Chapter 19. The Sociology of the Body: Health and Medicine

Chapter 19 Resources and Activities

Key Terms

ableism: Discrimination against persons with disabilities or the unintended neglect of their needs.

anti-psychiatry movement: A social movement skeptical of the scientific basis and effectiveness of psychiatric treatment, which considers psychiatry to be based on a power relationship between doctor and patient and the institutional authority of the diagnostic process.

anxiety disorders: Feelings of worry and fearfulness that last for months at a time.

biomedicine: A system of medical practice that defines health and illness in terms of the mechanics of the physical, biological systems of the human body.

biopolitics: The relationships of power that emerge when the task of fostering and administering the life of the population becomes central to government.

care for the self: Ways of acting upon the self to transform the self to attain a certain mode of being (e.g., “health”).

chronic diseases: Non-communicable diseases like cancer, heart disease, diabetes, hypertension, and obesity, characterized by the slow onset of symptoms.

commodification of health: The transformation of health and health services into products that can be bought and sold in the marketplace.

contested illnesses: Illnesses that are questioned or considered questionable by some medical professionals.

demedicalization: The social process that normalizes “sick” behavior.

disease: An organic based pathology which can in principle be measured through clinical or laboratory procedures. 

disease vector: Any living agent that carries and transmits an infectious pathogen to another living organism.

disability: An impairment in cognitive, developmental, physical, sensory, and mental abilities, compounded by social barriers that hinder full and effective participation in society on an equal basis with others.

disciplinary power: Detailed continuous training, control, observation, correction, and rehabilitation of individuals to improve their capabilities (or health).

epidemiologic transition: The long-term change in a population’s dominant health problems or profile from acute infectious diseases to chronic, degenerative diseases as societies go through the process of industrialization.

exclusion of the sick: A model of power that separates deviants from “normals,” or the sick from the healthy, and abandons them outside the care of society.

gerontocracy: Rule by old people.

health: A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.

illness: The subjective experience of ‘not feeling well.’

impairment: The physical limitations a less-able person faces.

infectious diseases: Communicable diseases caused by micro-organisms such as bacteria or viruses.

Körper: The physiological body, or what people are as physiological, neurological, and skeletal beings.

Leib: The lived body, or the way in which the body experiences the world and is itself experienced from within.

medical legitimation: When a physician certifies that an illness is genuine.

medical pluralism: A situation in which no one model of health practice can successfully claim to provide the definitive truth for how to attain health.

Medical Sociology: The systematic study of how humans manage issues of health and illness, disease and disorders, and health care for both the sick and the healthy.

medicalization: The process by which aspects of life that were considered bad or deviant are redefined as sickness and needing medical attention to remedy.

medicalization of deviance: The process that changes “bad” behaviour into “sick” behavior.

mental disorder: A condition that makes it more difficult to cope with everyday life.

mental illness: A severe, lasting mental disorder that requires long-term treatment.

mood disorders: Long-term, debilitating illnesses like depression and bipolar disorder.

neurodiversity: Neurocognitive variation among the human species

norm: A socially defined standard measure which allows us to distinguish between what conforms to a rule and what does not.

normalizing society: A society organized around the definition of norms used to discipline bodies and regulate populations.

personality disorders: Disorders that cause people to behave in ways that are seen as abnormal to society but seem normal to them.

phenomenology: The study of social structures and processes based on a systematic description of the contents of subjective experience.

pluralistic medical culture: See medical pluralism.

practice of the self: See care for the self.

public health care: Health insurance that is funded or provided by the government.

sick role: The pattern of expectations that define appropriate behaviour for the sick and for those who take care of them.

rehabilitation: Interventions to treat or cure disabilities in order to reintegrate disabled persons into “normal” society.

residual deviance: A violation of social norms not covered by any specific behavioural expectation.

risk management: Strategies to restructure the environment or context of problematic behaviour in order to minimize the risks to the general population.

social determinants of health model: A framework that describes the social variables that influence health outcomes for individuals and populations.

social epidemiology: The study of the causes and distribution of diseases.

stereotype interchangeability: When stereotypes don’t change, they get recycled for application to a new subordinate group.

stigma: A “mark” of difference that defines a socially undesirable characteristic.

stigmatization: When someone’s identity is spoiled; they are labelled as different, discriminated against, and sometimes even shunned due to an illness or disability.

stigmatization of illness: When people are discriminated against because of illnesses and sufferers are looked down upon or even shunned by society.

universal health care: A system that guarantees health care coverage for everyone.

vaccine hesitancy: A delay in acceptance or refusal of vaccines despite availability of vaccination services.

Section Summary

19.1 The Sociology of the Body and Health

Medical sociology is the systematic study of how humans manage issues of health and illness, disease and disorders, and health care for both the sick and the healthy. The social construction of health explains how society shapes, and is shaped by, medical ideas.

19.2 Global Health
Social epidemiology is the study of the causes and distribution of diseases. From a global perspective, the health issues of high-income nations tend toward diseases like cancer as well as those that are linked to obesity, like heart disease, diabetes, and musculoskeletal disorders. Low-income nations are more likely to contend with infectious disease, high infant mortality rates, scarce medical personnel, and inadequate water and sanitation systems.

19.3 Health in Canada
Despite the Canadian population having generally good health compared with less-developed countries, Canada is still facing challenging issues such as a prevalence of obesity and diabetes. Moreover, Canadians of historically disadvantaged Indigenous groups, socioeconomic status, and gender, experience higher levels of chronic health issues. Mental health and disability are health issues that are significantly impacted by medical definitions of normalcy.

19.4 Theoretical Perspectives on Health and Medicine 
While the functionalist perspective looks at how health and illness define specific roles in society, the critical perspective is concerned with how health and illness fit into the structures of power in society. The interactionist perspective is concerned with how social interactions construct ideas of health and illness.


Quiz: The Sociology of the Body: Health and Medicine

19.1 The Social Construction of Health

  1. Who determines which illnesses are stigmatized?
    1. Therapists
    2. The patients themselves
    3. Society
    4. All of the above
  2. Chronic fatigue syndrome is an example of                       .
    1. A stigmatized disease.
    2. A contested illness.
    3. A disability.
    4. Demedicalization.
  3. The Rating of Perceived Exertion (RPE) is an example of                       .
    1. The social construction of health.
    2. Medicalization.
    3. Disability accommodations.
    4. A contested illness.

19.2 Global Health

  1. What is social epidemiology?
    1. The study of why some diseases are stigmatized and others are not.
    2. The study of why diseases spread.
    3. The study of the mental health of a society.
    4. The study of the causes and distribution of diseases.
  2. Core nations are also known as                       .
    1. High-income nations.
    2. Newly industrialized nations.
    3. Low-income nations.
    4. Developing nations.
  3. Many deaths in high-income nations are linked to                       .
    1. Lung cancer.
    2. Obesity.
    3. Mental illness.
    4. Lack of clean water.
  4. According to the World Health Organization, what was the most frequent cause of death for children under five years in low-income countries?
    1. Starvation
    2. Thirst
    3. Pneumonia and diarrheal diseases
    4. All of the above

19.3 Health in Canada

  1. Which of the following statements is not true?
    1. The life expectancy of Indigenous males in Canada is approximately eight years shorter than for non-Indigenous males.
    2. The rate of tuberculosis for Indigenous Canadians is more than five times higher (per 100,000) than it is for non-IndigenousCanadians.
    3. Indigenous people have lower rates of chronic disease than non-Indigenous people have.
    4. Recent visible minority immigrants have lower levels of health than native-born Canadians have.
  2. The process by which aspects of life that were considered bad or deviant are redefined as sickness and needing medical attention to remedy is called                       .
    1. Deviance.
    2. Medicalization.
    3. Demedicalization.
    4. Intersection theory.
  3. What are the most commonly diagnosed mental disorders in Canada?
    1. ADHD
    2. Anxiety disorders
    3. Autism spectrum disorders
    4. Mood disorders
  4. Sidewalk ramps and Braille signs are examples of                       .
    1. Disabilities.
    2. Accommodations required by the Canadian Charter of Rights and Freedoms.
    3. Forms of accessibility for people with disabilities.
    4. Both b and c.
  5. The high unemployment rate among people with disabilities may be a result of                       .
    1. Medicalization.
    2. Obesity.
    3. Stigmatization.
    4. All of the above.

19.4 Theoretical Perspectives on Health and Medicine

  1. Which of the following is not part of the rights and responsibilities of a sick person under the functionalist perspective?
    1. The sick person is not responsible for their condition.
    2. The sick person must try to get better.
    3. The sick person can take as long as they want to get better.
    4. The sick person is exempt from the normal duties of society.
  2. The class, race, and gender inequalities in our healthcare system support the                        perspective.
    1. Critical
    2. Interactionist
    3. Functionalist
    4. All of the above
  3. The removal of homosexuality from the DSM is an example of                       .
    1. Medicalization.
    2. Deviance.
    3. Interactionist theory.
    4. Demedicalization.

[Quiz answers at end of chapter]

Short Answer

19.1 The Social Construction of Health

  1. Pick a common illness and describe which parts of it are medically constructed, and which parts are socially constructed.
  2. What diseases are the most stigmatized? Which are the least? Is this different in different cultures or social classes?

19.2 Global Health

  1. If social epidemiologists studied Canada in the colonial period, what differences would they find between now and then?
  2. What do you think are some of the contributing factors to obesity-related diseases in Canada?

19.3 Health in Canada

  1. What factors contribute to the disparities in health among ethnic, socioeconomic, and gender groups in Canada?
  2. Do you know anyone with a mental disorder? How does it affect their life?

19.4 Theoretical Perspectives on Health and Medicine

  1. Which theoretical perspective do you think best explains the sociology of health? Why?
  2. What examples of medicalization and demedicalization can you think of?

Further Research

19.1 The Sociology of the Body and Health

Spend some time on the two websites below. How do they present differing views of the vaccination controversy?

19.2 Global Health
Study this 2000–2015 W.H.O. map on global life expectancies. What trends do you notice?

19.3 Health in Canada
Is ADHD a valid diagnosis and disease? Some think it is not. This 2014 infosheet from the B.C. HeretoHelp website, and the Canadian Mental Health Association (CMHA) discusses ADHD in children and youth [PDF]

19.4 Theoretical Perspectives on Health and Medicine
Read and watch a dissenting view: Should alcoholism and other addictions be medicalized?


19.0 Introduction to Health and Medicine

Aston, J. (2012). MMR doctor John Walker-Smith wins High Court appeal. The Independent.

Centers for Disease Control. (2011). Pertussis. The Centers for Disease Control and Prevention.

CNN. (2011). Retracted autism study an ‘elaborate fraud,’ British journal finds. CNN, January 5.

Devlin, K. (2008). Measles worries MMR as vaccination rates stall. The Telegraph.

Government of Canada. (2021). COVID-19: Main modes of transmission. Government of Canada. (June 29).

MacDonald N. & SAGE Working Group on Vaccine Hesitancy. (2015). Vaccine hesitancy: definition, scope and determinants. Vaccine, 33(34), 4161–4.

Picard, A. (2012). Comeback of a deadly disease, and where we went wrong. Toronto Globe and Mail.

Statistics Canada. (2022, January 24). Deaths, 2020. Statistics Canada: The Daily.

Sugerman, D. E., Barskey, A. E., Delea, M. G. Ortega-Sanchez, I. E., Bi, D., Ralston, K. J., … & LeBaron, C. W. (2010). Measles outbreak in a highly vaccinated population, San Diego, 2008: Role of the intentionally undervaccinated. Pediatrics, 125(4), 747–755.

World Health Organization (WHO). (2022a). The true death toll of COVID-19: Estimating global excess mortality. World Health Organization.

World Health Organization (WHO). (2022b). Influenza (Seasonal). World Health Organization.

Zacharyczuk, C. (2011). Myriad causes contributed to California pertussis outbreak. Healio, Infectious Diseases in Children.

19.1 The Sociology of the Body and Health

Bauman, Z. (2005). Liquid life. Polity Press

Conrad, P. & Barker, K. (2010). The social construction of illness: Key insights and policy implications. Journal of Health and Social Behavior, 51(1 suppl), S67–S79.

CSEP. (n.d.) PAL Physical activity line: Rating of perceived exertion scale. [PDF] Canadian Society for Exercise Physiology.

Ewald, F. (1990). Norms, discipline and the law. Representations, 30, 138–161.

Foucault, M. (1979). Discipline and punish: The birth of the prison. Vintage Books.

Foucault, M. (1980). The history of sexuality. Volume one: An introduction. Vintage Books.

Foucault, M. (2006). History of Madness. Routledge.

Foucault, M. (2007). Security, Territory, Population: Lectures at the Collège de France, 1977–1978. Palgrave Macmillan.

Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Penguin.

Lamoureux, M. (2018, March 22). “Island of Death:” BC’s Forgotten Racist Leper Colony. Vice.

Rose, N. (2007). The politics of life itself: Biomedicine, power, and subjectivity in the twenty-first century. Princeton University Press.

Sarasin, P. (2020, March 31). Understanding the Coronavirus Pandemic with Foucault? G+C.

Sartorius, N. (2007). Stigmatized illness and health care. The Croatian Medical Journal, 48(3), 396–397.

World Health Organization (WHO). (2014). What is the WHO definition of health? In Frequently asked questions, World Health Organization.

19.2 Global Health
Bromet, E., Andrade, L.H., Hwang, I., Sampson, N.A. Alonso, J., de Girolamo, G., … Kessler, R. C. (2011). Cross-national epidemiology of DSM-IV major depressive episode. BMC Medicine, 9, 90.

Huffman, W. E., Huffman, S. K., Tegene, A., & Rickertsen, K. (2006). The economics of obesity-related mortality among high income countries, International Association of Agricultural Economists.

Mahase, E. (2019, September 3). Cancer overtakes CVD to become leading cause of death in high income countries. The BMJ.

Omram, A.R. (1971). The epidemiologic transition: A theory of the epidemiology of population change. The Milbank Memorial Fund Quarterly, 49(4), 509–38.

Organisation for Economic Co-operation and Development. (2013). Health at a glance 2013: OECD indicators. OECD Publishing.;jsessionid=11239ofxudi0c.x-oecd-live-01.

UNICEF. (2011). Water, sanitation and hygiene.

World Health Organization. (2011). World Health Statistics 2011 [PDF].

World Health Organization. (2021). World health Statistics 2021 [PDF].

Young, T.K. (1988). Are subarctic Indians undergoing the epidemiologic transition? Social Science and Medicine, 26, 659-671.

19.3 Health in Canada

American Psychological Association. (n.d.) Understanding the Ritalin debate. American Psychological Association.

Becker, D. (n.d.) Borderline personality disorder: The disparagement of women through diagnosis.

Bernstein, L. & Durkee, L. (2008). Sleep hygiene: Helpful hints for better sleeping. [PDF] University Health Network.

Brault, M.C. & Lacourse, É. (2012). Prevalence of prescribed attention-deficit hyperactivity disorder medications and diagnosis among Canadian preschoolers and school-age children: 1994–2007. Canadian Journal of Psychiatry, 57(2), 93–101.

Canadian Human Rights Commission. (2012). Report on equality rights of people with disabilities. [PDF] Minister of Public Works and Government Services. Catalogue no. HR4-20/2012E-PD.

Canadian Population Health Initiative. (2008). Reducing gaps in health: A focus on socio-economic status in urban Canada. Canadian Institute for Health Information.

CBC. (2013). Treating poverty works like medicine, doctors say: Financial support can pay off with better health. CBC News.

CBC. (2014). Project money: Health and wealth. The Current.

Centers for Disease Control and Prevention. (2014, March 28). Prevalence of autism spectrum disorder among children aged 8 years [PDF] — Autism and developmental disabilities monitoring network, 11 Sites, United States, 2010. MMWR, 63(2), 1–21.

Chapman, R. (2020). Neurodiversity, disability, wellbeing. In Bertilsdotter Rosqvist, H., Chown, N. and A. Stenning (Eds.), Neurodiversity Studies: A New Critical
Paradigm (pp. 57–72). Routledge.

de la Barra, X. (1998). Poverty: The main cause of ill health in urban children. Health Education & Behavior, 25, 1, 46-59.

Fox, B. and Worts, D. (1999). Revisiting the critique of medicalized childbirth: A contribution to the sociology of birth. Gender and Society, 13(3), 326–346.

Garner, R., Carrière, G., Sanmartin, C. (2010, June). The health of First Nations living off-reserve, Inuit, and Métis adults in Canada: The impact of socio-economic status on inequalities in health. [PDF] Statistics Canada, Catalogue no. 82-622-X No. 004.

Gellene, D. (2009). Sleeping pill use grows as economy keeps people up at night.

Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Penguin.

Health Canada. (2005). First Nations comparable health indicators. First Nations and Inuit health.

Hines, S. M. and Thompson, K. J. (2007). Fat stigmatization in television shows and movies: A content analysis. Obesity, 15, 712–718.

Jacobs, G. D., Pace-Schott, E. F., Stickgold, R. and Otto, M. W. (2004). Cognitive behavior therapy and pharmacotherapy for insomnia: A randomized controlled trial and direct comparison. Archives of Internal Medicine, 164(17), 1888–1896.

Jongbloed, L. (2003). Disability policy in Canada: An overview. Journal of Disability Policy Studies, 13(4), 203-209.

Kobayashi, K., Prus, S. and Lin, Z. (2008). Ethnic differences in selfrated and functional health: does immigrant status matter? Ethnicity & Health, 13(2), 129–147.

Lorber, J. (2000). Women get sicker, but men die quicker: Gender and health. In Phil Brown (Ed.), Perspectives in Medical Sociology (pp. 40–70). Waveland Press.

Marmot, M. G., Shipley, M. J., and Rose, G. (1984). Inequalities in death—Specific explanations of a general pattern? Lancet, 1, 8384, 1003–1006.

Michalko, R. (1998). The mystery of the eye and the shadow of blindness. University of Toronto Press.

Moloney, M. E., Konrad, T. R. and Zimmer, C. R. (2011). The medicalization of sleeplessness: A public health concern. American Journal of Public Health, 101, 1429–1433.

National Institute of Mental Health. (2005). National institute of mental health statistics.

National Institutes of Health. (2011a). Insomnia. The national institute of health.

National Institutes of Health. (2011b). What is autism spectrum disorder (ASD)? National institute of mental health.

NEDSAC. (2012, March). Findings from the national epidemiologic database for the study of autism in Canada (NEDSAC): Changes in the prevalence of autism spectrum disorders in Newfoundland and Labrador, Prince Edward Island, and Southeastern Ontario. [PDF] National epidemiologic database for the study of autism in Canada.

Navarro,V., Whitehead, M., Doran, T., Burström, B., Helmert, U., Costa, G. & Borrell, C. (2004). Summary and conclusions of the study. In Navarro,V. (Ed.), The political and social contexts of health: Politics of sex in medicine. Routledge. 

O’Donnell, C. V. (2008). Native populations in Canada. In Bailey, G. and Sturtevant, W. C. (Eds.), Handbook of North American Indians: Indians in contemporary society (pp. 285–293). Smithsonian Institute: Government Printing Office.

Pearson, C., Janz, T., and Ali, J. (2013, September). Mental and substance use disorders in Canada. Health at a glance. Statistics Canada, Catalogue no. 82-624-X.

Phelan, J. C. and Bruce G. Link. (2001). Conceptualizing stigma [PDF]. Annual Review of Sociology, 27, 363–85.

Phelan, J. C., and Link, B.G. (2003). When income affects outcome: Socioeconomic status and health [PDF] Research in Profile, 6.

Public Health Agency of Canada. (2002, October 3). A report on mental illnesses in CanadaPublic health agency of Canada.

Puhl, R. M. and Heuer, C. A. (2009). The stigma of obesity: A review and update. [PDF] Nature publishing group.

Scheff, T. (1963). Being mentally ill: A sociological theory. Aldine.

Schwarz, A. and Cohen, S. (2013, March 31). A.D.H.D. seen in 11% of U.S. children as diagnoses rise. New York Times.

Sinclair, J. (2012). Don’t Mourn for Us. Autonomy, the Critical Journal of Interdisciplinary Autism Studies, 1(1), 1–4.

Spitzer, D. (2005). Engendering health disparities. Canadian Journal of Public Health, 96(Supplement 2), 78–96.

Stastna, K. (2011, November 30). Clean running water still a luxury on many native reserves: About 39% of First Nations water systems deemed “high risk.” CBC News.

Statistics Canada. (2011). Aboriginal health and well-being. Canada Yearbook, Catalogue no.11-402-X.

Statistics Canada. (2013, December 3). Canadian survey on disability, 2012. The Daily.

Szasz, T. (1961). The myth of mental illness: Foundations of a theory of personal conduct. Harper Collins.

Winkleby, M. A., Jatulis, D. E., Frank, E. and Fortmann, S. P. (1992). Socioeconomic status and health: How education, income, and occupation contribute to risk factors for cardiovascular disease. American Journal of Public Health, 82, 6.

W.H.O. (2014). What is the WHO definition of health? (frequently asked questions). World Health Organization.

19.4 Theoretical Perspectives on Health and Medicine
Bauman, Z. (2005). Liquid life. Polity Press.

Carroll, W. and Shaw, M. (2001). Consolidating a neoliberal policy bloc in Canada, 1976 to 1996. Canadian Public Policy, 27(2), 195–217.

Conrad, P. and Schneider, J. W. (1992). Deviance and medicalization: From badness to sickness. Temple University Press.

Foucault, M. (1980). The history of sexuality: volume one. Vintage Books.

Foucault, M. (1997). The ethics of the concern of the self as a practice of freedom. In Paul Rabinow (Ed.), Ethics: subjectivity and truth (pp. 281–302). New York Press.

Marmot, M. G., Rose, G., Shipley, M., Hamilton, P. J. (1978). Employment grade and coronary heart disease in British civil servants. Journal of Epidemiology and Community Health, 32(4), 244–249.

Marmot, M. and Wilkinson, R. (1999). Social Determinants of Health. Oxford University Press

Parsons, T. (1951). The social system. Free Press.

Scheff, T. (1963). The role of the mentally ill and the dynamics of mental disorder. Sociometry, 26, 436–453.

Valverde, M. (1997). “Slavery from within:” The invention of alcoholism and the question of free will. Social History, 22(3), 251–268.

W.H.O. (2008). Closing the gap in a generation: Health equity through action on the social determinants of health. World
Health Organization.

Solutions to Section Quiz

1 C, | 2 B, | 3 A, | 4 D, | 5 A, | 6 B, | 7 C, | 8 C, | 9 B, | 10 D, | 11 D, | 12 C, | 13 C, | 14 A, | 15 D [Return to Quiz]


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