Science in Christian Perspective

Sociology
R. Heddendorf, M.A.
Problem Areas of Sociology: Medical Sociology and The Sociology of Mental Health
Part 11. Medical Sociology

From: JASA 13 (September 1961): 87-88.

It would not be inaccurate to state that the sociology of medicine is about 10 years old. The field did not develop in a unilateral fashion, but rather, as is the case with many areas of sociological research, there was convergence from a number of conceptualistic viewpoints.

Perhaps the most advanced researches performed by sociologists have to do with social and cultural variations and their associations with illness. Some of the social variables studied here are social mobility, residential segregation, and socio-economic status. From such studies has come a clear understanding that there is a high correlation between some diseases and certain social variables.¹

Other medical sociologists have centered their interest on social relations in medicine. There seems to be much theoretical basis for such studies, Sociologists with little interest in the sociology of medicine have conceptualized medical relationships in terms of a social system. As such, they offer a unique opportunity to study relationships which are not well understood in our society.

Among the most significant of these is an article by Parsons in which he conceptualizes the patient as a deviant.² The suggestion here is that illness provides the individual with an opportunity to be relieved of his everyday responsibilities. Such non-performance of role requirements is a potentially threatening situation for such institutions as industry. In addition, illness is an unstabilizing factor for the patient and the medically non-professional person with whom he interacts. For these reasons, it is suggested that a prime function of the doctor and the hospital is to provide socially acceptable mechanisms for the personality adjustment of the patients and his family. Such a thesis would seem to indicate that professional medical personnel have a responsibility beyond the limitations imposed by their medical skill.

A third major area of interest is concerned with viewing the medical profession as an institution. In this case also, sociologists particularly interested in formal organization, small groups, and bureaucracy have found the medical field to offer a rich source of problem areas.

Particularly significant studies have been made of the training of students in medical fields.³ Others have concentrated on medical associations such as the hospital and have found that the organization and structure of hospitals are factors in the efficiency which they achieve. Perhaps that area which has received the least attention is the relationship of medicine to such institutions as industry and the family.

Though the initial growth of medical sociology has been somewhat remarkable, there are several factors which would seem to indicate that further development will depend on evaluation of what has been accomplished. It will then be possible to direct studies toward those questions which are most pressing. At the present time, too much work is proceeding without adequate theoretical orientation. Such work results in little more than the development of isolated statistical studies. In addition, greater cooperation is needed from the medical profession before studies into such problems as doctor-patient relationship in the office environment can be made, Although more sociologists are serving on the faculties of medical schools and similar institutions, there are signs that such cooperation between the two fields is not being developed to the fullest.⁴

Though mental illness has been understood in terms of underlying psychological and physiological processes for some time, it seems to have been rather recently that social factors have been isolated as contributing factors. As such, mental illness has been conceptualized as a maladjustment to society. Reciprocally, sociological studies in this area would also be concerned with the attitudes of society toward the mentally ill person as a deviant.

As in medical sociology, the most rewarding work has been in the isolation of social and cultural factors which are related to mental illness. The original and widely held thesis that people living in an urban area of an associational society are more prone to mental illness has been brought into question. Nor does it seem to be true that the complexity and stress of modern life are causal factor of mental illneSS5 . Both of these developments would seem to indicate that any relationship which might exist between social factors and mental illness is of a much more complex nature than was first believed.

Additional studies of a similar nature would seem to indicate that there is a strong inverse relationship between social status and rates of schizophrenia. Also, it has been shown, in a number of cases, that there tends to be a relationship between geographical mobility and mental illness, though it has not been established that such mobility is a causal factor. A number of studies have dealt with the possible relationship of social mobility and schizophrenia. The results, however, tend to be inconclusive, for some studies would indicate that the downward mobile person is more susceptible to schizophrenia while others suggest that upward mobility seems to be the causal factor.

¹For a fine bibliography of studies in this area, see Freeman and Reader, "Medical Sociology: A Review of the Literature," American Sociological Review, Vol. 22, (1957).

²Parsons and Fox, "Illness, Therapy, and the Modern Urban American Family," Journal of Social Issues, XIII, 4, (1952).

³See, for example, Merton, Reader, and Kendall (eds.), The Student Physician, Harvard University Press, (1957).

⁶See Stanton and Schwartz, The Mental Hospital, Basic Books, 1954.