Handbook of Medical Sociology, Sixth Edition
Publication Year: 2010
Published by: Vanderbilt University Press
Table of Contents
Preface to the Sixth Edition
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A revision of The Handbook of Medical Sociology has appeared about once a decade since its original publication in 1963. Each edition was comprised of new, specially commissioned chapters reviewing or developing some aspects of medical sociology. As the field of medical sociology grew and diversified, new topics were included and older ones updated, and others continued to be represented by previous editions. When a new editorial team took over the fifth edition (Bird, Conrad, and Fremont 2000), we attempted to maintain the spirit of the earlier editions. We continue here with the sixth edition, reflecting some changes and new vistas in medical sociology, while updating and reconfiguring some perennially...
Part I. Social Contexts and Health Disparities
1. Social Conditions as Fundamental Causes of Health Inequalities
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We review in this chapter developments over the past fifteen years in the theory of fundamental social causes of health disparities, specify some issues that arise when the theory is applied to specific as opposed to general health outcomes (i.e., incidence or mortality due to a particular disease versus self-rated health and all-cause mortality), identify evidence that evaluates the theory, and indicate that we view the theory as a sociological...
2. Social Capital and Health
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Social capital has been hailed as one of the most popular exports from sociology into the field of population health. At the same time, the application of the concept to explain variations in population health has been greeted with spirited debate and controversy (Kawachi et al. 2004). The debates have ranged from the very definition of social capital—whether it ought to be understood as an individual-level attribute or as a property of the collective—to skepticism about the utility of applying the concept to the health field as a health promotion strategy (Pearce and...
3. Why Education Is the Key to Socioeconomic Differentials in Health
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People with higher socioeconomic status have better health than lower-status individuals, and inequalities in health grow with age. Education creates most of the association between higher socioeconomic status and better health because education is a root cause of good health. A great deal of evidence suggests that educational attainment leads to better health. Education increases physical functioning and subjective health among adults of all ages and decreases the age-specific rates of morbidity, disability...
4. Understanding Gender and Health: Old Patterns, New Trends, and Future Directions
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A central feature of mortality trends throughout the twentieth century is the sex/gender difference in life expectancy: in the United States, women live on average 5.2 years longer than men do (NCHS 2009). Women have not always held a mortality advantage (Berin, Stolnitz, and Tenenbein 1990) and it may not continue. In fact, the age-adjusted gender gap in longevity appears to widen and narrow due to environmental/behavioral risk and protective factors, as well as genetic, biological...
5. Social Support, Sex, and Food: Social Networks and Health
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Patterns of social connection are essential to human health and well-being. Researchers are increasingly taking note of the importance of networks, exploring how social networks shape health and health behaviors, and examining how health contributes to the formation, dissolution, and maintenance of social relationships. While several resources are broadly devoted to describing social networks and health (Levy and Pescosolido 2002; Luke and Harris 2007; Smith and Christakis 2008), here we focus on a subset of the ways that...
6. Race, Social Contexts, and Health: Examining Geographic Spaces and Places
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Race continues to have a strong association with health outcomes. African Americans, for example, have a higher incidence, greater prevalence, and longer duration of hypertension than do whites. These higher rates are a major risk factor for heart disease, kidney disease, and stroke (CDC 2007; Morenoff et al. 2007). The age-adjusted death rates for African Americans exceed those of whites by 46 percent for stroke, 32 percent for heart disease, 23 percent for cancer, and 787 percent for HIV disease...
7. The Latino Health Paradox: Looking at the Intersection of Sociology and Health
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The link between socioeconomic disadvantage and poor health has been observed consistently and over time (Berkman and Kawachi 2000). Ac- cording to U.S. census statistics, in 2007, 21.5 percent of Hispanics/Latinos were living in poverty, compared with 8.2 percent of non-Hispanic whites, 24.5 percent of blacks, and 10.2 percent of Asians.1 In spite of their disproportionate representation among the poor, Hispanics/Latinos have demonstrated lower all-cause mortal- ity and higher life expectancy than we otherwise...
8. A Life-Course Approach to the Study of Neighborhoods and Health
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Renewed attention to the importance of neighborhood context to health and well-being (Enttwisle 2007; Sampson et al. 2002) has led to insight and innovation in health research over the last decade. While biomedical research has focused on how processes within our bodies affect health, and much social science and public health research has emphasized how the behavioral and psychosocial characteristics of individuals affect health, research on neighborhoods reminds us that individuals live in a variety of social...
Part II. Health Trajectories and Experiences
9. The Social Construction of Illness: Medicalization and Contested Illness
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This chapter makes a case for the usefulness of a social constructionist approach to medical sociology, emphasizing the analytic potency of social constructionism for explaining a key cultural and historical trend of our time: medicalization (Clarke et al. 2003; Conrad 2007). It includes a detailed discussion of contested illnesses— illnesses where patients and their advocates struggle to have their medically unexplainable symptoms recognized in orthodox biomedical terms—and suggests that lay practices and knowledge, and the consumer demands they engender...
10. The Patient's Experience of Illness
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What happens when someone gets sick? What is it like to be sick? This review considers the patient’s experience of illness, broadly defined. Rather than a comprehensive survey, it is a selective look at some of the main contributions of research on the illness experience over the years and, more briefly, certain newer research areas, some suggestions for future research, and an assessment of the field’s contributions. Insofar as possible, it emphasizes topics less widely covered...
11. The Internet and the Experience of Illness
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Sociologists have studied the experience of illness for at least the past four decades (Conrad 1987). The earliest studies focused on how patients managed the sick role (Parsons 1951) or how they maneuvered through the stages of an illness caeer (Suchman 1965). Beginning with the work of Anselm Strauss and his colleagues (Glaser and Strauss 1965; Strauss and Glaser 1975), sociological researchers started investigating the experience...
12. The Sociology of Disability: Historical Foundations and Future Directions
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Disability is a high-profile issue situated at the intersection of the social sciences, health, and medicine. The definition of disability as a medical and social problem and proposed responses to it are central to discussions of health care and social welfare policies across the world today. The salience of disability issues is underscored by the recent high-level attention they are receiving from distinguished national and international organizations. Based on a coordinated analysis of more than a hundred recent national data surveys, the World Health Organization and the World Bank estimate in the 2010 “World Report on Disability...
13. Death, Dying, and the Right to Die
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Death in late-modern mass societies has a particular character which sociological analysis, informed by historical, anthropological, and demographic studies, is well suited to bring out. Such analysis exposes the underlying dynamics of common ethical dilemmas in end-of-life care, showing that subjective experiences otherwise thought to be purely psychological in origin—dying, grief, care provision—are shaped by historical and social forces. This chapter reviews some important...
Part III. Health-Care Organization, Delivery, and Impact
14. Gender and Health Care
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The health-care system is a deeply gendered social institution, often affecting men and women in dramatically different ways. In the United States and many European countries, health-care occupations are sex segregated: men constitute a majority of physicians, while women are concentrated in occupations that are less prestigious and poorly paid. Because women are more likely than men to seek medical treatment, they are the...
15. Institutional Change and the Organization of Health Care: The Dynamics of "Muddling Through"
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Many observers of the health-care system in the United States, including medical and organizational sociologists, have noted the profound changes that have occurred over the last four decades, particularly since the advent of the managed care “revolution” in the 1980s. From a highly stable sector that for decades was dominated by medical professionals and had long exhibited “dynamics without change” (Alford 1972), the...
16. Health-Care Professions, Markets, and Countervailing Powers
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For more than two decades, an international crisis of professionalism has pervaded health care and weakened the grip of professional organizations over the training and oversight of professional work, especially in the United States and United Kingdom where professionalism is a preoccupation. Governments and other institutional payers have moved in to monitor professional behavior...
17. The Sociological Concomitants of the Pharmaceutical Industry and Medications
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Pharmaceuticals are pervasive in medicine and society. The transnational industrial nature and scale of pharmaceutical markets and the level of technoscientific sophistication in pharmaceutical development in the last twenty to twenty-five years are unprecedented. Between 1960 and the early 1980s, prescription-drug sales were almost static as a percentage of GDP in most of the major Western economies, including the United States, which alone makes up about half the...
18. Evidence-Based Medicine: Sociological Explorations
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Evidence-based medicine (EBM) refers to a process of evaluating and incorporating research evidence into medical decision making. It is commonly defined as “the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients” (Sackett et al. 1996, 71). The term is rather loosely employed and can refer to anything from conducting a statistical meta-analysis of accumulated research, promoting randomized clinical trials, or supporting uniform reporting styles for research to a personal orientation toward...
19. The Sociology of Quality and Safety in Health Care: Studying a Movement and Moving Sociology
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In the last decade the emerging activities in the field of quality and safety improvement in health care are resulting in new practices of governing medicine and posing challenges to prevailing notions of what it means to be a good doctor, patient, manager, or even health-care system. Following the seminal work of Wennberg and Gittelsohn (1973), who analyzed high variation in treatment patterns in neighboring communities in New England that could not be explained by clinical differences or “case mix” (Wennberg 1984), and based on reported adherence rates...
Part IV. Crosscutting Issues
20. Religion, Spirituality, Health, and Medicine: Sociological Intersections
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When Michelle Bird, a white woman in her early forties, developed a rare form of cancer several years ago, she sought treatment at the Dana-Farber Cancer Institute in Boston. There she was cared for by Dr. George Demetri, an expert in the field. In addition to standard biomedical treatments, Michelle, a Catholic, received reiki and acupuncture at Dana-Farber and attended services and readings in the small interfaith chapel there. She met monthly with a priest to receive his blessings and carried books like Jerome Groopman’s The Anatomy of Hope: How People Prevail in the Face of Illness with her to medical appointments. She described talking daily with God as a way of...
21. Health, Security, and New Biological Threats: Reconfigurations of Expertise
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In recent decades, a series of new biological threats has raised both technical and political questions about how to understand and manage disease risk. In this chapter we explore what role the social studies of medicine can play in analyzing these new disease risks. We focus in particular on recent critical scholarship that has examined how existing forms of biomedical and security expertise are being reconfigured in response to new threats such as emerging infectious disease and bioterrorism.1 This work provides insight...
22. Health Social Movements: History, Current Work, and Future Directions
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The last several decades have seen a burgeoning movement in health activism in which patients, consumers, and other lay people, sometimes in conjunction with scientists and health-care professionals, have lobbied for a more active role in defining and finding solutions for health concerns. In the 1960s the women’s health movement began challenging prevailing conceptions of medical authority, feminine sexuality, and reproductive rights, with consequent changes in medical research, practice, and standards. In the 1970s...
23. The Application of Biomarker Data to the Study of Social Determinants of Health
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Medical sociologists have a shared goal of examining relationships of race, class, and gender inequity and health to ultimately reduce the burden associated with morbidity and mortality. For decades, much of the medical sociological research on health disparities focused on psychological outcomes, self-rated health, or mortality (Bird, Conrad, and Fremont 2000). Sociological studies of health have typically lacked the biological measures necessary to identify physiologic mechanisms by which life experiences—specifically...
24. Gene-Environment Interaction and Medical Sociology
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The boundaries between sociology and biology have long been sites of tension and contestation (Anderson 1967; Pescosolido 2006).1 In part, these contestations emerge from a concern that biological accounts of the production of human difference pose a threat to sociology’s defining focus on social and environmental causes of human health and social outcomes (Duster 2006). Medical sociologists have been at the vanguard of efforts to find productive modes of engagement between the social sciences and contemporary human genetics. Increasingly, these efforts center...
25. Biotechnology and the Prolongation of Life: A Sociological Critique
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Puzzles surrounding health, longevity, and death have preoccupied the human mind throughout history, but the question “Can we live forever?” has a decidedly contemporary resonance, since modern medicine holds out the actual possibility rather than the merely fantastic promise of longevity. Furthermore, contemporary medicine offers us longevity without disability and infirmity. In one sense, the issues surrounding aging are quite simple: can we be happy, healthy, and chronologically old, or is physical deterioration and death necessarily a depressing and destructive experience? Is death ultimately...
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Page Count: 512
Publication Year: 2010