infectious diseases described earlier in this preface for its emphasis on COVID-19 and the other (Chapter 22) by Alexandra C. H. Nowakowski (Florida State University College of Medicine) is on chronic illness. As someone who has experienced a chronic illness over her life course, Nowakowski brings an insightful and personal view to this chapter.
The final section is Part VI on health care delivery. It begins with a chapter by rising scholars Jason Adam Wasserman (Oakland University Beaumont School of Medicine) and Brian Hinote (Middle Tennessee State University) on health professions and occupations. Hinote and Wasserman are co-authors of Social and Behavioral Science for Health Professionals. Another rising scholar is Hyeyoung Oh Nelson (University of Colorado-Denver), who analyzes the doctor-patient relationship in Chapter 24. Eeva Sointu (York St. John University, UK), who has extensively researched complementary and alternative forms of medicine, provides a chapter (Chapter 25) on that topic.
Part VI concludes with chapters on the health care systems of the US, the UK, and China – three important countries in health affairs. Chapter 26 is by Bernice Pescosolido (Indiana University) and Carol Boyer (Rutgers University), who contribute a chapter on the American health care delivery system. The chapter explores the current vortex of health care reforms, problems of access, and costs pertinent to the ongoing legal, legislative, and political disputes taking place in American society. Pescosolido is Distinguished and Chancellor’s Professor of Sociology at Indiana University and Founding Director of the Indiana Consortium for Mental Health Services Research (ICMHSR). She has served as Vice President of the American Sociological Association, received several awards in sociology and public health, and elected to the National Academy of Medicine. Boyer has had a distinguished career at Rutgers where she is former Associate Director of the Institute for Health, Health Care Policy and Aging Research, and a well-known medical sociologist.
Chapter 27 on the British health care system by Jonathan Gabe (Royal Holloway, University of London, UK) is next, and he brings us up-to-date on that country’s national health service and health issues. A noted scholar, he is a former editor of the journal Sociology of Health & Illness, past chair of the European Sociological Association’s Research Network on the Sociology of Health and Illness, past president of the International Sociological Association’s Research Committee on Health Sociology, and a Fellow of the Academy of Social Sciences in the UK. The book concludes with Chapter 28 on the Chinese health care delivery system by Lei Jin and Chenyu Ye of the Chinese University of Hong Kong. This chapter was written in difficult circumstances as Hong Kong was undergoing political protests at the time, and the Chinese University’s campus was closed because of COVID-19. Nonetheless, they contribute an excellent chapter on China, including efforts to cope with the pandemic.
Finally, I would like to thank the efforts of several people at Wiley Blackwell in Oxford who had an important role in the development and publication of this book. These include Justin Vaughan, Charlie Hamlyn, Richard Samson, Merryl Le Roux, and Clelia Petracca. Katie McIntyre at Birmingham-Southern College worked on the index. The first volume of this book originated in a conversation with Justin in a bar in New York City one warm and pleasant afternoon during a long-ago American Sociological Association meeting. This version continues the venture. And thanks again to my wife, Cynthia, for her loving support.
William C. Cockerham
Williamsburg, Virginia
1 Medical Sociology and Its Changing Subfields
TERRENCE D. HILL, WILLIAM C. COCKERHAM, JANE D. MCLEOD, AND FREDERIC W. HAFFERTY
The sociological study of health, illness, and healing systems in the US has expanded substantively and deepened theoretically over the past half century. While work in this area once fit under the single moniker of “Medical Sociology,” we now use a range of alternative labels (e.g. Sociology of Medicine, Sociology of Health and Illness, Sociology of Health, Illness, and Healing, Sociology of Health, Health Sociology) and definitions to describe the field. Some definitions highlight topic areas:
“Medical sociology is the study of health care as it is institutionalized in a society, and of health, or illness, and its relationship to social factors” (Ruderman 1981: 927).
“The sociology of health and illness studies such issues as how social and cultural factors influence health and people’s perceptions of health and healing, and how healing is done in different societies” (Freund et al. 2003: 2)
“Medical sociology focuses on the social causes and consequences of health and illness” (Cockerham 2017: 4).
Others emphasize different aspects of the sociological perspective:
“Medical Sociology is the subfield which applies the perspectives, conceptualizations, theories, and methodologies of sociology to phenomena having to do with human health and disease. As a specialization, medical sociology encompasses a body of knowledge which places health and disease in a social, cultural, and behavioral context” (Committee on Certification in Medical Sociology 1986).
“The most important tasks of medical sociology are to demonstrate and emphasize the important influence of cultural, social-structural, and institutional forces on health, healing, and illness…” (Weiss and Lonnquist 2016: 11).
“An approach that emphasizes using the area of health, illness, and health care to answer research questions of interest to sociologists in general. This approach often requires researchers to raise questions that could challenge medical views of the world and power relationships within the health care world” (Weitz 2017: 346).
The many labels and definitions that have been offered suggest a lack of consensus on defining medical sociology’s substantive scope and its most significant contributions to knowledge. Some suggest that it is “hard to find a comprehensible statement of what… medical sociology is” (Chaiklin 2011: 585). Others describe the field as a “loosely connected network of disparate subgroups” (Veenstra 2002: 748). This state of the field raises several fundamental questions. How can we characterize our field in a general and consistent manner? What are our contemporary disciplinary boundaries? What are our major subfields? In other words, who are we now, and what do we do?
In this chapter, we propose a disciplinary structure for medical sociology that attempts to answer these questions. By “disciplinary structure,” we mean a representative model of our major subfields as defined by topic areas, theoretical orientations, and significant contributions to the study of health. All sciences invariably reflect on these important issues and, in doing so, define their scientific orientation and boundaries in relation to other sciences, including, for example, medical sociology (Bloom 1986; Gold 1977; Petersdorf and Feinstein 1980; Straus 1957), medical anthropology (Saillant and Genest 2007), health psychology (Baum et al. 2011), and health economics (Pauly et al. 2012). Explicit disciplinary structures are one way to set disciplinary boundaries, mark accomplishments, and direct future efforts toward a cumulative science. Substantive topics and concepts alone are too granular to signify a field’s major organizing principles. As Zerubavel (1991) once pointed out, things become meaningful only when placed into categories, and the “islands of meaning” that are created in this process explain what matters to a particular social world (or in this case, medical sociology) and help to determine the nature of its social order (or field of knowledge). In short, it is through the process of classification that we establish our boundaries and identity and, by extension, distinguish ourselves from other fields within sociology and other disciplines concerned with health.
The identification of a disciplinary structure was once integral to the development of the field, as evidenced in Straus’s (1957) classic distinction between the sociology of medicine and sociology in medicine. Six decades have passed since Straus offered his structure, and we believe
