An Introduction to the Sociology of Health and Illness

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AN INTRODUCTION TO THE SOCIOLOGY OF HEALTH AND ILLNESS Kevin White London: Sage, 2002, x + 196 pp., $55.95 (paperback).

This book's strength comes from Kevin White's keen interest in the history of medicine and philosophy of science. White insists that trends in medical knowledge and practice are shaped as much by political, economic and socio-cultural forces as by objective discoveries of the biological and clinical epidemiological sciences; the corollary of which is, as Ray Fitzpatrick says on the back cover, 'health and illness are products not just of our biology but of the society in which we are born'.

Of eight main chapters, three use history as their organizing principle, three introduce Marx, Parsons and Foucault, and two focus on gender and ethnicity. 'The Social Construction of Medical Knowledge' (Chapter 2), combines ideas from B.S. Turner, Fleck, Foucault and Kuhn. Readers of White's earlier work, especially his tour de force--the 1991 overview of 'The Sociology of Health and Illness' in Current Sociology--will be familiar with the essential arguments; and pleased to see fresh examples from medical history and today's health issues.

In Chapter 3 White shows how the sociology of health has evolved out of a sociology sympathetic to medicine into a sociology highly critical of medicine. He gives arresting examples of the medicalization of deviance--stories of 'drapetomania' from 19th-century America, of pathological gambling and alcoholism in the 20th century, through to the medicalization of everything, even old age.

'Postmodernity, Epidemiology and Neo-Liberalism' (Chapter 4) begins with a typology contrasting industrial and postmodern societies and the changing forms of the state, inequality, economy, politics and policy. The early social epidemiologists of industrial Britain blended statistical data with richly qualitative insights to explain the links between workers' exploitation, poverty and disease; but clinical epidemiology developed into an increasingly individualistic tradition aligned with neo-liberal ideas of consumer capitalism and the winding back of the welfare state. White argues that the current preoccupation with building 'social capital' is as much conservative reaction to the stresses of postmodern life as it is a deflection from its material inequalities.

It's tempting to describe Chapters 5, 6 and 7 as standard treatments of Marx, Parsons and Foucault in relation to health, medicine and the body. It's true that their central concepts and their applicability to the field of health are substantial and persuasive. In the main these chapters are intellectually rigorous, and in places strikingly profound; yet there are obscure statements, repetition of theory and complex, contradictory argumentation. …