Sociology_in_Health_Care

Within this essay I shall draw upon two sociological theories to discuss contemporary society, and the relationship between social factors and health. In order for me to illustrate this fully, I will examine both the conflict theory and feminism. The conflict theory states that all inequalities in society exist as a result of a small dominant group controlling and exploiting other weaker classes within society. This theory is based on the premise that society is divided into two classes; the ruling class and the working class. One conflict theorist is Marx, who has been extremely influential in both the origins of the conflict theory and in the field of sociology. Karl Marx (1818-83) proposes that there are two classes of people within society, the Bourgeoisie (ruling class) and the Proletariat (working class). Marx suggests that society has evolved to a capitalist system, and that all inequality stems from economic inequality (Giddens, 2006). For example, the Bourgeoisie owns the means of production (factories, businesses etc), and as a result of this they are in a position to financially exploit their Proletariat workers. Thus, in order for him to gain a livelihood, the proletariat must sell his only valuable asset, his labour to the bourgeoisie for a small fraction of profits (a wage), with all surplus profit going to the owners of production. An example of the Marxist concept that the owners of production exploit their workers is present today. Examples such as Western rich company owners using sweatshops abroad, where they can pay their workers next to nothing and regain the greatest percentage of profits encapsulate this aspect of Marxist theory (Giddens 2006). Leaning heavily and developing upon Marx’s perspective, Wright (1978) suggests that there are several dimensions of control over economic resources in modern capitalist society that allow us to identify the major classes that exist. According to this theorist, social class is a ‘complex construct’ that involves social status, wealth, background and occupation. For example, professionals (educated individuals such as lawyers) would be considered to be more socioeconomically affluent than manual labourers (such as factory workers) and would therefore fall into the middle classes, whereas factory workers, whose income is considerably less than that of professionals, would fall into the working class category (Giddens, 2006). While the inequalities identified by the conflict theory include socioeconomic factors, it also identifies a strong correlation between social class and ill health. Class inequalities in health have been accounted for in a number of ways. However, for the purpose of this essay, the most basic way to explain health inequalities within the UK is by illustrating findings from the Acheson Report 1998. By comparing different geographical areas, the Acheson Report (1998) provided clear evidence of a relationship between the individual’s social class and likelihood of that individual experiencing ill-health. This report identified health inequalities by focusing on both health damaging habits and material depravation within lower socio-economic groups. Smoking, diet, and exercise include the behaviours that were associated with health and ill health. For example, smoking has been classified as the major cause of premature deaths and poor health. In 2004/5, it was discovered that 19% of men and 13% of women in professional jobs smoked cigarettes, while 33% men and 33%women in unskilled occupation smoked cigarettes (Moonie, 2000). Diet is also associated with social class and health because better diet is found among the higher class (Townsend, Davidson and Whitehead 1988). In support of this, Blaxter (1990) argues that a nutritionally approved healthy diet combined specific food habits that include eating wholemeal, low fat foods, eating fresh fruit, salads and reducing the rate of chips, fried and low priced processed foods. This could explain why the upper class are generally healthier as they are more likely to afford a good diet and have the means of transportation to supermarkets to purchase fresher goods and than their lower class counterparts. This perspective also explains the extent of which lower socio-economic group use health services, i.e. the use of most health care like general practitioners varies with socio-economic and social position. Cartwright and O’Brian (1976) found out that inequality exists between doctors and patient; that a middle class consultation is 6.2 minutes, while the working class took 4.7 minutes. The different in time led to the conclusion that middle class patient get more information from the doctor and ask more questions regarding health (Hart, 1993). Lower class areas have fewer general practitioners and less funding, than the middle class areas. Patients from the lower socio-economic areas have more addiction problems, mental health problems and also social issues, as the doctors are pushed for time, patients need to make more appointment which is a huge drain on the general practitioners time. (Postcode lottery in GP health service 2002) In relation to social class, another factor that contributes to the amount of ill health an individual may experience is gender. Arguing from a feminist perspective, Walby (1982) states that historically women have been oppressed by men; and argues that women, particularly working class women, as having their rights taken away by both men and capitalism. This perspective see women as producing the next generation of workers and that women have the maternal role and thus responsibility of bringing up the children and as well as cooking and cleaning. In addition, they also have the role of providing support for their husband/partner and they do all this without pay.   They say that the responsibility and stresses of domestic life, such as dealing with all domestic, household and family duties, is the primary responsibility of the woman and that this ideology has been perpetuated through generations. In addition to this, Prescott-Clarke and Primatesta (1997), argue that for those women living in the least affluent conditions, a clear indicator of poor health is raised blood pressure. There is a clear social class differential among women, with those in higher classes being less likely than those in the manual classes to have hypertension or raised blood pressure. In 1996, 17 per cent of women in from working class and 24 per cent in the middle class had hypertension. There was no such difference for men where the comparable proportions were 20 per cent and 21 per cent respectively. To reiterate, Prescott et al (1997) suggest that, irrespective of social class, females report more cases of raised blood pressure than their male counterparts. According to Bird & Rieker (1999), the ‘socially constructed’ gender roles benefit men as they are deeply embedded in inequalities. For example, men appear to occupy the higher status and better paid jobs. While women, on the other hand, appear to occupy lower status and lower paid employment and as a result tend to suffer more, given that many work ‘double shifts’ as well as taking responsibility and stresses of their domestic life (Bird & Rieker 1999). This could, therefore explain why more women than men tend to report more cases of hypertension. While women have a greater life expectancy than men and can expect to live roughly five years longer, they also suffer from more ill health than their male counterparts. Evidence to support the argument that gender is a key factor which affects a person’s health include theory’s that males are more likely to be affected by external causations such motor vehicle accidents whilst women are more likely to be affected by internal causations such as depression or anxiety. Women are also more likely to suffer from arthritis and rheumatism then men. For example, in 2004/05 the prevalence rate for the above among women aged between 65 and 74 was almost twice that for men (194 per 1,000 women compared with 110 per 1, 00 men). In addition to this, in 2002 there were 42,023 new cases of breast cancer, 41,720 (99% for women) and 300 (1%) for men. Thus proving how much gender is a factor when affecting a person’s health. An explanation of this could be (as noted above) that women tend to live longer than their male counterparts. Overall, there exists a great deal of evidence to justifiably conclude that social class is one of the main several factors influencing the overall wellbeing of an individual’s health, with reports such as the Black report (1990) revealing a strong correlation between social class and ill health. However many believe that social class should not be considered as the only main factor and conclude that gender is also a key feature in health issues within contemporary society. Bibliography Acheson, D. 1998. Independent Inquiry into Inequalities in Health Report London, HMSO http://news.bbc.co.uk/1/hi/health/2116336.stm[accessed 01/02/2011] Bird, C.E. & Rieker P.P. 1999: Gender matters: an integrated model for understanding men's and women's health. Social Science & Medicine. 1999: 48(6):745–755. Blaxter, M. 1990: Health and Lifestyles. Routledge, London Giddens, A. 2006: Sociology 5th Ed Fully Revised & Updated. Blackwell Publishing Ltd, Cambridge Hart, G. 1993: Sociology of Health and Illness. Social Science & Medicine. 1993: 18 (3): 399-414 Moonie, G. 2000: Class Struggle and Social Welfare. Routledge, London Townsend, P. Davidson, N. and Whitehead, M. 1988. Inequalities in Health, the Black Report and the Health Divide Harmondsworth, Penguin Walby, S. 1984. Patriarchy at work: Patriarchal and Capitalist Relations in Employment. University of Minnesota Press Wright, E.O 1978: (Sociology in our times) cited in Giddens 5th Ed, Blackwell Publishing Ltd, Cambridge.