1. Chronic Illness and Social (Dis)ability
Week 21
Sociology of Health and Illness

2. Recap Thought about how health and illness are structured by society
Considered the ‘sick role’, medicalisation, surveillance medicine and ‘lay’ understandings of health
Considered social inequalities and health

3. Outline Look at chronic illness as biographical disruption
Consider to what extend disability is socially constructed
Consider the points of intersection and contestation between these two ideas

4. The rise of chronic illness
The 20th saw a move from acute illness to chronic illness
Existing theories (eg ‘sick role’)
could not easily explain these conditions
The meaning and experiences of
‘living with’ illness began the focus
of sociological attention

5. Illness as narrative reconstruction
Understandings of causes are constructed through the meanings and interpretations that are placed on it
People make sense of their condition (why me?) in relation to their social circumstances
This may not coincide with biological explanations

6. Illness as narrative reconstruction
Williams (1984) interviewed people with rheumatoid arthritis
Complex understandings which rejected potential biomedical explanations
Bill Made links to bad workplaces
Gill Gender roles
Betty God’s purpose
Narratives can become a coping mechanism

7. How useful do you think the idea of illness narratives is in explaining:
The social construction of illness?
The why me question of individuals?

8. Illness as biographical disruption
Bury (1982) argued that the onset of chronic illness should be seen as a ‘biographical disruption’
A person’s identity is under
threat as it changes their
previously ‘normal life’
They need to reassess their lives and perhaps adapt/take on a ‘new’ identity

9. Illness as biographical disruption
Issues include dealing with the uncertainty of symptoms or life expectancy
Learning to live with an altered body or status
Deciding whether or not to
disclose condition/symptoms/issues

10. Stigma
Goffman highlighted the ways in which bodies and illnesses come to be stigmatised
Stigma arises when an deeply discrediting attribute become known
It realigns an identity
from ‘normal’ to ‘discredited’

11. What conditions can you think of that are stigmatised?
How do you think this will impact on biographical disruption

12. Perspectives on Disability
From the Victorian Period onwards two dominant perspectives on disability
disability as a tragedy which has required the assistance of charity
disability as illness which has required treatment by professionals

13. Disability Movement
In the last 40 years, people with disabilities have challenged these ideas
Separation of illness and disability
Push for independent living and civil rights
The social model of disability
Successes include the Disability Discrimination Act and benefits paid directly to people with disabilities

14. The social model of disability
This model argues that is not physical or mental impairments
Societies failure to cope with
their needs
Physically through the
build environment
Mentally through
disabling attitudes

15. Maintaining Control
The Independent Living Movement has focused on the aims of control
Right to employment
Allowances for personal assistance
Needs need to met without disempowering the person with impairments

16. To what extend do you think that the experiences of disability are socially constructed?

17. Competing theories
Seeing illness as always biographically disrupting is problematic
Seen as inevitable part of ageing?
Reinforce some ideas about the self?
Does it reinforce the idea of bodily impairments as a personal tragedy?

18. Competing theories
The social model of disability has been critiqued for overemphasise physical and economic barriers
It ‘fits’ better with static rather
than deteriorating conditions
It does not easily explain how people adjust to bodily pain or impairment

19. Summary
Considered a range of theories which look at the experience and meaning of chronic illness and disability
Coming to terms with different bodies can cause a re/conceptualisation of the self
Stigma and social barriers impact of experiences of impairments

20. Next week Look at sociological understandings of mental illness
Consider relationships between social problems and mental health
Look at the impact of racism and sexism in diagnosis and treatment