Thinking Sociologically-a sociological perspective to health and illness.

A sociological perspective to health and illness enables health problems to be viewed as social issues. This essay will describe the "sociological imagination" (Mills 1959 cited in Germov, 21) and outline the interrelated historical, cultural, structural and critical factors of which it is comprised. The journal articles, "Researching Aboriginal health: experience from a study of urban young people ' s health and well being" (Holmes, Stewart, Garrow, Anderson and Thorpe, 2002) and "Indigenous women ' s perceptions of breast cancer diagnosis and treatment in Queensland" (McMichael, Kirk, Manderson, Hoban and Potts, 2000), are both discussed as excellent examples of what a sociological perspective has to offer with respect to Indigenous health issues.

The "sociological imagination" asserts that people do not exist in isolation but within a larger social network. The social mind examines the relationships and patterns of behaviour that shape our society (Willis, 1993) and the distribution of health within it. This facilitates a connection to be made between "private troubles" and "public issues" (Mills 1959 cited in Germov, 21) and further enables health problems to be viewed as social issues (Germov, 2002).

Evan Willis (1999 as cited in Germov, 22) suggests that understanding the interrelated cultural, historical, structural and critical factors is the key to the sociological pursuit. A historical and cultural awareness involves examining how the past and culture have impacted upon a current health situation. Considering the structural factors entails understanding how the organisation and institutions of society and health influence peoples lives. Finally, the social mind will apply a critical awareness to determine what can be done to improve the current situation (Germov, 2002).

The Holmes et al. (2002) quantitative study aims to examine the high prevalence of health problems for Indigenous youth and the responsible social determinants. The study is a pertinent example of the application of the sociological imagination. Research revealed that the impact of colonisation, removal of children and "exploitation" of the Indigenous population for medical research, are significant historical factors accounting for the reticence of Indigenous youth to seek healthcare or even participate in this study (Holmes et al, 2002).

From a cultural view point, difficulty with language and differing cultural attitudes also contributed to this phenomena (Holmes et al., 2002). For example, participants expressed concern that health workers would not be able to understand their traditional priorities. The majority also feared they would be recognised by family members whilst seeking health care. This dissatisfaction with the way that health care is structured lead many participants to suggest a separate clinic for young people and was one of the critical suggestions put forward by Holmes et al. (2002).

McMichael et al. (2000) is also an excellent example of the sociological imagination. The article is a qualitative study of social, structural and personal factors among Indigenous women associated with breast cancer treatment and care. Research revealed that Indigenous women are reticent to attend screening clinics because historically, breasts are imbued with "social and cultural significance as symbols of womanhood, sexuality and nurturing "(McMichael et al., 2000).

From a structural perspective, geographic distance to treatment clinics accounted for the high prevalence of untreated cancer. McMichael et al. (2000) cited the cost of travel and treatment is far beyond the economic reach of the majority of the Indigenous population. Low socio-economic status has resulted in crowded living conditions, so women are reluctant to perform self examination for fear of being "caught" (McMichael et al.,2000).

McMichael et al. (2000) and Holmes et al. (2002) both came to the critical conclusion that health services for the Indigenous community requires substantial improvement. McMichael et al. (2000) suggests that outreach programs will improve education and inspire greater commitment to breast cancer prevention. Furthermore McMichael et al. (2000) and Holmes et al. (2002) were critical of the tendency within the modern medical profession to treat disease and illness as a biological process. Both articles cited the need for the Indigenous community to take a more active and participatory role in their own health and health care.

It is evident through studies such as those by McMichael et al. (2000) and Holmes et al. (2002), applying the "sociological imagination" (Mills 1959 cited in Germov, 21) is the key to improving health within the Indigenous population. By examining the interrelated historical, cultural, structural and critical factors impacting on society, we are able to better understand the inequitable distribution of health and seek to improve upon the society in which we live.

References

Germov, J., 2002, "Imagining Health Problems as Social Issues", in J. Germov, ed, Second Opinion: An Introduction to Health Sociology, 2nd edn, Oxford University Press, South Melbourne, pp. 3-27.

Holmes, Stewart, Garrow, Anderson, Thorpe, 2002, "Researching Aboriginal Health: Experience From a Study of Urban Young People ' s Health and Well-Being", Social Science and Medicine, vol. 54, pp. 1267-1279.

McMichael, Kirk, Manderson, Hoban, Potts, 2000, "Indigenous Women ' s Perceptions of Breast Cancer Diagnosis and Treatment in Queensland", Australian and New Zealand Journal of Public Health, vol. 24, no. 5, pp. 515-519.

Willis, E.,1993, The sociological quest, Allen and Unwin, St Leonards.

References: Germov, J., 2002, "Imagining Health Problems as Social Issues", in J. Germov, ed, Second Opinion: An Introduction to Health Sociology, 2nd edn, Oxford University Press, South Melbourne, pp. 3-27. Holmes, Stewart, Garrow, Anderson, Thorpe, 2002, "Researching Aboriginal Health: Experience From a Study of Urban Young People ' s Health and Well-Being", Social Science and Medicine, vol. 54, pp. 1267-1279. McMichael, Kirk, Manderson, Hoban, Potts, 2000, "Indigenous Women ' s Perceptions of Breast Cancer Diagnosis and Treatment in Queensland", Australian and New Zealand Journal of Public Health, vol. 24, no. 5, pp. 515-519. Willis, E.,1993, The sociological quest, Allen and Unwin, St Leonards.