10.4 Sociological Theories of Health
Kathryn Burrows
Like all social problems, the concepts of health and illness are socially constructed. The definition of the social construction of illness experience is based on the idea that there is no objective reality, only our own perceptions of reality. The theories surrounding the social construction of health emphasize the social and cultural aspects of the discipline’s approach to physical, objectively definable phenomena. This section examines a comprehensive framework that focuses on the cultural meaning of illness, the social construction of the illness experience, and the social construction of medical knowledge (Conrad and Barker 2010).
The Cultural Meaning of Illness
Most medical sociologists contend that illnesses have both a biological and an experiential component and that these components exist independently of each other. Dominant White culture influences the way we experience illness, dictating which illnesses are stigmatized, which are considered disabilities or impairments, and which are contestable illnesses (Conrad & Barker 2010).
Contested illnesses are those that are questioned or questionable by some medical professionals. Disorders like fibromyalgia or chronic fatigue syndrome are real physical experiences, but some medical professionals contest whether these ailments are definable in medical terms. This causes a problem for a patient with symptoms that might be explained by a contested illness—how to get the treatment and diagnosis they need in the face of a medical establishment that does not believe their symptoms are real.
We also see the social construction of health and illness when we try to measure and treat pain. Individual and cultural perceptions of pain can make it difficult for healthcare workers to treat illnesses since they cannot be measured using a device. A person’s experience of pain is subjective, and a physician’s response to treating pain is highly variable. In addition to individual and cultural differences in the response to pain, the medical system’s response to pain varies by race. Minority women are less likely to receive adequate pain medication during childbirth (Lange, Rao, and Toledo 2017) and the postpartum period (Badreldin, Grobman, and Yee 2019). If you would like to learn more, How we fail black patients in pain [website] explores some reasons why physicians may give less pain medication to Black and Brown people than to White people.
In addition to pain, it can be challenging to come to a shared understanding of physical activity. Assessment tools like the Rating of Perceived Exertion (RPE) Scale attempt to measure exertion at the individual level using accessible language and visual cues. This RPE chart includes the Wong-Baker FACES pain assessment tool, which is used often in healthcare settings because it works for a variety of ages, ability levels, and can be understood by those whose primary language is not English. The Rating of Perceived