American Medical Sociology and Health Problems in the Global South

COVID-19 has focused global attention on disease spread across borders. But how has research on infectious and noncommunicable disease figured into the sociological imagination historically, and to what degree has American medical sociology examined health problems beyond U.S. borders? Our 35-year content analysis of 2,588 presentations in the American Sociological Association’s (ASA) Section on Medical Sociology and 922 articles within the section’s official journal finds less than 15 percent of total research examined contexts outside the United States. Research on three infectious diseases in the top eight causes of death in low-income countries (diarrheal disease, malaria, and tuberculosis [TB]) and emerging diseases—Ebola, Middle East Respiratory Syndrome (MERS), and Severe Acute Respiratory Syndrome (SARS)—was nearly absent, as was research on major noncommunicable diseases. Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) received much more focus, although world regions hit hardest received scant attention. Interviews suggest a number of factors shape geographic foci of research, but this epistemic parochialism may ultimately impoverish sociological understanding of illness and disease.

The Nexus of Physical and Psychological Pain: Consequences for Mortality and Implications for Medical Sociology

Although physical pain lies at the intersection of biology and social conditions, a sociology of pain is still in its infancy. We seek to show how physical and psychological pain are jointly parts of a common expression of despair, particularly in relation to mortality. Using the 2002–2014 National Health Interview Survey Linked Mortality Files (N = 228,098), we explore sociodemographic differences in the intersection of physical and psychological pain (referred to as the “pain–distress nexus”) and its relationship to mortality among adults ages 25 to 64. Results from regression and event history models reveal that differences are large for the combination of the two, pointing to an overlooked aspect of health disparities. The combination of both high distress and high pain is most prevalent and most strongly predictive of mortality among socioeconomically disadvantaged, non-Hispanic whites. These patterns have several implications that medical sociology is well positioned to address.

Sociology and psychology in public health

The disciplines of sociology and psychology differ in interesting ways but they also have common links both conceptually and methodologically. They differ in overall scope: psychology typically focuses on the individual while sociology examines the individual’s social action (agency) and the community’s sociocultural, economic, political, and physical context (structure) within which they live, interact, work, and play. One important similarity between sociology and psychology is that both disciplines have a dedicated subfield for the study of health and illness. These subfields are, respectively, health sociology (also known as medical sociology) and health psychology. Thus, in line with the objective of this volume, the focus of this chapter is on the contributions to public health by health sociology and health psychology, the two subfields most relevant to public health.

‘Health paradox’ and former Soviet Union immigrants: towards an integrated theoretical framework

This study examines the critical mechanisms explaining the health outcomes of such understudied social group as immigrants from the former Soviet Union (FSU), including Ukraine, Russia, and Belarus, among other countries. Literature on the ‘health paradox’ suggests that immigrants from various countries enjoy better health than their native-born counterparts. Importantly, however, this trend does not seem to exist among FSU immigrants, especially those residing in the United States. In addition, while research studies find that socioeconomic status (SES) is the fundamental cause of health and illness among native-born individuals, higher SES does not appear to be the health-protective factor among the FSU group, likely due to their unique experiences and beliefs. Consequently, a new model is necessary to provide a more nuanced explanation of health outcomes of immigrants from FSU countries. Drawing on medical sociology and epidemiology literature, first, this paper outlines unique factors that explain health of FSU immigrants and argues that particular attention should be paid to acculturation, its sources, and the mechanisms through which it affects health. Specifically, differential levels of acculturation shape the degree to which FSU immigrants engage in risky behaviours, hold unique beliefs, access health care, and cope with stressors, which, in turn, influences their physical and mental health. Second, hypotheses are proposed based on the new model to be tested by future studies and third, unique interactive effects on health outcomes are discussed including such factors as SES, gender, country of origin, and other social structural factors. Overall, this paper contributes theoretically to medical sociology, epidemiology, social psychology, and global studies by outlining the novel model conceptualizing immigration and health relationships among one of the fastest-growing immigrant groups in contemporary society.

A legacy of silence: the intersections of medical sociology and disability studies

Disability remains on the margins of the social sciences. Even where disability is foregrounded as a category of analysis, accounts regularly emerge in silos, with little interdisciplinary dialogue acknowledging the potential intersections and points of convergence. This discord is particularly acute within medical sociology and disability studies, yet there is mostly a legacy of silence about the relationship between the two disciplines. Drawing upon data from a qualitative study with parents of disabled children in the UK, I show the value of meshing ideas and tropes from medical sociology and disability studies to make sense of parents’ lived experiences. They described the challenges of living with 'impairment' and a need to readjust expectations. At the same time, parents were keen to not align with a deficit framing of their lives. They talked in affirmative terms about their children as sources of joy and vitality, perceived themselves as ‘normal’, and described convivial, even unremarkable, interactions in public spaces. Yet, parents encountered difficulties when navigating institutional settings and bureaucratic arrangements, or what was commonly referred to as ‘the system’. Their troubles were not located in their children’s bodies, but in—as per a disability studies sensibility—cultural and structural systems preventing their capacity to live well. I argue that both disability studies and medical sociology offer something to the analysis, thereby recognising the gains of not simply buying into the tradition of one worldview. I conclude by imploring for more concrete conversations between both disciplines.

Uncertain and under Quarantine: Toward a Sociology of Medical Ignorance

At the center of the COVID-19 pandemic lies a ubiquitous feature of medicine. Medicine is permeated with ignorance. Seizing this moment to assess the current state of medical sociology, this article articulates a sociology of medical ignorance. We join insights from earlier medical sociological scholarship on uncertainty with emerging research in the sociology of ignorance to help make sense of the omnipresent but sometimes invisible dynamics related to the unknowns in medicine. Then we examine two streams of inquiry with a focus on uncertainty and ignorance—(1) research on the interconnections between technology, medical authority, and ignorance and (2) research on lay expertise within the context of ever-present uncertainties. For decades, and to good effect, medical sociologists have asked, “What does medicine know, and what are the consequences of such knowing?” Going forward, we encourage medical sociologists to examine the unknown in medicine and the consequences of not knowing.

Evaluating the Continued Integration of Genetics into Medical Sociology

The 2010 special issue of Journal of Health and Social Behavior, titled “Fifty Years of Medical Sociology,” defined the contours of the medical sociological perspective. We use this as a backdrop to outline and assess the continued integration of genetics into medical sociology research. We contend that the explosion of genetic and epigenetic data in population health data sources has made the medical sociological perspective increasingly relevant to researchers outside of sociology, including public health, epidemiology, and quantitative genetics. We describe vast, underappreciated, and mostly unsolved challenges that limit the scientifically appropriate interest in incorporating genetics into existing paradigms. It is our hope that medical sociologists continue this integration but redouble efforts to maintain the core insights in social science research, such as the importance of environmental and structural (i.e., nonbiological) factors in determining health processes and outcomes and the use of rich, integrated, and rigorous empirical analyses.