The course imparts the basic concepts and understanding in Sociological and Anthropological perception of health and disease.

1. Health and diseases in different stages of
human evolution
Ashok Pandey
Visiting Faculty
17/30/2019

2. Unit 4: Medical Sociology/Anthropology 4 Hours
Introduction to medical sociology/anthropology
The present status of medical sociology/anthropology
Criteria and contributions of sociology/anthropology to public health
Difference between illness, sickness and diseases
Stages of illness
o The symptom experience stage
o Assumption of sick role stage
o The medical care contact stage
o The dependent / patient role stage
o The recovery of rehabilitation stage
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3. Introduction to medical sociology/anthropology
• Medical sociology is a specialization within the field of sociology.
• As a specialized field, Charles MacIntire first proposed it in 1894.
• It was not until 1960 that the section of medical sociology was
established as a part of the
• American Sociological Association (ASA).
• Then medical sociology was officially recognized as an independent
discipline.
• Medical Sociology is closely related to Medicine and Sociology.
• Medicine is defined as the science and art of maintaining health and
preventing, alleviating or curing disease.
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4. • Sociology is defined as the science of society, social institution and social
relationships. It is concerned with structure, interactions, and collective
behaviour of organized group of human beings.
• 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.
• Medical sociology is simply the study of the effects of social and cultural
factors on health and medicine. Specializing as a medical sociologist helps
individuals view the healthcare system as a function of the society and serve
it by examining and improving all its facets. It is a stepping stone towards
greater career opportunities in the medical field.
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5. • The task of Medical Sociology is to identify and to study social groups in
their activities of maintaining and preventing health, alleviating (make easier
to bear) or curing disease.
• Medical Sociology is concerned with the social facets of health and illness,
the social function of health institutions and organizations, the
relationship of health care delivery to other social systems, and social
behaviour of health personnel and those people who are consumers of the
health care.
• Broadly speaking medical sociology includes of the medical profession, if the
relationship of medicine or public and of the public and of the social factors
in the etiology, prevalence, incidence and interpretation of disease.
• Simply medical sociology is viewed as the study of the relationships between
health phenomenon and social factors. 57/30/2019

6. • Thus, in medical sociology one studies about health, illness
and medical care from sociology perspectives.
• The introduction of behavioural sciences to medicine is
recent development. Sociology has much to contribute to the
field of medicine. The distribution and etiology of disease in
society, the social and cultural perspective on disease, roles
attitude towards treatment all are within the field of medical
sociology.
• Sociology has contributed much to medicine and promises
greater contributions in the future.
• For many years, social scientists have ‘walked the wards’
with physicians and nurses, have interviewed patients, and
have taught medical students.
• Sociology has developed a distinct body of knowledge
concerning medicine and even added to general social
theory. In fact, it can contribute substantially to decision
making in medicine. 67/30/2019

7. The present status of medical sociology/anthropology
• H.E. Freeman et. al. instruct as health practitioners and researchers have
long recognized the importance of social dimensions in the etiology of
disease in the development of therapeutic interventions, and the delivery and
use of health services and preventive efforts.
• At the same time, medical sociology could only have emerged as a special
field of inquiry as part of the growth and institutionalization of the parent
discipline of sociology, particularly since World War II (1938-46).
• By the end of the 1950s, social science training program began to recive
support, initially from the National Institute of Mental Health, and later from
other federal agencies.
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8. • Of course, in previous years a few sociologists had been involved in
medical sociology. But only in the last 70 years were large numbers
of sociologists appointed to faculties of schools in the health
professions and to research positions in health agencies.
• In their new roles, sociologists participated in the training of public
health workers, medical students, residents, and other health
practitioners.
• At the same time, sociologist usually attached to departments of
sociology, although sometimes supported in health science schools
with extramural (additional to the fill-time activities of a university
etc.) funding, were undertaking primarily sociological research.
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9. Theoretical Perspective in Medical
Anthropology:
1. Structural Functionalism
2. Ecological: Human adoption, natural environment and
environmental challenge.
3. The Marxist Political Economy Model: Pharmaceuticals-
commodity, Essential drugs need, Profit.
4. Transactionalist Model: Outcome of competition at individual level,
profit, brokers, business.
5. Cognitive/ Symbolic Approach: What is illness, how do people
explain and label illness, how do they choose between various curative
alternatives, and how they communicate with health practitioners?
6. Critical Anthropology: A synthesis of above and other theories and
models.
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10. Criteria and contributions of
sociology/anthropology to public health
Some years ago Robert Straus proposed the helpful distinction
between Sociology/Anthropology IN medicine and Sociology/
Anthropology OF medicine.
Sociology/ Anthropology in Medicine refers to the application of
Sociology/ Anthropology theories in health sciences and of medicine
refers the explanation of rights and duties of the health organizations
and bureaucrats.
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11. • It sees health as a process in human development and states that it
cannot be achieved in isolation without associated socio-economic
development.
• For health it lays emphasis on all the aspects of health care that is,
preventive, promotive, curative and rehabilitative.
• Its shape is determined by social goals like quality of life and
maximum health benefits to the greatest number of people and
advises to attain these goals by social means like community
participation.
• It lays emphasis on essential health care which is accessible,
affordable and acceptable by the people and with their full
participation. This health care has to be scientifically sound and
socially acceptable. It requires co-ordinated efforts from all other
related sectors.
• It is based on the economic, socio-cultural and political conditions of
a country and it promotes equity.
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12. Contributions of sociology
•Social determinants and distribution of disease
•Attitudes and behavior of individuals and also individuals in group
settings towards health and illness and this in turn decides their concept
of health and illness, health seeking behavior and their level of
acceptance towards modern form of medicine, their perceived health
needs and their acceptance or rejection of various health programs.
•It also studies the social environment of medicine and helps to design
the curricula of trainings for health personnel.
•It also studies the relationship between health provider and consumer,
and thus decides the preference of consumer for a particular type of
service as well as compliance of the consumer to the physician's advice.
•It studies the medical organizations in structural and functional
manner.
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13. Health, Disease, Illness and Sickness
•Health
WHO has defined health, as "Health is a state of complete
physical, mental and social well being and not merely the absence
of disease or infirmity."(WHO-1948).
Some people define health as absence of symptoms or free from
discomfort or free from unusual condition which is opposite to the
disease.
Health is normal functioning of the human body. Normal in one
culture and it may not be normal in another culture.
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14. •Diachronic spyrocheetosis (a disease characterized
by spot) that appears on the skin was so common in a
particular South American tribe but American
Indians who have not it were regarded as abnormal.
•Therefore, a wide variety of diseases are not defined
by a particular group of illness condition because
they occur frequently and are regarded as the
common state of man.
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15. Disease
• Disease is a disorder or malfunction of the mind or body,
which leads to a departure from good health
• According to the Biomedical concept, human body is
considered as machine and disease as consequences of the
breakdown of the machine and one of the doctor’s tasks is
to repair of the machine.
• This concept minimizes the role of the environmental,
social, psychological and cultural determinants of health.
• So this concept is unable to address many diseased
conditions which are not being caused by germs such as
malnutrition, drug abuse, population explosion, cancer,
diabetes, Heart disease etc.
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16. • Disease is universal fact of human life from
primitive to this modern society and it can occur at
any time, places and society.
• Human groups of different stage of society had tried
to address with it on the basis of available
knowledge, resources and capacities that they had
during those period.
• They developed some set of belief, perception and
cultural practices about its cause and solution of it.
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17. Characteristics of disease
• Disease always has individual as well as social undesirable effects and it is
painful.
• Disease also affects to the performance of social work of an individual.
• It damage or threats acutely or chronically to human life or it may led to the
departure of life of human being from this living world.
• Diseases are recognized by medical institutions of society as requiring care under
its guidance.
• Disease are not only due to presence micro organism within human body
• Socio-cultural factors such as age, sex, class, caste, norms, beliefs, marital status,
level of education, custom, habit, and economic status influence to the health and
disease pattern of human population.
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18. Illness
• Illness is a subjective phenomenon.
• It refers to subjective defined state of an individual and what an
individual feels about him or herself regarding to that
condition.
• If s/he feels unhealthy or uncomfortable or unusual than before
it mean to say that s/he feels ill regardless of presence or
absence of disease.
• Therefore illness is a subjective phenomenon in which an
individual perceive, belief and feels not well as before and such
feelings will be based on his past experienced as well as on
socio-cultural ground.
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20. • Illness refers to the subjective feeling of not being well by
an individuals and these feelings includes pain, nausea,
vomiting, etc and it is defining him or herself as unhealthy
and seeking care and based on psychological concept.
• When s/he feels ill, they tend to modify their usual normal
behavior and that modified behavior is illness behavior of
that individual.
• Illness is assumed to be caused by diseased condition to an
individual such as HIV/AIDS patient may not feel ill until
s/he is diagnosed as HIV/AIDS patient.
• Most of the time disease causes illness to an individual and
illness is basically thought or feeling of an individual due to
disease condition or uncomfortable or unusual condition
experienced by an individual.
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21. Sickness
•Sickness refers to the social identity of an
individual by other members of society as being
unhealthy or diseased and treated differently than
other healthy persons. This is based on sociological
concept.
•If a person is defined by other society members as
being unhealthy and s/he is socially identified as
sick person.
•Sickness is social phenomenon.
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22. • Sick person are defined by other members of the society as being
unhealthy and treated in a different manner than other healthy
persons and that differentiate them from other person of the society
and such social identification of an individual is called as sickness.
• Such identification of sickness or defining as sick person may be due
to disease condition or illness and are based on the socio culture
ground of that society.
• Sick role is deviation from normal social functioning of an
individual and it must conform the norms of society.
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24. Stage of Illness
Suchman has derived different stage of Illness that occurs
with in a individual during unhealthy or uncomfortable
condition. There are five stages of illness.
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25. 1. The symptoms experience stage (Decision
that some thing is wrong)
• This is the first stage in which an individual and members of
society interpret or recognizes that there is something wrong
with him or her.
• During this stage s/he feels uncomfortable which may me
physical or mental discomfort and s/he cannot perform
regular activities as before.
• The person is aware that something is wrong. A person
usually recognizes a physical sensation or a limitation in
functioning but does not suspect a specific diagnosis.
• Three aspects:
– Physical (Fever, Muscle Aches, Malaise, Headache)
– Cognitive (Perception of “having flu”)
– Emotional (Worry on consequence of illness)
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26. 2. Assumption of the sick role stage (A decision
that is sick and need professional care)
• After interpretation of symptoms experience stage one as
indicating illness s/he inters the second stage in which s/he
seeks advice and care regarding to those symptoms that s/he
has experienced.
• Initially care provided for illness will be limited within home
remedy and self doctoring. Advices are sought with the “lay
referral system” which is basically based on discussion with
friends and relatives to get cured of illness.
• Special feature of this stage is the “provisional validation” of
illness from friend and relatives.
• At this stage individual’s lay consultation with friend and
relatives react to his symptoms and acceptance of any
interference with his social functioning and determining the
individual ability to enter sick role.
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27. 3. Medical care contact stage (Decision to
seek professional care)
• The person who feels ill is well on the road to become a
patient and to visit to health care facility.
• The person seeks authoritative conformation of his
provisional validation of his sick role.
• And at the same time he also takes course of treatment to
restore health. These above stages vary society to
society.
• Validation of real illness; Explanation of symptoms;
Reassurance or prediction of outcome
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28. 4. Dependent patient role stage
• The client depends on health care professionals for the
relief of symptoms.
• The client accepts care, sympathy and protection from the
demands and stresses of life.
• A client can adopt the dependent role in a health care
institution, at home, or in a community setting.
• The client must also adjust to the disruption of a daily
schedule.
• Accepts/rejects health professional’s suggestions; becomes
more passive and accepting; may regress to an earlier
behavioral stage 287/30/2019

29. 5. Recovery or rehabilitation stage
• This stage can arrive suddenly, such as when the symptoms appeared. In
the case of chronic illness, the final stage may involve in an adjustment
to a prolong reduction in health and functioning.
• Gives up the sick role and returns to former roles and functions
• For reasons we have just considered, the applicability of stage five to
chronic illness is strictly limited.
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