The sociology of health, illness, and health care has changed dramatically over the past few decades. The field was started primarily by sociologists who worked closely with doctors, taking doctors’ assumptions about health and health care for granted and primarily asking questions that doctors deemed important. By the 1970s, how- ever, the field had begun shifting toward a decidedly different set of questions. Some of these new questions challenged doctors’ assumptions, whereas others focused on issues that lay outside most doctors’ areas of interest or expertise such as how poverty affects health or how individuals develop meaningful lives despite chronic illness.
I entered graduate school during this shift, drawn by the opportunity to study how health and illness are socially created and defined and how gender, ethnicity, social class, and power affect both the health care system and individual experi- ences of health and illness. As a result, over the years I have researched such topics as how medical values affect doctors’ use of genetic testing, how midwives and doctors have battled for control over childbirth, and how social ideas about AIDS affect the lives of those who live with this disease.
Although I had no trouble incorporating this new vision of the sociology of health, illness, and health care into my research, I consistently found myself frus- trated by the lack of a textbook that would help me incorporate it into my teach- ing. Instead, most textbooks still seemed to reflect older ideas about the field and to take for granted medical definitions of the situation. Most basically, the books assumed that doctors define illness according to objective biological criteria, so they failed to question whether political and social forces underlie the process of defining illnesses. Similarly, most textbooks ignored existing power relationships rather than investigating the sources, nature, and health consequences of those relationships. For example, the textbooks gave relatively little attention to how doctors gained control over health care or how the power of the more developed nations has affected health in less developed nations. As a result, these textbooks used sociology primarily to answer questions posed by those working in the health care field, such as what social factors lead to heart disease and why patients might ignore their doctors’ orders. Consequently, these textbooks often seemed to offer a surprisingly unsociological perspective with their coverage of some topics differ- ing little from coverage of those topics in health education textbooks.
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