The cultural construction of illness (2022)

The cultural construction of illness (1)

There are two realities to any illness. One is a medically observed event that happens to the human body, the other a mass of culturally relative assumptions that affect how we make sense of that event. On the one hand, for example, is the metastasising of cells and the various treatments used to halt cancer, on the other the stories of bravery and the status of ‘survivor’ that our culture readily attaches to people recovering from the condition.

These latter stories are culturally and historically constructed, although we frequently mistake them for being natural or ‘just the way things are’. For example, in the 21st century TB is seen exclusively as an appalling condition linked with poverty, whereas in the early 19th century, fashionable metropolitans tried to cultivate a pleasingly pale and ‘consumptive’ appearance, driven by the perception of a link between tuberculosis and creativity.

We may think that we’re too smart to fall for this kind of thing today, but in fact it’s hard for anyone to avoid interpreting illness according to the norms of their culture. Those norms are different today than they were in the 19th century, but can obscure the experience of having or treating many kinds of illness just the same.

Why is this important? Put simply, not seeing beyond the dominant constructions can prevent us from developing messaging that is sufficiently credible, salient and distinctive. Here’s a characteristic example of how this can work.

Cultural bias cannot be avoided

Some years ago, we were asked to advise on marketing a cure for migraines in the UK. As we analysed communications by brands in the sector, it was remarkable how consistently migraines was represented as something which overtook women, rendering them helpless, even hysterical, until brought back into normative living by whatever treatment was being promoted. Perhaps unsurprisingly, the treatments themselves were represented as sober, male and commanding.

(Video) The Social Construction of Health and Illness

Two things became clear. Firstly, that most brands in the category were - probably unconsciously - conforming to the cultural idea of migraines as a woman’s problem and to an increasingly outmoded understanding of what that might mean. In this world, migraines were associated with ideas of the overly sensitive, or even hysterical woman, requiring rational male intervention to bring her back to her senses. There was even a sense that migraines weren’t a particularly serious condition - its role in popular comedy as an excuse given for refusing sex and its roots as a term used to describe a whim or a fancy (‘megrim’) all contributed to this.

Secondly, it was clear there was an opportunity for a brand to construct a different understanding of migraines, based on more self-determining ideas of womanhood, while representing the misery of the condition more respectfully. The brand communications developed as a result of these recommendations were highly successful and helped to evolve the way in which the condition is now marketed.

This was a case of a category unable to see beyond a certain cultural construction of the condition it was in the business of treating, something it took for granted that many of our clients weren’t even aware of.

Pharma is stuck in a rut

Although this project happened a few years ago, it’s telling that as we continue to work with pharmaceutical brands, many stories and ideas of illness recur across conditions. Some of these can be positive and lead to very effective communications, but many are habits that marketers can fall into and that prevent new and compelling ways of communicating from being developed.

Here are some examples:

We can be heroes

(Video) Soc 218 The Social Construction of Illness

It’s an obvious option to portray people with a serious condition as heroes confronting a formidable enemy; serious illness tends to be experienced as a catastrophe and we see plenty of messaging that plays on this using imagery of warfare (‘my battle against…’, ‘overcoming the challenge of…’, ‘I won’t give up fighting…’). It also presents the person with the condition as having individual agency and independence, all of which are highly valued by our culture.

This can be impactful - particularly for younger people - but it’s interesting how much this taps into a general cultural narrative of heroism which doesn’t have that much to do with illness. The result can be dramatic or even exciting, but also disconnected from the reality of illness as experienced by patients, carers and medical professionals.

In our work we’ve observed that, just as our culture is increasingly sceptical about medical products having heroic properties, so it’s starting to question the representation of people facing serious illness as heroes.

How does this account for the day-to-day experience of having a disease? Doesn’t it place an unrealistic expectation on the person with the condition?

To really connect with patients and professionals, brands need to find ways of avoiding both the negative associations of the victim and the overly positive associations of the hero.

Health always means harmony

Because illness is so strongly associated with disharmony in our culture, there’s a tendency to construct the return to health as always harmonious and calm. While this might be what many people aspire to, it can also inhibit strong depictions of how pharma products work to return people to health.

(Video) Class Power and the Social Construction of Health and Wellness

We’ve lost count of the times we’ve seen ‘recovery’ depicted as someone doing yoga on a beach or as the metaphor of a butterfly or a flower. These are clichés of course, but they also represent the deep-rooted cultural need to see the return to health as a kind of calm resolution.

It’s interesting to see the success you can have when you break these cultural conventions. Health can also be credibly constructed as messy and chaotic, joyful and engaged or even angry and defiant.

We once worked with a team marketing a product for people with HIV. Their advertising was failing to cut through and it became clear to us that one of the reasons for this was its depiction of happy, calm people living with HIV, but always depicted on their own. When the advertising was evolved to depict these people spontaneously playing with their children in messy, realistic homes or at the heart of social occasions, the uplift was substantial.

Moving away from the idea of the calm and settled individual as the signifier of health was the breakthrough here - finding an alternative but equally salient cultural construction helped move the brand on.

The necessity of taboos

We live in a culture that increasingly prides itself on being liberal and not squeamish when it comes to describing the workings of the body. It’s surprising, then, how we still use the constructions of taboos and euphemisms to represent certain conditions that are viewed as particularly sensitive or shaming.

Of course, it’s essential to show respect, sensitivity and compassion in marketing communications - but it’s also true that openness and black humour can create common currency between pharmaceutical brands and those purchasing them, just as it unites many people in patient support groups.

(Video) Lecture 06 The Social Construction of Illness and Medicine 3 February 2015

Work we conducted on COPD (Chronic obstructive pulmonary disease) in the US demonstrated this. There was an assumption among many people working in the category that the nature of COPD needed to be played down. It was too unpleasant and, since it tended to be linked to lifestyle, there was a perceived element of guilt and shame.

Through analysis of the language used by people with the condition when discussing it online, or by celebrities who lived with it, another picture emerged. Black comic imagery of ‘the elephant that jumps on my chest’ and a ‘you only live once, no regrets’ approach to past lifestyle choices were common. When this kind of language was incorporated carefully into advertising, the response was very positive from those with the condition and physicians alike.

The sense that the experience of having the condition was being more authentically portrayed was seen as empowering. The previous assumption that it needed to be talked about in terms of euphemism and that realistically representing it was too much, possibly reflected the cultural assumptions of the marketers more than the patients.

Embedding in culture to empower

Understanding how particular illnesses are culturally constructed is essential work for anyone in pharmaceutical marketing. It both reveals some of the assumptions getting in the way of developing better messaging and helps create better, more humane constructions that in turn can drive more effective campaigns that can help consumers cope more easily with their illnesses.

Those pharmaceutical marketers that frame communications around particular drugs and illnesses when selling to healthcare professionals can do more than improve sales of their drugs. Indeed, if done properly, this approach helps pharma companies to demonstrate their commitment to transforming people’s lives. Talking in terms of cultural constructs helps pharma reps educate healthcare professionals on the best way to talk to patients, their families and the wider public. In turn, this helps consumers to better understand how to deal with their condition and use the available drugs more effectively, which can significantly improve the length and quality of their lives which, ultimately, is what every pharma company is aiming for.

FAQs

What does it mean to say that illness is socially constructed? ›

What does it mean to say that an illness is socially constructed? Some illness are deeply embedded with cultural meaning that shapes how society responds to those afflicted and influences the experience of that illness.

Why is it important to study the social construction of illness? ›

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.

What do some cultures believe that illness is caused by? ›

Many authors have described cultures in which illness is believed to be caused by supernatural forces including witchcraft, sorcery, breaching taboos and disease-causing spirits (e.g., [22–25]). Supernatural explanations also dominated the discourse of ill-health causation in our study.

What factors play significant roles in terms of constructing the illness experience? ›

In terms of constructing the illness experience, culture and individual personality both play a significant role. For some people, a long-term illness can have the effect of making their world smaller, more defined by the illness than anything else.

What does it mean to say that illness is a social construction and a moral status? ›

Illness results from a combination of social and biological causes. Moral Status: Is a social condition that we believe indicates the goodness or badness, worthiness or unworthiness, of a person. From a sociological perspective, illness is not only a moral status but also a form of deviance. Deviance.

What is the meaning of social construction? ›

Briefly, social construction (SC) assumes that people construct (i.e., create, make, invent) their understandings of the world and the meanings they give to encounters with others, or various products they or others create; SC also assumes that they do this jointly, in coordination with others, rather than individually ...

How could the social construction of illness help us understand hypochondria? ›

Hypochondria: health anxiety, is worrying excessively that you are or may become seriously ill (Mayo Clinic). For people who suffer from health anxiety, the social construction of illness offers a diagnosis, different perspective/outlook, another answer to symptoms, a second opinion, etc.

Is health a cultural construct? ›

The ideas of illness and health are socially constructed within each society of every culture. These common terms cover a diverse range of connotations for which there has been no general agreement over their meaning.

How does social construction affect health? ›

The social construction of the illness experience deals with such issues as the way some patients control the manner in which they reveal their diseases and the lifestyle adaptations patients develop to cope with their illnesses.

How does culture influence health and illness? ›

The influence of culture on health is vast. It affects perceptions of health, illness and death, beliefs about causes of disease, approaches to health promotion, how illness and pain are experienced and expressed, where patients seek help, and the types of treatment patients prefer.

How does culture relate to people's perceptions of illness WHy would some cultures regard some illnesses as normal? ›

How does culture relate to people's perceptions of illness? WHy would some cultures regard some illnesses as normal? Some illness are very common in certain cultures, and they have never had the access to treatment and prevention, therefore these illnesses are seen as normal, and just a part of culture.

What are the cultural practices that affect health? ›

These include initiation, birth and death rites; arranged marriages, female genital mutilation, circumcision and various iterations of cleansing rituals associated with the body and mind.

What is the cultural construction of illness? ›

There are two realities to any illness. One is a medically observed event that happens to the human body, the other a mass of culturally relative assumptions that affect how we make sense of that event.

What is cultural construction? ›

Thus, cultural co-construction refers to the process related to gaining shared understanding and constructing interventions, whereas the static terms refer to the products of co-construction (i.e., culture-specific intervention program; see also, Nastasi & Hitchcock, 2016.

What is construct culture? ›

Culture is a dynamic construct that changes over time, through generations of life experiences. For example, the term 'Values active enough to influence...'10 has been used to emphasise how traditions may influence contemporary world views, but values and beliefs evolve and change from one generation to the next.

What is an example of social construct? ›

Simply put, social constructs do not have inherent meaning. The only meaning they have is the meaning given to them by people. For example, the idea that pink is for girls and blue is for boys is an example of a social construct related to gender and the color of items.

How is our perception of health socially constructed? ›

Your understanding of perceptions of health as social constructs should identify that an individual's interpretation of health is largely influenced by their: socioeconomic status (education, employment, income), sociocultural status (family, peers, media, religion, culture), and environment (geographical, political, ...

Why is culture important in healthcare? ›

Why Is Cultural Respect Important? Cultural respect is critical to reducing health disparities. It helps improve access to high-quality health care that is respectful of and responsive to the needs of diverse patients.

What are the factors affecting health and illness? ›

There are many different factors that can affect your health. These include things like housing, financial security, community safety, employment, education and the environment. These are known as the wider determinants of health.

What are cultural influences examples? ›

Attitude and Behaviours Influenced by Ones Culture:
  • Personality i.e. sense of self and society. ...
  • Language i.e. communication.
  • Dress.
  • Food habits.
  • Religion and religious faiths that is beliefs. ...
  • Customs of marriages and religions and special social customs.

How does culture influence modes of pain and suffering? ›

This depends on factors such as whether their culture values or disvalues the display of emotions, postural mobility or verbal expression in response to pain or injury. Some cultural groups expect an extravagant display of emotion in the presence of pain, but others value stoicism, restraint and playing down the pain.

How does culture affect communication in healthcare? ›

Outcomes associated with the use of culturally sensitive communication include increased patient and family satisfaction, improved adherence to treatment regimens, better engagement in patient and family centred care and improved health outcomes (Betancourt et al., 2014).

How religious and cultural values can affect health care? ›

The challenge for health professionals is in understanding that patients often turn to their religious and spiritual beliefs when making medical decisions. Religion and spirituality can impact decisions regarding diet, medicines based on animal products, modesty, and the preferred gender of their health providers.

How do cultural differences affect health care? ›

Culture influences healthcare at all levels, including communications and interactions with doctors and nurses, health disparities, health care outcomes, and even the illness experience itself. People in some cultures believe illness is the will of a higher power, and may be more reluctant to receive health care.

What is culture in health care? ›

Culture can be defined as the “personal identification, language, thoughts, communications, actions, customs, beliefs, values, and institutions that are often specific to ethnic, racial, religious, geographic, or social groups.”For both patients and providers, healthcare is defined through a cultural lens.An ...

What are some examples of cultural barriers in healthcare? ›

These include family roles, body language, concept of justice, notions of modesty, core values, family values, beliefs and assumptions, rules of conduct, expectations, gestures, and childrearing practices, all of which have been shown to influence our perception and approaches to health and medicine.

What does it mean to say that illness is socially constructed Inquizitive? ›

What does it mean to say that illness is socially constructed? The identification of a condition or activity as symptomatic of an illness varies by culture.

What is a social construct example? ›

Simply put, social constructs do not have inherent meaning. The only meaning they have is the meaning given to them by people. For example, the idea that pink is for girls and blue is for boys is an example of a social construct related to gender and the color of items.

What is the central message of postmodernism? ›

Postmodernism rejects the common origin of humans just as it rejects any constant and definite truth in ontology topics. They believe that human identity is constructed by national and local culture and is specifically influenced by three key cultural features of gender, social class, and race.

Which of the following points might a sociologist make against Damore's argument? ›

Which of the following points might a sociologist make against Damore's argument? -Employees are more likely to take on the characteristics ascribed to their jobs than to fit into jobs by reason of the job requirements.

When people refuse to hire highly qualified people of a different race and instead hire a less qualified applicant who is of their own race it is called? ›

When people refuse to hire highly qualified people of a different race and instead hire a less-qualified applicant who is of their own race, it is called. discrimination.

How is culture socially constructed? ›

By living together in society, people “learn specific ways of looking at life” (Henslin 2011:104). Through daily interactions, people construct reality. The construction of reality provides a forum for interpreting experiences in life expressed through culture.

How does social construction affect us? ›

Social Constructs Can Change

Humans can alter the construct as they continue to interact with the world. Attitudes toward those of different skin colors have changed over the last 100 years and they continue to change. The construct of race still exists, but what the construct means has changed.

What are the 3 stages in the social construction? ›

Burger and Luckmann (1966) argue that social construction works in three stages, externalization, objectification, and internalization.

Videos

1. Lay beliefs about #health and #Illness (#Medical #Sociology)
(Maryam Parvez -Clinical Psychologist)
2. Health & Medicine: Crash Course Sociology #42
(CrashCourse)
3. Health as a social construct
(pdhpe.net)
4. Sociological Imagination
(Sociology Live!)
5. Social Determinants of Health - an introduction
(Let's Learn Public Health)
6. Episode 7 - Pathologies of the postmodern - Professor Patricia Waugh
(cafeculturene)

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