SOC 5510 - 1

Weitz, R. (2017).  The sociology of health, illness, and health care: A critical approach  (7th ed.). Cengage.

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"LEARNING OBJECTIVESAfter reading this chapter, students should be able to:•Describe the sociological perspective.•Identify the difference between sociologyinmedicine and sociologyofmedicine.•Understand how social changes have affected the health of populationshistorically.•Evaluate research methods and sources.Shortly before her 46th birthday, my friend Lara found a lump in her breast. Amammogram (a type of X-ray) soon identified the lump as potentially cancerous,and so a surgeon removed part of the lump for further testing. A few days later,Lara learned that she did indeed have breast cancer. That week, she got her affairsin order and signed a“living will,”specifying the circumstances in which shewould want all treatment stopped, and a“medical power of attorney”giving melegal authority to make medical decisions for her if she could not do so herself.These two documents, she hoped, would protect her from aggressive medicaltreatments that might prolong her suffering without improving her quality of lifeor chances of survival.Two weeks after the initial tests, her surgeon removed the rest of the lump aswell as the lymph nodes under her arm (where breast cancer most often spreads).The surgery went well, but the subsequent laboratory tests showed that the cancerhad spread to her nodes.Yet in many ways, Lara was fortunate. Her breast cancer was detected at anearly stage, improving her odds of surviving. Although she had neither husbandnor children to turn to, her friends proved uniformly supportive. She receivedhealth insurance through her employer and had no fears of losing either her job orher insurance.Nevertheless, cancer changed Lara’s life irrevocably, making it, at times, anightmare. Having breast cancer shook Lara’s faith in her body and changed hersense of her physical self. At the same time, her illness threatened her relationshipswith others. Despite the supportive responses she received from friends andcoworkers, she feared that they would drift away as her illness continued or thatshe would chase them away with her all-too-reasonable complaints, worries, andneeds.Although she had far better health insurance than many Americans have, herdebts for items not covered by insurance mounted. In addition, she had to spendhours fighting her insurance company to obtain relaxation training and expensive" "but effective anti-nausea drugs to cope with chemotherapy’s side effects. Withoutthe drugs, chemotherapy made her so ill that she could barely function, let alonefight her insurance company. In addition, chemotherapy proved so toxic that itdamaged her veins with each painful intravenous treatment. As a result, herdoctors suggested inserting a semipermanent plastic tube into her chest wall so theycould instead administer the chemotherapy through the tube. Although doing sowould have reduced her pain, Lara rejected the suggestion because she felt that,with this sign of her illness physically attached to her body, cancer would becomeintegral to her very self, rather than merely one part of her life.After a year of surgery, chemotherapy, and radiation, Lara’s physicaltraumas ended, although it took another year before she regained her formerenergy.Lara’s story demonstrates the diverse ways that illness affects individuals’lives, as well as the diverse range of topics that sociologists of health, illness, andhealth care can study. This chapter opens with an overview of those topics, thesociological perspective, and the critical approach within sociology. We thenlook briefly at the history of disease, which helps put sociological research onhealth into context, before exploring the research sources used by sociologists.THE SOCIOLOGY OF HEALTH, ILLNESS,AND HEALTH CARE: AN OVERVIEWSociologists’research into health, illness, and health care falls into three maincategories. First, some sociologists study how social forces promote health andillness and why some social groups suffer more illness than others do. For exam-ple, researchers have explored whether working conditions in US factories helpexplain why poorer Americans get certain cancers more often than do wealthierAmericans. Similarly, sociologists can study how historical changes in social lifecan explain changes in patterns of illness. To understand why rates of breast can-cer have increased, for example, researchers have studied the possible impact ofenvironmental pollution, increased meat consumption, and women’s changingwork lives.Second, instead of studying broad patterns of illness, sociologists can studythe experiences of those, like Lara, who live with illness each day—exploring,for example, how illness affects individuals’sense of identity, relationships withfamily, or ideas about what causes illness. Similarly, sociologists can study theexperiences of health care providers. Some sociologists have analyzed how doc-tors’status and power have shifted over time, and others have investigated howpower affects interactions among doctors, nurses, and other health care workers.Still others have examined interactions between health care workers and patients," "asking, for example, how doctors maintain control over patients or whether doc-tors treat male and female patients differently.Finally, sociologists can analyze the health care system as a whole. Socio-logists have examined how health care systems have developed; compared thestrengths and weaknesses of different systems; and explored how systems can beimproved. For example, some have studied how US health insurance companiescan make it difficult for people like Lara to get needed care, explored why Euro-pean countries do better than the United States at providing health care to allwho need it, and examined whether European health care policies could workin the United States.The topics researched by sociologists of health, illness, and health care over-lap in many ways with those studied by health psychologists, medical anthro-pologists, public health workers, and others. What most clearly differentiatessociologists from these other researchers is thesociological perspective. The next sec-tion describes that perspective.THE SOCIOLOGICAL PERSPECTIVEThesociological perspectiveis a view of the world that focuses onsocial pat-ternsrather than onindividual behaviors. Whereas a psychologist might help a bat-tered wife develop a greater sense of her own self-worth so she might eventuallyleave her abusive husband, a sociologist likely would consider therapy a usefulbut inefficient means of addressing the root causes of wife abuse. Most batteredwives, after all, don’t have the time, money, or freedom to get help from psy-chologists. Moreover, even when therapy helps, it takes place only afterthe women have experienced physical and emotional damage. The sociologistwould not deny that individual personalities play a role in wife battering,but would find it more useful to explore whether social forces can explain whywife battering is much more common than husband battering, or why batteredwives so often remain with abusive husbands. Consequently, whereas the psy-chologist hopes to enable the individual battered wife eventually to leave herhusband, the sociologist hopes to uncover the knowledge needed by legislators,social workers, activists, and others to prevent wife abuse in the first place.As this example demonstrates, using the sociological perspective means fram-ing problems aspublic issues, rather than simplypersonal troubles. According toC. Wright Mills (1959: 8–9), the sociologist who first drew attention to thisdichotomy:[Personal]troublesoccur within the character of the individual and withinthe range of his immediate relations with others; they have to do withhis self and with those limited areas of social life of which he is directlyand personally aware. Accordingly, the statements and the resolutions oftroubles properly lie within the individual as a biographical entity andwithin the scope of his immediate milieu.... [In contrast,public]issueshave to do with matters that transcend these local environments of th"