The definition and understanding of health have evolved in the past three decades, going beyond the traditional focus on doctors, hospitals, and drugs. Nowadays, being healthy encompasses a broader range of practices and behaviors such as maintaining a nutritious diet, taking vitamin supplements, engaging in regular exercise, seeking therapy, practicing responsible drinking habits, and nurturing healthy social connections. The field of sociology of health acknowledges that health extends beyond the medical domain.
According to the World Health Organisation (WHO), health is defined as “a state of complete physical, mental, and social wellbeing and not merely the absence of disease or infirmity.”
The following definition highlights a positive outlook on health, rather than viewing it solely as the lack of sickness. Nevertheless, some argue that this definition is excessively optimistic and broad, as most people are not always in flawless physical or mental condition. Under this definition, even experiencing a headache or feeling slightly down would be considered unhealthy. Furthermore, this definition portrays health as an absolute concept, disregarding the reality that different societies have distinct interpretations of health and that it can differ across cultures and evolve over time.
In accordance with Dubos(1987), good health is defined as the relative capacity to function effectively, implying that individuals may experience health differently. Multiple factors, including gender, age, and occupation, can shape one’s perception of health. For instance, a young male professional athlete might have a unique perspective on health compared to an elderly female who relies on a wheelchair.
Illch (2002) suggests that the social construction of health and illness emphasizes the notion that health is a relative concept. According to Illch, attaining good health entails accepting our imperfect physical and mental condition, which includes unavoidable aspects such as aging and death. Acknowledging our inevitable encounters with illness, pain, and sickness while taking responsibility for our well-being is essential for being healthy.
Illch criticizes the influence of medicine on individuals’ capacity to attend to their own welfare. Taylor and Field (2007) contend that medical research focuses primarily on the biochemical or genetic aspects of illnesses. The majority of medical duties revolve around identifying and addressing abnormalities in the body, with healthcare practitioners, particularly doctors, being predominantly educated and trained to understand the human anatomy and intervene in disease advancement. This assesses the bio-medical model of health.
Sheeran (1995) has observed the growing success of applying medical knowledge principles in the western world. Nonetheless, the sociology of health and illness has developed by critiquing the medical model’s comprehension of health and illness and has presented various significant criticisms. The definition of health can be questioned for disregarding the subjectivity of health and illness. Additionally, the perception of being healthy or ill is socially constructed. Moreover, adopting a positive definition of health implies that experiencing ill-health is a common occurrence.
The root of poor health: The main emphasis on treating symptoms using scientific or medical remedies disregards the wider social circumstances that may have contributed to the sickness or ailment, such as pollution or poverty. Studies also show that there are various factors influencing ill-health, which are distributed differently based on social class, gender, and ethnicity.
Medical care: The National Health Service (NHS) primarily focuses on curative medicine and allocates only a small portion of its overall spending to health promotion and prevention strategies. Consequently, the underlying causes of poor health often go unaddressed. It is vital for healthcare policies to prioritize addressing risk factors associated with chronic diseases like smoking and excessive alcohol consumption. Moreover, traditional medicine has proven ineffective against emerging illnesses like AIDS.
The role of doctors: They hold exclusive authority and achievement in healthcare. According to Foucault (1973), the medical profession gained dominance by establishing and controlling a novel scientific language that describes the human body, thereby enhancing their professional standing.
Illch (2002) provides a critical examination of the role of doctors and medicine, suggesting that medicine does more harm than good. He introduces the concept of “iatrogenesis,” which refers to doctors causing illness. Illch argues that doctors have a vested interest in creating a high prevalence of diseases. Additionally, the term “social construction” originates from the work of Berger and Luckmann (1966), who were interactionist sociologists. They propose that our everyday concepts and the aspects of our world that we consider as given are actually formed through social interaction.
Consider the act of winking as an illustration. To briefly close or open one or both eyes is its definition. However, this definition alone does not encompass the significance linked to winking. The interpretation of winking relies on interactions with others within a specific social context. For instance, it may imply messages such as ‘I am aware of your secret’ or ‘I find you appealing’. Moreover, we acknowledge that the meaning of winking is socially constructed as it varies across different societies.
In certain Latin American cultures, the act of winking is seen as a gesture of romance or sexual interest. Conversely, Nigerian Yorubas may use winking to communicate their desire for their children to vacate the room. However, in Chinese culture, winking is generally considered impolite. In Hong Kong, it is crucial to avoid conspicuously blinking one’s eyes, as this may be interpreted as disrespectful or indicative of boredom. These instances illustrate that actions can only be comprehended based on the meanings attributed to them by individuals. When we assert that something is socially constructed, it does not imply that it lacks existence.
From a sociological viewpoint, the attitudes, values, and social norms of a specific society or community determine the key attributes of something such as crime statistics, disability, and childhood. These factors ultimately shape how that particular entity is perceived and understood. Consequently, the terms ‘health’ and ‘illness’ lack universal definitions as their meanings vary among individuals. The social construction of health and illness encompasses several dimensions outlined below.
If health and illness were objective, scientific, absolute facts, then everyone would interpret symptoms in the same way; all societies would have the same methods of diagnosis, and treatment and illness would be randomly distributed. However, sociologists argue that this is not true. Health and illness are actually relative concepts. This means that definitions of what is considered healthy or indicative of illness are not fixed facts; they differ from person to person within societies, vary across different societies cross-culturally, and change over time.
In societies, a person’s ideas about health and illness are connected to and mirror their beliefs regarding disease, illness, and treatment. According to Taylor et al. (1996), these ideas vary because they are formed, transmitted, and altered within the framework of societal interactions. Consequently, they are considered social constructs. Moreover, it is their nature as social constructs that makes health and illness subjective concepts. Within societies, health and illness can be regarded as relative notions due to varying definitions held by individuals.
Blaxter (1990) conducted the Health and Lifestyle survey, which involved surveying 9000 individuals at random. The purpose of the survey was to gather information about people’s perspectives on health and their own definitions of it. The survey aimed to address a criticism of the bio-medical model of health, which overlooks the perspectives and experiences of individuals by solely focusing on disease. Unlike doctors, who are considered authoritative in defining health, lay people may possess a more informed understanding of health since it is partly based on subjective experiences, as pointed out by Blaxter.
Blaxter’s research findings revealed that people have varying interpretations of health. These interpretations can be divided into negative and positive perspectives. Negative perspectives define health as the lack of sickness or disability symptoms, while positive perspectives associate it with physical strength or mental and social well-being. Additionally, Blaxter discovered specific societal patterns that shape individuals’ notions of health. Age and gender were found to influence how people perceive their own well-being. Younger men tend to prioritize physical power and fitness when assessing their health, while young women often concentrate on aspects like energy, vitality, and coping skills.
As individuals reach middle age, their perception of health broadens to include both mental and physical well-being. Older males especially tend to prioritize functional capabilities when evaluating their health. However, it is crucial to recognize that health can also encompass satisfaction, happiness, mindset, or even the presence of illness or disability. In addition to Blaxter’s research findings, other studies indicate that definitions of health not only vary among individuals but also differ across different groups.
In his study of elderly individuals in Aberdeen, Williams (1983) discovered three lay concepts based on his interview data: health as the absence of disease, health as a measure of strength, weakness, and exhaustion, and health as functional fitness. Additionally, there is evidence to indicate a correlation between beliefs about health and social class. For instance, D’houtard and Field (1984) found that in their study of 4000 individuals in France, respondents from non-manual backgrounds held more positive views on health compared to those from manual backgrounds, who expressed more negative definitions.
Research conducted in the UK shows that working-class women prioritize practical health ideas and place importance on fulfilling societal roles. A study by Pill and Stott (1982) includes a quote from a woman highlighting the significance of being a good mother and constantly staying occupied. She believes that her lack of time to worry about health problems, as well as the financial burden it would bring to her family, contribute to not having any such issues (pp. 49-50). Nevertheless, it is crucial not to overemphasize the association between beliefs and social class.
Calnan (1987) discovered that social class did not factor into the determination of health. Both working-class and middle-class women held unfavorable opinions about their own well-being. Howlett et al. (1992) performed a secondary examination on Blaxter’s information and contrasted the health beliefs of various ethnic groups – Asians, African-Caribbeans, and white individuals. The investigation demonstrated that Asians had a greater tendency to define health based on functionality, while Afro-Caribbeans associated it more with energy and physical strength compared to white respondents.
One can argue that marginalized groups in society are more prone to attributing illness to bad luck, as evidenced by their tendency to hold fatalistic beliefs about its causes. In a study conducted by Prior et al. (2002) on two Cantonese-speaking communities in the UK, a link between health and happiness was found, along with inner contentment. Good health was viewed as synonymous with happiness and considered a crucial characteristic. The definition and perception of health vary across diverse cultures.
Despite variations in beliefs about the origins and remedies for illness, most societies distinguish between health and illness. Additionally, societies differ in their acceptance of different levels of discomfort and pain as normal, and may interpret similar symptoms differently. According to Taylor et al., a person’s perception of well-being or sickness is influenced by their cultural context (1996, p423). Furthermore, studying shifts in a society’s perception of health and illness over time highlights the relative nature of these concepts.
Until 1957, homosexuality was considered a mental illness, and men who revealed their homosexuality often had to undergo aversion therapy. Nowadays, such a belief would not be acceptable since sexual equality is now protected by law in our society. Another example is discussed by Helman (1978) who explored people’s beliefs regarding contracting colds, chills, and fevers. Folk beliefs suggest that if your head, neck, and feet are exposed, you are more susceptible to catching a cold.
The act of catching a cold was considered to be a consequence of negligence. It was believed that it was the duty of every individual to dress appropriately and avoid going outside with wet hair in order to prevent illness. This reinforces the idea that health and illness are influenced by societal factors. Additionally, the social distribution of illness further supports this concept. If illness were solely determined by biological reasons, it would be evenly spread across the entire population. However, evidence from the section on health inequalities demonstrates that illness follows a pattern based on factors such as social class, gender, and ethnicity.
