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Sociology and Health!!

Dr. Purva Shoor


Asst. Prof. Community
Medicine

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Definition of Sociology
It is a science of society that studies
the relationship between human
beings, directly studies human
behavior in group.
Socius meaning individual and
societa meaning group

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Medical Sociology
Studies health, health behavior and
medical institutions
Studies social, behavioral and cultural
aspects of illness.
Studies aetiology, prevalence, incidence
and interpretation of disease according
to social background(social pathology)

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Social Anatomy
Social structure is otherwise termed as social anatomy

The structural and functional unit of society is a family

We have communities, political and economic class


and caste structure, village, township with
administrative units (stratification at each level)
Significance : structure of social institutions such as
hospital is studied (Doctor-patient, doctor-nurse,
specialist referral relationships)

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Community
The people living in a particular place
or region and usually linked by
common interests.
Example, village, town and city

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Structure-function
equilibrium
Social Institutions
Social organization or physiology

Organized complex pattern of behavior in


which a number of persons participate in
order to further group interest
For example, family, hospital, school, club ,
religion, caste, government and political
organization as different from herd, crowd or
mob(temporary)
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Temporary groups

Herd- has a leader, like nomads

Mob- has a leader who sensitizes


action like a rally
Crowd- group which has a common
aim- spectators of a cricket match

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Roles
Given by virtue of sex, age, socio-
economic status
Acquired by education or state of
disposition like the sick role, the
doctors role

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Social labelling
Social labeling & illness, disease, disability

Who is to be called ill, diseased, disabled is


determined by the individuals social position and
societys norms rather than by universal and
objectively defined signs and symptoms
A person is labeled in the course of social
interactions
de-labeling difficult

At each decision point it may be possible to return to


the normal label
STRUCTURE-FUNCTION & MEDICINE
Doctor-patient relationship

Institutional integration

The sick role (T. Parsons)

Illness as a form of deviance

Physicians discretion & return to equilibrium

Example, Alcoholism? Poverty related health


issues?
Compliance as solution?

Local healthcare system- structure and function


(finance, management, standards of healthcare
Abnormality/Deviance
& the Sick role (T. Parsons)

Rights:

The sick person is exempt from normal social


roles.
relative to the nature and severity of the illness

The sick person is not responsible for his or her


condition.
An individuals illness is usually thought to be beyond
his or her own control
A morbid condition of the body needs to be changed
and some curative process apart from person will
power or motivation is needed to get well.
Sick role
Obligations:

The sick person should try to get


well. The first two aspects of the sick
role are conditional upon the third
aspect
The sick person should seek
technically competent help and
cooperate with the physician.
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Disease-Illness
distinction
DISEASE as a bio-scientific concept
Abnormalities in the structure & function of body
organs & systems

ILLNESS -- lay concepts


Illnesses are experiences of disvalued changes in
states of being & in social function

Biomedicine presses the practitioner to construct


disease as the subject of study & treatment
Factors defining social status
Social control mechanisms: by authority and
subordination, Legislations, Opinion leaders

Customs and religion (mores and folkways)

Culture- learned behavior which has been


socially acquired

Acculturation- culture contact by Trade and


commerce, industrialization, propagation of
religion, education, conquest, inter-caste
marriages
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Standard of living
Goods we consume and services we enjoy

Depends on institutional hierarchy


(particular caste or class) and complex
systems operating in each community
meaning how it is stratified (Matriarchal or
patriarchal society/ what determines
higher or lower class and caste)

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Dynamics of social change
Demographic transition- expanding population to
declining, because of disasters (earthquakes and
hurricanes, floods)
Death rate reducing because of better health
services, expanding the population if same birth rate
Conflicts (social stress) between traditional and
modern societies that is, in transition, like son
changing his paternal occupation to how he really
wants to earn his living

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Social stress
Rural to urban migration

Famine, draughts, war

Death of the bread winner

Indebtedness

Such conflicts give rise to psychological and


physical disorders like Hypertension,
depression, cardiovascular disorders,
suicides, malnutrition
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Social Pathology

Root cause of illness

Social determinants of disease

Measured through surveys, case studies,


family studies, communication for
imparting corrective knowledge and
capacity building (Medico social work)

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Social Pathology
Determined by: doctor-patient relationship,
for complete social diagnosis and treatment
involves multi-specialty care starting from
primary care and
Intersectoral coordination ( for example,
environmental scientists plan on open drains
and malarial mosquito breeding- social
treatment)

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Social Defense
Control of social problems with the help of laws and
acts on: Central bureau of correctional services 1975
Juvenile delinquency- sexual offence, thefts, murders

Beggary

Social and moral hygiene

Prison reforms

Elimination of prostitution

Gambling and suicides etc.

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From medical ethics to social ethics
Social dimension of health

Equitable allocation of resources and on the


responsibility of people for their own health- socialism,
poor and vulnerables centered
DNR, Transplantation of organs, sex determination,
breast feeding by HIV mothers, assisted reproduction,
euthanasia, physician aided dying, sterilization have
social and community determinants to sought
Beneficience, avoiding harm (non maleficence) and
justice

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Social Problems
Prostitution

Juvenile delinquency- murder, theft,


sexual offence
Dowry system

Substance abuse and alcohol

Unmarried mothers and teenage


pregnancies
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Social Security
For sickness, maternity, old age,
death and invalidity
ESI Act 1948, Indira Gandhi Awas
yojana, Public distribution system,
Workmens compensation Act 1971,
Central Government Health Scheme

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Consumer protection Act
COPRA-in view of rights of the patient

Right to Choose

Right to Safety

Right to Information

Right to be Heard

Right to seek Redressal

Right to Consumer education


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Sociology in Health
Family planning to family welfare- when
vasectomy was compulsory, to when it
became a choice for sustained development
Housing, clothing and living conditions in
villages to control mosquito bites
Prevention of neonatal tetanus by preventing
cow dung application over umbilical stump

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Sociology in Health
Pre- lacteal feeds like honey, promoted in Iran,
whereas west prohibits due to risk of botulism
Traditional dais and puerperal tetanus and sepsis

Lifestyle management in mental health, obesity


and other chronic diseases (group dynamics)
Food myths and fads like hot and cold food, cold
milk helps gastritis, no egg intake during
pregnancy, cooking practices

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Sociology in Health
Preference of male child for proper nourishment and
care
Stigma associated with social problems like mental
health
Open field defecation habit and hook worm
infestation
Child rearing practices (applying kajal and trachoma)

Occupational health, work suited to man-


Ergonomics, like surgeons and stiff neck or back pain

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Formulate social diagnosis in
this case study.
Bala, a 17 years age girl, gave birth to
twins (girls) after 2 abortions one year
ago. She belongs to village karhari in
Mathura, her husband is a poor daily
wage earner. She has severe pallor, her
food habits are minimal and is on anti-
tubercular drugs, breast feeds infants.
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Social diagnosis
Adolescent pregnancy and Anaemia, Early marriage, Poor

living conditions- Tuberculosis- breast feeding, Diet (Anaemia),

may be due to poverty, ignorance, lack of family support (girl

child born in family)- further discuss social history

Lack of family planning which is an unmet need of the couple

Enquire about knowledge of free nutrition and drug schemes

Health seeking behavior (whether institutional delivery)


OUR AIM: Correction of social pathology through counseling
and follow-up using health workers

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Remember
mores(stringent
practices) and folkways
(usual ways of practices)
of your field practice
area
Thank you!!!!

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