Handbook of the Sociology of Health, Illness, and Healing (eBook)

Bernice A. Pescosolido is Distinguished Professor of Sociology at Indiana University and Director of the Indiana Consortium for Mental Health Services Research. Professor Pescosolido received a B.A. from the University of Rhode Island in 1974 and a Ph.D. from Yale University in 1982. She has focused her research and teaching on social issues in health, illness, and healing. Jack K. Martin is the Director of the Karl F. Schussler Institute for Social Research at Indiana University. He received his PhD in Sociology from the University of Utah in 1980 and has been on the faculty at Indiana University since 2001. Anne Rogers is Professor of the Sociology of Health Care and Head of the Health Sciences Research Group at the University of Manchester. Her research interests lie broadly within the sociology of health care, mental health and most recently social networks, relationships and personal long term condition management. Her research has ranged from exploring, patients experience of psychiatric services, the social patterning of mental health problems, lay epidemiology, professional knowledge and sociological analysis of old and new forms of treatment. Her recent research interests include a focus on the ‘work’ that patients undertake in the area of long term condition management and addressing how social position, networks, relationships and illness work undertaken in domestic settings connect to accessing resources in local communities and health services to support living with long term condition management. Jane D. McLeod is Professor of Sociology and Director of Undergraduate Studies. She also teaches in the Human Biology Program. Jane came to IU in 1998, after serving on the faculties at the University of Minnesota and SUNY-Albany. Her research traverses the areas of social psychology, medical sociology, sociology of mental health, stratification, and the life course.

Handbook of the Sociologyof Health, Illness, and Healing 3
Contents 5
Contributors 9
Part I: Rethinking Connecting Sociology’s Role in Health, Illness, & Healing,From the Top Down
Chapter 1: Taking “The Promise” Seriously: Medical Sociology’s Role in Health, Illness, and Healing in a Time of Social Change 14
Introduction: Taking Stock of the Intellectual and Societal Landscape of Medical Sociology 14
The Task Ahead: Mapping the Landscape of Health, Illness, and Healing for the Next Decades 16
The Metaphor of Cartography 17
Contextualizing and Researching Health, Medicine, Health Care, and the Biomedical Sciences: Time of Change from the Outside 17
Human Genome Project and the Larger Push for Understanding Context 18
The Mess that Is “Translational Science” and the Need for Sociological Clarity 18
The “Hundred Year’s War” of American Medicine and Mechanic’s Continued Call for Sociological Understandings 19
Putting Our Own House in Order: Time of Change from the Inside 21
Decoding the Discipline and the Subfield: The Three Medical Sociologies 21
The Boundary Divisions that Matter: The Three Medical Sociologies 22
Our House and Corner of the Map: Medical Sociology by and for Medical Sociology 22
Our Country: Mainstream Sociology with a Focus on Health, Illness, or Healing 23
Abandoning Home and Country for Richer, More Powerful Neighborhoods: Medical Sociologists Packed and Gone to Medicine, Public Health, and Policy 24
Triangulating the Community Map to Develop a Blueprint for the Next Decade of Research 24
Rethinking Communities and Landscapes 24
Organizing by Elevation 25
Connecting Communities 26
Connecting to Medicine: The Profession and Its Organizations 27
Connecting to the People: The Public as Patient and Powerful Force 27
Connecting Personal and Cultural Systems 28
Connecting to Dynamics: The Health and Illness Career 28
Connecting the Individual and the Body 29
Wrapping Up 29
References 29
Chapter 2: Medical Sociology and Its Relationship to Other Disciplines: The Case of Mental Health and the Ambivalent RelationshipBetween Sociology and Psychiatry 32
Introduction 32
Sociology and Mental Disorder 32
Case Study One: Social Psychiatry 34
The Heyday of Collaboration 34
Theoretical Shifts in Sociology and Psychiatry 35
Case Study Two: The Medicalisation of Stigma 40
The Challenge of the Concept of Stigma for the Psychiatric Profession 42
Case Study Three: Psychoanalysis 43
Conclusion: Between Medical and Sociological Imperialism 44
References 46
Chapter 3: Organizing the Sociological Landscape for the Next Decades of Health and Health Care Research: The Network Episode Model III-R as Cartographic Subfield Guide 49
Introduction 49
Why Networks? 51
Do We Really Need More Theories, Frameworks, and Models? 53
Fleshing Out the NEM 54
The Origins and Base of the NEM in Brief 54
Embracing Complexity Without Losing Utility: The NEM III-R 56
Defining Dynamics in the Health and Illness Career: The Core Target of the NEM III-R 58
Defining the Core Factors that Shape Illness/Disease and Treatment Pathways 62
The NEM III-R Core Subsystem: The Community 64
The Core Subsystem of the NEM III-R: Institutional Systems 66
The Core Subsystem of the NEM III-R: The Support System: Personal Networks 67
The Core Subsystem of the NEM III-R: The Individual: Self and Body 68
The Core Subsystem of the NEM III-R: The Molecular System: Genes and Proteins 69
Conceptualizing Cross-level Influences: Thinking in Fractal Terms 69
Summary: Looking Forward 72
References 72
Chapter 4: Fundamental Causality: Challenges of an Animating Concept for Medical Sociology 77
Fundamental Causality as a Concept 78
Fundamental Causality as a Theory 80
Differences in Means 80
The Ambiguity of “Resources” 81
Complements to Means 82
Fundamental Causality and Inquiry 85
Fundamental Causality and Policy 86
Conclusion 89
References 89
Part II:Connecting Communities 92
Chapter 5: Learning from Other Countries: Comparing Experiences and Drawing Lessons for the United States 93
Themes in Health Policy Research 94
Is Cost Control Best Achieved by the State or the Market? 94
Is There a Trade-Off Between Efficiency and Equality? 94
Is Health Care a Right or a Responsibility? 95
Lessons on Social Values and Ideologies 96
Public and Private Funding and Control 96
Regulating the Market 98
Lessons on Authority and Power in Decision Making 99
Rewarding and Guiding Providers 99
Rationing 102
Primary Care 103
Conclusion 104
Convincing the Dubious and Shaping Policy 105
Bibliography 105
Chapter 6: Health and the Social Rights of Citizenship: Integrating Welfare-State Theory and Medical Sociology 108
Classifying Health Care Systems and Welfare States 109
Theories of the Welfare State: What Attention to Health Adds 111
Institutionalizing Inequalities: The State and the Economy 112
The Welfare State as a Provider of Health Care 114
The Welfare State as Reflecting and Shaping National Culture 115
Toward a New Research Agenda 117
References 119
Chapter 7: Health Social Movements: Advancing Traditional Medical Sociology Concepts 123
Introduction 123
Background: The History of HSMs 124
Our Approach to HSMs 125
EHMs: Challenges to Science and Society 125
Beyond Typologies 127
Cross-Pollination Between HSMS and Medical Sociology: Tools and Theories 127
Empowerment 127
Movement-Driven Medicalization and Disempowerment 129
The Institutional Political Economy of Health 130
Through the Lens of the EBCM 131
Changing the Illness Experience 131
Lay-Professional Conflict and Cooperation 133
Challenges to Medical Institutions and the Production of Scientific Knowledge 134
EHMs and Challenges to Science 136
An Ecosocial View of Epidemiology and the Social Production of Disease 137
Conclusion: Further Steps to Develop the Study of HSMs 138
References 140
Chapter 8: Layering Control: Medicalization, Psychopathy, and the Increasing Multi-institutional Management of Social Problem 144
Introduction 144
Medicalization, Criminalization, and the Institutional Management of Deviance 145
Institutional Layering and the Increasing Formalized Social Control of Problems 147
The Psychopath, the Sociopath, and Others 148
Psychopathy and Institutional Layering: Who Takes Precedence? 150
Medical Understandings of Psychopathy 150
History of the Diagnosis 150
Medical and Biological Theories of Psychopathy 152
The Treatment of Psychopathic Individuals 153
Medico-Criminal Understandings of Psychopathy 153
The Appropriation of Evil: Moral Discourse and the Medico-Criminal Understanding of Psychopathy 155
The Irony of Psychopathy in Modern Society 157
Discussion: The agenda for Sociology 158
Future Questions 159
References 159
Chapter 9: Community Systems Collide and Cooperate: Control of Deviance by the Legal and Mental Health Systems 164
Introduction 164
Background: The Social History of Two Systems 164
Collision: The Two Systems Collide Over Rights 165
Beyond the Two Systems: Economic Forces Create New Problems 167
Cooperation: Recognizing the Need 169
Diversion Programs: Attempts to Solve Criminalization 169
Directions for Future Inquiry 171
References 172
Part III:Connecting To Medicine:The Profession and Its Organizations 176
Chapter 10: Medicalization and Biomedicalization Revisited: Technoscience and Transformations of Health, Illness and American Medicine 177
Introduction 177
Medicalization Theory Today 178
Defining and Historicizing Biomedicalization Theory 180
Defining 181
Historicizing 183
Situating Biomedicalization Theory: Twenty-First Century Questions of Life Itself 185
“Life Itself”: From the Clinical Gaze to the Molecular Gaze 186
Biocapital and Bioeconomics 187
Engaging “Life Itself.”: Individuals, Collectives, Populations 188
Critiques of Biomedicalization Theory 189
Biomedicalization Theory in Action 191
Medicalization, Biomedicalization, and Medical Sociology: An Agenda for the Future 193
References 195
Chapter 11: Two Cultures: Two Ships: The Rise of a Professionalism Movement Within Modern Medicine and Medical Sociology’s Disappearance from the ProfessionalismDebate 204
Two Cultures 204
The Case of Professionalism 205
The Emerging Sociology of Professions 206
Talcott Parsons and Medicine as a Profession 206
Professions Post Parsons: The Debate Ensues 207
The Great Debate 208
The Rise of Professionalism (With) in Organized Medicine 210
A Brief Look at Medicine’s Discourse of Professionalism 212
Some Contemporary Events that Continue to Shape Medicine’s Discourse of Professionalism 213
The Rise of a “New Professionalism” Literature 214
Conclusions 215
References 217
Chapter 12: Medicine as a Family-Friendly Profession? 223
The Medical Workweek: Kinder and Gentler or Crazier than Ever? 226
Today’s Physicians: Workaholics or Overworked? 228
The Culture of Unfettered Professional Commitment 229
Obstacles to Part-Time Work 232
Cultural and Organizational Factors 233
Economic Constraints 235
Practice Considerations 237
Residents and the 80-h-Per-Week Rule 240
The Development of the 80 h Work Rules 243
The Advent of “Convenient Care” 245
Inflexibility in the Lives of Individual Male and Female Physicians 245
Conclusion 250
Agenda for the Future 251
References 252
Chapter 13: Clash of Logics, Crisis of Trust: Entering the Era of Public For-Profit Health Care? 256
Introduction 256
The Multiple Layers of Trust 257
Institutional Logics: Public, Private, Profit? 258
The Private Logic 259
The Public Logic 260
The Nonprofit Logic 260
The For-Profit Logic 261
The Private Nonprofit Logic 261
The Public Nonprofit Logic 263
The Private For-Profit Logic 264
The Public For-Profit Logic 265
Restoring Trust? Issues for Medical Sociology 267
Potential Directions for Future Research 269
References 270
Chapter 14: Health Care Policy and Medical Sociology 272
Health Care Policy and Medical Sociology 272
Medical Sociology and Health Policy 273
Earlier Ideas About Medical Sociology and Health Policy 273
Health Services Research and Medical Sociology 274
The Policy Making Process in the USA and Incremental Reform 276
Important Themes: Access, Cost, Health Insurance, and Quality 278
Health Care Costs and Expenditures 278
Access to Healthcare and Healthcare Insurance 280
Quality of Care 281
Health Policy, Health Reform, and Medical Sociology 282
Health Disparities and Sociological Interests 282
Public Opinion Research 283
Politics, Sociology, and Policy Concerns 284
References 286
Part IV:Connecting To the People:The Public as Patient and Powerful Force 290
Chapter 15: The Consumer Turn in Medicalization: Future Directions with Historical Foundations 291
Medicalization in Sociological Perspective 292
Shifting Engines and Biomedicalization 292
Patients, Clients, Consumers, and Health Movements 294
Definitions 294
Situating the Medical Consumer 295
Consumerism and Patient Expertise in Health and Medical Care 296
“What Does the Term “Consumer” Do in/for Medicalization?” 297
Self-Help and Advocacy Groups 298
Embodied Health Movements 300
What Is Old Is New Again 301
Social Class and Intersectionality 301
Knowledge: Power, Authority, and Expertise 302
Conclusions 303
References 305
Chapter 16: Mundane Medicine, Therapeutic Relationships, and the Clinical Encounter: Current and Future Agendas for Sociology 308
Introduction 308
The Chronic Disease Epidemic and the Problem of Mundane Healthcare 310
Routinizing the Work of Patient-Hood 313
Shared Decisions and the Mobilization of Patient-Hood 316
Conclusion: Reconfiguring the Parsonian Paradigm 317
References 319
Chapter 17: After 30 Years, Problems and Prospects in the Study of Doctor–Patient Interaction 322
Introduction 322
Sociological Approaches to the Physician–Patient Relationship 323
The Physician–Patient Relationship: The View from Medicine 324
Studies of Doctor–Patient Interaction: A Methodological Dichotomy 325
Process Analysis 326
Microanalysis 327
Medicine as Discourse 328
Taking Stock 329
Conversation Analysis as an Approach to Physician–Patient Interaction 330
Primary Care Interaction Comprises an Overall Structure of Component Activities 331
Activities in Primary Care are Constructed as Interaction Sequences 331
The Turns Making up Sequences Have Significant Variability 332
Interaction, Contexts, and Outcomes 333
Conclusion 335
References 336
Chapter 18: Enter Health Information Technology: Expanding Theories of the Doctor–Patient Relationship for the Twenty-First CenturyHealth Care Delivery System 342
Introduction 342
Diffusion of Health Information Technology Within the Health Care System 343
HIT and the Sociological Study of Doctor–Patient Interaction 346
HIT and Patient–Provider Rapport 346
The Social Dynamics of Health Information Processing 349
HIT and the Deprofessionalization of Medicine 351
Conclusion 353
References 354
Part V:Connecting Personal & Cultural Systems
Chapter 19: Culture, Race/Ethnicity and Disparities: Fleshing Out the Socio-Cultural Framework for Health Services Disparities 360
Introduction 360
The Sociological and Social Science Roots of a Framework to Understand Health Service Disparities 361
The SCF-HSD: Outlining and Specifying the Frame 364
When Health Care Systems and Community Systems Meet: Mechanisms Producing Disparities 364
Dual Systems in Operation – Health Care and Community 364
The Macro-Level: Federal State and Economic Policy and Environmental Context 366
The Macro-Level: Communities 367
The Meso-Level: Operation of the Health Care System and Provider Organizations 368
The Meso Level: The Informal Community System – Family/Friend/Lay Network Sectors 370
The Micro-Level: Provider–Client Interactions 371
The Micro-Level: Individual Level Factors Excluding Need or Clinical Appropriateness 371
Discussion and Conclusion 373
References 374
Chapter 20: Health Disparities and the Black Middle Class: Overview, Empirical Findings, and Research Agenda 380
Overview 380
General Health Disparities 380
SES-Health Gradient 381
The Health Paradox 382
Who Is Black in the USA? 383
Who Are the Black Middle Class? 384
Can We Explain the Health Paradox of the Black Middle Class? 385
Where Do We Stand? Investigating the Paradox 386
General Health Disparities: Are Blacks in Worse Health than Non-Hispanic Whites? 386
Do All Blacks Present the Same Health Profile? 388
SES-Health Gradient and the Health Paradox: Education? 388
African Americans 388
Afro-Caribbeans 391
SES-Health Gradient and the Health Paradox: Income? 391
African Americans 391
Afro-Caribbeans 391
SES-Health Gradient and the Health Paradox: Occupation? 394
African Americans 394
Afro-Caribbeans 394
Discussion: Remaining Questions 397
What We Found 397
What May Underlie These Findings 397
Next Steps: Taking the Best from Past Research to Build a Promising Future Research Agenda 398
Social Networks: The Elephant in the Paradox Room 398
Appendix A. The dimensions of stratification identified by a select group of scholars to define the black middle class 401
Appendix B. Percentage of Black adults who qualify as members of the middle class based on select criteria linked to the dimensions of stratification 402
Appendix C. Description of measures used from the National Study of American Life 402
References 403
Chapter 21: Gender and Health Revisited 408
Introduction 408
Gender Differences in Health 408
Mortality 409
Physical Health 410
Mental Health 412
Explanations for Gender Differences in Health 414
Looking to the Future: Prospects and Challenges for Understanding and Reducing Gendered Health Disparities 416
Gender, Immigration, and Health 416
Gender and Health over the Life Course 418
Linking Mental and Physical Health 420
Conclusion 422
References 422
Chapter 22: Hearsay Ethnography: A Method for Learning About Responses to Health Interventions 427
Introduction 427
The Ethnographic Journals 429
The Journals and the Journalists: How Good Are the Data? 430
Agency and Action 432
Diagnosing AIDS Without a Blood Test 434
The “Domestication” of Offical Aids Information 436
Aids in Malawi: Misconceptions that Matter 437
Conclusions 440
References 440
Part VI:Connecting to Dynamics:The Health and Illness Career 442
Chapter 23: Life Course Approaches to Health, Illness and Healing 443
Basic Principles of the Life Course Perspective 444
Principle #1: Human Development and Aging are Life-Long Processes 444
Principle #2: The Antecedents and Consequences of Life Transitions, Events Vary According to Their Timing in a Person’s Life 445
Principle #3: Lives are Lived Interdependently and Sociohistorical Influences are Expressed Through This Network of Shared Relationships 445
Principle #4: The Life Course of Individuals is Embedded in and Shaped by the Historical Times and Places They Experience over Their Lifetime 445
Principle #5: Individuals Construct Their Own Life Course Through the Choices and Actions They Take Within the Opportunities and Constraints of History and Social Circumstance 446
Insights from European Approaches to the Life Course 446
Emerging Life Course Contributions to Health, Illness, and Healing 447
Neglected Areas of the Life Course Perspective in Health, Illness, and Healing 450
Agency Within Constraints: Applications to Health, Illness, and Healing 450
Historical and Organizational Change and Illness Careers 452
Conclusions 454
References 455
Chapter 24: The Complexities of Help-Seeking: Exploring Challenges Through a Social Network Perspective 459
Complex Models in Health Sociology 459
Network Structures: Linking Individuals and Organizations 462
Network Content: Actors’ Social Representations 464
Sequence Analysis: Exploring Social Processes 466
Conclusion 469
References 471
Part VII:Connecting the Individual and the Body 474
Chapter 25: Bodies in Context: Potential Avenues of Inquiry for the Sociology of Chronic Illness and Disability Within a New Policy Era 475
Introduction 475
Reflecting Back on the Sociology of Chronic Illness 476
Chronic Illness Experiences: Biography and Narrative 476
The Social and Cultural Significance of the Body 477
Adaptation 478
Engaging Policy: Exploring Motivation and Illness Management 479
The Limits of Psychological Determinism 479
Shifting Identities and Broader Social Influences in Chronic Disease Management 481
Exploring Evolving Domains of Knowledge and Technological Support from Beginning to End of Illness Trajectories 483
Contested Knowledge and the Shifting Diagnostic Terrain for Chronic Symptoms 484
Information and Assistive Technologies for Supporting Chronically Ill and Disabled People 485
Theoretical, Conceptual and Methodological Considerations for Future Research 486
Habitus, Therapeutic Landscapes and Social Networks 487
Conclusions 490
References 491
Chapter 26: Identity and Illness 497
Introduction 497
General Themes and Frameworks in the Field of Identity and Illness 498
The Effect of Illness on Identity 498
The Interplay of Illness and Identity (Stigma and Labeling Theory) 500
The Effect of Identity on Illness 502
Identity Theory 503
Structural Symbolic Interaction 504
Affect Control Theory 507
Identity Control Theory 510
Conclusion 512
References 513
Chapter 27: Learning to Love Animal (Models) (or) How (Not) to Study Genes as a Social Scientist 518
Introduction 518
A History of Lurking Variables and Simplistic Models 518
From Twin Studies to Data Mining: Contributions and Limitations of Traditional Genetics 519
SNP Research: A (Small) Step Forward for Mankind 520
Linkage and Gene Networks: Additional Layers of Complexity 522
What Is to Be Done? A Social Scientific Model for Genetic Research 526
Step 1: Deploy Animal Models 526
Step 2: Apply to Human Population Data and Add Exogenous Environmental Variation 528
Dead Man Walking 531
Conclusion 532
References 532
Chapter 28: Taking the Medical Sciences Seriously: Why and How Medical Sociology Should Incorporate Diverse Disciplinary Perspectives 534
Introduction 534
The Complexity of Disease Processes: An Integrative Model of Health and Illness 535
Boundary Work and Ideological Speedbumps in the Twentieth Century 536
Points of Convergence: Interactions Between Biological and Social Systems 538
Endocrine and Nervous System Activity: Conversations between Brain and Body 538
Neuroplasticity: The Brain that Changes Itself 539
Gene-Environment Interactions: Beyond the Nature/Nurture Debate 540
Confronting Professional and Institutional Barriers to Integrative Research 541
Beyond Business as Usual: Directions for Future Research 541
Dynamic Developmental Models and the Life Course Perspective 542
The Promise of a Social Networks Approach 542
The Interplay of Culture and Biology 543
The Physical Experience of Illness 545
The Need for Thoughtful Methodology 545
The Role of Medical Sociology: A Developmental Model Meets Social Constructionism 546
References 549
Index 554