http://hsb.sagepub.com/ The Social Construction of Illness : Key Insights and Policy Implications Peter Conrad and Kristin K. Barker Journal of Health and Social Behavior 2010 51: S67 DOI: 10.1177/0022146510383495 The online version of this article can be found at: http://hsb.sagepub.com/content/51/1_suppl/S67
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The Social Construction of Illness: Key Insights and Policy Implications Peter Conrad1 and Kristin K. Barker2
Journal of Health and Social Behavior 51(S) S67–S79 © American Sociological Association 2010 DOI: 10.1177/0022146510383495 http://jhsb.sagepub.com
Abstract The social construction of illness is a major research perspective in medical sociology. This article traces the roots of this perspective and presents three overarching constructionist findings. First, some illnesses are particularly embedded with cultural meaning—which is not directly derived from the nature of the condition—that shapes how society responds to those afflicted and influences the experience of that illness. Second, all illnesses are socially constructed at the experiential level, based on how individuals come to understand and live with their illness. Third, medical knowledge about illness and disease is not necessarily given by nature but is constructed and developed by claims-makers and interested parties. We address central policy implications of each of these findings and discuss fruitful directions for policyrelevant research in a social constructionist tradition. Social constructionism provides an important counterpoint to medicine’s largely deterministic approaches to disease and illness, and it can help us broaden policy deliberations and decisions. Keywords social construction, illness, medical knowledge, health policy
In the last 50 years, the social construction of illness has become a major research area in the subfield of medical sociology, and it has made significant contributions to our understanding of the social dimensions of illness. In this article we briefly trace the roots of a social constructionist approach to illness, and we present some of the key findings of social constructionism organized under three themes: the cultural meaning of illness, the illness experience as socially constructed, and medical knowledge as socially constructed. In addition, we address central policy implications of these findings and fruitful directions for policy-relevant research in a social constructionist tradition. Social constructionism is a conceptual framework that emphasizes the cultural and historical aspects of phenomena widely thought to be exclusively natural. The emphasis is on how meanings of phenomena do not necessarily inhere in the phenomena themselves but develop through interaction in a social context. Put another way, social constructionism examines how individuals and
groups contribute to producing perceived social reality and knowledge (Berger and Luckman 1966). A social constructionist approach to illness is rooted in the widely recognized conceptual distinction between disease (the biological condition) and illness (the social meaning of the condition) (Eisenberg 1977). Although there are criticisms and limitations of this distinction (Timmermans and Haas 2008),1 it is nevertheless an exceedingly useful conceptual tool. In contrast to the medical model, which assumes that diseases are universal and invariant to time or place, social...