Health as a Social Construct: Illness and Disease

Question 1

What is meant by Marinker’s Three Levels: Disease Illness Sickness (sick role)

Answer 1

Disease is biological

Illness is how a person negotiates disease

Sickness - how society deals with disease and/or illness

Question 2

What is the WHO definition of health?

Answer 2

A complete state of physical, mental and social well-being and not merely the absence of disease and infirmity

Question 3

What is the biochemical model of Illness?

Answer 3

Germ theory -

each disease has a single and specific cause, therefore target all research on this casual agent

Health and illness are qualitatively difference. No continuum between the two

Question 4

What is the epidemiological triangle? Apply the example of the treatment of heart diseases to this model

Answer 4

Host - exercise more

Agent - reduce fatty food intake

Environment - more opportunities for exercise, healthy food

Question 5

What do the causal models of disease entail?

Answer 5

Disease can be prevented by modifying factors that influence exposure and susceptibility

Less useful if single causal agent remains unidentified e.g. arthritis

Question 6

What is meant by the social construction of health?

Answer 6

Disease categories are not created independently from social or moral forces

This does not mean that medicine is unscientific BUT that medicine and science are social processes

Question 7

What is the socio-environmental approach?

Answer 7

One framework for classifying determinants of health

• personal health practices
• individual capacity and coping skills
• social and economic environment
• the physical environment
• health services

Question 8

What is medicalisation?

Answer 8

a process by which non-medical problems become defined and treated as medical problems usually in terms of illness or disorder

Question 9

Medicalisation occurs on three levels:

Interactional level

Conceptual level

Institutional level

Answer 9

1. interactional level- patient actively asking doctor to give them a sick role/ doctor defines a problem as medical
2. conceptual level- behaviour labels e.g. ADHD
3. institutional - institutions treat people as disease or conditions

Question 10

What are the past and present drivers of medicalisation?

Answer 10

Past drivers

• professional dominance, intitutions/pressure groups

Present drivers

• biotechnology, consumerism, the ‘care’ industry, media

Question 11

What is iatrogenesis? What are the 4 types?

Answer 11

being made sick through medical practice

• Medical incompetence
• Cascade iatrogenesis - start off with one intervention, then another to deal with the symptom of first intervention, polypharmacy, side effects
• Social iatrogenesis - people around a patient leave them because they are considered abnormal. difficult to readjust to society after institutionalisation
• Structural iatrogenesis - forced into sick role e.g. eating disorders and force feeding

Question 12

What is disease mongering? Give examples

Answer 12

Widening the diagnostic boundaries of illness and aggresively promoting their public awareness in order to expand their markets for treatment e.g. erectile dysfunction, female dysfunction, restless leg syndroe, bowel flora