Sociological Theories & Perspectives

in Understanding Health
Supriyati
Department of Health Behavior, Environment and Social Medicine
Faculty of Medicine, Public Health and Nursing UGM
https://hpu.ugm.ac.id/
Expected learning outcome: 2

01
Able to explain the focus
Understanding
study of medical sociology health from
various
perpectives

Able to explain 03
02 sociological theories
and perspectives in
understanding health

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 What is Health?
– A state of complete physical,
mental, and social well-being,
and not merely the absence
of disease or injury (WHO)
– health as the capacity to
carry out their daily activities
→ ability to function
Health is a resource for everyday life, not the objective of living (Ottawa Charter, 1986)
https://hpu.ugm.ac.id/
 Ability to function
Health provider Communities
perspectives perspectives

Sehat adalah…jika… Sehat jika….

 How to overcome health problems?
Health provider Communities
perspectives perspectives
Berobat ke dokter / nakes Rely on magic or other treatment
according to their believe of the
source of problems

Indikator yang
digunakan adalah Depend on their
indicator kesehatan: health literacy level
tekanan darah, dll

Considering evidence
Considering
based medicine testimony ?
Social determinants of
health are
the conditions in the
environments where
people are born, live,
learn, work, play,
worship, and age that
affect a wide range
of health,
functioning, and
quality-of-life
outcomes and
risks
Perspective is one
of the big
communication
barrier
 What should we do?
We need to
01 understand what are
their perspectives ?

02 We need to adjust our

communication strategy

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Public health expert need to
recognizes the critical role
social factors play in
determining or influencing
the health of individuals,
groups, or larger population

medical sociology is important

for public health expert
 What is sociology ?
the study of society

the study of the development, structure, and

functioning of human society

the study of human social relationships and

institutions (include the social interaction, social
relationship, and culture)
Medical sociology
• Also known as
health sociology
• The study of cause
and consequences
of health and illness
(Cockerham, 2011)
What do medical sociologists study?
Social causes and patterns of health and disease

Social behavior of health care personnel and their patients

Social functions of health organizations and institutions

Social pattern of the utilization of health services

Relationship of health care delivery systems to other

social systems

Cockerham cit. Pearson, 2012

 The role of Indonesian
patients’ health behavior in
delaying the diagnosis of
nasopharyngeal carcinoma
(Fles et al, 2017)
Fles et al 2017
 MODIFYING factors
Demographic factors
Sociopsycology Likelihood of action
Structural variable Perceived benefit and
Individual perception barrier
(Knowledge)
-Perceived susceptibility
of disease
Cultural and religion
Seirousness of disease

Perceived treat of Likelihood of behavioral

disease change

Cues to action
Peer support
Fles et al 2017 Advice from other
Education
Illness family member
Interaksi masyarakat dan respon
masyarakat terhadap Covid-19
Rebahan anti
mainstream
Blood Taboo in Papua
giving birth women must be isolated (2-3
weeks)

19
In Papua, blood is considered as bad
luck which means women during
menstruation and childbirth are not
allowed to be in the village.

They are sent away to a secluded

area in the wilderness give birth by
herself (in the jungle or at the beach).
All activities such as cooking, eating,
sleeping, to defecate and others
should not be out of the huts that
have been made for her.

20
• Sifon : Atoni Tribe in Timor island
• Sifon : a man is supposed to be engage in
sexual relationship with at least 3 women
• Sifon : a social tool to form a man’s masculinity
and the way to avoid disharmony in the family
(Ungu, 2012)
• the sexual intercourse must be done before
the wound from the circumcision has healed
→ to discard “the heat of body”
• the community belief has influence their
behavior related to health → STD’s?
Sociolocigal Paradigm
Social fact

Social definition

Social behavior
Social facts paradigm
Structure-functionalism
(consensus)

Marxist (conflict)

Social system (pearson)

 Social definition Paradigm
Action theory

Symbolic interactionism

Phenomenology

Humanbeing is creative one and the live is so dinamic

Social behavior paradigm
Behavioral sociology

Exchange theory

Rational Choice theory

 #1. Structure-functionalism theory (consensus)
• Focuses on how society is organized and how social institutions
meet the needs of people living within a collectivity
• Like an organism
• As understanding human body ---- human social system (has many
parts/institution such as education, religion, economy, politic) →
These institutions secure the evolution and growth of society
• The consensus focus upon the good of the overall society; sub-
groups of society must be willing to sacrifice for the good of the
whole
Structure-functionalism theory – conflict theory – System theory
 The characteristics of society
• Well planned uniformity
• Stability and equilibrium between different parts
• Consensus of the main values
• Every institution has a function which helps society to remain stable
• What is, is good – “natural selection” of good institutions/functions
 4 key functions of social system
• production and distribution of goods and services:
Adaptation The economy

Goal attainment • writing and enforcing of the rules: The policy

• procreation and socialization of children; integration

Integration of social activities: Family and education

Latency • a system of values and beliefs: Religion

 Social action Dinamic Social institution
taken places equilibrium must adjust to
as a dynamic means society is changes in other
equilibrium always changing institution

- Unprepared to address changes that occur due to misuse of power

- highly useful in understanding ongoing adjustments to social
institutions in response to changes in the other institutions
 Research question :
Mapping, describing, and analysing
Positive function

Institution

The dysfunctions
Example :
Could you please
explain the health
seeking behavior
pattern after the
national health
insurance ?
•
#2. Conflict theory
Guides inquiries into the use and misuse of power within and across
social systems
• The fundamental processes of society are competition and conflict,
rather than cooperation for the good of the whole
• All social systems have a small minority of powerful elites
• Social action takes place within an arena of conflict and exploitation
between dominant and secondary segments of society → must be
anticipated
• Focus on the material condition such as clothing, education, access
to health care
Structure-functionalism theory – conflict theory – System theory
 conflict

Integrity
 Conflict in modern sociology
Not only focusing on class struggle as Marx
did, but on the overall power structure in
society, such as conflicts between different
groups of interests

Producers and consumers, employers

and employed, among religions,
teachers and students, parents and
kids, personality and culture
 Conflict cause social change

Social
conflict
change
Conflict does not necessary mean violence, rather tension,
competition or disagreement about objectives and values,
conflict of interests
Deklarasi Keparakan : a community deal

Kesepakatan bersama :
1. Tidak merokok di
dalam pertemuan
2. Tidak merokok di
dalam rumah
Smoke free on the village office
The conflict lead to
the social change
 Research question

Mapping of power-relations

Someone is making benefit of the situation at the expense of

someone else

How can we dissolve the conflict? Can there be a win-win solution?

 Social definition paradigm

• Action theory
• Symbolic interactionism
• Phenomenology
 Social definition

Focus on social action

Action --- meaningful

Understand – response
 Action theory
Tindakan dilakukan untuk mencapai tujuan (subjek dan objek)

Bertindak menggunakan cara yang dianggap cocok mencapai

tujuan

Kelangsungan tindakan dibatasi eksternal yang tak dapat

dikendalikan

Manusia memilih, menilai dan mengevaluasi tindakannya

Action theory – Simbolic interasctionism - phenomenology

Action theory
 Interactionism symbolic
• Focuses on how individuals influence
and are influenced by society. It
guides investigations into how the
rules of society are re-created
everyday through our interactions
with one another
• the symbolic meanings we attach to
things and events

Action theory – Simbolic interasctionism - phenomenology

 Some concepts…
Reality is socially constructed through our interactions with
one another. Morality, ethics, and values, are not given; we
create them through our interactions with one another

Social action is influenced by person's beliefs, attitudes,

perceptions, and negotiations of meanings

The rules are open for grabs. If you do not like your society:
work hard to change it!
Conflict Vs Fuctionalist
• The conflict paradigm highlights parts of
society where functionalists usually do
not focus on
• The weakness of the conflict paradigm is
that they miss the consensus- and balance
in society
 Social behavior paradigm

• Behavioral Sociology
• Exchange theory
• Rationale choice theory
 Apa yang menjadi
Paradigma perilaku sosial keyakinan dan
motivasi ?

Perilaku individu dipengaruhi oleh keyakinan,

motivasi, dan tujuan

Ketika perilaku menjadi terpola / tetap, maka

menjadi perilaku sosial
 Exchange theory
• explains social change and stability as a process of negotiated
exchanges between parties
• posits that all human relationships are formed by the use of a
subjective cost benefit analysis and the comparison of
alternatives
• norm of reciprocity

Behavioral Sociology – Exchange theory – rational choice theory

Post Modernism /
postStructuralism
• Deconstruction
• Discourse/discourse analysis
• Plurality of knowledge and
method
• Power and knowledge;
Relativism
The Network Episode Model (Pescosolido, 2006)
 References
• Engman A & Cranford C., 2016. Habit and the Body: Lesson for
social Theories of Habit from the Experiences of People with
Physical Disabilities. Sociological Theory. 34(1):27-44
• Jovanovic M., 2014. Creating the “Dis-ease” of high
cholesterol: A Sociology of diagnosis reception analysis. Social
Science & Medicine: 101: 120-128
• Ritzer G. 2012. Sociological Theory. 8th ed. USA: McgrowHill