subfield is as broad as sociological social psychology itself, encompassing interactionist analyses of self and identity in illness (Charmaz 1991), experimental studies of the health implications of small group processes (Taylor 2016), and multilevel analyses of the social determinants of health (House 2002). What distinguishes research in this subfield from descriptive Social Epidemiology is its emphasis on process (i.e. how outcomes are accomplished) and on subjective experience. Process and subjectivity are relevant to a range of topics, encompassing the onset and course of illness and disease, and individual and social responses, including help-seeking. The Social Psychology of Health and Illness can also be contrasted with health psychology (Taylor et al. 1997). Much like the distinction between sociological and psychological social psychology, the fundamental difference is defined by the primacy given to the analysis of social arrangements versus individual dispositions.
While research in the Social Psychology of Health and Illness draws inspiration from diverse theoretical traditions, among the most common orienting concepts are stress, identity, and stigma. The stress process framework and its constituent concepts (stressors, social support, and coping) provide explanations for health inequalities inasmuch as social groups differ in their exposure to stressors and their access to resources for managing stress (Aneshensel 1992; Pearlin 1989; Turner et al. 1995). Identity processes have been invoked to analyze variation in stress responses. For example, research shows that racial/ethnic identity can moderate or buffer the association between discrimination and health (Mossakowski 2003; Sellers et al. 2003). Identity processes have also been shown to have broader application in studies of how self and identity change in response to illness (Charmaz 1983). Stigma responses become incorporated into illness identities, shape the course of illness, and influence decisions about help-seeking (Pescosolido et al. 2008).
Because of its breadth, studies in this subfield defy easy categorization. Studies can address a broad range of topics. They can be quantitative or qualitative; based on surveys, interviews, or experiments. We offer two examples that illustrate the breadth, as well as the common elements, of research in the Social Psychology of Health and Illness.
Carr and colleagues (2017) used data from the Disability and Use of Time supplement from the Panel Study of Income Dynamics to evaluate the extent to which marital/partner strain and support moderate the association of disability with emotions among older adults, and whether those patterns differ by gender. They found that relationship support helps to protect women with severe impairment from feelings of frustration, sadness, worry, and negative mood, but the same support was associated with heightened distress for men, perhaps because men find support threatening to their sense of competence. The buffering effects for women suggest that emotional support may foster positive reinterpretations of disability and provide emotional resources to manage adjustments to roles and activities. This study exemplifies the Social Psychology of Health and Illness in that it uses social psychological concepts to shed light on health-related processes while also yielding insight into the social psychology of gender.
In a very different study, Kaiser (2008) analyzed in-depth interviews of women with breast cancer to explore how they interpret and use the survivor identity. She observed that, although some women embraced the identity, others rejected it. Women who rejected the identity cited fear of recurrence, not being sick enough to justify the label, and discomfort with the implied social identity as reasons for the rejection. Kaiser (2008) concluded that cultural images of cancer survivorship can be alienating and distressing to some women with cancer. By applying the concept of identity to the cancer illness experience, Kaiser (2008) highlights the centrality of the self to the experience of illness and to treatment responses.
Although different in their theoretical underpinnings and methodological approaches, these two studies are nevertheless related through their use of social psychological concepts to analyze the processes through which social conditions produce health and illness and the individual and social responses that follow. Both show how structural arrangements and cultural beliefs shape proximate life experiences and, finally, health.
Sociology of Medicine
The term “Sociology of Medicine,” as previously noted, refers to half of Straus’s (1957) original two-subfield model. The term is still appropriate for the broad subfield that takes medicine and its various activities pertaining to health and illness as an object of study. The Sociology of Medicine is characterized as research and analysis of the medical or health environment from a sociological perspective (Broom et al. 2013; Cockerham 2017; Straus 1957). The most relevant language from the Committee on Certification in Medical Sociology (1986) that pertains to the Sociology of Medicine today is that it covers “medical occupations or professions and the organization, financing, and delivery of medical care services; medicine as a social institution and its relationship to other social institutions; cultural values and societal responses with respect to health, illness, and disability.”
Initially, the Sociology of Medicine encompassed the Social Psychology of Health and Illness and those facets of Social Epidemiology pertaining to the effects of social structures on health – essentially everything except sociological work that occurred within medical and health-related institutions (i.e. Sociology in Medicine). With the emergence of these other subfields as distinctive entities in medical sociology, the Sociology of Medicine is now primarily centered on issues linked with health care delivery and health care experiences, medical knowledge, and health social movements, including social inequality, social institutions, and health policy/law.
In its original conception, the Sociology of Medicine was centered in university sociology departments and characterized as “academic” rather than “applied” because of its grounding in sociological theory. This is the subfield where theory originated with Parsons’ sick role and where theory has been closely identified in medical sociology. Although other subfields, particularly Social Epidemiology and the Social Psychology of Health and Illness, consistently test theories of health causation, Sociology of Medicine applies a broader range of sociological theories related to structure, culture, and social institutions. For example, social epidemiological research on structural health inequalities by race, class, and gender can spill over into the Sociology of Medicine when those disparities are linked to inequitable distributions of health insurance and health care within institutions of medicine (Lutfey and Freese 2005).
The Sociology of Medicine is perhaps best represented by the emergence of research on medicalization (Conrad 1992), pharmaceuticalization (Abraham 2010), biomedicalization (Clarke and Shim 2011), and health-related social movements (Brown et al. 2013). For example, Conrad’s work on medicalization has uncovered the role of the medical profession in defining previously non-medical problems in medical terms, usually as an illness or disorder requiring a medical intervention. Conrad and others subsequently found that the forces driving medicalization have shifted to include biotechnology (Clarke and Shim 2011), patients and consumers (Barker 2002; Brown et al. 2001), and mass media advertising and the profit incentives in managed care systems (Conrad and Leiter 2004). Such critical perspectives on the roles of capitalism and social control in health care is one of the Sociology of Medicine’s most important contribution to Medical Sociology.
Sociology in Medicine
Sociology in Medicine is the subfield of medical sociology primarily focused on applied research within institutions of medicine, with substantive focus on medical treatment, health professions, and the marketing of health care (Broom et al. 2013; Cockerham 2017; Straus 1957). The sociologist in medicine is one who collaborates directly with physicians and other health personnel in studying the social factors that are relevant to addressing problems in health care settings. The work of the sociologist in medicine is intended to be directly applicable to patient care or to solving issues related to public health. In these ways, Sociology in Medicine can be characterized as applied research and analysis that is more motivated by medical problems than sociological problems. Sociologists in medicine
