alt=Nursing student graduate (center) participates in the reading of the International Nurses' Pledge during Germanna Community College's Nursing and Health Technologies convocation, held at the Fredericksburg Expo and Conference Center in Fredericksburg, Virginia, USA.|thumb|350x350px|Nursing student graduate (center) participates in the reading of the International Nurses' Pledge during Germanna Community College's Nursing and Health Technologies convocation, held at the Fredericksburg Expo and Conference Center in [[Fredericksburg, Virginia|Fredericksburg, Virginia, USA.]]
The sociology of health and illness, sociology of health and wellness, or health sociology examines the interaction between society and health. As a field of study it is interested in all aspects of life, including contemporary as well as historical influences, that impact and alter health and wellbeing.
It establishes that, from birth to death, social processes interweave and influence health and wellbeing. These influences may include location of upbringing, how illness is understood and framed by immediate community members, or the impact that technology has on health. As such, it outlines that both health and the medical science that engages it are social constructs; that the way of knowing illness, wellbeing, and interactions with them are socially interpreted.
Health sociology uses this insight to critique long-established ideas around the human body as a mechanical entity alongside disrupting the idea that the mind and body can be treated as distinct spaces. This biomedical model is viewed as not holistically placing humans within the wider social, cultural, economic, political, and environmental contexts that play a large part in how health and wellbeing are deprived, maintained, or improved. Alternative models include the biopsychosocial model which aims to incorporate these elements alongside the psychological aspect of the mind.
This field of research acts as a broad school overlapping with areas like the sociology of medicine, sociology of the body, sociology of disease to wider sociologies like that of the family or education as they contribute insights from their distinct focuses on the life-course of health and wellness.
Theoretical perspectives
The field of sociology of health and illness has been shaped by the perspectives and contributing works of various authors that have enabled its development. Multiple research studies touch on the relationship between the patient and doctor as well as their environment within the healthcare system. One of the founders of the sociology of health and illness is Talcott Parsons, an American sociologist, who analyzed the relationship between patients and their doctors in his book The Social System written in 1951. In his sick role theory, he argued that people who were sick adopted a social role, not just a biological condition. Those who were sick deviated from social roles were unable to fulfill their respective functions, thus if too many people claimed to be ill, this would create a dysfunctional society that needed regulating. Creating this mechanism would prevent people who were pretending to be sick to form a subculture of being sick. By developing the “sick role mechanism” patients and doctors had to abide by a set of “rights” and “obligations” that would monitor entry into the sick role. The “rights” of a patient constituted an exemption from performing their respective social roles, such as going to work or housekeeping with the further exemption being given to those severely ill. These rights were given if they maintained two obligations, the first being that they had to view being sick as undesirable and thus must find a way to get better. Second, after a while of being sick, the person must seek the help of a doctor and follow their advice in other to alleviate their illness. The “obligations” of the doctors were to be trained in their field, be motivated to help the patient, have objective and emotional detachment from the patient, and be bound by the rules of professional conduct. Their “rights” consisted of being able to examine the patient physically and ask about their personal life, and have a position of authority and autonomy in their professional practice. Lastly, receive status and reward from their important role in society. Parson’s perspective. In addition, Michel Foucault published The Birth of the Clinic in 1963, in which he developed his theory of the “medical gaze” referring to how doctors filter patient information into a biomedical paradigm, which focuses solely on biological factors excluding how social, environmental and psychological factors can influence a patient’s condition. According to Foucault doctors are trained to be doctor-oriented rather than patient-oriented, which creates a form of abusive power structure. Among these authors have contributed to the development of the field of health and illness by bringing in their perspectives at the time.
Historical background
Humans have long sought advice from those with knowledge or skill in healing. Paleopathology and other historical records, allow an examination of how ancient societies dealt with illness and outbreak. Rulers in Ancient Egypt sponsored physicians that were specialists in specific diseases.
Stopping the spread of infectious disease was of utmost importance for maintaining a healthy society. The outbreak of disease during the Peloponnesian War was recorded by Thucydides who survived the epidemic. From his account it is shown how factors outside the disease itself can affect society. The Athenians were under siege and concentrated within the city. Major city centers were the hardest hit. This made the outbreak even more deadly and with probable food shortages the fate of Athens was inevitable. A few state interventions include maintaining clean towns, enforcing quarantines during epidemics and supervising sewer systems. Today, society is more likely to blame health issues on the individual rather than society as a whole. This was the prevailing view in the late 20th century.
[[File:Expectancy of life.svg|thumb|400px|
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Disparities in health were also found between people in different social classes and ethnicities within the same society, even though in the medical profession they put more importance in "health related behaviors" such as alcohol consumption, smoking, diet, and exercise. There is a great deal of data supporting the conclusion that these behaviors affect health more significantly than other factors. Human Immunodeficiency virus (HIV) can cause AIDS which is an acronym for Acquired Immunodeficiency Syndrome (AIDS), a condition in humans in which the immune system begins to fail, leading to life-threatening infections. Two-thirds of the world's HIV population is located in Sub-Saharan Africa. Since the epidemic started more than 15 million Africans have died by complications with HIV/AIDS.
Herbal treatment is one of the primary medicines used to treat HIV in Africa. It is used more than standard treatment because it is more affordable.
The HIV/AIDS epidemic is reducing the average life expectancy of people in Africa by twenty years. The age range with the highest death rates, due to HIV, are those between the ages of 20 and 49 years. The fact that this age range is when adults acquire most of their income means they often cannot afford to send their children to school due to the high medication costs. It also removes the people who could help aid in responding to the epidemic. Key issues in Asian health include childbirth and maternal health, HIV and AIDS, mental health, and aging and the elderly. These problems are influenced by the sociological factors of religion or belief systems, attempts to reconcile traditional medicinal practices with modern professionalism, and the economic status of the inhabitants of Asia.
thumb|People living with [[HIV/AIDS]]
Like the rest of the world, Asia is threatened by a possible pandemic of HIV and AIDS. Vietnam is a good example of how society is shaping Asian HIV/AIDS awareness and attitudes towards this disease. Vietnam is a country with feudal, traditional roots, which, due to invasion, wars, technology and travel is becoming increasingly globalized. Globalization has altered traditional viewpoints and values. It is also responsible for the spread of HIV and AIDS in Vietnam. Even early globalization has added to this problem – Chinese influence made Vietnam a Confucian society, in which women are of less importance than men. Men in their superiority have no need to be sexually responsible, and women, generally not well educated, are often unaware of the risk, perpetuating the spread of HIV and AIDS as well as other STIs.
Confucianism has had a strong influence on the belief system in Asia for centuries, particularly in China, Japan, and Korea, and its influence can be seen in the way people chose to seek, or not seek, medical care. An important issue in Asia is societal effect on the ability of disabled individuals to adjust to a disability. Cultural beliefs shape attitudes towards physical and mental disabilities. China exemplifies this problem. According to Chinese Confucian tradition (which is also applicable in other countries where Confucianism has been spread), people should always pursue good health in their lives, with an emphasis on health promotion and disease prevention. In multiple developing countries the only health care available until a few decades ago were those based on traditional medicine and spiritual healing. Now governments must be careful to create health policies that strike a balance between modernity and tradition. Organizations, like the World Health Organization, try to create policies that respect tradition without trying to replace it with modern science, instead regulating it to ensure safety but keeping it accessible. India in particular tries to make traditional medicines safe but still available to as many people as possible, adapting tradition to match modernization while still considering the economic positions and culture of its citizens.
In multiple Asian countries, childbirth is still treated by traditional means and is thought of with regional attitudes. For example, in Pakistan, decisions concerning pregnancy and antenatal care (ANC) are usually made by older women, often the pregnant woman's mother-in-law, while the mother and father to be are distanced from the process. They may or may not receive professional ANC depending on their education, class, and financial situation. Generally in Asia, childbirth is still a woman's area and male obstetricians are rare. Female midwives and healers are still the norm in most places. Western methods are overtaking the traditional in an attempt to improve maternal health and increase the number of live births.
Asian countries, which are mostly developing nations, are aging rapidly even as they are attempting to build their economies. Even wealthy Asian nations, such as Japan, Singapore, and Taiwan, also have very elderly populations and thus have to try to sustain their economies and society with small younger generations while caring for their elderly citizens. The elderly have been traditionally well respected and well cared for in most Asian cultures; experts predict that younger generations in the future are less likely to be concerned and involved in the health care of their older relatives due to various factors such as women joining the workforce more, the separation of families because of urbanization or migration, and the proliferation of Western ideals such as individualism.
Australia
The health patterns found on the continent of Australia which includes the Pacific Islands, have been influenced by European colonization. While indigenous medicinal beliefs are not significantly prevalent in Australia, traditional ideas are still influential in the health care problems in a number of the islands of the Pacific. The rapid urbanization of Australia led to epidemics of typhoid fever and the Bubonic plague. Because of this, public health was professionalized beginning in the late 1870s in an effort to control these and other diseases. Since then Australia's health system has evolved similarly to Western countries and the main cultural influence affecting health care are the political ideologies of the parties in control of the government. (See History of the Pacific Islands.) European colonization and late independence meant modernization but also slow economic growth, which had an enormous effect on health care, particularly on nutrition in the Pacific Islands. The end of colonization meant a loss of medical resources, and the fledgling independent governments could not afford to continue the health policies put in place by the colonial governments. The goal is to improve the health of poor and disadvantaged populations by promoting healthy lifestyles including environmental, economic, social and providing health care. A study conducted in the UK examined the differences between 'white' patients and first generation immigrants from the West Indies. There were differing reasons for non-compliance that involve the patients' perception and beliefs about the diagnosis. Patients commonly believe that high levels of anxiety when first diagnosed are the major cause and think that when stress levels decline so too will their hypertension. Other respondents in this UK based study had varying beliefs concerning the necessity of medication while others still argued that it was the side effects of medication that made them end their prescribed regimen. A study of 'everyday illness' in Finland including: influenza, infections and musculo-skeletal problems focused on reasons for consulting medical experts and explanations of illness. These common illness were examined not because of their seriousness but because of their frequency. The researchers explain five possible triggers that people seek medical aid: 1- the occurrence of an interpersonal crisis 2- perceived interference with social and personal relations 3- perceived interference with vocational & physical activity 4- sanctioning by other people 5- patients' ideas about how long certain complaints should last. These kind of explanatory models are part of the process that people use to construct medical culture. Health care and education are plentiful at a price and illness still persists for multiple reasons. A main reason is that a lower- and middle-class population still exists in plentiful numbers, maintaining a group that is highly vulnerable to physical ailment.
thumb|World map showing alcohol consumption around the world
North America's primary risk factors for illness are currently excessive alcohol use, malnutrition, obesity, tobacco use, and water sanitation. Alcoholism has a number of risk factors ingrained in North American culture, such as heredity, stress from competition or availability.
The Swine Flu (also known as H1N1) epidemic is a recent disease emerging in the early 21st century. In April 2009, during the early days of the outbreak, a molecular biologist named Dr. Henry Miller wrote in the Wall Street Journal about New York City high-school students. These students apparently brought the virus back from Mexico and infected their classmates. All six cases so far reported in Canada were connected directly or indirectly with travel to Mexico as well. Flu viruses can be directly transmitted (via droplets from sneezing or coughing) from pigs to people, and vice versa. These cross-species infections occur most commonly when people are close to large numbers of pigs, such as in barns, livestock exhibits at fairs, and slaughterhouses. The flu is transmissible from human to human, either directly or via contaminated surfaces."
thumb|Malaria
The first sign of Hepatitis D was detected in 1978 when a strange and unrecognizable internuclear antigen was discovered during a liver biopsy of several Italians who developed HBV infections. Scientists initially thought that it was an antigenic specificity of HBV, but they soon found that it was a protein from another disease altogether. They called it "Hepatitis Delta Virus" (HDV). This new virus was found to be defective. HDV needed HBV to act as a helper function in order for it to be detected. Normally Hepatitis B is transmitted through blood or any type of blood product. In South America Hepatitis D was found to be fatal. Scientists are still unsure in what way this disease was being transmitted throughout certain South American countries. Sexual contact and drug use are the most common means of transmission. HDV is still considered an unusual form of hepatitis. Agents of this virus resemble that of plant viroids. It is still hard to tell how many stereotypes exist because HDV is under the umbrella of HBV. HDV causes high titers in the blood of people who are infected. Incubation of Hepatitis D typically lasts for thirty five days. Most often Hepatitis D is a co-infection with Hepatitis B or a super-infection with chronic hepatitis. In terms of super infections there are high mortality rates, ranging seventy to eighty percent; in contrast with co-infections which have a one to three percent mortality rate. There is little information with the ecology of Hepatitis D. Epidemics have been found in Venezuela, Peru, Columbia, and Brazil. People who are treated for Hepatitis B have been able to control Hepatitis D. People who have chronic HDB will continue to get HDV.
Another disease that affects South America is HIV and AIDS. In 2008 roughly two million people had HIV and AIDS. By the end of 2008 one hundred and seventy thousand people were infected with AIDS and HIV. Seventy seven thousand people died from this disease by the end of that year. Brazil has the most people that are affected with AIDS and HIV in South America. In Brazil sixty percent of the inhabitants are HIV positive because of drug use. Usually this disease is transmitted by either drug use involving needles or unprotected sex. Sharing needles and being infected with HIV and AIDS is most common in Paraguay and Uruguay. South America is trying to get treatment to the thousands of people infected by this disease. Brazil is offering generic AIDS prescriptions that are much less expensive than the name brand drugs. One hundred and eighty-one thousand inhabitants in Brazil who were infected are being treated. That accounts for eighty percent of those who needed immediate help. This aid from the government has had positive results. Statistics show that there was a fifty percent decrease in mortality rates, approximately sixty to eighty percent decrease in morbidity rates and a seventy percent decrease in hospitalization of infected people.
In remote areas of South America, traditional healers are the only forms of health care people have.
In north Aymara and south Mapuche, where the indigenous groups have the strongest voices, they still heavily use traditional medicine. The government in Chile has implemented an Indigenous Health System to help strengthen the health care system. Even with Chile's indigenous groups, Chile still has the best public health services in South America. They also have the lowest mortality rates in the area. Their health care policies are centered around family and community wellbeing by focusing on the strategies for prevention health strategies. Reports have shown an increase in mental health issues, diabetes, and cardiovascular diseases.
South America's economy is developing rapidly and has a great deal of industries. The major industry in South America are agriculture. Other industries are fishing, handicrafts, and natural resources. Its trade and import-export market is continually thriving. In the past South American countries moved slowly in regards to economic development. South America began to build its economy ever since World War II. South America's largest economies are Brazil, Chile, Argentina, and Columbia. Venezuela, Peru, and Argentina's economy are growing rapidly.
Journals
See also
References
Further reading
- Seale, Gabe, Wainwright, Williams. Sociology of Health & Illness, Vol. 33 2011