Social Construction of the Definitions of Health and Illness

Over the next two days we are going to look at two specific types of illness, mental illness and terminal illness, to see what different types of affects they have on the family. However, before diving in to particular illness, I think it is important to pause and look at how society influences the definition and creation of illness in the first place. As a culture immersed in an era of elite medical technology, we look at illness often as an entirely biological process. Diseases are defined by what medicine says is happening in the body, and this is not something that can be challenged or changed, right? Cancer is cancer – there does not seem to be anything society can do to change that or affect its meaning. It’s purely biology!
In reality though, ideas about health and illness are always social constructions. While science is a major contributor, society’s nonscientific beliefs regarding anything from health and illness to morality have an enormous impact on the development of diseases. For one, our ideas about the human body are social constructs. This is because cultural beliefs, practices, etc. shape the way the body is perceived and idealized. One example is the practice of foot binding in China – a situation in which cultural beliefs about what the body should look like is directly affecting the biological make-up of their people. In this way, illness is not simply a biological experience, but a social one as well. Just as the women’s bodies in China are literally be altered and shaped by society, our cultural values influence what we consider to be healthy as well as what we consider to be sick. The International Dictionary of Medicine and Biology defines health as “a state of well-being of an organism or part of one, characterized by normal function and unattended by disease”. While this may seem very straight forward and very scientific, it has many social ideas imbedded it. For instance, what if our society did not place so much importance on the ability to function? Would that still be included as a criteria for being healthy? Or, what if there were certain diseases that our society considered to be special or beneficial? For instance, in “The Spirit Catches You and You Fall Down”, a Hmong family tries to explain to their doctor that in their culture, epilepsy is a seen as a gift from the Gods, and therefore a privilege to those who receive it. In such a case, the total absence of illness would not accurately define health, because some diseases would be considered to be healthy! In this way, even simple definitions of something like health are a combination of medicine and social values – and therefore are ultimately socially constructed.
It is difficult sometimes to believe, as mentioned above, that the actual definition of a disease can be influenced by social factors. However, in the same way that “health” is influenced by society, so can be definitions of disease, such as “AIDS”. One very poignant example of this actually happened in the case of masterbation. While it is still an uncomfortable topic in many ways in the US today, as a whole society now sees it as a natural and biologically encouraged practice. However, this was not always the case. In the eighteenth century, masterbation was actually considered a disease all of its own. It was a medically defined disease called “onanism” and was also referred to as “self-abuse” or “self-pollution”. It was said to cause impotence, epilepsy, blurred vision, headaches, rheumatism, mental disorders, and much more. By the mid-eighteenth doctors actually identified and defined a type of mental insanity as “masturbatory insanity”. One article describes it saying:

“The masturbatory hypothesis provided an explanatory model for many conditions for which the medical profession of the day could find no other diagnosis and for which they could do nothing. By the early nineteenth century self-abuse was beginning to be blamed not only for physical and nervous ailments, but also for mental disorder. By the mid-century, in Britain and North America in particular, a particular form of "masturbatory insanity" was identified. This was strongly associated with ADOLESCENCE, and in some cases may have been dementia praecox.”

Commenting on where these ideas about masterbation came from, the article states that:
“Some historians have argued that the rise of masturbation paranoia reflected anxieties within Protestant culture, cut off from old sources of moral authority, but masturbation fears were at least as prevalent in Catholic nations, possibly reflecting anxieties generated by political, social, and economic change.”

Just from this quote, it is evident that everything from religious, political, social, and economic values or events can influence something that seems as scientific as the definition of disease. In the case of masterbation, as medicine progressed the symptoms were seen to be false, and simultaneously our culture transitioned in to an era of much more relaxed views regarding sexuality. In this way, it was the combination of changes in medical technology and societal constructs that redefined this issue and the many diseases that went along with it.

In the end, before looking at specific disease such as mental illness, it is important to think about where the definitions of these diseases come from and how they are constructed. For instance, one of the things we will talk about regarding mental sicknesses is the stigma that surrounds them throughout society and how that plays a part in the lives of those suffering from it and their care givers. In this way, we see that not only are do our ideas regarding a defined illness have an impact on people’s lives, but they also play a part in defining the illness to begin with.

After reading this…
1) Have you ever thought before that definitions of health and sickness could be socially constructed? If you never have, why do you think that is?
2) Do you agree with the information provided? Or do you think that medical definitions are purely scientific?
3) How do you think this idea of medical definitions and illness affects the way you see or think about illness? Are there any illnesses that you can think of that you do not think should be considered sicknesses?
4) Do you know of any other examples to share of diseases that have developed over time with the advancement of technology and society combined?



Sources:
“Health, Illness, and the Social Body: A Critical Sociology.” (Ed. 4) Freund, P., McGurie, M., Podhurst, L. (2003) Upper Saddle River, New Jersey: Prentice Hall.

http://www.faqs.org/childhood/Ke-Me/Masturbation.html