Two major sociological theoretical perspectives on health and illness are: functionalism and Weberianism. Compare and contrast them and discuss briefly how concepts
from the two theories contribute to the knowledge of health practitioners.
Order Description
Assessment One – Essay covering Modules 1 & 2

NUR 210 Health Sociology Module 1
Learning Materials
Module One Sociology for Health Professionals
1.1 Content overview 1.2 What is Sociology? 1.3 Definition of health and illness. 1.4 The Biomedical model.
1.5 The sociological approach to the study of health and illness.
1.6 Understanding and explaining social phenomena
1.7 Theories, Discourses and Paradigms
1.8 Sociological concepts and theories 1.9 Historical Origins of Social Health 1.10 Social structural approaches: Societies as objective realities 1.11 The
functionalist perspective of health and illness
1.12 The Marxist perspective of health and illness 1.13 Interpretative approaches: Societies as subjective realities 1.14 The Symbolic Interactionist perspective of
health and illness 1.15 The Social Constructionist perspective of health and illness – The relativity of social reality 1.16 Feminist Perspectives
1.17 The Structure –Agency Continuum 1.18 The Sociology of health and illness: Defining the field
1.19 Blackboard activity

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Module One Sociology for Health Professionals
1.1- Content overview This first module explores the questions of ‘what is sociology?’ and ‘how is it relevant to the
health profession?’
This topic contains: ? An overview of Sociology ? An introduction to Health Sociology ? Online learning activity ? A reading list 1.2 -What is Sociology?
We begin this module by exploring the concept of sociology.
The simplest view of the academic discipline of sociology is that it is somehow concerned with the
understanding of human societies. However, this does not take us very far as most people feel they
know a good deal about the society in which they live because they experience it every day; this can
be described as ‘common-sense’ knowledge. Another approach would be to define sociology as a
research based study of society.
However, there are other academic disciplines such as history, politics, economics, anthropology and
social psychology that also have human society as the object of study. Probably the best way of
defining the contribution of sociology is by looking at the key questions that originally stimulated the
development of the academic discipline and which continue to underpin sociological research today:
What gives social life a sense of stability & order?
How does social change & development come about?
What is the nature of the relationship between the individual and the society in which they live?
To what extent does the society into which people are born shape their beliefs, behaviour, & life chances (including health outcomes)?
In other words, sociology looks at the social influences of politics, economy, religion, family, gender
roles and so on, and their impact or importance in understanding behaviour (Kellehear, 1990).
Sociology tries to understand the underlying patterns in the social world. Although other disciplines
do this also, Sociology has its own special way of doing it. Sociologists do not just describe the social
world but attempt to theorise, measure, analyse, interpret and test its subject matter. As Waters
and Crook (1993, p. 3) state, doing sociology is about approaching the familiar world with new eyes.
So why study health Sociology and how is it relevant to working as a health practitioner?
Health Sociology analyses the interaction between SOCIETY and HEALTH. Where medical research
might gather statistics on a disease, a sociological perspective on an illness can provide insight into
what external factors caused the demographics who contacted the illness to become ill.
An example of this is if we look at the table below. Life expectancy for both Indigenous men and
women is well below the average for non-Indigenous men and women. Health Sociology tries to look
at and analyse reasons why this might be so.
Understanding some of the underlying factors can help governments, policy makers and other
stakeholders to make positive changes.
The health industry like any other is embedded with a number of dominant values, assumptions and
processes which shape it. Sociology helps provide the language and tools to critically analyse and
reflect on these. Hence we will be looking at what the social determinants of health are in the
Australian context whilst critiquing the philosophy of primary health care and the dominance of the
medical model.

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To Van Krieken et al. Some aspects that can be the focus of sociology can include the examination of,
social, economic and political influences on the selected area which could be the local, national or
global setting (Van Krieken, R, Smith, P, Habibis, D, McDonald, K, Haralambos, M and Holborn, ,M
2000). Over the weeks this will certainly become evident.
When we look at health from a sociological perspective we take into account all of the social
influences such as politics, the economy, religion, culture, family, gender etc. that influence
behaviour and as a consequence health outcomes.
Readings
The following provide an overview of Sociology and lay the foundation for this unit. I strongly recommend that you read beyond the set text.
Set Text Germov, J (2014)Imagining Helath Problems as Social Issues. In J. Germov (Ed.), Second Opinion; An Introduction to Health Sociology, Melbourne: Oxford
University Press, pp.5-22 Germov, J (2014) Theorising Health: Major Theoretical Perspectives in Health Sociology. In J. Germov (Ed.), Second Opinion; An Introduction
to Health Sociology, Melbourne: Oxford University Press, pp.23-39 Heil,D., (2014) Wellbeing and WellnessIn J. Germov (Ed.), Second Opinion; An Introduction to Health
Sociology, Melbourne: Oxford University Press, pp.23-39 eReserve Kellahear, A. (1990). What is Sociology and why study it? (Chapter One). In A Kellehear (Ed.), Every
student’s guide to sociology: A quick and plain speaking introduction. South Melbourne: Thomas Nelson Australia. Van Krieken R. (2000). What is sociology? In Van
Krieken,R., Smith,P ,Habibis,D., McDonald,K, Haralambos,M. ,Holborn,M. (2000) Sociology: Themes and Perspectives (pp. 1-35). Frenchs Forest, N.S.W. Pearson Australia.
link: http://ereadings.cdu.edu.au/view/cdu:20848 Cockerham, W.C (2007). Medical Sociology. In Medical Sociology (10th ed) (pp. 1-20). Upper Saddle River, New Jersey:
Pearson Prentice Hall. Further Readings Schofield, T (2015). A Sociological Approach to Health Determinants Cambridge University Press, Australia, pp16-32 and 53-55,
Giddens, A., Sutton,P.(2014),Essential Concepts in Sociology, p 4-26, Polity,UK Jones,P., Bradbury, L. Boutillier,S.(2013) Introducing Sociology Second Edition,
Polity, pp1-103
1.3 -Definition of health and illness.
There is no uniform definition of health and illness.
Definition: Health. “…[S]tate of complete physical, mental, and social well-being and not merely the absence of disease, or infirmity” (WHO, 1946)
For example, it is dismissed as “patently absurd and unattainable” and “highly dangerous” given that it is deemed impossible to tell whether individuals or groups have
achieved this state, or for such a state to be measured or evaluated (Sax, 1990, p.1). Additionally, the reference to a state of “complete social well-being” is
claimed as “so freighted with individual interpretations that it alone renders the definition useless” (Hudson, 1993, p.45)
‘Historically, the word health appeared approximately in the year 1000 A. D. he word originally came
from Old English and it meant the state and the condition of being sound or whole. More precisely,
health was associated not only with the physiological functioning, but with mental and moral
soundness, and spiritual salvation, as well’ (Boruchovitch, E., Mednick, B, 2002).
There are a many different definitions of health and illnesses which are often determined by who is
doing the defining and what perspective they are coming from. There is a number of cultural
perspectives and some of these encompass ideas of the spirit whilst others involve sorcery and/or
witchcraft or other non-human sources. In the contemporary Western framework, the dominant
perspective of health and illness is the biomedical model.
1.4 -The Biomedical model.
The biomedical model is based on the principal of scientific rationality. The body is viewed as a
machine and illness in viewed as a defect or malfunction. Illness is the result of the body part
involved failing to function properly, or is the result of germs or disease. The biomedical model
excludes social, psychological and behavioural aspects of illness. It reduces illness to something that
happens to a person’s “parts” rather than to the whole person.
In Module 5 looks we will look at the biomedical model in greater depth.
1.5- The sociological approach to the study of health and illness.
A sociological approach to health and illness is premised on the belief that health and illness must be
analysed in their social context. Health professionals using a sociological approach will recognise that
the patient/client is situated within a social context that will construct that person’s experiences, beliefs, knowledge, actions and interactions. Sociology assists
health professionals to recognise that
membership of a particular group in society (e.g. age, sex, family type etc) can influence experiences

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of illness and wellbeing. Sociologists therefore speak of the social distribution of health and illness.
In various sections of this study guide for example, you will note that there exist social patterns of
health and illness.
A common explanation for health inequalities is based on the belief that individuals are responsible
for what happens to them. In attempting to understand and explain health differences, a health
worker who uses a sociological approach will look beyond the individualistic explanations. Whilst
there is no denying that individual psychology may play an important role in determining an
individual’s health status, a sociological approach would lead us to examine the underlying social
causes of health and illness. A sociological approach to health and illness will also be concerned with
social processes and social relationships. Sociologists are interested in the processes whereby
certain groups gain and maintain control over others. They are also interested in the interaction
between health professionals and clients/patients.
Sociologists may also be concerned with differing beliefs about health and illness. As stated
previously, beliefs about the causes of illness vary greatly across cultures.
1.6- Understanding and explaining social phenomena
In an effort to answer the questions laid out in the “What is Sociology?” section, sociology pursues
an objective scientific approach attempting to explain why social life is not a random series of
events, but is structured and shaped by particular sets of rules (both obvious & hidden). This is not
to say that social structures determine human behaviour, rather that social structure is both the
ever-present condition for, and reproduced outcome of, intentional human agency or actions.
Like any other academic discipline, sociology is theory-based. That is, in order to understand how
societies work (or why particular bio-chemical processes occur), we must go beyond a simplistic
description of the phenomenon under investigation. Also like any other academic discipline which
has as its object of study the human and social world, the field of sociology consists of a range of
competing explanatory paradigms. Empirical research necessarily involves making assumptions
about the nature of social reality.
Sociology challenges both naturalistic and individualistic explanations of social phenomena. These
understandings arise as a consequence of growing up (`being socialised’) within a particular culture
and set of social structures, and can result in people seeing their everyday roles and behaviour as
being somehow `natural’. Equally, when looking at other people`s behaviour i.e. `unhealthy
lifestyles’ or lack of motivation; for example, the focus is all too often on particular individual
characteristics ignoring the social factors that influence such behaviour and beliefs.
1.7 -Theories, Discourses and Paradigms
Throughout this topic we will be referring to different theories, discourses and paradigms. In order
for you to grasp these concepts within the sociological context I have set below some general
defintions.
‘A theory is … a system of ideas that uses researched evidence to explain certain events and to show why certain facts are related’ (Germov, 2002, p. 13).
A discourse can be viewed as verbal communication and a formal treatment of a subject in written
and/or verbal communication. The notion of discourses is critical to our understanding of Sociology
and we will talk a bit more about them in later weeks. At this stage it is important to understand the
idea bought about by postmodernism that rejected the view that science provides a universal truth.
It challenged the notion of the unbiased, impartial writer. Rather,
“(C)ritical theory, poststructuralism, and postmodernism expose science’s apparent authorlessness
as one possible rhetorical stance among many” ( Agger, B. 1991, p.122).
According to Dictionary.com a paradigm is ‘a framework containing the basic assumptions. Ways of
thinking, and methodology that are accepted by members of a scientific community’ and a ‘cognitive
framework shared by members of a discipline or group’.
For many paradigms are viewed as self-perpetuating, Newman for example, views the dominant
medical paradigm, a search for causality dominates and all “ non-evidence based” phenomena is
ignored and each new health worker is acculturated into the paradigm ( in Picard, 2005).
1.8 -Sociological concepts and theories
These perspectives or schools of thought will be discussed in detail further into these study materials
but you should try to become familiar with them before you continue. The chapter by Van Krieken et
al (2000) is a good place to start exploring these theories in more depth
Within sociological theory, there exists a divide between those sociologists who argue that society
can be studied in an objective manner through identifying and examining the structures of society,
and those who argue for an interpretative or subjective approach to social phenomena more
focused on social actors. Structuralist approaches often tend to focus on the macro level (that of

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society) while subjectivist approaches tend to focus on the micro level of interaction (between
individuals). However, in more recent time’s a third position has developed which attempts to
breakdown this duality between the relative importance attached to social actors versus social
structures. These three approaches are explored in the next few pages.
1.9- Historical Origins of Social Health.
In the middle of the 19th century, with the industrial revolution came the spread of disease. This was
mainly due to huge influxes of people from country into the cities as this was where the work was
located. As a result housing became an issue and there was little to no regard for hygiene or
sanitation. As a result, preventable diseases like Cholera and Typhoid resulted in thousands of
deaths. It was through health sociology and Karl Marx that the linkage between poverty and working
class conditions were first articulated. Social legislation based on the principals of sanitation was
passed.
What this demonstrates for us is that theories are a product of the historical time, place and
specificity of the theorist.
Within Sociological analysis you need to ask;
? Why is this particular question being asked at this time? ? What are the structural paradigms that support the current structure? ? What cultural paradigms are
involved?
It is therefore important to critically analyse the phenomena from each of these
perspectives.
We are now going to look at some of theoretical approaches.
1.10 -Social structural approaches: Societies as objective realities
Social structural approaches to exploring social reality include those empiricist sociologists who
believe that an objective ‘science of society’ is possible in much the same way as a physical science
such as biology or physics. This empirical sociology seeks to explain the norms of social life in terms
of various identifiable linear causal influences. Social structural approaches would also include those
sociologists who see human society as being shaped by an underlying material social and economic
structure. These are structures that may not always be visible, but nevertheless are fundamental in
explaining social and individual processes.
In relation to health, a predominantly social structural approach would draw upon quantitative data
derived from social surveys, epidemiological studies and comparative studies in order to point to the
relative influence of societal structures and processes in determining health outcomes for social
groups.
Within the academic discipline of sociology, two major theoretical perspectives exist which seek to
analyse human societies utilising a social structural or systems approach. These perspectives are
structural functionalism and Marxism, and their very different organising principles are described in
relation to the social determination of health outcomes below. As a brief illustration of the two
approaches to structural analysis we will briefly examine the issue of poverty. The functionalist
explanation would set poverty in the context of social stratification and the unequal distribution of
rewards associated with complex economies where different tasks are performed by different
groups within society. Some groups are relatively less well off than others because they have less
skills and knowledge and so their contribution to the functioning of society is not as extensive as
other groups. Whilst the Marxist explanation would set poverty in the context of the class structure,
specifically the relationship of social groups within an capitalist system of economic production in
which there are the exploited and the exploiters (with some intermediate groups of managers and
supervisors).
1.11- The functionalist perspective of health and illness
This theoretical perspective stresses the essential stability and cooperation within modern societies.
They believe that the basis of an orderly society is the existence of common value systems that bind
its members together. Social events are explained by reference to the functions they perform in
enabling continuity within society. Society itself is likened to a biological organism in that the whole
is seen to be made up of interconnected and integrated parts; this integration is the result of a
general consensus on core values and norms. Through the process of socialisation we learn these
rules of society which are translated into roles. Thus, consensus is apparently achieved through the
structuring of human behaviour. Within medical sociology, this approach is essentially concerned
with the theme of the ‘sick role’, and the associated issue of illness behaviour. Talcott Parsons, the
leading figure within this sociological tradition, identified illness as a social phenomenon rather than
as a purely physical condition. Health, as against illness, being defined as:
‘The state of optimum capacity of an individual for the effective performance of the roles and tasks for which s/he has been socialised.’ (Parsons, 1951)

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Health within the Functionalist perspective thus becomes a prerequisite for the smooth functioning
of society. To be sick is to fail in terms of fulfilling one’s role in society; illness is thus seen as
‘unmotivated deviance’. The regulation of this sickness/deviance comes about through the
mechanism of the ‘sick role’ concept and the associated ‘social control’ role of doctors in allowing an
individual to take on a sick status
1.12 – The Marxist perspective of health and illness
A key assertion of the Marxist perspective is that material production is the most fundamental of all
human activities – from the production of the most basic of human necessities such as food, shelter
and clothing in a subsistence economy, to the mass production of commodities in modern capitalist
societies. Whether this production takes place within a modern or a subsistence economy, it
involves some sort of organisation and the use of appropriate tools; this is termed the ‘forces of
production’. Production of any type was recognised by Marx as also involving social relations. In
modern capitalist societies these ‘relations of production’ lead to the development of a division of
labour reflecting in the existence of different social classes. For Marx, it is these forces and relations
of production together that constitute the economic base (infrastructure) of society. The
superstructure of a society – the political, legal, educational, and health systems and so on, are
shaped and determined by this economic base.
The orientation of this approach as applied within medical sociology is towards the social origins of
disease. Health outcomes for the population are seen as being influenced by the operation of the
capitalist economic system at two levels.
First, at the level of the production process itself, health is affected either directly in terms of
industrial diseases and injuries, stress-related ill health, or indirectly through the wider effects of the
process of commodity production within modern societies. The production processes produce
environmental pollution, whilst the process of consuming the commodities themselves have long-
term health consequences such as eating processed foods, chemical additives, car accidents and so
on. Second, health is influenced at the level of distribution. Income and wealth are major
determinants of people’s standard of living – where they live, their access to educational
opportunities, their access to health care, their diet, and their recreational opportunities. All of these
factors are significant in the social patterning of health
Also known as conflict theory, this perspective on health and illness focusses on the role of the
medical profession and how working and living conditions in a capitalist society contribute to health
outcomes. They would argue for example that dangerous work environments and poor living
conditions result in higher morbidity rates in the working classes, hence they make the link
between low occupational status, power , income and poor health outcomes.
1.13 -Interpretative approaches: Societies as subjective realities
Sociologists within this wide tradition would argue that the social world cannot be studied in the
same way as the physical world because people:
‘Engage in conscious intentional activity and, through language, attach meanings to their
actions… [therefore] sociologists should be less concerned to explain behaviour than to
understand how people come to interpret the world in the way they do.’ (Taylor and Field,
1993, p.15)
In attempting to achieve this goal of interpretative understanding, reliance is placed on essentially
qualitative research methodologies in order to get as close as possible to the world of the subjects or
social actors being studied. In terms of health and illness, this interpretative approach focuses upon
the (symbolic) meanings of what it is to be ill in our society, and would not confine its interest in
health to what would be perceived as the closed world of clinical biomedicine (this would not rule
out the study of the interactions of clinicians themselves both with patients and with colleagues).
The following issues in health and illness are examples of the research focus of interpretative
sociology:
Within this interpretative sociological tradition two distinct perspectives stand out; symbolic
interactionism and social constructionism. These approaches will be outlined in relation to health
and illness below.
1.14- The Symbolic Interactionist perspective of health and illness
This perspective developed from a concern with language and the ways in which it enables us to
become self-conscious beings. The basis of any language is the use of symbols that reflect the
meanings that we endow physical and social objects with. In any social setting in which
communication takes place, there is an exchange of these symbols: that is, we look for clues in
interpreting the behaviour and intentions of others. Communication being a two-way process, this
interpretative process involves a negotiation between the parties concerned. The negotiated order
that develops therefore involves:

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‘People construct[ing] understandings of themselves and of others out of experiences they have and the situations they find themselves in. These understandings have
consequences in turn for the way in which people act, and the manner in which others react to them.’ (Aggleton, 1990, p. 91)
Interactionist sociology asserts that the social identities we possess are influenced by the reactions
of others. So if we demonstrate some abnormal or ‘deviant’ behaviour it is likely that the particular
label that is attached within a society at a particular time to this behaviour will then become
attached to us as individuals. This can bring about important changes in our self-identity. A disease
diagnosis could be one such label.
Within this perspective medicine too would be viewed as a social practice, and its claims to be an
objective science would be disputed. In the doctor-patient interaction, patient dissatisfaction can
result if the doctor too rigidly superimposes a pre-existing framework (disease categories) upon the
subjective illness experience of the patient. Symbolic interactionist focus on agency and how people
construct, interpret and give meaning. They contend that health and illness are subjective constructs
that vary over time and between cultures.
Foucault proposed that communication of any kind is influential in bringing the world into being. He
used the word discourse to refer to this social process and argued that it always involved power.
Discourses as such make reality.
‘ What is created through text- including and what is left out-creates the truth of reality for people,
shaping their behaviours and actions. Formal knowledges, such as the various branches and
modalities of science, are especially powerful discourses, but so, to, are religious and political beliefs.
Discourses in fact, are critical in bringing us into being as individual subjects with specific identities’
(Schofield, T.,2015,p.54)
1.15 -The Social Constructionist perspective of health and illness – The relativity of social reality
This sociological perspective derives from the phenomenological approach of Berger and Luckmann
(1967), who argue that everyday knowledge is creatively produced by individuals and is directed
towards practical problems. ‘Facts’ are therefore created through social interactions and people’s
interpretations of these ‘facts’. This essentially subjectivist approach embraces a number of very
different sociological paradigms, but what such paradigms do have in common in relation to health
and illness is a focus on the way we make sense of our bodies and bodily disturbances. Social
constructionism refuses to draw a distinction between scientific (medical) and social knowledge. Nor
would it ignore disease in favour of examining the illness experience; unlike the interactionist
perspective. Rather, it maintains that all knowledge is socially constructed. We are seen to come to
know the world through the ideas and beliefs we hold about it, so that it is our concepts and
categories which are the realities of the world.
Foucault (1973,1980,1985,1986) and the work of so-called post-structural social theorists are
included within this perspective, though their concerns are frequently different from those
researching within the tradition of phenomenology. Foucault is interested in power in itself, not as
reduced to an expression of some other conceptual starting point such as class, the state, gender or
ethnicity. He seeks to approach the relationship between agency and structure not through an
essentialist analysis but by using an ‘interpretative analytics’ of practices and discourses, discerning
the workings of power and knowledge in social relations. He tried to define the relationship between
language, social institutions, subjectivity and power.
In terms of health and illness, this Foucauldian approach to cultural constructionism draws attention
to the ways in which we experience ourselves and our bodies not in some naturalistic way, but in
what is termed a ‘symbolically mediated fashion’ – the body as a ‘field of discourse’. He looked at
how some discourses such as biomedicine for example, created meaning systems and have gained
the status of “truth” and hence are able to dominate how we continue to define and organise
ourselves as individuals and society as a whole. Other alternative discourses become marginalised as
a result.
1.16- Feminist Perspectives
Feminist perspectives in Sociology first emerged in the 1960s in response to the neglect of
gender issues and the sexist nature of many traditional sociological theories.
There are many different perspectives placed under the feminist banner. Despite this
diversity they all emphasise the importance of patriarchy and challenge biological
assumptions about the nature of women. They have made a major contribution to Health.
1.17 -The Structure –Agency Continuum
As you can see one of the key debates across sociology is between structure and agency that is what
is the degree in which human behaviour is determines or influenced by the structures, institutions,
systems and groups that surround them as compared with the ability of the individual to direct their

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own experience. This is not an either or phenomena but rather they are interdependent that is,
humans shape and at the same time are shaped by society.
1.18 -The Sociology of health and illness: Defining the field
Sociology brings two distinct focuses of analysis to the study of health and illness. At one level it tries
to ‘make sense of illness’, by applying sociological perspectives both to an analysis of the experience
of illness, and to the social structuring of health and disease. At this level, sociology makes an
important contribution to multi-disciplinary research into issues of interest to clinicians and other
health professionals, the development of health policy, and epidemiological studies. At a second
level, sociological enquiry can open doors to an understanding of the impact of wider social
processes upon the health of individuals and social groups. Such processes include social
inequalities, professional relationships, change and self-identity, knowledge and power, and
consumption and risk.
1.19- Question for discussions:
In order to get the most out of this subject and to learn from each other, s