Medicalization/Biomedicalization
Medicalization is a major theoretical concept in medical sociology. According to Peter Conrad (2007; 2013), medicalization in its simplest form means “to make medical.” It refers to the process by which previously nonmedical conditions become defined and treated as a medical problem, that is, as either a disease or disorder of some type. Conrad provides several examples of conditions which medicine assumed control over by defining them as a medical problem to be treated by medical means, even though in the past they were not necessarily considered as such. These include attention deficit hyperactivity disorder (ADHD), normal sadness, grief, shyness, premenstrual syndrome (PMS), sleep disorders, aging, obesity, infertility, learning disabilities, erectile dysfunction, surgical cosmetic enhancements, and baldness among others. The approach of the medicalization concept, however, is not to contest diagnoses but examine how a problem becomes defined as medical and the social consequences of doing so.
Conrad finds the sources or “drivers” of medicalization are now changing. Physicians are slowly being sidelined by new engines of medicalization making things medical, namely (1) biotechnology, especially the pharmaceutical industry and genetics, (2) consumers desiring treatments, and (3) managed care when health insurance companies make decisions about what is or is not included in their coverage. The changes connected to the increasing significance of biotechnology have led to the introduction of biomedicalization theory (Clarke et al. 2010). Biomedicalization consists of the rise of computer information and other new technologies to increase medical surveillance and treatment interventions by the use of genetics, bioengineering, chemoprevention, individualized designer drugs, multiple sources of information, patient data banks, digitized patient records, and other innovations. Also important in this process is the Internet making it easier to get medical information and merchandise, be exposed to advertising, and enhance the role of pharmaceutical companies in marketing their products.
Feminist Theory
Feminist theory in medical sociology has been linked in some instance to social constructionist accounts of the female body and its regulation by a male-dominated society. Social and cultural assumptions are held to influence our perceptions of the body, including the use of the male body as the former standard for medical training, the assignment of less socially desirable physical and emotional traits to women, and the ways in which women’s illnesses are socially constructed (Annandale 2014). Other feminist theory is grounded in conflict theory or symbolic interaction, and deals with the sexist treatment of women patients by male doctors and the less than equal status of female physicians in professional settings and hierarchies (Riska and Wegar 1993; Hinze 2004). There is, however, no unified perspective among feminist theorists other than a “woman-centered” perspective that examines the various facets of women’s health and seeks an end to sexist orientations in health and illness and society at large (Annandale 2014; Nettleton 2020).
Intersectionality theory, originating among American black feminist scholars has been one of the more promising feminist theoretical perspectives expanding into medical sociology (Collins 2015, 2019; Collins and Bilge 2016). It calls attention to the multiple forms of social inequality affecting black women and other disadvantaged individuals. In doing so, it expresses an activist orientation connected to community organizing, identity politics, coalition politics, and social justice. The approach focuses on examining forms of discrimination and inequality stemming from gender, race, ethnicity, class, age, nation, and sexual orientation, and makes the key point that such variables are not simply individual characteristics but operate simultaneously at multiple levels in people’s lives. Thus, individual and group characteristics cannot be fully understood by prioritizing one variable (e.g. class) over another (e.g. gender) since all such variables combine to disadvantage some people in relation to others at the same time. People do not experience inequality only from the standpoint of one social characteristic but undergo all of them concurrently. Intersectionality theory therefore provides a perspective intended to investigate the interaction of numerous characteristics of a population, not only at the individual level but also at structural levels in order to capture the multiple factors that influence individual lives. Most of the research using intersectionality theory, however, has been qualitative because of the difficulty in measuring all variables simultaneously using quantitative methods.
Pierre Bourdieu
Once ranked as the leading intellectual in France, Bourdieu (1984) focused on how the routine practices of individuals are influenced by the external structure of their social world and how these practices, in turn, reproduce that structure. Through his key concept of habitus, Bourdieu connects social practices to culture, structure, and power (Swartz 1997). Bourdieu (1990) describes the habitus as a mental scheme or organized framework of perceptions (a structured structure operating as a structuring structure) that predisposes the individual to follow a particular line of behavior as opposed to others that might be chosen. These perceptions are developed, shaped, and maintained in memory and the habitus through socialization, experience, and the reality of class circumstances. While the behavior selected may be contrary to normative expectations and usual ways of acting, behavioral choices are typically compatible with the dispositions and norms of a particular group, class, or the larger society; therefore, people tend to act in predictable and habitual ways even though they have the capability to choose differently. Through selective perception, the habitus adjusts aspirations and expectations to “categories of the probable” that impose boundaries on the potential for action and its likely form.
Of all Bourdieu’s works, the one most relevant for medical sociologists remains his book Distinction (1984), in which he systematically accounts for the patterns of cultural consumption and competition over definitions of taste of the French social classes. It includes an analysis of food habits and sports that describes how a class-oriented habitus shaped these particular aspects of health lifestyles. Cockerham (1999, 2000, 2007; Cockerham et al. 1997) follows Bourdieu’s theoretical framework in his theory of health lifestyles and in identifying negative health lifestyles as the primary social determinant of ongoing downturn in life expectancy in Russia. The group most responsible for reduced longevity are middle-age, working-class males. The living conditions of these men and their relatively low and powerless position in the social structure produced a habitus