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

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

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

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

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

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

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

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

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

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’

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

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

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

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

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

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

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?

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

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

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