HCD 1123: INTRODUCTION TO BASIC SOCIOLOGY AND ANTHROPOLOGY

Sociology is the study of society and culture. Sociology’s subject matter is diverse, ranging
from crime to religion, from the family to the state, from the divisions of race and social class to
the shared beliefs of a common culture, and from social stability to radical change in whole
societies. Unifying the study of these diverse subjects of study is sociology’s purpose of
understanding how human action and consciousness both shape and are shaped by surrounding
cultural and social structures.

Sociology is an exciting and illuminating field of study that analyzes and explains important
matters in our personal lives, our communities, and the world. At the personal level, sociology
investigates the social causes and consequences of such things as romantic love, racial and
gender identity, family conflict, deviant behavior, aging, and religious faith. At the societal level,
sociology examines and explains matters like crime and law, poverty and wealth, prejudice and
discrimination, schools and education, business firms, urban community, and social movements.
At the global level, sociology studies such phenomena as population growth and migration, war
and peace, and economic development.

Concepts of health seeking behavior

Health-seeking behavior has been defined as a “sequence of remedial actions that individuals
undertake to rectify perceived ill-health.” In particular, health-seeking behaviour can be
described with data collected from information such as the time difference between the onset of
an illness and getting in contact with a healthcare professional, type of healthcare provider
patients sought help from, how compliant patient is with the recommended treatment, reasons for
choice of healthcare professional and reasons for not seeking help from healthcare professionals. 

In the broadest sense, health behavior includes all behaviors associated with establishing and
maintaining a healthy physical and mental state,(Primary Prevention). Health-seeking behaviors
also include behaviors that deal with any digression from the healthy state, such as controlling
(Secondary Prevention) and reducing impact and progression of an illness (Tertiary prevention).

The concept of studying health seeking behaviors has evolved with time. Today, it has become a
tool for understanding how people engage with the health care systems in their respective socio-
cultural, economic and demographic circumstances. All these behaviors can be classified at
various institutional levels: family, community, health care services and the state. In places
where health care systems are considered expensive with a wide range of public and private
health care services providers, understanding health seeking behaviors of different communities
and population groups is important to combat unaffordable costs of health care

Health Seeking Behavior: Models

Health-seeking model: Various studies demonstrated that one’s decision to engage with a
particular medical channel is influenced by a variety of socio-economic variables, sex, age,
social status of women, type of illness, access to services and perceived quality of the service.

Pathway Model

Suchman was the first to use the pathway model to describe the steps of the process from
identification of symptoms to the use of particular health care providing facilities. This model
aims to identify a logical sequence of steps. It also analyses how social and cultural factors
affects this sequence.

Determinants Model

This model is based on a more bio-medical and quantitative approach. Instead of focusing on the
steps one would take to preserve or improve health, this model focuses on highlighting a set of
determinants which are associated with the choice of different kinds of health service. 

There are various models to explain the different determinants of Health-seeking behaviors.
Andersen’s grouping of factors influencing determinants into 3 main categories: population
characteristics, health care systems and the external environment. Next, another researcher
focused on the individual’s health behavior and adoption of the sick role. This model specifically
focuses on one’s health behavior and it ignores the effect of social network on the decision-
making process.

All of these models of determinants and factors influence health-seeking behaviors are vital as it
helps us to understand how and why one would seek care earlier than others. As for illnesses that
require immediate care, such models are informative as it contributes to interventions for the
reduction of transmission and complications arising from neglect

Methods Used in Studying Health Seeking Behaviors

Household surveys

Household surveys are the most commonly used method to study health seeking behaviors. Most
of the household surveys administered are disease specific. Sample size varies each time, but
usually around an average of 1000-2000 respondents for each survey. These household surveys
are usually conducted using structured interview questionnaires. The World Bank provides
guidelines and advice on how to design ‘multi-topic household surveys’. According to them, a
household survey should include modules such as: consumption, education, health, employment,
anthropometry, non-labor income, housing, price data, environmental issues, fertility, household
income, savings, household enterprises and time use.

Facility-based surveys

Facility based surveys are usually patient surveys and are often disease specific in areas such as
Tuberculosis or neonatal care. Clients are recruited at health care providing facilities and
followed up using either qualitative or quantitative methods. Conclusions drawn from facility or
household surveys may appear mundane or obvious, but they still hold significant importance

Patterns of Resort

A person's approach to health-seeking behavior can be described as a “pattern of resort.”

According to the Encyclopedia of Medical Anthropology, people usually opt for the simplest
form of treatment, which usually is the cheapest, most effective treatment they deem to be. Only
when the simplest form of treatment is proved unsuccessful do people seek higher level, more
costly and unconventional treatments. Health-seeking is a dynamic process and can involve
many aspects of medical units at the same time. Because of this, people are allowed to garner
information and make informed choices about the wide range of medical services that are
available to them.

Factors that affect Health- Seeking Behaviors

Illness types, severity

Depending on illness type, people seek different forms of treatments specific to the disease they
are diagnosed with. In addition, depending on the severity of the diagnosed disease, people might
select different forms of treatments and medication.

It was found that individuals perceived their illness to be either mild or not for medical
treatment, which prevented them from seeking healthcare treatment. In addition, poverty
emerged as a major determinant of health-seeking behavior as treatments were often perceived as
either a waste of money, lack of money, or poor attitude of health worker.]

Accessibility & Availability

Depending on the area a person lives in, some treatment might be available but not other forms
of treatments. Therefore, a patient is limited to what is accessible and available to them when
seeking treatment for a disease.

Social Determinants of Health and Health-Seeking Behavior

The World Health Organization defines the social determinants of health as the “conditions in
which people are born, grow, live, work and age.” In 2011, the World Health Organization
argues “the distribution of money, power and resources at global, national and local levels”
creates these conditions. Socio-Economic Status (SES), gender, race, and education are factors of
health-seeking behavior that are influenced by the social determinants of health.

Socio-Economic Status (SES) and Health-Seeking Behavior

A study done by John D. O’Neil (1989) stresses the importance of the “social relationship”
between a doctor and patient in his article, The Cultural and Political Context of Patient
Dissatisfaction in Cross-Cultural Clinical Encounters: A Canadian Inuit Study. In his paper,
O’Neil explains that because of an unequal distribution of power and knowledge of health leads
to patients being unsatisfied with their health care provider, which in turn leads to patients to
stop seeking treatment.
Gender and Health-Seeking Behavior

The difference between gender roles is significant in the patterns of health-seeking behavior
between men and women. According to Currie and Wiesenberg(2003), women tend to engage in
less health-seeking behavior compared to their male counterparts. In their article, Currie and
Wiesenberg (2003) highlights three components a woman’s decision-making process for seeking
healthcare. Firstly, women generally are less likely to identify disease symptoms in the first
place. Women might shrug of symptoms as normal everyday muscle aches or normal regular
occurrence. To be able to recognize and identify a health problem, one needs to have some form
of knowledge and awareness of symptoms and illnesses. Secondly, the study revealed that
women tend to belief that they are more restricted compared to their male counterparts in terms
of health care accessibility. This is due largely to cultural ideas about the social value of women,
which is lower compared to men. Thirdly, it is revealed that women do not engage in healthcare
treatments even if they recognized that they have a health problem (Currie and Wiesenberg,
889). This is partly due to restricted accessibility to health services given the social roles of
women, which may limit their ability to visit healthcare facilitates when they are open during the
day (Currie and Wiesenberg, 889).

Culture and Health-Seeking Behavior

Factors such as cultural values and gender roles are significant in influencing the decision
making process associated with health-seeking behavior (Tung, 536). Asian-American cultures,
for example, are strongly influenced by Confucian doctrines, which emphasized the importance
of “interdependence,” “collectivism,” and “familism” (Tung, 536). These values reinforce the
expectation of individuals to place the needs of the family before their own, which may
discourage them to pro-actively seek healthcare in a timely manner. Furthermore, these values of
Asian-American cultures suggest that physical and mental distress are family problems rather
than an individual ones meaning that they should not be revealed to people outside their kin
(Tung, 536). Seeking help from health care professionals or seeking financial aid from the
government to pursue treatment would be exposing the problem beyond their family network,
which is considered shameful and could pose a threat to the status or reputation of the family.
Consequently, Asian-American people tend to turn to family members before pursuing external
help, thereby delaying the act of seeking professional health care (Tung, 537).
Implications for the Healthcare System

It is important for health care professionals to understand the different factors that affect an
individual’s decision to seek healthcare treatments. This is to ensure that professionals are better
able to recommend treatments that are appropriate to the individual, so as to promote health’s
seeking behaviors, instead of providing options that patients might not feel comfortable with
because of social norms or values. Having knowledge of the roles that cultural beliefs and gender
roles play in terms of health-seeking behavior can help healthcare providers improve their
relationship professional-patient relationships and develop strategies to encourage people to seek
appropriate treatments as soon as possible.

Stigma and Health-Seeking Behavior

Erving Goffman (1963) describes stigma or social devaluation “as a mark of social disgrace”
often leading others to see us as untrustworthy, incompetent, or tainted. Gender, race, social
status, mental and physical health are topics vulnerable to stigma It is important to note that
some cultures or individuals feel that seeking treatment is a shameful thing because it’s akin to
announcing to public that you have an illness. Therefore, education is needed to break this
negative stigma in order to increase health-seeking behaviors. For example, people in Asia are
usually reluctant to seek professional counseling help because they are afraid that their friends
and family might shun away from them, thinking that they are "crazy".

Relationship between social- economic factors and health

 Income- is acknowledged as being one of the key socio-economic variables influencing

health status. The health of a population is affected more by the degree of inequality of
income distribution than by the level of wealth per Se.

 There is substantial evidence that a low level of education is associated with poor health
status, and that those with the lowest level of education are disproportionately at risk of
ill-health.

 Lower social class is consistently linked with higher death rates, both overall and from
most major causes of death
  The unemployed have worse physical and mental health than the employed. This is a
consistent finding from research using a range of assessment methods. Two significant
subgroups within the unemployed are the tong-term unemployed and the young
unemployed; research indicates that the health impacts of unemployment are different for
these subgroups, with long-term unemployment being particularly detrimental to health.

 Gender- Men have higher death rates than women at all ages and have a shorter life
expectancy. Women experience more ill-health than men and make greater use of health
services, much of which is for care related to reproduction.

 Housing has three types of direct impact on health, arising from the cost, the condition
and the location of the housing. Lack of housing or substandard housing substantially
increases the risk of ill-health, especially for children; this risk may last well beyond the
period of housing problems. Substandard housing is a problem for those with least choice
in the housing market such as Maori and Pacific Island Polynesians. Those with a
psychiatric disability have particular difficulty obtaining adequate housing.

 Being without private transport or without access to public transport, affects health status
both directly, by reducing access to health services, and indirectly, by reducing social
networks beneficial to good health.

 Religious beliefs

 cultural beliefs

Organization sociology
Definition of society as defined by Calhoun et al (1994): "A society is an autonomous grouping
of people who inhabit a common territory, have a common culture (shared set of values, beliefs,
customs and so forth) and are linked to one another through routinized social interactions and
interdependent statuses and roles

Social organization: the arrangement of the parts that constitute society, the organization of
social positions and distribution of people within those positions

 Status: socially defined niches, positions (student, professor, administrator)

 Role: every status carries a cluster of expected behaviors; how a person in that status is
expected to think, feel, as well as expectations about how they should be treated by
others. The cluster of expected duties and behaviors that has become fixed in a consistent
and reiterated pattern of conduct.

 Group: two or more people regularly interacting on the basis of shared expectations of
others’ behavior; interrelated statuses and roles.

 Institutions: patterns of activity reproduced across time and space. Practices that are
regularly and continuously repeated. Institutions often concern basic living arrangements
that human beings work out in the interactions with one another and by means of which
continuity is achieved across generations. The basic building blocks of societies. Social
institutions are like buildings that are at every moment constantly being reconstructed by
the very bricks that compose them.

 Social structure: Structure refers to the pattern within culture and organization through
which social action takes place; arrangements of roles, organizations, institutions, and
cultural symbols that are stable over time, often unnoticed, and changing almost
invisibly. Structure both enables and constrains what is possible in social life.

Inequality:

 Social stratification: the division of people socioeconomically into layers or strata.

When we talk of social stratification, we draw attention into the unequal positions
occupied by individuals in society. In the larger traditional societies and in industrialized
countries today there is stratification in terms of wealth, property, and access to material
goods and cultural products.
  Race: a human group that defines itself and/or is defined by other groups as different…
by virtue of innate and immutable physical characteristics. It is a group that is socially
defined on the bases of physical criteria.

 Ethnicity: cultural practices and outlooks of a given community of people that set them
apart from others. Members of ethnic groups see themselves as culturally distinct from
other groups in a society, and are seen by those others to be so in return. Many different
characteristics may distinguish ethnic groups from one another but the most usual are
language, history or ancestry - real or imagined, religion, and styles of dress of
adornment. Ethnic differences are wholly learned

Social Groups

The term group has a special meaning in sociology because it represents a concept that is central
to any sociological analysis. Quite several definitions have been given to the term group by
different sociologists.

Generally, a social group is defined as the collectivity or set of people who involve in more or
less permanent or enduring social interactions and relationships.

Members of a social group have common basis for interaction and shared characteristics, a
feeling of identity or belongingness, shared psychology or consciousness and a definite set of
norms to govern the behaviors of the individual participant in the group.

Basic Features of a Social Group

In their sociological analysis of the group behavior of human society, sociologists have
identified some essential elements of a social group. For a set or collectivity of people to be a
social group, it has to have the following essential traits or features

1. Members of the group continue to interact with one another;

2. Membership requires living by norms that are special to the group;

3. Members view each other as part of the group; members feel some sense of identification with
the group and with one another; and there is a social boundary between members and non-
members;
4. Members are functionally integrated through role and status relationship in the group
structure; and

5. Others see members as group.

Social interaction among the members is relatively permanent; it is not causal. Common
interests should characterize as a basis for interaction. The emotional, shared consciousness is
also important. The feeling of belongingness is very important. Social norms and values govern
behavior of group members. All of the following are examples of social groups, from the
smallest possible level to the largest possible. A dyad (made up of two persons like fiancés,
husband and wife), a family, a group of students in a dormitory, peer group, a friendship,
an ethnic group, a community, a nation, a continent, a university, an organization, etc

Anthropology

 Is the study of humans and human behavior and societies in the past and present.

The concept of culture

Culture: sets of traditions, rules, symbols that shape and are enacted as feelings, thoughts, and
behaviors of groups of people. Referring primarily to learned behavior as distinct from that
which is given by nature, or biology, culture has been used to designate everything that is
humanly produced (habits, beliefs, arts, and artifacts) and passed from one generation to another.
In this formulation, culture is distinguished from nature, and distinguishes one society from
another.

Basic Characteristics of Culture

1. Culture is organic and supra-organic: It is organic when we consider the fact that there
is no culture without human society. It is supra organic, because it is far beyond any
individual lifetime. Individuals come and go, but culture remains and persists.

2. Culture is overt and covert: It is generally divided into material and non-material
cultures. Material culture consists of any tangible human made objects such as tools,
automobiles, buildings, etc. Non- material culture consists of any non-physical aspects
like language, belief, ideas, knowledge, attitude, values, etc
 3. Culture is explicit and implicit: It is explicit when we consider those actions which can
be explained and described easily by those who perform them. It is implicit when we
consider those things we do, but are unable to explain them, yet we believe them to be so.

4. Culture is ideal and manifest (actual): Ideal culture involves the way people ought to
behave or what they ought to do. Manifest culture involves what people actually do.

5. Culture is stable and yet changing: Culture is stable when we consider what people
hold valuable and are handing over to the next generation in order to maintain their
norms and values. However, when culture comes into contact with other cultures, it can
change. However, culture changes not only because of direct or indirect contact between
cultures, but also through innovation and adaptation to new circumstances.

6. Culture is shared and learned: Culture is the public property of a social group of
people (shared). Individuals get cultural knowledge of the group through socialization.
However, we should note that all things shared among people might not be cultural, as
there are many biological attributes which people share among themselves.

7. Culture is symbolic: It is based on the purposeful creation and usage of symbols; it is

exclusive to humans. Symbolic thought is unique and crucial to humans and to culture.
Symbolic thought is the human ability to give a thing or event an arbitrary meaning and
grasp and appreciate that meaning Symbols are the central components of culture.
Symbols refer to anything to which people attach meaning and which they use to
communicate with others. More specifically, symbols are words, objects, gestures,
sounds or images that represent something else rather than themselves.

Elements of Culture

Culture includes within itself elements that make up the essence of a society or a social group.
The major ones include: Symbols, values, norms, and language

Symbols

Symbols are the central components of culture. Symbols refer to anything to which people attach
meaning and which they use to communicate with others. More specifically, symbols are words,
objects, gestures, sounds or images that represent something else rather than themselves.
Symbolic thought is unique and crucial to humans and to culture. It is the human ability to give a
thing or event an arbitrary meaning and grasp and appreciate that meaning. There is no obvious
natural or necessary connection between a symbol and what it symbolizes.

Language: a system of verbal symbols through which humans communicate ideas, feelings,
experiences. Through language these can be accumulated and transmitted across generations.
Language is not only a tool, or a means of expression, but it also structures and shapes our
experiences of the world and what we see around us.

Values: ideas people share about what is good, bad, desirable, undesirable. These are usually
very general, abstract, cut across variations in situations.

Norms: behavioral rules or standards for social interaction. These often derive from values but
also contradict values, and serve as both guides and criticisms for individual behavior. Norms
establish expectations that shape interaction

Mores: Are important and stronger social norms for existence, safety, well-being and continuity
of the society or the group or society. Violation of, and deviation from these kinds of norms,
may result in serious reactions from the groups. The strongest norms are regarded as the formal
laws of a society or a group. Formal laws are written and codified social norms. The other kinds
of mores are called conventions. Conventions are established rules governing behavior; they are
generally accepted ideals by the society. Conventions may also be regarded as written and signed
agreements between nations to govern the behaviors of individuals, groups and nations.
Folkways: Are the ways of life developed by a group of people. They are detailed and minor
instructions, traditions or rules for day-to-day life that help us function effectively and smoothly
as members of a group. Here, violating such kinds of norms may not result in a serious
punishment unlike violating mores. They are less morally binding. In other words, folkways are
appropriate ways of behaving and doing things. Examples may include table etiquette, dressing
rules, walking, talking, etc. Conformity to folkways usually occurs automatically without any
national analysis and is based upon custom passed from generation to generation. They are not
enforced by law, but by informal social control. They are not held to be important or obligatory
as mores, or moral standards, and their violation is not as such severely sanctioned. Although
folkways are less binding, people have to behave according to accepted standards. Some
exceptional behaviors are regarded eccentric behaviors. Folkways are distinguished from laws
and mores in that they are designed, maintained and enforced by public sentiment, or custom,
whereas laws are institutionalized, designed, maintained and enforced by the political authority
of the society. Folkways in turn may be divided into two sub types: fashion and custom.
Fashion: Is a form of behavior, type of folkways that is socially approved at a given time but
subject to periodic change. Adherents combine both deviation and conformity to norm of a
certain group.
Custom: Is a folkway or form of social behavior that, having persisted a long period of time, has
become traditional and well established in a society and has received some degree of formal
recognition. Custom is a pattern of action shared by most or all members of a society. Habit is a
personality trait, where as the custom is a group trait.