Social constructionist approaches to illness are informed by many sociological aspects, such as symbolic interactions.
Illnesses carry a social meaning. They carry a metaphorical meaning that affects how patients view, react to, and care for their condition. They also affect how physicians register, interpret, and treat illness.
Moreover, the cultural meaning of illnesses affects how the general public regards people with certain illnesses.
Here are 4 crucial things to know about the social construction of illness.
1. Illnesses and the stigmatization or non-stigmatization of them are not derived from biological influences, but rather from social reasoning.
A great example of this is discernible with HIV/AIDS. There is nothing about the debilitating nature of the HIV/AIDS condition that warrants for it to be stigmatized, but it is the social discourse and public response and interpretation of the condition that causes it to become publicly stigmatized by both the general public and healthcare providers. In turn, this stigmatization can negatively affect the health of the patient because treatment options may become limited, and their personal relationships will become tainted.
2. Disabilities and impairments may seem the same, but they are separate entities.
Social interactions can define what physical impairment is. This means that when we analyze disability from a social lens, we can see that two components emerge: physical impairment is an attribute, and disability is the social experience surrounding such an impairment.
It is our society that has decided to define an impairment as a disability. What is most interesting is that even within this social construction, there is disagreement on what constitutes an illness, impairment, or disability.
3. Sociologically speaking, it’s hard to define illness.
Contested illnesses are disorders that many healthcare providers do not recognize or acknowledge due to the lack of association with a physical abnormality. This means that patients who do claim to have a contested illness, such as fibromyalgia, may not receive adequate care from their provider, which is a direct downplay of the suffering and symptoms of a patient. Contested illnesses are a great example of how illness has a cultural meaning because they clearly display the social view of illness that is inconsistent among the public, further proving that illness is not strictly biological.
Stigmatized and contested illnesses, along with disabilities have policy implications that can be both harmful and beneficial. HIV/AIDS patients are less likely to regularly stay up to date with their condition by seeking appropriate treatment from medical professionals due to the stigmatization of their illness. This can also be reflected in the potential mistreatment of HIV/AIDS patients by their healthcare providers.
Overweight women are also less likely to visit the gynecologist due to the stigma associated with obesity, which may contribute to why obese women have higher rates of gynecological cancers. For contested illnesses, physicians may choose not to treat those claiming a contested illness, and insurance companies may not cover related treatment costs. This presents a significant barrier to acquiring the necessary treatment. In addition, some health organizations may declare that they will diagnose a contested illness, but simply treat it with generic and low-cost medication, which can become overused and challenging to manage. This creates a separate issue that makes the healthcare process even more expensive for patients.
4. Social constructions of illness alter the nature of a condition.
With disabilities, there are some positive policy implications such as the Americans with Disabilities Act (ADA) that helps to remove some of the physical and public limitations associated with disease. The ADA also helps us understand that the social construction and societal viewpoint of an impairment can alter the nature of the condition. In this case, the ADA changed the nature of a disability to conclude that an impairment shouldn’t be disabling when enforcements can accommodate them.
Let’s use COVID-19 as an example:
I speculate that the illness of COVID-19 could have a cultural meaning informed by the social construction of illness. The USA is divided on its perception of COVID-19, with some people believing in its severity and accepting the vaccine, while others do not consider it a threat and refuse to become vaccinated.
Due to this division, there is a cultural meaning to the illness that directly informs the stigmatization, patient experience, and consequences of identity.
Through social interaction and public discourse, COVID has gained a cultural meaning that I believe can be categorized as a contested illness — except that in this case, it is the patients (apart from a few physicians) who do not recognize or acknowledge it. In the future, there could be policy implications regarding pandemic-defense precautions, which may be a federal vaccine mandate for all Americans.
Please read the inspiration for this article — a brilliant research and policy analysis conducted by Peter Conrad and Kristin Barker
