The Aim Of This Essay Is To Look
The aim of this essay is to look at both the biomedical and sociological aspects when looking at health and illness. It will discuss and evaluate both models and look at aspects which affect them, including perspectives from different theorists including functionalists and marxists. It will look at inequalities within society and how health care can be affected.
Health and illness is not specifically labelled or looked at in a certain way. Different people have different views on what is considered healthy and well. The World Health Organisation (WHO, 1985) defines health as ‘a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity’.
Different people viewing health and illness in different ways can be down to social factors which can have an influence on peoples ideas and views. These can include, but are not limited to, wealth, class, gender and ethnicity.
To be healthy is generally seen to be in a state of physical and mental wellbeing and not just absence of disease.
Illness can be described as something that affects the body or mind, long or short term. This would in turn, affect a persons health.
Illness is used to describe a poor state of health. A disease is an abnormal condition that affects the body.
The biomedical model of health has been the most dominant health model used in Western societies for around 200 years. It originated from the enlightenment period which began between the late seventeenth and eighteenth century, it was a time when theoretical social changes were happening and a breakthrough in medical science was discovered.
The model looks at an illness or disease and that only. The biomedical model is favoured by scientists and they argue that health and illness are caused by factors inside the body rather than social factors.
It will not take into account any of the above mentioned social factors such as income, ethnicity or gender. Why for example, the illness has occurred and what preventative measures could be put in place to stop it from happening again. It presumes illness is due to the body being dysfunctional, rather than looking at any other contributing factors. The basis of the model is that a health professional will treat the illness and that is all. This is usually associated with Talcott Parsons who was a structural functionalist in the 1950s. Talcott Parsons introduced what is known as the ‘sick role’. He argues that one needs to be fit and healthy in order to function within society and for society to run smoothly, this would mean people would carry on working and would not be deemed deviant. ‘Good health and effective medical care are essential for the smooth functioning of society’ (2012books, 2015).
This means everything would carry on working, if people are off sick, society will cease to work as it should like cogs in a machine. Hence why the biomedical model looks at eradicating the illness and getting someone better as soon as possible. The most likely cause of illness will be found as will the easiest cure, this is known as reductionism. This means they can continue in their daily lives, helping society to run as it should.
The biomedical model aims to get the body back to functioning as normal, although this is a problematic way of health professionals looking at an illness or disease as normal means different things to different people.
The biomedical approach will treat an ailment with medication or surgery, this is widely due to medicine being such a profitable business.
Marxists will argue that the biomedical model is so widely used as it means more profits for the capitalist class.
Instead of referring a lower class patient with signs of depression to therapy, the biomedical approach would simply prescribe medication. If for example, a depressed patient from a very affluent background was to seek medical advice, the likelihood is that they would be given a choice. Lower class people have that choice taken away from them, simply so they can get back to work and start functioning within society again.
The biomedical approach focuses on treatment and not prevention. QUOTE
It is suggested that by using this approach, morbidity and premature mortality rates drop, thus meaning people live longer, work longer and continue to contribute towards society for as long as possible.
The reason the biomedical model is so widely adhered to can be attributed to the fact that people have a general agreement that it works. This is known as a consensus theory. QUOTE
It is suggested within the biomedical model that only a medical professional has the authority to class a person as ‘sick’ and the sick person must adhere to the rules of the sick role. This includes consulting with a medical professional and to want to get well speedily. The medical professional will establish the cause of the illness by using aietology which discusses the cause or origin of the illness or disease. Pathology may also be used as a way to examine organs or tissue to make a diagnosis. ‘Pathology is the study of disease. It bridges science and medicine and underpins every aspect of patient care’ (Royal College of Pathology, 2016)
The biomedical model looks at a persons habits i.e. drinking, smoking, drug taking and would not look at why the person may be dependant on such things. These contributing factors may include poor housing or poor education.
Marxists disagree with the biomedical model as they believe the model diverts attention away from aforementioned social factors that they believe contribute towards ill health.
The sociological perspectives on health is a way of looking at a patient in an holistic way. It looks at all social factors including gender, class and ethnicity and why a person could be ill. These aspects include, living environment, working environment and wealth. It focuses on the complete wellbeing of a person rather than just the illness. Marxists such as Karl Marx, believe that to be healthy means more than being free from disease. QUOTE
A disease is classed as an abnormality of the body or an organism whereas an illness is to be in a poor state of health. Disease is defined by the Mariam Webster Medical Dictionary (2016) as, ‘an impairment of the normal state of the living animal or plant body or one of its parts that interrupts or modifies the performance of the vital functions’.
When looking at the different classes within society in this model, there are two which are distinct. The two classes are ‘bourgeoisie’ and ‘proletariat’. Bourgeoisie are the social middle class and proletariat are the working class. It is suggested that the National Health Service (NHS) is of benefit to the bourgeoisie as it is there to maintain health within the working force. QUOTE The working class however are under the illusion that the system is fair. Looking back at the biomedical model it could be argued that it is in fact only fair for the middle class. It is clear when looking at health from the sociological point of view that higher class people have better access to better healthcare. The Acheson Report (1998) clearly reports that mortality rates were in a higher decline amongst the upper class.
‘Over the last twenty years, death rates have fallen among both men and women and across all social groups. However, the difference in rates between those at the top and bottom of the social scale has widened’ (Gov.co.uk, 1998)
Poor education can be a contributing factor. Not knowing the right places to go and access help can have a knock on affect to a persons health. Poor, damp housing conditions for example which can be a contributing factor to asthma. ‘If you have damp and mould you’re more likely to have respiratory problems, respiratory infections, allergies or asthma’. (NHS choices, 2016)
The sociological model would address the social situation, the biomedical would merely hand out medication. It is considered that curative medicine is simply hiding the causes of social illness. QUOTE
Poverty can expose people to health hazards. People living in poverty are more likely to be living in sub standard housing and in unsafe areas.
The Black Report (1980) evidences the trends and evidence when looking at social class and inequality in health. Most people who live in poverty are in receipt of some form of benefit from the government QUOTE.
This can be attributed to poor diet and poor housing, in turn, resulting in poor health.Social inequality may have an affect on a persons state of mind. This in turn could have consequences on their physical wellbeing. Stressful social situations can lead to a plethora of issues. As well as physical issues i.e. heart problems due to stress, alcoholism and drug abuse could also become a problem.
Black and minority ethnic (BME) groups can face many inequalities within healthcare. This could be due to race, culture, religion and nationality. The Health Survey for England shows that BME groups are more likely to report ill health and that ill health is reported earlier than those in White British origin. (HSCIC, 2015)
People within the BME minority generally experience higher rates of poverty than the White British. This includes living in deprived areas and being on benefits. These social factors are attributed to ill health within the BME group.
Achesons Independent inquiry into inequalities in health (1998) ‘put a strong emphasis on the effects of wider inequalities, poverty and social exclusion on health inequalities.’ (Parliamentary office of science and technology, 2016)
When looking at gender as an inequality, in most cultures around the world women have less access to medical resources than men and can often be denied access to education. In addition to poor education, in some cultures women are not given the same medical rights as men.
While women have lower mortality rates than men (Annandale, 2014). This leads us to believe that ‘men die quicker but women are sicker’ (Bartley, 2004), although recent figures show that the gender gap is closing.
‘A newborn baby boy could expect to live 78.7 years and a newborn baby girl 82.6 years if mortality rates remain the same as they were in the United Kingdom (UK) in 2010-2012 throughout their lives’ (Office for national statistics, 2014)
Feminism offers a broad insight into understanding a womans position within society. Feminists argue that women are of a disadvantage in society due to constraints and limited opportunities. While significant advances where made in equality during the 20th century within capitalist society’s, the feminist theory argues that women are still exploited by society’s structural organisation combined with embedded cultural attitudes and ideas that function together to exert social control over women (Turner, 2013; McDonnell et al, 2009; Rogers, 2009).
Looking again at Talcott Parsons sick role within this model it is argued that ‘Parsons’ sick role concept has become problematic in the face of the increased significance of chronic illnesses’ (Mathiuss Zick Farul, 2016) Parsons saw the sick role as a form of deviance, or going against societal expectations (study.com, 2016). This meaning if you are excused from regular social duties by a medical professional or ‘legitimised’ you will not be deemed deviant.
One problem with the concept of Parsons sick role as previously mentioned, is that it cannot apply to those with chronic illness as these illness’s are not likely to improve. It could also be said that the responsibilities laid out in the role for the patient to adhere to may not be able to be met. ‘You cannot attempt to get well, since your condition is permanent and no further treatment available at this time will improve it’ (study.com, 2016).
The marxist, Navarro (1979) suggested that, ‘doctors are agents of the State by promoting individualistic view of responsibility for illness, although Mckinley argues that the doctors themselves are little more than workers in a vast industry concerned with nothing more than production of profit.’
The Inverse Care Law (Tudor Hart, 1979) suggests the greater the need for medical care, the lower the level of recourses. This suggests that people living in lower class areas are less likely to receive help and support needed. Le Grand (1979) also makes the point that the middle class have gained more from the health service than the lower class.
It has been discussed that the biomedical model is a scientific way of looking at ill health and is focused on eradicating the illness with medicine or surgery. This clearly works as it is used so widely within society today. Without medicine or surgery, illness and disease could not be treated and would result in higher mortality and morbidity rates. It is important however, for medical professionals to take into account social factors and understand that ill health is not merely the body dysfunctioning but it can stem from a variety of social issues. By using the two models in tandem, it gives the opportunity to take preventative measures to try and ensure problems do not start or get any worse.
When looking at healthcare in modern society, it is clear that from what has been researched and discussed that both biomedical and sociological models need to work together in order to get the best outcome for the patient.