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Sociology of health and illness
1. ⚖Models of Health and Illness
Models used to define disease and illness.
1.1 The biomedical model (BM)
The six characteristics of the biomedical model and critiques
All illness and all symptoms and signs arise from an
underlying abnormality within the body referred to as a disease. This
disease is the single cause of the illness and symptoms.
=/no room for other factors, what about illnesses where the disease
isn't found/doens't exist?
All diseases give rise to symptoms, eventually if not
initially, and although other factors may influence the
consequences of the disease, they are not related to its
development or manifestations
What about people who have a disease but aren't sick? eg. corona
hebben, maar dit niet merken.
risk: medicalisation of common abnormalities in the body
Health is the absence of disease
What about people who are ill, but don't have a disease?
Mental phenomena, such as emotional disturbance
or delusions, are separate from and unrelated to other
disturbances of bodily function
Somatic view, only focus on the natural processes and the physical
body not on 'the mind'.
Sociology of health and illness 1
, Only mental malfunctions that are caused by a dysfunction in the
body are diseases. ⟶ other mental problems can't be studied with
the biomedical model. (new discipline of behavioral science?
Detaching psychiatry from medicine?
Reductionist view: Alle behavioral phenomena of disease have to
be conceptualized as somatic principals in order for them to be
recognized as a disease. They recognize that mental diseases
exist. (they are called believers, but still have a very limited view
on mental diseases)
Exclusionist view: everything that can't be explained in a somatic
way isn't a disease. = Mental illness is a myth, psychiatry isn't
medicine = opponents
The patient is a victim of circumstance with little or
no responsibility for the presence or cause of the
illness.
What about lung cancer and being a chain smoker?
The patient is a passive recipient of treatment,
although cooperation with treatment is expected.
Does the patient accept the sick role?
General
BM is a positivist approach
No room for studying the illness experience
The biomedical model is reductionist: a complex thing evolves from one
singular cause.
Reductonism: view that complex phenomena are derived from a single
primary principle.
Assumes that chemistry and physics sufces to explain biological phenomena.
This specifc
cause resides in a dysfuncton of bodily processes. BM tries to reduce
phenomena
Sociology of health and illness 2
, the biomedical model has a Mind-body dualism: the mental is separate
from the somatic
Mind-body dualism: all diseases (mental disorders included) result from
bodily dysfunctons,
hence the realm of the mind has to be separated from the realm of the body
The biomedical model is the folk model or popular model in Western
Europe
We have accepted the biological model als the norm in our society, the
biological model also influences our cultural interpretation of diseases and
illness.
DANGER difficult for researchers to go against this model, it is
accepted as a dogma, this makes it more difficult to think critically
about it.
Why did it evolve in the west?
Christianity: medicine was concerned about the body, religion dealt
with the mind
Scientific basic principal used to be: the whole can be studied by
the parts (there was no attention for external factors)
In this model illness is secondary to disease, what are the
consequences of this view?
Illnesses can't be put in the biomedical model because it requires:
1 1 single cause
2 this single cause is always disease
3 removal of the cause will improve health
Als de ziekte niet achterhaald kan worden, krijgen de symptomen een
label (bv. chronisch vermoeidheidssyndroom)
You can feel ill without being sick and without having a disease.
Chronic fatigue syndrome: syndroom that is named as being chronic
fatigued. Nothing else. Only a cluster of behaviors and we gave a
Sociology of health and illness 3
, name to that cluster. Disease was never found. Most of the people
with cfs have difficulties to be recognised as sick, because it's not a
disease.
Having a disease is has more advantages for a patient than having an
illness/label
Often more trouble with health care administration
it's frustrating for a patient not to know the cause
patients that don't have a disease are not taken as seriously
More social understanding for people with a disease
1.2 The Biopsychosocial model (BPM) /Engel
In contrast to the biomedical model, it recognizes that psychological
and social factors influence a patient’s perceptions and actions and
therefore the experience of what it feels like to be ill. = ATTENTION
FOR THE ILLNESS EXPERIENCE
Illness experience
Illness is an illness experience. We think illness experiences are less important
than
diseases. But this is a misunderstanding. We seldom consult a doctor because we
have a disease we consult because we feel ill. Doctor often doens't give
empirical evidence of a disease, he says it's a virus and gives you paracetamol
and if you can't sleep take some brufen. You feel ill for a few days and it's over,
nobody knows what disease. So we have to focus on illness experience, diseases
are often not discussed or
relevant.
Good about the model
Sociology of health and illness 4
Sociology of health and illness
1. ⚖Models of Health and Illness
Models used to define disease and illness.
1.1 The biomedical model (BM)
The six characteristics of the biomedical model and critiques
All illness and all symptoms and signs arise from an
underlying abnormality within the body referred to as a disease. This
disease is the single cause of the illness and symptoms.
=/no room for other factors, what about illnesses where the disease
isn't found/doens't exist?
All diseases give rise to symptoms, eventually if not
initially, and although other factors may influence the
consequences of the disease, they are not related to its
development or manifestations
What about people who have a disease but aren't sick? eg. corona
hebben, maar dit niet merken.
risk: medicalisation of common abnormalities in the body
Health is the absence of disease
What about people who are ill, but don't have a disease?
Mental phenomena, such as emotional disturbance
or delusions, are separate from and unrelated to other
disturbances of bodily function
Somatic view, only focus on the natural processes and the physical
body not on 'the mind'.
Sociology of health and illness 1
, Only mental malfunctions that are caused by a dysfunction in the
body are diseases. ⟶ other mental problems can't be studied with
the biomedical model. (new discipline of behavioral science?
Detaching psychiatry from medicine?
Reductionist view: Alle behavioral phenomena of disease have to
be conceptualized as somatic principals in order for them to be
recognized as a disease. They recognize that mental diseases
exist. (they are called believers, but still have a very limited view
on mental diseases)
Exclusionist view: everything that can't be explained in a somatic
way isn't a disease. = Mental illness is a myth, psychiatry isn't
medicine = opponents
The patient is a victim of circumstance with little or
no responsibility for the presence or cause of the
illness.
What about lung cancer and being a chain smoker?
The patient is a passive recipient of treatment,
although cooperation with treatment is expected.
Does the patient accept the sick role?
General
BM is a positivist approach
No room for studying the illness experience
The biomedical model is reductionist: a complex thing evolves from one
singular cause.
Reductonism: view that complex phenomena are derived from a single
primary principle.
Assumes that chemistry and physics sufces to explain biological phenomena.
This specifc
cause resides in a dysfuncton of bodily processes. BM tries to reduce
phenomena
Sociology of health and illness 2
, the biomedical model has a Mind-body dualism: the mental is separate
from the somatic
Mind-body dualism: all diseases (mental disorders included) result from
bodily dysfunctons,
hence the realm of the mind has to be separated from the realm of the body
The biomedical model is the folk model or popular model in Western
Europe
We have accepted the biological model als the norm in our society, the
biological model also influences our cultural interpretation of diseases and
illness.
DANGER difficult for researchers to go against this model, it is
accepted as a dogma, this makes it more difficult to think critically
about it.
Why did it evolve in the west?
Christianity: medicine was concerned about the body, religion dealt
with the mind
Scientific basic principal used to be: the whole can be studied by
the parts (there was no attention for external factors)
In this model illness is secondary to disease, what are the
consequences of this view?
Illnesses can't be put in the biomedical model because it requires:
1 1 single cause
2 this single cause is always disease
3 removal of the cause will improve health
Als de ziekte niet achterhaald kan worden, krijgen de symptomen een
label (bv. chronisch vermoeidheidssyndroom)
You can feel ill without being sick and without having a disease.
Chronic fatigue syndrome: syndroom that is named as being chronic
fatigued. Nothing else. Only a cluster of behaviors and we gave a
Sociology of health and illness 3
, name to that cluster. Disease was never found. Most of the people
with cfs have difficulties to be recognised as sick, because it's not a
disease.
Having a disease is has more advantages for a patient than having an
illness/label
Often more trouble with health care administration
it's frustrating for a patient not to know the cause
patients that don't have a disease are not taken as seriously
More social understanding for people with a disease
1.2 The Biopsychosocial model (BPM) /Engel
In contrast to the biomedical model, it recognizes that psychological
and social factors influence a patient’s perceptions and actions and
therefore the experience of what it feels like to be ill. = ATTENTION
FOR THE ILLNESS EXPERIENCE
Illness experience
Illness is an illness experience. We think illness experiences are less important
than
diseases. But this is a misunderstanding. We seldom consult a doctor because we
have a disease we consult because we feel ill. Doctor often doens't give
empirical evidence of a disease, he says it's a virus and gives you paracetamol
and if you can't sleep take some brufen. You feel ill for a few days and it's over,
nobody knows what disease. So we have to focus on illness experience, diseases
are often not discussed or
relevant.
Good about the model
Sociology of health and illness 4
