Health: Concepts of Health, Illness and the Medicalisation of Society
Sociologists of health and illness examine how health, illness and medicine are socially defined and organised, not simply biological facts. The biomedical model treats illness as a purely physical malfunction to be diagnosed and treated by medical experts, whereas the social model of health argues that social factors, poverty, housing, employment and lifestyle, are major determinants of health and illness, and that a purely biomedical approach can miss or downplay these causes. Illich's concept of 'iatrogenesis' argues that modern medicine itself can cause harm, distinguishing clinical iatrogenesis (direct medical harm, such as a drug's side effects), social iatrogenesis (medicine creating dependency on medical experts for problems people once managed themselves) and cultural iatrogenesis (medicine undermining people's own capacity to cope with pain, illness and death as a normal part of life). Zola's concept of 'medicalisation' describes the process by which an increasing range of everyday human experiences, such as childbirth, ageing, unhappiness or misbehaviour, come to be defined and managed as medical problems requiring medical intervention, extending medicine's authority and social control over daily life. Parsons's concept of the 'sick role' describes the socially agreed rights (exemption from normal social duties, not being blamed for being ill) and obligations (wanting to get well, seeking competent medical help) that structure how society expects a sick person to behave. Feminist sociologists, including Oakley, have specifically criticised the medicalisation of women's reproductive experiences, such as childbirth and menopause, arguing natural processes have been reframed as medical conditions requiring expert (often male-dominated) medical management.
Before you start
No specific prerequisites - this is a good place to start.
Method
- Contrast the biomedical and social models of health clearly at the outset, since most of this topic's evaluation depends on weighing them against each other: biomedical treats illness as physical malfunction requiring expert treatment, social treats health as substantially shaped by social conditions such as poverty and housing.
- Explain Illich's three types of iatrogenesis with a distinct example for each: clinical (a harmful drug side effect), social (a person relying on medical experts for a problem they could once have managed independently), cultural (losing the everyday ability to cope with pain, illness or death without medical framing).
- Explain Zola's medicalisation concept as a process, not a single event: an increasing range of ordinary human experiences (childbirth, ageing, unhappiness) come to be defined and treated as medical conditions over time, extending medicine's social authority into areas of life it did not previously govern.
- Explain Parsons's sick role precisely as a pair of rights and obligations, not just a description of being ill: the rights (exemption from normal duties, no blame for the illness) are conditional on meeting the obligations (wanting to recover, seeking competent help), so the sick role is a negotiated social status, not an automatic one.
- Use Oakley's feminist critique to give a specific, gendered example of medicalisation: the reframing of childbirth from a natural process managed by women (often with midwives) into a medical event requiring expert, historically male-dominated, intervention.
- If the item describes a specific health experience or medical practice, identify whether it best illustrates the biomedical model, the social model, a type of iatrogenesis, medicalisation, or the sick role before generalising.
- For an evaluative answer, weigh the biomedical model's genuine successes (effective treatment of many acute conditions) against the social model's evidence that health inequalities track social inequality closely, and consider whether medicalisation and iatrogenesis represent a real cost of medical expansion or an overstated critique given medicine's benefits.
- For a 20-mark essay, plan a biomedical/medicalisation paragraph, a social model/critical paragraph (using Illich, Zola or Oakley), an evaluation paragraph weighing benefits against costs, and a conclusion answering the specific question set.
Worked example
Item A: Over recent decades, an increasing range of children's behaviour once considered ordinary boisterousness has come to be diagnosed and treated as a medical condition, with rising numbers of prescriptions for behaviour-related medication, and some parents report feeling they must seek a medical diagnosis before a school will accommodate their child's behaviour. Applying material from Item A and your knowledge, analyse two ways the item illustrates the concept of medicalisation. (10 marks)
- Identify the item's key claim: ordinary childhood behaviour is increasingly defined and treated as a medical condition, and a diagnosis is now sometimes required for practical accommodation.
- Way 1: use Zola's medicalisation concept directly, behaviour that was previously understood as ordinary (not medical) is now defined and managed within a medical framework, exactly matching Zola's account of medicine's authority extending into new areas of everyday life.
- Develop way 1 with the item's detail on rising prescriptions: this shows the process has a concrete practical consequence, increased use of medication, not just a change in how behaviour is labelled or discussed.
- Way 2: use Illich's social iatrogenesis, the item's detail that parents feel they must seek a diagnosis before a school will accommodate their child shows dependency on medical authority being built into an institutional system (school accommodation), extending medicine's social control beyond direct medical treatment itself.
- Add a brief evaluative note: a biomedical model supporter might argue the rise reflects genuinely improved diagnostic ability rather than problematic medicalisation, showing the same evidence can be read differently depending on the underlying theoretical model.
- Check both ways are tied explicitly to the item's detail on prescriptions and school accommodation, and named using Zola and Illich rather than a generic account of medicalisation.
Practice questions
Try each question, then tap to reveal the answer.
Q1What is the key difference between the biomedical and social models of health?Show answer
Answer: The biomedical model treats illness as a physical malfunction to be diagnosed and treated by medical experts; the social model argues social factors, such as poverty, housing and employment, are major determinants of health and illness.
Q2Name Illich's three types of iatrogenesis and give a brief example of one.Show answer
Answer: Clinical, social and cultural iatrogenesis. Clinical iatrogenesis is direct medical harm, for example a drug's harmful side effects.
Q3What does Zola mean by 'medicalisation'?Show answer
Answer: The process by which an increasing range of everyday human experiences, such as childbirth, ageing or unhappiness, come to be defined and managed as medical problems requiring medical intervention.
Q4What are the two obligations of Parsons's sick role?Show answer
Answer: Wanting to get well and seeking competent medical help.
Q5What are the two rights of Parsons's sick role?Show answer
Answer: Exemption from normal social duties, and not being blamed for being ill.
Q6How does Oakley's feminist critique apply the concept of medicalisation to childbirth?Show answer
Answer: She argues childbirth, once a natural process largely managed by women themselves, has been reframed as a medical event requiring expert, historically male-dominated, medical management, restricting women's control over the experience.
Exam-style questions
Written in the style of a A Level Sociology exam paper, with a full mark scheme.
Outline and explain two criticisms of the biomedical model of health.
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Item B: A woman recovering from a diagnosed illness was expected by colleagues and family to rest and was excused from her usual responsibilities, but only after she had visited a doctor and was actively following medical advice to recover; when she stopped following the advice, some around her began to question whether she was really still ill. Applying material from Item B and your knowledge, analyse two ways the item illustrates Parsons's concept of the sick role. (10 marks)
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Item C: Rates of medical diagnosis and treatment for conditions such as low mood, sleep difficulty and behavioural issues in children have risen substantially over recent decades. Supporters of increased diagnosis argue this reflects better medical understanding and access to genuinely helpful treatment, while critics argue ordinary human experiences are increasingly being redefined as medical problems requiring expert management. Applying material from Item C and your knowledge, evaluate sociological explanations of medicalisation in modern society. (20 marks)
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