Presentation on theme: "Chapter 14: The Sociology of the Body"— Presentation transcript:
1Chapter 14: The Sociology of the Body Today we are going to be talking about health and the body. You may be wondering how exactly that is a sociological topic, and that’s just what I’m going to explain and illustrate.Chapter 14: The Sociology of the BodyHealth, Illness, and Sexuality
2Important topics Social forces and the body Theoretical approaches to health and illnessAlternative medicineHealth inequalitiesGlobal health and infectious diseasesSexuality and societyThere are innumerable questions to ask and issues to address, but let me outline the main topics I’ll be covering:First off, I’ll spend some time explaining the relationship between social forces and the body. That is, how do things like the economy, someone’s race, and popular culture affect the body?Second, I’ll introduce two theoretical approaches to studying health and illness.Third, I’ll discuss alternative medicine, especially how it relates to our “traditional” model and the social contexts from which it emerges.Fourth, I’ll illustrate and begin to explain some of the glaring health inequalities that persist today, despite the seeming availability of excellent medical care.Then, and very much connected to issues of inequality, I’ll spend a bit of time talking about the history of global health, and especially infectious disease.And finally, I will close up our conversation about the body by discussing sexuality and how it, too, has social components.
3Sociology of the bodyExplores the relationship between society and the bodyExamines the ways that cultural and social factors affect health and other conditions of the bodyI know that’s a lot to cover, so let’s now start at the beginning. What is the sociology of the body? As a subfield in sociology, the study of the body is fairly new, but growing. While a significant part of that has to do with the sociology of medicine, I suspect you will notice other areas where many interesting questions remain.Sociology of the body, conceived broadly, seeks to understand the relationship between society and they body. Sometimes that means examining the actual behaviors individuals enact, other times it means discovering global patterns of disease, so again, we have to think broadly.This kind of sociology is attempting to measure—quantitatively and qualitatively—the impact various social and cultural forces have on health, sexuality, fitness, and so on. We’ll talk about several examples of this today.3
4BodiesLet’s think about bodies sociologically. Here before you are two images of emaciated, starving looking women. Does that make them the same? What do you think might be different?The woman on the left is so very thin as a result of living in a place where hunger is often the norm. Where weather and other circumstances—some of which are far more social than natural—have left people without the basic necessities for survival.The woman on the right lives in a wealthy, Western society. She is so very thin as a result of anorexia nervosa, an eating disorder that is driven by psychological and social factors, and that can result in death.Two thin bodies, both starving, but two very different stories.4
5Society and eatingA dual example of a sociological approach to understanding the body: our relationship with food.Eating disordersObesityWhat I’m going to do now, rather than just explain the sociology of the body further, is offer two extended—and related—examples. The two examples are eating disorders and obesity, and what they have in common is that both have to do with our relationship, as humans, to food.In earlier periods of human history, food really was a means for survival, but as you are all well aware, it is now much more than that in wealthy societies. Eating is a highly social behavior, and over time, our relationship to food has proven to be unhealthy in many ways.
6Anorexia and bulimia 90% of those with eating disorders are women 20% of anorexics will die from anorexiaOur diet culture:25% of men and 45% of women are dieting60% of girls age 13 dietOver 80% of girls age 18 dietEating disorders have been an issue of public discussion for many years now, with anorexia nervosa and bulimia nervosa being the two best known types. As you can see, the vast majority of those with eating disorders are women (some 90 percent). This tells us a great deal about the way in which our society frames femininity and beauty, and also about the desire of women, particularly young women, to fit that image. Twenty percent of anorexics will eventually die from complications from the disease, which progresses from a social cause to the ultimate bodily result.It should come as no surprise that while most of society does not have anorexia or bulimia, we are quite conscious of our weight (this does not mean we are thin, just that we aware of how we are supposed to look). One-quarter of men and nearly half of women in the United States are dieting at any given time (textbook p. 403), and the dieting starts very young. More than half of 13-year-old girls have dieted, and the number jumps to 80 percent by age 18. Clearly there is something in our culture—in our social environment—that compels us to organize our relationship to food in this way.6
7BMI BMI = 703 x ____weight ___ height x height _____________________________________ Note: Weight in pounds, and height in inches.Category BMI RangeUnderweight < 18.5Normal weight –24.9Overweight –29.9Obese I –34.9Obese II –39.9Obese III (Morbidly Obesity)__________________________________________________Source: National Heart, Lung, Blood Institute 1998.Obviously I’m not asking you to share your BMI, but just keep in mind that over 60 percent of adult Americans now have a score of over 25, which indicates they are overweight. Perhaps more shocking is that over 30 percent fall into the obese category. These numbers have climbed dramatically in recent years.7
8Obesity epidemic in the U.S. 1990: 0 states > 15% obese2008: 32 states > 25% obeseWe live in an “obesogenic” social environmentPoverty also contributes to obesityDespite the fact that over 60 percent of adults are overweight, there remains a powerful stigma attached to obesity.In 1990, there was not a state in this country that had an obesity rate over 15 percent. Just 18 years later, 32 states had rates over 25 percent. How could this have happened?There are many factors that contribute to what has become an epidemic of obesity, but perhaps the situation is best summed up by what one scholar has called our “obesogenic” social environment. Our lives are more sedentary than ever before, our food is prepackaged and prepared, we are in a near-constant hurry, portions are huge, advertisements are virtually hypnotic, and even children no longer spend their days outside running around. The way in which our time and activities are structured is clearly related to our now dangerous relationship to food.There are, of course, other, more classical social factors also involved. While in developing countries poverty often means starvation, in wealthy Western countries like the United States, poverty is closely associated with obesity. Foods that are fresh and healthy are also expensive. Foods that are cheap tend to be low in nutrition but high in calories. The diets of those living in poverty in the United States are typically very high in carbohydrates and low in fresh fruits, vegetables, and protein.An additional feature of obesity that is worth considering is that despite the fact that over 60 percent of adults are overweight, a strong and negative social stigma continues to be attached to it. In fact, there are even groups that seek civil rights for the obese.8
9Socialization of nature Processes that were once natural, or biological, are now influenced by social forces and social decisions.Norms and culture can lead to unhealthy behaviors.Society, then, is affecting the body.As you can see with these examples—eating disorders and obesity—the body is very often influenced by society. It is important to note that this influence is not always negative: it is good, for example, that those who can afford it and have time are motivated by the renewed calls for physical fitness.The point, though, is that processes that used to be “natural” or biological now have a significant social component. This is what your textbook calls the socialization of nature, and it is clearly seen, as I’ve shown you, in our relationship with food.It is interesting that at the same time our culture is telling us that women, in particular, need to be slim and beautiful, women are literally dying of both anorexia and morbid obesity. Our culture tells us one thing, but the organization of our society leads to something quite different. Clearly, society and culture affect our bodies.
10Being illA phenomenological or symbolic interactionist approach to illness: what is the experience of being sick?How are daily patterns, relationships, and activities disrupted?How do we react? How do we cope?How do we deal with stigma?One theoretical approach to studying the body, and more specifically illness, is to look at the experience of being sick. Both symbolic interactionists and phenomenologists argue that it is critical to understand how those who are ill live their lives and make meaning out of their experiences.They want to understand how all aspects of everyday life are affected: home and work routines, all kinds of relationships, activities: Are these things disrupted completely, in part? And how do people react? Do they cope well and manage illness? Do they make meaning out of being ill? And what happens when someone is ill with a stigmatized disease?There are many, many questions we can ask, all of which illustrate that being ill is not just a medical condition, but also a social condition worth examining.
11The sick roleA functionalist approach looks at how the sick person tries to minimize any damage her illness might create.The sick role has three basic expectations; they are:Not responsible for the poor healthEntitled to release from normal dutiesExpected to work to get wellThe notion of the sick role comes to us from the functionalist theorist Talcott Parsons. The idea was that illness is a situation of dysfunction and that people who are ill will try to adapt in ways to minimize any social disruption. We are all socialized into the basic expectations of the sick role throughout our lives, and as a result playing it is second nature. Additionally, others know how to respond to us, because they, too, have been socialized in the sick role and the appropriate responses.So what are the expectations of someone in the sick role: she is not responsible for her poor health, she is not expected to perform normal work and home duties, and she is expected to everything within reason to get well. There are exceptions, particularly to the first of those expectations. There are certain illnesses that do not receive the benefit of not being held responsible, and thereby miss out on the other advantages of the sick role. People with HIV/AIDS, for example, are often heavily stigmatized and blamed for their disease.Certainly there is something very useful about illuminating the various aspects of the sick role, knowing that it is looking at something quite different from the more experiential approach.
12Alternative medicineThe norm in Western societies is a biomedical model of health.Increasingly alternative forms of medicine are now available.Complementary and alternative medicine (CAM)Traditional Chinese medicineOsteopathyAnother interesting way of thinking about the body sociologically is to consider variation in approaches to the body across both time and space. In other words, how has medicine changed over time, and how does medicine look in a variety of different cultures/societies. The norm in Western societies is a scientific, biological approach to medicine, with treatment taking place in sterile settings, etc. This is usually called the biomedical model of health.What is interesting is that even with the continued dominance of the biomedical model, there is increasingly availability to and social approval of alternative medicine. Alternative medicine is a catch-all term that has come to mean virtually anything outside of the norm. Part of the reason for this new acceptance is that in some ways, certain forms of alternative medicine have been accommodated for under the current system , and reassigned the moniker CAM, complementary and alternative medicine. This has the effect of putting alternative forms of treatment under the umbrella of “modern medicine.”
13Health inequalitiesImprovements in health and healthcare are not equally distributed among societies.There are inequalities both within and between countries dealing with:ClassRaceGenderYet another approach to the study of illness and the body is that of examining health inequalities. This is a significant perspective and I’ll spend a little while working through it from several angles.What we know is that despite many excellent advances in medical treatment and care, not everyone has the same access or medical know-how. The three most obvious ways we see this inequity are in social class, race, and gender, but as I’ll talk about in a moment, there are global systems of inequality that must also be considered.We know that in the United States the poor and the non-white have poorer access to health care, and not surprisingly, poorer health. The relationship between race and class is a complicated one, with compounding factors that seem to be the most problematic for African Americans. Women, although they actually live longer than men, generally report poorer health and seek medical care more often than men do.Perhaps the most significant kind of health inequality that persists is the result of a largely private insurance system that has long excluded significant portions of the population. Legislation passed in 2010 will eventually make coverage available to many of those who are currently uninsured.13
14The spread of diseasesInfectious diseases are often spread through travel and high population density.Colonialism was a major engine for the spread of disease.New diseases were introduced to populations.New farming techniques led to problems.Infectious diseases are still a much bigger problem in the developing world today.Without minimizing important inequalities in the United States, let’s move on to think about global health, including the health inequalities to which I referred a couple moments ago.During the colonial period, certain deadly diseases were spread around the world. This happened because travel is one of the primary ways in which infectious diseases move from one place to another, and people from more densely populated European countries brought illnesses never before seen to previously undeveloped regions. The indigenous populations had no resistance and no treatment for these new scourges. There were terrible outbreaks of diseases like small pox and measles among native populations, which left indelible scars, and sometimes wiped out entire groups. Thus, colonialism is often seen as a major player in the global spread of disease.Another way that colonialism contributed to the spread of disease has to do with the farming techniques brought by the colonizers. One problem was that the colonizers forced the indigenous populations to shift from growing many things to growing a single cash crop. After the colonies gained independence, this long established cash crop system left them with little diversity of crops, and thus a very poor foundation for feeding themselves cheaply or in a nutritious way. This situation has its most devastating effects on the poorest segments of the population even today, since they have so few resources and typically farm only one crop. The health impacts of this situation can be seen especially clearly when we learn about global epidemics like HIV/AIDS, where the poorest members of society are most susceptible and least likely to receive proper treatment.14
15HIV/AIDSDespite significant advances in treatment, HIV/AIDS remains a global epidemic.Major inequalities persist in terms of access to treatment and diagnosis of new cases.The majority of new cases are heterosexuals.Almost half are women.Over half are in sub-Saharan Africa.AIDS is, as you all know, a global health epidemic. As I was indicating, it is a serious problem in many parts of the world that were once colonies of the European powers, especially in sub-Saharan Africa. That region alone accounts for more than 50 percent of all new cases each year. The AIDS epidemic has hit some of the poorest parts of the world disproportionately hard, which has had not only tragic human costs, but has also severely crippled other aspects of these societies, namely their economies. One of the biggest questions in looking at global HIV/AIDS is: why is it that with drugs that can extend a relatively normal life for fifteen or more years, that people outside of the Western world are still dying in such large numbers? This is a big, complicated question, but is one that sociologists have the tools to investigate.What we know about AIDS more broadly is that it is not, as was once thought, a “gay disease.” The majority of new cases are heterosexuals and nearly half are women. The disease remains highly stigmatized, even in the West.
18Barriers to success Money Stigma Lack of nutrition Lack of medical literacyOngoing motherchild transmissionEconomic impact keeps deepening the spiralResearch has shown us the major barriers to slowing the spread of AIDS and improving treatment, particularly in the developing world: lack of funds to equip clinics and provide medications, ongoing stigma which prevents people from talking about the disease, lack of good nutrition necessary to work with the drugs if they are available, lack of public health education and knowledge, and ongoing transmission from pregnant women to their infants.Several of these factors appear to be easy to deal with, but once we consider the full scope of the social environments in which public health workers do their jobs, it becomes much more complicated. Cultural factors that are deeply entrenched and meaningful can be difficult to work with when we also wish to respect them. Money can be donated, but much of it goes to administering programs that focus almost exclusively on medical factors but miss how embedded social and cultural issues are in the problems of HIV/AIDS. None of this is easy.What we do know is that if improvement is not made in dealing with HIV/AIDS, and if young people continue to die in such large numbers, some societies will have no way to maintain a viable economy. If such a situation were to occur, say in sub-Saharan Africa, it could lead to serious regional destabilization, which would ultimately affect us all.
19Sex and sexuality Sex norms vary considerably across cultures. There are many possible sexualities (not just heterosexual, homosexual, and bisexual).There are great variations in norms of sex practice as well as sexual attractiveness.Okay, now I am going to move on from AIDS to talk for a few minutes about another very important aspect of studying the body sociologically: sex and sexuality.To begin, one thing sociologists have shown is that norms regarding sex and sexuality vary a great deal across cultures, and that they change over time. For example, there are, according to at least one scholar, as many as ten possible sexualities, not just the two or three that we typically consider. Equally, what counts as sexual attractiveness also varies a great deal. In Western societies we typically consider slim women more attractive, but that is by no means a cultural universal; there are many societies that prefer more full-figured women. What is considered normal sexual practice also looks very different among different social groups.19
20Sex in Western culture Increasingly permissive Increasingly egalitarian according to gender1960s era was the shifting pointMen are happy with the increasingly open sexuality of women, but also a bit undone or confused by it.What does sex look like here, now? Sexual norms have become increasingly permissive, with both men and women having sex at younger ages and with more partners. There has been a trend, since the 1960s, of more egalitarian norms and behaviors between men and women. This is not to say that the sexual double-standard is gone (sexually promiscuous men being glorified and women being defamed), but it is weakening.What’s a little bit funny about all of this is that while men are quite happy with the increased openness in terms of women’s sexuality, it also presents a bit of a problem for them. One of the emblematic differences between men and women in Western culture has been this distinction in sexuality. Men’s sexual vigor was a core part of masculinity, so what does women’s sexual vigor mean? Some analysts fear it could spark a revival of misogynist behavior aimed at reestablishing male power, but at this point it remains hard to know.20
23Sexual orientation Homosexuality was once seen as mental illness. The bigger question today: is it social or biological?Most sociologists believe it is a combination.While attitudes have clearly shifted, homophobia and overt discrimination and violence remain.Another aspect of sexuality that has received a good deal of investigation is sexual orientation. In our own society, it was once considered a form of mental illness to be gay. People would stay “in the closet” for fear of social reprisal and would live their lives as though they were heterosexual. Attitudes today are a far step removed from such strong positions, but homophobia is certainly still an issue, and especially in adolescence, a great deal of open hostility exists toward the very idea of homosexuality. Gay and lesbian high school students are often targets of harassment. Perhaps this is an artifact of the heightened sexual energy that surrounds both biological puberty and American adolescent culture, but in society at large, homophobia is on the decline.A big question for sociologists has been, is sexual orientation biological or social? There are those who take a strong position in each direction, but most sociologists now take a middle position. It appears that there may well be some kind of genetic predisposition for being gay or straight, which is likely mobilized by social environment and experience.23
24Gay and lesbian rights Is this a civil rights issue? What is being sought?Anti-discrimination lawsMarriage rightsAdoption rightsAlthough I’ve said homophobia appears to be declining, the structure of our society still prevents homosexuals from attaining certain rights. Is this a civil rights issue?Certainly gay rights activists would say yes. They argue that gay and lesbian individuals are routinely discriminated against at work and in other parts of their lives, and that this constitutes a violation of their civil rights. Opponents argue that leading a gay or lesbian lifestyle is different than other bases for civil rights like race and gender, and therefore does not qualify. What do you think: is it different? If yes, do the differences make discrimination against homosexuals okay?Gay marriage has been a front-burner political issue for many years now. Although politicians—even very liberal ones—often continue to only support policies like civil unions half-heartedly, the populace is increasingly okay with gay unions. Today, only one state blocks gay couples from adopting children, another sign that support of gay families is on the rise.24
25Chapter 14: The Sociology of the Body As you now can see, the sociology of the body is a subfield that covers a great deal of territory. It includes medical sociology, the sociology of AIDS, alternative medicine, and sexualities. As sociologists we can give all of these issues new meaning by placing them within the social environments and social forces that surely shape them.
26Clicker Questions1. Which of the following best describes the field known as “sociology of the body”? a. It investigates how and why our bodies are affected by our social experiences and the norms and values of the groups to which we belong. b. It investigates any kind of regular intervention we make into the functioning of our bodies in order to alter them in specific ways. c. It investigates anything we use to adorn our bodies, such as glasses, watches, and jewelry. d. It investigates the increasing use of such devices as cell phones, pagers, and hand-held computing devices that make it possible for people to communicate over large distances.Answer: BRef: Introduction, p The field known as sociology of the body focuses on how our bodies are affected by social influences; health and illness, for instance, are shaped by social and cultural influences.26
27Clicker Questions2. What is the “socialization of nature”? a. Phenomena that used to be “natural,” or given by nature (such as the circumstances under which a woman can get pregnant), have now become “social”—they depend on our own social decisions (such as coming off the birth control pill or not using condoms). b. It is the use of agricultural land for house building and of nature reserves for tourism. c. It is the public ownership of natural resources. d. It is the provision of birth control and abortion by public hospitals.Answer: ARef: How Does Social Context Affect the Human Body?, p. 404
28Clicker Questions3. According to Talcott Parsons, which of the following is one of the three pillars of the sick role? a. The sick person is personally responsible for being sick. b. The sick person is not entitled to withdrawal from normal responsibilities. c. The sick person should work to regain health by exercising and dieting. d. The sick person should consult a medical expert.Answer: DRef: How Do Sociologists Understand Health and Illness?, p The sick role is characterized by three normative expectations: The sick person is not held personally responsible for his or her poor health, the sick person is entitled to certain rights and privileges, including a release from normal responsibilities, and the sick person is expected to take sensible steps to regain his or her health, such as consulting a medical expert and agreeing to become a patient.
29Clicker Questions4. Anorexia and obesity are both conditions of the body, yet the causes reflect a. social factors more than physical or biological factors. b. the changing expectations about men’s and women’s roles. c. the spread of fast food restaurants over the past forty years. d. increased globalization and contact among societies with different standards.Answer: ARef: Introduction, p Both conditions are very recent social problems; are highly stratified by social factors such as gender, social class, race, and ethnicity; and are shaped by cultural context.
30Clicker Questions5. Most sociologists currently believe that sexual orientation a. results from biological factors. b. results from social factors. c. results from both biological and social factors. d. results primarily from biological factors and secondarily from social factors.Answer: CRef: How Does Social Context Shape Human Sexual Behavior?, p. 424
31Clicker Questions6. Which of the following is a part of what Kelly Brownell calls the “obesogenic environment”? a. sedentary jobs, which have replaced physical jobs such as farming b. restaurants that no longer offer “kids meals,” which provided smaller portions c. large grocery stores that are popping up in poor neighborhoods and selling low-cost produce d. lack of sidewalks in rural and suburban areas, which make exercising outdoors potentially harmfulAnswer: ARef: How Does Social Context Affect the Human Body?, pp. 406–407. Jobs that require us to sit all day long, children who are more likely to sit in front of a computer or television rather than play outdoors, parents who often turn to unhealthy fast food due to hectic work and family schedules, and restaurants that provide enormous serving sizes at low prices to lure bargain-seeking customers, among other things, are all part of the “obesogenic environment.”
32The Sociology of the Body: Health, Illness, and Sexuality Art Presentation SlidesChapter 14The Sociology of the Body: Health, Illness, and SexualityAnthony GiddensMitchell DuneierRichard P. AppelbaumDeborah Carr
47Essentials Of Sociology W. W. Norton & Company Independent and Employee-OwnedThis concludes the Art Presentation SlidesSlide Set for Chapter 14Essentials Of SociologyTHIRD EDITIONbyAnthony GiddensMitchell DuneierRichard P. AppelbaumDeborah Carr