Social pathology (causes of disease and illness)

Sociologists have demonstrated that the spread of diseases is heavily influenced

by the:
 Socioeconomic status of individuals
 Ethnic traditions or beliefs,
 Cultural factors
 Demographics
 There has historically been a long-term decline in mortality within
industrialized societies.

 On average, life expectancies are considerably higher in developed,

rather than developing or undeveloped, societies.  
  Patterns of global change in health care systems and research make
it comprehend, “the sociology of health and illness”.
 Continuous changes in economy, therapy and technology can affect
the way individual communities view and respond to the medical
care available. These rapid fluctuations cause the issue of health and
illness within social life to be very dynamic.
 Information technology is vital because as patterns evolve, the study
of the sociology of health and illness constantly needs to be updated.

Social pathology
 It can be grouped into three categories:
 Social constraints
 Social evils
 Social deviance
Social constraints
 These are the restrictions or impediments that arrest the growth and
development of people.
 These include
1. Poverty and destitution
2. Illiteracy and ignorance
3. Migration and environmental crisis
4. Industrialization and urbanization

Social evils
 Social evils are undesirable practices that give rise to multiple social
problems, erode the social fabric and undermine socio-economic
development.
 The primary social evils of our society are:
1. Smoking and drinking
2. Gender bias and gender discrimination
3. Child neglect and child abuse
4. Child labor and child abandonment
5. Stress and stress behavior
6. Crime and corruption
7. Prostitution and STIs
Social deviance
 It is an anti-social behavior pattern of individuals who failed to conform to
acceptable social norms and adopt a way of life that goes against the
interest of society and themselves.
  Drug abuse
 Juvenile delinquency
 Suicide
1. Poverty and destitution
Poverty: it is a condition of poor economic status in relation to others in a
society.
Destitution: it is a state of abject poverty; a state of extreme deprivation
whereby a family is not able to obtain even the minimum quantity of food.
Causes of poverty:
 Unemployment
 Distorted socio-economic development
 Unequal distribution of national wealth
 Decreasing allocations on health, housing, nutrition and education
 Increasing allocations on non-productive ventures of false prestige
 A system of governance promoting favoritism, nepotism, crime and
corruption.
 A political system based on casteism, communalism, dynamism, and
mutual hatred
 A problem of mounting debt burden due to years of
misappropriation and misgovernance.
Poverty at national level is reflected in
 Inadequate piped water supply
 Poor waste disposal services
 Poor sanitary arrangements
 Insanitary housing conditions
  Growing environmental pollution
 Inadequate basic health care services
Poverty is associated with
 High mortality
 High morbidity
 High fertility
2. Illiteracy and ignorance
 For census purpose a person is considered illiterate if he/she can merely
read.
 National education budget
 Literacy rate for the year 2009 was:
 Total 58%
 Male 69%
 Female 45%
 References
 http://finance.gov.pk/survey/chapter_10/10_Education.pdf

Ignorance
 A lack of knowledge, understanding, or education.
 It is more widespread than illiteracy and potentially more dangerous if
found in political leaders, religious leaders. technocrats and bureaucrats.
Illiteracy and ignorance
These are the root causes of
 poverty and
 ill health.
 Unhealthy life styles
 Inability to avail PHC services
 Resistance to public health measures
  Contribute to high mortality, morbidity and fertility
3. Migration and environmental crisis

 Migration within countries may be rural-urban or rural-rural.

 Both types lead to environmental crisis that disturbs ecosystem.
 Migration is an outcome of synergistic interaction between
o Push factors
o Pull factors
Push factors for migration to urban area
 Unequal land ownership
 Diminishing land holdings
 Mechanized farming practices
 Dwindling agriculture employment
 Non-existent land reforms
 Unemployment of village youth
Pull factors for migration to urban area
 Job opportunities
 Facilities provided in respect to
 Education
 Communication
 Health care
Consequences of rural-urban migration
 Migrants settle in peri-urban slum and shanty areas
 Proximity of fly and mosquito breeding places
 Usually fouled by garbage dumps, slaughter house effluents, etc.
  Threatened by rats, dogs, rodents etc.
 Migrants are at increased risk of; air borne, water borne, vector borne, soil
borne and dust borne illnesses.
 Also exposed to social evils
Rural-rural migration
 Push factors:
 Non-availability of employment
 Pull factors
 Availability of lands
 Settlement usually occurs in low productivity zones, less-fertile lands, hilly
fringes and desert margins.
Consequences of rural to rural migration
 Environmental degradation
 Overcutting of trees
 Over grazing by cattle
 Erosions of forests and agricultural lands
 Desertification and
 Shrinking of agricultural resources
 Migrant population suffer from water-borne, vector borne and dirt-borne
diseases.
 More exposed to zoonotic diseases, snake and scorpion bites
4. Industrialization and urbanization

 Industrialization is the principle mean of socio-economic development

 It accelerates urbanization
Penalty of industrialization
 Environmental pollution
 Pollutants released by industries lead to air, water, soil, noise and
radioactive pollution.
 Increase magnitude of public health problems
 Population at risk are: workers and local population.
Unplanned urbanization brings about:
 Population problems: increase pressure on basic needs like
 water supply and sanitation,
 solid waste disposal,
 housing and land tenure,
 communication facilities,
 law and order facilities,
 education,
 health and
 social welfare facilities
 Industrial problems:
 Industrial hazards
 Environmental hazards
 Health problems:
 Infectious diseases
 Deficiency diseases
 Stress-related diseases
  Road traffic accidents

 Social problems:
 Alcohol intake
 Crime
 Violence
 Illegitimacy
 Prostitution
 antisocial activities and disorders
Management of social constraints Development approach:
 Fair distribution of economic gains
 Preferential distribution for the poorest
 Concentrate more on food, education and public health measures
 Decrease production of weapons
 Decentralization and community participation
 Generate employment opportunities for agricultural workers and
marginal farmers in their villages
 Preserve ecosystem, prevent pollution and degradation of
environment
 Discourage proliferation of slums around industrial areas.
Educational approach
 Best investment against poverty
 Make education vocation oriented
 Mass education dispel prejudices and misbelieves associated with illiteracy
and ignorance.
  Help alleviate poverty

Legal approach
 Laws to guide the growth and development of industries on scientific lines
protecting workers and local population
 Laws to control the emission and disposal of industrial effluents, preventing
environmental pollution and preserving ecosystem.
 Laws to discourage the proliferation of slums and slum associated social
evils.
Social approach
 Equality & Equity
Culture of Medicine Sociological Perspective on Health

MEDICAL SOCIOLOGY is the Sociological Analysis of

• medical organizations and institutions;
• the production of knowledge and selection of methods,
• the actions and interactions of healthcare professionals,
• and the social or cultural (rather than clinical or bodily) effects of medical
practice.

Sociology assumes that a functioning society depends upon healthy people and
upon controlling illness. This correlates with the knowledge of retaining the
understanding of the key concepts in this context:
i. Health
ii. Medicine
iii. Healthcare

Health refers to the extent of a person’s physical, mental, and social well-being.
This definition emphasizes the importance of being more than disease free, and
recognizes that a healthy body depends upon a healthy environment and a stable
mind. As this definition suggests, health is a multidimensional concept. It is
possible for someone to be in good physical health and poor mental health, or
vice versa.
Medicine refers to the social institution that seeks to prevent, diagnose, and treat
illness and to promote health in its various dimensions. It is the social institution
that diagnoses, treats, and prevents disease. To accomplish these tasks, medicine
depends upon most other sciences—including life and earth sciences, chemistry,
physics, and engineering.
Finally, health care refers to the provision of medical services to prevent,
diagnose, and treat health problems.
Preventive medicine is a more recent approach to medicine, which emphasizes
health habits that prevent disease, including eating a healthier diet, getting
adequate exercise, and insuring a safe environment.
The Medical Culture
The White Coat- Dress Code
 The Doctor Talk- Shared Language– Supreme order of the physician!
 The Explanatory Model- used to define health and illness
Sociologists working in health may use health behavior and institutions as areas of
study to advance theory and methods in sociology generally, or may be motivated
primarily to solve applied problems relating to improvement of health care,
organizational arrangements, and processes of care (Freeman and Levine 1989).
 The Sick Role
Talcott Parsons identified what he called “the sick role,” or the social definition of,
the behavior of, and the behavior toward those whom society defines as ill.
Parsons identified four components to the sick role.
The Sick person is:
1. Not held responsible for being sick.
2. Not responsible for normal duties.
3. Not supposed to like the role.
4. Supposed to seek help to get out of the role.

If all these expectations are met, sick people are treated as sick by their family,
their friends, and other people they know, and they become exempt from their
normal obligations to all these people. Sometimes they are even told to stay in
bed when they want to remain active.
The Physicians Role
Diagnose the patient decide how to treat the patient help the patient get well
To do so they require cooperation of the patient answer all necessary

questions of the physician follow the physicians’ instructions.

Physician-patient relationship is hierarchical (Persons): the physician gives the

orders (or, more accurately, provides advice and instructions), and the patient
follows them.
KEY TAKEAWAY
 A sociological understanding emphasizes the influence of people’s social
backgrounds on the quality of their health and health care. A society’s
culture and social structure also affects health and health care.
 The functionalist approach emphasizes that good health and effective
health care are essential for a society’s ability to function, and it views the
physician-patient relationship as hierarchical.
 The conflict approach emphasizes inequality in the quality of health and in
the quality of health care.
 The interactionist approach emphasizes that health and illness are social
constructions; physical and mental conditions have little or no objective
reality but instead are considered healthy or ill conditions only if they are
defined as such by a society and its members.