The Cultural Meaning of Illness

Many medical sociologists contend that illnesses have both a biological and an experiential component, and that these components exist independently of and external to each other. Our culture, not our biology, dictates which illnesses are stigmatized and which are not, which are considered disabilities and which are not, and which are deemed contestable (meaning some medical professionals may find the existence of this ailment questionable) as opposed to definitive (illnesses that are unquestionably recognized in the medical profession) in the medical field (Conrad and Barker 2010).

For instance, sociologist Erving Goffman (1963) described how social stigmas hinder individuals from fully integrating into society. In essence, Goffman (1963) suggests we might view illness as a stigma that can push others to view the ill individual in an undesirable manner. The stigmatization of illness often has the greatest effect on the patient and the kind of care they receive. Many contend that our society and even our healthcare institutions discriminate against certain diseases—like mental disorders, AIDS, venereal diseases, and skin disorders (Sartorius 2007). Facilities for these diseases may be sub-par relative to facilities aimed at addressing and alleviating other conditions; they may be segregated from other healthcare areas or relegated to a poorer environment. The stigma attached to a specific condition may keep people from seeking help for such conditions, consequently being detrimental to the individual’s and society’s well-being.

Contested illnesses are those that are questioned or questionable by a fraction of medical professionals. Disorders like fibromyalgia or chronic fatigue syndrome may be either true, objective, and tangible illnesses or, as argued by some medical professionals, may exist only in patients’ heads. This dynamic can affect how a patient seeks treatment and what kind of treatment they receive.

The Sick Role

Sick role is a term used in medical sociology regarding sickness and the rights and obligations of the affected. It is a concept created by the American sociologist Talcott Parsons in 1951. Parsons argued that the best way to understand illness sociologically is to view it as a form of deviance that disturbs the social functioning of society. The general idea is that the individual who has fallen ill is not only physically sick, but now adheres to the specifically patterned social role of being sick. “Being Sick” is not simply a “condition, it is a social status. As with all statuses, being sick comes with a set of expectations based on the social norms that surround it, and therefore plays a role in everyday, normative interactions.

Parsons’ theory outlined two rights of a sick person along with two obligations. The sick person’s rights are: being exempt from normal social roles, and not being responsible for their condition. Conversely, the sick person’s obligations include trying to get well and cooperating with medical professionals.

The Social Construction of the Illness Experience

The idea of the social construction of the illness experience is based on the concept of reality as a social construction. In other words, there is no objective reality; there are only individual perceptions of it, which are always relative and involve a process of construction. The social construction of the illness experience addresses the way some patients control the manner in which they reveal their diseases, and the lifestyle adaptations patients develop to cope with their illnesses.

In terms of constructing the illness experience, culture and individual personality both play a significant role. For some people, a long-term illness can have the effect of making their world smaller, leading to a life that is more defined by the illness than by anything else. Their illness becomes their marker, or their focal status. For others, illness can be a chance for discovery, for re-imagining a new self (Conrad and Barker 2007). Culture plays a substantial role in how an individual experiences illness. Widespread diseases like AIDS or breast cancer have specific cultural markers that have changed over the years and that govern how individuals—and society—view both the condition and the individual directly affected by the condition.

Today, many institutions of wellness acknowledge the degree to which individual perceptions shape the nature of health and illness. Regarding physical activity, for instance, the Centers for Disease Control (CDC) recommends that individuals use a standard level of exertion to assess their physical activity. This Rating of Perceived Exertion (RPE) gives a more complete view of an individual’s actual exertion level, since heart rate or pulse measurements may be affected by medication or other factors (Centers for Disease Control 2011). Similarly, many medical professionals use a comparable, somewhat universal scale for perceived pain to help determine pain management strategies.

The Social Construction of Medical Knowledge

Conrad and Barker show how medical knowledge is socially constructed; that is, it can both reflect and reproduce inequalities in gender, class, race, and ethnicity. Conrad and Barker (2011) use the example of the social construction of women’s health and how medical knowledge has changed significantly in the course of a few generations. For instance, in the early nineteenth century, pregnant women were discouraged from driving or dancing for fear of harming the unborn child, much as they are discouraged, with more valid and evidence-based reason, from smoking or drinking alcohol today.