Author: Andre Coleman

The research paper will briefly introduce the topic of research paper work specifically defining the key words. In the discussion part, the research paper will examine the reasons for high divorce rates in the military. The research will set out reasons for high divorce rate in the military especially those of marriage age, and the previous existence marriages. It will focus also on the race impacts upon marriage, which are the largest influences behind high divorce rate in the military. The paper will explain the sociological research findings, and sociological theoretical perspectives of high divorce rates in the military. The conclusion will finally summarize the causes of high divorce rates in the military basing them on sociological theoretical perspectives.

Introduction

Military people are those brave individuals employed by a government in the armed forces in order to take care of national security. Divorce is a final marital union termination, and cancelling a legal marriage duties and responsibilities, and dissolving matrimonial bonds between two partners. Research indicates that military men and women have high divorce rates in the military.

Discussion

There are wide ranges of cases in the last few decades that have risen within the marriage institution among the military populace. Early marriages leads to a short lasting period of familial stability than those enacted later on, in adulthood. An estimate of divorce rates shows that 48 percent of all initiated first marriages ends before a wife attains the age of 18 years. The first marriages of about 25 percent begin when female spouses attains at least 25 years old. Amongst divorce predictors, establishment of age at marriage is the most consistently indicative regardless of starting period of marriage (Hack, 2008). The issue of high divorce rates is a big question for the sociologists. Sociologists have studied vigorously in order to find direction and solid reasons that lead to high divorce rates in the military. There are more informed reasons and sociological theories attempting to explain the high divorce rates in the military (Crown and Karney, 2007).

The highest rate of divorce in the military branches continues to be a worsening statistic compared to other careers. Many causes contribute to it. Inadequate time spent with the family is the leading cause. This is because most military personnel spend little time with their families. Military men and women also undergo divorce problem because of a lot time spent out in a war thus lack adequate time for their loved ones. This makes their partners to move away from such marriage in search of the partners who are ready to stay with them every moment.

This contributes to another cause; poor communication. Families with poor or lack of communication, and those spending many hours in the work place have high chances of divorce. The spouses of military men and women have a tendency to become unfaithful when the former are far away from their families. When their partners discover this, they end up separating. More often than not, they finally end up filing divorce cases in the courts. With vital communication, military people can build solid block or lay well foundation basing on trust, loyalty, and love (Chall, 2001).

The work involved in military is hard and needs full dedication as well as devotion. Because of this, most military people get to deal with the stress in fighting, and defending their countries. They encounter problems in handling divorces especially when the spouses are not even within the same country they are serving. Most military people try to handle divorce related stress through counseling available from couples who have encountered problems of separation for long periods (Hack, 2008). Another thing that can help them to reduce divorces rate is by ensuring that before they engage and marry, they should be ready for commitment.

Strenuous jobs contribute to the increased rate of divorce. It is not only in the military divorce that the rates are rising up, but also in 50% of the couples doing strenuous jobs end up divorcing. The statistical research shows that the bigger percentages of married people working in the military have high divorce rates than other ordinary couples (Crown and Karney, 2007). In military, there is little time to rest and almost no time to socialize with family and friends. Therefore, military people should try to talk about their feelings with their families if they want to secure their marriages, and avoid chances of separation and divorce.

Place of women in the society theory attempt to define and explain the role of the female gender in the society. It details how they have violated their roles. The place of women in the society is nowadays changing and is leading to high divorce rates. The military is neither spared. The role of woman has undergone modification and has become manly. Women are no longer watchers of the house, cooks, or cleaners, but they do the same roles that men play. Men dominance is now fading because they compete with women in places of work, and in almost all fields in the economies (Chafetz, 2006).

The marriage question in the institution theory has it that social dynamics keeps on changing making marriage less meaningful than it was before. People no longer have respect to moral ideals. Mothers who are working nowadays are common in the military, and the marriage expectations are very different than they were, previously. It is no longer the responsibility of men to use their own income to support an entire family. This is because women can comfortably support them in household chores. Most communities have accepted this kind of changed arrangement. Therefore, divorce rates keeps on rising due to changes in the roles of women, especially those in the military (Sowers, 2006).

Conflict theory better explains various phenomena that occur in the military. The conflict perspectives focus on a wide range of things for instance drug abuse, and extra-affairs. Abuse and affairs are justifiable in some extents, and is the most obvious reason for high divorce rates in the military. It is understandable that couples would not like to live with someone who causes violence in the family. Many couples consider divorce especially when they do not want to stay in a miserable marriage. This have an even bigger impact on children especially when their parents fight in front of them and it worsens when parents divorce. Children may feel unsafe, or lack parental love when of the parents walks out of marriage.

Some military men abuse substances such as marijuana, cocaine, and laudanum thinking that they will make their minds function properly. These drugs finally end up causing addiction and the result is violence, or conflict in the family. The conflict theory attempts to refute the perspective of the functionalist explaining social problems in the military. This theory considers that a society function in order to ensure each group of persons play a certain role just like body organs (Sowers, 2006).

Stress factor can be an enormous cause of marital difficulties in the military. Research indicates that money factor especially limited financial income leads to divorce. This is quite evident among junior enlisted personnel with children, and those on long-term deployment. Many marriage counselors are of the notion that money is the root cause divorce in military marriages (Crown and Karney, 2007). Some say society itself contributes to divorce cases, but more value placed on individualism, self-expression, self-realization, and choice of personnel are the main causes of increasing military divorce. In financial cases especially among enlisted junior personnel, divorces often occur because of separation of couples for a long time on multiple occasions. These problems can reduce incase there is allowance of shorter deployment periods to limit marriage issues and to better family life (Karen, 2008).

Cultural theory traces back where early marriages were discouraged in the society. Research further indicates that, each year, cases of early marriages made between the ages of 15 to 19 are on the increase. Many young married couples often do not keep their original relationship together. High divorce in the military is increasing because of changes in the law. Over the decades, marriage institution earned respect, and there were rare divorce cases because it was illegal to divorce. Nowadays this has changed, and military people keep walking in and out of marriages because of non-restriction in marriage. Anybody can file cases of divorce if there are minor disagreements in a marriage.

The sociological context in cultural theory places divorce in traditional society as something that deteriorated the society thus divorce rarely occurred. The present society has high divorce that result even from sexual problems in the family. Several couples in military are sexually frustrated. They are not having enough sex when their partners keep on spending long working time outside (Anderson and Taylor, 2007).

Conclusion

The high divorce rates in the military are explained well by sociological perspectives. These sociological theories have their premises on the behavior of human beings. They blame contrasting and dynamic features of social life in expounding on high divorce rates in the military. Cases of divorce in the military are increasing every time, and the research shows that the military, as an occupation, is leading in divorce. These perspectives put several reasons forth, and all seem to justify. Therefore, the causes of high divorce rates are multifaceted and are dependent on the nature of a given case.

Today, in our world one of the biggest issues that have risen amongst health care activist in the United States is how health disparity and inequality has affected rural areas and culture. However, it is important to keep in the back of our minds that this is not a problem that only exists in the U.S., it is a worldwide concern. Health disparity is taking an in depth look at the differences in health status between different social groups, gender, race, ethnicity, education, income, disability, and sexual orientation. While on the other hand, health inequalities is taking a look at the unjust and unfair treatment one gets because of their socioeconomic status and demographic area in which they are part of. Having such a wide array of difference in health inequality and disparity is what also contributes to the United States ranking in the bottom of industrialized western nations when it comes to life expectancy rate, and infant mortality rate. Finding ways to close the gap between life expectancy from one race to the other may greatly contribute in making the U.S rank as one of the top nations in the western part of the world.

One of my main reasons for selecting this topic was because I wanted to take an in depth look through research and studies to find out why health inequality and disparity still exists in a great and rich country like the United States. In addition to that, my second point in selecting this research topic was to find out how there can be equality amongst people living in urban and rural areas in the U.S. when it comes to the area of health care. Even though over the years they have been great improvements and minor changes; there is still more work to be done in order to make health and equality for all.

Health should be a right for all, and not a privilege based on whether one lives in a rural or urban area, or whatever socioeconomic status they may have. One should get the rights to have the same privileges. One of the huge differences when looking at health disparity is life expectancy age between white, black, and African males, and black, white, and African American females. For example, the life expectancy for an average white male is 76.7 years old while on the other hand for an African American male the average age of life expectancy is 67.8 years old. Comparing the two ages there is a difference of 8.9 years between a Caucasian, and an African American male. After looking at the difference one may ask themselves these questions: they are all American why can one race live longer than the other? This is a question I have asked myself before, however taking this class through the semester helped me to understand why. Baer mentions, “African Americans experience about 67,000 more deaths than they would have had their mortality rates been similar to whites.” “This translates into 2.2 million more years of life lost.” One of the main reasons for this is that most Caucasian males live in an urban area with good jobs, good incomes, good health insurance, and access to good doctors, while on the other hand, an African American male living in a rural area does not have access to health insurance, does not have a good job, or does not have access to a family doctor. This may lead to a lot of stress to an individual which may cause different diseases such as chronic heart disease, hypertension-which may lead to stroke, heart attack, and renal failure. This in turn may lead to premature death of an African American male. These results are the same for women also. As stated by, “premature mortality (75 years of age) is greater rural residents than among urban residents, and rural-urban mortality differences vary by age.”

Premature death and mortality is one of the key issues when taking a look at health and inequality in the United States. Nevertheless, another subject to closely examine is how health and diseases are not distributed fairly. Individuals who live in rural areas are more likely to get a disease than one who lives in an urban area. This also contributes to the kind of health individuals may get. For example, diseases like tuberculosis would be common in a rural area because of the life style one may live, the kind of income they may earn, and the health care they may be receive could be totally different than the one they receive in the urban area. According to, (levy and Sidel) “The cause of many diseases are complex interplay of multiple factors, many of which are due to social injustice.” For instance, Caucasians receive more attention and care when they visit a doctor which may lead to a wide variety of issues. However, the one that stands out the most is because the color of the individual’s skin, he/she may be looked at differently, or not given the same care a Caucasian would have received.

The subject of disparity and inequality does not only stop with adults, it also reaches down to children. Unfortunately it is a subject that affects all ages from infants to adulthood. In some cases there have been findings that when it comes to certain diseases and long term hospitalization, infants whom their parents are of different social class or race are treated differently and are cared about differently than kids that are Caucasian, or not minorities. While doing my research for this project I was amused to find out the inequality and disparity comes down to this level that even infants are cared for differently because they belong to a certain minority group. As I have stressed out in my paper and continue to do so, I really believe that everyone should have equal access to health care regardless of their differences. In one of my articles it takes and in depth look at how children’s asthma hospitalization and urban areas in Texas are different. Grineski mentions, “It talks about how poor children are dispropriately affected as they have higher asthma prevalence rates (and more servere asthma) than non poor children.” I found this to be a very interesting finding that areas where poor children and non- poor children were living would affect their health. This could be because of several reasons, for one it could be because of the demographic area or the type of housing conditions in which these infants live in. All these factors could play a big part in contributing to the findings that kids in rural areas are more probable to get Asthma.

However, there are also many other factors that also contribute to health disparities. There are socioeconomic factors that include the individual’s race, ethnicity, the kind of education they may have, and the kind of income they earn annually that also contribute to the individual’s health. As mentioned earlier, the individual’s health may allow him/her to receive a different treatment from another individual whom is of a different race. For example, John, an African American male, goes to see his doctor because he has been coughing for a week and wants to get checked out. Instead of giving John all the different tests, the doctor would just give him medicine and tell him he just has a cold or flu, yet if it is a white male they would probably give him a thorough check up to see what was really wrong with the individual, and then give that person the necessary medication they need.

Also, ethnicity brings an additional dimension to health disparity. As mentioned earlier, when it comes to health care for minorities they generally have a harder time getting the kind of care they need, especially ones that live in the rural areas. Baer mentions that, “Health disparity research suggests that ethnic minority groups like African Americans, Latinos, and Native Americans suffer a triple burden in seeking health care: 1. They are significantly less likely to have health insurance than whites, and so accessing care is a major challenge, and while adequate acute care is hard enough to come by, preventive care is all but impossible for those who are insured”

The kind of education one has also contributed to the gap between health inequalities between individuals. The more education one has the longer they live, and the healthier life style they have. This is mostly due to the fact that the higher education you have the higher income one may get, and the better education one may get the more likely the individual may have a good job with great security which helps to provide financially for their families. The less education they have the less they can earn, the more stressful the job can be, and the less job security they have in order to provide for their families. Also, the more education you have the more educated you become about living a healthier life style. For example, eating healthier by getting good nutrients and a having a good diet is smart, but in order to live this kind of life style one must be able to afford it which does not allowed everyone in the United States to have this opportunity. Kaplan states, “On this view, we can understand why controlling for the SES and education reduces the health disparities between blacks and white Americans but does not eliminate them.” “Because black Americans are also systematically disadvantaged with respect SES and education and because SES and education are associated with health outcomes in the United States.”

Another determent that also brings a problem to health inequality and disparity is the environment one lives in. The environment we live in plays a big role on the kind of diseases we get and develop. Plus, the area one lives plays a big part in the kind of health care one receives. For example, one living in a rural area may not have access to a hospital, or the right doctor they may need to help them give them the right attention they need to live a healthier life style. An additional thing that plays a role on the kind of health we get from the environment could be the kind of water one has access to. The kind of water people in rural areas may use may have things in it that are not healthy for one to drink and may cause different kinds of stomach viruses or stomach problems. The kind of food individuals get in the grocery store maybe not be as healthy as the ones individuals from urban areas may get. Some food may contain more fat and carbohydrates, than the ones they have in the grocery store in urban American cities nationwide. According to McElory and Townsend, “That changes in components of their model (e.g. new subsistence patterns) can cause in balances in the other components ( e.g. new subsistence strategies can lead to exposure to new risk ), and a very severe imbalance to generate stress and disease.” As the above quote points out, health inequality and disparity can be a big part of the kind of environment one lives in. After selecting this topic I wanted to personally drive through the urban and rural areas of Fort Wayne and compare the differences. Hartley mentions, “Traditional concerns as to access to primary and hospital continue to dominate rural health policy.” As I drove through town I observed a few things. One observation was that there were barely any hospitals in the rural area. I found a couple of clinics but all the major hospitals, and big health facilities were located in the urban areas. In my opinion, this is a huge disadvantage for someone living in a rural area in Fort Wayne. Another thing I observed during my drive was that there are far more liquor stores located down south. For example, you can drive down a block and you can see three or four liquor stores by the time I was done driving through the block. In contrast, up in the urban areas there are liquor stores but not as many as the ones I came across while in the rural areas. Another thing I also noticed while I was doing my observation was that the urban areas are well taken care of. The streets are clean, buildings were properly done, and roads were done properly with no dirt on the streets. Yet in the rural areas the opposite was true. There were several buildings that were left unfinished; roads were not as clean, housing areas were not as properly done as the ones done in urban areas in Fort Wayne. These are several inequalities I observed on my own. It was a firsthand experience, and I was very shocked to find out that such things are going on in our on back yard here in Fort Wayne. I believe that in order for us to address this problem as a nation we must first focus in our own cities and towns and then work our way up.

Individuals in rural areas have been accustomed to receive unfair health care attention that people that live urban areas in the United States are used to recieving. As mentioned earlier in my paper this not only a problem in the United States but a problem that is effecting millions of other continents around the world. Joyce and Bambra state that, “Despite overall improvements in health outcomes since the second world war, health inequalities between the best and worst of society are persistent in developed nations and in some in some instances are continue to widen”

As a community how can we address health inequality and disparity in our communities to help this stigma get away? Studies have definitely shown that they are minor improvements that have taken place over the years, but never the less, as a community we have a lot of work to be done. Hartley mentions, ” Recent trends in rural health research and policy suggests that effective policy interventions must be based on differences among rural regions. “When arguing for progressive rhetoric for rural American, “rickets noted that Urban-Rural comparisons.” One of the first things I think we need to do as a community is first try to improve our rural areas. The next step I believe we should do as a country is have a universal health care program in place where everyone will be able to have insurance for every citizen in the United States. In making health insurance accessible to every one in the United States any person will be able to receive the health care they need. An additional thing we as a community need to do in order to address health inequality and disparity is to have more hospitals in the rural areas and not just in the urban areas. We need to have hospitals and clinics more accessible to them. So if they need to see the doctor they do not need to make a fifteen to twenty minute drive they can have it right in their neighborhood.

I firmly believe education is the key to removing health inequality and disparity from our communities. The better we educate individuals that are of a different race, socioeconomic status, and ethnicity, the more adequate a person knows about how to live a healthy life style and eat properly. We need to get them to exercise more in order to live healthier, and also educate them about the effects of smoking cigarettes and what it causes. For example, have health fair programs that will tell them how smoking can cause lung cancer, and many other chronic diseases, and also better educate them how drugs and sharing needles can affect one’s life style and cause many diseases such as HIV-which is a very serious epidemic that is killing millions of people in our world today. Also having different organizations that are pro-health that would go into the different rural communities and talk and mentor individuals on what they can do to live a good and healthier life would be a great asset in educating individuals.

Another way for us to draw the gap when it comes to health and inequality is to create more jobs for individuals, so that they will be able to work and support their families. In doing this it will give them something to stress less about, which in turn will help individuals to be stress free. As mentioned earlier in my paper, stress causes a lot of health issues which can lead to different cardiovascular heart problems, effect once growth, diabetes, and hypertension which are all various disease one can get from living a healthier life style. So hopefully creating more jobs in rural communities may be able to create a less stressful life for individuals.

Improving the environment are also ways in which we can address health disparity in our communities and country. For us to take the next step in which we can overcome health disparity and inequality is to clean up the rural areas. They should be cleaned up, they should also have access to clean water to drink, and tap water should be sterilized to certain standards to meet the States regulations. Also fountains and lakes should be monitored and kept clean, having clean water is important in other for mosquitoes and other parasites to not take over rural communities. Not having all these necessary steps taken people in rural areas may have easy access to malaria and other diseases which may greatly affect their community.

Doing away with majority of the liquor stores in rural areas will also help to bring inequality to our neighborhoods, because having alcohol in rural areas in my opinion just helps to destroy the individuals in these areas. Drinking may also contribute too many other diseases that may cause premature death in one area. Another substance that we can do away with is creating awareness about drinks and get them off the streets. In getting both drugs and alcohol out of the rural areas we can only hope that we can try to get the rural areas to be almost equivalent to urban areas although one that will not be easy to do.

In doing the following we can hope that health inequality and disparity in rural areas can be improved to met the standards that urban areas have. The U. S is such a wealthy nation that they should not be anything such as health inequality and disparity amongst different areas in the . From my research I do however believe that there is hope for the future. Changes are been made however, we just have to put our differences apart in other for us to reach the point where health is equal and available to everyone no matter how much income they make, the amount of education they have, or the color of the skin they should have access to it .

Overall, I learned a lot of from this project I gained a lot of knowledge from it. I became aware of things that I was not previously not aware of in the past. I never looked at health as inequality and disparity; I rather looked at it from a different prospective but in doing this project it made me understand what it means when one mentions the United States health care system has inequality and disparity in its system. From doing this project I also gained passion for this topic and down the road I would like to volunteer, or be health activists, because as repeated earlier in my paper I believe health services should be offered to everyone.

HEALTH INEQUALITIESINTRODUCTION

The aim of this essay is to compare and contrast different sociological perspectives of health and illness. The definition of health, rather than being absolute is always relative and it differs from person to person. According to the WHO: “Health is a state of complete physical, social and mental well-being and not merely the absence of disease or infirmity. The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being, without distinction of race, religion, political beliefs or economic and social conditions.” (World Health Organisation 1948) (WHO, 1946). Thus, illness can be defined as a disturbed physical, social or mental state of an individual.

The second objective is to analyse the existing evidence of social variations in health and illness in the society. Various reasons such as social factors, lifestyle, race, nationality etc. have an effect on the health of an individual. Reasons for inequalities in health due to such factors will be studied.

Lastly, sociological issues which effect a person’s well being will be explained. These can be bad habits, poverty, work environment, geographic factors, unequal distribution of health services etc.

We again go back to the first paragraph and look at the definition of health as provided by WHO. As we can see, though all the factors of health (physical, social, mental) have been taken under consideration, as to what is “the highest attainable standard of health” is a matter of debate. This might depend on the society, class, religious or cultural beliefs or even personal expectations of the individuals. These standards will definitely differ according to the nationalities and the type of government. There are a range of perspectives presented by sociologists, philosophers and economists regarding health and illness. Presented below are a few of those.

Talcott Parson, an American sociologist, was a believer in the ‘Functionalist’ perspective where the “whole world (or the community, society) is treated as a system having various parts which function in tandem to maintain the vitality of the system.” In such a system, illness is seen as a condition which is not normal. Hence, a sick person is not bound to follow the social norms or rules of the society due to his or her condition. Also, it is understood that the sick person is not the one who is to be blamed for his or her condition. The person’s illness is due to external factors and the person could not have done anything to prevent the illness (or sickness). But the person should try their best to get well as soon as possible. Also, it is important that the person should seek the best technical help possible and should cooperate with the physician in order to get better. The Functionalist perspective describes illness as a temporary, medically sanctioned form of deviant behaviour which can be cured by technical expertise and proper attention.

Another approach is that of the Marxist perspective as presented by Vicente Navarro (1986). This perspective states is more concerned with conflict rather than stability. According to this approach, economic system shapes societies therefore the class system has produced two distinct classes, the bourgeoisie (those who own the means of production) and the proletariat (those that sell their labour). Further, it states that the NHS is responsible for the wellbeing of the working class of the society and it has to see that the workers remain fit enough to work. Even when two classes are in existence, the workers must believe that the system is fair and beneficial for all. Also, the sale of alcohol and tobacco should have limited control as these products garner profits.

Looking at the first perspective, it becomes obvious that the illness of a person is the only thing that is taken into consideration when putting forward the views while in the second approach, a marked distinction is made between the two classes. Parson believes that though person is not responsible for the sickness, it is the persons responsibility to acquire adequate health care in order to get fit again. Marx, on the other hand holds the NHS responsible for providing health services to the masses and making them good enough to work. While the functional approach treats all factors and forms of illness as the same, the Marxist perspective provides various reasons for the illness. Thus, as can be seen, there is a stark difference between the two perspectives on health and illness.

A few more perspectives such as the interactionalists & social action approach and the feminist approach looks at health care with an objective viewpoint. The Feminist approach is mainly concerned with the male domination of the medical profession. According to this, many woman specific conditions such as pregnancy and childbirth have related to medical issues though they are natural processes which are bound to occur in every woman at a particular stage in their lives. Also, contraception is not given enough priority and thus risking women’s health. As women have to balance family and work, they suffer from stress in addition to other mental and physical illnesses. The interactionalist approach treats illness as an individual’s viewpoint. What condition can truly be defined as illness differs from person to person. This approach does not take into consideration the cause of illness but is only concerned as to what illness.

As discussed earlier, each and every individual does not have the same health requirements. Neither do everyone have access to the same facilities. These variations can be due to a variety of factors. In the following paragraphs, some of them have been discussed and analysed.

There are a number of reports that claim that there is a link between the social class of an individual and health of that individual. The social class is decided by the occupation, the income level, education and housing. These factors together decide in which social class an individual belongs to.

The first report in this category is the Black Report of 1980 which states that the gap in inequalities of health is ever widening between the higher and lower classes of the society. Some interesting findings were made in this report. As we go down the social ladder, the percentage of people affected by ill health increase. This has little to do with the facilities provided by the NHS. Unemployment, poor hygiene and housing, lack of education, low income are stated as the major reasons for this inequality. Another such report, the Acheson report (1998), had an in-depth survey conducted of the lower classes in the society. The results were same as those of the black report. The Acheson report blames poverty to be the root cause of the disparity observed. A startling fact of this report is that it states that health inequalities start before the birth of an individual. It also recommends lessening the gap between the rich and the poor to improve health standards for everyone, irrespective of the class.

While the Black report simply states the factors which affect health and illness, the Acheson report actually provides statistics for the same. It shows that as we move from social class I to social class V, there is increased risk of variety of diseases like cancer, respiratory, heart, strokes etc. Also, the chance of accidents and suicides also increase in the lower classes. It states that poor men and women are more likely to die than rich ones. Thus mortality is also proportional to the social class that an individual belongs to.

Other than the social aspect of inequality in health and illness, sociological factors also come in play when we talk about an individual’s health. Unlike social factors, sociological factors cannot be grouped in broad categories as they involve many personal characteristics. Some of these are unhealthy habits such as drinking in excess, smoking, no exercise, too much junk food etc. Also, such an unhealthy lifestyle maybe an outcome of lack of knowledge or education. People might not be informed about the harm such a lifestyle may cause them in the wrong run or the services offered to them to overcome these habits. As a result, more inequality in wellbeing is created.

Some criticism is offered against the propaganda of a healthy lifestyle. One major concern is the cost of following a healthy lifestyle. It is argued that healthy meal options are expensive than their fast-food counterparts. The recommended five a day is also considerably costly than everyday food. In order to exercise, one has to pay a gym or a club membership which adds to the expenses made for a fit lifestyle. In some cases, bad habits like drinking and smoking might be adapted due to the pressure and stress of work rather than at will.

It is also argued that as the working-class people usually have blue-collared jobs that involve more manual work than what is done by the people of the upper class, they are more exposed to accidents. Also, as the masses get paid less than the cream class, there is less security in case of death or physical injury of the earning member of a family. If repetitive, monotonous work is done by an individual, various physical as well as psychological problems might arise. Due to lack of job satisfaction, these problems might aggravate to a dangerous level.

The theory of social capital is put forth which is the measure of how connected people are to their communities via various means such as work, family, clubs, faith groups, organisations etc. This connectedness is believed to have a direct impact upon the health of a person. A study showed that in a community where people are more connected, there were 50% less heart-attacks than the neighbouring areas where such amount of social capital was not present.

Another reason of health inequalities may be the “Inverse care law” which states that the resources are distributed in inverse proportion to the need. When most required, they are least likely to be available and where there is no need, they will be in abundance. An example could be of physicians who setup practices in major areas where there is little need rather than in small towns where there is a true need. Also, some doctors show a bias while treating a well-to-do patient as they expect a higher fee in return.

Not quite unlike the social capital, Pierre Bourdieu (1960) defined the cultural capital (which is essentially money), is a deciding factor in obtaining health care. Money is directly related to a better lifestyle, higher status in the society and better education. Instead of waiting for obtaining health care facilities due to limited funds, cultural capital gives people power to immediately get access to them.

Due to the inequality in the health services provided in various areas, it is thought that the patient’s chances of survival can be affected largely by where they live. This is because health care provision is not the same across the country. The inner city areas have fewer health care facilities and qualified doctors. This results in below par health amenities and further health and illness inequalities.

Another theory looks at the gender bias as the cause for health inequalities. It states that poor mental health of women can be directly related to discrimination by male doctors. It also states that as woman manage multiple things at once like doing house chores, working and taking care of children, it all adds to the mental stress they experience. Lack of social contact or inability to have time for one might further harm health.

James Nazroo (1997) provided more theories which try to explain the existing inequalities in health in the country. A genetic condition may put individuals at a disadvantage to their healthier counterparts. Cultural factors such as unhealthy food, no exercise etc. may also result in illness. Other factors like material (less income, poor work condition), racism or discrimination, irregular work hours etc. seriously affect productivity and health of the individual.

In conclusion, it is wise to say that although there are many theories and explanations for health inequalities, the reasons provided by all of them are quite similar. The top amongst them are poverty, unhealthy lifestyle and lack of health care facilities. If an improvement is done in the above mentioned areas, these inequalities can be controlled and uniform health care can be provided to all the people of the society. Awareness should also be spread regarding these inequalities so that people themselves protest against these.

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http://www.staff.city.ac.uk/apryce/marxist.htm

http://www.sochealth.co.uk/history/black.htm

http://www.archive.official-documents.co.uk/document/doh/ih/ih.htm

Compare and contrast two of the five approaches to mental health & illness within Sociology. (social causation, social reaction (labelling theory), critical theory, social constructivism & social realism)Mental Health Illness

The issue of mental health has long been an object of study for society, the psychiatric professions and sociology has similarly had a long tradition of offering theoretical insights into the phenomenon. Why this might be is open to debate and many of the key sociological theories in relation to mental health have in fact as much to say about the prevailing viewpoints within society and within professional bodies towards mental health as they do about those who suffer from mental health related problems (Cockerham, 1992). The two most radical of the sociological theories concerning mental health have been social reaction or labelling theories as well as that of social constructivism.

Both these theories examined within this essay offer a radical conception of mental health in comparison to what might be called the dominant medical and social views on mental health. However while both of these theories offer a radical view of mental health they differ substantially in the theoretical framework which they respectively utilize towards understanding mental health. These differences can be located in broader trends which have occurred within the discipline of sociology itself as a shift in the major theoretical traditions within the discipline, (Delanty, 1999). The two sociological theories examined are that of social reaction and social constructivism.

Social Reaction

This critical theory emerged in the 1960s which in itself might serve to highlight the broader critical strands present within society when this theory was formulated. Labelling theory works from the simple premise that to define someone as mentally ill conveys upon them a stereotypical image which the person will then act. It drew its framework from the symbolic interactionism school of sociology so at its root this theory sought to examine the ways in which roles and actors interacted and played out within the drama of mental illness (Pilgrim and Rogers, 1999. Thus for labelling theory the relationship between the patient (or the individual defined as ill), family, medical professions and society generally is the determining factor for analysis in relation to mental illness.

For labelling theorists then the primary framework for analysing mental illness is to examine the twin concepts of primary deviance and secondary deviance. Primary deviance relates to things which might actually be wrong or actions or circumstances which involve actual rule breaking, (Pilgrim and Rogers, 1999) and for labelling theorists the most interesting item regarding this is the way those around sufferers rationalise and ignore this behaviour up unto a point, (Ineichen, 1979:11). Perhaps the most illustrative study of this phenomenon was the work of Yarrow, Schwartz, Murphy and Deasy (1955) which illustrated the various ways in which wives would dismiss strange behaviour up until a point was reached in terms of deviant behaviour.

However it is secondary deviance which labelling theory sees as the much more problematic of the two forms of deviance and it is here that the links also between the second of our theories examined are strongest. For labelling theorists secondary deviance has a number of critical factors. But simply put secondary deviance refers to those manifestations of symptoms which are not related in any way to the actual physical incidence. Thus we might say that the aetiology of secondary deviance is a function of the societal conditions surrounding the individuals rather than intrinsic conditions within the individual themselves. As Rosenham (1973) states The question of whether the sane can be distinguished from the insaneis a simple matter: do the salient characteristics that lead to diagnoses reside in the patients themselves or in the environmentsin which observers find them (250).

In Rosenham’s case where eight pseudo-patients gained entry into hospitals on the pretence of being insane to answer to this question lay firmly in the area of the observers. While popular at first with a number of studies finding the concepts expressed in the theory to be true in a number of famous studies labelling theory has not decreased in popularity with a number of major criticisms being levelled at the theory as a result of further investigation and continued studies

While labelling theory surmised that primary and secondary deviance were linked in that one will tend to lead to the other as a result of the ensuing interaction between the individual sufferer and those that label the sufferer this was not borne out by the research. In the case of Rosenham’s study it was found that the label of deviant though at first an uncomfortable and disturbing experience did not persist for a great length of time with the pseudo-patients in the experiment, (Pilgrim and Rogers, 1999).

Another weakness expressed in labelling theory is the relationship between the stereotypical images of the insane believed to be held by the public. If society was to blame for labelling the insane then it would have been expected that the images lay people had conformed to the images of diagnosis, yet research has shown that this is not the case. Indeed lay perceptions to mental illness have been demonstrated to only marginally relate to the images associated with medical diagnosis, (Pilgrim and Rogers, 1999:18).

Labelling theory accepts then (and is a criticism of the theory) that a distinction can be drawn between physical disorders, primary deviance, and the ensuing reaction from society which causes secondary deviance. For the second theory we examine here the existence of both categories is dependent on society or in other words that mental illness exists as a completely subjective definition.

Social Constructivism

While referring to a broad range of social critiques across a many wide variety of disciplines it is perhaps best represented in terms of its comments on mental health by the works of the French theorist Michel Foucault. In particular his seminal work The Birth of the Clinic sets out the radical viewpoint with which social constructivism is associated. In this Foucault argues that insanity exists as a classificatory concept derived from the subjective description of medical knowledge. Or that the objectification of insanity occurred after as well as in tandem with the development of psychiatric knowledge, the insane developed as a problematised group which in turn led to strategies being developed to manage them, (Foucault, 1976)

Superficially then we can see many similarities between these two theories in that both see a critical role for society in the determination of the meaning of mental illness. The critical difference is that while for social reactionists and labelling theorists a division exists between primary deviance which has a physical locus and secondary deviance which arises out of societal causes whereas social constructivists assign the loci of mental health strictly to the social environment. It does this through utilising the theoretical framework of discourses, thus the subjectivity of being mad is defined through the objectifying process of psychiatric or medical knowledge generally (Pilgrim and Rogers, 1999).

While many works recently have adopted social constructivist viewpoints in relation to medical knowledge it is Foucault’s works which are the best known and also which have been the most influential in developing this theoretical viewpoint. Foucault’s work was in particular concerned with how the shifting conceptions of what madness meant to society led to the development of a discrete set of knowledges which pathologise mental states according to a classificatory system related to madness and what were the strategies which developed as a result of this knowledge towards the control and management of the insane (Foucault, 1972, 1976).

This concept has had radial implications for a consideration of mental health and how it is defined in as well as by society. This theoretical framework can be seen thusly to criticise not only psychiatric practice but also psychiatric knowledge and even more critically the processes through which psychiatric knowledge is generated. Indeed from a social constructivist viewpoint it is the very construction of knowledge which leads to the boundaries and categories which delineates and determines who it is we call insane and indeed what it is that makes them insane for society.

Perhaps the biggest criticism we can make of the social constructivist viewpoint is the lack of a normative basis to its analysis. While the critique may be valid social constructivist theories can be distinctly vague about resistances to the all powerful discourses which they describe and analyse. Similarly the ability to formulate social policies arising out of the critique may similarly be limited (Rogers and Pilgrim, 2001: 175). A secondary point and one which we have already made in relation to labelling theory is that perhaps social constructivism deconstructs too much certain incidences of mental illness, perhaps there are some illnesses which in their aetioloigcal sense reveal themselves to be indeed physical manifestations of what we might actually be able to call a disorder (Zinberg, 1970).

Thus from this analysis we can see the close links as well as the clear differences between these two theories. While both are radical in their outlook we can argue that social constructivism has even been more radical. Similarly while social reaction theories have fallen out of favour along as well it must be noted as symbolic interactionsim in general social constructivist theories have been and continue to be hugely influential not only in relation to mental illness but to a broad range of social scientific disciplines and social issues.

References

Cockerham, W. C. (1992); Sociology of Mental Disorder; 3^rd Ed., Simon and Schuster Co.; New Jersey US

Delanty, G. (1999); Social Theory in a Changing World, Polity Press, Malden US

Foucault, M. (1976); The Archaeology of Knowledge, Tavistock, London UK

Foucault, M. (1976); The Birth of the Clinic, Tavistock, London UK

Ineichen, B. (1979); The Social Structure of Modern Britain: Mental Illness, Longman, London UK

Pilgrim, D. and Rogers, A. (1999); A Sociology of Mental Illness, 2^nd Ed., Open University Press, NY US

Rogers, A. and Pilgrim, D. (2001); Mental Health Policy in Britain, Palgrave, Basingstoke UK

Rosenham, D.L. (1973); ‘On Being Sane in Insane Places’; Science, Vol 179 Jan

Yarrow, M., Schwartz, C, Murphy, H. and Deasy, L. (1955); ‘The Psychological Meaning of Mental Illness in the Family’, Journal of Social Issues, Vol 11 No. 12

Zinberg, N. (1970); ‘The Mirage of Mental Health’, British Journal of Sociology, Vol. 21 No. 3

Americans mistakenly believe that the reason we spend more on health care is because we have the best health care system in the world. It would not be wrong to state as a matter of fact that we spend more on health care than any other developed country in the world. We as Americans spend twice as much on health care as the Japanese, but there are really very few who would argue, without a doubt, that our health care is better (Paraphrase Mahar 20). Or let us take a closer look to home, if one were to ask any Canadian what the main difference is between Canada and the United States, two countries so close geographically speaking, yet so different ideologically speaking, the Canadian would most likely say “health care.” “Ninety-six percent of Canadians say they prefer their health care system to the U.S.’s and nearly every politician in Canada knows to support the Canadian health care system as if it were some sort of sacred trust” (Armstrong, Armstrong & Fegan 1). The United State’s Canadian neighbor has a government that not only provides insurance, but the government pays for it. In a 2006 Harvard Medical School study, it was found that Americans are “42% more likely to have diabetes, 32% more likely to have high blood pressure, and 12% more likely to have arthritis then citizens in other industrialized nations (Associated Press). This study came right after another study that found that middle aged, white Americans are much sicker than their counterparts in England a country that has a national health care system (Associated Press). Universal health care can improve the health of Americans by affording them the health care that other countries such as Canada, England, and Japan already have. The problem with health care in the United States is essentially how we view it. Many view health care as a luxury, something for the rich, but health care is not a luxury, it is a right, and if America were to implement a universal health care system, Americans would be healthier overall. Healthier citizens would not just mean a happier country, but it would also mean a wealthier country, and this is something that countries like England, Canada, and Japan have already figured out. By denying our citizens health care, we are putting off costs that will be tripled in the long run because of the fact that people have to put off being seen by a doctor and thus their illnesses become either more severe or irreversible. Either way, Americans end up paying more.

Approximately 50% of Americans do not have some form of health insurance coverage. This number seems absurd when there is the fact that “the United States has a $2 trillion health care system, which is as large as the economy of China” (Herzlinger 15). Despite the fact that millions of dollars are spent on this so-called system, millions of people with chronic diseases and disabilities cannot get the treatment that they need. So where are these millions of dollars going? A universal health care system would allow people with chronic diseases and disabilities to get the treatment that they need. It would also benefit people in helping to prevent disease, which is a major part of modern medicine. In our system, doctors and hospitals are paid for treating sick patients, not for keeping them healthy, but without preventative medicine people are bound to be sick as opposed to bound to be healthy. Therein lies a major ethical dilemma. In a universal health care system, doctors and hospitals would take more of an interest in preventative doctoring because health care would already be paid for. All of this would lead to healthier individuals in the bigger picture. We have to ask ourselves, when did medicine become about simply fixing and not about preventing? The question is especially valid when we consider that modern medicine cannot even fix, unless for less than an exorbitant amount, the most common of illnesses and diseases that people are acquiring.

The U.S health care system is commonly referred to as the health care industry. Health and industry become one in terms of health care in the U.S. It is no wonder why with our health care, being an industry, people in America are, on average, unhealthier than their counterparts in Canada, Europe, and Japan, and pretty much every other developed and progressed country in the world. When we consider that the current U.S. health care system comes in at over $2 trillion dollars a year, that averages to roughly “$7,000 per man, woman, and child, healthy or sick or roughly $25,000 annually for the average family” (Relman 113). With that kind of money, it would be possible to have universal coverage in the U.S. This would equate into good quality care for all, which would therefore mean that our sick could be treated and our healthy taken care of with preventative measures. Most people who do not get health coverage through their jobs or through other means such as their family cannot afford the exorbitant costs of individual health insurance policies, therefore many people simply go without insurance, harming their health in the long run. This leads me to my next point, physicals performed by doctors are crucial to maintaining good health. It is through annual check-ups that many doctors spot issues that could turn disastrous if the person were to have gone without care. For Example, some types of cancers that if caught early enough could be kept from being fatal. Moreover, high blood pressure and cholesterol tests alert people to make changes in their diets and adapt to a healthier lifestyle. However, the 26 million uninsured in America are denied the right to these tests. People who are denied access to regular check-ups are being denied the right to good health.

In our current health care situation, there is a proliferation of sickness among the poor because they cannot afford health insurance or the out-of-pocket costs of seeing a doctor or buying prescriptions. Many advocates of universal health care believe that health care is as much a birthright as is education, yet half of our country slips by without access or means to doctors and hospitals to keep them healthy or cure them of their illnesses. It does not speak well about a country so prosperous that denies its citizens the right to the best health possible. When politicians turn their back on this important issue, they are turning their backs on the country. Without the people, there is no country, and so it makes sense that our country develops a universal health care system immediately.

Many Americans are in favor of a universal health care system, especially when we hear of a top health insurance company executive bringing home $24 million a year, many believe that a single payer system is the only way to ensure the health of our citizens (Paraphrase Mahar). Physicians for a National Health Program (PNHP) reports that a single-payer option is supported by a majority of doctors, nurses, as well as general public and health care experts. When the very people who provide care are in favor of a different health care system, we have to stop and take note. When our own doctors and nurses are telling us that a universal health care system is crucial to our collective health, the people in the United States should listen. But what has happened is that America’s medical system has become a system that is driven by money rather than by the health of its citizens (Paraphrase Herzlinger). Insurance companies have become massively rich corporations that profit by taking money away from the citizens. They are companies that pay their executives out of this world wages yet deny to pay for screenings and physicals for its clients.

Japan, another country that is much healthier collectively than the United States, has a universal health system where all citizens are covered equally and they can go to any doctor or hospital they want, with no difference in cost (Summary Mahar 219). If Americans had the option of seeing any doctor that they needed or wanted to, no matter where they were in the United States, it would prevent many deaths and treatable diseases. The fact that Americans are lashed to one doctor or one hospital means that many will choose to wait to see a doctor or even forego seeing a doctor at all when they really need to. Perhaps lives could have been saved and perhaps more will be saved if a universal health care system is put into place.

The bottom line is that a universal health care system is the only fair and right system. It is a system not an industry that would be for the people and the people are what make up a country, so why shouldn’t our country care about the health of its citizens? Without insurance forms, policies, paperwork, high premiums and other red tape, our citizens would be in better health. The situation right now is that if a person has to choose between feeding their family and seeing a doctor for a pain in their chest, they will probably feed their family. This is not the way it should be, people should not have to choose between what is best for them and what is best for the people they love because an insurance company is standing in the way of their lives. People have the right to health care and the right to be the healthiest that they can be, whether that health is given through medical visits or through sustenance. A universal health care system would ensure that every citizen has the opportunity to receive the best care possible so that they can live a healthy and long life no matter how much money they make and what job they have. Health care is not something that should be negotiable in a country as wealthy and developed as the United States.

Universal health care would improve the health of the people of the United States and would ensure the health of the individuals who will become citizens in the future. The research shown has proven that countries where a universal health care system is in place have much healthier people when compared to U.S. counterparts. The research is obvious and the facts cannot be denied. The United States can learn a lot from the countries that offer a universal health care system such as our close neighbor, Canada, and neighbors not so close like Japan.

The United States adoption of a universal health care system is the only way that America can go when it comes to health care. One has to ask, where can a country, which is made up by people, go wrong when its citizens are not only treated, but they are taken care of? To prevent illness and disease is what medicine should be about these days and not just treating the already sick and disease ridden. We have the tools to see that certain diseases, certain cancers are avoided, so why would we put our nation in jeopardy by not giving people the preventative care that they not deserve but have a right to as citizens of the United States?

The United States is one of – if not – the richest nations on the earth. It does not matter that are health care system is embarrassing or an abomination in the eyes of other countries, what does matter is whether or not our health care system is embarrassing or an abomination in the eyes of ourselves and our own nation. If we cannot see that everyone in this nation, this rich nation, deserves health care, has a right to health care, then we are what the abomination is – not the “system” or the “industry.”

Many people consider healthcare to be a privilege while others consider it a right. Health care should be a right; everyone should be entitled to proper healthcare and not be subject to being medically treated or not, based on their financial status. This has been an argument for over 100 years. In a country like ours, it is a shame that we do not provide something that should be a basic human right to every citizen. The Preamble of the United States Constitution and in Article One, section 8 of the U.S. Constitution both describe the original purpose of our United States: to promote general welfare for every citizen. I believe that health care is a vital part of our general welfare and it is the government’s responsibility to provide this for us. It should be our right to health and health care.

Even in 1943 when President Franklin D. Roosevelt had proposed a Second Bill of Rights for Americans, for he suggested this was due to the political rights that are guaranteed by the Constitution and the Bill of Rights had proved to be inadequate to assure us the equal opportunity in the pursuit of happiness. Roosevelt’s remedy for this was to declare an economic bill of rights, which included “the right to adequate medical care and the opportunity to achieve and enjoy good health.” However, unfortunately the United States turned its back on Roosevelt’s vision for a more secure and happy America, and as a result our health care system is in a state of crisis.

Figure 1-Roosevelt, Franklin. The Economic Bill of Rights. Web. www.fdrheritage.org

The right to health however is guaranteed elsewhere through international human rights treaties and declarations such as, the Universal Declarations of Human Rights, the American Declaration on the

HEALTH CARE: A RIGHT OR COMMODITY 2.

Rights and Duties of Man, the Convention on the Rights of the Child, and the International Covenant on Economic, Social and Cultural Rights. The right to health is also recognized by national constitutions around the world, and even some U.S. state constitutions include protection of the public health as a core government function.

“Everyone has the right to a standard of living adequate for the health and well being of himself and his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or lack of livelihood in circumstances beyond his control” ~Universal Declaration of Human Rights- Article, 25 ~

The country of France funds its health care system by using taxes from income, pharmaceutical companies, and products that are harming to one’s health such as tobacco. With their health care plan, they charge a co-payment for certain specific procedures that are performed, but every citizen still has health care. Denmark also has a universal health care system; it is different from France’s where it is free to everyone who is a citizen. Their government made the decision to fund its program through taxes. Germany has the world’s oldest universal health care system, which covers the majority of the German population. Not everyone is forced to participate in the standard program, people with higher incomes can choose to pay a tax and opt out of the universal plan and purchase private insurance. Those who have chosen to opt out to get private insurance then pay premiums that are linked to their health status. Many countries enjoy a universal health care system, where every citizen and even non-citizens can afford to get proper health care. How the system works basically, is everyone pays taxes towards medical care based on their income and allows everyone to use it without prejudices. This system is used successfully in many countries worldwide especially in Europe and Canada.

HEALTH CARE: A RIGHT OR COMMODITY 3.

When you hear someone from another country talk about the United States they are saying that

we have a great country to live in. With being in such a great country why is something as essential as health care considered as a luxury item. In addition, with our country being so rich and a country that actually helps to build other nations; it is sad that we as citizens are penalized on whom the better health care gets depending on money. The United States has one of the worst health care systems in the world and as far as industrialized countries we are the only country without a universal health care system and our citizenship does not include health care as a right. Either in the United States, we receive our health insurance through an employer-sponsored plan or we purchase our own insurance that often includes high premiums as well as high deductibles for a basic plan. I can definitely understand a person who cannot afford to pay the premiums that goes along with having private insurance; it can make you feel like you are stuck in a difficult situation. You know you need the insurance, but when something does happen that requires you to use it how will you pay for it all? The premiums are expensive enough as it is when you add the thousands of dollars for the co-payments and the deductibles; you can easily spend over $10,000.00 a year. Additionally, because of the economic downturn, many people do not have health care or cannot afford healthcare.

Figure 2-Nesri. (n.d.). Retrieved from http://www.nesri.org/programs/what-is-the-human-right-to-health-and-health-care

Health care is a luxury in our society, we have the people that can afford to pay for the medical services they receive, and we have the ones who cannot and they are left in the cold. Simply put, our HEALTH CARE: A RIGHT OR COMMODITY 4.

health care system serves too few, costs too much, harms too many, and is too inefficient. A decade ago, affordability was primarily a problem limited to low income families, but has become an issue with middle class families.

There have been many that have tried to pass a universal health system for the United States, but with no success. This goes way back to the 1912 Progressive Party Platform and Theodore Roosevelt’s Bull Moose Party when they both made passionate cases for a compulsory national health plan in their Declaration of Principles of the Progressive Party. Unfortunately, this did not go anywhere because of the opposition it received from the American citizens and the start of World War I.

“The protection of home life against the hazards of sickness, irregular employment and old age through the adaptation of a system of social insurance adapted to American use” ~1912 Declaration of Principles of the Progressive Party~””Roosevelt , T. (n.d.). Progressive party platform, 1912. Retrieved from http://www.pbs.org/wgbh/americanexperience/features/primary-resources/tr-progressive/

The most recent attempt was in April 2006 when the state of Massachusetts became the first state in our nation to require all of its residents to purchase health insurance. This was to ensure that every uninsured citizen in Massachusetts will have affordable health insurance, this was particularly in part due to today’s health care costs which are rising twice as fast as inflation which makes insurance unaffordable for many of the employers and individuals. Currently, we have over 47 million Americans that have no health insurance. So in an effort to solve the problem in their state, Governor Romney and the Massachusetts state legislature enacted this plan with twin goals of reducing the cost of health care and guaranteeing coverage for all Massachusetts residents.

The Massachusetts plan consisted of the following elements: The state would establish a governmental authority known as the Commonwealth Health Insurance Connector(or Connector) to

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serve as a clearinghouse through which individuals would be able to purchase state approved insurance plans. Every resident would be required to purchase a health insurance plan, either from a private insurer or through the Connector, which there would be stiff penalties for those who failed to comply. For those who could not afford the insurance would have their expenses provided for by the state in part or in full, depending on their income. Employers with more than ten employees would also be required to provide health insurance for their employees or pay a special fee to provide coverage for low income individuals. The theory of this plan was to lower individual patient’s insurance costs by enlarging the pool of insured patients. Particularly, the younger and healthier patients (who often choose not to purchase insurance), would be required to do so, thus paying a portion of the health costs of the larger population.

So for these reasons, mandatory health insurance became popular with the politicians in both major political parties. This idea has also been endorsed by the National Small Business Association and the National Business Group on Health. This idea also made several states that includes New Jersey, Ohio, Rhode Island, Pennsylvania, Illinois, and Colorado to consider or are considering to incorporate some version of mandatory health insurance.

But after two years after it started, the Massachusetts plan failed to achieve either of its goals. The plan did not lower health care costs, nor did it achieve universal coverage. Instead, this plan has increased costs for individuals and the state, reduced revenues for doctors and hospitals. Costs have increased to the individual because Massachusetts requires insurance plans that includes 43 mandatory benefits, including in vitro fertilization, blood lead poisoning treatment, and chiropractor services-whether you want them or not. These mandated benefits have raised the costs of health insurance in Massachusetts by 23 to 56 percent. Costs to the state government have sky-rocketed and are projected

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to run hundreds of millions of dollars over budget. This is due to that mandated insurance is so expensive, the government has had to support the costs of the premiums not only for the lower income residents, but also for those with incomes as high as $60,000.00 for a family of four-which is 3 times the Federal Poverty Level. The state had anticipated a significant drop in spending for the uninsured instead, overall costs to the state has risen by more than $400 million, that is 85 percent more than originally projected. As a result of these rising costs and falling revenues, access to medical care has dwindled for many patients.

So what caused this innovative plan to fail in accomplishing its intended goals? The plan had failed for two reasons: First, it violates individual rights; second, health insurance is a commodity-a good or service created by businessmen for trade in the marketplace. As with any other commodity, health insurance cannot be created by a government mandate. The proper function of government is not to create or provide goods or services, but to protect individual rights. Selling health care to those who can afford it is a logical way to distribute it. That was certainly typical in the early days of this country when the doctors was paid in whatever manner the family could manage. Charity, for those who could not afford care, was the domain of the church and the community, not the government.

Our health care system is based on the premise that health care is a commodity like TVs and computers and that is should be distributed according to the ability to pay in the same way that consumer goods are. This is what health care is not about, health care is a need-not a commodity, and it should be distributed according to need. This is a fundamental mistake in the way this country and only this country, looks at health care. Let’s not forget about individual choice and personal liberty aspects of the American Way. We should be able to spend our own money in whatever way we see fit for we have earned it.

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Taking responsibility for our own health care means paying for it if I can, or doing without if I cannot. So those without financial resources receive inferior care, and those who can afford it receive quality care. I do not believe that unaffordable health care is anyone’s intent; however circumstances have made the cost of health care rise with the health care development and technology. It should be clear to everyone that United States health care system is failing and not serving its citizens.

In the most recent presidential election, the final two candidates provided positions on health care. John McCain’s idea focused on an open market contest rather than government spending. With his plan there were tax credits-$2,500 for individuals and $5,000 for families who could not purchase or could not get health care through their employer. To help people who are denied coverage by insurance companies due to pre-existing conditions, McCain proposed working with states to create what he called a “Guaranteed Access Plan”. President Obama called for a universal health care system. His plan calls for the government to establish a National Health Insurance Exchange that would include private health insurance plans and a Medicare-like government run option. With the universal health plan everyone would have coverage regardless of health status like if they had a pre-existing condition, it would also put an end to charging premiums based on your health. It would have required all Americans to buy insurance through the government health care plan or a private insurance plan, but all Americans would be required to have insurance.

” I think health care should be a right for every American. In a country as wealthy as ours, for us to have people who are going bankrupt because they cannot pay their medical bills-for my mother to die of cancer at the age of 53 and have to spend the last months of her life in the hospital room arguing with insurance companies because they are saying that this may be a pre-existing condition and they don’t have to pay her

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treatment, there’s something fundamentally wrong about that” ~Barack Obama Oct. 7,2008 ~

President Obama is right about the unsustainable course of our health care spending. We spend $2.5 trillion per year for our health care, 17.5 percent of the gross domestic product. Under these current trends, this will increase to 48 percent of GDP by 2050. By that point, government health care programs like Medicare and Medicaid alone will consume 20 percent of our GDP. Simply put, we cannot provide all the health care that everyone might want. Any health care reform will have to confront the biggest single reason costs keep rising: The American people keep buying more and more health care. If a treatment can save our lives or increase quality of life, we want it. Therefore, in the long run, the only way to spend less on health care is to consume less health care. Someone, sometime, has to say no. The real debate here is about if we should ration care but who should ration it. Right now, that decision is often made by the insurance companies or other third party payers.

So if health care is considered as a commodity and not a right, it makes a fairly strong case that is should be bought and sold like any other commodity, for a profit, and at the highest price the market will tolerate. It seems that our current system of private- for sale- at a profit, health insurance makes the most sense when health care is considered as a commodity. Then our private health insurance corporations as they exist now will not need to change very much if at all. In regards to our private health care insurance system, we overpay for our health care due to buying more and more health care. Besides paying for our actual health care services themselves, we are also paying the operating costs of the insurance company, plus whatever profit’s the insurance company builds into our premiums. And although they are regulated to a certain extent, private health care insurers are not directly accountable to the public as government institutions are.

Health care is just not another commodity. It is not a gift to be rationed on the ability to pay. It is

HEALTH CARE: A RIGHT OR COMMODITY 9.

time to make universal health care a national priority, so that the basic right to health care can become a reality for all Americans. There should be a clearly defined basic health care plan that is available to all Americans. I am not talking about a health care plan that will cover at no cost, elective medical care. I would advocate for financing a health plan that be based on a concept of public good rather than a commodity. If all citizens can receive benefits, then they all can contribute based on their own ability to pay through income taxes. These funds then would pay for all medically acceptable inpatient and outpatient services, both mental and physical. A properly financed, universal health insurance program will provide the best opportunity to provide what we Americans want most, high quality, affordable health care for all. I also believe this would be something that most physicians also want and would benefit from. Our current system of health insurance tends to put the cart before the horse, the role of financing is first then the delivery of health care. If we can define the delivery of health care, we would have a better opportunity to create a more user friendly system. It would also support an extensive range of services made available to all Americans which reflects extensive community based, primary and secondary levels of care. We might finally recognize and fund what we have ignored for too long: long term, respite and nursing home care.

Health is the general condition of a person in all aspects of life. It can be seen as the level of functional and or metabolic efficiency of an organism, often implicitly human. According to World Health Organization (WHO), health is ‘a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity’- (WHO 1986). It can be defined as the absence of disease, a state of health unless symptoms emerge that demonstrates a deviance from normality.

Mechanic and Volkhart (1961) define illness behaviour as ‘ the way in which symptoms are perceived, evaluated and acted upon by a person who recognizes some pain, discomfort or other signs of malfunction’. Coe, (1979) asserts that illness is a subjective phenomenon. Individuals perceive themselves as not feeling well and hence may deviate from usual normal behaviour. According to him, “the individual may feel sick without a disease being present, (or he/she may not experience illness even though a disease is present). Two persons with the same clinical symptoms may act altogether differently in degree and kind of concern expressed, and whether and how they search for treatment”

Foster and Anderson (1979) posit that the state of illness comes with a time sequence. “There is the beginning, an awareness of the first faint symptoms, there is a progression, the social and psychological progresses that occur, and there is a termination, through recovery or death. At many points during the course of illness, medical and social decisions must be made, roles adjusted and attitudes changed to confirm to the reality of the situations”. Medical sociologist believes that illness behavior is to a large extent influenced by the individual’s social class, ethnic background and culture of orientation.

The definition of health and illness polarizes between those that rely upon objectives, scientific criteria at one extreme, and awareness, at the other. It has generated divergent views and understanding which is reflected in the academic debates about the nature of health and illness.

Traditional Medical View

The traditional medical view is that there is such a thing as a normal functioning of the body, which has a limited degree of variation. When operating within the normal boundaries of these variations, a person can be defined as healthy, and when they are outside these normal boundaries, they are ill or there organs are diseased. Health can be defined within this framework as the absence of disease. It assumes a state of health unless symptoms emerge that demonstrate a deviance from normality.

The Positivist Approach

The positivist approach accepts the concept of disease, but, brings out a much broader social element into the definition, suggesting that health is not just a physical state, but also a wider sense of well-being, closely linked to our social surroundings.

While the Lay Models of Health perspective emerged to use the functional definition by arguing that health can be defined as the ability to perform normal daily activities (Haralambos and Holborn 2008:280-1). The functionalist approach to the sociology of health and illness derives from the work of Talcott Parsons. He explored the relationship between illness and social control. Parson (1951) put forward one of the most famous concept in the sociology of health and illness: the sick role. This is the role assumed by an individual who excuses him or her from the normal behaviour because he is sick due to injury or incapacitation. He/she then seeks compassion from colleges, friend and family members and is no longer able to carry out normal activities. The sick person has the right to be exempted from normal social obligations, such as attending employment, or fully engaging in family activities. More so, sickness is something that no person can do anything about and for which the sick should not be blamed -they therefore have the right to be looked after by others.

However the obligation of the sick role entails that the sick person must accept that he/she is in a situation that is undesirable and should seek to get well a soon as possible. The sick person must seek professional help and cooperate with the medical profession to get better.

To the functionalist, illness has positive adaptive function which only a critical analysis can bring out. Dysfunctionally, disease and illness are destructive of human organism attacking cells and tissues thus reducing organism’s adjustment. It brings loss resources for the individual and his/her group and can engender role problems as one individual or some people are put off temporally or permanently. On manifest, illness serves to forewarn the individual about the possible collapse of his/her physical structure and to effect repair. It makes the individual, his/her group or society to mobilize for such and similar occurrence, and for the group or society to train members for multiple roles incase of incapacitation of some people.

On the latent functions, illness relieves the victim of unbearable pressure, mainly from relatives and dependants. It is used to gain attention and also maybe a device to expiate sinful feelings.

The Work of Foucault

A Foucaultian perspective drives social constructionalism much further on, right to the heart of the natural or biological, arguing that what we know as disease are themselves fabrications of powerful discourses, rather than discoveries of ‘truths’ about the body and its interaction with the social world (Bury 1986)

The corpus of his major work from the 1960s to the 1980s is an attempt to write a new history of the subject as constituted through historically located disciplinary powers. Foucault’s starting position is the configuration of knowledge or episteme which constitutes particular subjects during specific historical periods. For Foucault (1973) sociology was deeply implicated in the very episteme which had given rise to medicine. The discipline of medicine provided the tool whereby subjectivity could be experienced and enforced.

Contemporary sociology is not against medicine or professional practice, but rather seeks to problematize the taken- for- granted categories or reality within which they operate and deploy power/knowledge. The relationship between sociology and medicine and practices has always had a major impact on the field of the sociology of health and illness. His work went further to review the changing relationship before moving on to discuss some key characteristic of a sociological account for modern medicine and the social functions of medical knowledge. Although it is inappropriate to label Foucaults work postmodern it has been an important influences upon postmodernists.

Post Modernism

This approach allows the analysis of the fabrication of ‘health’, illness and “patient” subjectivity and the effect of the inscription on the body. It is suggested that health care professionals need to be more reflexive about their own knowledge claims and to resist the discursive practices which disempower and reduce choice.

There is sustained application of post-modernist ideas to the sociology of health and medicine, although there is certainly an interest among many to explore their relevance for the field. The objective of sociologists of postmodernity is to understand the nature of contemporary postmodern society. As a result of developments in medicine, the overall increase in levels of health, have created the belief that most people will live long healthy lives. “There is an increasing emphasis on ‘life planning’ and ‘self-identity’aˆ¦.as the constraints of life-threatening diseases early death and insecurity have given way to a more predictable life course” – Bury (1997). The experience of chronic illness therefore threatens much of what has come to be accepted as normal in contemporary society. Bury(1982) argued that chronic illness constitutes a major disruptive force in people lives undermining the taken-for-granted assumptions they had about the world and their place in it and forcing them to review their lives their own bodies and their own identities. He called this process biographical disruption. Narrative reconstruction is used by people to create a sense of coherence and order-why they got the disease.

Interactionist Perspective

Symbolic interactionism has probably been the most influential theoretical approach in the sociology of health and illness with studies focusing on the processes involved in people arriving at the decision to seek professional help, the interaction between the ill person and the medical professional in arriving at a definition of the illness and the impact on the person of being labeled as ill. This perspective rejects the notion that illness is a direct result of some form of disease instead they perceive it as a form of social deviance. What constitutes illness is a result of social definitions.

Mechanic (1968) defines illness behaviour as the way in which symptoms are perceived evaluated and acted upon by a person who recognizes some pain discomfort and other signs of organic malfunction.

Feminist Approach to Health

These can include liberal feminism, socialist feminism and radical feminism. Divisions are apparent in the theoretical debates on feminism within the sociology of health and illness.

All of them focuses in particular on inequalities of health between male and female and has sought explanations for these differences within the different role and economic positions of men and women. It tends to sought equality of numbers of men and women in the higher status medical professions and research has been undertaken to demonstrate the smaller number of women who occupy senior medical position and also the way in which nursing is regarded as lower-status, female profession. It also points to the lack of power that women have in their relations with the medical profession and demands a greater say in women’s health particularly in childbirth and conception.

Soialist feminist emphasizes that it is not possible to change the role of males and females within a capitalist patriarchal society as liberal feminist seek to do.

Conclusion

Health and illness in contemporary societies has been subjected of discuss from centuries back. Contemporary medicine includes unofficial, unorthodox, holistic and non conventional – reflects both the range of models of health which underlie these differing medicines and the ability of the more powerful biomedical profession to have them defined as somehow subservient to (complementary) or less proven (alternative than biomedicine.

Although there is general acceptance of the importance of social explanation in helping to understand health and illness within sociology, there is little consensus as to the exact mechanism which links social class, gender, ethnicity, and geography to different level of health – with the explanations ranging from those which stresses the wider economic structure of society, to those which stress the individual life style choice.

Finally the conceptualization of health and illness in contemporary society has brought out the idea that there are areas of knowledge which are natural and can only be understood through a sociological and physiological framework.

This essay will assess the question: has feminism achieved its goals? The essay will outline the three strands of feminism. The first section focuses on Liberal feminism which asserts the idea that in order for feminism to achieve its goals it must create equality among men and women. The second section turns to socialist feminism that believes that the only way feminist goals can be achieved is with the overthrow of the capitalist system and that of patriarchy. The Third and final section analyses radical feminism that advocates the goal of political lesbianism. This essay will conclude that feminism has not achieved its goals, however Liberal feminists believe their aim for equality is achievable in the near future.

Has Feminism achieved its goals?

Feminism as an issue first became prominent in the 17th and 18th century in France and America. It was not until the suffragette movement of the 19th century that feminism was seen as important in Britain. The scholar Estelle Freedman compares first and second-wave feminism saying that the first wave focused on rights such as suffrage, whereas the second wave was largely concerned with other issues of equality, such as ending discrimination. [1] Feminism is a contested issue, therefore difficult to define, due to the fact that feminism has a directory of meanings, however the term feminism can be used to describe a political, cultural or economic movement aimed at establishing equal rights and legal protection for women. Within feminism there are many strands, the most important and commonly known strands are Liberal, Socialist, Radical and more recently Post-modernist. Within these strands there is an on-going argument of whether or not feminism has achieved its goals.

Early feminism was heavily influenced by liberalism. Liberal Feminists main goal comes from the liberal idea of equality of opportunity, freedom for the individual. The idea that everyone, both men and woman deserve to be considered to be of equal worth. However these liberal feminists take into consideration that this is not the case in society. Their goal thus being to create a society consisting of a culture of equal rights. They believe that woman’s subordination is a product of stereotyping, for instance seeing a woman as a mother only. It is often implied that feminine behaviour is a weakness meaning that men are seen as the stronger part of society, creating this inequality. Friedan sees this as the ‘feminine mystique’ which she refers to as a cultural myth. [2] This is the idea that woman see certain things as more important; for instance the need for security and love is typically seen as feminine, whereas success and superiority is typically seen as masculine. This assumption thus disadvantages women and separates them from entering employment.

Liberal feminists therefore dismiss the notion that biological differences make women less competent than men, and believe that societies socialisation patterns need to change, so that gender socialisation does not occur, in other words males and females need to distance themselves from stereotypical roles. As both men and women our humans, they should have the same type of freedom and rights. Wollstonecraft asserts this view claiming that ‘the distinction of sex would become unimportant in political and social life’ [3]

Liberal Feminists believe that they can achieve this goal of equality through reform, for instance laws against sex discrimination in employment secures equal opportunities for woman. Added to this, they have the belief that society should not be organised by gender, but as Mill puts it: according to the ‘principle of equality’ [4] and that accidents of birth like the sex of the child should be irrelevant, thus suggesting that women should be open to all the aspects of society, just like men, having all the rights and liberties that men enjoy such as the right to vote.

Liberal Feminism is an optimistic theory, and overall believes that the goals of feminism are progressing and that over time gender equality will become the norm. This progression can be seen through different rights such as the right to initiate divorce proceedings and the reproductive rights of women to make individual decisions on pregnancy. Thus they believe that the goals of feminism may not be achieved at this moment in time, but the changes in society mean that soon they will be.

Liberal feminists have been criticised for this over optimism, they see the obstacles to equality as simply the prejudices of individuals or irrational laws, ignoring the possibility that there are deep seeded structures causing women’s oppression, such as patriarchy. Socialist and radical feminists criticise liberal feminists stating that one needs to recognise the underlying causes of female subordination, and that it is naive to believe that changes in the law will be enough to bring equality. Instead, they believe that revolutionary changes are needed.

Socialist feminists connect the oppression of women to Marxist ideas about exploitation, oppression and labour. They think unequal standing in both the workplace and the domestic sphere holds women down. Socialist feminists see prostitution, domestic work, childcare and marriage as ways in which women are exploited by a patriarchal system that devalues women and the substantial work they do. They focus their energies on broad change that affects society as a whole, rather than on an individual basis. They see the need to work alongside not just men, but all other groups, as they see the oppression of women as a part of a larger pattern that affects everyone involved in the capitalist system.

Socialist feminists dismiss the liberal feminist view that women’s subordination is due to stereotypes. They see women’s subordination as rooted in capitalism; although men may benefit from women, the main beneficiary is capitalism. For them the tension between men and women is due to the economic structure of society and only by overthrowing capitalism will women be equal to men. Thus their goal is: a revolution- that is they believe that the subordination of women can only be understood in terms of economic factors, for instance the idea that women are unpaid workers in the home. This subordination performs a number of functions for capitalism: women reproduce the labour force; women absorb the anger of men. Ansley for example describes wives as ‘takers of shit’ [5] . It is for these reasons that woman’s interests and thus their goal should be the overthrow of capitalism. If this is their goal, then it is quite clear that feminism, according to the socialist feminist side has not achieved its goals.

However modern socialist feminists refuse to look at the status of women in terms of economic factors and instead focus on the cultural roots. Mitchell suggests women perform four functions in society: ‘1) members of the workforce, 2) reproduce the human species 3) responsible for socialising children 4) sex objects.’ [6] Looking at this, the only way according to modern socialist feminists to achieve their goal is if they separate themselves from each of these areas, not just the idea of capitalism being replaced by socialism. This has yet to be achieved.

Many criticisms have been made of socialist feminists. For some, they fail to explain women’s subordination in non-capitalist societies. As women’s subordination is also found there. Unpaid domestic labour may benefit capitalism, but it does not explain why it is women and not men who perform it. They place insufficient emphasis on the ways in which men and not just capitalism oppress women and benefit from their unpaid labour.

Radical Feminism dismisses both liberal and socialist feminism, focusing on gender as the reason for all social divisions. They consider the male controlled capitalist hierarchy, which it describes as sexist, as the defining feature of women’s oppression. Radical feminists believe that women can free themselves only when they have done away with what they consider an inherently oppressive and dominating patriarchal system. For them the key concept is Patriarchy: which literally means rule by fathers and is seen process of gender oppression.

Patriarchy has come to mean a society where men dominate women, that there is a male-based authority and power structure and that it is responsible for oppression and inequality. As long as the system and its values are in place, society will not be able to be reformed in any significant way. Patriarchy is universal, existing in all societies. According to Firestone the origins of patriarchy are in biology; women bearing children makes them more dependent on men. However this is criticised by De Beauvoir who believes that the position of women is based not on natural factors but social factors, showing a critique of patriarchal culture.

The basis of radical feminism is the idea that sexual oppression is the biggest feature of society and that other forms of inequality for instance class exploitation take a back seat. For radical feminists patriarchy is the biggest form of inequality, men are women’s main enemy. Most radical feminists advocate the idea of separatism and Political lesbianism. Separatism refers to the idea of living apart from men creating a culture of female independence. Political Lesbianism is the idea that women become involved in lesbian relationships for political reasons. Many radical feminists argue that lesbianism is the only non-oppressive form of sexuality; ‘feminism is the theory; lesbianism is the practice’ [7]

The relationship between men and women must be transformed if women are to be free. Radical feminists argue that women and men should be separate, women should raise their consciousness about women’s oppression in women only groups and they stress that political lesbianism is the only non-oppressive form of sexuality.

Thus, this means that the goal of radical feminists is to live separate lives from men. However they recognise that this will not solve all the problems of the patriarchal society. Some radical feminists see no alternatives other than the total uprooting and reconstruction of society in order to achieve these goals. These goals have clearly not been achieved as heterosexual relationships are still the norm, although having said this there has been a rise of homosexual relationships in the last thirty years.

Socialist feminists argue that class, not patriarchy, is the primary form of inequality. They also argue that capitalism is the main cause and beneficiary of women’s oppression, and not men. Radical feminism offers no explanation of why female subordination takes different forms in different societies. It assumes that all women are in the same position and ignores class, ethnic differences. Liberal feminists argue that women’s position has improved greatly and that women are now more equal to men.

These three strands represent the different views and ideas of different feminist theorists. Although they all have different opinions, having considered all the arguments it is clear that they all believe that feminist goals have not been achieved. Liberal feminists believe that they are well on their way to achieving equality, whereas both socialist and radical feminists disagree. Socialist feminists asserting the view that an overthrow of capitalism is needed, whereas radical feminists assert the view that in order to be free they need to live separate lives from men.

Evaluate the contribution of grounded theory, as an approach to data analysisIntroduction

The concept of grounded theory is from the Glaser and Strauss’ research in 1967. In 1960s, they made a research for medical personnel to deal with an imminent death of the patient’s field observation in a hospital, and then discovered and developed the grounded theory. In this essay, I will evaluate the grounded theory in 5 parts. The first part is the characteristics of grounded theory; the second part is the procedure of grounded theory; the third part is comparison with other types of research methods and the forth part is the contribution of grounded theory research in management field, and the last part is the future of grounded theory.

1. The characteristics of grounded theory

Some perspectives of grounded theory

In Suddaby’s (2006) view, the grounded theory can be described as:

“Grounded the­ory is best understood historically. The methodology was developed by Glaser and Strauss (1967) as a reaction against the extreme positivism that had per­meated most social research.” (Suddaby 2006, p.633)

And Gephart (2004) points out:

“Glaser and Strauss (1967) proposed grounded theory as a practical method for conducting re­search that focuses on the interpretive process by analysing the “the actual production of meanings and concepts used by social actors in real settings” (Gephart, 2004, p.457).

And another view is Glaser’s perspective (1992, p16), he argues that:

“The grounded theory is a general methodology of analysis linked with data collection that uses a systematically applied set of methods to generate an inductive theory about a substantive area.”

Grounded theory research method is a type of qualitative research which is based on induction. It used in many sociological research areas such as education, religion, and many others. Zhigang (2007) argued that the method is characterized by extracting the theory from the phenomenon to create or enrich existing theoretical system.

In the view of Layder (1993), Grounded theory method is a process of generating a theory, which including constant comparison, thinking, analysis and transformation of information. The characteristics of emphasis on information and more interactive approach, which makes the researchers collect data by making use of a continuous and intimate interactions of the parties and events.

In summary, in the first place, according to Zhigang’s perspective,(2007) the grounded theory is a bottom-up approach to establish substantive theory, which is finding the core concepts reflects the social phenomenon based on systematical data collection, and then generate the relative theory through the links between these concepts. Secondly, grounded theory must be supported by empirical evidence, but it is not the main feature of grounded theory, the main feature is that it generates new theory or idea abstracted form the experience and data analysis. Lastly, in philosophical ideology, grounded theory approach is a paradigm based on the post-positivist, which emphasize on falsifying current theory which has been constructed.

The comparative analysis – the core of data analysis of grounded theory

Strauss & Corbin (1998) pointed out that the grounded theory emphasizes on development of the theory, but also the theory is based on the data collection of realities, and continuing data analysis through the comparison.

The strategy of comparative analysis usually used in sociology research. In grounded theory, it is a very important process. Glaser and Strauss (1967) argued that it should be first contrasted the use of the method with certain other users in the research process, and then define and describe what type of theory be created through comparative analysis. The purpose of comparative analysis, as a strategic method for generating theory, is to obtain the accurate evidence, which is the difference between establishing theory and verifying theory. The evidence collected from some comparative groups, which is used to examine whether the original evidence was correct.

The characteristic of comparative analysis for establishing theory or concept puts a high emphasis on theory as process. In other words, theory is not perfected; it needs develop continuously through comparative analysis. Glaser and Strauss (1967) believed that theory renders the reality of social interaction and its structural context as a process.

The coding

Coding is a key element of the data analysis in grounded theory. BaiKai and YuanBo (2009) argued that the encoding is the usually used technology in the qualitative research which is entirely different from quantitative research. In qualitative research, the purpose of coding is not counted, but rather “deconstruction” of information to form the concept. They would be re-arranged in different categories, in order to promote the comparison of information and proposition of theoretical concepts in one category.

Zhigang (2007) points out that the effective use of the grounded theory primarily depends on the following two aspects: on the one hand, the researchers should make an effort to choose a meaningful direction or area of research. It is difficult to identify the gaps that may exist in the theoretical proposition; On the one hand, the researchers should pay attention to data collection and collation, and propose some theoretical assumptions and refining the new conclusions in accordance with the principles, steps and techniques of the grounded theory.

2. The procedure of the grounded theory

In Strauss and Corbin’s view (1998), it is important that focus mainly on the process. They believe that the process is more important as describing and coding everything which is continuously changing.

The process of grounded theory research made based on the view of Pandit. N (1996)

Source: Pandit. N (1996) The Creation of Theory: A Recent Application of the Grounded Theory Method

As can be seen clearly, there are mainly 3 phases in the process of grounded theory – research design phase, data collection phase and data analysis. The whole process is started at review of technical literature and finished at reaching closure, but it is need to note here is that if the result is theoretical saturation after the theoretical sampling step, it should be restarted the second step – selecting cases.

According to the Suddaby’s view (2006), There are 2 key points in the method which described by Glaser and Strauss (1967) – “constant comparison,” and “theoretical sampling,” in which data are collected and ana­lysed simultaneously, and “theoretical sampling,” in which decisions about which data should be collected next are determined by the theory that is being constructed. Therefore, the most important steps in the process are data analysis and theoretical sampling, which are the key difference in contrast with other research methods.

3. Comparison with other methods of qualitative research

Grounded theory and other various ways in social research have different advantages and disadvantages. Possibly different types of methods can be used in different areas. Researchers select different research methods, could means that they have different research ideas and objectives. At the same time, selection and use of methods could more depend on the topic or the attribute of research. The necessary requirement of obtaining the valuable research findings is the appropriate combination between objectives and methods of the research.

Comparison with Hypothesis Testing

The Hypothesis testing method is different from the Grounded theory method. The definition of Hypothesis testing can be described as: “Hypothesis testing research investigates a phenomenon in terms of a relationship between an independent and dependent variable, both of which are measurable numerically. This relationship is called a hypothesis. The aim of the research is to test whether the hypothesized relationship is actually true, using statistical methods.” (Auerbach and Silverstein, 2003, p.3)

Although hypothesis testing and grounded theory are good research methods to do the research in some areas, there are some differences between them. The hypothesis testing method is mainly different from the grounded theory in the process of building theory. In hypothesis testing method, the hypothesis or idea has been generated first. Researchers can make hypothesis without any evidence, then they will look for the evidences or collect data and information to support their hypothesis or idea. In contrast, grounded theory is an inductive method which focuses on the discovery and does not rest on hypothesis testing but on building hypotheses according to the data and relative information. Suddaby (2006) point out: “Glaser and Strauss rejected positivist notions of falsification and hypothesis testing and, instead, described an organic process of theory emergence based on how well data fit conceptual categories identified by an observer, by how well the categories explain or predict ongoing interpre­tations, and by how relevant the categories are to the core issues being observed.” (Suddaby, 2006, p.634) It is clear that the hypothesis testing a grounded theory would be used in different fields, such as the hypothesis could be used for working out the mathematics problem and grounded theory could be used in the research in the social areas. Which method can be chosen for research depends on the objectives of the research.

Comparison with Ethnography

Creswell (1998) argued that ethnography involves prolonged observation of the group, typically through participant observation in which the research is immersed in the day to day lives of thepeople or through one on one interviews with members of the group. Clearly, the ethnography method could be more used in the research of human, culture and language etc.

From the view of Creswell (1998, p148), the following table can describe the differences between grounded theory and ethnography in data analysis process.

Data analysis and representation

Grounded theory

Ethnography

Data managing

Create and organize files for data

Create and organize files for data

Reading, Memoing

Read through text, make margin notes, form initial codes

Read through text, make margin notes, form initial codes

Classifying

Engage in axial coding

Engage in open coding

Analyse data for themes and patterned regularities

Interpreting

Engage in selective coding

Develop a conditional matrix

Interpret and make sense of findings

Representing, Visualizing

Present a visual theory

Present propositions

Present narrative presentation augmented by tables, figures and sketches

Source:

Creswell, J. (1998) Qualitative inquiry and research design: choosing among five traditions

As can be seen clearly, the most difference between grounded and ethnography is from classifying step to visualizing step. The 3 core coding steps play an important role in the data analysis of grounded theory, which make the grounded theory can be developed through the constant comparison. And also it is one of the advantages of grounded theory in contrast with other qualitative methods as an approach to data analysis.

Mello and Flint (2009) believe that the grounded theory primarily uses interviews, but also uses observation and documents analysis like an ethnography method. It differs from an ethnography method because of its purpose, which is to build theory. Like many other interpretive qualitative approaches, grounded theory has helped other disciplines open up fruitful new avenues of research.

Hammersley (1990) argues that much ethnography places emphasis on the ‘description’ as an important purpose of research, there are other strands that focus on a form of ‘theoretical description’. However, while Glaser and Strauss think that grounded theory is related to the wider context of qualitative analysis and method. The grounded theory approach is highly distinctive and unlike other types of qualitative methods.

4. Grounded Theory in management research

It is no doubt that the grounded theory can be used in a wide range of research such like nursing, business and management, mathematics and many types of sociology. Then, I will talk about the contribution of grounded theory focus on the business and management area. Firstly, the following table gives some examples of the grounded theory used in management research.

Examples of grounded theory in management research
Example
references

Senior executives and IT

Systems development

Managing understanding in orgnisations

Organisational culture

Staff perspectives on work

Retailer response to manufactures’

low-cost programmes

Rural women entrepreneurs

Competitive strategy and manufacturing

Process technology

Building co-operation in competitive industries

Consumer behaviour

Advertising and mass media

Marketing

Career development

Electronic data interchange

Leadership in organisations

Strategic alliances

Ideal business images for women

Tourist behaviour

Employment outcomes

Seeley and Targett (1997)

King (1996), Calloway and Ariav (1995)

Brown (1994, 1995)

Turner (1981, 1988)

Clegg et al. (1996)

Nuefeldt et al. (1996)

Manning et al. (1998)

Egan (1997)

McKinley-Wright (1995)

Schroeder and Congden (1995)

Congden (1995)

Browning et al. (1995)

Houston and Venkatesh (1996)

Goulding (1999b,1999c,2000b,2000c)

Hirschman and Thompson (1997)

Burchill and Fine (1997)

De la Cuesta (1994)

Beard (1989)

Sperber-Richie et al. (1997)

Crook and Kumar (1998)

Parry (1998)

Hunt and Ropo (1995)

Lang (1996)

Kimle and Damhost (1997)

Riley (1995, 1996)

Mullins and Roessier (1998)

Source: Goulding, C. (2002) Grounded Theory: A Practical Guide for Management, Business and Market Researchers

From the table above, it is obvious that the grounded theory can be used in many researches about business and explores a wide range of management problems. “These situations merely serve to demonstrate the transcending nature of grounded theory and its potential for application in the field of management research.” (Goulding, 2002, p.51) Taking the marketing field as an example, “grounded theory has begun theoretical development in the areas of the creation of a market oriented firm, moving away from previous research that merely described what a market oriented firm looks like.” (Gebhardt, Carpenter, and Sherry, 2006, citied in Mello, and Flint (2009) A Refined View of Grounded Theory and Its Application to Logistics Research p.109)

5. Grounded theory in the future

What grounded theory will happen in the future? It is no doubt that the grounded theory will be used for doing research in the wider range of fields. Increasing researchers will choose the grounded theory as the first choice.

Youhui (1996) think that one of the characteristics of grounded theory method is that the discover believe that it is necessary to generate theory in the research of sociology and both data analysis and theory building should be focused in qualitative research and any other research methods. Therefore, the grounded theory method is ideally suited to the areas such as: the existing theoretical system which is not perfected, the phenomenon which is very difficult to effectively explain, or the new areas and phenomenon which has no systematical theory currently.

About the Justifying Grounded Theory in the future, Glaser described it as:

“The future will bring less need to legitimize grounded theory; hence, there will be less need to justify using it. Now, many researchers have to explain it and argue for its use. Its future portends that grounded theory will be as accepted as are other methods (e.g., surveys) and will require little or no explanation to justify its use in a research project.” (Glaser, B.G. 1999, pp.845)

Charmaz (2005 citied in Denzin, N.K. and Lincoln, Y.S. (2005) Handbook of Qualitative Research) believe that a major strength of the grounded theory is that they provide tools for analysing process, and these tools hold much potential for studying social justice issues. She also believed that coding practices can help us to see our assumptions, as well as those of our research participants. Rather than raising our code to a level of objectively, we can raise questions about how and why we developed certain codes.

Grounded theory has its own advantages, it is to believe that grounded theory will be developed deeper and suitable for the research, Charmaz (2005 citied in Denzin, N.K. and Lincoln, Y.S. (2005) The SAGE Handbook of Qualitative Research 3rd ed.) write that:

“As its best, grounded theory provides methods to explicate an empirical process in ways that prompt seeing beyond it. By sticking closely to the leads and explicating the relevant process, the researcher can go deeper into meaning and action than given in words. Thus, the focused inquiry of grounded theory, with its progressive inductive analysis, moves the work theoretically and covers more empirical observations than other approaches. In this way, a focused grounded theory portrays a picture of the whole.” (Charmaz, 2005, pp.529)

Conclusion

To sum up, the grounded theory has a wider use range than other methods. For those social areas which lack current theory and some phenomenon which lack enough evidence and explanation, the grounded theory method is an effective analytical technique as an approach of data analysis. This method not only can help researchers to use inductive methods to abstract the basic theory from the phenomenon in the research, but also it is a good way to build and develop the theoretical system gradually to achieve the combination with the current theory effectively. There are many contributions of grounded theory in many different areas such as business, education, medicine and other many others. In terms of many advantages and characteristics of grounded theory, we believe that it will be use in more range of social research as an approach to data analysis and developed more to be accepted by more researchers.

Reference

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Different people of different religions, race, age and culture have different perceptions of death and the way to go about the loss. The following research tries to explain why people behave the way they do in their different manner. It defines death and grief, why, when and how they occur.

It also explains about the misconceptions that people have about death and grief. It gives a more understanding of these phenomena and explores what people go through when they experience them. The paper also gives solutions on how a person should handle the situation once it has happened to him.

Grief is the reaction to loss; it is mainly associated with a loss of something or someone to whom a person had formed a bond with. A person can respond to grief emotionally, socially, physically or even through the way they behave. Grief is caused by loss of a variety of things. It can be as a result of a divorce, an illness, loss of someone’s possessions, status, employment, pets and loved ones (O’Connor, Irwin, & Wellisch, 2009).

Different people react differently when they go through a loss. The different reactions may be as a result of what one has lost. These reactions may be manifested from one person to another or within the same person. The different reactions emanate from peoples diversity cultures, personalities, age, religious and spiritual practices and beliefs (Kubler, 1991)

Grief exacerbates both and physical and psychiatric morbidity. This is common especially after a loss of a spouse. During this period, the bereaved usually exhibits symptoms such as headaches, heart palpitations, dizziness and trembling. The bereaved also tends to suffer from depressive symptoms during the first year after the loss. Those who are bereaved young tend to take more symptom relief drugs as well as showing more physical distress than older people. For the older people, the number of visits to the physician as well as hospitalization increases during the time of physical distress.

Grieving is an early and old phenomenon. During the olden days, people used to seek help with their grief from religious leaders, extended families, and close neighborhoods as well religious institutions. Today, because of secularization, lack of a sense of community and lack of belief in formal religion, has led to the bereaved seeking help from health workers (Worden, 2002).

Children differ in mourning with adults. They tend to return to an earlier behavior like clinging to a toy, thumb sucking or even depicting an angry behavior. They are not mature to mourn like adults but they mourn intensely. A loss in childhood can result to emotional problems as well as physical illness. This poses a great risk as the child can contemplate suicide or become a delinquent. This is mostly common in adolescents (Kubler, 1991)

Dr. Elisabeth Kubler-Ross believed that grief has its own stages. These stages include emotional reactions like denial, anger, bargaining, depression and acceptance. She advises that understanding grief is an important part of the human experience as it is a necessary response that helps to heal from the overwhelming experience of loss (Kubler, 1991)

Dr. Kubler suggests some of the things that a griever can engage in order to overcome grief. Some of these things may include participating in support groups which may either be faith based or secular. Those people going through a complicated grieving process are advised to attend a therapy session with a psychologist or any other qualified professional dealing with mental health. She also advises grievers to take food supplements as well as eating healthy foods (Kubler, 1991)

Exercise and work outs like jogging and aerobics are also recommended during this period of grieving. Grieving is also an emotional drainer process thus she recommends enough rest for the person grieving. Places of worship are also known to be very helpful in providing solace and comfort to those grieving. Dr. Kubler recommends that grievers show emotions whenever possible like letting the tears to flow as this facilitates the healing process (Kubler, 1991)

At this point of grieving, the griever requires a lot of acceptance and support from friends, family or the people around. The griever may depict a wide range of emotions that may require a lot of understanding from people around (O’Connor, Irwin, & Wellisch, 2009).

To grieve is more than just to show sadness. It involves positive experiences when it deepens interpersonal connections.

Grief can cause great wear and tear to both the psyche and the physical body. It is experienced in a very personal way although there are some commonalities to grief. Different people may go through similar reactions to grief such as nightmares, hallucinations and problems with appetite. Other people may experience sleeping disorders while others may go short of breath.

Intense or complicated grief can result to complicated responses. These responses may include suicide attempts, murders, shock and even mental disorders. Grief which is complicated can be debilitating, it involves pangs of painful emotions which are recurrent. It may also involve intense longing and yearning for the lost person or thing and also thoughts which are preoccupied with the lost person or thing.

Death

It is the cessation or termination of biological functions that make up a living organism. Death refers to both a particular event and the condition that result thereby. Many religious beliefs tend to be concerned more with the condition than a particular event.

People have different perceptions of dying and death. Many wonder how it occurs or whether the dying just accepts death quietly. Many questions also linger in our minds whether the dying think of their possible decomposition, being consumed by maggots or rotting in hell (Piven, 2004).

The process of dying is a process that is known because it is witnessed and described by those involved in it. Certain factors influence the dying experience. These are interpersonal relationships, gender, nature of a disease and the treatment environment, and age. A young child may not understand the nature of death as a mature adult with diverse life experiences would. The dying process is also influenced by gender as a result of different roles played by women and men. A dying man is more likely to think of financial provisions for his family while a dying woman is more concerned with family integrity. Individuals who have experienced a poor interpersonal relationship experience a greater distress while dying than one who had a good relationship (Wass & Neimeyer, 1995).

Death is seen to be an event as it occurs in a particular time, at a particular place and in a particular way. Death is also seen to be a condition as one is seen to be incapable of carrying the important functions of life. It is a condition that is not reversible. It is also a universal certainty. It forms the centre of many organizations and traditions.

Death can be accidental, intentional or natural. Many species die from predation. Intentional activities causing death may involve death by one’s self i.e. suicide, death by others i.e. homicide and calamities like war. Death by natural causes is mostly caused indirectly by human activities (Appel, 2005).

To determine whether a person is dead or not, there are signs that one can look for. Some of these signs may include; respiration cessation. Breathing stoppage is a good sign that a person is dead. Lack of body metabolism can also suggest that a person is no longer alive. Other signs are a lack of a pulse, body becoming pale a few minutes after the person dies, body temperature reducing and stiffness of the corpse’ limbs (Appel, 2005).

Death can be clinical or legal. When a person ceases to breathe and to circulate blood, the person is declared to be clinically dead. This happens when a person gets a cardiac arrest or the heart simply stops to beat.

During this time, the person losses consciousness and the brain activities stop. Procedures to resuscitate the patient are initiated. These include putting the patient under cardiac life support machine which attempts to restart a heartbeat. The resuscitation continues until the recovery of a heartbeat or when a physician determines that the recovery is impossible and the patient is declared legally dead. A brain dead patient with heart and lungs that are functioning can be pronounced to be legally dead (Safar, 1988).

Legally, the state brain dead defines death. This occurs when the brain activities both voluntary and involuntary are irreversible and hence cannot sustain life. Irreversible loss of brain functions is caused by direct trauma to the head as a result of a gunshot wound or an accident caused by a motor vehicle. Loss of brain functions can also be caused by massive hemorrhage as result of high blood pressure complications (Murray, 1990).

Legal death is when a qualified personnel declares that a patient does not require further medical care and the patient be pronounced dead under the law. Some of the circumstances favorable for a person to be pronounced legally dead is when brain dead. This is when the brain activity is not detected.

Psychology of dying

According to psychologists, when going through the process of dying one goes through the experience of pain, regret, and fear of the unknown. Our social systems also break down death into distinctive dreads. Example, as a means to obtain moral obedience, religions mold death anxiety into fear of agonizing hell (Wass & Neimeyer, 1995).

The fears and ideas that people have about death are not innate; they are learnt from their cultural and social environments. A particular culture’s system of death conditions the behaviors of the living. For instance, their willingness to receive an organ transplant, suicide contemplation, their will to take risks, to purchase a life insurance, preference for cremation or burial, their attitude towards abortion or capital punishment and their hope for resurrection

Religion is also known to shape people’s attitudes toward death. This could be positive or negative. The more religious members display a more consistent attitude of death as measured by the level of fear of death. Those who believe in afterlife have a coherent understanding of situations related to death. Death anxiety, threat and fear result into other forms of psychological distress. Health status is unrelated to the level of fear and anxiety of death (Wass & Neimeyer, 1995).

Pursuing a death-exposure profession like medicine or attending the morgue does not necessarily increase the fear of death or anxiety. Those professionals or volunteers who work closely with the dying show reduced fear of death and much death competency.

Physicians usually have a difficult time with their patients whom they know have no chance of recovery. Telling a patient about his dying is never justified. On the same note, to withhold a patient’s dying information is not warranted.

According to Dr. Kubler (1991), people regardless of their age, religious orientation, race or cultures recognize when they are about to die. Some may start bidding farewell even if death is not expected. Dr. Kubler equates death to being born into a different existence. To die is like to move from one house to another only a more beautiful house this time. It does not matter how death may have occurred because the experience is the same (Kubler, 1991).

When one dies, i.e. when the soul leaves the body, it is still possible to perceive what is happening around the dying place i.e. where the body was left. One is able to register everything with a new awareness different from the earthly consciousness. This happens the same way as when one is lying unconscious having a surgery. During surgery, many patients have an out of body experience where they watch surgeons work on them and can actually hear them talk. The same thing happens when a dying patient is in a deep coma. The patient can neither move nor talk but can hear and understand everything being said to him (Kubler, 1991).

Nobody dies alone. When one leaves the physical existence, one joins another existence where time, space or distance does not exist. The power of thought is able to bridge long distances in a split of a second. Many people have experienced this when someone who lived many thousands of miles away suddenly appears to them and then later come to realize that they just passed away a few hours or days ago.

When patients are on their deathbeds, they report to see people whom they used to see and play with when they were little, only to have forgotten their existence when they grew up. These people die peacefully and happy knowing that someone who loves them will be waiting for them. Generally, people waiting for us on the other side are those who loved us the most (Kubler, 1991).

People die at different times; as little children, as young people or very old people. According to Dr. Kubler, the young have already learnt what they were supposed to learn and the old have accomplished what they were supposed to do at the time of their death. If we live well, we will not worry about dying (Kubler, 1991).

Conclusion

Different people of different religions, race, age and culture have different perceptions of death and the way to go about the loss. The study has identified grief as a reaction to loss, where the victim responds in an emotional, social and physical manner to portray his/her state. In this case, the study has identified that the different reactions exhibited by people as a result of death varies with their diversity cultures, personalities, age, religion and spiritual practices and beliefs. The study has identified several stages taken in a grief process. These include emotional reactions like denial, anger, bargaining, depression and acceptance.

There are, however different ways of overcoming grief, the study has identified a simple method as group participation in a faith based or secular to be an effective approach. On the other hand, individuals undergoing through a complicated grieving process are advised to attend a therapy session with a psychologist or any other qualified professional dealing with mental health. Eating food supplements and healthy eating habits also helps to overcome grief. Death is seen to be an event as it occurs in a specified time, place, and in a certain way. Death is also seen to be a condition as one is seen to be incapable of carrying the important functions of life. It is a condition that is not reversible. Dr. Kubler has argued that people, regardless of their age, religious orientation, race or cultures recognize when they are about to die. People die at different times; as little children, as young people or very old people. When one dies, i.e. when the soul leaves the body, it is still possible to perceive what is happening around the dying place.