Sociological approach to health and disease

SOCIOLOGICAL
APPROACH TO HEALTH
AND DISEASE
THEORIES.
By C. Settley

What is the sociological
perspective? (Pretorius, 2)
• The sociological perspective is a
perspective on human behavior and its
connection to society as a whole. It invites
us to look for the connections between the
behavior of individual people and the
structures of the society in which they live.
Typically, we tend to think of our society
as just natural.

• Sociology is a tool towards understanding the
world.
• And to confront its problems.
• This means that the methods and theories of
sociology enable us to collect data for example
about how many people are there in a particular
society, how the population is distributed in
terms of age and what the main health concerns
are.
• Such information enables the authorities to plan
for appropriate healthcare provision.

• Direct • Indirect

• Now, we have said that: Sociology can be defined as the
study of human social life.
• Think about the following questions:
1)How has society shaped you?
2)What institutions have formed you?
3)How have these institutions formed who
you are?

• An important statement to think about is:
‘We are the products of our environment’.
- Our environment influence the way we think and
how we act.

• The sociological imagination allows us to
objectively look at our own personal
issues and social surroundings and relate
them to the way society works.
• Although we have personal issues that we
feel affect only us many of our personal
issues are felt by others and are caused
by public issues within society.

• For example, people may see
unemployment as a personal weakness,
however when a sociologist looks from an
individual to a society we can see that
many people are suffering from
unemployment by looking at the high
unemployment rate.
• Since so many people are affected by the
unemployment rate we can look at it as a
social problem and not a personal
problem.

• Throughout class, you will develop your
own sociological imagination which will
allow you to objectively view problems that
you once though we personal.
• You will start to gain an understanding of
how to objectively view society and the
social processes that shape who you are.

Establishing patterns
• The sociological perspective aims to do
more than describe events in society.
• Hence sociologists attempt to establish
generalisations

Example: Different occupations
• Instead of classifying these occupations,
sociologists have come to realise that one
can identify groups of people who do more
or les the same kind of work for which they
are paid more or less similarly….(Social
class!)

Example continued
• See stores below:
• Casual employees
• Fruit ails employees
• Dry foods employees
• Wine section employees
• Furniture employees
• Appliances employees
• Floor Managers employees
• Store managers employees

Establishing patterns continued
• Sociologists interested in health and illness
could investigate the incidence and prevalence
of illnesses among different classes
• They would then further be able to make
generalisations about the relationship between
health and society, such as the rate of death
rate of people from the working class is
consistently higher than that of people from the
professional class, e.g. doctors, lawyers and
business people.

Social classes
GENERAL: Broad Schematic
Representation of the Social Class
6 Basic Classes with subclasses
Varies according to societal
dynamics

• This means that sociologists will be able to
identify certain patterns pertaining to health in a
particular society.
• They will be able to explain why these patterns
exist and;
• What their consequences are for the society.
• They can also make recommendations on the
patterns.
• Ever notice the order on campus/in
town/malls/roads?
• Regularities of social life.
Establishing patterns continued

• Sociology differs from common sense explanations.
• They study the routines of daily life, but look at them differently.
• They understand the larger picture and impact of the social forces on our
private lives.
• Referring to Refiloe’s story……
• While we think life is all about individual actions and free choices, many are
influence by social circumstances that we cannot always control.
• The story illustrate the key idea of sociology- to understand people and the
phenomena in their personal lives
• Sociological imagination allows us to recognize that solutions to many of our
problems le not in changing the personal situations and characteristics of
individuals, but in changing the social institutions and roles available to them
• Problems such as drug addiction, homelessness, sexual violence will not be
solve by treating or punishing the individuals,
• But social institutions should provide programs to assist such individuals.
The sociological Imagination

• While we think that life is all about individual
actions and free choices- such as what to wear,
what to eat, who our friends are etc- many of
these free choices are dictated or at least
influenced by social circumstances that we
cannot always control.
• In Refiloe’s story we also have to look at current
and past economic trends that affect the number
of available jobs and at the country’s political
past and the legacy of apartheid.

• Globalisation significantly impacts all our lives.
• Globalisation= when peoples lives become
interconnected and interdependent in many
spheres of life- economically, politically,
environmentally and culturally.
• “if US sneezes, the rest of us catch the cold”

Globalisation: Advantages
• Resources of different countries are used for producing goods and
services they are able to do most efficiently.
• Consumers to get much wider variety of products to choose from.
• Consumers get the product they want at more competitive prices.
• Companies are able to procure input goods and services required at
most competitive prices.
• Companies get access to much wider markets
• It promotes understanding and goodwill among different countries.
• Businesses and investors get much wider opportunities for
investment.
• Adverse impact of fluctuations in agricultural productions in one
area can be reduced by pooling of production of different areas.

Globalisation: Disadvantages
• Developed countries can stifle development of undeveloped and
under-developed countries.
• Economic depression in one country can trigger adverse reaction
across the globe.
• It can increase spread of communicable diseases.
• Companies face much greater competition. This can put smaller
companies, at a disadvantage as they do not have resources to
compete at global scale.

The sociological imagination
• The sociological imagination thus allows
us to recognise that the solutions to many
of our most serious problems lie not in
changing the personal situations and
characteristics of an individual, but in
changing the social institutions and roles
available to them.

The sociological theory
• Theories are considered practical and useful because they:
• - enable a better understanding of human social behavior
• - allow us to make predictions about future behavior and events
• - assist us in making suggestions for interventions or change
• What is a theory?
• - comprises a set of interrelated concepts, definitions and
propositions
• - presents a systemic view of phenomena by specifying relations
among variables
• - aims to explain and predict these phenomena
• VIDEO ON SOCIOLOGICAL THEORIES!

Structural Functionalism
• The oldest theoretical perspective in sociology and other social
sciences
• Inspiration primarily from the ideas of the French sociologist Emile
Durkheim (1858-1917).
• One of the first sociologists who made use of scientific and
statistical techniques in sociological research
• Structural functionalism is structural theory (macro theory)
• The perspective is based on two pillars:
• 1) The application of the scientific method to the objective social world
• 2) The analogy of society as an organism

Structural Functionalism:
1) The scientific method
• During the middle ages, people based their knowledge on religious beliefs
• Intellectual Movement, termed the Age of Enlightenment or the Age of
reason
• These thinkers believed that superstition and religious tyranny had been the
cause of suffering and death to millions in religious wars and wanted to free
humankind from these
• Positivism: the theory that knowledge can be acquired only through direct
observation and experimentation was termed positivism.
• Mainly applied to natural and human sciences
• August Comte developed the first sociological version of positivism.
• He developed his positive philosophy during the time that natural sciences
were achieving success- he was impressed and influenced by this

Structural Functionalism:
1) The scientific method continued
• He argued that to make sense of society, sociology had
to adopt the methods of natural sciences, especially
biology
• Social analysis had to be based on careful observation,
which had to be directed by and also interpreted by a
theory.

1) The scientific method continued
• Comte’s sociological positivism comprised
the following aspects:
• Establishing sociology as an objective science.
• Recognition that there is no difference between the methods of the natural
sciences and the social sciences.
• The field of study of sociology, namely society, was defined in terms of an
organism evolving by means of the workings of specific natural laws.

2) Society as an organism
• 2.1. A Systems approach
• Society is a system that operates like a living organism
(the body) and consists of interrelated and
interdependent parts or subsystems such as families,
education, religions, politics and economy (organs)
• Each subsystem functions to maintain a healthy society
• So, the subsystem of the family is dependent upon the
subsystem of education to prepare the children for jobs
in order to support their own families
• Society work together to produce order, stability,
productivity

• 2.2. A tendency towards equilibrium
• By means of socialization
• Values and norms are being internalized by members of the society
• Values and norms become part of their nature
• Act according to the rules and expectations of the particular society
• Aim of socialization is to reach consensus/cohesion. ‘the glues that
holds the society together’
• When Social change occurs rapidly, society becomes unsure of the
social norms. Durkheim called this anomie (this means being in a
state of normlessness.
• Societies have various social control mechanisms- informal and
formal sanctions

• Emile Durkheim sought to explain social cohesion and
stability through the concept solidarity. It takes one of
two forms:
• 1) Mechanical solidarity
• When people in a society maintain similar values and
beliefs, share common symbols and types of work.
Traditional societies
• 2) Organic solidarity
• Develops when the members of society hold varying
values and beliefs. Industrialized societies (In sociology,
industrial society refers to a society driven by the use of technology to enable mass
production, supporting a large population with a high capacity for division of labour).

• 2.3. Statuses and Roles
• Statuses are socially defined positions that individuals
occupy within society: wife, nurse, cook, student, etc.
Not associated with prestige or rank
• Difference between a person and a status- they are not
the same
• Expectations of roles
• Ascribed status- sex or race
• Achieved status- educational level

• 2.4. Functions
• Robert Merton divides human functions into two types:
• 1) Manifest functions- intentional, planned and obvious
• 2) Latent functions- unintended , not obvious and unrecognized

• 2.4. Social structure and the individual
• Focus on social structures rather than the individual
• Durkheim study on suicide. Catholics and Protestants.

2) Evaluation
• Strengths of Structural Functionalism:
• 1) There is a general consensus about the values and norms of society by
the majority e.g. wealth is good, murder is bad. They wish to keep the status
quo. Individuals and groups have to accept their roles in society.
• 2) Society is made up of integrated parts that are tied together, thus if
something is wrong with one it will effect the others. (It functions like the
organs of our body). These parts in society are the institutions of our society
e.g. family, school, economy, justice system, etc.
• 3) Society tends to seek stability and avoid conflict. Conflict is seen as
dysfunctional.
• 4) Macro level analysis

2) Evaluation
• Weaknesses of Structural Functionalism:
• They do not see anything wrong with inequality in a
society based on class, gender or race.
• Is not open to social change
• Does not look at the causes (root) of social problems
• Less concerned with the ways in which individuals are
able to control their own destiny.
• Tend to over-emphasise the harmonious nature of
society.
• Supports the status quo.

Conflict theory
• Conflict theory is a prominent sociological theory that is
often contrasted with structural functionalism. It also tried
to address the shortcoming of structural functionalism.

Conflict theory
1. Influence of Karl Marx
•According to Marx, there are two major social groups, the
ruling class and a subject class.
•The ruling class possess the power because they own and
control the forces of production.
•Its members exploit and oppress the subject class.
•As a result there is always conflict between the two
classes

Conflict theory
2. View of Society
• When conflict theorist look at society, they do not see a
system striving for equilibrium, but rather a system
characterised by inequality and a constant struggle and
conflict over resources.
• One of the basic assumptions of this theory is that
competition rather than consensus is characteristics of
human relationships.
• Society is made up of individuals competing for limited
resources, such as anti-retroviral medicine, money,
leisure, etc.

Conflict theory
2. View of Society
• These theorists note that unequal groups usually have
conflicting values and agendas, causing them to
compete against one another.
• They challenge the status quo, stating that inequalities in
power and rewards are built into all social structures.
• Some people thus have more resources, such as power
and influence.
• Individuals and groups who benefits from any particular
structure strive to see that structure maintained.
• They use their power and influence to maintain their own
position in society.

Conflict theory
3. Change in society
• Change is an ever present reality in society, caused by
conflict between competing interests rather than through
adaptation.
• The nature of change is abrupt and revolutionary rather
than evolutionary.
• Conflict theorist encourage social change, because they
believe that rich and powerful people force social order
on the poor and weak.
• Whereas Marx focused on the struggle between classes,
contemporary conflict theorists are interest in various
sources of conflict and inequality, race, gender, religion,
politics, etc.

Conflict theory
4. Evaluation
• Strengths of Conflict theory:
• Able to explain social change in society
• Views society from the perspective of the underdog, the
underprivileged.

Conflict theory
4. Evaluation
• Weaknesses of Conflict theory:
• Focus on conflict results in downplaying or overlooking the elements
of society that different groups and individuals share.
• It overlooks the stability of society.
• It has an overly negative view of society.
• It emphasizes on inequality has led some critics to argue that it is a
perspective motivated by a particular political agenda.
• In comparing and contrasting the two macro- level theories, it
becomes apparent that they can be used complementarily, with
structural functionalism focusing on equilibrium and solidarity, and
conflict theorist focusing on change and conflict.
• VIDEO ON CONFLICT THEORY!

Symbolic interactionism
• Aims to understand the relationship between individuals
and society, and is engage in analysis on a micro level.
• It focus on the subjective aspects of social life, rather
than objective, macro structural aspects of social life.

1. Human action and interaction
• Interactionist based their theoretical perspective on their
image of humans, rather than that of society.
• In this approach, human are portrayed as acting as
opposed to being acted upon.
• Symbolic interactionism basic idea is that human action
and interaction are understandable only through the
exchange of meaningful communication or symbols.

1. Human action and interaction
• Symbol is something used to represent or stand for
something else.
• Wedding- wedding bands, cake, church, etc.
• People attached meaning to symbols, such as language,
dress and gesture and then act according to their
subjective interpretation of it.
• Conversation is an interaction of symbols between
individuals, words being the predominant ones.
• The task of the symbolic interactionist is to consider the
symbols and details of everyday life, and then to look for
the meanings that individuals ascribe to their own
actions and symbols and also to those of others.

2. Social construction of society
• According to interactionism, we cannot understand
society unless we understand the meanings that people
attach to their actions and beliefs.
• This is called the definition of the situation.
• Society is socially constructed, meaning, it is defined by
people’s interactions and develops from the numerous
daily symbolic interactions between them.
• This perspective maintains that the objective world has
no reality for humans.
• Only subjectively defined objects have meaning.

2. Social construction of society
• Humans neither acquire meanings at birth, nor through
familiarisation.
• Meanings can however changed by human’s creative capabilities
and individuals may influence the meanings that form their society.
• Symbolic interactionism differs from structural functionalism:
• Structural functionalism focus on stable norms and values.
Interactionism emphasis more changeable, continually readjusting
social processes.
• Functionalist regard socialisation as the process that creates
stability in the social system. Interactionist consider negotiation
among members of society to create temporary, socially constructed
relations that remain in constant flux.

3. Roles
• The emphasis on symbols, the social construction of society and
negotiated reality lead to an interest in the roles people play.
• George Mead emphasised that role taking is the key mechanism of
interaction.
• It refers to people’s ability to read one another's gesture and to
understand the identity that others are presenting in a situation.
• Role taking permits us to take the other’s perspective, to see what
our actions might mean to the other actors with whom we interact.
• At other times, roles are improvised, this is referred to as role
making which is the opposite of role taking.
• It is a significant mechanism of interaction, because all situations
and roles are essentially uncertain.
• In all encounters individuals orchestrate their behavioural outputs
and gestures to assert a role for themselves in the situation

4. Research methodology
• Symbolic interactionist prefer and use a specific methodology in
their research.
• They see meaning as the fundamental component of human and
society interaction.
• Study this interaction requires getting at that meaning
• They thus tend to utilise qualitative methods such as participant
observation and focus group interviews, rather than quantitative
measures such as surveys.
• They argue that close contact and engagement in the every day
lives of participants, are necessary for understanding the meaning
of actions, definition of the situation itself and the process which
actors construct the situation through interaction.

5. Evaluation
• The value of this perspective is that in the final analysis society
consist of people who interacts with one another
• CRITISISM:
• It neglects macro level of interpretation.
• Their research methods have been called vague and
unsystematic.
• VIDEO ON SYMBOLIC THEORY!

Comparison of theoretical
perspectives
SOCIOLOGICAL
PERSPECTIVE
KEY CONCEPTS MAIN ASSUMPTIONS
Structural functionalism Manifest and latent
functions
Dysfunctions
Social stability
Social institutions are
structured to maintain
stability and order in
society
Conflict theory Power
Inequality
Conflict
dominance
The various institutions
in society promote
inequality and conflict
among groups of people
Symbolic interactionism Symbolic communication
Social interaction
Subjective meaning
Society is structured and
maintained through
everyday interactions
and people’s subjective
definitions of their worlds

Applying the theoretical
perspectives
• All 3 theories have positive and negative characteristics.
• Meaning that one or more perspective has to be used at
times to understand a particular phenomenon.
• Read page 22 in Pretoruis et al.
• Sociological approaches are differentiated by the level of
analysis. Macrosociology involves the study of
widespread social processes . Microsociology involves
the study of people at a more interpersonal level, as in
face-to-face interactions.

REFERENCES.
Du Toit, D. & le Roux, E. (2014). Nursing sociology. 5th ed. Pretoria: Van Schaik.
Pretorius, E. Matebesi, Z and Ackermann, L. (2013). Juta’s Sociology for healthcare
professionals. Lansdowne, Cape Town, South Africa. Page 9- 24.
http://www.enotes.com/homework-help/list-advantages-disadvantages-globalization-113517
. Retrieved 07/07/2015

Sociological approach to health and disease

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