Health & Medicine in Modern Society
The ways in which a society understands and interacts with its medical system is the focus of this paper. Medical systems, treatments, and prevention services are constantly evolving. The development of new technologies provides a foundation for more intricate and complicated procedures. This broad topic encompasses the ways in which people across a vast range of cultures create meaning in health and illness. The notion of what it means to be healthy varies widely across cultures, as do the medical systems designed to treat illness. The ways in which we provide access to health care and the lack of access to health care for many people around the world are studied under the broader term of the sociology of health and medicine. Different cultures have created their own means of treating illness, and these systems have evolved over time to influence what many call modern or technological medicine.
Keywords Alternative Medicine; Cultural Divide; Disability; Folk Medicine; Homeopathy; Impairment; Socioeconomic Inequalities; Specialization; Stigma; Universal Health Care
With the introduction of antibiotics in the 1950s and the growth of the pharmaceutical industry, the way in which medicine is practiced has evolved significantly. The latter half of the twentieth century and the beginning of the twenty-first have witnessed a remarkable change, with the introduction of spectacular technologies such as the MRI, the CAT Scan, organ transplants, and arthroscopic and laparoscopic surgeries. These technological advances have sparked a worldwide change in the way we perceive the concepts of health and illness.
The ways in which illness has constructed a specific identity for people over the years has been drastically altered. Even as recently as the early twentieth century, illness was often mired in myth and notions of miasmas and other ill-conceived ideas. People who were sick were often identified by their sickness, and terms such as crippled, helpless, and vulnerable were applied. Today, many strive to develop a different construct around the notion of illness and identity.
To some researchers, such as the late medical sociologist Irving Kenneth Zola (1935–1994), science and medicine have been responsible for constructing very specific identities around the body and illness. Zola, a man with a disability, wrote about the ways in which this construct affects people both when they are ill and when they are not. Zola's work emphasizes that factors such as ethnicity and gender highly influence people when it comes to understanding and coping with illness. One of his most influential ideas was that of medicine as an institution of social control. According to Williams (1996):
Zola identified four ways in which the attaching process was taking place, leading to the medicalisation of society: through the expansion to what in life is deemed relevant to the good practice of medicine; through the retention of absolute control over certain technical procedures; through the retention of near absolute access to certain 'taboo' areas; and finally through the expansion of what in medicine is deemed relevant to the good practice of life. The consequence of these developments is that every aspect of our lives contains risks to health—living itself is injurious to health (p. 114).
The interrelationship between illness and identity is also affected by perceptions of gender. For women, notions of the ideal body shape, femininity, and sexuality can all be affected by illness. A woman who undergoes a mastectomy, for example, may begin to feel less womanly because society informs her that a woman with one breast is less womanly than a woman with two. "Body image is related to negotiated cultural messages about women's appearance and ideal body shape. Research shows, for example, that there is a connection between frequent media use and greater body dissatisfaction as etched in cultural ideals of femininity" (Fernandes, Papaikonomou, & Nieuwoudt, 2006, p. 855).
The norms and values of a society give meaning to the construct we know as the body and the state of being that we call illness. Together, society creates a meaning for the sick body versus the healthy body. When people become ill, they assume the identity of a sick person—that is, they may not be able to work, may have to go on short- or long-term disability, and may face restrictions on socializing, exercising, and other activities valued as part of a healthy lifestyle.
Cultural Beliefs about Illness
Our individual and collective beliefs about illness affect us. According to Donkin, Ellis, Powell, Broadbent, Gamble, & Petrie (2006), "[r]esearch suggests that patients' illness beliefs may be important in the area of cardiac symptoms" (p. 423). In a New Zealand study, researchers found that people of Maori, Asian, European, and Pacific Islander cultures all maintain different ideas about illness, treatment, and recovery (Donkin et al., 2006).
Zola's research bore out similar results. Williams (1996) noted, "From his comparison of prospective patients of Irish, Italian, and Anglo-Saxon origin, Zola was able to demonstrate that it would take different symptoms to bring these patients to the doctor…" (p. 111). In the end, Zola maintained that society is taking increasingly greater control over peoples' health care and that being sick is an institutionalized identity which is controlled by the medical profession.
It was perhaps in his work on disability-related issues that Zola made the most impressive impact. He pioneered the movement to define disability as a social construct and therefore as something located in society and not peoples' bodies. Zola recognized that people could have 'impairments,' but he separated that from the notion of disability. An impairment is the lack of function in a particular area of one's body. Disability is the social prejudice leveled against people with impairments and barriers to their full participation. When society locates disability in the body, it is a form of social oppression. That oppression is integral to the medicalization of disability and the human body (Williams, 1996).
It is a sad reality that millions of people do not have equal access to health care. There are two levels to this problem. One is the lack of access due to the poverty of nations, and the other is lack of equality in health care in Western countries. There is perhaps no country which exemplifies this latter problem more so than the U.S. "Socio-economic inequalities in health reflect differential social circumstances that are divided along social class lines" (Prus, 2007, p. 276). People interact with medical systems on a micro and macro level—that is, a personal level and a population level (Prus, 2007). Both on a personal and a population level, there are people who are at a significant socioeconomic disadvantage.
There is a significant amount of research to demonstrate that socioeconomic status and health are strongly interrelated. People who are poor often suffer from a higher degree of illness. Some are beginning to suggest that access to health care is becoming one of the greatest signs of social inequality. There are those who look to countries with universal health care, such as Canada, as the answer. Yet, even there, some disparities have been recorded. Sin, Svenson, Cowie, and Man (2003) suggest that some of the reasons may include the following: "…poor health habits, crowded living conditions, inconsistent patterns of immunization and parental care, obesity, standard nutrition, and poor physical fitness…" (p. 54). This analysis suggests that unless poverty and social inequalities are dealt with at a root level, universal health care may not make much of a difference in peoples' quality of health. According to Lantz, Lichentenstein, and Pollack (2007):
The overarching goal of improving health status has become displaced by the immediate goal of increasing access to health services. As a result, we have a fragmented and beleaguered health care safety net; and insufficient policy attention is being paid to socioeconomic conditions that give rise to health vulnerability in the first place (p. 1253).
(The entire section is 3669 words.)