The capitalists exploits the workers since they do not get recognition for what they do as get have minimum wage and make surplus profit by persuading the lower class to buy the goods by advertising. The capitalists are opposite of socialism since the capitalists control what we think and what we do, the working class people are ‘brain washed’ into accepting set of beliefs that benefits the capitalists. These messages are seen to be transmitted through the cultural institutions such as media, which are controlled by the capitalists to influence the workers. The capitalists creates the dominant values that benefits the powerful and disadvantages the powerless. For instance, the monarch claim their position as god gifted and the religion help supports their point, due to which the working class people are convinced to what have to say since they have faith in their religion.
Inequality in capitalist societies still exists and is unfair but they do not recognise it because the capitalists convince them that it is their fault for not achieving what they want. For instance, the capitalists would convince working class by saying the GCSE result of upper class is higher than that of lower class because they have been able to provide private tutors for their children, and it would be their fault if their children got low grade, since they were not able to provide their children with private tutors.
Marxist believes that the definition of health and illness and the health and social care services provided to the powerless serve the interests of the powerful dominant classes. The capitalists regard people who do not produce wealth as unhealthy. Marxists believe that doctors are the example of agents that work for capitalists interests rather than those of patients so that they can go to work as soon as possible and provide the capitalists with healthy work force. The government allows the capitalists to make profit from the products that cause health issues, such as alcohol and tobacco. The industries that capitalists establish cause to pollute the atmosphere and produce toxic waste that affect the people and get ill. This approach believes that illness is related to difference in the social class. For instance, poverty-stricken areas have higher levels of illness and have lower life expectancy. According to this approach, the government do no handle this issue as this would make people ill, as this leads this money and the capitalists would make advantage of it.
- Feminists
Feminism is a range of movements and ideologies that work towards goal, which establish and achieve equal political, economic, cultural, personal and social rights for women. Feminism seeks to establish equal opportunities for women in different sectors like education and employment and supports for equal rights and equality of women. The feminists believe that gender inequality still exists in today’s society.
Feminism is a perspective that believes that women are disadvantaged in the society and should have equal rights with the men. The feminists are critical of patriarchy. Patriarchy is a social system where the men hold the power and authority. The women have fought throughout the history for their rights and equality, which caused creation of waves of feminism. The first wave was observed in the mid late 19th century, campaigning for the change in rights for the women in early 20th century. They campaigned for two main strategy; right to vote and right to be educated. In 1928, the women were given the right to vote, but only rich women over 30 who owned property were allowed.
The second wave of feminism was observed from 1960s, this lead to the formation of Women’s Rights Movement (WRM) and Women’s Liberation Movement (WLM). These organisations campaigned for right to equal pay act, domestic violence, sex discrimination, employment, violence services, education, family and health & social care. WRM and WLM were successful in achieving their rights for Equal pay Act in (1970), Sex Discrimination Act (1975) and right to be educated and be employed.
Due to variation in opinion of causes of gender inequality and solutions to it, there was formation of three types of feminism; liberal feminism, Marxist feminism and radical feminism. Liberal feminism proposed that gender inequality stills exists in the society because of social and cultural attitudes that is gained by the process of socialisation i.e. primary and secondary socialisation. Liberal feminist helped to promote equality through Sex Discrimination and Equal Pay Act. Marxist feminism explained that the capitalists to earn profit using women. They would persuade women to buy groceries such as fabric softener, so that they would spend their money and exploit them. Radical feminism explains that the society is ruled by the men, whereas the female are oppressed, exploited and are regarded as second-class citizen. It states that men exploit women by relying on free domestic labour and men may use aggression to control women in the home. Through the gender role socialisation, women are convinced to accept female subordination and see motherhood as a key goal in life.
The feminist writers have focused male domination in the medical profession and its effects on women. They are concerned with the way in which pregnancy and childbirth have been regarded as a medical issue rather than as natural process. Feminist writers have protested on the way which the medical professions and related pharmaceutical industries have given low priority about development and promotion of male contraceptives. It explains how women had to face medical conditions such as mental health, anxiety and depression using the contraceptives, due to which their position in the society is exploited. Theorist have been concerned about the impact of social inequality on women’s health and dual role of women.
- Interactionism
The founder of interactionism was Max Weber.
Interpretivist describe that the society and the social structure are seen as the creation of individuals. Unlike functionalists, they see individuals of the society as actors not as puppets. The individuals have free will and are able to make choices of their own. Unlike in the functionalism, the power come from bottom to up. They believe that the people’s choices or decisions are influenced by how they make sense of social situations. For instance, marriage means different things to different person; an individual whose parents are divorced might have negative definition of marriage, whereas the individual who have grown up in a good family might have positive definition of marriage. The Interpretivist suggests that people make impression on how you perceive symbols, they make impression on what you wear. For instance, people will make assumption that you are smart, just because you wear glasses. These theorists are concerned with the small or micro scale situations rather than the systems, they focus on the individuals in social interaction situations. Interpretivist believe that our identity is based on how we see ourselves or how other sees us. For instance, if a student in the school is praised and us labelled as smart, then he/she might do better his/her studies as this helps to boost their self-esteem. We get influenced by media, friends and family about how we see ourselves.
According to Browne labelling refers to “defining a person or a group in a certain way-as a particular ‘type‘ of person or a group”. According to Interpretivist people are attached to the labelled and it can actually damage some group of people such as disabled people. The person labelled behaves in the same way expected and they have fulfilled the prophecy and lived up to the label.
Interactionist believe that health and illness are the product of social construction that affects people’s wellbeing. They believe that disease is socially constructed”. Disease does not exist as a social phenomenon until it is somehow perceived as existing” (Rosenberg 1989). This approach focuses on negotiation between the patients and medical practitioners. For instance, a female patient would feel comfortable to talk to female doctor about her reproductive health rather than a male doctor. They are concerned with labelling and self-image and social interaction differences affected by class, ethnicity and age. Symbolic interactionism is critical of Marxists and Functionalists as Interpretivist look individual as subjective through doctor and patient exchange. The argument here is that illness is a social diagnosis among actors rather than just a matter of physiological malfunction.
- Postmodernism
Postmodernism is an approach in sociology as well as in other subjects, which believes that society is changing rapidly and continuously, which is marked as an uncertainty and the social structure are being replaced by whole range of different and constantly changing social relationships. This theory believes that modern society was developed at around 1750s and has been replaced by the end of 20th century due to massive social change. The Functionalists and the Marxism perspective might be interested in modernity as they thought that if properly understood, societies could be improved. But the postmodernists argue that there is no longer a place in sociology for these type of theory. This theory suggests that the postmodern society has no progress, predictability (norms that people would predict to behave), order and continuity, due to which insecurities and anxiety has been developed in people living in postmodern society as people do not know how to behave and what is expected from others. Order, predictability and continuity are essential as it gives us routine and reassurance that provides us safety and security. Society has changed as it has gone through different industrial revolution or industrialisation, technological advances, urbanisation and secularisation. Industrialisation is the process of going from agricultural economy to heavy industrial/manufacturing economy. Secularisation is the decline of belief in religion due to rise of science whereas urbanisation means movement of people from rural areas to towns and cities.
Postmodernists suggests that modern society no longer exists and we live in a postmodern era or in post modernity, where the society is media saturated. Due to the revolution of technology, globalisation has occurred where the world has become a smaller place to live in. The mass media has dominated our lives to the extent that we confuse media images with reality. This theory concludes that people in the postmodern society can have their own form of identities, how they want to see themselves or how they want to define themselves. There is diversity, choices and ‘pick and mix’ culture in this society. There is no imposition on people on how to behave and there is flexibility in the work. Due to fluidity and flexibility in the postmodern society, people might feel insecure and unsafe.
- Collectivists and New Rights
Collectivists
Collectivists believes that their goal are more important than the individual goals because they believe that society as a whole has more importance than the individual alone. This theory focuses on the importance of the society and community and gives priority to the group goals than the individual goals.
This approach aims to address the inequalities in the society due to different levels of wealth and status in the society. With an aim to sort out the inequalities, welfare state was established to get rid of five giant evils; want (poverty), idleness (unemployment), squalor (poor quality housing) and ignorance (underachievement). Services were made free after these giant evils were identified. To eradicate disease existing in the society, NHS service was established in 1948 to make sure that the people lived healthy life. The basic principle of collectivism is to provide people with education, health and social services for the individuals in the society who cannot afford it through taxes then access on the basis of rights as opposed to the ability to pay.
These helped to provide foundation for the Welfare State which is based on the collectivists principle ‘cradle to grave’ or child to old age pension. This approach was adopted by The Labour Party who represented workers which aimed for the redistribution of wealth through taxes. In this policy, the government would cut off taxes from the wealthy people and share it with the poor (shares some ideas with Marxists). Collectivists believes that we have equal rights and the government should administer responsibility for Welfare State.
The New Rights criticises the Collectivism as it creates the dependency culture. They point out that people become irresponsible, lazy and don not work as benefits are demotivating for the people.
New rights
The New Right was popular during 1980s. They are the political movement with a considerable cultural influence that looks at individualism and distrust of the state as controlling and interfering in what is essentially the private world of the individual. They proposed to cut the public spending and cut taxes. They wanted the rich people to have more money to spend money as they choose. The New rights was critical of Collectivists stating that the rising costs to government of the welfare state were preventing the economic growth and the individuals were becoming dependant on the welfare state. The New Rights were critical of public services owned/controlled by the government and they preferred pro private services e.g. education and health care. The New Right is argued to favour ‘the rich’, but they believe that everybody in the society has equal opportunity, so anyone can become rich. E.g. Alan Sugar. They believe that people must be responsible for their own and their family’s welfare and they should not be dependent on the government. The New Rights are completely opposite to Collectivism. The most radical New Rights would abolish the Welfare State.
g) Bio-medical and social models
Bio medical Model
Biomedical model focuses on the physical or biological aspects of disease and illness. The doctors or the health care professionals are associated with the care and treatment of diseases in this model of health. The bio medical model accept a ‘negative’ definition of health. The negative definition of health explains that the individual believes that they have good state of health and wellbeing because they have absence of physical illness, disease, injury, mental stress, free from pain and discomfort. The bio medical model of is dominant model in our society since it is based on objectivity thus this model has influenced or convinced people in the society. This model emphasises on diagnosis and treatment of the individuals separately from their living condition, due to which this model is not holistic approach. The reasons for illness are not at the centre of biomedical model.
This model believes that health is a biological normality and describe that having ill health is deviant. This model believes that the disease is caused by identical factors such as germs, genes and accidents. They can be identified by having examination tests like blood, urine, saliva test, X-ray and MRI. They accept that the professionals diagnose disease then treatment is identified and cure is offered to the patient. The professionals views the human body as a machine and see things very clinically and do not really take consideration to people’s feeling. They often promote the view that disease or illness is temporary. This model indicates that we all have equal chance of getting ill and some people get ill due to weak health, whereas some people get ill due to factors such as weak sanitation. It assumes that medical treatment has had the most important impact on improving the health of individual. For instance, the NHS helps in the prolonged and preserves life, but this can be argued as health of an individual had already started to get better due to access to clean water, exercise and diet.
The strength of bio medical model of health is that it is based on scientific knowledge and research and has provided many effective treatments for disease and physical condition. The bio medical model of health has be successful to provide many effective cure and treatments for disease throughout the history of humankind. The weakness of biomedical model of health is that the treatments can be expensive and require training or expertise to deliver and this model focuses on the individual and pays insufficient attention to environmental and social factors, which is not a holistic approach.
Social Model
The social model accepts the positive definition of health. The positive definition of health can be described as the achievement and maintenance of physical fitness and mental stability. This model believes that health is a relative concept and a social construct. For instance, being voluptuous centuries ago was a sign of good health, but today’s day it is regarded as health issue or overweight. This model claims that ill health is caused due to social factors (including environmental factors). For instance people can get ill because of the unhealthy diet they are consuming, poor living condition or pollution. This model is critical of ‘modern’ medicine, which are elements of biomedical model. E.g. Iatrogenisis medicine caused deformity in the baby consumed by pregnant mother eaten for nausea sickness. It argues with the biomedical model saying that illness is not randomly distributed and are critical of the assumption that medical treatments has had the most important impact on improving health. Social model can explain why population level health improvements were achieved when social conditions improved late 19th/early 20th centuries due to the improvement of sanitation and supply of clean water the health of population improved, and argues it was not because free health services was delivered to the people.
The strengths of social model of health is that it focuses population health and takes a broad range of factors into account and it is widely used and understood by health care practitioners in developed countries. This model offers board and flexible and inclusive way of understanding health and illness. Whereas the weakness of this model is they do not have a clear way of identifying or classifying health problems and this model cannot explain illness or many mental health problems where there are no physical signs or symptoms, which can be distressing. The social model cannot be used to address an individual’s health problems, especially where emergency care is needed.
Reference
Class notes
Class hand-outs
- National Health and Social Care Book 1
By Crittenden M. et al (2007)
- Introduction to Sociology for Health Carers
By Walsh, M. (2010)
By Moore, S. et al (2005)
by
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