Social-Conflict Analysis of Health & Medicine
Sociologists define health not just as the absence of disease, but more fully, as a state of physical, mental, and social well-being. This article discusses, from the social conflict perspective of sociology, the social context of health — how we define ourselves, and how others define us as healthy or sick — and how our social class affects our ability to receive medical care. Sociologists from the conflict perspective view medicine as having a monopoly on the definition of health and illness and how to treat illness, as well as whom to treat, calling this the medicalization of society.
Keywords Conflict Perspective; Demographics; Epidemiology; Health; Infant Mortality Rate; Life Expectancy; Medicalization of Society; Medicine; Sociological Imagination; Universal Healthcare
Sociology of Health
The Conflict Perspective
The conflict perspective is a theoretical approach in sociology that views social interaction as a struggle for the resources of society between conflicting groups. Power struggles over control of society's and the world's resources characterize the conflict perspective. This conflict may be political, legal, economic, or even familial. The best-known conflict perspective is Marxism, which focuses on the expected clash between two social and economic groups: the bourgeoisie, or capitalists, and the proletariat, or workers. Karl Marx, the founder of Marxism, studied and wrote extensively about the exploitation of the workers by the capitalists in the workplace.
Other classical sociologists who are considered to subscribe to the conflict perspective include C. Wright Mills, who focused on the power elite in the United States and developed the notion of the sociological imagination. Using the sociological imagination, one can separate personal problems, such as loss of a job, from social problems, such as the recession of the economy, which can cause the job loss.
Sociologist Max Weber also subscribed to the conflict perspective, taking Marxism a step further, adding to the economic struggle between social groups the concepts of power (the ability to get what you want despite the objections of others) and prestige (the ability to influence people through a place of honor) (Kendall, 2006). An example of power that does not necessarily include economic power is the presidency of the United States. An example of prestige without economic or positional power might be Irena Sendler, a Polish woman nominated for the 2007 Nobel Peace Prize for her work in saving 2,500 Jewish infants and children during the Holocaust.
Good health is a state of well-being, including the physical, the mental, and the social. Illness, then, is the opposite of health because it indicates a lack of well-being in one or more of these three areas. For example, globally, infectious diseases have not yet been properly addressed through vaccination processes for the multitudes, although these same diseases may no longer exist in wealthier countries. These diseases, for which there are modern cures, are killing thousands and reducing life expectancy considerably in the undeveloped world. But even in the United States, people tend to be overweight and contract diseases related to obesity such as diabetes and heart disease, indicating that money isn't always the answer to good health. Sick people often need help, and they seek out the assistance of the medical system, an institution that practices medicine and engages in the diagnosis, treatment, and prevention of illness.
Another measure of global health is infant mortality, because it is a primary indicator of health care (Schaefer, 2008). The rate of infant mortality is figured by the number of deaths of infants under the age of one year for every one thousand births in a year. For example, in low-income countries, the infant mortality rate is relatively high, with 6 percent of infants (sixty out of every thousand) dying in the first year of life in 2010, according to the World Health Organization (WHO); this was ten times the rate (six out of every thousand) recorded in high-income countries.
Politics and the economy play a part in global health. Consider the governments of some countries that will not allow Western medicine to assist within their borders, even though the well-being of the people is at stake. Or, consider the embargoes against food and medical supplies that the U.S. currently has in place for Cuba, causing innocent people to suffer.
Economics also affects global health. People who live in low-income countries often do not have the resources to learn about or to pay for medical attention for themselves or their children. The costs of Western medicine is usually beyond the means of many people in places like sub-Saharan Africa and Asia. Conflict theorists assert that global health could improve if research concentrated more on the diseases of the poor, rather than the cosmetic desires of the wealthy.
Demographics of Health in the U.S.
The United States is considered the richest country in the world, and many people see it as the home of the finest health care in the world, too. However, Americans are by far not the healthiest people in the world.
The young and the old are hit hardest when it comes to illness, particularly chronic or long-term illness. According to a report from the Centers for Disease Control and Prevention (CDC), infant mortality in the United States declined 12 percent from 2005 to 2011, to a rate of about six infant deaths per thousand births (MacDorman, Hoyert, & Mathews, 2013). However, that rate was still considerably higher than countries in much of the rest of the developed world, according to WHO statistics; countries in western Europe, for example, experienced rates of more like two or three infant deaths per thousand births in 2010 (WHO, 2013).
The existence of chronic diseases tends to increase with age and people over age sixty-five, who are living longer and must look to medical institutions for their well being more often, more expensively, and more frequently. With 20 percent of the U.S. population expected to be over age sixty-five by 2050, the strain on the medical community and the cost to society could rise sharply (Kendall, 2006). Elders above the age of seventy-five in the U.S. are five times more likely to use health services and to be hospitalized than younger people in the mid-teens to mid-twenties age bracket (Schaefer, 2008).
Women live longer than men in the United States because of a biological advantage, which they have from birth. But the primary reason for the longevity of females compared to males is gender roles. Males take on dangerous occupations such as commercial fishing and mining, engage in violence, and are more likely to do unhealthy things like drinking alcohol heavily and smoking cigarettes. But this does not mean that women are generally healthier than men, even though they tend to live about five years longer, on average. Women have higher rates of chronic illness than men (Waldron, 1994), but tend to seek medical help sooner.
Certain racial and ethnic groups tend to live below the poverty line, and their health options can therefore be curtailed. The poor economic and environmental conditions experienced disproportionately by African Americans, Hispanics, and Native Americans contributes to higher mortality rates for these groups. For example, African Americans have higher death rates than whites from heart disease, pneumonia, diabetes, stroke, and cancer. According to the CDC, life expectancy for blacks in 2010 was 75.1 years compared to 78.9 years for whites (Kochanek, Arias, & Anderson, 2013). Some researchers argue that racial tension could be causing ill health such as hypertension among black Americans who experience lifelong prejudice and discrimination (Morehouse Medical Treatment and Effectiveness Center, 1999). Others point to the differences in health care coverage and inferior treatment because of the same prejudice and discrimination, which becomes a double-edged sword (Caesar & Williams, 2002).
If you live in a wealthier neighborhood, your health can be affected positively. These living areas tend to offer opportunities for exercise, better selection of foods, and access to good jobs. Notice that fast food restaurants and mom-and-pop cigarettes-and-beer stores, for example, tend to hover around low-income areas, making healthy choices more of a challenge. Class, then, is related to health because of things like crowded and substandard housing, poor diet, and stress, all of which can contribute to ill health (Schaefer, 2008).
People who live in rural areas have fewer health care options than those in the cities. Only 9 percent of doctors practice in rural areas, where 20 percent of the U.S. population resides. Those without adequate means of transportation to get medical care in the city could therefore suffer due to inadequate hospitals and facilities.
Other lifestyle factors such as drug use can affect health. Americans are well aware of the overuse of drugs, both illegal and legal, in their country. One legal drug, alcohol, is consumed at an average rate of 22 gallons of beer (more than either milk or coffee), one gallon of liquor, and two gallons of wine per person, per year, according to a 2003 U.S. Census Bureau finding. Nicotine found in cigarettes is also a legal drug with major health ramifications. Tobacco-related illness kills one out of every five people in the U.S. per year, according to the CDC.
Illegal drugs such as marijuana and its derivatives are consumed by about one-third of people over the age of twelve. If a pregnant woman smokes marijuana, her fetus can develop physical and neurological problems (Fishbein & Pease, 1996). Others who smoke marijuana can develop cancer and lung problems from inhaling the substance. Cocaine use (engaged in by about 1.6 million Americans in 2012) causes high rates of infection, heart disease, hypertension, and other medical problems (Substance Abuse and Mental Health Services Administration,...
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