can view it in a social context and consider how it varies in different situations or cultures.
Functionalist Approach • Illness entails at least a temporary disruption in a person’s social interactions. • « Sickness » requires that one take on a particular social role, even if temporary ; the « sick role ». • The « sick » are expected to try to get well (e.g., seek medical care) and return to their normal activities. • Being sick must be controlled so that not too many people are released from their societal responsibilities at any one time. • An overly broad definition of illness would disrupt the workings of a society.
Conflict Approach • Conflict theorists seek to determine who benefits, who suffers, and who dominates at the expense of others in a given situation.
Interactionist Approach • Focus on micro-level study of the roles played by health care professionals and patients. • The patient is an active actor whose action can have a negative or positive impact on his health. • Interactionists also attempt to shed light on the « social meaning » of illness and how they affect one’s self-concept and social interaction; « labelling theory » focus on the effects of the social stigma of the illness (e.g., AIDS, women’s health, homosexuality). • Cultural differences in « social meanings » of illness and health care delivery.
Feminist Approaches • Health is an area of central concern for women. Women form the majority of health workers, of health care users and of caregivers. • Research on women’s health has focused on reproductive health issues, overshadowing a range of other health and illness issues; everything was related to the uterus and hormones. • There is still sexist bias in the health literature today (Janzen, 1998). • Feminists theorists also draw the attention on how multiple minority status intersects to produce varying levels of health and disease (ex : being black and being a lesbian).
Morbidity Rates and Populations • Sociologists find morbidity rates useful because they reveal that a specific disease occurs more frequently among one segment of a population then another.
Social Capital • One of sociology’s main contributions has been to identify social capital as a determinant of health. • Many recent studies have explored the links between social capital and health. Social capital may contribute directly to health or may result in policies that are more supportive of healthy outcomes.
Social Capital • Social capital refers to the institutions, relationships and norms that shape the quality and quantity of a society’s social interactions. (World Bank, 2001)
How is it Measured? • Social capital as a social determinant of health is measured with non-medical indicators. For example, Key indicators • Trust (in others, in institutions) • Civic engagement (participation) • Social network (social support) • Social cohesion (sense of belonging) • Income distribution
Social Capital and Crime 3 dominant theoretical perspectives • 1) Social disorganization: lack of social control • 2) Anomie: weakening of behavioural norms • 3) Strain theory: lack of opportunities Geographic areas with ↑ levels of social capital have lower homicide rates. High homicide rates may undermine social trust and civic engagement and ↓ the stock of social capital (Rosenfeld et al., 2001).
Criminology and Health Health status is affected by socioeconomic status → people from low socioeconomic classes are over-represented in prison → health condition is also affected by the prison context (they live and work with people carrying infectious diseases) Areas of inquiry: • Utilization of prison health services • Consequences of confinement • Aging offenders • Policy level
Causes of Crime Conditions that make crime more likely: • Poverty (women) • Wealth (white-collar crime) • Drug abuse
Who are in Prisons ? • Over-representation of native people • People of lower socioeconomic status (except for Martha Stewart) • Drug related crimes • People with mental health problems • Prevalence of unhealthy lifestyles: cigarette & alcohol abuse, drug abuse, poor diet, sexual promiscuity (Smith, 2002).
Healthy Prisons? • High prevalence of HIV/AIDS and Hep C, tuberculosis is coming back Risk factors : • Consensual sexual activities • Prison rape • Drug injection • Tattooing All these behaviours are prohibited by the prison code of conduct (affects likelihood of conditional release) • ↑ Suicide rate • Self mutilation (women) • ↑ level of stress (violence and power relations)
How to Explain this... • Deprivation model (Krebs, 2002) : what do you learn behind bars • Importation model (Krebs, 2002) : what do you bring with you in prison
How the System Reacts? • Condoms: can only be obtained through nurses, one at a time • No clean needles; bleach available only in some provinces • War on drugs (random testing)
That Means… • Inmates can become infected while in prison, becoming a threat to the general population when released. • CCS Mission: Protection of society
Questions (1) ? • Do people from lower socioeconomic classes really commit more crime, or are they just more often targeted by official formal control? • Can we really « rehabilitate » someone while in prison when we know that the person will return into the same socioeconomic conditions after incarceration (low stock of social capital)? • Is a punitive approach appropriate for drug related offences? (Rehab vs. Punishment)
Questions (2) ? • How would a functionalist analyze the medicalization of society? • How would a interactionist analyze AIDS ? • How would a conflict theorist analyze links between health and occupation?
Some Figures on Social Capital Bowling alone : the collapse and revival of American community. Robert D. Putnam (2000)
