{"id":7888,"date":"2019-07-19T12:44:00","date_gmt":"2019-07-19T12:44:00","guid":{"rendered":"https:\/\/courses.lumenlearning.com\/wmopen-introtosociology\/chapter\/outcome-health-and-medicine\/"},"modified":"2020-07-03T22:51:52","modified_gmt":"2020-07-03T22:51:52","slug":"the-social-construction-of-health","status":"publish","type":"chapter","link":"https:\/\/courses.lumenlearning.com\/suny-esc-introtosociology\/chapter\/the-social-construction-of-health\/","title":{"raw":"The Social Construction of Health","rendered":"The Social Construction of Health"},"content":{"raw":"<div class=\"textbox learning-objectives\">\r\n<h3>Learning outcomes<\/h3>\r\n<ul>\r\n \t<li>Explain the cultural significance and social construction of health<\/li>\r\n \t<li><span style=\"color: #333333\">Apply functionalist, conflict theorist, and symbolic\u00a0interactionist perspectives to health issues<\/span><\/li>\r\n<\/ul>\r\n<\/div>\r\nMedical sociology is the systematic study of how humans manage issues of health and illness, disease and disorders, and healthcare for both the sick and the healthy. In this section, you'll learn about the importance of medical practices and how the social construction of health explains how society both shapes medical ideas and is shaped by them.\r\n\r\n<img class=\"aligncenter wp-image-6029\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2034\/2016\/05\/28183911\/photo-1471864190281-a93a3070b6de.jpeg\" alt=\"This is a zoomed in photo on a pile of prescription medications.\" width=\"522\" height=\"348\" \/>\r\n<h2>The Cultural Significance of Health<\/h2>\r\nIf sociology is the systematic study of human behavior in society, <strong><span id=\"import-auto-id2417119\">medical sociology<\/span><\/strong> is the systematic study of how humans manage issues of health and illness, disease and disorders, and healthcare for both the sick and the healthy. Medical sociologists study the physical, mental, and social components of health and illness. Major topics for medical sociologists include the doctor\/patient relationship and power dynamics within the relationship, the structure and socioeconomics of healthcare, unequal access to healthcare (what is often referred to as health inequality),\u00a0and how culture impacts attitudes toward specific\u00a0diseases, conditions, and wellness.\r\n<p id=\"import-auto-id1175361\">The social construction of health is a major research topic within medical sociology. At first glance, the concept of a social construction of health does not seem to make sense. After all, if disease is a measurable, physiological problem, then there can be no question of socially constructing disease, right? Well, it\u2019s not that simple. The idea of the social construction of health emphasizes the socio-cultural aspects of the discipline\u2019s approach to physical, objectively definable phenomena. Sociologists Peter Conrad and Kristin Barker (2010) offer a comprehensive framework for understanding the major findings of the last fifty years of development in this concept. Their summary categorizes the findings in the field under three subheadings: the cultural meaning of illness, the social construction of the illness experience, and the social construction of medical knowledge.<\/p>\r\n\r\n<section id=\"h21901_01\">\r\n<h3>The Cultural Meaning of Illness<\/h3>\r\n<p id=\"import-auto-id2337591\">Many medical sociologists contend that illnesses have both a biological and an experiential component, and that these components exist independently\u00a0of\u00a0and external to\u00a0each other. Our culture, not our biology, dictates which illnesses are stigmatized and which are not, which are considered disabilities and which are not, and which are deemed contestable (meaning some medical professionals may find the existence of this ailment questionable) as opposed to definitive (illnesses that are unquestionably recognized in the medical profession) in the medical field\u00a0(Conrad and Barker, 2010).<\/p>\r\n<p id=\"import-auto-id1820434\">For instance, sociologist Erving Goffman (1963) described how social stigmas hinder individuals from fully integrating into society. In essence, Goffman (1963) suggests we might view illness as a stigma that can push others to view the ill individual\u00a0in an undesirable manner. The <span id=\"import-auto-id2286466\"><strong>stigmatization of illness<\/strong><\/span> often has the greatest effect on the patient and the kind of care they\u00a0receive. Many contend that our society and even our healthcare institutions discriminate against certain diseases\u2014like mental disorders, AIDS, venereal diseases, and skin disorders (Sartorius, 2007). Facilities for these diseases may be sub-par relative to facilities aimed at addressing and alleviating other conditions; they may be segregated from other healthcare areas or relegated to a poorer environment. The stigma attached to a specific condition\u00a0may keep people from seeking help for such conditions,\u00a0consequently being detrimental to the individual's and society's well-being.<\/p>\r\n<p id=\"import-auto-id3078986\"><strong><span id=\"import-auto-id2770690\">Contested illnesses<\/span><\/strong> are those that are questioned or questionable by\u00a0a fraction of\u00a0medical professionals. Disorders like fibromyalgia or chronic fatigue syndrome may be either true, objective,\u00a0and tangible\u00a0illnesses or, as argued by some medical professionals, may exist only in patients\u2019 heads. This dynamic can affect how a patient seeks treatment and what kind of treatment they\u00a0receive.<\/p>\r\n\r\n<h3><span style=\"color: #000000\">The Sick Role<\/span><\/h3>\r\n<span style=\"color: #333333\">Sick role is a term used in medical sociology regarding sickness and the rights and obligations of the affected. It is a concept created by the American sociologist Talcott Parsons in 1951.\u00a0Parsons argued that the best way to understand illness sociologically is to view it as a form of deviance that disturbs the social functioning of society. The general idea is that the individual who has fallen ill is not only physically sick, but now adheres to the specifically patterned social role of being sick. \"Being Sick\" is not simply a \"condition\"; it contains within itself customary rights and obligations based on the social norms that surround it, and therefore plays a role in everyday, normative interactions.<\/span>\r\n\r\n<span style=\"color: #333333\">Parsons' theory outlined\u00a0two rights of a sick person\u00a0along with two obligations. The sick person's rights are: being exempt from normal social roles, and not being responsible for their condition. Conversely, the sick person's obligations include trying to get well and cooperating with medical professionals.<\/span>\r\n\r\n<\/section><section id=\"h21901_02\">\r\n<h3>The Social Construction of the Illness Experience<\/h3>\r\nThe idea of the social construction of the illness experience is based on the concept of reality as a social construction. In other words, there is no objective reality; there are only individual perceptions of it, which are always relative and involve a process of construction. The social construction of the illness experience addresses the way some patients control the manner in which they reveal their diseases, and the lifestyle adaptations patients develop to cope with their illnesses.\r\n\r\n[caption id=\"\" align=\"alignright\" width=\"250\"]<img src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/120\/2016\/04\/15204710\/Figure_19_01_01.jpg\" alt=\"A chart of numerical pain levels ranging from 0 to 10 is shown here. 0 being 'No pain', and 10 being 'Excruciating pain'.\" width=\"250\" height=\"375\" \/> <strong>Figure 1.\u00a0<\/strong>The Mosby pain rating scale helps health care providers assess an individual\u2019s level of pain. What might a symbolic interactionist observe about this method? (Photo courtesy of wrestlingentropy\/flickr)[\/caption]\r\n<p id=\"import-auto-id1425675\">In terms of constructing the illness experience, culture and individual personality both play a significant role. For some people, a long-term illness can have the effect of making their world smaller, leading to a life that is\u00a0more defined by the illness than\u00a0by anything else. Their illness becomes their marker, or their focal status.\u00a0For others, illness can be a chance for discovery, for re-imagining a new self (Conrad and Barker, 2007). Culture plays a substantial role in how an individual experiences illness. Widespread diseases like AIDS or breast cancer have specific cultural markers that have changed over the years and that govern how individuals\u2014and society\u2014view both the condition and the individual directly affected by the condition.<\/p>\r\n<p id=\"import-auto-id1883634\">Today, many institutions of wellness acknowledge the degree to which individual perceptions shape the nature of health and illness. Regarding physical activity, for instance, the Centers for Disease Control (CDC) recommends that individuals use a standard level of exertion to assess their physical activity. This Rating of Perceived Exertion (RPE) gives a more complete view of an individual\u2019s actual exertion level, since heart rate or pulse measurements may be affected by medication or other factors\u00a0(Centers for Disease Control, 2011). Similarly, many medical professionals use a comparable, somewhat universal\u00a0scale for perceived pain to help determine pain management strategies.<\/p>\r\n<p style=\"text-align: center\"><strong>Watch this video to learn more about the sick role and ways that society influences health. Look for examples of how health, disease, and illness are socially constructed.<\/strong>\r\n[embed]https:\/\/www.youtube.com\/embed\/8NGlENS1qgo[\/embed]<\/p>\r\n\r\n<\/section><section id=\"h21901_03\">\r\n<h3>The Social Construction of Medical Knowledge<\/h3>\r\n<p id=\"import-auto-id2753636\">Conrad and Barker show how medical knowledge is socially constructed; that is, it can both reflect and reproduce inequalities in gender, class, race, and ethnicity. Conrad and Barker (2011) use the example of the social construction of women\u2019s health and how medical knowledge has changed significantly in the course of a few generations. For instance, in the early nineteenth century, pregnant women were discouraged from driving or dancing for fear of harming the unborn child, much as they are discouraged, with more valid and evidence-based reason, from smoking or drinking alcohol today.<\/p>\r\n\r\n<div class=\"textbox exercises\"><section id=\"h21901_03\">\r\n<h3 class=\"title\">Has Breast Cancer Awareness Gone Too Far?<\/h3>\r\n[caption id=\"\" align=\"alignright\" width=\"250\"]<img src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/120\/2016\/04\/15204712\/Figure_19_01_02.jpg\" alt=\"Pink ribbon lollipops are shown here.\" width=\"250\" height=\"375\" \/> <strong>Figure 2.\u00a0<\/strong>Pink ribbons are a ubiquitous reminder of breast cancer. But do pink ribbon chocolates do anything to eradicate the disease? (Photo courtesy of wishuponacupcake\/Wikimedia Commons)[\/caption]\r\n\r\nEvery October, the world turns pink. Football and baseball players wear pink accessories. Skyscrapers and large public buildings are lit with pink lights at night. Shoppers can choose from a huge array of pink products. In 2014, people wanting to support the fight against breast cancer could purchase any of the following pink products: KitchenAid mixers, Master Lock padlocks and bike chains, Wilson tennis rackets, Fiat cars, and Smith &amp; Wesson handguns. You read that correctly. The goal of all these pink products is to raise awareness and money for breast cancer. However, the relentless creep of pink has many people wondering if the pink marketing juggernaut has gone too far.\r\n<p id=\"eip-52\">Pink has been associated with breast cancer since 1991, when the Susan G. Komen Foundation handed out pink ribbons at its 1991 Race for the Cure event. Since then, the pink ribbon has appeared on countless products, and then by extension, the color pink has come to represent support for a cure of the disease. No one can argue about the Susan G. Komen Foundation\u2019s mission\u2014to find a cure for breast cancer\u2014or the fact that the group has raised millions of dollars for research and care. However, some people question if, or how much, all these products really help in the fight against breast cancer (Begos, 2011).<\/p>\r\n<p id=\"import-auto-id1497539\">The advocacy group Breast Cancer Action (BCA) position themselves as watchdogs of other agencies fighting breast cancer. They accept no funding from entities, like those in the pharmaceutical industry, with potential profit connections to this health industry. They\u2019ve developed a trademarked \u201cThink Before You Pink\u201d campaign to provoke consumer questioning of the end contributions made to breast cancer by companies hawking pink wares. They do not advise against \u201cpink\u201d purchases; they just want consumers to be informed about how much money is involved, where it comes from, and where it will go. For instance, what percentage of each purchase goes to breast cancer causes? BCA does not judge how much is enough, but it informs customers and then encourages them to consider whether they feel the amount is enough (Think Before You Pink, 2012).<\/p>\r\n<p id=\"import-auto-id2903030\">BCA also suggests that consumers make sure that the product they are buying does not actually <em>contribute<\/em> to breast cancer, a phenomenon they call \u201cpinkwashing.\u201d This issue made national headlines in 2010, when the Susan G. Komen Foundation partnered with Kentucky Fried Chicken (KFC) on a promotion called \u201cBuckets for the Cure.\u201d For every bucket of grilled or regular fried chicken, KFC would donate fifty cents to the Komen Foundation, with the goal of reaching 8 million dollars: the largest single donation received by the foundation. However, some critics saw the partnership as an unholy alliance. Higher body fat and eating fatty foods has been linked to increased cancer risks, and detractors, including BCA, called the Komen Foundation out on this apparent contradiction. Komen\u2019s response was that the program did a great deal to raise awareness in low-income communities, where Komen previously had little outreach (Hutchison, 2010), therefore justifying their seemingly contradictory goals.<\/p>\r\nWhat do you think? Are fundraising and awareness important enough to trump issues of health? What other examples of \u201cpinkwashing\u201d can you think of?\r\n\r\n<\/section><\/div>\r\n<div class=\"textbox key-takeaways\">\r\n<h3>Further Research<\/h3>\r\nVisit the <a href=\"http:\/\/www.humanologyproject.org\/\" target=\"_blank\" rel=\"noopener\">Humanology Project website<\/a>, which works to\u00a0shift common perceptions and misconceptions about illnesses.\r\n\r\n<\/div>\r\n<div class=\"textbox learning-objectives\">\r\n<h3>Think It Over<\/h3>\r\n<div id=\"sh1901_ex01\" class=\"exercise\">\r\n<div id=\"fs-id2109896\" class=\"problem\">\r\n<ul>\r\n \t<li>Pick a common illness and describe which parts of it are medically constructed, and which parts are socially constructed.<\/li>\r\n \t<li>What diseases are the most stigmatized? Which are the least? Is this different in different cultures or social classes?<\/li>\r\n<\/ul>\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<\/section>\r\n<h2>Theoretical Perspectives on Health and Medicine<\/h2>\r\n<span style=\"color: #333333\">Each of the three major\u00a0sociological theoretical perspectives approach the topics of health, illness, and medicine differently. You may prefer just one of the theories that follow, or you may find that combining theories and perspectives provides a fuller and more accurate\u00a0picture of how we experience\u00a0and understand health and wellness.<\/span>\r\n\r\n<section id=\"fs-id1842585\">\r\n<h3>Functionalism<\/h3>\r\n<p id=\"import-auto-id1373740\">According to the functionalist perspective, health is vital to the stability of the society, and therefore sickness is a sanctioned form of deviance. Talcott Parsons (1951) was the first to discuss this in terms of the <strong><span id=\"import-auto-id1294726\">sick role<\/span><\/strong>: patterns of expectations that define appropriate behavior for the sick and for those who take care of them.<\/p>\r\n<p id=\"import-auto-id2851281\">According to Parsons, the sick person has a specific role with both rights and responsibilities. To start with, they have\u00a0not chosen to be sick and should not be treated as responsible for their condition. The sick person also has the right of being exempt from normal social roles; they are\u00a0not required to fulfill the obligation of a well person and can avoid normal responsibilities without censure. However, this exemption is temporary and relative to the severity of the illness. The exemption also requires <strong>legitimization<\/strong>\u00a0by a physician; that is, a physician must certify that the illness is genuine.<\/p>\r\n<p id=\"import-auto-id2764853\">The responsibility of the sick person is twofold: to try to get well and to seek technically competent help from a physician. If the sick person stays ill longer than is appropriate (malingers),\u00a0they may be stigmatized.<\/p>\r\n<p id=\"import-auto-id1425474\">Parsons argues that since the sick are unable to fulfill their normal societal roles, their sickness weakens the society. Therefore, it is sometimes necessary for various forms of social control to bring the behavior of a sick person back in line with normal expectations. In this model, doctors serve as gatekeepers, deciding who is healthy and who is sick\u2014a relationship in which the doctor has all the power. Moreover, medical providers function as dispensers of resources for the healing of the sick. But is it appropriate to allow doctors so broad discretion in deciding who is and is not sick? And what about people who are sick, but are unwilling to leave their positions for any number of reasons? (e.g., personal\/social obligations, financial need, or lack of insurance)<\/p>\r\n\r\n<\/section><section id=\"fs-id1539334\">\r\n<h3>Conflict Perspective<\/h3>\r\n<p id=\"import-auto-id1307554\">Theorists using the conflict perspective suggest that issues with the healthcare system, as with most other social problems, are rooted in capitalist society. According to conflict theorists, capitalism and the pursuit of profit lead to the <strong><span id=\"import-auto-id2620181\">commodification<\/span><\/strong> of health: the changing of something not generally thought of as an abstract object into something that can be bought and sold in a marketplace in order to create profit for someone somewhere. In this view, people with money and power\u2014the dominant group\u2014are the ones who make decisions about how the healthcare system will be run. They therefore control the degree to which the individuals and groups without political and economic power will remain subordinate. This creates strife within the larger healthcare system and also results in personal health disparities between the dominant and subordinate groups.\u00a0The inequality that is seen in other spheres and institutions is pervasive in healthcare access, further accumulating disadvantage to already subordinate groups.<\/p>\r\n<p id=\"import-auto-id1674089\">Alongside the health disparities created by class inequalities, there are a number of health inequalities created by racism, sexism, ageism, and\u00a0LGBTQ+ discrimination. When health is a commodity, the poor are more likely to experience illness caused by inadequate diet, to live and work in unhealthy environments, and are less likely to challenge the system or its authority. In the United States, a disproportionate number of racial minorities also have less economic power, so they bear a great deal of the burden of poor health. It is not only the poor who suffer from the conflict between dominant and subordinate groups. For many years,\u00a0and only until very recently,\u00a0homosexual couples had\u00a0been denied spousal benefits, either in the form of health insurance or in terms of medical responsibility. Further adding to the issue, doctors hold a disproportionate amount of power in the doctor\/patient relationship, which provides them with extensive social and economic benefits.<\/p>\r\nDiscrimination is often the result of stigma towards specific groups or medical conditions. This stigma is rooted in the perception of an undesirable condition or attribute. Take HIV\/AIDS, for example. Because of their illness, individuals with HIV\/AIDS have lost jobs, been denied educational opportunities, been kicked out of their homes, or have been mistreated (or not treated at all) by the healthcare system.[footnote]Hiv.gov. (May 2017). Activities Combating HIV Stigma and Discrimination. Retrieved from <a href=\"https:\/\/www.hiv.gov\/federal-response\/federal-activities-agencies\/activities-combating-hiv-stigma-and-discrimination\" target=\"_blank\" rel=\"noopener\">https:\/\/www.hiv.gov\/federal-response\/federal-activities-agencies\/activities-combating-hiv-stigma-and-discrimination<\/a>.[\/footnote] Most importantly, because of the stigma attached to the disease, individuals have foregone medical assistance and have passed away as a consequence. Legal protections have been put in place, yet the stigma and discrimination remain prevalent. Until we de-stigmatize the condition itself, and despite the implementation of policy, individual acts of discrimination will likely continue. HIV continues to be an epidemic in parts of Africa, not necessarily because of stigma, but because of the lack of available treatment resources.\r\n<p style=\"text-align: center\"><strong>Watch the following two videos to see real-life examples of HIV stigmatization, even within the medical community.<\/strong>\r\n[embed]https:\/\/www.youtube.com\/watch?v=8Tm0j07lJUw[\/embed]<\/p>\r\n\r\n<p style=\"text-align: center\">[embed]https:\/\/www.youtube.com\/embed\/yiU8nQ_-q9s[\/embed]<\/p>\r\n<p id=\"import-auto-id2746266\">While conflict theorists are right to point out certain inequalities in the healthcare system, and their critiques have propelled equity-driven policy,\u00a0they do not give enough credit to medical advances that would not have been made without an economic structure to support and reward researchers, a structure that has typically been dependent on profitability. While this market solutions model has indeed provided many advances, a conflict theorist would likely respond that greater state-sponsored investment--with better public health outcomes as the goal\u2014could also effect the same evolutions in treatment. Also at issue for conflict theorists and their critics is the degree to which the hard-won medical expertise possessed by doctors and not patients might render a truly mutual understanding elusive.<\/p>\r\n\r\n<\/section><section id=\"fs-id1845462\">\r\n<h3>Symbolic Interactionism<\/h3>\r\n<p id=\"import-auto-id2199126\">According to theorists working in this perspective, health and illness are both socially constructed. As we discussed in the beginning of the module, interactionists focus on the specific meanings and causes people attribute to illness. The term <span id=\"import-auto-id1351647\"><strong>medicalization of deviance<\/strong><\/span> refers to the process that changes \u201cbad\u201d behavior into \u201csick\u201d behavior. A related process is <strong><span id=\"import-auto-id2019508\">demedicalization<\/span><\/strong>, in which \u201csick\u201d behavior is normalized again. Medicalization and demedicalization affect who responds to the patient, how people respond to the patient, and how people view the personal responsibility of the patient (Conrad and Schneider, 1992).\u00a0Under this perspective, as our perception of a condition changes, so do the social consequences of that condition.<\/p>\r\n\r\n<figure id=\"import-auto-id1221324\">\r\n\r\n[caption id=\"\" align=\"alignright\" width=\"200\"]<img src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/120\/2016\/04\/15204720\/Figure_19_05_01.jpg\" alt=\"An old engraving depicting \u201cKing Alcohol\u201d is shown.\" width=\"200\" height=\"496\" \/> <strong>Figure 3.\u00a0<\/strong>In this engraving from the nineteenth century, \u201cKing Alcohol\u201d is shown with a skeleton on a barrel of alcohol. The words \u201cpoverty,\u201d \u201cmisery,\u201d \u201ccrime,\u201d and \u201cdeath\u201d hang in the air behind him. (Photo courtesy of the Library of Congress\/Wikimedia Commons)[\/caption]<\/figure>\r\n<p id=\"import-auto-id795889\">An example of medicalization is illustrated by the history of how our society views alcohol and alcoholism. During the nineteenth century, those who drank too much were considered bad, lazy people. They were called drunks, and it was not uncommon for them to be arrested or run out of a town. Drunks were not treated in a sympathetic way because, at that time, it was thought that it was their own fault that they could not stop drinking. During the latter half of the twentieth century, however, people who drank too much were increasingly defined as alcoholics: people with a disease or a genetic predisposition to addiction who were not responsible for their drinking. With alcoholism defined as a disease and not a personal choice, alcoholics came to be viewed with more compassion and understanding. Thus, \u201cbadness\u201d was transformed into \u201csickness.\u201d<\/p>\r\n<p id=\"import-auto-id2081442\">There are numerous examples of demedicalization in history as well. During the Civil War era, slaves who frequently ran away from their owners were diagnosed with a mental disorder called <em>drapetomania<\/em>. This has since been reinterpreted, unsurprisingly, as a completely appropriate response to being enslaved. A more recent example is homosexuality, which was labeled a mental disorder or a sexual orientation disturbance by the American Psychological Association until 1973.<\/p>\r\n<p id=\"import-auto-id1357822\">While interactionism does acknowledge the subjective nature of diagnosis, it is important to remember who most benefits when a behavior becomes defined as illness or condition. Pharmaceutical companies make billions treating illnesses such as fatigue, insomnia, and hyperactivity that may not actually be illnesses in need of treatment.<\/p>\r\n<p style=\"text-align: center\"><strong>Watch this video to review and see examples of how each of these key paradigms views medicine.<\/strong>\r\n[embed]https:\/\/www.youtube.com\/embed\/6c8BCZd6GXU[\/embed]<\/p>\r\n\r\n<\/section><section id=\"fs-id1414585\" class=\"short-answer\">\r\n<div class=\"textbox learning-objectives\">\r\n<h3>Think It Over<\/h3>\r\n<div id=\"fs-id1740164\" class=\"exercise\">\r\n<div id=\"fs-id1484217\" class=\"problem\">\r\n<ul>\r\n \t<li id=\"import-auto-id1447416\">Which theoretical perspective do you think best explains the sociology of health? Why?<\/li>\r\n \t<li>What examples of medicalization and demedicalization can you think of?<\/li>\r\n<\/ul>\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<\/section>\r\n<div class=\"textbox key-takeaways\">\r\n<h3>glossary<\/h3>\r\n[glossary-page]\r\n[glossary-term]commodification:[\/glossary-term]\r\n[glossary-definition]the changing of something not generally thought of as a commodity into something that can be bought and sold in a marketplace[\/glossary-definition]\r\n\r\n[glossary-term]contested illnesses:[\/glossary-term]\r\n[glossary-definition]illnesses that are questioned or considered questionable by some medical professionals[\/glossary-definition]\r\n\r\n[glossary-term]demedicalization:[\/glossary-term]\r\n[glossary-definition]the social process that normalizes \u201csick\u201d behavior[\/glossary-definition]\r\n\r\n[glossary-term]legitimation:[\/glossary-term]\r\n[glossary-definition]the act of a physician certifying that an illness is genuine[\/glossary-definition]\r\n\r\n[glossary-term]medicalization of deviance:[\/glossary-term]\r\n[glossary-definition]the process that changes \u201cbad\u201d behavior into \u201csick\u201d behavior[\/glossary-definition]\r\n\r\n[glossary-term]medical sociology:[\/glossary-term]\r\n[glossary-definition]the systematic study of how humans manage issues of health and illness, disease and disorders, and healthcare for both the sick and the healthy[\/glossary-definition]\r\n\r\n[glossary-term]sick role:[\/glossary-term]\r\n[glossary-definition]the pattern of expectations that define appropriate behavior for the sick and for those who take care of them[\/glossary-definition]\r\n\r\n[glossary-term]stigmatization of illness:[\/glossary-term]\r\n[glossary-definition]illnesses that are discriminated against and whose sufferers are looked down upon or even shunned by society[\/glossary-definition]\r\n[\/glossary-page]\r\n\r\n<\/div>\r\n<section>Hiv.gov. (May 2017). Activities Combating HIV Stigma and Discrimination. Retrieved from <a href=\"https:\/\/www.hiv.gov\/federal-response\/federal-activities-agencies\/activities-combating-hiv-stigma-and-discrimination\" target=\"_blank\" rel=\"noopener\">https:\/\/www.hiv.gov\/federal-response\/federal-activities-agencies\/activities-combating-hiv-stigma-and-discrimination<\/a>. \u21b5Licenses and Attributions<\/section>","rendered":"<div class=\"textbox learning-objectives\">\n<h3>Learning outcomes<\/h3>\n<ul>\n<li>Explain the cultural significance and social construction of health<\/li>\n<li><span style=\"color: #333333\">Apply functionalist, conflict theorist, and symbolic\u00a0interactionist perspectives to health issues<\/span><\/li>\n<\/ul>\n<\/div>\n<p>Medical sociology is the systematic study of how humans manage issues of health and illness, disease and disorders, and healthcare for both the sick and the healthy. In this section, you&#8217;ll learn about the importance of medical practices and how the social construction of health explains how society both shapes medical ideas and is shaped by them.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-6029\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2034\/2016\/05\/28183911\/photo-1471864190281-a93a3070b6de.jpeg\" alt=\"This is a zoomed in photo on a pile of prescription medications.\" width=\"522\" height=\"348\" \/><\/p>\n<h2>The Cultural Significance of Health<\/h2>\n<p>If sociology is the systematic study of human behavior in society, <strong><span id=\"import-auto-id2417119\">medical sociology<\/span><\/strong> is the systematic study of how humans manage issues of health and illness, disease and disorders, and healthcare for both the sick and the healthy. Medical sociologists study the physical, mental, and social components of health and illness. Major topics for medical sociologists include the doctor\/patient relationship and power dynamics within the relationship, the structure and socioeconomics of healthcare, unequal access to healthcare (what is often referred to as health inequality),\u00a0and how culture impacts attitudes toward specific\u00a0diseases, conditions, and wellness.<\/p>\n<p id=\"import-auto-id1175361\">The social construction of health is a major research topic within medical sociology. At first glance, the concept of a social construction of health does not seem to make sense. After all, if disease is a measurable, physiological problem, then there can be no question of socially constructing disease, right? Well, it\u2019s not that simple. The idea of the social construction of health emphasizes the socio-cultural aspects of the discipline\u2019s approach to physical, objectively definable phenomena. Sociologists Peter Conrad and Kristin Barker (2010) offer a comprehensive framework for understanding the major findings of the last fifty years of development in this concept. Their summary categorizes the findings in the field under three subheadings: the cultural meaning of illness, the social construction of the illness experience, and the social construction of medical knowledge.<\/p>\n<section id=\"h21901_01\">\n<h3>The Cultural Meaning of Illness<\/h3>\n<p id=\"import-auto-id2337591\">Many medical sociologists contend that illnesses have both a biological and an experiential component, and that these components exist independently\u00a0of\u00a0and external to\u00a0each other. Our culture, not our biology, dictates which illnesses are stigmatized and which are not, which are considered disabilities and which are not, and which are deemed contestable (meaning some medical professionals may find the existence of this ailment questionable) as opposed to definitive (illnesses that are unquestionably recognized in the medical profession) in the medical field\u00a0(Conrad and Barker, 2010).<\/p>\n<p id=\"import-auto-id1820434\">For instance, sociologist Erving Goffman (1963) described how social stigmas hinder individuals from fully integrating into society. In essence, Goffman (1963) suggests we might view illness as a stigma that can push others to view the ill individual\u00a0in an undesirable manner. The <span id=\"import-auto-id2286466\"><strong>stigmatization of illness<\/strong><\/span> often has the greatest effect on the patient and the kind of care they\u00a0receive. Many contend that our society and even our healthcare institutions discriminate against certain diseases\u2014like mental disorders, AIDS, venereal diseases, and skin disorders (Sartorius, 2007). Facilities for these diseases may be sub-par relative to facilities aimed at addressing and alleviating other conditions; they may be segregated from other healthcare areas or relegated to a poorer environment. The stigma attached to a specific condition\u00a0may keep people from seeking help for such conditions,\u00a0consequently being detrimental to the individual&#8217;s and society&#8217;s well-being.<\/p>\n<p id=\"import-auto-id3078986\"><strong><span id=\"import-auto-id2770690\">Contested illnesses<\/span><\/strong> are those that are questioned or questionable by\u00a0a fraction of\u00a0medical professionals. Disorders like fibromyalgia or chronic fatigue syndrome may be either true, objective,\u00a0and tangible\u00a0illnesses or, as argued by some medical professionals, may exist only in patients\u2019 heads. This dynamic can affect how a patient seeks treatment and what kind of treatment they\u00a0receive.<\/p>\n<h3><span style=\"color: #000000\">The Sick Role<\/span><\/h3>\n<p><span style=\"color: #333333\">Sick role is a term used in medical sociology regarding sickness and the rights and obligations of the affected. It is a concept created by the American sociologist Talcott Parsons in 1951.\u00a0Parsons argued that the best way to understand illness sociologically is to view it as a form of deviance that disturbs the social functioning of society. The general idea is that the individual who has fallen ill is not only physically sick, but now adheres to the specifically patterned social role of being sick. &#8220;Being Sick&#8221; is not simply a &#8220;condition&#8221;; it contains within itself customary rights and obligations based on the social norms that surround it, and therefore plays a role in everyday, normative interactions.<\/span><\/p>\n<p><span style=\"color: #333333\">Parsons&#8217; theory outlined\u00a0two rights of a sick person\u00a0along with two obligations. The sick person&#8217;s rights are: being exempt from normal social roles, and not being responsible for their condition. Conversely, the sick person&#8217;s obligations include trying to get well and cooperating with medical professionals.<\/span><\/p>\n<\/section>\n<section id=\"h21901_02\">\n<h3>The Social Construction of the Illness Experience<\/h3>\n<p>The idea of the social construction of the illness experience is based on the concept of reality as a social construction. In other words, there is no objective reality; there are only individual perceptions of it, which are always relative and involve a process of construction. The social construction of the illness experience addresses the way some patients control the manner in which they reveal their diseases, and the lifestyle adaptations patients develop to cope with their illnesses.<\/p>\n<div style=\"width: 260px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/120\/2016\/04\/15204710\/Figure_19_01_01.jpg\" alt=\"A chart of numerical pain levels ranging from 0 to 10 is shown here. 0 being 'No pain', and 10 being 'Excruciating pain'.\" width=\"250\" height=\"375\" \/><\/p>\n<p class=\"wp-caption-text\"><strong>Figure 1.\u00a0<\/strong>The Mosby pain rating scale helps health care providers assess an individual\u2019s level of pain. What might a symbolic interactionist observe about this method? (Photo courtesy of wrestlingentropy\/flickr)<\/p>\n<\/div>\n<p id=\"import-auto-id1425675\">In terms of constructing the illness experience, culture and individual personality both play a significant role. For some people, a long-term illness can have the effect of making their world smaller, leading to a life that is\u00a0more defined by the illness than\u00a0by anything else. Their illness becomes their marker, or their focal status.\u00a0For others, illness can be a chance for discovery, for re-imagining a new self (Conrad and Barker, 2007). Culture plays a substantial role in how an individual experiences illness. Widespread diseases like AIDS or breast cancer have specific cultural markers that have changed over the years and that govern how individuals\u2014and society\u2014view both the condition and the individual directly affected by the condition.<\/p>\n<p id=\"import-auto-id1883634\">Today, many institutions of wellness acknowledge the degree to which individual perceptions shape the nature of health and illness. Regarding physical activity, for instance, the Centers for Disease Control (CDC) recommends that individuals use a standard level of exertion to assess their physical activity. This Rating of Perceived Exertion (RPE) gives a more complete view of an individual\u2019s actual exertion level, since heart rate or pulse measurements may be affected by medication or other factors\u00a0(Centers for Disease Control, 2011). Similarly, many medical professionals use a comparable, somewhat universal\u00a0scale for perceived pain to help determine pain management strategies.<\/p>\n<p style=\"text-align: center\"><strong>Watch this video to learn more about the sick role and ways that society influences health. Look for examples of how health, disease, and illness are socially constructed.<\/strong><br \/>\n<iframe loading=\"lazy\" id=\"oembed-1\" title=\"Health &amp; Medicine: Crash Course Sociology #42\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/8NGlENS1qgo?feature=oembed&#38;rel=0\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<\/section>\n<section id=\"h21901_03\">\n<h3>The Social Construction of Medical Knowledge<\/h3>\n<p id=\"import-auto-id2753636\">Conrad and Barker show how medical knowledge is socially constructed; that is, it can both reflect and reproduce inequalities in gender, class, race, and ethnicity. Conrad and Barker (2011) use the example of the social construction of women\u2019s health and how medical knowledge has changed significantly in the course of a few generations. For instance, in the early nineteenth century, pregnant women were discouraged from driving or dancing for fear of harming the unborn child, much as they are discouraged, with more valid and evidence-based reason, from smoking or drinking alcohol today.<\/p>\n<div class=\"textbox exercises\">\n<section id=\"h21901_03\">\n<h3 class=\"title\">Has Breast Cancer Awareness Gone Too Far?<\/h3>\n<div style=\"width: 260px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/120\/2016\/04\/15204712\/Figure_19_01_02.jpg\" alt=\"Pink ribbon lollipops are shown here.\" width=\"250\" height=\"375\" \/><\/p>\n<p class=\"wp-caption-text\"><strong>Figure 2.\u00a0<\/strong>Pink ribbons are a ubiquitous reminder of breast cancer. But do pink ribbon chocolates do anything to eradicate the disease? (Photo courtesy of wishuponacupcake\/Wikimedia Commons)<\/p>\n<\/div>\n<p>Every October, the world turns pink. Football and baseball players wear pink accessories. Skyscrapers and large public buildings are lit with pink lights at night. Shoppers can choose from a huge array of pink products. In 2014, people wanting to support the fight against breast cancer could purchase any of the following pink products: KitchenAid mixers, Master Lock padlocks and bike chains, Wilson tennis rackets, Fiat cars, and Smith &amp; Wesson handguns. You read that correctly. The goal of all these pink products is to raise awareness and money for breast cancer. However, the relentless creep of pink has many people wondering if the pink marketing juggernaut has gone too far.<\/p>\n<p id=\"eip-52\">Pink has been associated with breast cancer since 1991, when the Susan G. Komen Foundation handed out pink ribbons at its 1991 Race for the Cure event. Since then, the pink ribbon has appeared on countless products, and then by extension, the color pink has come to represent support for a cure of the disease. No one can argue about the Susan G. Komen Foundation\u2019s mission\u2014to find a cure for breast cancer\u2014or the fact that the group has raised millions of dollars for research and care. However, some people question if, or how much, all these products really help in the fight against breast cancer (Begos, 2011).<\/p>\n<p id=\"import-auto-id1497539\">The advocacy group Breast Cancer Action (BCA) position themselves as watchdogs of other agencies fighting breast cancer. They accept no funding from entities, like those in the pharmaceutical industry, with potential profit connections to this health industry. They\u2019ve developed a trademarked \u201cThink Before You Pink\u201d campaign to provoke consumer questioning of the end contributions made to breast cancer by companies hawking pink wares. They do not advise against \u201cpink\u201d purchases; they just want consumers to be informed about how much money is involved, where it comes from, and where it will go. For instance, what percentage of each purchase goes to breast cancer causes? BCA does not judge how much is enough, but it informs customers and then encourages them to consider whether they feel the amount is enough (Think Before You Pink, 2012).<\/p>\n<p id=\"import-auto-id2903030\">BCA also suggests that consumers make sure that the product they are buying does not actually <em>contribute<\/em> to breast cancer, a phenomenon they call \u201cpinkwashing.\u201d This issue made national headlines in 2010, when the Susan G. Komen Foundation partnered with Kentucky Fried Chicken (KFC) on a promotion called \u201cBuckets for the Cure.\u201d For every bucket of grilled or regular fried chicken, KFC would donate fifty cents to the Komen Foundation, with the goal of reaching 8 million dollars: the largest single donation received by the foundation. However, some critics saw the partnership as an unholy alliance. Higher body fat and eating fatty foods has been linked to increased cancer risks, and detractors, including BCA, called the Komen Foundation out on this apparent contradiction. Komen\u2019s response was that the program did a great deal to raise awareness in low-income communities, where Komen previously had little outreach (Hutchison, 2010), therefore justifying their seemingly contradictory goals.<\/p>\n<p>What do you think? Are fundraising and awareness important enough to trump issues of health? What other examples of \u201cpinkwashing\u201d can you think of?<\/p>\n<\/section>\n<\/div>\n<div class=\"textbox key-takeaways\">\n<h3>Further Research<\/h3>\n<p>Visit the <a href=\"http:\/\/www.humanologyproject.org\/\" target=\"_blank\" rel=\"noopener\">Humanology Project website<\/a>, which works to\u00a0shift common perceptions and misconceptions about illnesses.<\/p>\n<\/div>\n<div class=\"textbox learning-objectives\">\n<h3>Think It Over<\/h3>\n<div id=\"sh1901_ex01\" class=\"exercise\">\n<div id=\"fs-id2109896\" class=\"problem\">\n<ul>\n<li>Pick a common illness and describe which parts of it are medically constructed, and which parts are socially constructed.<\/li>\n<li>What diseases are the most stigmatized? Which are the least? Is this different in different cultures or social classes?<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n<h2>Theoretical Perspectives on Health and Medicine<\/h2>\n<p><span style=\"color: #333333\">Each of the three major\u00a0sociological theoretical perspectives approach the topics of health, illness, and medicine differently. You may prefer just one of the theories that follow, or you may find that combining theories and perspectives provides a fuller and more accurate\u00a0picture of how we experience\u00a0and understand health and wellness.<\/span><\/p>\n<section id=\"fs-id1842585\">\n<h3>Functionalism<\/h3>\n<p id=\"import-auto-id1373740\">According to the functionalist perspective, health is vital to the stability of the society, and therefore sickness is a sanctioned form of deviance. Talcott Parsons (1951) was the first to discuss this in terms of the <strong><span id=\"import-auto-id1294726\">sick role<\/span><\/strong>: patterns of expectations that define appropriate behavior for the sick and for those who take care of them.<\/p>\n<p id=\"import-auto-id2851281\">According to Parsons, the sick person has a specific role with both rights and responsibilities. To start with, they have\u00a0not chosen to be sick and should not be treated as responsible for their condition. The sick person also has the right of being exempt from normal social roles; they are\u00a0not required to fulfill the obligation of a well person and can avoid normal responsibilities without censure. However, this exemption is temporary and relative to the severity of the illness. The exemption also requires <strong>legitimization<\/strong>\u00a0by a physician; that is, a physician must certify that the illness is genuine.<\/p>\n<p id=\"import-auto-id2764853\">The responsibility of the sick person is twofold: to try to get well and to seek technically competent help from a physician. If the sick person stays ill longer than is appropriate (malingers),\u00a0they may be stigmatized.<\/p>\n<p id=\"import-auto-id1425474\">Parsons argues that since the sick are unable to fulfill their normal societal roles, their sickness weakens the society. Therefore, it is sometimes necessary for various forms of social control to bring the behavior of a sick person back in line with normal expectations. In this model, doctors serve as gatekeepers, deciding who is healthy and who is sick\u2014a relationship in which the doctor has all the power. Moreover, medical providers function as dispensers of resources for the healing of the sick. But is it appropriate to allow doctors so broad discretion in deciding who is and is not sick? And what about people who are sick, but are unwilling to leave their positions for any number of reasons? (e.g., personal\/social obligations, financial need, or lack of insurance)<\/p>\n<\/section>\n<section id=\"fs-id1539334\">\n<h3>Conflict Perspective<\/h3>\n<p id=\"import-auto-id1307554\">Theorists using the conflict perspective suggest that issues with the healthcare system, as with most other social problems, are rooted in capitalist society. According to conflict theorists, capitalism and the pursuit of profit lead to the <strong><span id=\"import-auto-id2620181\">commodification<\/span><\/strong> of health: the changing of something not generally thought of as an abstract object into something that can be bought and sold in a marketplace in order to create profit for someone somewhere. In this view, people with money and power\u2014the dominant group\u2014are the ones who make decisions about how the healthcare system will be run. They therefore control the degree to which the individuals and groups without political and economic power will remain subordinate. This creates strife within the larger healthcare system and also results in personal health disparities between the dominant and subordinate groups.\u00a0The inequality that is seen in other spheres and institutions is pervasive in healthcare access, further accumulating disadvantage to already subordinate groups.<\/p>\n<p id=\"import-auto-id1674089\">Alongside the health disparities created by class inequalities, there are a number of health inequalities created by racism, sexism, ageism, and\u00a0LGBTQ+ discrimination. When health is a commodity, the poor are more likely to experience illness caused by inadequate diet, to live and work in unhealthy environments, and are less likely to challenge the system or its authority. In the United States, a disproportionate number of racial minorities also have less economic power, so they bear a great deal of the burden of poor health. It is not only the poor who suffer from the conflict between dominant and subordinate groups. For many years,\u00a0and only until very recently,\u00a0homosexual couples had\u00a0been denied spousal benefits, either in the form of health insurance or in terms of medical responsibility. Further adding to the issue, doctors hold a disproportionate amount of power in the doctor\/patient relationship, which provides them with extensive social and economic benefits.<\/p>\n<p>Discrimination is often the result of stigma towards specific groups or medical conditions. This stigma is rooted in the perception of an undesirable condition or attribute. Take HIV\/AIDS, for example. Because of their illness, individuals with HIV\/AIDS have lost jobs, been denied educational opportunities, been kicked out of their homes, or have been mistreated (or not treated at all) by the healthcare system.<a class=\"footnote\" title=\"Hiv.gov. (May 2017). Activities Combating HIV Stigma and Discrimination. Retrieved from https:\/\/www.hiv.gov\/federal-response\/federal-activities-agencies\/activities-combating-hiv-stigma-and-discrimination.\" id=\"return-footnote-7888-1\" href=\"#footnote-7888-1\" aria-label=\"Footnote 1\"><sup class=\"footnote\">[1]<\/sup><\/a> Most importantly, because of the stigma attached to the disease, individuals have foregone medical assistance and have passed away as a consequence. Legal protections have been put in place, yet the stigma and discrimination remain prevalent. Until we de-stigmatize the condition itself, and despite the implementation of policy, individual acts of discrimination will likely continue. HIV continues to be an epidemic in parts of Africa, not necessarily because of stigma, but because of the lack of available treatment resources.<\/p>\n<p style=\"text-align: center\"><strong>Watch the following two videos to see real-life examples of HIV stigmatization, even within the medical community.<\/strong><br \/>\n<iframe loading=\"lazy\" id=\"oembed-2\" title=\"HIV, AIDS patients face discrimination\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/8Tm0j07lJUw?feature=oembed&#38;rel=0\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p style=\"text-align: center\"><iframe loading=\"lazy\" id=\"oembed-3\" title=\"Living With The Stigma Of HIV\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/yiU8nQ_-q9s?feature=oembed&#38;rel=0\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p id=\"import-auto-id2746266\">While conflict theorists are right to point out certain inequalities in the healthcare system, and their critiques have propelled equity-driven policy,\u00a0they do not give enough credit to medical advances that would not have been made without an economic structure to support and reward researchers, a structure that has typically been dependent on profitability. While this market solutions model has indeed provided many advances, a conflict theorist would likely respond that greater state-sponsored investment&#8211;with better public health outcomes as the goal\u2014could also effect the same evolutions in treatment. Also at issue for conflict theorists and their critics is the degree to which the hard-won medical expertise possessed by doctors and not patients might render a truly mutual understanding elusive.<\/p>\n<\/section>\n<section id=\"fs-id1845462\">\n<h3>Symbolic Interactionism<\/h3>\n<p id=\"import-auto-id2199126\">According to theorists working in this perspective, health and illness are both socially constructed. As we discussed in the beginning of the module, interactionists focus on the specific meanings and causes people attribute to illness. The term <span id=\"import-auto-id1351647\"><strong>medicalization of deviance<\/strong><\/span> refers to the process that changes \u201cbad\u201d behavior into \u201csick\u201d behavior. A related process is <strong><span id=\"import-auto-id2019508\">demedicalization<\/span><\/strong>, in which \u201csick\u201d behavior is normalized again. Medicalization and demedicalization affect who responds to the patient, how people respond to the patient, and how people view the personal responsibility of the patient (Conrad and Schneider, 1992).\u00a0Under this perspective, as our perception of a condition changes, so do the social consequences of that condition.<\/p>\n<figure id=\"import-auto-id1221324\">\n<div style=\"width: 210px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/120\/2016\/04\/15204720\/Figure_19_05_01.jpg\" alt=\"An old engraving depicting \u201cKing Alcohol\u201d is shown.\" width=\"200\" height=\"496\" \/><\/p>\n<p class=\"wp-caption-text\"><strong>Figure 3.\u00a0<\/strong>In this engraving from the nineteenth century, \u201cKing Alcohol\u201d is shown with a skeleton on a barrel of alcohol. The words \u201cpoverty,\u201d \u201cmisery,\u201d \u201ccrime,\u201d and \u201cdeath\u201d hang in the air behind him. (Photo courtesy of the Library of Congress\/Wikimedia Commons)<\/p>\n<\/div>\n<\/figure>\n<p id=\"import-auto-id795889\">An example of medicalization is illustrated by the history of how our society views alcohol and alcoholism. During the nineteenth century, those who drank too much were considered bad, lazy people. They were called drunks, and it was not uncommon for them to be arrested or run out of a town. Drunks were not treated in a sympathetic way because, at that time, it was thought that it was their own fault that they could not stop drinking. During the latter half of the twentieth century, however, people who drank too much were increasingly defined as alcoholics: people with a disease or a genetic predisposition to addiction who were not responsible for their drinking. With alcoholism defined as a disease and not a personal choice, alcoholics came to be viewed with more compassion and understanding. Thus, \u201cbadness\u201d was transformed into \u201csickness.\u201d<\/p>\n<p id=\"import-auto-id2081442\">There are numerous examples of demedicalization in history as well. During the Civil War era, slaves who frequently ran away from their owners were diagnosed with a mental disorder called <em>drapetomania<\/em>. This has since been reinterpreted, unsurprisingly, as a completely appropriate response to being enslaved. A more recent example is homosexuality, which was labeled a mental disorder or a sexual orientation disturbance by the American Psychological Association until 1973.<\/p>\n<p id=\"import-auto-id1357822\">While interactionism does acknowledge the subjective nature of diagnosis, it is important to remember who most benefits when a behavior becomes defined as illness or condition. Pharmaceutical companies make billions treating illnesses such as fatigue, insomnia, and hyperactivity that may not actually be illnesses in need of treatment.<\/p>\n<p style=\"text-align: center\"><strong>Watch this video to review and see examples of how each of these key paradigms views medicine.<\/strong><br \/>\n<iframe loading=\"lazy\" id=\"oembed-4\" title=\"Relating social theories to medicine | Society and Culture | MCAT | Khan Academy\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/6c8BCZd6GXU?feature=oembed&#38;rel=0\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<\/section>\n<section id=\"fs-id1414585\" class=\"short-answer\">\n<div class=\"textbox learning-objectives\">\n<h3>Think It Over<\/h3>\n<div id=\"fs-id1740164\" class=\"exercise\">\n<div id=\"fs-id1484217\" class=\"problem\">\n<ul>\n<li id=\"import-auto-id1447416\">Which theoretical perspective do you think best explains the sociology of health? Why?<\/li>\n<li>What examples of medicalization and demedicalization can you think of?<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n<div class=\"textbox key-takeaways\">\n<h3>glossary<\/h3>\n<div class=\"titlepage\">\n<dl>\n<dt>commodification:<\/dt>\n<dd>the changing of something not generally thought of as a commodity into something that can be bought and sold in a marketplace<\/dd>\n<dt>contested illnesses:<\/dt>\n<dd>illnesses that are questioned or considered questionable by some medical professionals<\/dd>\n<dt>demedicalization:<\/dt>\n<dd>the social process that normalizes \u201csick\u201d behavior<\/dd>\n<dt>legitimation:<\/dt>\n<dd>the act of a physician certifying that an illness is genuine<\/dd>\n<dt>medicalization of deviance:<\/dt>\n<dd>the process that changes \u201cbad\u201d behavior into \u201csick\u201d behavior<\/dd>\n<dt>medical sociology:<\/dt>\n<dd>the systematic study of how humans manage issues of health and illness, disease and disorders, and healthcare for both the sick and the healthy<\/dd>\n<dt>sick role:<\/dt>\n<dd>the pattern of expectations that define appropriate behavior for the sick and for those who take care of them<\/dd>\n<dt>stigmatization of illness:<\/dt>\n<dd>illnesses that are discriminated against and whose sufferers are looked down upon or even shunned by society<\/dd>\n<\/dl>\n<\/div>\n<\/div>\n<section>Hiv.gov. (May 2017). Activities Combating HIV Stigma and Discrimination. Retrieved from <a href=\"https:\/\/www.hiv.gov\/federal-response\/federal-activities-agencies\/activities-combating-hiv-stigma-and-discrimination\" target=\"_blank\" rel=\"noopener\">https:\/\/www.hiv.gov\/federal-response\/federal-activities-agencies\/activities-combating-hiv-stigma-and-discrimination<\/a>. \u21b5Licenses and Attributions<\/section>\n\n\t\t\t <section class=\"citations-section\" role=\"contentinfo\">\n\t\t\t <h3>Candela Citations<\/h3>\n\t\t\t\t\t <div>\n\t\t\t\t\t\t <div id=\"citation-list-7888\">\n\t\t\t\t\t\t\t <div class=\"licensing\"><div class=\"license-attribution-dropdown-subheading\">CC licensed content, Original<\/div><ul class=\"citation-list\"><li>Introduction to The Social Construction of Health. <strong>Provided by<\/strong>: Lumen Learning. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\">CC BY: Attribution<\/a><\/em><\/li><li>Revision, Modification, and Original Content. <strong>Authored by<\/strong>: Florencia Silveira for Lumen Learning. <strong>Provided by<\/strong>: Lumen Learning. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\">CC BY: Attribution<\/a><\/em><\/li><li>Health and Medicine. <strong>Provided by<\/strong>: CrashCourse. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/www.youtube.com\/watch?v=8NGlENS1qgo&#038;index=43&#038;list=PL8dPuuaLjXtMJ-AfB_7J1538YKWkZAnGA\">https:\/\/www.youtube.com\/watch?v=8NGlENS1qgo&#038;index=43&#038;list=PL8dPuuaLjXtMJ-AfB_7J1538YKWkZAnGA<\/a>. <strong>License<\/strong>: <em>Other<\/em>. <strong>License Terms<\/strong>: Standard YouTube License<\/li><li>Additional Content on Aids. <strong>Authored by<\/strong>: Florencia Silveira. <strong>Provided by<\/strong>: Lumen Learning. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\">CC BY: Attribution<\/a><\/em><\/li><\/ul><div class=\"license-attribution-dropdown-subheading\">CC licensed content, Shared previously<\/div><ul class=\"citation-list\"><li>Health and Medicine. <strong>Authored by<\/strong>: OpenStax CNX. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/cnx.org\/contents\/AgQDEnLI@10.1:X5DRDy9q@3\/Introduction-to-Health-and-Medicine\">https:\/\/cnx.org\/contents\/AgQDEnLI@10.1:X5DRDy9q@3\/Introduction-to-Health-and-Medicine<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\">CC BY: Attribution<\/a><\/em>. <strong>License Terms<\/strong>: Download for free at http:\/\/cnx.org\/contents\/02040312-72c8-441e-a685-20e9333f3e1d@3.49<\/li><li>Colorful medication. <strong>Authored by<\/strong>: freestocks.org. <strong>Provided by<\/strong>: Unsplash. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/unsplash.com\/photos\/nss2eRzQwgw\">https:\/\/unsplash.com\/photos\/nss2eRzQwgw<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/about\/cc0\">CC0: No Rights Reserved<\/a><\/em>. <strong>License Terms<\/strong>: https:\/\/unsplash.com\/license<\/li><li>The Sick Role, The Functionalist Perspective. <strong>Provided by<\/strong>: Boundless. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/courses.lumenlearning.com\/boundless-sociology\/\">https:\/\/courses.lumenlearning.com\/boundless-sociology\/<\/a>. <strong>Project<\/strong>: Boundless Sociology. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><\/ul><div class=\"license-attribution-dropdown-subheading\">All rights reserved content<\/div><ul class=\"citation-list\"><li>Relating social theories to medicine. <strong>Provided by<\/strong>: Khan Academy. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/www.youtube.com\/watch?v=6c8BCZd6GXU\">https:\/\/www.youtube.com\/watch?v=6c8BCZd6GXU<\/a>. <strong>License<\/strong>: <em>Other<\/em>. <strong>License Terms<\/strong>: Standard YouTube License<\/li><li>HIV, AIDS patients face discrimination. <strong>Provided by<\/strong>: ABC7 WJLA. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/www.youtube.com\/watch?v=8Tm0j07lJUw\">https:\/\/www.youtube.com\/watch?v=8Tm0j07lJUw<\/a>. <strong>License<\/strong>: <em>Other<\/em>. <strong>License Terms<\/strong>: Standard YouTube License<\/li><li>Living With The Stigma Of HIV. <strong>Provided by<\/strong>: BBC Three. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/www.youtube.com\/watch?v=yiU8nQ_-q9s\">https:\/\/www.youtube.com\/watch?v=yiU8nQ_-q9s<\/a>. <strong>License<\/strong>: <em>Other<\/em>. <strong>License Terms<\/strong>: Standard YouTube License<\/li><\/ul><\/div>\n\t\t\t\t\t\t <\/div>\n\t\t\t\t\t <\/div>\n\t\t\t <\/section><hr class=\"before-footnotes clear\" \/><div class=\"footnotes\"><ol><li id=\"footnote-7888-1\">Hiv.gov. (May 2017). Activities Combating HIV Stigma and Discrimination. 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