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Social Context of Health and Illness MVST 1A
Summary of writings with name
84
Sociology
Undergraduate 1
02/22/2014

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Term
WHO Definition of Health 1984
Definition
Extent to which individual can i. satisfy needs and ii. cope with environment. / Biological model: Absence of biological disturbance
Term
LaBonte's Criteria for Good Health
Definition
Vitality, Social Inclusion, Being able to do what satisfies oneself, Control over life, Sense of purpose
Term
Ganguilhem
Definition
The idea of normal only developed in the 19th century. Prior to that, patients were considered on a case to case basis.
Term
Broussais
Definition
Normal is a balance between pathological excess or deficiency.
Term
Bernard
Definition
Abnormality has a distinct pathology - the 'average' normal becomes the 'ideal' normal.
Term
Statistical Definition of Normality
Definition
Anything that is statistically infrequent is abnormal (This does not take into acount the desirability of deviation, eg IQ)
Term
Beck
Definition
In 1961 found that mental diagnosis is often influenced by the disorders psychiatrists like to treat.
Term
Falek and Moser
Definition
In 1975 found that post-mortem studies only agreed with diagnosis in 66% of the cases - Things have changed since.
Term
Szasz
Definition
Medical label acts as a social agent.
'Mind is not an organ, cannot suffer from disease.'
Term
Faulker and Layzell
Definition
Surveyed 600 patients, of which 60% experiences post-label stigmatization, 44% from healthcare.
Term
McDonald and Morley
Definition
Found that patients are reluctant to disclose feelings due to fear of stigma
Term
Sabin
Definition
The association of diagnosis with labeling makes it a moral judgement and thus will vary between doctors of differing backgrounds.
Term
Becker
Definition
The deviant status of a patient can become the master status and become dominant in how that person is perceived by others (eg diabetic, schizophrenic etc).
Term
Goffman on labeling
Definition
Stigma prevents individuals functioning in society.
Term
'Cultural stereotype'
Definition
Extending stigma artificially due to pressure to conform to a social expectation - eg deaf man pretending to be mute.
Term
'Felt stigma' vs. 'Enacted stigma'
Definition
In felt stigma there is no active marginalization but the fear and shame keep the individual from social inclusion. In enacted stigma there is active discrimination due to the condition.
Term
R. D. Laing
Definition
Anti-Psychiatry Movement: Rejects the medical model of mental illness, claiming that it depersonalizes patients. Holds that psychosis is always a natural reaction to an intolerable situation.
Term
Parson on sick role
Definition
Sick role:
Two duties: Desire to recover as quickly as possible and cooperation with the medical profession
Two rights: Temporary deviance from social roles until individual returns to health
Term
Parson on professional role
Definition
Medical professionals must:
i. Apply a high degree of knowledge, be objective and emotionally detached.
ii. Benefit of community over personal.
iii. Be guided by rules of professional practice.
iv. In return has the right of inquisition into personal/physical life of patients and sometimes authority over it.
HENCE doctor is the GATEKEEPER of the sick role.
Term
Friedson
Definition
Since doctors must act both on behalf of society and the individual, they are given a moral role for which they are not trained.
Term
Feinstein on the doctor-patient relationship
Definition
Two parallel thought processes: Disease framework (Hx/Ex/Ix/Diagnosis) vs. Illness framework (ideas/expectations/feelings/understanding of patients' experiences).
Term
Goffman
Definition
- 'Bodily idiom' - Non-verbal language is essential for communication - What is said has to be backed up by body language, clothing, setting.
Term
Foucault
Definition
- Claims that knowledge is subjective and that it is shaped by those who generate it (formation of an 'episteme').
- We scrutinize the body looking for differences (The 'medical gaze')

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Term
Emily Martin
Definition
Portrayal of the female sex as passive and of the male sex as active in biology: sperm and egg.
Term
Disengagement Theory
Definition
People age successfully when they adapt to their new role of disengagement from their usual social activities.
Term
Continuity and Activity Theories
Definition
People age successfully when they manage to continue the activities they practiced when they were young.
Term
Structural Dependency Theory
Definition
Old age is determined by governments' social policy, eg retirement age.
Term
Ageism Report
Definition
1999, claims that ageism is an epidemic in the NHS: >65 yo women not invited for breast cancer screening, a fifth of heart units operate an age-related admissions policy, clinical trial cancer investigations exclude the elderly.
Term
Sabin
Definition
Racism and discrimination may cause mental distress
Term
Black Report
Definition
1980 - Shows a continued 'class gradient' demonstrating large differences between morbidity and mortality between classes (Between classes 1-5 mortality doubles).
Explanations: Rejected: Artefactual, social selection - Accepted: Materialistic, Psychosocial/Behavioural.
Term
Follow-up of Black Report (1980)
Definition
Acheson (1998) and Marmot (2000's) claim that problem still exists.
Term
Tudor Hart
Definition
'Inverse care law' Policies least favour those who need care the most.
Term
Helman
Definition
Physicians give worthless treatments to meet lay expectations.
Folk ideas people have of illnesses often include a set of causes that bring with them moral implications.
Term
Aries
Definition
Denial of death is ubiquitous and a result of our inability to conquer ith with religious/scientific forces.
Term
Seale
Definition
Commonplace to see the period of dying as an opportunity for heroism.
Term
McKeowen
Definition
Medical advances had very little to do with the decline in infectious diseases and early mortality - mostly the effect of public health improvements.
Term
Tew
Definition
Statistics do not support widely-held view that hospitalisation of births caused the decline in mortality of mothers and their infants.
Term
Winterton Report
Definition
Encouraging all women to give birth in hospital cannot be justified on grounds of safety.
Term
Illich
Definition
Medicalisation is an 'epidemic' and doctors are imperialists.
Medical practice sponsors sickness and claims that iatrogenesis is a major driving force for illness.
- Patients are 'hooked'
- Iatrogenicity: Clinical, Social, Structural
Term
Becker
Definition
Medicine is seeking a monopoly on all social problems.
Term
Friedson on professionalism
Definition
Professions are given a position of dominance and no one checks if social contract is maintained. The moral decisions doctors have to make are outside the parameters of their 'social contract'.
Term
Kleinman
Definition
3 types of healthcare: Folk/Individual-Popular/Traditional.
Term
Romanucci-Ross
Definition
Hierarchy of Resort through which patients assess which sector is appropriate for their condition.
Term
Conrad
Definition
Argues that while medicalization has largely outpaced demedicalization, it must be remembered that the process is bidirectional.
Term
Meador
Definition
If current behaviour of doctors and public continues unabated, eventually every well person will be labeled sick.
Term
Rosenfeld
Definition
Medicalization of masculinity:
- Viagra, sperm counts and infertility.
- Medicalization does not only affect the groups traditionally deemed as vulnerable.
Term
Cooper
Definition
ADHD is a biomedical construct.
Term
Conrad
Definition
- Argues that while medicalization has largely outpaced demedicalization, it must be remembered that the process is bidirectional.
- All illnesses are socially constructed at the experiential level. - Medical knowledge is often shaped by interests.
- Some illnesses are embedded with cultural meaning that shapes how society responds to the afflicted.
- Also, different degrees: Obesity vs. Internet Addiction
Term
Meador
Definition
If current behaviour of doctors and public continues unabated, eventually every well person will be labeled sick.
Term
Rosenfeld
Definition
Medicalization of masculinity:
- Viagra, sperm counts and infertility.
- Medicalization does not only affect the groups traditionally deemed as vulnerable.
Term
Cooper
Definition
ADHD is a biomedical construct.
Term
Meador
Definition
If current behaviour of doctors and public continues unabated, eventually every well person will be labeled sick.
Term
Richman
Definition
The needs of psychiatry are overestimated due to the diffusion of traditional boundaries and medicalisation.
Term
Moynihan
Definition
Female sexual dysfunction may be a pharma construct but the label may improve the quality of some women's lives.
Term
Revans
Definition
In 1959 connected the recovery rates of patients quite directly with the morale of the nursing staff.
Term
Broadbent et al
Definition
Psychological stress impairs early wound repair following surgery.
Term
Iona Heath
Definition
Patients are unique individuals and no two people ever experience the same illness.
Concept of diagnosis needs to change to match our understanding of how individuals are affect in varying ways by a disease.
Term
Dubos
Definition
The real measure of health is the ability of the individual to function in a manner acceptable to himself and to the group of which he is part.
Term
Feinstein, Field and Kleiman
Definition
All made the disease-illness distinction.
Term
Cartesian dualism
Definition
Distinguishes the physical body from the non-physical mind. Influenced science to tend to ignore the mind.
Term
Huber
Definition
From static to dynamic definition of health: Ability to adapt and self manage in the face of social, physical and mental challenges.
Term
Eivors et al
Definition
Warn against focus on symptoms in the context of eating disorders.
Term
Michie et al
Definition
Patient-centredness and the 'patient activation' approach may be beneficial as it is more likely to produce compliance and greater health outcomes.
Term
Nettleton
Definition
Reminds us that society is very reluctant to provide access to the sick role in people with 'medically unexplained symptoms'.
- Doctors are dismissive of MUS patients, while they want the 'permission to be sick' to gain the empathy from society.
Term
Bennett et al / Gilbert Lewis
Definition
The paradox of Hansen's disease (leprosy) - Despite the natural resistance of the majority of the population of it, it is still associated with social stigma.
- Gilbert Lewis stresses the effect experts from the Leviticus have had on Western's society's perception of leprosy, as it is there associated with sin.
Term
Link and Phelan
Definition

- Stigma is labeling, stereotyping, separation and status loss and always occurs in a power-imbalance situation.

- Has been found to significantly impact life outcomes (income, general health, mortality)

Term
Rosenhan experiment (Science, 1973)
Definition
"On being sane in insane places":
1st stage: Send pseudopatients - All diagnosed and taken in - Then act normally, no change.
2nd stage: Agree to send pseudopatients for staff to pick out - Staff picks out 41/193 - None were sent.
- Conclusion: "it is clear that we cannot distinguish the sane from the insane in psychiatric hospitals"
Term
Greenhalgh
Definition
Bangladeshi immigrants - Sweat loss, exercise, attitudes towards diabetes.
Term
G. Williams
Definition
Narrative reconstruction necessary when considering causality to understand the patients' non-compliance.
Term
Abel
Definition
How do we go from social inequality to health inequality?
- Economic capital(housing, consumption, recreation)
- Interpersonal support
- Cultural capital (Education, Knowledge, Skills, Health Enhancing Values)
Term
Engels
Definition
Likens health inequalities to social murder.
Term
Wilkinson
Definition
Income inequality is a good predictor of social health gradients.
Ill health is not merely the result of different exposures to material circumstances but also involves psychosocial processes.
Term
Link and Phelan on policy implications
Definition
i. Interventions should require analysis of the root cause.
ii. Modest impact on many diseases might be more beneficial that major impact on one disease.
iii. Individual-based risk factors that lie relatively close to disease in a causal chain overlook important sociological processes.
Term
van Mook
Definition
Medicine is a vocation with a body of knowledge and skills put into service for the good of others - The epitome of an ethical service. - Since professional status is granted by society, the society's needs must be met. - Changes in doctors' attitudes due to peer pressure and self interest and increasing media attention consist well-established challenges to medical professionalism.
Term
Arraez-Aybar
Definition
Dissection is means of facing up to emotional challenges and attitudes and thus consists a form of medical socialization.
Term
Into the valley
Definition
Image of medical student hard at work highly valued in the world of medicine.
Term
Friedson
Definition
Argues against medical professionalism and claims that it has risen as a result of power and commerce and that it is not a sufficiently complex skill. The professional autonomy is a result of political and economic processes and is not socially granted.
Term
Minerva and Giubilini
Definition
'After-birth abortion' should be granted in all cases where abortion is, including cases where the newborn IS NOT DISABLED.
Term
Bell
Definition
The fallacy of discussing consent as a binary entity: Consent and unconsent are graded on a scale from hypothetical, to implied, to express.
Term
Gillon
Definition
Freedom - doing what one wants to do
Autonomy - doing what one wants to do on the basis of thought and reasoning
Term
Marmot
Definition
'No necessary biological reason why life expectancy should be 48yrs longer in Japan than in Sierra Leone.'
Term
Hippocratic Oath
Definition
'Into whatever homes I go, I will enter them for the benefit of the sick.' BUT 'In purity and according to divine law I will carry out my life and act."
Term
Blaxter (1990)
Definition
Definitions of health:
Negative - Absence of illness
Functionally - Ability to cope with everyday activities
Positively - Fitness and well-being
Term
Becker
Definition
Coined the term 'moral entrepreneur'
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