Sociology in Health Care

Society

• Definition 1 (Pg. 3)

  • A community of people who share common values, traits, and habits.

  • Continuous interaction occurs among members.

• Definition 2 (Pg. 20)

  • A large number of people living in the same territorial area.

  • Relatively independent of outsiders.

  • Share a common culture.

• Practical relevance for nurses

  • Understanding a patient’s community context helps interpret behaviours (dietary customs, family roles, expectations of care).

  • Territorial clustering may explain disease clusters, e.g. \text{TB incidence}\uparrow in over-crowded urban wards.

Sociology

• Scientific study of human groupings and societies (Pg. 3 & 20).

• Concerned with

  • Human conditions & culture.

  • Societal structure (government departments, businesses).

  • Societal interactions (how people contact & communicate).

  • Social groups & organisations.

  • Social relations & deviance.

  • Social inequalities.

  • Social institutions.

  • Social change (Pg. 3-4).

• Significance for health care

  • Provides analytical tools to explore why illnesses distribute unevenly across gender, race, class.

  • Offers language for discussing power, inequality, stigma.

Medical Sociology (Pg. 7)

• Focus: social causes & consequences of health and illness.

• Main interests

  • Effects of disease on the human environment.

  • Illness behaviour (how, when, where people seek help).

  • Patient–professional relationships & interactions.

  • Hospital as a social institution/setting.

  • Social causes & outcomes of illness (poverty, racism, policy).

• Value for nurses

  • Bridges clinical reasoning with community realities.

  • Encourages holistic care plans incorporating social interventions (social work referral, transport vouchers, diet subsidies).

Sociological Imagination (C. Wright Mills adapted for nursing)

• Core definition

  • Ability to see interrelationships between personal lives and larger social forces.

  • Requires distancing from one’s own biography to grasp wider context.

• Nursing example (Diabetic patient)

  • Low-income area ➜ food deserts.

  • Transport cost barrier ➜ missed appointments.

  • Long hours/no leave ➜ difficulty in self-management.

  • Cultural diet high in carbs/sugar.

  • Limited health literacy.

• Historical dimension (Pg. 6)

  • Enables comparison of marriages, family patterns, disease patterns across generations.

• Subjective vs Objective (Pg. 7)

  • Personal views = private; sociology analyses social phenomena = public, observable.

• Practical pay-offs (Pg. 8)

  • Distinguish individual experience from social trends.

  • Link patient story to structural context.

  • Suspend judgement; replace with inquiry into circumstances & value systems.

  • Example action: before labelling a patient “non-compliant,” assess income, transport, literacy, cultural diet norms.

Levels of Analysis (Pg. 9)

• Macro level ("large photograph")

  • Examines society as an integrated whole.

  • Focus: institutions, large-scale phenomena (health-care system, economy, national policy).

• Micro level ("small photograph")

  • Zooms in on specific components & interactions.

  • Focus: families, peer groups, staff–patient interactions.

• Nurses should pivot between levels

  • Macro ➜ policy advocacy (e.g. universal health coverage).

  • Micro ➜ bedside communication & patient education.

Functionalism (Pg. 11-13)

• Also called Structural Functionalism; Macro perspective.

• Sees society as a system of interdependent parts ≈ human body analogy.

  • Social institutions = organs (family, economy, religion, politics, health system, etc.).

  • Each has structure, functions, norms, values.

• Key analytical foci

  • Structure: how components relate.

  • Functions: contribution of each component to social maintenance.

  • Processes: dynamic operation keeping society orderly.

• Dysfunction & compensation

  • If one component fails, others adjust.

  • Physiological parallel: diarrhoea ➜ dehydration ➜ kidneys reduce urine to maintain \text{pH} & fluid balance.

• Orderly bias

  • Assumes social equilibrium is normal; change is gradual, not conflict-ridden.

• Self-study prompts

  • Distinguish manifest functions (intended) vs latent functions (unintended).

  • Evaluate benefits & critics of functional approach in health (e.g. overemphasis on stability may downplay inequity).

Symbolic Interactionism (Pg. 14-15)

• Micro perspective: studies daily interactions among individuals & small groups.

• Core assumptions

  • People actively create & modify social reality.

  • Meaning arises through symbols & interaction.

• Key concepts for nursing

  • Symbols: language, uniforms, epaulettes, stethoscope, hospital rounds ritual.

  • Interaction patterns: handover reports, multidisciplinary meetings.

  • Meaning negotiation: what “pain,” “recovery,” or “terminal” signify for each patient.

• Visibility of nurses

  • Uniforms & specialised language make professional identity clear; also shape patient expectations & power dynamics.

Conflict Perspective (Self-Study)

• Transcript tags as self-study; still note core tenet

  • Society characterised by inequalities & conflicts over scarce resources (e.g. money, power, access to care).

  • Health disparities interpreted as outcomes of structural exploitation (class, gender, race).

• Nursing implication

  • Critical consciousness: recognise how policy & corporate profit affect patient well-being.

Sociology in Medicine (Applied Research) (Pg. 14)

• Term: “sociology in medicine” = application of sociological knowledge to solve practical medical problems.

• Research agenda

  • Determine disease incidence across populations: where, when, why.

  • Study group reactions to disease & treatment.

  • Analyse participation in prophylaxis programmes (vaccination, screenings).

  • Examine microsystems: family organisation, division of labour, social support.

  • Assess how these factors modulate an individual’s chance of being healthy or ill.

• Orientation

  • Group/population level (not purely clinical, individual-focused).

  • Aimed at planning disease control & health improvement.

• Example outcomes

  • Data on vaccine hesitancy by socioeconomic status guides tailored outreach.

  • Understanding gendered caregiving roles helps design caregiver support services.

Integrative Take-Aways for Nursing Practice

• Use sociological imagination to contextualise patient behaviour & design feasible care plans.

• Employ macro & micro lenses depending on task (policy vs bedside).

• Apply functionalism to map institutional roles & anticipate systemic ripple effects (e.g. nursing strikes → hospital throughput).

• Draw on symbolic interactionism to refine communication, negotiate meanings, and manage stigma.

• Keep a conflict perspective in mind to advocate against inequitable structures (pharmaceutical pricing, insurance barriers).

• Engage in sociology in medicine by participating in community health assessments, quality-improvement audits, and health-promotion campaigns.

Quick Glossary

• Society: territorially bounded population sharing culture.

• Sociology: systematic study of social life.

• Medical Sociology: branch examining social dimensions of health.

• Sociological Imagination: linking biography with history & structure.

• Macro vs Micro: large-scale vs small-scale social analysis.

• Functionalism: system view of interdependent parts.

• Symbolic Interactionism: study of symbols & everyday interaction.

• Conflict Perspective: focus on power & inequality.

• Sociology in Medicine: applied sociological research for health solutions.