Chapter 1
Sociology and Health
1.1 Introduction
Many people (including students of sociology) often wonder about the relevance of
sociology to health issues. In general, it is often a challenge to discuss the nexus
between social science and health. Why medical sociology? What does sociology
have to do with medicine or health? These are some of the pressing questions that
require explanations. The fundamental problem starts with a lack of deeper knowl-
edge of the meaning and focus of sociology. Therefore, it is necessary to proceed by
defining sociology and briefly explaining some of its foundational focus. After this,
its relevance to health will be explained.
Sociology has been variously defined since Auguste Comte coined the term in
1838. Simply, sociology is the study of human society and social problems. Soci-
ology is the scientific study of social relations, institutions, and society (Smelser
1994). In addition, sociology can be defined as the scientific study of the dynamics
of society and their intricate connection to patterns of behaviour. It focuses on so-
cial structure and how the structures interact to modify human behaviour, actions,
opportunities, and how the patterns of social existence engender social problems.
Social institutions include kinship, economic, political, education, and religious in-
stitutions. The institutions are like pillars that hold up society because they are the
constituent parts of the social system (society). These parts are interdependent and
interrelated with specialised functions towards the survival of the society. This is
why the human society is often referred to as a social system. Every institution ful-
fils some functional imperatives. The family institution supports the procreation and
socialisation of new members of society while the economic institution deals with
the production and exchange of goods. The economic institution employs people
from the family institutions, and the family in turn needs the goods and services
produced by the economic institution. The health institutions are organised to cater
to the well-being and survival of human beings.
Generally, sociology employs scientific approach to study and develops generali-
sations about human patterns, groupings, and behaviour. In a more concise definition,
the American Sociological Association (ASA) defined sociology “as the study of so-
cial life, social change, and the social causes and consequences of human behaviour”.
J. Amzat, O. Razum, Medical Sociology in Africa, DOI 10.1007/978-3-319-03986-2_1, 1
© Springer International Publishing Switzerland 2014
,2 1 Sociology and Health
Social life is the most central part of the focus of sociology; it implies the connection
which an individual holds with others in the society. To sociologists, social life or
interaction is the essence of human existence. The process of social interaction itself
may put individuals at risk of some communicable disease such as tuberculosis (TB),
severe acute respiratory syndrome (SARS), and measles. In terms of communicable
diseases, mere contact with an infected person (in the process of social interaction)
can normally put others at risk. The investigation of social “causes” and conse-
quences is basic in sociological research. There is often a problem of biomedical
reductionism, assuming “only the germ causes the disease” without an interrogation
of the social conditions enabling vulnerability to diseases. For instance, commercial
sex work puts an individual more at risk of human immunodeficiency virus (HIV)
than many other occupation groups: that is a kind of occupational condition, which
is a risk factor for HIV.
1.2 Health Problems as Social Problems
The historical focus of sociology is on social problems in human society. Social
problems include health problems, crime, deviance, violence, poverty, inequality,
population problems, delinquency, and institutional instability. Social forces such
as modernisation and industrialisation marked the beginning of unprecedented so-
cial alteration, especially since the beginning of the eighteenth century. This social
change led to a number of problems as a result of changes in the relations of produc-
tion. The industrial revolution led to new forms of production systems, community
relations, migration, urbanisation, and especially new forms of employer-employee
relations. Industrialisation marked the overthrow of the family as an economic unit.
This was a tremendous change in the social system with resultant consequences,
hence emerging social problems such as unemployment, poverty, child labour, gen-
der discrimination, crime, and health problems. This is not to argue that all these
problems only emerged during the industrial revolution, but they rapidly multiplied
during that period. Social problems are conceived as strains within the system, seen
as the product of certain objective conditions within the society, which is inimical
or detrimental to the realisation of some norms or values for members of the society
(Lyman et al. 1973, p. 474). Any issue that threatens the well-being or survival of the
society is regarded as a social problem. Weber (1995, p. 9) defined social problems
“as a social phenomenon that is damaging to the society or its members, is perceived
as such, and is socially remediable.”
It is important to note that just as crime is damaging to the society or individual,
so is any health problem. Apart from this fact, a social problem can be identified
through the following characteristics, which include:
1. It is an objective condition. This implies that it can be empirically defined. A
social problem exists as a condition that can be verified. Even when subjective
interpretation may be required, a social problem is an evidence-based problem,
not just mere perception of an individual but a general knowledge that is usually
, 1.2 Health Problems as Social Problems 3
definite. This represents a utilitarian view, which holds that social problems are
objective things, or what Durkheim regarded as social facts (Smelser 1996).
Smelser observed that the assertion is like the medical model which views social
problems as a form of disease with an identifiable cause, definite symptoms, and
calls for a cure.
2. It has social aetiology or could be linked to it. This implies that a social prob-
lem emanates from the pattern of social interaction, organisation, association,
or simply is engendered by social conditions. This point should be noted as a
relevant perspective in explanation of human health/diseases and not an absolute
explanation. For instance, Wellcome (2002, p. 30), summarising Day Karen’s re-
search report, observed that “. . . Falciparum parasite [malaria] we see today arose
about 3200–7000 years ago—an era that coincides with the dawn of agriculture in
Africa. This was a time of massive ecological change, when humans began to live
in large communities and the rainforest was being cut down for slash-and-burn
agriculture. . . there was also a major change in the mosquito vector at that time,
when it began biting humans instead of animals. . . ” It is further observed that P.
falciparum migrated with Africans to other parts of the world. This means that the
process of migration aids the spread of malaria. This is why Smelser (1996) also
observed that the increasing world traffic of people would internationalise many
health problems. It is for this reason that HIV, first diagnosed in the United States
in the early 1980s (Jackson 2002), is now a global problem. Moreover, some
diseases are rooted in genetics or heredity, thereby multiplying through marriage
patterns or human relationships. Holtz et al. (2006, p. 1665) observed that it is
impossible to understand population health without considering the social ori-
gins of diseases—“the risk of exposure, host susceptibility, course of disease,
and disease outcome; each is shaped by the social matrix. . . ” Social conditions
are now invoked as fundamental causes of diseases in human society because
such conditions affect exposure to diseases, as well as course and outcomes of
diseases (see Chap. 4 for social determinants of health, Sect. 6.4 for fundamental
cause theory).
3. It poses social damage. A social problem often incapacitates the individuals in
a society. As poverty prevents individuals from satisfying basic needs, so, too,
health problems prevent individuals from functioning effectively as members of
society. A health problem may reduce the functionality of an individual within
the social system. Invariably, a social problem is inconsistent with the normative
value of the society. Society wants its members to be healthy, and the unattain-
ability of this desire shows a discrepancy between social value and reality. Such
a discrepancy represents a social problem.
4. It affects the collectivity. A social problem is different from a personal problem
in that the former affects a substantial number of people in the social system
(see Harris 2013). Health problems are ubiquitous like other problems such as
crime and poverty. There may be a geographical variation in the magnitude or
frequency, but most social problems are a pandemic. It is thus a problem when a
significant number of people believe that a certain condition is, in fact, a problem
(Kerbo and Coleman 2007), and it constitute a problem to their social existence
or wellbeing.
Sociology and Health
1.1 Introduction
Many people (including students of sociology) often wonder about the relevance of
sociology to health issues. In general, it is often a challenge to discuss the nexus
between social science and health. Why medical sociology? What does sociology
have to do with medicine or health? These are some of the pressing questions that
require explanations. The fundamental problem starts with a lack of deeper knowl-
edge of the meaning and focus of sociology. Therefore, it is necessary to proceed by
defining sociology and briefly explaining some of its foundational focus. After this,
its relevance to health will be explained.
Sociology has been variously defined since Auguste Comte coined the term in
1838. Simply, sociology is the study of human society and social problems. Soci-
ology is the scientific study of social relations, institutions, and society (Smelser
1994). In addition, sociology can be defined as the scientific study of the dynamics
of society and their intricate connection to patterns of behaviour. It focuses on so-
cial structure and how the structures interact to modify human behaviour, actions,
opportunities, and how the patterns of social existence engender social problems.
Social institutions include kinship, economic, political, education, and religious in-
stitutions. The institutions are like pillars that hold up society because they are the
constituent parts of the social system (society). These parts are interdependent and
interrelated with specialised functions towards the survival of the society. This is
why the human society is often referred to as a social system. Every institution ful-
fils some functional imperatives. The family institution supports the procreation and
socialisation of new members of society while the economic institution deals with
the production and exchange of goods. The economic institution employs people
from the family institutions, and the family in turn needs the goods and services
produced by the economic institution. The health institutions are organised to cater
to the well-being and survival of human beings.
Generally, sociology employs scientific approach to study and develops generali-
sations about human patterns, groupings, and behaviour. In a more concise definition,
the American Sociological Association (ASA) defined sociology “as the study of so-
cial life, social change, and the social causes and consequences of human behaviour”.
J. Amzat, O. Razum, Medical Sociology in Africa, DOI 10.1007/978-3-319-03986-2_1, 1
© Springer International Publishing Switzerland 2014
,2 1 Sociology and Health
Social life is the most central part of the focus of sociology; it implies the connection
which an individual holds with others in the society. To sociologists, social life or
interaction is the essence of human existence. The process of social interaction itself
may put individuals at risk of some communicable disease such as tuberculosis (TB),
severe acute respiratory syndrome (SARS), and measles. In terms of communicable
diseases, mere contact with an infected person (in the process of social interaction)
can normally put others at risk. The investigation of social “causes” and conse-
quences is basic in sociological research. There is often a problem of biomedical
reductionism, assuming “only the germ causes the disease” without an interrogation
of the social conditions enabling vulnerability to diseases. For instance, commercial
sex work puts an individual more at risk of human immunodeficiency virus (HIV)
than many other occupation groups: that is a kind of occupational condition, which
is a risk factor for HIV.
1.2 Health Problems as Social Problems
The historical focus of sociology is on social problems in human society. Social
problems include health problems, crime, deviance, violence, poverty, inequality,
population problems, delinquency, and institutional instability. Social forces such
as modernisation and industrialisation marked the beginning of unprecedented so-
cial alteration, especially since the beginning of the eighteenth century. This social
change led to a number of problems as a result of changes in the relations of produc-
tion. The industrial revolution led to new forms of production systems, community
relations, migration, urbanisation, and especially new forms of employer-employee
relations. Industrialisation marked the overthrow of the family as an economic unit.
This was a tremendous change in the social system with resultant consequences,
hence emerging social problems such as unemployment, poverty, child labour, gen-
der discrimination, crime, and health problems. This is not to argue that all these
problems only emerged during the industrial revolution, but they rapidly multiplied
during that period. Social problems are conceived as strains within the system, seen
as the product of certain objective conditions within the society, which is inimical
or detrimental to the realisation of some norms or values for members of the society
(Lyman et al. 1973, p. 474). Any issue that threatens the well-being or survival of the
society is regarded as a social problem. Weber (1995, p. 9) defined social problems
“as a social phenomenon that is damaging to the society or its members, is perceived
as such, and is socially remediable.”
It is important to note that just as crime is damaging to the society or individual,
so is any health problem. Apart from this fact, a social problem can be identified
through the following characteristics, which include:
1. It is an objective condition. This implies that it can be empirically defined. A
social problem exists as a condition that can be verified. Even when subjective
interpretation may be required, a social problem is an evidence-based problem,
not just mere perception of an individual but a general knowledge that is usually
, 1.2 Health Problems as Social Problems 3
definite. This represents a utilitarian view, which holds that social problems are
objective things, or what Durkheim regarded as social facts (Smelser 1996).
Smelser observed that the assertion is like the medical model which views social
problems as a form of disease with an identifiable cause, definite symptoms, and
calls for a cure.
2. It has social aetiology or could be linked to it. This implies that a social prob-
lem emanates from the pattern of social interaction, organisation, association,
or simply is engendered by social conditions. This point should be noted as a
relevant perspective in explanation of human health/diseases and not an absolute
explanation. For instance, Wellcome (2002, p. 30), summarising Day Karen’s re-
search report, observed that “. . . Falciparum parasite [malaria] we see today arose
about 3200–7000 years ago—an era that coincides with the dawn of agriculture in
Africa. This was a time of massive ecological change, when humans began to live
in large communities and the rainforest was being cut down for slash-and-burn
agriculture. . . there was also a major change in the mosquito vector at that time,
when it began biting humans instead of animals. . . ” It is further observed that P.
falciparum migrated with Africans to other parts of the world. This means that the
process of migration aids the spread of malaria. This is why Smelser (1996) also
observed that the increasing world traffic of people would internationalise many
health problems. It is for this reason that HIV, first diagnosed in the United States
in the early 1980s (Jackson 2002), is now a global problem. Moreover, some
diseases are rooted in genetics or heredity, thereby multiplying through marriage
patterns or human relationships. Holtz et al. (2006, p. 1665) observed that it is
impossible to understand population health without considering the social ori-
gins of diseases—“the risk of exposure, host susceptibility, course of disease,
and disease outcome; each is shaped by the social matrix. . . ” Social conditions
are now invoked as fundamental causes of diseases in human society because
such conditions affect exposure to diseases, as well as course and outcomes of
diseases (see Chap. 4 for social determinants of health, Sect. 6.4 for fundamental
cause theory).
3. It poses social damage. A social problem often incapacitates the individuals in
a society. As poverty prevents individuals from satisfying basic needs, so, too,
health problems prevent individuals from functioning effectively as members of
society. A health problem may reduce the functionality of an individual within
the social system. Invariably, a social problem is inconsistent with the normative
value of the society. Society wants its members to be healthy, and the unattain-
ability of this desire shows a discrepancy between social value and reality. Such
a discrepancy represents a social problem.
4. It affects the collectivity. A social problem is different from a personal problem
in that the former affects a substantial number of people in the social system
(see Harris 2013). Health problems are ubiquitous like other problems such as
crime and poverty. There may be a geographical variation in the magnitude or
frequency, but most social problems are a pandemic. It is thus a problem when a
significant number of people believe that a certain condition is, in fact, a problem
(Kerbo and Coleman 2007), and it constitute a problem to their social existence
or wellbeing.
