Introduction
Sociology is defined as the study of human society in a scientific way. This means that sociology apply scientific principles in the study of human society. Aspects of society that are studied by sociologists include among others, the school as an institution, conflicts, customs, traditions, the social structure, social stratification etc.
The term or concept of sociology is a parent concepts, this means that sociology is all embracing concepts that encompasses many other branches such Sociology of Education, Sociology of Law, Military Sociology, Political Sociology, Sociology of Social Problems, Sociology of Medicine or Medical Sociology, etc.
The subject sociology actually emerges as a result of revolutions, such as the American revolution, the industrial revolution, etc. With these revolutions that swept across most societies, people felt that there was something wrong with the social status quo. This is why sociology is sometimes referred to as the science of social crisis.
Having set this preamble, it is pertinent to be particular in our area of major concern, i.e. medical sociology.
What is medical sociology?
Medical sociology according to Wikipedia Encyclopaedia is the study of individual and groups behaviours with respect to health and illness. This medical is a little simplistic, as the focus is not only on medical professionals or their behaviours, but also focuses on human behavioural responses to health and illness.
It can further be explained, as it concerned itself with individual and group responses aimed at assessing well-being, maintaining health, acting upon real or perceived illness, interacting with health systems and maximizing health in the face of physiological condition resulting from our environment on health.
Talcotte is often considered the father of Medical Sociology because of his description of the “Sick Role”. The sick role describes the difference between the roles of a sick person as opposed to the “Social Role” of a healthy person. He defined the sick role as defining the motivation of the patient. The sick role comprises four aspects which includes,
- Exemption from normal social responsibilities.
- The privilege of not being held responsible for being sick.
- The obligation to find help and.
- Follow that advice.
The meaning of health and illness
Health and illness are not just medical terms, they are social issues. They are relative terms which definitions vary from one society to the other. There are various definitions of health and some are based on the beliefs and experience of professional and groups about the terms. For example, doctors and nurses may have different ideas about what health is compared to social scientists. However, health professionals are better of if they have an idea about the way different people define the term, including the lay people. The word health is derived from whole, hale and healing, specifying that “health concerns the whole person and his or her integrity, soundness, or well-being” (Naidoo & Wills, 1996).
Health is the state of complete physical, mental and social well-being and not merely absence of disease or infirmity, (WHO, 1946). Health has two meanings in everyday life usage, one negative and one positive. The negative definition of health is the absence of disease or infirmity. This is the meaning of health within the western scientific medical model.
The positive definition of health is the state of well-being, (WHO, 1996).The importance of this definition for health promotion practice is that unlike in health education where health care workers emphasize the negative aspect of health (absence of disease and infirmity), in health promotion, the emphasis is on the positive aspect (the state of well-being). In other words, health promotion is concern with how to remain healthy or a state of well-being.
Based on the WHO definition of health, Aggleton and Homans (1987) cited by Naido and Wills (1994) explained that physical health concern the body, mental health concern the ability to think and make judgment, emotional health refer to the recognition and appropriate discharge of feeling states. Social health involves in integration of somebody in a web social relationship, spiritual health is the recognition and ability to put it into practice moral or religious principles or beliefs. Another important dimension is sexual health, which is the acceptance and ability to achieve a satisfactory expression of ones sexuality. The importance of this definition is that it provides a frame work, which can be used to measure health by focussing on the different directions mentioned above. In spite of the various criticisms levied against it, it is the only standard definition that can be applied by researcher and scientist to measure health in different setting without being subjective.
The most radical critiques of the definition of health advance by Dubos (1960), believes that the WHO definition is too nebulous, over-ambitious and cannot be operationalized. According to him, the definition refers to a state of “Utopia” which is not attainable by human being considering the circumstances under which human kind operates. On the part of the social scientists, they raised an issue about this definition. How can a person at all times satisfy all these criteria of physical well-being, social well-being, mental well-being, spiritual well-being and sexual well-being laid down by WHO?
Ill-health or illness
Illness is a subjective terms. It refers to the subjective interpretation of problems (signs and symptoms, which are perceived to be health- related. According to Parson (1972), illness refer to “any state of disturbance in normal functioning of the total human individual including both the state of organism as biological system and his personal and social adjustment”. Another way of defining illness is to refer to it simply as inability to perform social rules. It refers to a state of deviation from the standard expected of people of one’s social group.
Illness is a deviant state because it makes the individual to deviate from culturally acceptable standard of performance of social roles, for example, a 10 year-old boy who cannot walk because of complications arising from Poliomyelitis has deviated from the culturally acceptable norm and therefore he is regarded as deviant. Depending on the nature of the illness, whether acute or chronic, the deviant status may be temporary or permanent. It lasts until the individual has recovered from the illness and complications.
All societies accept the fact that human body is not a stone. Therefore, provision should be made for the needs of person who is occupying the sick role. A sick person has many rights which include the right to be treated, the right to be given physical and emotional support, the right to be excused from duty, etc. On the other hand, he must reciprocate this kind gesture by the society. Therefore, his obligation include: promptly seeking medical care from recognized agents, complying with medical regimen, taking enough time to rest and accepting the fact that he must return to duty as soon as he his fit to do so (Parsons, 1972). In recognition of the above, the society has established the health care facilities, such as the hospitals and PHC centres where illness status can be legitimized and treatment offered, and if necessary, a medical officer excuses the individual from duty.
In contrast to illness, disease is not a highly subjected phenomenon. It is a medical conception of pathological abnormality diagnosed by means of symptoms and signs. Unlike illness, the meaning of the term disease is more clear-cut. For example, a person who is experiencing some pain, loss of appetite and loss of weight decide to go to the hospital because he think that he is ill. In the hospital, investigations which may include physical examination, x-ray and laboratory tests might later fulfil that he is suffering from a chronic disease, like cancer or HIV/AIDS.
Socio-cultural and psychological causes of illness
The health status of members of a community depends on many factors including their cultural practice. Culture refers to all the values, practices, materials and beliefs of a group of people. People’s culture including the types of foods they grows and eat, their pattern of housing, dressing, religion, education, etc. all these can influence people’s health.
Our culture affects both our health and illness. For example, many cheap, proteinous food and meat are forbidden for children, pregnant women and lactating mothers as a result of food taboos. Specifically, children are not expected to eat “big” meat because it is believed that this will indulge them and they may start to steal. Pregnant women are forbidden from eating the meat of snake, or monkey. In the case of snail, the child will “salivate” excessively. Although these statements might appear funny to us but our people take them seriously and if any women should feel stubborn and eat the forbidden foods, she will be labelled a deviant and be made to face the wrath of the extended family of the husband.
The major cause of malnutrition in children is not always poverty. It is often due to various cultural practices, such as adopting the child to an illiterate grandmother or aunty, lack of awareness of what contribute a balanced weaning diet, lack of knowledge and skill about the best use of locally available foods, poor hygiene, making frequent necessary and unnecessary journey and leaving the child behind or stopping breastfeeding before the child is at least year of age. So, when given health education on the prevention of malnutrition in children, all those point and others must be included.
There are various other socio-cultural practises that can cause ill health. In the recent past, many of them have caught the attention of the government and so mass-media health education has been employed to create awareness about them. Some of them include wife inheritance, female circumcision, the use of cow-dung to decorate homes, using broken bottle or sharp bamboo to cut umbilical cord of newly born children, initiation ceremonies, sharing shaving blade or razor with other people, given children concoction during convulsion or burning the feet of a convulsing child.
Psychological problems are those serious problems which affect the mind; they often result from deep rooted prolonged, emotional problems which the individual cannot solve, such as poverty, bereavement, unemployment, infertility and divorce/separation. All these can lead to both mental and physical illness. For example, serious problems, such as unemployment can lead to peptic ulcer, migraine, etc. These are called psychosomatic disorders.