Epidemiology, Sociology and Psychology of Health and Disease

Abstract

This chapter traces the developments in the three interrelated fields of health, namely, epidemiology, medical sociology and health psychology. In epidemiology, people like Chadwick, Snow, Farr and Virchow began to question the bio-centricism of medical thought and highlighted the environmental and economic factors as responsible for the occurrence of certain kinds of diseases in certain kinds of populations. The sanitary movements in England in the late nineteenth century and the discussions on economic causation of disease (relating disease with poverty) are instances of the impact of methodological holism on epidemiology. The entire shift of focus in epidemiological studies from the population to an individual, from social, economic and natural environmental factors of disease aetiology to behavioural and bio-chemo-physiological factors of disease aetiology, is part and parcel of the shift in the philosophical paradigm from methodological holism to methodological individualism. In medical sociology, the prominent figures included Talcott Parsons, Evert Hughes, Robert Merton and August Hollingshead. Medical sociology can be described as the study of social factors in health and illness (referring to illness as the experience of becoming and being ill and its behavioural counterparts) or as the construction of medical health and illness, reality and social factors in health care. Unfortunately, it has restricted itself to ‘theories of middle range’ and to even narrower hypotheses, which in the last few years have tended to hide behind the pretentious concept of ‘models’. Medical sociology then becomes a mere instrument of propaganda for the welfare state or a producer of ideologies, as formulated by the German sociologist Lepsius. In health psychology, the impact of methodological individualism has been overwhelming, manifesting itself in the form of behaviourism. Behaviourism has been the most instrumental force in structuring the cult of ‘victim blaming’ in public health.