Health and Society

Optimum health is a principle goal for people and their communities. Government legislation promotes policies designed to counteract poor health. Social science is of central importance in understanding individuals and the community in which they live, why do some people live longer than others, or is health simply the absence of disease. Social science helps us to question many of the assumptions we make of every day life, the family, social roles, social inequalities and other factors affecting health. Moon and Gillespie (1995) ask, "Is good health something that is in our own hands, or is it determined by social forces. Is medicine always objective and scientific? Is it always the best option or sometimes does it operate in the interests of a certain interest groups.

The Black Report (1980) demonstrated the influence of inequality on health. This started a new era focusing on broader perspectives detrimental to health. "The continuing research stimulated by this report is transforming our understanding of both society and health" (Wilkinson 1994). When the report was first published the findings were of little interest to the conservative government of the time, who were pursuing a different political agenda. Nevertheless, it is now clear that the scale of income differences in a society is a most powerful detriment to health standards, by influencing health through its impact on social cohesion.

The success of some poor countries in achieving comparable life expectancy to developed countries suggests that it is social rather than material factors, which are the limiting component in the quality of life in those societies. "These factors remain the most powerful influence on health in the modern world and turns the exploration of the determinants of health into a social science". (Wilkinson 1994). Problems associated with deprivation impose huge public costs on society through crime, delinquent children, drug addiction etc and private costs through fear of these problems. Politicians tend to have short term policies that deal with symptoms and are reluctant to deal with the problems that leads to the build up of these costs due to the lack of reform of social structure.

Linten (1945) stated, "The culture of a society is the way of life of its members, the collection of ideas and habits that they learn, share and transmit from generation to generation. For a society to function effectively, the culture needs to be shared by its members, enabling them to communicate and cooperate. According to Haralambos and Holborn (2000), "Culture determines how members of society think and feel. It directs their actions and defines their outlooks on life. Culture defines accepted ways of behaviour for members of a particular society". Such definitions differ from society to society; this can lead to misunderstanding, particularly in relation to health care and prevention of infectious disease.

The process by which individuals learn the culture of their society is known as socialisation. It begins within the family by responding to parental attitude, moves on through the education system, the peer group and occupational. The individual learns to conform to the accepted ways of a social group and to appreciate the fact that social life is based on rules and guidelines known as norms. Norms are enforced by positive and negative sanctions. Certain norms are formulised into laws enforced by official sanctions, which are a major part of the mechanisms of social control. Values on the other hand establish what is considered to be good and bad. It defines what is important, worthwhile and worth striving for.

In Western society the value placed on health is expressed in the norms of good hygiene, vaccination, health and safety in the workplace and access of medical care. Shared norms and values enable society to comprehend the behaviour of others to co-operate and work together. Unfortunately, when conflicting values arise the result means individuals not co-operating and pursuing incompatible goals, destabilising the social structure.

Human societies have passed through broad phases of development in the shift from transitional rural societies based on agriculture to modern societies based on industry and urban life. According to Garman (1996), "Populations from agrarian and rural societies in Europe before the industrial revolution and much of the third world today are vulnerable to predominantly infectious disease carried by water, food, air or vectors such as fleas and mosquitoes. Infant mortality tends to be high and men usually live longer than women."

The growth of thousands of cities brought with it numerous social problems such as crime and health problems caused by overcrowding and lack of sanitation. The new cities also destroyed the traditional sense of community that they associate with rural villages. Modernity puts its faith in the ability of technology and science to solve human problems, a belief in the ability and rights of humans to shape their own lives and a reliance upon industry to improve living standards. This reliance gives extraordinary power to the industry barons. Foucault saw power as a relationship which was localised, dispersed, diffused and typically disguised through the social system, operating at a micro, local and covert level through sets of specific practices (Turner, 1997). Foucault saw power in the day-to-day practice of the medical doctor within the clinic to the activities of social worker and through the decision making of politicians. It existed through the disciplinary practices, which produced particular individuals, institutions and cultural arrangements. Foucault saw that power and knowledge were always inevitably and inextricably interconnected so that any extension of power involved an increase in knowledge and every elaboration of knowledge involved an increase in power.

Health should be seen as a positive concept, emphasising psychosocial factors as well as the physical capabilities and environmental factors which contribute to the optimum well being of the individual. This concept of health integrates ideas of community and individual contributions, by the development of their self-esteem so that they assume control over their health without having to refer to a higher authority.