In the game stage the child can see wider roles and has more understanding, they will now have more of an idea on how these roles interact and the development of social awareness will take place.
Interactionism has very different views on the whole of society, they refuse to apply anything to the whole society and just look at it in the smaller scale. They think that humans are distinctive because they can reflect on their own thoughts and actions, they emphasise on the fact that individuals gain shared understanding of meanings attached to objects and these meanings only exist as the result of social interaction.
Collectivism
Collectivism came around when the passing of the poor law was introduced in 1601; they believe that society and its individuals have the responsibility to meet the needs of all the individuals within it. Although there was very minimal help provided and that was for the starving, society still believed that it was your fault that your poor. People within the society pay taxes and national insurance to the government which then funds education and health and social care services. Collectivists aim to address all the inequalities which are in society and they believe they can do this by compensating people who may be on a lower wage giving the access to education and health services for free. Every individual within the society will be benefiting from any means of production that they have, even if they are the less wealthy.
New Right
The new right perspective on society is very much involved with the individual and the emphasis around the individual having the maximum amount of freedom. They think that people begin to rely on the government rather than planning a real future, so therefore they believe that the government should only play a very small role in any individual’s life. Within their society they tried to reduce state control over education and health services and even though reality remained that most people could not afford to pay for it themselves they still think that state support is intrusive. They are very influenced by Margaret Thatcher and one of the particular quotes they are interested in is “there is no such thing as society”, as they have a very negative view on the whole society being so reliant with the government. They do not trust the government because they think that they are too controlling an interfering, this is when they bought new ideas to the NHS about the individual having more choice in the treatment they have.
Post Modernism
Post modernists believe that the old sociological perspectives such as feminism and Marxism no longer help us to understand society as nothing is staying the same, family, religion and even the economy are dramatically changing and have changed since these perspectives were brought to light. Postmodernists have rejected a lot of perspectives like ‘science over superstition’ because they think that it is absolutely impossible to understand society in this way. Post modernism has only emerged since the mid-1980s so it is one of the newest sociological perspectives. Post-modernists believe that society is changing rapidly and that individuals make their own life-style choices choosing from wide ranges.
P2 – Understanding different concepts of health
Health is described in so many different ways by various sociologists.
There is the negative approach to health which is termed as the absence of disease; this is simply having nothing wrong with you.
Then there is the Positive definition of health which coincides with the World Health Organisation and the Holistic approach that “health is not just the absence of disease but also the state of complete physical, mental, spiritual and social well-being” (WHO, 1974).
In some health and care settings they use the holistic approach to treating people with illnesses, so they will look at every aspect of the persons life and try to work out why they are unwell. For example, if a young lady was diagnosed with depression using the holistic approach they would look at why she had the depression whereas using the negative approach the lady would be given tablets and they would consider her healthy again.
Holistic approaches in health and social care settings are usually used more within private care as they have the time, money and resources to look at things in this way. When using the NHS they are more likely to use more of a negative approach where they just prescribe you drugs to treat the specific problem rather than looking at what might actually be causing the problem.
People’s understandings of health and well-being can differ in various situations, in 1990 Mildred Blaxter
P3 – Describe the bio-medical and socio-medical concepts of health
Bio-medical model of health
The bio-medical model of health is an approach that some people take to health and illness; they basically identify ‘health’ as the absence of disease within the individual. This particular model is the most popular and has been since the industrial revolution in the mid-19th century, mainly because they underpin the ideas, beliefs and values of the NHS. The bio-medical model states that the intervention of health professionals is needed in times of ill health, and that these professionals will use scientifically approved methods of dealing with the health of the individual. They do not really believe that social and environmental factors can affect a persons health, although they will look at different causes of illnesses they pay very little attention to the environment or any social factors.
The bio-medical model is largely followed by functionalists, if people are ill within the community then they can’t fulfill their role within the society therefore society will not run smoothly so these people need to be treated with drugs and get back to work as soon as possible. If people are of ill health and are refusing treatment from the health services then functionalists believe that they are not taking on their responsibilities properly as they are not trying to get better meaning they are not contributing to society effectively.
Socio-medical model
This model focuses on the social and environmental factors that make an influence on an individuals well-being. Research has shown that life-expectancy rose and death rates begun to fall when:
- There were major improvements to the cleanliness of water
- New council houses were built
This is when the standards of living were generally increased, in the late-19th century to the early-20th century. This evidence backs up the fact that social and environmental factors do affect an individuals well-being and its not just down to the individual.
The socio-medical model is more backed up by conflict theorists as they would explain that the reason there is a higher death rate and higher rate of general ill health among the poorer people in society is because of their living conditions.
The conflict theorists will particularly look at the impact of poverty, poor housing, diet and pollution.
“Poor housing and poverty are causes to respiratory problems, and in response to these causes and origins of ill health, the socio-medical model aimed to encourage society to include better housing and introduce programmes to tackle poverty as a solution.”
()
P4 - Describe different concepts of ill health
Disability and impairment
When talking about disabilities and impairments it is very hard to produce a clear definition, different people will view these terms in various different ways. Tom Shakespeare formed a helpful definition of both impairment and disability (1998).
Impairment – Impairment focuses on an individual and the day to day restrictions that they may come across because of a mental or physical condition such as schizophrenia. This has been linked to the bio-medical concept of health and illness, from this point of view the service providers are the ones who are responsible for making these limits bigger so that patients can achieve more.
Disability – Tom Shakespeare see’s disability as “A problem which arises when a society does not take into account the needs of people with impairments”. Disability is seen as a restriction meaning that someone can not take part in the normal life with everyone in the community. People have often referred to some places as a ‘disabling environment’ meaning that they do not have proper facilities in place to assist people with impairments. For example: within a community someone with a hearing impairment has not been provided with a hearing aid or been taught how to lip read so they are not being helped.
Iatrogenesis
Latrogenesis is in conjunction with and generate by already existing medical activity and practices. The term was brought about by ‘Ivan Illich (1976)’ he decided to bring his attack in this way on the industrialised society. Although this was quite a long time ago, it is still very involved within modern day debates. The main things that are regularly talked about are the spread of infections within hospitals, the side-effects of drugs and the risks of trialing new drugs. Illich identified three particular areas that he believed there was trouble with:
-
Clinical iatrogenesis – This is the unwanted side effects of any kind of medical intervention
-
Social iatrogenesis – this involves the fact that people within the society have become too reliant on drugs prescribed from the doctors, and Illich believes that we are becoming ‘mass consumers of medical products’
-
Cultural iatrogenesis – This is when a society becomes over-concerned about ‘perfect health’ which makes it very difficult for anyone to have a positive attitude towards their health and also makes it even harder for people to cope with death.
The clinical iceberg
This is a term which is sometimes used to refer to the clinical levels of illness because it is said that these statistics can not always be completely true as not all people that are ill will visit their doctor, for various different reason.
P5 – Produce a chart to compare the different health and illness experiences of three different social groups
I have chosen to look at poor health within various ethnic groups. I found a graph on () which gives me percentages from the different ethnic groups that are reporting ill health.
This shows me that Pakistani individuals have reported the most ill health within the different ethnic groups with a big 15%, Chinese people have reported the lowest at only 6% and White British people are a little above the Chinese with 8%.
It is difficult to study the link between ethnicity and illness because of the definition. Also there is a high proportion of ethnic minorities which live in areas of deprivation which is associated with poor housing, pollution and relatively high unemployment which makes it hard to separate the poor health to ethnicity or poverty. Although in comparison to the white majority ethnic group there is evidence that:
- There is a higher incidence of rickets in children from the Asian sub-continent because of the deficiency of vitamin D in their diet.
- Most ethnic minority groups have a shorter life expectancy
- Most ethnic minority groups have higher infant mortality rates
Ethnic minority groups who live in poverty will also not have very good access to health care services, language and other cultural barriers will prevent the individuals from wanting to visit the doctors or other medical services. Some ethnic minorities are scared of being discriminated against when not in their own country and therefore will not make constant trips to health care services because of the fear of racism. As they have this fear of discrimation against their race or religion they sometimes will feel too ‘embarrassed’ or ‘scared’ to visit the health care professionals therefore leaving them open to higher levels of ill health.
Looking at my graph I can see that Pakistani individuals have the highest percentage of reported ill health, there are various different explanations for this. It is possible that they have the highest ill health because they quite simple have poorer working and living conditions although this is not the only reason:
- They are a minority group and therefore they may find it harder to get jobs meaning they will have no money coming in
- The traditional diet they follow might be quite unhealthy
- It could be that their culture are just considered as hypochondriac’s meaning that they are always feeling ill and automatically going to the doctors whenever they fall ill
- The statistics might not always be very reliable therefore you need to find out where they have come from although my graph is from a government website so the result should be quite reliable
- If the results were founded by someone like the equality board they may base their results to their advantage so they could find that ethnic groups are in poorer health as they can use it when fighting against discrimation
-
M1 – Use two sociological perspectives to explain different concepts of health
Functionalist approach:
This approach to health comes from Talcott Parsons he said that for society to function well it needs all of it’s members to be healthy. He described illness as a form of ‘deviance’ and also said that the ill members in society were playing a social role – the sick role. He decided that if people were taking on this ‘sick role’ responsibilities and rights would also come with it.
The rights which were associated with the sick role were:
- To be exempt from normal social obligations like school, work, college and even normal family obligations
- To be cared for
Parsons thought that it was one of the key responsibilities of the family to care for the sick and any other dependant members of the family group. There was also the responsibilities which come with the sick role for the individual:
- Taking all reasonable steps to get better and seeking to resume their normal work place in society as soon as possible
- Co-operating with medical professionals, specifically doctors and their staff
So the functionalist view of ill health is that illness has a ‘social consequence’ and must be quickly dealt with where possible, for the good of society.
Marxist approach:
Marxist’s believes that the health care services provided are in the interests of the upper class section of society, the doctors are viewed as ‘agents’ who are there to make sure that people get back to work as soon as they can as they are working in the interests of the employers rather than the employee’s (patient). The doctors and medical staff are present to provide the company owners with health workforce members. This approach to health is almost the complete opposite of the functionalists approach, who see ill health as something that will occur randomly Marxist’s believe that illness is in conjunction with the level of social class that you are. So there is higher levels of illness and lower life expectancy ages in areas that are living in poverty, Marxists however believe that the government are not doing enough about this problem.
M2 – Bio-medical and socio-medical models of health applied to everyday practices
I have written out a scenario to help me apply both the bio-medical and socio-medical models of health
Shontelle and Tyrone are parents of two young children, Jack and Emma, they are currently living in a flat on a sink estate in a very deprived part of south east London. The flat has two bedrooms, Emma and Jack are currently sharing a double bed but next month when Emma shall be turning 10 they will need to have separate rooms which will prove very difficult when they only have a two bedroom flat. The flat is high rise meaning and has quite a lot of dampness, they also find it very hard to keep warm in the winter. Both Shontelle and Tyrone are unemployed meaning that they are claiming benefits, although the benefits they receive are not a lot and therefore they are not able to lead a very healthy lifestyle. All of the family are in poor health particularly the children who both have asthma and eczema, Shontelle is also depressed and being prescribed anti-depressants by her GP. Both Shontelle and Tyrone smoke over 20 cigarettes a day, Tyrone also has high blood pressure and heart disease, which has been caused by stress and his bad lifestyle of smoking and drinking. Because of his high blood pressure he often has anger outbursts which makes the living environment dangerous for the children; this just worsens Shontelle’s depression.
When looking at this scenario from a bio-medical point of view they would accept that they are not living in the best situation or best living conditions. They would prescribe medication for the depression that would make her feel better and therefore in theory she would be better. Both of the children would be prescribed ventolin for their asthma and steroid cream for their eczema preventing both conditions from worsening. Tyrone is also being prescribed blood pressure and cholesterol tablets to control his problems. All of the problems and symptoms are being treated within the family and therefore they will all be as well as they can be.
The socio-medical point of view however is completely opposite to that of the bio-medical model. They will look more into why they are actually ill rather than just prescribing tablets and things to make them better. They will look at the fact that the individuals are only ill because of the environment they are living in and the lifestyle they lead. Seeing as they have both got a very low income it means that they do not have a lot of money to spend on healthy foods which can sometimes be quite expensive. They also spend a lot of time indoors and watching the televisions as that is the only form of entertainment, if they spent more time going for walks and in the outdoors then their health might be slightly better. The damp and coldness of the flat is not good for the children’s eczema and asthma so there should be appropriate measures taken to make the flat better. Shontelles depression is more than likely due to her living environment and the lifestyle she is leading, the fact that they do not have a very big disposable income means that they probably all live off of a very bad diet. The lack of exercise within the family is also not good for any of their health, both asthma and depression will suffer more if there is no form of exercise being done.
M3 - The black report
The black report looked at four different reasons of why there may be differences in levels of illness and life expectancy rates within different social classes. The four sociological explanations were:
- The statistical artifact explanation
- Natural or social selection
- Cultural or behavioral explanations
- Material or structural explanations
The statistical artifact explanation
This explanation focused on the fact that the statistics themselves actually produced biased results. They thought that were a higher number of older people working in traditional but dangerous jobs so they would obviously have higher levels of illness whereas their were younger people working in office environments who would not be working within such a dangerous place therefore not reporting such high levels of illness. The explanation argued that it was more of an age structure than social class, although more recent studies that even when this problem was accounted for there was still a link between lower social classes and higher levels of illness.
In relation to my graph in P5 looking at this theory I need to think about who the results were actually produced by as people of different ethnic backgrounds might produce biased results to make their own race look better as it were. It also refers to people who have reported ill health, not necessarily people are actually in ill health. The individual’s medical background may also include the amount of times that they have visited their GP which does not always directly relate to the amount of people who are in poorer health. The graph is based on ethnic groups who have reported poorer health than average, although the average could be based upon anything as they have not specified what the average actually is, different individuals would also view being healthy in different ways as there are people who may be disabled and paralysed but they still see themselves as healthy.
Natural or social selection
This explanation looks at the fact that it might not be the factors associated with being in a lower class that cause higher levels of illness instead its because you are in the lower class that you have these problems like lower levels of health, poor housing and living conditions. This explanation however has been rejected by various different sociologists because there is evidence that it is the circumstances that cause the ill health rather than it being the individual’s lack of energy or drive.
This theory would look at the fact that they could be in poorer health as they are not as ‘hardy’ as some of the other races, people who were not born in this country and then come to live here may also find it harder to acclimatise and therefore find themselves being in poorer health. However in reality it has to be taken into account their working wage is bad and the environment that they might live in would then also not be great.
Cultural or behavioral explanations
The explanation suggests that it is the behavior and lifestyle of people who are in the lower social classes, evidence has shown that people in lower classes smoke more, drink more and partake in less exercise. The way that they chose to live their lives lead to various illnesses including heart disease, bronchitis and diabetes. Although some individuals in the lower classes find smoking and alcohol helps them to escape and cope with their very stressful lives. “It is their difficult circumstances that lead to their lifestyle choices”.
Different cultures obviously have various different lifestyle choices that they live through their culture, for example Asians and Muslims cover their bodies as a sign on respect but this also means that they are very sheltered from any kind of sunlight which could be a main reason for their poor health. Also the ethnic diets that individuals have may not be very good for them, for example it might not contain much fresh fruit and vegetables.
Material or structural explanations
This explanation focuses on inequalities in wealth and income for the lower social classes and the impact that has on levels of health. It is the poor housing and environments and the lack of job security that are associated with deprivation which brings about differences in health and well-being of various individuals.
In relation to my graph in P5 this theory would look at barriers of individuals, when people who do not speak the first language of the country that they are living in they will find it particularly hard to succeed within both school and the work place. Not so much now but there would have also been situations where some ethnic minorities may have missed out on job opportunities and promotions because of their colour.
