What you'll learn

• How the biomedical model explains illness and disability, and why sociologists criticise it.
• The main sociological theories: functionalist, Marxist, interactionist, feminist and postmodernist.
• How to apply these theories to contemporary UK examples such as the NHS, health inequalities, diagnosis and disability rights.
• How to evaluate theories using AO3: comparison, evidence, methods and real-world limitations.

Starting point: health and disability are social as well as medical

In everyday life, people often talk about health as if it is purely biological: you are either ill or well because of what is happening inside your body. Sociology does not deny biology, but it asks a wider question: who gets ill, who is labelled ill, who receives care, and whose bodies are treated as “normal”?

A key distinction is between the medical model of disability, which sees disability as an individual problem located in the body, and the social model of disability, associated with writers such as Oliver, which argues that society disables people through barriers such as inaccessible buildings, inflexible work and stigma.

The diagram below gives you a “map” of the theories. Notice that some theories focus on large-scale structures such as capitalism or patriarchy, while others focus on meanings, labels and identity.

The biomedical model

The biomedical model is the dominant medical way of understanding health. It sees illness as caused by biological problems inside the body, such as infection, injury, genetics or organ malfunction. The solution is diagnosis and treatment by medical professionals.

In the UK, the biomedical model underpins much of the NHS: GP consultations, blood tests, scans, medication, surgery, vaccination programmes and cancer screening all rely on scientific diagnosis and evidence-based treatment.

Strengths of the biomedical model

The biomedical model is powerful because it has produced major improvements in survival and quality of life. Antibiotics, anaesthetics, vaccines, insulin, chemotherapy and surgery are obvious examples. It is also often reliable, because doctors can use standardised tests and clinical guidelines.

Sociological criticisms

Sociologists argue that the biomedical model can be too narrow. It may ignore social determinants of health, meaning the social conditions that shape health chances, such as income, housing, education, employment, ethnicity, gender and environment.

It can also encourage medicalisation, where more areas of life become defined as medical problems needing professional treatment. Writers such as Illich criticised modern medicine for creating dependency and sometimes causing harm, known as iatrogenesis.

Functionalist explanations

Functionalism is a consensus theory. A consensus theory argues that society is held together by shared values and institutions that generally work together to maintain order.

Functionalists see health as important because society needs people to perform their roles: workers need to work, parents need to care, students need to study. If too many people are ill, social life becomes disrupted.

The key functionalist thinker here is Parsons. In 1951, he introduced the idea of the sick role.

The sick role

Parsons argued that sick people have two main rights:

• They are not personally blamed for being ill.
• They may be excused from normal responsibilities.

But they also have two obligations:

• They should want to recover.
• They should seek competent medical help and cooperate with doctors.

This makes doctors important gatekeepers, because they decide whether someone is legitimately ill. For example, a GP may provide a fit note for work or refer a patient to a specialist.

Evaluation of functionalism

Functionalism works best for short-term, acute illness, such as flu or a broken leg. It is weaker for chronic illness, mental illness and disability, where “getting better” may not be possible or may not be the person’s main goal.

It can also be criticised for assuming that doctors are neutral and that patients are passive. Interactionists and feminists challenge this by showing that diagnosis can involve negotiation, stigma and unequal power.

Marxist explanations

Marxism is a conflict theory. A conflict theory argues that society is shaped by inequality, exploitation and struggles between groups. Marxists focus especially on capitalism, a system where a small owning class profits from the labour of the working class.

Marxists argue that health and disability are linked to class inequality in three main ways.

First, capitalism can produce illness through poor working conditions, stress, pollution, low pay and insecure housing. This links to evidence such as the Black Report in 1980, which showed persistent class inequalities in health in Britain.

Second, healthcare may reproduce inequality. Tudor Hart’s inverse care law argued that those who need medical care most are often least likely to receive good care.

Third, medicine can support capitalist ideology by treating illness as an individual problem rather than asking why society creates unhealthy conditions. Marxists such as Navarro, Doyal and Waitzkin connect health to power, profit and inequality.

Marxism and disability

Materialist disability theorists such as Oliver argue that capitalism values people mainly as workers. Disabled people may be excluded because workplaces, transport systems and education are organised around a narrow idea of the “productive” body.

This links strongly to power and stratification: disability is not only about impairment, but about unequal access to employment, income, housing, transport and political voice.

Interactionist explanations

Interactionism is a micro-level theory. A micro-level theory focuses on small-scale social interactions, meanings and identities rather than large social structures.

Interactionists argue that illness and disability are partly shaped through labelling, where people, professionals or institutions define someone in a particular way. Becker’s labelling theory was developed in deviance studies, but it is useful for health because diagnosis can change how others treat a person.

Goffman used the term stigma to describe a socially discrediting attribute. Disability, mental illness, HIV status or visible difference may become stigmatised if others attach negative meanings to them.

Interactionists also study the doctor-patient relationship. Freidson argued that doctors have professional power to define illness. However, patients are not always passive: they may negotiate, resist, search online, seek second opinions or join support communities.

Evaluation of interactionism

Interactionism is useful because it shows how diagnosis affects identity and everyday life. It is especially helpful for understanding mental health, hidden disabilities and chronic illness.

However, it can underplay structural inequalities. For example, stigma matters, but so do poverty, racism, sexism, inaccessible transport and NHS funding.

Feminist explanations

Feminism is a conflict perspective focusing on patriarchy, meaning male power and gender inequality. Feminists argue that health and medicine have often been shaped by male-dominated institutions and assumptions.

Doyal, in What Makes Women Sick, argued that women’s health is affected by paid work, unpaid caring work, poverty, reproduction, domestic labour and male violence. Feminists also argue that women’s bodies have been heavily medicalised through pregnancy, childbirth, menstruation, contraception, menopause and cosmetic surgery.

In contemporary UK society, feminist arguments can be applied to issues such as delayed diagnosis of endometriosis, women’s heart attack symptoms being missed, maternity care inequalities and the gendered burden of unpaid care.

Feminists also study masculinity. Ideas of hegemonic masculinity, associated with Connell, may encourage men to avoid seeking help because they are socialised to appear strong and self-reliant. This connects health to socialisation, culture and identity.

Feminism and disability

Disabled women may face both ableism and sexism. For example, they may experience barriers to reproductive healthcare, employment, education, safety and independent living. This is an intersectional point: gender, disability, class, ethnicity and age can combine to shape health experiences.

Postmodernist explanations

Postmodernism argues that contemporary society is fragmented, diverse and uncertain. Instead of one shared truth about health, there are multiple sources of knowledge: doctors, online forums, influencers, charities, pharmaceutical companies, alternative therapies and patient communities.

Postmodernists argue that health has become part of identity and lifestyle. People are encouraged to monitor, improve and display their bodies through diets, fitness trackers, cosmetic procedures, wellness apps and genetic tests.

Writers such as Foucault are useful here. Foucault argued that modern societies use knowledge and surveillance to define what is normal and abnormal. His idea of the medical gaze suggests that medicine can turn people into cases, symptoms and bodies to be examined.

Beck’s idea of the risk society is also relevant: people are increasingly expected to manage risks to their own health, such as diet, smoking, alcohol, exercise and screening.

Postmodernism and disability

Postmodern ideas can help explain disability identity politics, online activism and the neurodiversity movement. Disabled people may reject purely medical labels and create alternative identities and communities.

However, postmodernism can overstate choice. Not everyone can choose private healthcare, specialist diets, gym memberships or digital health tools. Marxists would argue that class inequality still limits people’s options.

Quick comparison for essays

Evidence and methods points

You can use official statistics, such as ONS data on life expectancy, disability and deprivation, to support arguments about health inequalities. These are often high in reliability because they are collected systematically.

However, official statistics may not show the full lived experience of illness or disability. Some conditions are underdiagnosed, and some groups may face barriers to accessing doctors. Qualitative research, such as interviews with disabled people or patients with chronic illness, may offer higher validity because it captures meanings, stigma and identity.