Sociological Determinants Of Health: An Analysis From Structural Functionalism And Conflict Theory Perspectives

Sociological Determinants of Health

Discuss about the Complexity Systems Research and Behavioral.

A healthy population can promote the overall development and well being the community and society. Health is referred to the state of complete physical, mental and social well-being, whereas illness is referred to a state of the body, where the physical, mental or social status is compromised. According to the social perspectives, a sick person contributes negatively towards the well being of the society (Marmot et al., 2012). Therefore, it is important to keep the members healthy, to contribute towards the health and social well being of the society. In this essay, the social perspectives will be analyzed for understanding the sociological determinants of health and how it differs from medical model.

Sociological determinants of health are the social and economic conditions as well as their distributions among the population, influencing the differences among individual and group regarding health status. These are the health promoting factors; rather than individual risk factors, influencing the risk of disease, vulnerability or injury; these are found in individual’s living and working conditions (Marmot & Bell, 2012). However, the sociological determinants of health are mostly responsible for developing health inequalities among communities. During 2003, WHO suggested the followings as the social determinants of health:

According to WHO, the unequal distribution of health damaging experiences are not natural phenomenon, rather these are the results of combination of poor social policies and unfair economic arrangements  (Ahnquist, Wamala & Lindstrom, 2012). The social determinants of health can be analyzed with the help of two sociological perspectives, i.e. the structural functionalism theory and the conflict theory.

According to the structural functionalism perspective, society is a complex system consisting different parts, all of which contributes together for promoting stability and solidarity of the society. This theory visualizes society through a macro-level orientation, with a wide focus on the social structures, shaping the society as a whole. According to the theory, the sick individuals are not the productive member of society; therefore, this deviance needs to be policed, which is done by the medical professional. According to this theory, the sociology visualizes elements of society as the part of a cohesive and self-supporting structure (Ahnquist, Wamala & Lindstrom, 2012). In this context, deviance is the behaviour or action that intends to violate the cultural and social norms, laws and regulations of society.  

This theory defines the sick role as the concept regarding sickness, i.e. being sick referred to the role of “sanctioned deviance”, the person is not contributing in a productive manner, according to this theory. Sociologists provided two rights and two obligations for the sick role (Cockerham, 2014). In case of rights, the person no longer is liable for his normal social role as well as responsible for his condition. In contrary, the person would try to get well and cooperate with the medial professional. There are three versions of sick roles, which are conditional, unconditional legitimate, and illegitimate.

Structural Functionalism Perspective

According to this structural functionalist theory, all the parts, i.e. members are contributing to the overall well being of the society. The sociological determinants of health are the factors contributing, which are causing differences among different communities and population. According to the functionalism perspective, in low socio-economic communities, where the economy is poor and the risk factors are higher in level, if one person becomes sick, he is no longer remains able to complete his social role to contribute towards the healthy society. In is causing a deviance, which is being distributed throughout the society and hindering the effective functioning of the society (White, 2016). According to this theory, it is the responsibility of the medical professionals to control the deviance. However, in the low socio-economic communities, medical professionals play least role in modifying or controlling the distribution sickness through the society. It is because; these disadvantaged groups can rarely access health care facilities, due to their inability to afford expensive care facilities. Unemployment and lower educational qualifications are the key factors, promoting the inefficiency. As a result, the overall performance of society becomes compromised. Therefore, the socio-economic factors, i.e. living condition, economic factors, social support network

The second sociological perspective is the ‘conflict theory’, with which also the sociological determinants of health can be analyzed. The conflict theory emphasizes the social, political or material inequality of a social group. The sociologist Karl Marx demonstrated that “capitalism would inevitably produce internal tensions leading to its own destruction” (Song, 2013). This theory argues that the economic and political structure of a society is responsible for creating the social divisions, hierarchies, classes and the conflicts, leading to social inequalities. This theory promote capitalism is the key for producing internal tensions leading to the social conflicts. According to Karl Marx, the capitalist society is unable to observe the way the system is shaping the entire operation of the society. This theory demonstrated “false consciousness, which involves explanations of social problems as the shortcomings of individuals rather than the flaws of society” (Stroebe et al., 2012). The theorist attempted to eliminate these kinds of thinking with the “class consciousness, which is when workers recognize themselves as a class unified in opposition to capitalists and ultimately to the capitalist system itself”. This theory is also related with other social perspectives, some of which include “critical theory, feminist theory, postmodern theory, post-structural theory, postcolonial theory, queer theory, world systems theory and race-conflict theory”.  Overall, this theory indicates that the wealthy and powerful people try to hold on to it by suppressing the poor powerless people.

Conflict Theory Perspective

According to conflict theory, the social factors, like government, political powers and economic factors are creating a significant gap within the health status of disadvantaged population with the others. In this context, according to the Marx’s conflict theory, the disadvantaged population in the society and their social determinants, like economy, employment, living standard are affected by the power class and this uneven distribution is maintained by through the ideological coercion. In addition, this class division subjects the society to worsening conditions. Therefore, the social determinants of health are manipulated by the political and social factors, which are controlled by the higher class of people. According to Karl Marx, the inequality between classes is powered by the unequal distribution of resources. As the resources are limited, the power class absorbs most of the resources, leaving insufficient resources for the minority or disadvantage class (Gallo, 2013). For example, with high economic status and high educational qualifications, available employments are absorbed by the wealthy class, thereby reducing the employment level among the disadvantaged class and enlarge the barriers to live a healthy life.

In contrast to the sociological perspectives, the medical model, i.e. the biomedical model focuses upon the biological factors contributing towards the health and well being of a population. In contrast to the sociological theory, the biomedical model of health focuses on the physical or biological perspectives of disease and illness. This medical model of care is practices by the medical practitioners, which is associated with diagnosis, cure and treatment (Deacon, 2013). This model focuses upon diagnosing and treating individuals separately from their living conditions and environmental factors, which is being focused by the sociological perspectives. The medical model of health attempts to return the physical health of the person to a pre-illness state, instead of focusing upon the reason behind illness.

According to this model, the social determinants of health are not contributing in creating health inequalities directly; rather these determinants might have influence upon the biological or medical reason behind health inequalities. For instance, poverty or contributes to malnourishment of the disadvantaged group, which makes people in the disadvantaged group more prone to be affected by bacterial, fungal or viral infection, which is in turn dispersed within the community via different routes of transmission (Song, 2013). On the other hand, economic factors and unemployment may contribute to the development of stress, which can significantly contribute to mental disorder; however, this model does not consider environmental, cultural or social factors as the key contributing factors in determining the health status of a population.

Comparing these models, it has been revealed that both sociological and medical model has advantages and disadvantages. For instance, the biomedical model improves quality of life, creates advances in technology, but it does not relies upon all the contributing factors, narrows down the view of health (Song, 2013). In contrast, the sociological perspectives emphasizes on overall wellbeing of population, encourages society members to take their own responsibility and increase economic development, but some diseases cannot be prevented and some results from these perspectives are difficult to measure.

Concluding the discussion, it can be said that health and illness is a key factor, determining the development status of a society. The sociological perspectives can effectively analyze the social determinants of health along, whereas the biomedical model considers only the biological factors. However, a new model, known as “biopsychosocial model” has been introduced, which can efficiently identify and analyze the sociological determinants of health.

Reference List

Ahnquist, J., Wamala, S. P., & Lindstrom, M. (2012). Social determinants of health–a question of social or economic capital? Interaction effects of socioeconomic factors on health outcomes. Social Science & Medicine, 74(6), 930-939.

Cockerham, W. C. (2014). Medical sociology. John Wiley & Sons, Ltd.

Deacon, B. J. (2013). The biomedical model of mental disorder: A critical analysis of its validity, utility, and effects on psychotherapy research. Clinical Psychology Review, 33(7), 846-861.

Gallo, G. (2013). Conflict theory, complexity and systems approach. Systems Research and Behavioral Science, 30(2), 156-175.

Marmot, M., & Bell, R. (2012). Fair society, healthy lives. Public health, 126, S4-S10.

Marmot, M., Allen, J., Bell, R., Bloomer, E., & Goldblatt, P. (2012). WHO European review of social determinants of health and the health divide. The Lancet, 380(9846), 1011-1029.

Rohall, D. E., Milkie, M. A., Lucas, J., & Lucas, J. W. (2013). Social psychology: Sociological perspectives. Pearson Higher Ed.

Song, L. (2013). Social capital and health. In Medical Sociology on the Move (pp. 233-257). Springer Netherlands.

Stroebe, W., Kruglanski, A. W., Bar-Tal, D., & Hewstone, M. (Eds.). (2012). The social psychology of intergroup conflict: Theory, research and applications. Springer Science & Business Media.

White, K. (2016). An introduction to the sociology of health and illness. Sage.