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  • 1. Definitions of health and illness Lay definitions of health and illness This refers to how ordinary people (or lay people) construct their definitions of health and illness. If definitions of health and illness vary, then we need to know just what factors appear to influence the way in which individuals define their sense of being healthy or ill. Sociologists have suggested that culture, age, gender and social class are particularly important. Cultural differences Different social groups have differening ideas of what constitutes illness. For example, Krause (1989) studied Hindu and Sikh Punjabis living in Bedford, and in particula r focused on their illness called ‘sinking heart’ (dil ghirda hai) which is characterised by physical chest pain. According to Krause, this illness is caused by a variety of emotional experiences- most importantly, public shame of some sort. No such illness exists in other mainstream cultures in Britain. Do you think that ‘sinking heart’ is an illness? Explain. What else could it be? .................................................................................................................................................................... .................................................................................................................................................................... .................................................................................................................................................................... .................................................................................................................................................................. Age differences Older people tend to accept ‘normal’ as range of pains and physical limitations which younger people would define as symptoms of some illness or disability. As we age, we gradually redefine health and accept greater levels of physical discomfort. In Blaxter’s (1990) national survey of health definitions, she found that young people tend to d efine health in terms of physical fitness, but gradually, as people age, health comes to be defined more in terms of being able to cope with everyday tasks. She found examples of older people with really serious arthritis, who nevertheless defined themselves as healthy, as they were still able to carry out a limited range of routine activities.
  • 2. Think about older people you know. How do they respond to illness or disease? .................................................................................................................................................................... .................................................................................................................................................................... .................................................................................................................................................................... .................................................................................................................................................................... Gender differences According to Hilary Graham (2002), men have fewer consultations with doctors than women and appear to have lower levels of illness. This is partly due to the greater number of complications associated with childbirth and menopause that women face, but it is also partly due to the fact that men are less likely to define themselves as ill or as needing medical attention. The idea of ‘masculinity’ includes the belief that a man should be tough and put off going to the doctor. Despite the greater readiness of men to define themselves as healthy and to visit GPs less often, men have considerably high mortality (death rates) than women. Why do you think men have higher mortality rates than women? .................................................................................................................................................................... .................................................................................................................................................................... .................................................................................................................................................................... ................................................................................................................................................................... Social class differences Blaxters research also showed that working –class people were far more likely to accept higher levels of ‘illness’ than middle-class people. Blaxter describes working- class people as ‘fatalistic’- that is, they accepted poor health as ‘one of those things’. As a result, people from lower social classes are less likely to consult a GP than middle- class people. This may be because they will accept a higher level of pain and discomfort before considering themselves ill enough to visit a doctor. To what extent do you agree with this? .................................................................................................................................................................... .................................................................................................................................................................... .................................................................................................................................................................... .................................................................................................................................................................
  • 3. Illness and disease Eisenberg (1977) suggested that we should make a distinction between illness and disease. Illness is an individual’s subjective experience of symptoms of ill health, whereas diseases are clinical conditions defined by medical professionals. It is therefore perfectly possible to have an illness without a disease and a disease without an illness. Give examples .................................................................................................................................................................... .................................................................................................................................................................... ....................................................................................................................................................................