CH 02: Theorizing Health: Major Theoretical Perspectives in Health Sociology

What are the main theoretical perspectives in health sociology?

• Structural functionalism

• Marxism

• Weberianism

• Symbolic interactionism

• Post-structuralism/postmodernism

• Feminism

• Human rights & anti-racist approaches

Who are the key theorists of structural functionalism?

Emile Durkheim, Talcott Parsons, and Robert Merton.

What is the main assumption of structural functionalism?

Society is a system of integrated parts with functional prerequisites that must be fulfilled to maintain social order and stability.

Why is functionalism sometimes called “consensus theory”?

Because it emphasizes how social order is achieved and maintained through consensus and integration.

How did Parsons connect health and social stability?

He argued health is essential for performing social roles. Illness disrupts society, so individuals must return to health through the sick role.

What are the rights of the sick role (Parsons)?

• Exemption from normal social roles (legitimized by medical diagnosis).

• Not held responsible for their illness.

What are the responsibilities of the sick role (Parsons)?

• Seek medical assistance.

• Comply with treatment.

• Recover and return to normal roles.

How did Segall revise the sick role?

He separated the informal sick role (self-care) from the formal patient role (medicalized) and recognized entry/exit without medical help.

What are key critiques of the sick role?

• Doesn’t apply well to chronic, terminal, or disabling conditions.

• Accepts medical profession uncritically.

• Ignores limits of the biomedical model.

• Overlooks inequalities (class, race, gender, access to doctors).

• Under neoliberalism, health responsibility is individualized, limiting sick role access.

What is the core principle of Marxism?

Society is driven by class conflict between the bourgeoisie (capitalist class) and proletariat (working class).

What is praxis in Marxist theory?

Conscious human action that transforms society, balancing the structural constraints of capitalism with human agency.

What is the Marxist perspective on health and illness?

Illness is shaped by working/living conditions in capitalism. Health inequalities reflect exploitation and profit motives, not just individual biology.

How does Marxism critique the medical profession?

Doctors serve class interests, individualize illness, and reinforce capitalist ideology by ignoring illness-generating social conditions.

What is the medical-industrial complex?

The profit-driven entry of corporations (pharmaceuticals, private hospitals, insurance) into healthcare, commodifying health and creating conflicts between profit and public need.

How do neoliberal policies relate to Marxist health critiques?

Neoliberalism cuts social programs, privatizes health care, and exacerbates health inequalities (e.g., by overburdening nurses or inflating drug costs).

What is the political economy approach to health?

A materialist, critical perspective examining how economic, political, and social organization affects health outcomes.

What types of questions does political economy ask?

• Why do some people have better health than others?

• Why do some countries have universal healthcare while others don’t?

• Why do inequalities in access to health care exist?

What is the key emphasis of the political economy approach?

Social inequalities and material conditions (work, class, gender, globalization) as determinants of health.

What are Weber’s major contributions to sociology?

• Concept of social action

• Verstehen (understanding meaning)

• Analysis of bureaucracy

• Concepts of class, status, and party in inequality

How did Weber’s class analysis differ from Marx’s?

Unlike Marx’s two-class model, Weber included the middle class and emphasized status groups and parties as additional bases of inequality.

What is social closure in Weber’s theory?

The process by which groups restrict access to resources, privileges, or status to maintain exclusivity.

What did Weber mean by rationalization and bureaucracy?

Rationalization is the trend toward efficiency and rules. Bureaucracy is its organizational form—hierarchical, rule-bound, specialized. Weber warned this could create an “iron cage” limiting individuality.

How do Weberian perspectives analyze health?

They focus on health professions, bureaucracy in healthcare, and how class, status, and power affect health inequalities.

Which theorists are most associated with symbolic interactionism?

George Herbert Mead, Charles Cooley, Howard Becker, Erving Goffman, Anselm Strauss, Herbert Blumer (who coined the term in 1937).

How does symbolic interactionism differ from structural functionalism?

Functionalism sees humans as shaped by external forces; symbolic interactionism emphasizes agency, human interpretation, and meaning-making through interaction.

What is the “core philosophical assumption” of symbolic interactionism?

Humans create reality through their actions and the meanings they attach to them; society is the cumulative effect of interaction and interpretation.

What is Cooley’s “looking-glass self”?

The idea that our self-concept is shaped by how we believe others perceive us (e.g., being told you are smart/attractive shapes behavior and self-image).

How does symbolic interactionism view health and illness?

They are socially constructed, vary across cultures/time, and reflect cultural, political, and moral values rather than being purely biological.

How does symbolic interactionism view health and illness?

They are socially constructed, vary across cultures/time, and reflect cultural, political, and moral values rather than being purely biological.

What is Becker’s definition of deviance (1963)?

Deviance is not inherent in an act; it is a consequence of others applying labels and sanctions. Deviant behavior is behavior that people define as such.

What does labelling theory emphasize?

The effects of being labelled deviant, why certain behaviors/groups are labelled, and how institutions (police, courts, psychiatry) use labels as social control.

What did Erving Goffman contribute to symbolic interactionism?

He studied stigma and total institutions. He identified three types of stigma (physical deformity, individual traits, tribal identity) and showed how stigma produces “spoiled identities.”

What is Goffman’s concept of “total institutions”?

Places like asylums/prisons where people are cut off from wider society, subjected to strict control, and often develop an “underlife” to resist authority.

What do postmodernists reject?

Universal truths, grand theories, structural determinants (class conflict, patriarchy, rationalization). They argue all knowledge is socially constructed and subjective.

Who is the most influential postmodernist in sociology?

Michel Foucault.

What is Foucault’s concept of the panopticon?

A metaphor for surveillance and social control—people regulate themselves because they assume they are being watched.

How has Foucault’s work been applied to health and the body?

He showed how medical knowledge and discourse regulate bodies, e.g., beauty standards and body surveillance leading to self-discipline.

What did early feminist sociology critique?

The neglect of women’s experiences, sexism in theory, and assumptions like Parsons’ expressive roles for women.

What distinction did Dorothy Smith make?

A sociology of women (studying women as objects) vs. a sociology for women (centering women’s everyday experiences as knowledge).

What is institutional ethnography (IE)?

Smith’s method linking everyday experiences to broader relations of ruling, showing how institutions shape people’s lives.

What is intersectionality?

A framework recognizing overlapping and interdependent systems of oppression (race, class, gender, sexuality, etc.), producing unique experiences of inequality.

What did Patricia Hill Collins argue about intersectionality?

Oppressions work together, not separately, to create injustice; we must move beyond simple additive models of race + class + gender.

What health issues have feminists highlighted?

Medicalization of women’s bodies, sexism in health research, domestic violence, sexual health, body image, eating disorders, and inequalities in women’s health care.

What does the Universal Declaration of Human Rights (1948) say about health?

Everyone has the right to the highest attainable standard of physical and mental health, requiring safe conditions, food, housing, and social security.

How does a human rights approach connect to health?

It frames health inequities as violations of social justice and emphasizes links between health and other rights (political, economic, cultural).

How does George Sefa Dei define race?

A socio-political construction used by dominant groups to maintain power and privilege.

How does racism affect health?

Racism is a source of stress and hypertension, contributes to marginalization, and creates barriers in access to health care.

What does critical race theory emphasize in health sociology?

Eliminating racism is essential for achieving health equity; it examines how structural racism shapes both health outcomes and knowledge production.