Are Health and Illness Social Constructions? (AQA A-Level Sociology): Revision Notes
Are Health and Illness Social Constructions?
Understanding social construction
The concept of social construction challenges the idea that health and illness are purely biological or natural phenomena. When sociologists discuss social construction, they suggest that our understanding of health and illness has been shaped by cultural values, social norms, and prevailing beliefs about how things should be, rather than being fixed or universal truths.
Social construction theory suggests that many concepts we take for granted as "natural" or "universal" are actually created and maintained through social processes, cultural values, and shared beliefs within societies.
This perspective becomes particularly relevant when examining Western medicine, which appears dominated by scientific objectivity and technological advancement. However, the variations in how different cultures define and understand health, along with concepts like Talcott Parsons' sick role, demonstrate how health and illness can be viewed as constructed rather than purely biological states.
Even within scientific medicine, there remain significant uncertainties and unknowns. Medical interpretations and treatments often vary across cultures, highlighting how the meaning of health and illness can be value-laden and potentially lead to stereotyping, labelling, and stigmatisation.
Key sociological perspectives
Michel Foucault (1926-84), a prominent post-structuralist thinker, described Western medicine as a discourse - essentially one particular way of understanding and discussing health among many possible approaches. Foucault's analysis reveals that whilst Western scientific medicine has become the dominant framework for viewing health, particularly in developed societies, it represents only one possible perspective rather than the definitive truth.
In Foucault's terms, a discourse is a way of constituting knowledge, together with social practices, forms of subjectivity and power relations. Medical discourse shapes not just how we understand health, but how we experience our own bodies and illnesses.
This perspective aligns with interpretive sociologists who emphasise the subjective meanings people attach to health and illness experiences, contrasting with functionalist approaches that tend to favour positivistic, scientific explanations of health phenomena.
Contrasting medical approaches
The biomedical model
The biomedical model dominates Western healthcare systems and focuses on understanding health through scientific analysis of bodily components, often down to sub-cellular levels. Giddens and Sutton (2013) observe that despite the complexity involved in defining health, this scientific approach has become the predominant method for understanding health and illness in Western society.
While the biomedical model has brought tremendous advances in treating disease, it's crucial to remember that its dominance doesn't negate the existence or validity of alternative frameworks for understanding wellbeing and disease.
However, this model represents just one way of approaching health concerns. Its dominance doesn't negate the existence or validity of alternative frameworks for understanding wellbeing and disease.
Holistic approaches
Complementary and Alternative Medicine (CAM) and traditional systems like Chinese medicine adopt fundamentally different approaches to health. These holistic approaches view the body as consisting of interdependent parts, where focusing on isolated symptoms ignores how other bodily systems may be affected.
Holistic medicine emphasises treating the whole person by considering body, mind, spirit, and emotions together. This comprehensive approach offers an alternative to the reductionist tendencies of Western scientific medicine, demonstrating that multiple valid frameworks exist for understanding health and illness.
Contemporary applications and global trends
Scientific medicine has expanded beyond Western developed nations to become increasingly influential globally. This globalisation of Western medical approaches further supports the social construction argument, as it shows how particular cultural understandings of health can spread and become adopted across different societies.
The persistence and validity of alternative medical systems, however, demonstrates that Western scientific medicine remains just one among several possible approaches to health and healing, rather than a universal truth about human wellbeing.
Social determinants of health research
Benoit et al (2009) study
Research Study: Social Determinants of Health
Researchers: Benoit et al
Focus: Social causes of health inequalities
Year: 2009
Scope: Canadian context with universal application to developed countries like the UK
Key findings: The research highlighted that maintaining and promoting population health is only partially achieved through public investment in healthcare services such as hospitals, physicians, and advanced medical technology. This finding challenges purely medical approaches to health improvement.
Social determinants identified: The study emphasised that health gaps result from fundamental social factors including gender, socio-economic status, race, ethnicity, immigration status, employment conditions, and geographical location.
WHO recommendations
The World Health Organisation (2008) suggested that health gaps between and within countries could be addressed within a decade through two main approaches:
- Improving access to primary healthcare
- Taking coordinated action to address underlying social determinants of health
Policy implications and victim blaming
Government health policies increasingly focus on victim blaming approaches, placing responsibility on individuals to maintain their health through lifestyle choices such as regular exercise, healthy eating, moderate drinking, and not smoking. This individual-focused approach contrasts with addressing structural and social causes of health inequalities.
Critical Policy Issue: Focusing solely on individual behaviour change ignores the powerful influence of social determinants on health outcomes. This approach can unfairly blame individuals for health problems that stem from structural inequalities beyond their control.
Progressive policy changes suggested by researchers include:
- Increasing minimum wages for both private and public sector employment
- Implementing equal pay for work of equal value
- Establishing policies to raise the value of care work
- Creating national childcare systems and public funding for vulnerable populations
- Improving educational and economic opportunities for marginalised groups
- Investing in primary healthcare to improve access and quality of care
Key Points to Remember:
- Social construction means health and illness are shaped by cultural values and social norms, not just biology
- Foucault viewed Western medicine as one discourse among many possible ways of understanding health
- The biomedical model dominates Western healthcare but holistic approaches offer valid alternatives
- Social determinants like socio-economic status and geography affect health more than individual lifestyle choices alone
- Government policies often focus on victim blaming rather than addressing structural causes of health inequalities