Page 160 - The ISA Handbook in Contemporary Sociology

9781412934633-Chap-09 1/10/09 8:44 AM Page 131

HEALTH SOCIOLOGY 131

inequality and race, has been institutionalized of conflict, competition, cooperation as
in the American context due to the special explanatory factors on health.
political language adopted in current US health While the reductionist explanations of
policy. Health inequalities are described as health and illness offered by the new neuro-
‘health disparities’, a new concept which, biological and biogenetic research challenge
more often than not, is sanitized from all the approach of medical and health sociology,
indications of economic and structural those taking a social constructionist approach
inequalities. This conceptualization of ill to technology and science gave sociology a
health has been confirmed in a recent US special role in unravelling ‘truth claims’,
law – the Minority Health and Health especially to document how rates and cate-
Disparities Research and Education Act of gories are constructed (Duster, 2006: 10;
2000 (P.L. 106–525) – that encourages Epstein, 2004; Timmermans, 2000). For
research on what sociologists have tradition- example, it has enabled sociologists to point
ally called race and class. to the ways in which subjects are sorted,
named, and classified into categories which
then become referred to in explanations as
‘natural’ categories, like gender and race.
CHALLENGES FOR THE TWENTY-FIRST The individualization of health risks over-
CENTURY laps with another trend in current public
health thinking that attributes to health infor-
The entry of the biological body mation a crucial role in shaping health
behaviour. Increasingly the individual’s
and the cultural body
health behaviour is interpreted in terms of a
Brain research and genetic research have cre- conscious choice and personal responsibility
ated an intellectual climate that has increased in avoiding health risks and in selecting
the authority of reductionist science for appropriate health services. As Mildred
explaining a wide range of social problems Blaxter (2004) relates in a review, although
and social behaviour (Duster, 2006). While there is an increasing imperative to (attempt to)
sociological research on health and illness control risks to health, the ability to do so is
has looked at forces outside the body for not evenly distributed in the population.
explaining inequalities in health, biological She points out that this chimera of risk con-
scientists are searching for neurotransmis- trol is apparent even for the resource-rich.
sion pathways and patterns or specific For example, even when all known risk fac-
genetic markers inside the body which would tors for heart disease – one of the (if not the)
provide a more generic and ‘fundamental’ leading causes of death in most developed
scientific reason (Conrad, 2000, 2005; nations – are considered together, they
Duster, 2006: 3–5). account for only about 40% of the incidence
Risk-factor thinking has introduced new of the disease.
forms of reductionism and medicalization of Another challenge to the social-causation
behaviour. This thinking tends to ignore the perspective on health and illness is the emer-
structuring of health by social class, race, gence of a new subfield in sociology: the
age, and gender and therefore the way that sociology of the body. The merit of early
certain macro-level institutions and ideolo- sociological theory of the body was that it lib-
gies in society influence health. Health risks erated the sick role from its abstraction and
are interpreted as individual responses that, contextualized the body as part of modernity
at the aggregate level, result in certain health (e.g., Shilling, 1993; Turner, 1984). As noted
patterns. This reductionist view of the deter- earlier, the new theoretical focus turned
minants of health gives little credibility to the the body into a feature of reflexive modernity
impact of social factors related to the themes and the reflexive self (Giddens, 1991) as it