When you think of "health" and "illness", you probably think of pure biology: a virus invading a cell, a broken bone on an X-ray, or a chemical imbalance in the brain. However, sociologists argue that health and illness are not just biological facts. They are socially constructed. This means their definitions, meanings, and treatment are created by human society, shifting across different cultures, time periods, and power structures.

In these study notes, we will explore the different ways sociologists understand health, illness, disability, and the body, moving from biological models to deeply critical social perspectives.

What you'll learn

• The crucial differences between the Biomedical and Social models of health and illness.
• How conditions become medicalised and how medical power operates as a form of social control.
• The distinction between impairment and disability through the social model of disability.
• How the physical human body is constructed by social practices, discourses, and expectations.

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1. Models of Health and Illness

To understand how health is socially constructed, we first need to look at the two competing frameworks that define how medicine is practiced and understood: the Biomedical Model and the Social Model.

The Biomedical Model

For over a century, Western medicine has been dominated by the biomedical model. This model treats the human body like a biological machine.

Under this model:

• The body is a machine: When it breaks down (illness), a specialist mechanic (the doctor) must fix it.
• Scientific objectivity: Disease is viewed as an objective, measurable biological pathology.
• Individual focus: The focus is on the individual's biology, largely ignoring their social position, poverty levels, or employment stress.

The Social Model

Sociologists argue that the biomedical model is too narrow. They propose the Social Model of Health, which shifts the focus from the microscope to the wider social structure.

Instead of simply prescribing medicine to treat a chronic lung condition, a social model practitioner asks: Is this patient living in a damp, moldy, rented flat? This approach views prevention and structural change (like better housing policies and reducing wealth inequality) as more important than post-illness clinical cures.

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2. The Social Construction of Illness

If illness is socially constructed, then what is considered "sick" or "healthy" is not fixed. It changes depending on time, place, and who holds the power to define it.

Deviance and the Sick Role

Functionalist sociologist Talcott Parsons (1951) was one of the first to argue that illness is a social state, not just a physical one. Parsons argued that being sick is a form of deviance because it disrupts the smooth running of society. To keep society stable, Parsons introduced the concept of the Sick Role.

According to Parsons, when you are sick, society grants you two rights:

1. You are exempt from normal social duties (like going to school or work).
2. You are not held responsible for your condition (it’s not your "fault").

However, these rights come with two strict obligations:

1. You must actively want to get better.
2. You must seek professional help (cooperate with doctors) to recover.

Medicalisation and Social Control

As society has secularised, the medical profession has taken over from religion as a major agent of social control. Behavior that used to be defined as "sinful" or "immoral" is now defined as a "medical condition." This process is called medicalisation.

Sociologists like Peter Conrad argue that medicalisation is driven by pharmaceutical companies, the medical profession, and insurance companies who benefit from turning normal human variations into treatable pathologies.

Think about how the following have transitioned over time:

• ADHD: Children who were once labeled "disruptive" or "naughty" are now diagnosed with Attention Deficit Hyperactivity Disorder and prescribed stimulants.
• Mental Illness: Normal processes of grief or sadness are increasingly categorized as clinical depression requiring medical intervention.
• Homosexuality: Historically treated as a criminal offense, it was then medicalised as a psychiatric disorder in early versions of the DSM (Diagnostic and Statistical Manual of Mental Disorders), and only later de-medicalised as a normal variation of human sexuality.

Critical Perspectives on Medical Power

• Ivan Illich (1975) coined the term iatrogenesis to describe the harm caused by medical interventions. He argued that modern medicine actually creates illness. This can be clinical iatrogenesis (side effects of drugs, hospital-acquired infections) or social iatrogenesis (the medicalisation of life stages like birth, aging, and dying, which robs people of their autonomy).
• Thomas Szasz famously argued that many mental illnesses are "myths"—they are merely labels used by the powerful to control socially disruptive or non-conforming behavior.

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3. The Social Construction of Disability

The way we understand disability has undergone a massive paradigm shift. Sociologist Michael Oliver (1983) argued that disability is entirely a social construction, and he drew a sharp distinction between two concepts:

• Impairment: A physical, sensory, or cognitive limitation of an individual's body (e.g., being unable to walk, being blind). This is a biological fact.
• Disability: The disadvantage, restriction of activity, or social exclusion caused by a society that fails to accommodate people with impairments. This is a social construction.

The Individual (Medical) Model vs. The Social Model of Disability

The Medical Model views disability as a personal tragedy. The "problem" lies entirely within the individual's broken body, and the solution is to cure, rehabilitate, or adjust the individual to fit into society.

The Social Model completely reverses this. It argues that people are not disabled by their impairments, but by society's barriers. These barriers can be:

• Physical barriers: Buildings with stairs but no ramps, narrow doorways, inaccessible public transport.
• Systemic barriers: Rigid working hours, lack of sign-language interpreters.
• Attitudinal barriers: Prejudice, patronising assumptions, and discrimination from employers.

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4. The Social Construction of the Body

Even the physical body itself is not a simple biological entity. Poststructuralist sociologists, most notably Michel Foucault, argue that our bodies are shaped, disciplined, and constructed by power and knowledge.

Foucault: The Clinical Gaze and Biopower

Foucault argued that in the 18th century, medicine developed what he called the clinical gaze (le regard medical). Doctors began to look at patients not as whole human beings, but as collections of organs to be observed, categorised, and monitored.

Through this medical discourse, bodies became objects of surveillance and biopower—the state's use of medical knowledge to regulate, manage, and control populations (e.g., vaccination campaigns, fertility policies, obesity guidelines).

Feminism and the Body

Feminist sociologists argue that women's bodies are particularly targeted by social construction:

• Medicalisation of female life cycles: Pregnancy, childbirth, and the menopause have been taken out of women's hands and placed under the control of male-dominated medical institutions.
• The Beauty Myth: Sociologists like Susie Orbach point out that the female body is socially constructed through media and capitalism to fit unrealistic, highly commodified ideals (e.g., diet culture, cosmetic surgery), leading to high rates of eating disorders which are then medicalised.

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Worked Example

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