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The world over, good health is highly valued. So far, so obvious. More noteworthy is that scientifically informed medicine has become the most authoritative source of evidence and intervention promoting health for individuals and populations, across the globe. Medicine and the promotion of health through medical means is a complex set of interests encompassing markets, capital, governments, professions, configured nationally and transnationally and alongside people’s existential and embodied experiences and fantasies. The founders of sociology failed to nominate medicine as a motor of modernity, on a par with religion, the law and the family. While Engels and Marx noted the ill effects of poor wages, food and environment on Manchester factory workers’ health, the institutional power of medicine was not spotted as a feature of modernist society: medical personnel, products and interventions traded as part of transnational markets, serving the interests of capital in interaction with institutions and industries. Without an interrogation of medicine’s power and influence, key aspects of contemporary personhood, commerce and society would be missing.
Examining medicine’s practice and how this becomes a commodified product or service is one way of interrogating the sociology of medicine’s relationship with health and illness. The range of research possibilities includes micro-level interactions in the clinic, population-level analysis of mortality inequalities and macro-level policy analysis of governance.
Meso-level patterns in interactions within families, communities, clinics, professional and patient networks are studied for their connections with illness outcomes and health behaviours. Research across a range of disciplines including Public Health, Anthropology, Nursing and the Caring Sciences, Primary Care, Global Health and Community Medicine adjoin sociological research. Interdisciplinary work is important for research around health since insights at so many levels, from laboratory to market, to patient’s bedside to community setting have to be held in play. But within the range of approaches to health and medicine there is nonetheless a need for the distinctive, critical sociological approach.
Sociological approaches to health and medicine attend to power and the disjuncture between stated intentions, practice and outcomes, keeping the various levels where health and illness are produced in view, including paradoxical effects. When an intervention to reduce the incidence of disease is more effective with wealthier people, socio-economic inequality in mortality can widen – demonstrating the paradox of individual health benefits alongside damage to the social good of equity. Studying health and medicine in context can offer evidence towards a more equitable society. But it also offers existential insight, for instance into the changing limits of ethical and moral behaviour in the light of new biotechnological reproductive practice. Theoretically and methodologically eclectic, sociology seeks evidence from a range of sources in pursuit of a vision of good health for our embodied, imaginative selves in the societies where our practice and aspirations are played out.
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