Health, Illness, and the Social Body: A Critical Sociology (3rd Edition) - Softcover

The world is, increasingly, a single place. The crisis events, epidemics, and environmental pollution in seemingly remote countries can and do affect our own health and well-being. In 2001, as we began writing this text, events surrounding attacks on the World Trade Center and the Pentagon, American troops in battle in Afghanistan, fear of an epidemic of anthrax, and a serious economic recession, reminded Americans that our health and our lives cannot be taken for granted. Yet, as we seek greater security for our people, we must remember that real security requires much more than military security. It requires social security—the assurance that the society will support its members, mutually protecting each other through our institutions and social policies. Enduring security, thus, involves society-wide health security.

This volume addresses that larger image of the kind of health security we need. Sickness and death are not random but occur in discernible patterns. Carefully using societal resources to address the sources of those patterns of sickness and death can promote real health security. For example, rather than focusing narrowly on trying to prevent bioterrorist contamination of city water supplies, we could address all sources of water contamination, such as industrial pollution and inadequate sewage treatment. Instead of wondering merely how to protect government office and postal workers from anthrax spores, we could ask how to make work in the whole society safer and less stressful. Rather than pay profiteering pharmaceutical corporations for a stockpile of treatments for bioterrorism, we could address the problems of drug pricing and the failure of the system to make needed pharmaceutical available to all citizens. Instead of worrying about preventing terrorists from aerial spraying of toxic substances, we could create adequate environmental controls to prevent agribusinesses from aerial spraying of toxic pesticides and manufacturers from releasing sickening air pollution. Rather than focusing on providing temporary relief for those unemployed in the aftermath of terrorist attacks, we could assure all citizens that they could earn an adequate living-wage to support themselves and their families.

Despite the fact that the United States spends far more (per capita and as a percentage of the Gross National Product) on health care than any other country in the world, our citizens do not enjoy better health or longer lives. In fact, as Chapter 11 shows, on most measures of health, Americans fare worse than nearly all other economically advanced countries. National security of health, in this wider sense, would address the causes of so many Americans' premature deaths. The sociology of health and illness identifies many of these causes.

This is not a standard medical sociology text; instead, it presents a critical, holistic interpretation of health, illness, and human bodies that emphasizes power as a key social-structural factor in health and in societal responses to illness. Some of the most interesting recent health-related research explores precisely those areas of social life where power differences are evident: gender, race and ethnicity, poverty and wealth, work and professions, abuse and violence, the physical and social environment, and health care financing and delivery, among others. The politics of the debate over U.S. health care "reform" also illustrates the importance of power and wealth—especially of corporate actors—in setting the very terms of discourse, not merely affecting the policy outcomes.

This text does not attempt to cover every relevant topic, but is organized as a set of core essays around which to build a course. Thus, for example, the topics of women's health issues, race and ethnic factors in health and illness, and HIV/AIDS are discussed in several different sections, rather than all under one heading. Students using the Index will find a wealth of information and references for further research on these and other important issues. Using this text as a core reading, i4istructors can assign related articles, monographs, or readings to complement their own emphases.

Chapter 1 outlines relevant problems and key concepts in the field, and especially shows how this text links materialist and social-constructionist theories of health and illness through the unifying theme of power. Chapter 2 introduces students to social epidemiology, and outlines broad patterns of morbidity and mortality. This fourth edition emphasizes international health and illness comparisons and issues, especially in Chapters 2, 3, and 11. Chapters 3 through 5 describe the social production of unhealthy bodies and develop interpretations of the nature of connections among mind, body, and society. Chapters 6 through 9 discuss the social context of ideas and experiences of health and illness. Chapters 10 through 12 examine social and cultural factors in the medical system's treatment of sick persons and the political economy of health care in the United States.

Appendix A outlines major resources for a search of the literature in the field. Students preparing term papers or theses will find these resources essential. The book's extensive bibliography should also be invaluable for researchers. Appendix B is an annotated list of new video resources. We have found good visual presentations to be excellent aids for concretizing and illustrating points that are often far from students' personal experiences, as well as for stimulating discussion. These Appendices (including the full annotated list of recommended films), together with a chapter-by-chapter list of Recommended Readings and other pedagogical aids, will be available with links at http://www.trinity.edu/mmcguire .

Previous users of this text will recognize that we now have the assistance of a third author, Dr. Linda Podhurst, a medical sociologist at the University of Medicine and Dentistry of New Jersey. Even as this book was being written, Dr. Podhurst began work on an important new international public health initiative in pediatric AIDS treatment and prevention. Her work in Newark, New Jersey, sub-Saharan Africa, and other places hard hit by the global epidemic of HIV/AIDS is highly relevant for our emphasis on seeing U.S. health and illness in a global context.

In writing this fourth edition, we have received additional help from several persons, whose assistance we gratefully acknowledge: Miriam Fisher, Lauren Johnson, Debra Kantor, Liana Knudsen, George Martin, Bob Podhurst, Jim Spickard, Sheryl Tynes, and Freda Zackin. Special thanks to Jim Spickard for constructing our charts and graphs and for giving much IT support. We appreciate the advice and encouragement of our editors, Nancy Roberts and Sharon Chambliss. Also, we very much appreciate Kieran McGuire's graphic design tailored to this text. We thank Kristen Carney, Irma DeLeon, Ashley Fry, Kathryn Hanunond and Franke Johnson for assistance in manuscript preparation. Finally, we want to thank our partners and families for putting up with us during the writing of this book and for illustrating by their very lives why sociologists should care about health.