The Social Causes of Health and Disease. William C. Cockerham. Читать онлайн. Newlib. NEWLIB.NET

Автор: William C. Cockerham
Издательство: John Wiley & Sons Limited
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Жанр произведения: Социология
Год издания: 0
isbn: 9781509540372
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      For more than three-quarters of a century, medical sociology has evolved as a subdiscipline of mainstream sociology. In the beginning, it was more indebted to medicine than sociology for its support, even though the field evolved into one of the most popular sociological specialties. Time invariably brings change, and medical sociology has indeed changed since its inception. The old claim that medical sociology is atheoretical has been definitively quashed; there is now even a specialized journal (Social Theory & Health) and books on the topic. Sociological theory has become one of the most essential and distinctive research tools in the field.

      Moreover, medical sociology has positioned itself to provide even more precise and extensive analyses of the social aspects of health and disease. The first edition of this book represents one of the first treatises of the twenty-first century describing a new direction for research – namely, the investigation of the social determinants of health – that as predicted has become commonplace. This third edition follows up on that argument. The book begins with the notion that society can make you sick and then explains how this happens.

      The revised book is a continuing extension of a lecture I presented at the University of Montreal on a cold, grey, slushy, wet Canadian afternoon long ago in January 2006. This presentation was part of the university’s “Alexis de Tocqueville: Questions on American Society” lecture series. Arnaud Sales of the Sociology Department and Andrée Demers of Groupe de recherche sur les aspects sociaux de la santé et de la prevention (GRASP) were wonderful hosts. In preparing for this lecture, I wanted to look forward in discussing medical sociology and focus on the future rather than the present or past. It seemed clear that the current state of theory and developments in statistics for multilevel and longitudinal analyses allows medical sociologists to better assess the effects of different layers of social structure on the health of individuals. This not only forecasts a greater concern with structure in our future work, but will also permit us as a community of scholars to further uncover the social mechanisms that cause health and disease. This book represents a continuing step in that direction.

      I would like to acknowledge the assistance of Jonathan Skerrett, the sociology editor for Polity in Cambridge, England, for his continued high level of professionalism and insightful strategies for revisions concerning this manuscript. Also, I would like to acknowledge the contributions of Karina Jákupsdóttir, the assistant sociology editor in the production of the manuscript.

      Mike Bury, Emeritus Professor of Sociology at Royal Holloway University London, was a stalwart critic as a reviewer for Polity on the first edition. His detailed comments helped sharpen the book’s thesis, and he went beyond reviewing to make many cogent and lasting suggestions that proved to be extraordinarily helpful. I would like additionally to acknowledge former University of Alabama at Birmingham doctoral students Brian Hinote, Jason Wasserman, Carrie Betcher, and Katie McIntyre, who provided important assistance for various editions of this book. Anonymous reviewers for Polity likewise provided very helpful comments. I would also like to acknowledge the library resources and support of the sociology departments at UAB and more recently at the College of William & Mary which proved significant in supporting this work. Finally, I would like to thank my wife, Cynthia, for her continued support. Time and time again, as noted previously, she has proven herself to be an intelligent, insightful, and wry observer of the human social condition.

      William C. Cockerham

      Williamsburg, Virginia

      The capability of social factors to make people ill seems to be widely recognized by the general public. Ask people if they think society can make them sick, and the probabilities are high they will answer in the affirmative. Stress, poverty, low socioeconomic status, unhealthy lifestyles, and unpleasant living and work conditions are among the many inherently social variables typically regarded by lay persons as causes of ill health. However, with the exception of stress, this view is not expressed in much of the research literature. Studies in public health, epidemiology, behavioral medicine, and other sciences in the health field typically minimize the relevance of social factors in their investigations. Usually social variables are characterized as distant or secondary influences on health and illness, not as direct causes (Link and Phelan 1995, 2000; Phelan and Link 2013). Being poor, for example, is held to produce greater exposure to something that will make a person sick, rather than bring on sickness itself. However, social variables have been found to be more powerful in inducing adversity or enrichment in health outcomes than formerly assumed. Society may indeed make you sick or, conversely, promote your health.

      How can this be? Just because most diseases have a social connection of some type does not necessarily mean that such links can actually cause a disease to occur – or does it? Social factors such as living conditions, lifestyles, stressors, norms, social values, and attitudes are obviously not pathogens like germs or viruses, nor are they cancer cells or coagulated clots of blood that clog arteries. Yet, quarantined in a laboratory, viruses, cancers, and the like do not make a person sick. They need to be exposed to a human host and assault the body’s physiological defenses in order to be causal. However, assigning causation solely to biological entities does not account for all of the relevant factors in a disease’s pathogenesis, especially in relation to the social behaviors and conditions that bind the person to the disease in the first place. Social factors can initiate the onset of the pathology and, in this way, serve as a direct cause for several diseases. Two of many examples are the coronavirus and smoking tobacco.

      Does the “social” have a causation role with respect to COVID-19? The answer is clearly “yes,” as seen in the stringent requirement for “social distancing” (keeping away from other people) and the likely causal trail. Early information indicated that the coronavirus originated in bats in China that likely infected an anteater-like creature known as a pangolin. The evidence comes from testing the genome sequence of the coronavirus in bats and pangolins, which was found to be almost identical with the virus’s genome in infected humans (Andersen et al. 2020; Zhou et al. 2020). If the coronavirus had stayed