Category: Free Essays

In order to begin this essay it is worth outlining some of the meanings behind the terms ‘mental illness’ and ‘stigma’. Mental illness is a conceptually problematic term as there as different ways of speaking about normal and abnormal behaviour (Pilgrim and Rogers, 1999). It can broadly be described as a type of health problem which affects an individual’s thoughts, feelings and the way they interact around other people. It also has a cognitive dimension as it can affect anybody at any time and may be temporary or permanent (Pilgrim, 2005). Scheff (1984) discusses the medicalisation of mental illness, he argues that ‘residual deviance’ (pg. 36) can refer to the variety of conditions which are held under the umbrella term of mental illness simply because they do not come under any other category, such as criminal. Essentially, any form of unacceptable or deviant behaviour which is not classed in other ways, becomes a form of mental illness. Scheff’s approach uses labelling theory to discuss mental health; this is something I will turn to later. Surveys have revealed that the majority of us are acquainted with mental illness and are familiar with it damaging effects either through a friend or relative etc. 15% of us have had a mental health problem ourselves (Layard, 2005). Stigma can be defined as ‘the social consequences of negative attributions about a person based upon stereotype. In the case of people with mental health problems, it is presumed that they lack intelligibility and social competence and that they are dangerous’ (Pilgrim, 2005, pg 157). Goffman (1963) argued that stigma ‘spoils’ a person’s social identity, it creates a gap between a typical, ordinary social identity which we expect others to have and our real social identity. It disrupts everyday social interaction because ‘normal’ individuals do not know how to behave with stigmatized individuals and vice versa (pg. 15). Goffman identified three types of stigma, stigma deriving from physical defects or abnormalities, stigma of race and religion and finally ‘perceived blemishes of individual character’ this includes such things as sexuality, political beliefs and mental health (Goffman, 1963, pg. 14). Goffman’s work is very important in discussing the complexities of stigma and discrimination and I plan to use his work throughout this essay. Skinner et al (1995) argue that a hierarchy of stigma exists in which inferior social statuses such as ‘prostitute’ and ‘alcoholic’ are ranked. They identified mental illness as being at the bottom of the hierarchy. The stigma of mental illness is different from others because it involves changes in behaviour which attracts negative judgment by others. It makes people wander about an individual’s stability and whether they pose a risk to themselves or others (Bury, 2005).

In order to better understand the stigma of mental illness it is necessary to conduct research into the lay views held amongst the public, this includes accounts from people with mental health problems (MHP) who discuss their experiences, and also the views of those without MHP (Pilgrim, 2005). A qualitative study by Dinos et al (2004) which researched the experiences of 46 people with a mental illness revealed that stigma was a major concern to most of the participants. Stigma defines individuals in terms of their mental illness and has the potential to impact on all aspects of life. Goffman (1963) formulated stigma into a ‘double perspective’, the first is obvious to others and cannot be hidden. He referred to this as ‘discrediting’. The second type is ‘discreditable’ and is not necessarily noticeable to others (pg. 14). With this form the problem is managing personal information, whether this means hiding the fact that they have a mental illness, or hiding the nature and extent of the condition. Dinos et al (2004) found that the management of information was a major problem and ‘a potent source of stress, anxiety and further feelings of stigma even in the absence of any direct discrimination’ (pg. 176). Some of the patients chose to downplay their illness by telling others it was another type, such as depression. Experiences of stigma were also dependent on the nature of the illness, those with depression and anxiety were more likely to feel stigmatized. While those with schizophrenia and bi-polar disorder were more likely to experience physical and verbal attacks. The effects of stigma can be extremely damaging, individuals may feel ‘depersonalized, rejected and disempowered’ (Pilgrim, 2005, pg 158). This can lead to isolation and an acceptance of the treatment received as justified. This in turn can cause a further decline in their health (Dinos, et al, 2004).

In terms of lay views of mental health held amongst the public, these are usually ones of distrust and sometimes hostility. Many people hold stereotypical views of mentally ill people in which psychotic behaviour is expected (Pilgrim, 2005). The influence of the media is important here and is something I will turn to later. Attribution theory (Corrigan et al, 2000 and Bury, 2005) can be used to explain stigma and discriminatory practices. It consists of two aspects, ‘controllability’ and ‘stability’ the former refers to the extent to which individuals are responsible for their own mental illness and stability refers to whether the illness can improve over time and to what extent. Studies which use attribution theory reveal that many believe that individuals with MHP are to blame for their illness and do not deserve any sympathy. They believe them to be potentially dangerous and should be avoided. Also, they show no optimism about people reaching recovery (Corrigan, et al, 2000). An example of such a study comes from Weiner and colleagues (cited in Corrigan, 2000), they asked 59 students to rate various disability groups according to aspects of controllability and stability, the results revealed that they viewed mental illness much more severely than other illnesses. The widespread stigmatization of mental illness is rooted historically in ‘fear of the unknown, our tendency to attack ridicule or laugh at what we don’t understand’ (Lalani and London, 2006). Since the deinstitutionalization of mental illness and the introduction of care in the community initiatives, this fear of the ‘other’ has become much more significant as the boundaries between the ‘sane’ and ‘insane’ have become blurred. We have a strong need to distance ourselves from things that we fear, therefore the stigma of mental illness is one of panic and hostility.

Having discussed the stigma of mental illness and the perceptions held amongst the population in a little more depth, this leaves the question of how it is culturally constructed. Thoits (1985) discusses how we learn to act and feel through repeated social interaction. Our emotions are governed by the norms of society which we internalize from an early age. ‘We know how we should feel in a variety of circumstances e.g. sad at a funeral lively at a party, happy at a wedding, proud on success, angry at an insult and so on.’ (pg. 224). Equally, we recognize when our behaviour may be viewed as inappropriate to others and learn to control it. For example, ‘big boys don’t cry’ and ‘keep a stiff upper lip’ (pg. 224). We have a shared awareness of how we ought to behave in the social world, therefore anybody who breaks these norms is subject to ridicule. Thoits develops a theory which contrasts with Scheff (1984). She argues that self-labelling processes are significant in mental health, as people assess their own behaviour and seek professional help voluntarily. Scheff on the other hand focuses on the involuntary nature of mental health treatment and how people come to be defined as mentally ill; his concern lies with the institutionalization of mental illness.

The perceptions of people with mental illness held by wider society are ones of devaluation and discrimination (Link cited in Gaebel et al, 2006). When a person is labelled as mentally ill, these conceptions become part of his or her sense of self. Labelling theory is useful in understanding the stigma of mental illness. We react to mental illness is a similar way to crime and the criminal. This approach to deviance focuses on the reaction of others in maintaining and amplifying rule breaking or secondary deviance (Marsh et al, 2000). The labelling process can have a detrimental effect on a person’s status and identity. Their old identity is discarded and a new ‘master status’ label takes its place. In the case of the mentally ill individual, his or her condition comes to define who they are, regardless of the other roles they may have (such as parenthood or their job). Their stigmatized role of mentally ill dominates their existence (Marsh et al, 2000 and Pilgrim, 2005). The negative effects of labelling are very clear, research has suggested that employers are less likely to offer jobs to those who have been labelled mentally ill. They are also less likely to be given housing and more likely to have charges made against them for violent crimes. Some studies however, have indicated that labelling has had positive benefits for the individual (Pilgrim, 2005).

The main source of information for the general public about mental illness comes from the mass media. The media have come to represent the beliefs and perceptions of wider society and frequently exaggerate events and portray inaccurate stereotypes of people with MHP. ‘There is an unquestioning acceptance in the media of the ‘rising toll of killings’ as a result of community care’ (Dunn, 2002). For example, in the Daily Mail (21 February, 2003) the headline ‘400 care in the community patients living by murder park’ was printed after a woman was found dead in East London. After discovering that a large number of care in the community patients lived near the park, the police and the media assumed she was ‘murdered by a deranged psychiatric patient living in the community.’ Headlines like this are not uncommon and newspapers consistently present the image of the dangerous, unstable, incurable mental patient (Lalani and London, 2006). Other examples of hard-hitting headlines include ‘violent, mad. So doc’s set him free. New ‘community care scandal’ (The Sun, 26 February 2005) and ‘Bonkers Bruno locked up’ (The Sun, 22 September 2003). Philo (1996) found that two thirds of news coverage made associations between mental illness and violence, but media depictions are not consistent with the facts about mental health and violence. Home office statistics indicate that there is little or no correlation between violence and mental illness. In reality, people with MHP are more likely to be the victims of crime than the perpetrators (Dunn, 2002). There is a lot of empirical evidence to suggest that the media informs us about mental illness and that their depictions are ‘characteristically inaccurate and unfavourable (Wahl, 1992, pg. 351). Wahl and Roth (cited in Wahl, 1992) found that mentally ill characters in prime time TV shows lacked a social identity. They were usually single, unemployed and described negatively with adjectives like “aggressive” “confused” and “unpredictable” (pg. 345). Many other studies have produced similar results, with dangerousness and violence being the most common traits of people with MHP. Wahl argues that these portrayals must have an effect on our behaviour and attitudes towards mental illness. Many studies have ‘demonstrated that repeated exposure to media stereotypes in general influences conceptions of social reality’ (pg. 346). He cites research that demonstrates that heavy viewers of television tend to relate the real world to televisions distorted representations. One study asked students to complete a questionnaire about mental health before and after a viewing of “One flew over the cuckoo’s nest” those who saw the film had a less positive view of mental illness than those who hadn’t seen it (Wahl, 1992). It is clear then that the overall relationship between the media and the mentally ill ‘is not in dispute: it is one of sensationalism, exaggeration and fear mongering’ (Lalani and London, 2006). It is important however to mention that not all aspects of the media perpetuate negative stereotypes and it can be a useful tool in tackling discrimination and stigma.

For many people living with a mental illness, the cultural attitudes of fear, hostility and ignorance has contributed to experiences of isolation and social exclusion. A report by the Citizens advice Bureau (CAB, 2003) revealed that most people with a MHP are unemployed and that those who did have jobs end up leaving because their employers convince them that they are unable to cope. Jo, a mental health service user discussed her experiences at work in a report to the mind inquiry (Dunn, 2002 pg. 11) when she informed her boss that she had to see a psychiatrist ‘his reaction said it all, as soon as mental illness is mentioned people literally back away from you’. Pilgrim (2005) highlights that people with MHP are three time as likely to be unemployed than those with physical disabilities. This is mainly because of the attitudes of employers and not because of a lack of willingness on the part of the individual (CAB, 2003). There also exists a disincentive to work for those who are in receipt of welfare benefits. For many, their income upon finding work would only increase at a small rate, if it all, and they would lose out on any supplementary benefits such as housing benefits. Further to this is the difficulty in having their benefits reinstated should the job not work out (CAB, 2003). Social exclusion is a complicated and often cyclical process. It can affect a person’s access to education, social services and health care. Such limited access to one service can have a knock on effect on others. For example, restricted use of education and training opportunities can sustain unemployment further which in turn contributes to the benefit trap and can of course deepen a person’s exclusion and cause a further decline in their health (Dunn, 2002). It is clear then that the social exclusion of people with MHP denies them the basic levels of citizenship, happiness and wealth available to everybody else (Pilgrim, 2005).

To conclude, the stigma of mental illness is based on generalizations about insanity. These stereotypes are constructed through feelings of fear and anxiety over things we do not understand and struggle to relate to. There is no doubt that our views of mental illness are completely ungrounded and are transmitted repeatedly through the mass media, thus reinforcing a distorted image in our collective psyche. Stigma is used to identify and expose something abnormal about an individual (Goffman, 1963). However some are critical of the stigma framework and argue that it is too individualistic. If we study the collective discriminatory practices which cause exclusion for many people with mental illness, such as poverty and labour market disadvantage, then strategies for change may be easier to develop (Pilgrim, 2005). Layard (2005) identified mental health as our biggest social problem. It is not just a major health concern, it is a political issue. With such high numbers of people affected my mental illness, the costs to the economy are significant. Tackling stigmatization is an essential step in improving the lives of those affected. This involves inclusion of groups themselves, as only those with the knowledge and experience cans suggest what is right for them.

Even in the twenty-first century tuberculosis is a major public health concern, with an estimated 8.9 million new cases and 1.7 million deaths in 2004 Dye, 2006. TB is an infectious disease caused by a bacterium called Mycobacterium tuberculosis and it primary affects the lungs however it can also affect organs in the circulatory system, nervous system and lymphatic system as well as others. Commonly in the majority of cases an individual contracts the TB bacterium which then multiplies in the lungs often causing pneumonia along with chest pain, coughing up blood and a prolonged cough. As the bacterium spreads to other parts of the body, it is often interrupted by the body’s immune system. “The immune system forms scar tissue or fibrosis around the TB bacteria and this helps fight the infection and prevents the disease from spreading throughout the body and to other people. If the body’s immune system is unable to fight TB or if the bacteria breaks through the scar tissue, the disease returns to an active state with pneumonia and damage to kidneys, bones, and the meninges that line the spinal cord and brain” (Crosta, 2012). Thus, TB is generally classified as either latent or active; latent TB is the state when bacteria are present in the body however presents no systems therefore is inactive and not contagious. Whereas, active TB is contagious and can consists of numerous aforementioned symptoms. This essay will attempt to illustrate the ways in which social constructions of TB reflect wider socio-cultural values within contemporary global society. In the first part I will examine the historical context of TB and its link with poverty which continues on in present time. Secondly, I will explore the stigmatism and isolation with TB and finally I will relate the social construction of TB with the work of Emile Durkheim.

It is important to recognise the geographical disparities in the prevalence of TB. For example, countries such as Australia have a “relatively low incidence of the disease with new cases primarily being identified in migrant populations a decade after their settlement. In some European nations with substantial public healthcare facilities, TB continues to be a problem particularly within large thriving cities such as London. This disproportionate increase in disease incidence compared with other community groups and national rates can be found in those who are socially disadvantaged including homeless, drug and alcohol addicted, people with HIV, prisoner populations as well as refugees and migrantsaˆ¦” (Smith, 2009: 1). This demonstrates the negative connotations society denotes to TB infected individuals as well as suggesting that in order to better understand the social construction of TB, the history of the bacterium needs to be explored. In 1882 Koch isolated the Mycobacterium tuberculosis and it was acknowledged that the disease was spread through overcrowded conditions, insufficient nutrition and a penurious lifestyle. It can be argued that TB has been constructed in two main ways: socially and biologically. “Biologically through science as an organism and socially by the community as a slow wasting death that was often associated with pale individuals being removed from the community” (Smith, 2009: 1).

Throughout history TB has been ambiguously represented. Much of the Western nineteenth century fictional literature highly romanticized the disease and reinforced the prevailing practices and beliefs. Often referred to as ‘consumption’; people were described as being consumed and exhausted by the disease as symptoms were assumed to be individuals looking ‘delicate’, ‘pale’ and ‘drained’ of energy. Treatment during this period in history mirrored these romanticised notions. Medical care was commonly described as a combination of fresh air, companionship and rest. In contrast, many non-European countries “negatively popularised TB as part of vampire myths as people tried to make sense of the disease symptoms (Smith, 2010). As a result, diseased bodies were exhumed and ritually burnt to remove vampire’s existence” (Smith, 2009: 1). This demonstrates the contrasting representations of TB within differing societies, suggesting that the hegemonic socio-cultural values of a disease in this case TB plays a crucial role in the social representations of a disease. As well as illustrating the importance of considering the impact of spatial and temporal differences.

Following the identification of the disease the discovery of streptomycin and other anti-tuberculosis medications quickly emerged. This gave the impression that TB was no longer a major health problem but instead incurable and controllable. Despite being important for treating TN, streptomycin, isoniazid and other anti-tuberculosis drugs contained limits for treatment. Resistance quickly developed and resistant strains of the bacterium quickly emerged limiting the use of many drugs. Consequently, to stop resistance several of the anti- TB drugs are required in combination and need to be taken for a period between 6 months and two years during therapy (Gandy and Zumla, 2002). However, recent outbreaks of multi-drug (MDR) TB have once again brought the disease to the forefront of global health problems. MDR TB is said to have emerged due to inadequate treatment of TB, commonly due to over- prescribing or improper prescribing of anti-TB drugs. Problems with treatment generally occur in immunocompromised patients, such as malnourished patients and Immune Deficiency Syndrome (AIDS) patients (Craig et al., 2007). In addition, it can be observed that the increase in TB closely reflects the rise cases of human immunodeficiency virus (HIV) and AIDS globally. Frequently, individuals with “immune disorders are not only more likely to contract and develop TB, they are also more likely to be in contact with other TB patients due to often being placed in special wards and clinics, where the disease is easily spread to others” (Gray, 1996: 25). In 2009, 12% of over 9 million new TB cases worldwide were HIV-positive, equalling approximately 1.1 million people (WHO, 2010). One of the most significantly affected countries is South Africa, where 73% of all TB cases are HIV-positive (Padarath and Fonn, 2010).

Furthermore, in the early twentieth century improved medical knowledge and technology allowed for better diagnosis. During this period words such as ‘contagion’ and ‘plagues’ were popularly used in negative terms in association to judge societies. TB was reported as “a form of societal assessment, infecting the ‘bad’ and the ‘good’ being disease free. A number of reports suggest a sense of apprehension became apparent as differing tuberculosis beliefs began to emerge (Smith, 2009: 1). This highlights the importance of social representations in terms of common terms associated with a disease play in the social constructions of TB. Moreover, it could be argued that people’s perceptions of a disease are not only shaped by their direct experiences and the impressions received from others but also significantly through media representations of the disease (Castells, 1998). It is important to recognise the symbiotic relationship between media representations of a disease and the dominant public discourses. It should be acknowledged that the term ‘discourse’ has multiple meanings, nevertheless this essay will employ Lupton’s (1992) assessment that ‘discourse’ as “a set of ideas or a patterned way of thinking which can be discerned within texts and identified within wider social structures”. The discourses that are founded and circulated by the media (mainly newspapers) can be regarded as working to produce what Foucault (1980) calls ‘particular understandings about the world that are accepted as “truth” (Waitt, 2005). Thus in the process of disseminating such “truths”, it could be argued that the media as a collective and commercial institution is implicated in ‘governing populations’. Meaning that “the power of the media can (directly or indirectly) influence the conduct of its audiences” (Lawrence et al., 2008: 728). This illustrates that media representations of a disease (TB) impact and are themselves influenced by dominant societal discourses thus helping to shape the social constructions of TB.

Moreover, it could be argued that there is strong link between those associated with TB and stigmatism and isolation as well as poverty and dirt (Scambler, 1998). Historically, TB was romanticised and referred to as ‘consumption’, however once it’s infectious nature was recognised this notion quickly changed. By the early twentieth century, the prevailing social and cultural values at the time generally believed that the disease festered in environments of dirt and squalor and was known as the diseases of the poor which could then be spread to the middle and upper classes. However, by the twenty-first century this discourse shifted from “the ‘poor’ (although marginalised groups such as the homeless and those with AIDS were still implicated) to the role played by Third World populations in harbouring the disease which threatens to ‘explode’ into the developed world” (Lawrence et al., 2008: 729). This demonstrates that as society’s socio-cultural values change the way in which disease is constructed and perceived also changes. It is important to consider the ways which these socio-cultural values change as well as acknowledge the interlinked relationship between dominant discourses, media representations and prevailing socio-cultural values. The relationship between TB and poverty has been recognised (Elender, Bentham and Langford, 1998) and arguably may not only “reflect medical and social characteristics of poor individuals, but also characteristics of housing and neighbourhood which foster airborne spread of TB infection, such as crowding and poor ventilation. Population groups with an increased prevalence of latent infection (such as new immigrants) are disproportionately found in poor areas- often with lower quality housing” (Wanyeki et al,. 2006: 501). This illustrates that not only socio-cultural values influence the social constructions of TB but socio-economic factors such as income and housing play a key role too.

Additionally, it is important to recognise the global disparities with TB. For example, Dodor et al (2008) argue that in countries where treatment for TB is not readily available, the disease has become highly stigmatised and infected individuals are exceedingly discriminated. According to Link and Phelan (2001) “stigma arises when a person is identified by a label that sets the person apart and prevailing cultural beliefs link the person to undesirable stereotypes that result in loss of status and discrimination” (Gerrish, Naisby and Ismail, 2012: 2655). This can be illustrates in common cases where people with TB often isolate themselves in order to avoid infecting others may try to hide their diagnosis to reduce the risk of being shunned (Baral et al,. 2007). From research in Thailand, Johansson et al. (2000) distinguish two main forms of stigma; one based on social discrimination and second on fear from self-perceived stigma. Furthermore, patients commonly experience social isolation in family sphere where they are obligated to eat and sleep separately (Baral et al,. 2007). This is a common case in countries such as India where little factual knowledge exists about the causes and treatments of TB and access to the necessary healthcare is diminutive (Weiss and Ramakrishna, 2006). As well as many rural communities where knowledge is passed through previous generations; stigmatism and isolation related to TB is substantial- representing the social cultural beliefs of the community.

It is important to recognise that the stigma and its associated discrimination have a significant impact on disease control (Macq, Solis and Martinez, 2006). Concern about being identified as someone with TB can potentially put off people who suspect they have TB to get proper diagnosis and treatment. These delays in diagnosis and treatment mean that people remain infectious longer thus are more likely to transmit the disease to others (Mohamed at al,. 2011). In a study conducted by Balasubramanian, Oommen and Samuel (2000) in Kerala, India stated that stigma and fears about being identified with TB were responsible for 28% of patients and this was a significantly greater problem for women (50%) than men (21%). This illustrates those socio- cultural values, for example the gender inequality highly present in Indian societies has a crucial impact on the social construction of TB. Also, in another study of social stigma related to TB conducted in Maharashtra, India, showed that stigma and discrimination of the disease resulted in late diagnosis and treatment. Moranker et al,. (2000) found that 38 out of 80 patients they studies (40 women and 40 men) reported to actively attempting to hide their disease from the community. “Social vulnerability contributed to women’s reticence to disclose TB, and such women were typically widows or married and living with joint families (Weiss, Ramakrishna and Somma, 2006: 281). This demonstrates the extent to which negative socio-cultural beliefs and values about TB can help to construct the disease- in terms of diagnosis, treatment and contagion.

Emile Durkheim’s (1915) work can help to better understand the argument that social constructions of TB reflect wider socio-cultural values. One of Durkheim’s core arguments was his claim that ‘the ideas of time, space, class, cause and personality are constructed out of social elements’. This allows us to examine the human body not only as a reflection of social elements but it draws attention to changes over time. Durkheim’s idea that space and classification are socially constructed stems from the collective experience of the social group. According to Durkheim the fundamental social division is dualistic in that one is between the social group and the other not the social group; which he applied to religion resulted in the ‘sacred’ and the ‘profane’. This central framework can then be used to various ways of viewing the world. Simply put as one geographic space could be labelled as ‘A’ and another as ‘not A’. Social anthropologist Mary Douglas (1966) extended this Durkheimian vision and discerned that:

“far from a chasm separating the sacred and profane, as Durkheim had argued, there was a potential space which existed outside the classification system: this ‘unclassified’ space polluted the purity of classification and was therefore seen as potentially dangerousaˆ¦Douglas’s analysis of purity and danger can equally be applied to the rules underpinning public health which are concerned with maintaining hygiene. The basic rule of hygiene is that some things are clean and others are dirty and therefore dangerous. Danger arises primarily from objects existing outside the classification system and therefore by determining what is dangerous and where it comes from it is possible to reconstruct the contemporary classification system” (Armstrong, 2012: 16-17).

This illustrates the essay’s central argument that social constructions of TB reflect wider socio- cultural values- meaning that till present day in many parts of the world TB is still perceived as an unknown variable and thus outside of society’s normal classification system therefore is commonly professed synonymously with connotations of ‘danger’ and ‘dirt’. These results in significant stigmatism, isolation and discrimination associated with individuals with TB (Heijnders and Van Der Meij, 2006). Furthermore, this highlights the fluid nature of social constructions of TB- meaning that since societies change over time so do their values and beliefs resulting in changes in the ways in which disease are socially constructed. Therefore, in order to fully understand how social constructions of TB reflect wider socio-cultural values, the historical context in which these factors are based and the dominant discourses must be considered.

For example, in the mid nineteenth century public health, mainly relied on quarantine as a preventative method, slowly began to classify new sources of ‘danger’ in objects and processes such as “faeces, urine, contaminated food, smelly air, masturbation, dental sepsis, etc.” The prevailing public health strategy at the time of ‘Sanitary Science’; which monitored objects entering the body (air, food, water) or leaving it (faeces, urine, etc.). Whereas, in the twentieth century new sources of ‘danger’ emerged including venereal disease and TB .Thus, a new public health regime of Interpersonal Hygiene developed. “Interpersonal Hygiene identified the new dangers not as emerging from nature and threatening body boundaries but as arising from other human bodies. TB, which had been a disease of insanitary conditions in the nineteenth century, became a disease of human contact, of coughing and sneezing” (Armstrong, 2012: 18). This further demonstrates the changing and interlinking relationship between socio-cultural values and social constructions of TB.

In conclusion, this essay has attempted to explore the various ways in which social constructions of TB reflects wider socio-cultural values in contemporary global society, by briefly examining the history of the disease and its prevalence in present time. As well as exploring the relationship between TB and poverty- statistically it can be observed that individuals with TB often belong to marginalised social groups and economically impoverished groups. Also, global disparities of TB prevalence was noted demonstrating that since each society is different and has varying socio-cultural beliefs and in lieu of the social constructionist theory this essay has adopted it could be argued that each society has its own particular social construction of TB influenced by its unique socio-cultural beliefs. This may be problematic given that if social constructions of TB are diverse but TB is perceived as a global health problem thus requiring global action then the nuances between the diverse social constructions of TB will be overlooked thereby arguably hindering the possibility of improving TB diagnosis and treatment. This also points to the need for not only considering the medical sphere of TB but also if we argue that TB is socially constructed then it is important to recognise the need for including the social aspects to health policies.

Furthermore, this essay examined the link between TB and stigmatism, isolation and discrimination through time and present day. Establishing that there are two main types of stigma associated with people with TB; self-stigmatism and societal stigmatism. Both are results of the negative connotations TB has held throughout time. Also, I briefly examined the role media representations play on the social construction of TB- particularly newspapers where the reader is viewed as an active agent. Finally, I utilised Emile Durkheim’s work to better understand and link the arguments presented in the essay. Durkheim states that ideas of time, space, class, personality are all produced with social elements. This highlights the argument that not only does the social construction of TB reflect wider socio-cultural values but that these values change over time thus the social construction of TB also correspondingly changes.

Word Count: 2997

The essay focuses on the social construction of crime, and the possible reasons for these social constructions. In the first section, the essay explains what crime is, and the constructionist perspective theory. In the Second section my essay focuses on the crime as socially constructed and why it is socially constructed. In the third section essay explains, three levels of explanation in the study of deviant and criminal behaviour. In the final section, it focuses on the historical theoretical periods, which plays an important role in revitalising past discoveries.

Crime is a term that refers to many types of misconduct that is forbidden by law. There are a number of different reasons as to why crime can be viewed as a social construction. There cannot be ‘social problems’ that are not the product of social construction – naming, labelling, defining and mapping them into place – through which we can ‘make sense’ of them’ (Clarke, 2001). In this essay I will explain what is social construction, also what crime is, and why we think, that crime is socially constructed. Furthermore, I will explain how media construct crime and the stigma of black crime. In the last paragraph I will explore the importance of Marxist and Durkheim’s theories on the emergence of crime.

There is no doubt that crime is socially constructed. The constructionist perspective draws on a very different sociological inheritance, one that treats society as a matrix of meaning. It accords a central role to the processes of constructing, producing and circulating meanings. Within this perspective, we cannot grasp reality in a direct and unmediated way Reality is always mediated by meaning (John Clarke p.6). Indeed, some of its proponents argue that what we experience is ‘the social construction of reality’ (Berger, 1967). How something or someone is named, identified and placed within a map of the social orders has profound consequences for how we act towards it or them (Becker, 1963).

Public concern over crime relates mainly to theft and violence, which are regarded as being serious enough to warrant sustained attention from the police. This concern, reflected in periodic moral panics, tends to ensure that many of those who are involved in theft and criminal violence do so as a form of secondary deviation. As a result, many of them develop a criminal identity (Becker, H. S, 1963).

The national British crime survey (BCS) reports showed that the risk of being victims of crime is shaped by locality, lifestyle, age, gender and ethnicity. BCS confirm that the risk of being a victim of contact crime are highest for men those aged under 30, those living in intercity areas and those living in privately rented accommodation. Noon the less according to the BCS it is frequently those who are least at risk of crime who are most anxious about it, notably older people and women(May et al,2009).

The very good example of how crime can be socially constructed is ‘Black Crime’ (McLaughlin, 264). During the early 1970s indicated, that the media has continued to project an image of Britain as a white society (Hartman 1974). Crime and criminality came to be the central motif that constructed black people as a problem presence, and also signifying that they were not really British (McLaughlin, 264). Gilroy (1987) has added to this by analysing discourses on race, crime and nations. Perceptions of the ‘weakness’ of black culture and family life, sometimes explained by absence of a father or authority figure, or more crudely, by a lack of respect for the Law and British tradition of civility, served to define black people as ‘lesser breeds without the Law , as ‘the others’ who stands outside what is meant to be British(Gilroy, 1987). However the significance of the prolonged campaign that led to the inquiry into the murder of Stephen Lawrence cannot be overstated. Dominant representations of black people as a ‘problem’ for white British society have been successfully challenged (Murji, 274).

The media is the most powerful organisation which does a big impact on social construction of the crime. The importance of the news media in framing the public understanding of social problems is widely recognized (McLaughlin, 263). Research in many countries confirms that crime reports are among the most headlines catching of news commodities. It is also suggested that there is broad correspondence between the images of criminality articulated in the news media and the interpretation for this (Murji, 264). Such as media presentation of the information reinforces social construction of the crime (McLaughlin et al, 264).

There are three levels of explanation in the study of deviant and criminal behaviour. A first level of explanation is concerned with the existence of the many different forms of human behaviour that occur in any society (Becker, 1963). Biology may contribute towards an explanation of this diversity, but it can never provide the whole explanation. It is always necessary to take account of processes of socialization (Becker, 1963). Biological theory of crime, arguing that any association between physical characteristics and their behaviour can be explained(Young 1999). According to Young, lower working class children who are more likely to be involved, in the crime, are also by virtue of diet, continual manual labour, physical fitness and strength, more likely to be mesomorphic (Young 1999, 387).Young claims that males chromosome could lead to behaviour that to others it would look odd, and this differences may exclude them from normal social life, which in turn may lead them to crime. However according to Kelly, behaviour attributed to biological causes may not necessary lead to crime. The biochemistry of the body may affect behaviour as he points out for example A Diabetic person, without recent insulin injection may become tense, short tempered, but his behaviour does not constitute a criminal act( Haralambos 1999). A second level of explanation is concerned with the variation in norms between social groups, as manifested particularly in cultural and subculture differences (Becker, 1963). Lea and Young stress out that crime is only one aspect, though generally a small one, of the process of cultural adaptation to oppression. Unlike Gilroy, they see West Indian crime as a response to condition in Britain rather than as a continuation of traditions from the West Indies (Lea el at.1999, 428). Socialization takes place within particular social groups, and it is the norms of these groups that provide the standards for the identification of particular kinds of behaviour as criminal (Becker, 1963). The third, and final, level of explanation is concerned with the ways in which particular individuals are identified as criminals by others and so come to develop a criminal identity. This is a matter of social reaction and control (Becker, H,1963).

In addition to understand social construction of crime, it is very important to look back at historical theoretical periods, which plays an important roles in revitalising past discoveries, putting new stress on the interpretation of events and relating these to current happenings(Jock Young, 307).

First of all I would like to look at Marxist theory, where he sees crime being endemic in the social order. According to Marxism, men make their own history, but they do not make it just as they please: they do not make it under circumstances chosen by themselves, but under circumstances directed encountered, given and transmitted from the past (Marx, 1969,p.360). Marxist frameworks have developed a Marxist theory of crime. From Marx perspectives crime is seen largely as the product of capitalism, with criminal and antisocial behaviour indicative of the contradictions and problems inherent in the capitalist system (Marsh, 1997, 519). The basic motivation of capitalism, such as emphasis on materialism and self- enrichment, encourage self-interested, anti-social and, by implication, criminal behaviour (Marsh, 1997, 519). Marxist s argues that business crime is largely ignored by the legal system. There are some well publicized exceptions, but these tend just to reinforce the impression that criminals are mainly from the working classes and that business criminals are not ‘real’ criminals – they are just doing what everyone else does (Marsh,1997,519). Marxist arguments suggest that capitalism produces the conditions that generate criminal behaviour. According to him, crime occurs because of economic deprivation and because of the contradictions that are apparent in capitalist society. Working-class crime is a rebellion against inequality and against the system that uses the legal process- including the Law, the police, courts and prison as weapons in a class war(Marsh, 1997, 522).

According to Durkheim’s crime theory, he points out two arguments on crime growth. The first argument is, that modern industrial urban societies encourage a state of ‘egoism’ which is contrary to the maintenance of social solidarity and to conformity to Law , and second is, that in periods of rapid social change ‘anomies’ occurs. By this he meant an ‘anomic’ disordered society lacking effective forms of social control, and thereby leading to a state of individually perceived formlessness (Frank Heathcote, 347). Durkheim argument’s that crime is inevitable and functional does not explain the causes of crime or why certain people are more likely to engage in, criminal activities than others (Frank Heathcote, 348). Regarding to Durkheim, crime is present in all types of socially, and that crime is higher in more industrialised countries ( Haralambos 1999,389). Durkheim explains why he sees crime inevitable, he explains that it is inevitable because not every member of society can be equally committed to the collective sentiments, and that it is impossible for all to be alike (Holborn 1999.389). He also explains crime as being functional, and that its function not to remove crime in society, but to maintain the collective sentiments at their necessary level of strength. Durkheim believed that without punishment the collective sentiments would lose their force to control behaviour and crime rate would become dysfunctional. Durkheim view that healthy society requires both crime and punishment ( Haralambos. 1999, 390). More recently functionalist theories, based on the notion of there being a general consensus of values and norms, have focused on causes of criminal behaviour.

Functionalist theories of crime tend to assume that there is general consensus within society over what is right and wrong behaviour. The interactionist approach questions this assumption; it does not see criminals as essentially different from so called ‘normal’ people. Many people commit criminal action and it is therefore not easy to maintain a clear distinction between the criminal in terms of particular personal characteristics (Marsh, 1997, 517).

To summary, in my essay firstly I discussed that, crime has been seen as a response to the frustration felt by those who cannot achieve the norms or goals of society. Secondly, how dominant representations of black people as problems for white people society have been successfully challenged. Thirdly, that the media is the most powerful organisation which does a big impact on social construction of the crime, and finally I argued two most important theories, which are still in use.

References:

Becker. H. S. (1963), Outsiders: Studies in the Sociology of Deviance (New York: Free Press).

Fitzgerald. M. el at (1990). Social Disorganisation theories. Heathcote F (1990). Crime and Society. London: The Open University Press.

Haralambos, M. el at (1999). Themes and Perspectives. Fourth Edition. London: Harper Collins.

May. M. el at (2009). Crime Disorders and Community Safety. Dee Cook. (2009) Understanding Social Problems, Australia: Blackwell.

Marsh. I. el at (2009). Making Sense of Society. Fourth Edition. London: Longman.

The social construction of Health and Illness

Abstract

In what ways can it be claimed that health and illness are socially constructed? Refer to sociological theory in your response, and give examples from everyday life.

This assignment reviews the theory of social constructivism and its significance to Today’s social construction of Health and Illness , and how health and Illness are perceived and interpreted by society . This paper will explore different aspects to the social constructionist debate, on the two of the most important aspect such as “problematisation” , but mostly focusing on “medicalisation”. It will explore the macro-social factors, cultural aspects,the socio-economic conditions that could possibly be some of the fundamental aspects of the construction of both Health and Illness.It will also focus on analyzing the terminology and the etymology of the words and how it changed its meaning historically.

The social construction of Health and Illness

Introduction

A social vision of medicine seems to move attention to the promotion and information of health, on the social, cultural, political and economic health in terms of factors and variables in relation to each other without forgetting that the center is the individual. It is in this perspective that relational sociology intends to look at health in a post-modern reality in where the values appear to move continuously toward individualism systemic, a need for efficiency, a multiplication of the roles of the social actor.

Social Constructivism

I would like to start this assignment with an example of what social construction of health is. From the Iconic contents of the Iliad and the Odyssey, we can understand the significant knowledge of the Epoch on the ancient pathologies. Omer describes the fractures of the Femur, with very medicalised terms very accurate detail but most importantly he uses a very significant metaphor to describe the state of health as the joy and strive of Ulysses as soon as he spot a land like the recovery from an Illness.

Ulysses is a mature man , a man that suffered a lot but most significantly a man that depended on travelling , we can relate to Ulysses in our Modern and contemporary lives.

Ulysses comes back to not go back , so he doesn’t get recognized and not to recognize. The Return of Ulysses is the Journey , not his landing, like this the individual looks and strives for health as a definitive experience inasmuch as health doesn’t seem to be an ideal state but rather a construction, of a reality .

“The sociology of knowledge must concern itself with whatever passes for “knowledgeaˆY in a society, regardless of the ultimate validity or invalidity (by whatever criteria) of such “knowledge”. (Berger, P. L. and T. Luckmann ,1971.pp. 15), “To understand the state of the socially constructed universe at any given time, or its change over time, one must understand the social organization that permits the definers to do their defining. Put a little crudely, it is essential to keep pushing questions about the historically available conceptualizations of reality from the abstract “What?aˆY to the socially concrete “Says who?aˆY (Berger, P. L. and T. Luckmann ,1966),

The social constructionist debate is one of the most important in social science analyses of health and illness. It is part of a critical approach to biomedicine and biomedical knowledge that emerged in the 1970s. Many of the assumptions and values of the medical profession and biomedicine were challenged and criticised for being consistent with the patriarchal and capitalist structures of the society in which they were located.

From this emerged an anti-psychiatry movement which argued that much of what was labelled a mental illness was simply a social construction created by psychiatrists who acted as powerful agents of social control.

Diagnosing someone as schizophrenic for example, enabled psychiatrists to declare that person unfit to participate fully in social life. Diagnostic categories were called into question and the application of medical knowledge was seen as being political and not just a technically neutral act.

These ideas in the social constructionist debate have been applied to question the assumptions on which biomedicine’s autonomous and extremely powerful position in society is based.

There are several different aspects to the social constructionist debate, two of the most important are “problematisation” and “medicalisation”.

This approach states that diseases are not simply real but are products of social reasoning and social practices. Calling a set of symptoms “bronchitis” does not mean that a discrete disease exits as an entity independent of social context.

That is how medical science at a given place and time with the aid of laboratory tests and theories has come to define it. Someone with bronchitis will experience pain and suffering but the interpretation of it will vary between time and place.

In this sense then the idea of medical discoveries is misleading. There are no fixed realities of the human body waiting to be discovered. There are fabrications or inventions by biomedicine which implies that the disease was established through certain investigations which confirmed its reality.

It is indirectly related to social constructionism – it does not question the basis of medical knowledge as such but challenges its application. It draws attention to the fact that medicine operates as a powerful institution of social control. It does this by claiming expertise about matters of life which had previously not been regarded as medical matters e.g. ageing, childbirth, alcohol consumption and childhood behaviour.

Social construction of Health and Illness

Health does not qualify as a given, but a map and a construct generated by coordinating various points of view. As disease, health is a model, socially constructed, to interpret reality. So health, can be configured as an event, that the individual can use to interpret the world and relationships with the society in which he lives: a repertoire of signs that the social actor can use to interpret the social order.

So the disenchantment of the world, a result of erosion of traditional paradigms, leaves the individual alone, only to represent themselves in different roles in which he is called by many of the company.

The definition of health and the promotion of health itself exceeds the model, so to speak, ideal health, what which is constituted as the absence of disease: health becomes a condition which has an almost unconscious, seems coincide with the flow of life.

The disease, as agent that interferes with this flow, it seems revealing it as a lost condition. This model of the relationship between health and disease seems be that prevailing paradigms in medical and health facilities.

The logic seems to characterize the medical paradigms seems develop according to a complex system of different modes:

The first mode is the linear one in which a given injury causes a disease condition and treatment become a system in place to repair the damage had.
The second way is the individualistic : health and disease are determined by absence / presence of resources in the individual and care form interventions directed exclusively to the individual.
The Last is the a-historical: it ignores the interaction of the individual with his environment, its culture, its history, its social condition.

In this direction, macro-social factors, cultural differences, events external and extreme, the socio-economic conditions, the lack of a adequate social support, the relational environment against, are all, factors totally or relatively independent of the characteristics biological or psychological of an individual. (Canguilhem, 1988; Stern, 1927; White, 1991a; Zinsser, 1935).

The micro-social contexts and macro-social have a crucial role in the onset and evolution health status of individuals.

The networks of relationships can foster the creation of informal mechanisms of protection against disease and old age or, through the stimulation of collective action, can improve the efficiency and effectiveness of the provision of certain services by the public sector.

Kleinman (1980) has proposed a distinction between etymologies: disease, which refers to abnormalities in the structure or operation of organs and systems, and that is the domain of the biomedical model; illness, which is refers to the individual perception of a state that has a negative connotation and that includes, but is not limited to disease; sickness, indicating the events that can become disease or illness.

The term illness should refer to the direct experience of sick, the experience of the disease, while the disease is indicated conceptualization of the disease by the physician. Therefore, there is a difference between being sick and having a disease, a difference that in the German language is perceived as Erkrankung and Krankheit, needed to introduce a further term, sickness, indicating the perception of the disease by part of the social non-medical.

Precisely in this perspective Young (2004 ,p.26), exploring the social construction of the disease, proposed the further specification by the term sickness, which does not seem to be simply an ambiguous term that defines the was among the biological damage and the subjective perception of the damage.

The disease-sickness is to be understood as in fact the process through which, in conduct of concern and biological symptoms, is given a meaning socially recognizable and, therefore, acceptable.

Every culture has, according to Young (2004), the rules for “transforming” signs of the body in the symptoms, to connect the symptoms in a model etiological and intervention.

The disease-sickness, then, seems to be a process for socializing disease and disease-illness. The same set of signs, for example, can match, and different types of diagnosis and therapy. Is the causative dominant model in that society that “decides” what kind of disease the individual has and what will be the appropriate therapy.

The disease-sickness, also determines the size of individual of the disease. But it is society that determines which symptoms pay attention, when it is legitimate to feel bad and when it is not.

The role of Medicalisation

Medicine constructs or redefines aspects of ‘normal’ or accepted everyday life as medical problems. Professionals tend to offer technological or biomedical solutions to what are inherently ‘normal’ aspects of everyday life or social problems. Medicine has become a major institution of social control and this has been related to an increasing complex and bureaucratic system which encourages a greater reliance on experts.

High-tech modern medicine has become increasingly dangerous to the population’s health by:

reducing their autonomy and their ability to cope with their problems;
making them dependent on the medical profession;
damaging their health by the side effects of drugs and surgical interventions;

The medical system operates in close relationship with the manufacturers of pharmaceuticals and medical equipment, and this relationship is not necessarily in the patient’s interest. (Illich, I. 1977)

Inherent in the medicalization thesis are Marxist and Phenomological approaches to health and illness. This thesis considers definitions of illness to be products of social interactions or negotiations which are unequal because people do not have equal influence on the social construction of reality. Medical professionals are more able to define what counts as sickness than ordinary people. Medical professionals, therefore, have great scope for social regulation because if matters have to be defined as medical concerns, then health professionals have the authority to monitor, intervene and pass judgements upon them.

A common construction of the cause of disease portrayed in our culture , especially the idea that lifestyles are freely chosen , individualizes and obscures the way in which disease is socially produced.

The conceptualization of medicine as the application of ‘objective’,‘scientific’ knowledge to a purely biological body, obscures how diseases are produced in structures of inequality that are social that are mainly based on class, gender, or ethnicity.

At the centre of all sociological accounts of medicine is the argument that medical knowledge performs social functions independently of whether it cures and heals. Medical knowledge and practices are social accomplishments, and not the inevitable outcome of science or nature.

Conclusion

The sociological perspective on medicine seems focus its attention to the information and promotion of health, on the cultural, social, economic and political health in terms of factors and variables in relation to each other without excluding that the center is the individual. It is in this perspective that relational sociology intends to look at health in a post-modern reality in where the values appear to move continuously toward individualism systemic. The micro-social contexts and macro-social have a crucial role in the onset and evolution health status of individuals.

References

Albrecht, Gary L., Fitzpatrick, Ray and Scrimshaw,Susan C. (eds) (2000) Handbook of Social Studies in Health and Medicine. London: Sage

Berger, P. L. and T. Luckmann (1966),The Social Construction of Reality: A Treatise in the Sociology of Knowledge, Garden City, NY: Anchor

Conrad, P. (ed.) (2001) The Sociology of Health and Illness: Critical Perspectives. New York:

Conrad, P. and Barker, K. (2010) ‘The social Construction of Illness: Key insights and policy implications’ Journal of Health and Social Behaviour 51(S) 67-79

Dausset J., La medicine predictive et son ethique, in Pathologie et Biologie, 1997, pp. 199-204.

Freund, P. and McGuire, M. (1999) Health, Illness and the Social Body. Engelwood Cliffs,NJ: Prentice Hall.

Illich, I. (1977). Limits to medicine: Medical nemesis: the Exploration of health. NY: Penguin

Young,J.T. (2004) ,”Illness Behaviour : A Selective Review and Synthesis”, Sociology of Health and Illness,26,1:1-31

White, Kevin (2002).White, Kevin (2002). An introduction to the sociology of health and illness. SAGE. p. 42. SAGE. p.42.

1

“Inequality is a feature of my country, (the UK), however, it is of little social consequence”. Discuss.
Introduction

Inequality in society means that some people are at a disadvantage compared to others. In the UK inequalities are featured in a number of different contexts. Women for example are socially disadvantaged in comparison to men and ethnic minorities are often disadvantaged in comparison to the dominant white community because they may not have the same opportunities. There are also class inequalities in Britain where those from a working class background are often disadvantaged compared to people from a middle-class background (Giddens, 2001). This assignment will discuss the statement that inequality is a feature of the UK and assess the view that it is of little social consequence, this will be done with reference to class and gender inequalities in health.

Class Inequalities

Those who belong to the higher capitalist classes and to the middle classes tend to be better educated than people from a working class background. This often means that the higher classes have greater material resources than those from a lower class. Having more money means that people also have greater access to other resources. They tend to fare better when it comes to education and to health because they live in better areas which tend to have less crowded and better performing schools (Giddens, 2001). The working classes tend to have more stressful, or more physically demanding jobs that pay less money than, for example, teaching or being the manager of a successful business. This means that they often cannot afford the same kind of diet as those who earn more money and live in a better area. This puts them at a disadvantage in terms of how healthy they are and how long they might expect to live (Walsh et al, 2000). Such inequalities do not simply occur as a result of class inequalities but in areas where people do not have the same equality of opportunity. Since the late nineteen sixties feminists such as Walby (1990) have pointed to the fact that in a capitalist society women do not have the same access to material or other social resources and that this is due to the gender inequalities which exist in a patriarchal society.

Gender Inequalities

Britain is a patriarchal society. In patriarchal societies women are seen as the subordinate sex. Patriarchy is bound up with traditional notions of the family where the father was seen as the head of the family unit. This, feminists say, can be seen in all the structures of patriarchal societies where laws and social structures operate in such a way as to benefit men at the expense of women (Walby, 1990). Since the nineteenth century the traditional family has been one where the man goes to work and the woman stays at home and looks after the house and any children in the family. Walby (1990) argues that this arrangement made women invisible and their labour in the home, which allowed men to have a public life, has not been taken into account. With the rise of feminism and the struggle for equal opportunities for women the situation has changed somewhat and many women now work outside the home. Work does not readjust the gender imbalances that exist in British society because in most jobs women still earn less than men.

Walby (1990) has argued that gender is a primary category when it comes to inequaltity and the oppression of women. State policies may no longer aim to keep women in the home but have done little to alleviate the inequalities between women and men in the public sphere. Certain occupations such as teaching, nursing, shop or clerical work are still regarded as women’s work. Although women may now be involved in the public sphere and can be found in the labour market in increasing numbers, Walby states that they still remain segregated from wealth, power and status.

Doyal (1995) has said that research shows that while paid work brings benefits to a family it can also bring extra stresses and responsibilities. These may then affect women’s health. The increasing number of roles that women are called upon to play in contemporary society affects their emotional, mental and physical well being.

Class, Gender, and Health

For some time there has been concern over the fact that there appear to be inequalities in health provision and the ways in which this impacts on people’s lives. As a result of this sociologists look the body, or aspects of the body and the ways in which factors such as class, race and gender affect a person’s experience of health (Giddens, 2001).The Acheson Report (1998) pointed out that health inequalities are complex, certainly more than people had previously believed. Material deprivation alone is not the cause of inequalities in health, rather there are wider cultural and economic factors which interact with personal choices based on psychological and biological influences. Acheson recommended that a wider range of intervention and policy initiatives would be needed to address health inequalities. Many commentators believe that class inequalities in health have worsened over the last twenty five years with the introduction of market forces into healthcare i.e. operating the health system as though it were a business (Giddens, 2001). This particularly affects those people at the lower end of the class scale because facilities in poorer areas are often over stretched and therefore people may have to wait longer for the care they need.

Women in Britain tend to use the health services a lot more than their male counterparts. This is explained in terms of women generally living longer than men, having more chronic illnesses and generally being the main care giver and child rearer in the family (Provincial Health Officer’s Report, 1995). Feminists such as Abbott and Wallace (1997) point out that what is often missed is that women will also visit the doctor on behalf of another family member. Feminists also point out that because there is no specific health care policy for women the processes of menstruation, childbirth and the menopause are over medicalised.

Are These Inequalities of Social Consequence?

Clearly there are class and gender inequalities which are endemic to society in the United Kingdom and this results in inequalities in other areas of social life such as health. It might be argued that these inequalities do have social consequences. Class inequalities in health for example can result in working class members of society suffering from greater ill health and dying prematurely. The results of this could mean a shortage of workers in jobs that are not usually held by people from other classes it could also mean that the working class are more of a burden on the health system than their middle class counterparts. These things could have much wider social consequences, a shortage of services, in the construction industry for example, and a shortage of hospital beds in some areas. Similarly gender inequalities could also have wider social consequences. If women do not have sufficient access to health services then they may not be healthy enough to take care of other members of the family.

Conclusion

Clearly there are inequalities in this country and it would certainly appear that these inequalities may not seem to be of great social consequence but if they are left to carry on unaddressed could have wider ramifications. The introduction of the Community Care Act in 1990 for example relies on family members to take care of those people who may not be able to look after themselves as a result of mental health problems, or simply due to age. Members of the upper and middle classes may well have the resources to pay for care but working class people do not. If health inequalities are not addressed then there may be no-one who is fit enough to look after those people who are unable to look after themselves. This could have serious consequences for the health system, the benefits system, and Government policy making in general.

1250 words

Bibliography

Abbott and Wallace, 1997 An Introduction to Sociology: Feminist Perspectives. London, Routledge

Acheson, D. 1998. Independent Inquiry into Inequalities in Health Report London, HMSO

Doyal, L. 1995 What Makes Women Sick London, Macmillan

Giddens, A. 2001 4^th ed. Sociology, Cambridge, Polity Press

www.polity.co.uk/giddens

Pollert, A. 1996. “Gender and class revisited or the poverty of patriarchy” Sociology vol. 30 no. 4

Provincial Health Of. cer’s Annual Report (1995). Report on the Health of British Columbia.

BC Ministry of Health and Ministry Responsible for Seniors.

Townsend, P. Davidson, N. and Whitehead, M. (eds) 1988. Inequalities in Health, the Black Report and the Health Divide Harmondsworth, Penguin

Turner, B. 1987.Medical Power and Social Knowledge. London, Sage.

Walby,S. 1990. Theorising Patriarchy. Blackwell, Oxford.

Walsh, M. Stephens, P. and Moore, S. 2000 Social Policy and Welfare. Cheltenham,

The theory asserts that conflict in the families is a very normal occurrence .Conflict theories view family as a class in society, which one of the group is oppressing others. Debatably, a family is not just a social entity of children and married couples. It is a social group in which its members are linked to each other through marriage, ancestry, living together and adoption .In addition they care for each other and share economically. Family is just but a section of society. Conflict theories have variety of roots from systematic approach of society by Marxist and intra-psychic approach of individuals by frauds. Functionalists analyzed family as a miniature society in which each member of the family performs different essential activities that will lead to survival and continuity of the family.

Social conflict theories are based on a family as a difficult system characterized by conflict and inequality that causes social change. Conflict theory focuses the way in which members of the family struggle for different aspects of life. This include struggle for resources and power. As the family grows individuals within the social unit compete for wealth and prestige hence it leads to creation of conflict. It is not always true that families live harmoniously. Conflict theory is there to challenge on such stereotype beliefs. In the contemporary society then economy has inflated hence there is need to struggle in order to survive. According to Marxist groups and individuals in society have different non-material and material resources. The more powerful individuals use their powers to exploit and oppress those with no power.

The conflict theory views the family as a societal init that is in a continuous clash and a state of disharmony. The dynamics in the world have led to changes in roles played by each member of the family. The theory identifies and elaborates on the dynamism of roles and the genesis of conflicts in the family. Furthermore it uncovers on ways in which the members of the family deals with conflicts, adversity and changes. In families their exist diversity of powers. For example in most communities it is believed that the father is the head of the family. When families have been separated it is important to create a good relationship. It is within the family setup that its members understand and become more emphatic to the causes of conflict.

It is so difficult for individuals to interact without conflict, growth of all the family members of the family occurs through conflict. The conflicts and changes that occur in human life are important indicators of normal development and growth of family members. The important aspect of conflict is how to manage it. Family members should learn how to manage conflicts so that it does not lead to alienated relationship.

The theory pus lots of emphasizes on establishing the causes and solutions of conflict. Families have disagreements of various things, from the minor ones like what to eat for supper to bigger ones on how to bring up children. Members of the family differ in interests, extent of hostility, nature, personality and how we express and react on conflicts. In a nuclear family for example the mother and father may have conflicting goals such as how to spend the salaries. Due to the development of women rights working women argue that if both members are working they should divide all the activities in the house equal, but men will always belief that the household chores belongs to the women. The family as a unit is made up of individuals with different sex, age personalities and ideologies hence the occurrence of conflict is based on nature. Families too differ in power; some of the sources of power include love, money, physical cruelty and legitimacy. Each member of the family has power; the only difference is its degree and sources. Perhaps, communication is the most important solution to family issued. Members of the family should ensure that they establish a good communication.Furthaermore individuals should be understanding and empathic. The families should be ready to change in order to resolve conflict.

Conflict theories of the family have various assumptions .If families interact there is no way of escaping conflict. As a family there are conflicting interests. In addition the family will feel the social change and growth through conflict. Secondly the theories assume that change and conflict in families are ever-present, foreseeable and normal in e very family relationships. The theory states conflict has been a prevalent; hence the main goal is to manage it so that it does not grow to alarming levels that may cause damage to the family members. Given a chance to develop conflict families will inevitably break and cause unhealthy separation. For example divorce occurs when issues are not solved hence becoming chronic. Families too face scarcity of resources, in most cases conflict occurs because the resources that are available are not enough to meet all the needs of the family members. We could only be free of conflict if each member gets his needs .Individuals within the family have different level of intrinsically uneven elements, hence power is not equally distributed. Individuals who have access to power in the families work towards building himself instead of changing the family as a whole.

The conflict theories are not free from critiques. The theory emphasizes on the negative sides only yet in a family there are good things. For example caring parents and couples who love are not fine. The theory views this as a tool to oppress others in the family. In addition the theory emphasizes on differences within family members as the cause of conflict. Differences are appreciated and accepted because of how we were made. Certainly contemporary families do their things in a secretive manner hence it is hard to measure the level of conflict.

In conclusion family setup is not the avenue on oppression and conflict. Parents work together with their children for their betterment and for the good growth. The parents should socialize with their children and the all family so that each one of them grows to fit the dynamic society. We should learn to accommodated and appreciate our diversity within the family. The family is the primary source of all the traits in the society.

In the last few decades, quality of life has replaced the idea of wealth as the dominant goal of societal development. In opposition to the individual-centered perspective of societal development, several other welfare concepts emerged which put the focus on the aspects concerning societal qualities such as the extent of equality, security or freedom, or the quality and structure of the social relations within a society. Among those welfare concepts referring to characteristics of societies are, for example, „sustainability“, „social cohesion“, „social inclusion“ etc. Idea of the social cohesion of a society received great political attention at the national and supranational level. In regard to these developments, this paper attempts: first, to clarify the meaning of the concept of social cohesion and to determine its inherent dimensions by reviewing the existing theoretical approaches to this issue; second, to explore relationship between social cohesion and the quality of life.

Quality of life is a concept related to the individual welfare. Although social cohesion represents a societal quality, it affects the individual quality of life because the elements of social cohesion are perceived and experienced by the members of the society. Thus, the social cohesion of a society can be conceived as an aspect relevant to the individual life situation, and in this sence, it represents a part of the individual quality of life. Under this perspective a broad conceptualization of quality of life seems appropriate. Quality of life can be considered as the complex policy goal which includes social cohesion as one component. The very broad and multidimensional notion of quality of life enlarged the perspective of societal development by considering not only economic aspects but also social and ecological concerns. Several welfare concepts emerged which put the focus on aspects concerning societal qualities such as the extent of equality, security or freedom, or the quality and structure of the social relations within a society. One of these welfare concept is social cohesion.

The goal of this paper is: first, to clarify the meaning of the concept of social cohesion and to determine its inherent dimensions by reviewing the existing theoretical approaches to this issue; second, to explore relationship between social cohesion and the quality of life.

1. The concept of social cohesion

The idea of social cohesion is difficult to express in a single definition. Emile Durkheim first coined the concept of social cohesion at the end of the nineteenth century. He considered social cohesion as an ordering feature of a society and defined it as the interdependence between the members of the society, shared loyalties and solidarity [14]. Aspects often mentioned in describing social cohesion are the strenght of social relations, shared values and communities of interpretation, feelings of a common identity and a sense of belonging to the same community, trust among societal members as well as the extent of inequality and disparities [26; 14). The simpler the division of labor in a society is, the stronger the bond between individuals and the social group will be. This bond is a result of mechanical solidarity, which arises from segmented similarities based on territory, traditions and group customs. The social division of labour that modernity brings with it erodes and weakens such bonds, as does the

increased autonomy of individuals in modern society. In such a context, cohesion is part of the social solidarity that is required in order for the members of a society to remain bound to it with a force comparable to that of pre-modern, mechanical solidarity. This requires stronger, more numerous ties, and must even include bonds based on common ideas and feelings, leading to what Durkheim calls “organic solidarity”.

As of today there is no single definition of social cohesion and it is still debated whether social cohesion is a cause or a consequence of other aspects of social, economic and political life. There is no clear definition of the concept – probably because the very tradition of social citizenship that characterizes European societies assumes that social rights entail an intrinsic relationship between social inclusion and the provision of mechanisms to integrate individuals and give them a sense of full membership in society.

According to this view, social cohesion implies a causal link between the mechanisms that provide integration and well-being, on the one hand, and a full individual sense of belonging to society, on the other. Inclusion and belonging, or equality and belonging, are the cornerstones of the idea of social cohesion in societies organized around the principles of the welfare state.

The concept of social cohesion is often confused with other concepts, like social capital, social integration, or social inclusion. Social capital is closely related to social cohesion, and the two are very important concepts in policy and policy research circles. Social capital – understood as a symbolic societal asset consisting of the ability to manage rules, networks and bonds of social trust which strengthen collective action, pave the way for reciprocity and progressively spread throughout society resembles cohesion, and can largely be described as a stock upon which social agents can draw to make society more cohesive. However, social capital is both a consequence and a producer of social cohesion. Whereas social cohesion emphasizes processes and outcomes, social capital emphasizes the notion of investments and assets that bring benefits, benefits that are not fully appropriated by the individuals making the investments.

Social cohesion is often confused with social inclusion. Inclusion mechanisms include employment, educational systems, rights and policies designed to encourage equity, well-being and social protection. In that context, social cohesion may be understood in terms of both the effectiveness of instituted social inclusion mechanisms and the behaviours and value judgments of the members of society. Behaviours and value judgments include issues as diverse as trust in institutions, social capital, belonging and solidarity, acceptance of social rules and the willingness to participate in deliberative processes and collective endeavours.

Another proximate notion is that of social integration, defined as the dynamic, multifactoral process whereby individuals share in a minimum standard of well-being consistent with the level of development achieved by a country. This restrictive definition views integration as the opposite of exclusion. In a broader sense, integration into society has also been defined as a common system of efforts and rewards, which levels the playing field in terms of opportunities and delivers rewards based on merit.

The idea of social inclusion may be viewed as an expanded form of integration. Rather than emphasize a structure to which individuals must adapt in order to fit into the systemic equation, it also focuses on the need to adapt the system in such a way as to accommodate a diversity of actors and individuals. Inclusion requires not only an improvement in conditions of access to integration mechanisms, but also an effort to increase the self-determination of the actors involved.

The idea of a social ethic also includes an essential aspect of social cohesion, emphasizing common values, agreement on a minimum set of rules and social norms, solidarity as an ethical and practical principle, and the assumption of reciprocity.

These concepts are part of the “semantic universe” of social cohesion. Viewed in this light, the specific difference that sets social cohesion apart is the dialectical relationship between integration and inclusion, on the one hand, and social capital and social ethics, on the other. Consequently, there is a distinction between social inclusion and social cohesion, inasmuch as the latter includes the attitudes and behaviours of actors, without being limited to those factors. Social cohesion may thus be defined as the dialectic between instituted social inclusion and exclusion mechanisms and the responses, perceptions and attitudes of citizens towards the way these mechanisms operate.

A definition of social cohesion by relating it to the concepts of social exclusion/exclusion and social capital has also been present. For example Dahrendorf et al. described a social cohesive society as a society preventing social exclusion: „Social cohesion comes in to describe a society which offers opportunities to all its members of a framework of accepted values and institutions. Such a society is, therefore, one of inclusion. People belong; they are not allowed to be excluded“ [4, str.vii]. Other scientist have emphasised that the social capital of a society is an essential foundation of its social cohesion [18; 17].

On the basis of review of the various approaches we could conclude that the concept of social cohesion incorporates mainly two societal goal dimensions which can be analytically distinguished:

1) The first dimension concerns the reduction of disparities, inequalities, and social exclusion.

2) The second dimension concerns the strengthening of social relations, interactions and ties. This dimension embraces all aspects which are generally also considered as the social capital of a society [6].

These two dimensions must be viewed as independent from each other to a certain degree. In principle, strong ties within a community can be accompanied by the tendency to discriminate and exclude those people who do not belong to that community [19]. This problem highlights the importance of considering both dimensions – disparities/inequalities/social exclusion and social relations/ties/social capital – in order to get a comprehensive picture of the social cohesion of a society.

3. Social exclusion

Social exclusion represents concept with increasing popularity among scholars during last decade. The popularity of the concept was especially promoted through the growing interest in matters of social exclusion at the level of the European Union. The European Commission

launched a series of research programmes in the framework of the European Observatory on National Policies to Combat Social Exclusion and of the European Poverty Programmes.

Research on social exclusion replaced, to some extent, older terms of poor living conditions, such as poverty or deprivation. Originally, the term was used in the context of debates on a new poverty and defined as a rupture of the relationship between individual and the society due to the failure of societal institutions to integrate individuals. Today, it is suggested that social exclusion should be conceptualised as the insufficiency of one or more of the following four systems [1, str. 258-259]:

This approach focuses on relational issues, i.e. on the disruption of social ties between individual and the society. Unlike social cohesion, poverty is concerned with distributional issues, i.e. on the lack of resources at the disposal of individuals or househods [23; 12]. Thus poverty may be regarded as characteristic of indiviudals and households, whereas social exclusion may be conceived as a feature of societies and of the individuals’ relations to society.

In contrast to this position are considerations that social exclusion can be regarded both as a property of societies and as an attribute of individuals. As an individual attribute it is defined as a low level of welfare (economic disadvantage) and the inability to participate in social life (sociopolitical disadvantage). This perspective equals social exclusion to a multidimensional notion of poverty which describes a state or an outcome of a process. As a societal characteristc the term social exclusion refers to the impairment of social cohesion caused by the way in which institutions regulate and thereby constrain access to goods, services, acitivities and resources which are generally associated with citizenship rights. This view focuses attention to the processes of social exclusion and its causes which are attributed to the failure of institutions [5].

The conclusion arising out of these considerations is the requirement to differentiate between the causes of disadvantageous living circumstances and the processes leading to them on the one side and the outcomes of those processes themselves, that is peoples’ living situation. The causes may be attributed to societal institutions and can then be described by the concept of social exclusion as a property of societies. The impact of social exclusion on people is observable in the form of poor living conditions. In this sense, social exclusion represents a characteristic of individual and corresponds to the concept of poverty in a multidimensional notion.

4. Social capital

The counceptualization of social cohesion as it is proposed here considers social capital as representing a second main dimension which may be used to describe the social cohesion of a society.

Social capital represents one of the most powerful and popular metaphors in current social science research. Broadly understood as referring to the community relations that affect personal interactions, social capital has been used to explain an immense range of phenomena, ranging from voting patterns to health to the economic success of countries [7]. Literally hundreds of papers have appeared throughout the social science literature arguing that social capital matters in understanding individual and group differences and further that successful public policy design needs to account for the effects of policy on social capital formation. In this paper we will give the primary focus to the role of social capital in stenghtening the social cohesion and further link with the quality of life.

We often observe countries with similar endowments of natural, hysical, and human capital achieving very different levels of economic success. This paradox has led scholars to search for deeper and more meaningful explanations about what holds people and societies together in order to foster economic development. Over time, scholars have constructed various frameworks for understanding the social aspects of this phenomenon and what we currently refer to as “social capital”. Fueled by continuous empirical investigations, these frameworks have evolved quite rapidly in recent decades. Since Loury [16] introduced it into modern social science research and Coleman’s [3] seminal study placed it at the forefront of research in sociology, the term social capital has spread throughout the social sciences and has spawned a huge literature that runs across disciplines. James Coleman popularized the term as he sought to conceptualize the aspects of social structure that facilitate economic transactions. His work is widely recognized as one of the most significant, as is Robert Putnam’s study of voluntary associations in Italy. Putnam [21] concluded that the high density of voluntary associations in the north was responsible for the region’s economic success. Many others have also made significant strides in advancing our knowledge and understanding of the subject. However, despite the immense amount of research on it, however, the definition of social capital has remained elusive.

There are various theoretical approaches and perspectives of social captial which use more or less narrow concept. But they all have in common that they regard social capital as a property of a social entity and not of an individual [10]. It is a relational concept, it presupposes a social relation and exists only as far as it is shared by other individuals. Therefore, it cannot be the private property of a single person, but heas a character of a public good [11; 19]. The social capital of a society includes the institutions, the relationships, the attitudes and values that govern interactions among people and contribute to economic and social development. Social capital, however, is not simply the sum of the institutions which underpin society, it is also the glue that holds them together. It includes the shared values and rules for social conduct expressed in personal relationships, trust and a common sense of civic responsibility, that makes society more than a collection of individuals. Without a degree of common identification with forms of governance, cultural norms and social rules, it is difficult to imagine a functioning society [25, str.1].

Social capital is not only considered to be an essential basis for the social cohesion of a society, but at the same time as a main component of the wealth of a nation and as an important determinant of economic growth, besides physical, human and environmental capital [13]. The view is empirically supported by results showing a relation between the social capital of a society and its economic well-being [21; 15; 24]. Furthermore, there are also investigations pointing to the improvement of other dimensions of welfare such as education, health, rates of crime, and the environment [3; 20].

5. The interdependence of social cohesion and the quality of life The concepts of social cohesion and quality of life are interrelated [8; 9]. Althought social cohesion represents an attribute of a society, it ultimately rests on the behaviour, attitudes and evaluations of its members, too. Social cohesion is based on social capital which is also created by social relations and ties established, maintained and experienced by individuals. Thus, looking at the social cohesion of a society involves aspects which are part of the individual life situation and in this sense components of the individual quality of life. Secondly, elements of the social cohesion of a society may have direct impact on individual quality of life. Empirical examples are the above cited results on the influence of social capital on economic and other dimensions of welfare. At a conceptual level, the perspective of social exclusion as a process rooting in the malfunction of social institutitons and resulting in a deprived living situation of the individual is another example.

Social cohesion can be conceived as a societal quality which is experienced by individuals in their daily lives, for example in the form of the perceived inequality or the social climate at the working place, at school or in the neighbourhood, and thus also refers to the individual quality of life. This perspective conciders elements of the social cohesion of a society to form an integral part of the quality of life of the individuals belonging to that society. Such a position, which is supported here, advocates a broad conceptualisation of quality of life encompassing not only individual characteristics of the life situation but also societal qualities. In this sense, quality of life represents the common policy goal with social cohesion as an important component to be addressed.

6. The measurement of social cohesion On the basis of the conclusion about two dimensions of social cohesion, measurement of social cohesion should include measures concerning:

Concerning the first dimension – measurement dimensions for the various aspects can be derived for nearly all domains. Regional disparities are taken into account for example with respect to access to transport, leisure and cultural facilitites, educational and health care institutions, employment opportunities or the state of the environment. Issues of equal opportunities/inequalities could be considered therough political participation and employment opportunities, generation of inequalities in social relations or unemployment risks; inequalities between disabled and non-disabled people in access to public transport or educational institutions; etc. The aspect of social exclusion can be operationalised in many domains, too. Manifestatios of social exclusion are ususally measured such as homelessness, social isolation, long-term unemployment, poverty or a lack of social protection.

Concerning second goal dimension of social cohesion and that is strenghtening the social capital of a society, most of the aspects of this dimension refer to the life domain of „social and political participation and integration“. This domain covers all general issues of social relations and engagement outside the own household community such as the availability of relatives and friends, frequency of contacts and support within those personal networks, membership in organisations, engagement in the public realm such as volunteering and political activities. The quality of societal institutions is a component of social capital which applies to several life domains since, for example, institutions of education, health care, social security or the legal system.

7. Possible contemporary threats to social cohesion There are numerous possible demographic, socio-economic and political trends and processes which have been associated with a general deterioration of social cohesion throughout the world.

Over the past three decades, globalization in the form of processes of structural transformation has impacted severely, in many ways, on people throughout the world. The intensified linkage of local social conditions with activities and decisions within world financial, commodity and labor markets is increasingly apparent and in many places it’s consequences are devastating.

Perhaps the most fundamental feature of structural transformation in industrial countries has been reducing the share of industry in the formation of GDP and consequently the massive decline in manufacturing employment. We have been witnesses to the massive relocation of capital, jobs and manufacturing to areas of the globe where labor is cheaper. Instead of a relatively stable work conditions, characterized by institutionalized wage agreements and strong trade unions, internal labor markets within large firms, and secure, tenured and full-time employment; new socio-economic patterns emerge:

More and more, opportunities for work and flows of income became variable and unpredictable and stable conditions characterizing employment are replaced by growing insecurity. These kinds of changes add to a growing polarization not only between employed and unemployed, but between secure, highly skilled, well paid workers and the larger proportion of insecure, unskilled, low paid workers. In addition to that, the gender dimension is critical to this shift, since women are greatly over represented in the new flexible yet precarious sectors of casual, part-time and short-contract employment [2, str. 142].

The rise of neo-liberal political philosophy has driven many of the processes of political restructuring over the past two decades. A key aspect of the neo-liberal vision of society is bringing the market principle, along with notions of self-responsibility and individualism, to almost every sphere of politics, economics and society. Aspects of political change which have subsequently emerged, and impacted dramatically on social cohesion, include:

Such policies and processes which have brought about “the new inequality”’ can be seen as fuelling a process of “inequalisation”. The consequences for social cohesion, however defined, are devastating. “’Such a divergence of the life chances of large social groups”, Dahrendorf observes, “is incompatible with civil society” [4, str. 38]. The most socially stigmatised, spatially segregated and economically disadvantaged also become the most politically excluded.

The combined forces of economic and political restructuring, along with the new social fissions created in their wake, have also threatened a key socio-psychological source of social cohesion, the idea of “the nation”. The changes associated with globalization (here considered as processes involving the intensified linkage and increased scope, scale and speed of world-wide economic activity) are now so pervasive that national governments arguably no longer hold the keys to their own national larders. The flow and control of a variety of forms of investment, currency trading, commodity markets, and labor pools are increasingly determined by agents and forces above and beyond the reins of nation-state policy. For the nation-state, prerogatives and margins for maneuvers in economic policy are greatly reduced.

Conclusions

Social cohesion represents a concept which focuses on societal qualities such as the extent of inequality or the strength of social relations and ties within a society. In the terms described above, it is both a means and an end. As an end, it is an object of public policy, to the extent that policies attempt to ensure that all members of society feel themselves to be an active part of it, as both contributors to and beneficiaries of progress. In an age of profound, rapid changes resulting from globalization and the new paradigm of the information society, recreating and ensuring a sense of belonging and inclusion is an end in itself. Social cohesion is also a means, however, in more ways than one. Societies that boast higher levels of social cohesion provide a better institutional framework for economic growth and attract investment by offering an environment of trust and clearly defined rules. Moreover, long-term policies that seek to level the playing field require a social contract to lend them force and staying power, and such a contract must have the support of a wide range of actors willing to negotiate and reach broad agreements. In order to do so, they must feel themselves to be a part of the whole, and they must be willing to sacrifice personal interests for the good of the community. The formation of the social covenants needed to support pro-equity and pro-inclusion policies is facilitated by a greater willingness to support democracy, become involved in issues of public interest, participate in deliberative processes and trust institutions, as well as a stronger sense of belonging to a community and solidarity with excluded and vulnerable groups.

In this paper we have established two goal dimensios inherent in the concept of social cohesion: 1) the reduction of disprarities, inequalities and social exclusion and 2) the strenthtening of social relations, interacions and ties. Concerning the first dimension of social cohesion, examples of measurement dimensions within various life domains are regional disparities of the state of environment, equal opportunities of women and men in employment, inequalitites between social strate in the state of health, social exclusion from material goods measured by income poverty. As far as second dimension is concerned, it comprises all aspects which together constitute the social capital of a society. This includes the social relations available at the informal level of private networks and the more formal level of organisations, the activities and engagement within private networks as well as within public realms, the quality of social relations and the quality of societal instiutitons. The quality of societal institutions represents a
component of social capital which applies to several life domains. Institutions of education, health care, working life, social security, social services, the political system and legal system. The perceived quality of these institutitons are measured by the level of trust, satisfaction with or approval of institutions.

The combined forces of economic and political restructuring, along with the new social fissions created in their wake, threaten to deteriorate a key sources of social cohesion in contemporary societies. It is therefore not surprising that idea of social cohesion receives great attention by social scientists as well as by politicians and gradually establish itself as one of the central societal goals at the national and the supranational level.

As social beings we naturally form groups for survival and support, as the popular saying goes “No man is an island”, and indeed, we are not. We form social groups that unite us with one another and give us a sense of security. These groups can be created from the tiniest of excuses, for example; a group of people that meet at the bus stop every Tuesday at 5am, after seeing each other regularly they easily form alliance and share mutual goals and norms i.e. getting the bus on time. It is within these groups that we receive our social identities. These social identities can be awarded within a small intimate group like a family or in a large scale group like a class in society. Their common goals create an ‘us’ and a ‘them’ response governed by a group conscience (Tajfel, 1971). This response can be a strength, for example, a great championship team attempting to win 4x400meter relay race, find that distinguishing themselves from others could be positive experience that builds self-esteem, making them work harder than others and mesh better. However, even though these social groups provide us with positive identities, securities etc., they can at the same time have a negative effect and create bias towards other groups whether they realise it or not. In this essay, I will discuss how specific social groups based on class and status, come to exist and explore their importance in society.

The disadvantages or advantages experienced by a social group within a stratum reflect the amount of power they have in society. The power comes directed from the resources one is advantaged enough to have, for example, ranging from being able to afford an education, from which, one can gain employment, from which, one can move up to a moderate position within a company, from which, they have the income to buy a house, car and pay for healthcare; to owning an international chain of restaurants, from which, one can afford a luxury yacht that offers luxury cruises, generating enough income to buy a third house and another yacht or two. This is why sociologists believed that social stratification was the core factor that influences the sharing of power in society.

There have been many attempts to determine a deciding factor for social power. Some feminists like Firestone (1971) believed that “all societies were divided into opposed ‘sex classes’ that were the basis of gender inequalities”. She argued that all men in society oppressed women because of the biological, psychological and physical shortcomings they experienced due to pregnancy, child-birth and child rearing. Her ideas stemmed from the women’s liberation movements in Europe and America in the 1960s and represented emancipation. Meanwhile, other systems presented a supressed, racially influenced explanation of social stratification. In the 19th century, the idea that race determined specifically by inherited biological distinctions was the deciding factor in social strata becoming prominent in society. Gumplowicz (1885) viewed “ethnic and racial conflict as the fundamental mechanism of social development”. Gumplowicz believed that it inevitable and natural for one ethnic group to surpass another, giving chance for the strongest to emerge. Gobineau (1853-5) and Chamberlain (1899) promoted racial stratification and warranted the oppression of ‘inferior’ ethnicities. Ideas like these were detrimental to the seemingly ‘inferior’ ethnicity and fuelled thinkers like Adolf Hilter (1925) who sought to eliminate inferior races in favour of the ‘Aryan’ race.

Sexual and racial inequalities are undeniably influential, however, they cannot be individually crowned as the primary causes of social stratification. Race itself does not exist, it is a social construct, and there is only one human race (Gordon, 1964). Ethnicity instead of race, on the other hand, does exist, based on cultural differences springing from history, origin, religion language and the like, however, it is an inequality that contributes to social stratification but does not solely determine the outcome. Similarly, sexual stratification struggles to define all social division because men and women thrive in complete isolation. Men and women’s sexual differences are the building blocks of society and essential for existence so they cannot be the core reason for stratification because stratification is division of society, they are requirements. Neither sexual nor racial inequalities can define a single source of stratification because people are so complicated and diverse, they cannot individually account for the complexities within society. Other sources of stratification are political status, religion or class.

Max Weber (1948) suggested that a wider perspective that incorporates sex and ethnicity should be considered. He believed that there were three unique aspects that spread across humanity and influenced the distribution of power in society and life chances in their own way. The three aspects were class (economic power), status (communal power) and authority (authoritative power). Weber was initially influenced Karl Marx and further developed his own ideas specifically about class and status. Social class refers to a conscious group of people that share the same socio-economic background, whose life chances are decided by the class they belong to. The class system in Britain is a prime example, society is divided into the upper class (mostly aristocrat families, headed by the Queen); middle class (upper-middle class e.g. architects, barristers, high level doctors etc.; middle-middle class e.g. management, teachers, accountancy, social work etc.; and the lower-middle class e.g. clerical, administrative etc.); working class (skilled e.g. a white van man or self-employed contractor and unskilled e.g. customer service or telesales); and the underclass (long term unemployed living off welfare).

Marx (1867) believed that almost every society was a class society with exception of the most primitive societies because they were smaller and undeveloped. He viewed possessing ‘means of production’, especially property, was the deciding influence in social division. He suggested society was of capitalist nature, distinguishing two conspicuous classes: the bourgeoisie and the proletariat. The bourgeoisie owned the means of production and derived majority, if not, all of their income from capital. They were known as the capitalist class. On the reverse were the proletariat, who did not own any means of production and instead work for the bourgeoisie. They were known as the working class. The bourgeoisie, owning the means of production, kept majority of the wealth generated by the proletariat; the bourgeoisie received surplus value from their resources, meanwhile, the proletariat only received a small percentage of their economic worth. He believed that skilled labour in particular had greater value and deserved higher wages. Marx strongly believed that the proletariat were oppressed to the extent that the existed in a state of false consciousness, where they were content with their hardship. He believed that over time the classes would collapse due to internal conflict and a revolution would ensue. He believed the solution to the class system was effective communism.

Weber, influenced by Marx, overruled the idea of effective communism, thinking that the proletariat revolution was highly unlikely because the power of false consciousness was too strong. He understood the bourgeoisie/proletariat class relationship was not so black and white. There were grey areas such as the manager that does not own the means of production and governs the proletariat but does not receive surplus let alone receiving their fair wages. He suggested the distribution of power was not rooted purely in economic power. Both the possession and non-possession of economic assets disperse power in society because from both avenues income is secured, for example, working for an company is labour which has to be ‘bought’ by the employer, thus, providing income/capital via the non-possession of economic assets. Weber viewed class divisions as having economic basis only and that individually class alone could not condition people into stratum. He believed that the increase in wages that Marx sought after would, if granted, would produce cause and effect experience from significant changes in lifestyles, subsequently creating antagonism in the disadvantaged groups. This revolution would be spurred by rational motives instead of stir from false consciousness.

Instead of just class, there were two more aspects determining distribution of power and life chances in society: status (communal power) and authority (authoritative power). Status, for example, held ground when it came to prominent religious figures/poets that were highly significant in society with little economic power. Authoritative power could be executed by a senior police officer that has a lot of authority but not a lot of property. Other criticisms were that the boundaries between various groups are almost impossible to specify. Also, a moral stance was not identified, whether the motives for the division where good or bad. Dahrendorf (1959) also mentioned that in many western societies there are fairly large middle classes because education was more prevalent and available, creating the opportunity to progress.

Weber understood that unlike Marx, explaining stratification in only terms of economic factors was unreasonable and stressing the importance of non-economic factors. He further developed his ideas on the non-economic factor of status. Social status refers to the ranking of an individual in a society as superior or inferior according to the values that they have in common. It is the reputation of the individual granted by lifestyle and duties, dictating their life chances, those that successfully conform to the required standard receive great honour and prestige (high status); and vice versa. In minute societies, status is determined by intimate details gathered from regular face to face interaction. However, in larger, complicated societies, ranking is generated by generalisations based on age, sex, family relationships, ethnicity, sexuality etc., putting one into a specific social group regardless of ability or accomplishments. It is the potentially boosting or diminishing assessment of lifestyle choices without any real information about the individual preferences.

Diminishing status can be very dangerous because it can create a sense of negativity around those of said status, if not worse. For example, in the Indian Caste system, status is assigned according to ethnicity. They range from the religious scholars and leaders at the highest status group known as the Brahim, and the lowest status group known as the Dalits or the untouchables. This is a closed/ascribed status system where despite challenges one cannot change their status because they are born into it. An open/achieved status system is one where status groups are based on merit and achievement so there is social mobility. According to Parsons (1940) status is assigned depending on the most significant social position in a society, for example, lineage, gender, age etc. An example of status assignment are in a tribal society where older men have the highest ranking and young women have the lowest ranking until married off, then a young woman can increase her ranking via her association with her husband. Modern societies alternatively, determine membership by specific public positions. Despite the large variety of occupations, those with the most prestigious receive higher status and vice versa. Strangers are usually judged based on the assumed status gathered from clothing to accents to cars. In contemporary societies status is assumed via income and consumption, and aspirations are geared towards earning higher incomes.

Parsons was criticised by an array of sociologists, some argued that not everyone in contemporary societies share the same significant social positions. Therefore, a unified set of views cannot be assumed. Modern societies also have multiple value systems that dictate status. Others stated that in some value systems a person that is, for example, a black doctor despite the high status of being a doctor would be assigned a low status because of his ethnicity. Weber (1924) believed that when it came to life chances, status was a more important factor instead of class because majority of the population would be more likely to make sacrifices based on social status as it affected their day to day life more.

From a Functionalist perspective, stratification is essential for society to operate smoothly; especially in industrial societies with complicated division of labour. They believe that the inadequate wages served to motivate people to aim higher, creating competition for important roles in society. Critics contended that the definition of important roles were inadequate and stated that the importance of roles does not directly reflect in wages. Society is not a meritocracy because many are born into their class and status. Also, how is inequality essential for society?

Another perspective was the conflict theory stating that stratification is universal but inevitable, unnecessary and not vital for society. Stratification was fashioned and maintained by the elite to guard and enhance their interests. Inequality is not inevitable and it does not promote the ideal functioning of society. They continue to sustain disparity by controlling ideas and information of the masses to keep them in their boxes spreading ideologies such as “scientific racism”, “the divine right of kings” and “a fair day’s pay for a fair day’s work” etc. Information released to the public is often manipulated or filtered e.g. Paris Hilton being mentioned on BBC’s 10 o’clock News etc. Technology is used to monitor our habits e.g. mobile phones, surveillance cameras, oyster cards, credit cards, Facebook etc. The elite sustain by keeping close-knit social networks that pass their privileges from generation to generation.

Having looked at the in-depth definition of stratification, I think society is divided for worse. Established class and status play an important role in keeping the rich ‘rich’ and the poor ‘poor’. I support the Marxist view when it comes to the bourgeoisie oppressing the proletariat recklessly. However, as Weber stated it is more complicated that two distinct classes but the presence of the “elite” is still felt. However, communism is not necessarily the answer to society’s woes. Stratification is naturally inevitable to a degree because the variety of innate differences in people’s abilities. It also provides necessary structure to govern large populations. Evolution states that after distribution of essential resources, the surplus will eventually rank some as more affluent. Symbolic interactionists mention that predominant symbols i.e. wealth, define all social interactions, which in turn develops a person’s sense of self and placing in society. Wealth is not necessarily a bad thing, particularly when it is earned through hard work; it is just harmful when its distribution is extremely lop-sided due to exploitation. The proletariat are the building blocks of society and they deserve a share of the capital.

We all have same basic needs and it is selfish for people to have ridiculous amounts of excess i.e. four twenty bedroom mansions and a private jet while the majority of people elsewhere cannot guarantee where their next meal is coming from. This is inequality and an exhibition of the ‘us’ and ‘them’ mentality to highest order. It is not necessary for the groups to fuse into one group and develop intimate social ties; however the groups should have mutual respect towards one another as fellow human beings regardless of personal differences. The resources in the world are not infinite and they do not belong to a single social group. Diversity should not be punishment; it is what makes humans great, ideally the gap between rich and poor would be moderate. Other than that, stratification is natural and the wealth should be distributed more freely throughout to ease irresponsible division and unnecessary antagonism in society.

Introduction:

Social class is a form of social stratification which impacts on peoples’ lives either negatively or positively. It refers to wealth, education level, occupation and prestige of a particular group of people. Factors which are inter-connected include the gender, sexuality, race and abilities (McDowell et al., 2013). It is important that social class be understood in the context from which it originates, primarily due to factors which occur inter-connectedly as mentioned above. There are many concepts relating to social stratification, but for the purpose of this essay I will focus mainly on Karl Marx’s conflict theory, supplemented by Max Webber’s functionalist ideology. Similarly factors such as education and employment will be central in this essay. I believe that the acquisition of knowledge and prestige via employment plays an important role in defining an individual’s lifestyle and subsequently their life chances.

Body:

It must be noted that most of the research done by Karl Marx was based on westernized capitalist societies and it is primarily due to this fact that his concept of conflict theory exists in an economic realm or context (Lenski, 2008). Marx demarcated class of people in terms of either lower, middle or upper class. In ‘Manifesto of the Communist Party’ Marx refers to lower-class societies as the proletariat and the upper-class as the bourgeoisie. The proletariat are a class of people who do manual labour which requires no specific skill, or simply put, they are the working (blue-collar) section of society. The bourgeoisie employ the working class society in order to increase their capital (Mohandesi, 2013). It is interesting to note that the position an individual finds himself or herself relative to the above category, impacts on their life chances and thus their social class. According to Max Weber (Davidson, 2009) social class and a person’s life chances are interdependent. In this sense, the higher an individual is positioned in the social hierarchy (class) the better his or her life will be; the opposite occurs for those who are in a poorer position. Factors include becoming wealthier, increasing one’s prestige, the acquisition of knowledge and the improvement of an individual’s living conditions. These are known as social advancements or improvements.

According to a research study by Jean Anyon (1980) educational opportunities vastly improved as the socio-economic conditions of a particular social group increased. Anyon (1980) in ‘Social Class and the Hidden Curriculum of Work’ found that schools were organised in a manner which reflects the social class of the families. Her results were derived from five schools which were broken down into working-class, middle-class, affluent professional and executive elite schools. Furthermore Anyon (1980) concludes that skills and knowledge which moves toward social power or prestige are obtainable to children from higher social groups but are inaccessible to the working class which are offered a practical curriculum. This study shows that the curriculum grooms children to fill an employment role suited to their social class or better put, so that the more challenging professions are occupied by the most skilled and talented individuals. In this sense, lower class schools educated individuals in a manner which requires them to follow orders rather than use their own initiative and understanding of the work. The emphasis on individualism increases as the social class of the school increases. In my experience I concur with what Anyon has found because there exists numerous types of schools or institutions ranging from technical to managerial and professional. Examples are the Cape Peninsula University of Technology, Cape Town College and The University of the Western Cape. Marx also suggests that institutions are used to oppress the subordinates of a society, this statement coupled with Anyon’s research, displays a rather frightful image. Institutionally people are being transformed and socialized, from a young age, to follow the layers of strata found in society.

Education ultimately leads to employment which in turn culminates in the acquisition of wealth or material property. According to Max Weber, the ownership of physical assets, which is obtained by means of production, creates unique characteristics in terms of the individual’s life chances (Shortell, 2012). Furthermore, Weber believes that the ownership of property is central to class differences and in this case there will always be a relationship between employee and employer or property renter and property owner. In our modernized capitalist society empowered by neoliberalism, emphasis is placed on the acquisition of wealth thereby stratifying society into upper-class rich and the lower-class poor inhabitants. In this sense one can improve one’s social class by increasing wealth and also the ownership of property-making this an open societal system (opposed to the system of slavery). Employment is therefore an opportunity to achieve wealth and increase status, however, inequalities occur whereby a bread baker (regardless of his skill) has less chances to improve his conditions than the owner of the bakery. Functionalists (Marxism) would argue that economic disparity benefits the majority of society and is also an essential element for the operation of society as a whole (Lenski, 2008).

Conclusion:

In my opinion, I see employment as the second phase in a three phase process in light of an individual’s life chances. The first phase being education and the last being a successful business owner or CEO. As mentioned above, the level of education provided to individuals varies according to their socio-economic standing. This is the crux of my argument mainly due to the manner in which institutions shape society in preparation for their pre-planned future i.e. external forces of which they have no control over. A false consciousness thus exists in the open capitalist society whereby the proletariat is made to believe that they have equal opportunities to improve their life chances, when in actual fact their original social class serves as a key which only opens a limited number of doorways to success. Those who are endowed with a higher social class are granted unlimited opportunities to all elements of success, prestige, wealth, knowledge and ultimately advantages to better their life’s chances.

Assess and explain the impact of social class inequalities on education outcomes

In this essay I will explain and evaluate the impact of social class inequalities on education and its outcomes. Sociologists see society as a stratification system that is based on factors such as; hierarchy of power, privilege and wealth, which leads into social inequalities. Inequality is about who gets what, how they get it and why they get it. Social inequality is about class, gender and ethnicity, it is characterised by the presence of unequal opportunities and rewards for different social groups. There are two main views of social inequalities in education within sociology; the functionalists and the marxists.

The functionalists believe that the education system is meritocratic because if you work hard, you get rewards. Emile Durkheim believes that education contributes to social solidarity which is essential for society as it binds society together. It has provided norms and values, a sense of history and a feeling of belonging in society. Durkheim also believed that education contributes to individual’s specialised skills as these are taught with education and being passed on from parents. The education system teaches individuals the skills and knowledge required to enable an individual to do the job. Talcott Parsons developed further into Durkheim’s theory and suggests that education is a secondary socialisation where schools build on the primary socialisation, which is taught by parents. That education system develops on value consensus and prepares children for their adult roles. He believed that education helps with individual achievement as it rewards high achievers with praise, it offers equal opportunity for individuals to a chance of success. He also believes that schools are a miniature version of society which prepares them for adult roles and assists with role allocation as it helps them discover their talents and expands them further. However functionalists were criticised as there is evidence that certain groups underachieve in schools which suggests that individuals do not have equal opportunities, their talent is was not effectively developed or the role allocation is not effective.

The marxists believe that the education system operate as an ideological tool. Louis Althusser believed that schools prepare individuals for their roles in jobs, are taught to except future exploitation and are provided with education and qualification to match their job roles. He believes that the education system brainwashes and manipulates individuals. Bowles and Gintis argue against Parsons’s role allocation theory as they suggest individuals who get the highest qualifications and the top jobs do so because they work hard and do as they’re told. They found the individuals with the high grades where obedient, hardworking and conforming and are rewarded with high grades as they are the qualities required for adult work.

It is said that the higher a person’s social class, the higher their educational qualification, which has been proved over the past 50 years by sociological research and government statistics. For example statistic in 2012/13 show that in London, pupils living in the area of Westminster achieve 86.6% in achieving 5+ A*-C grades, compared to pupils living in the area of Newham achieve 79.1%. Although both areas are within inner London the results show a difference due to class social factors within educational attainment. It is also said that a parent’s social class has a greater impact on how a child preforms at school, research by the University of London’s Institute of Education found that parent(s) who are in professional and managerial jobs were at least eight months ahead of pupils who parent(s) were unemployed. They took into consideration such factors as ethnicity and family size. The education system has been suggested as being biased and designed for white, middle class children and ignoring the needs for the working class and ethnic minority. However it is argued that there is a similar range of ability in every social class and factors within society such as low expectations, lack of deferred gratification and economical issues are the reasons for failure in working class. Working class children tend to experience economical hardship than any other class, because it has been linked to material deprivation, such as lack of money and things money could buy is the reason for working class underachievement. Sociologists believe that the children are unable to obtain needed educational items such as computer with internet, desks and books which is a disadvantage for them as well as the costs of education such as tuition fees meaning that people within the working class believe they cannot afford to attend further education. Parsons believed that middle class children from a young age receive more attention and encouragement from their parent(s), which gives them a higher attainment for when they begin school. However J Douglas believed that the working class children’s parent(s), do not understand what their children needs are to succeed in education. He believed that the interest displayed by parent(s) in the children’s attainment contributed to their education. Also the attitudes of the parent(s) to the teachers becomes apparent and this can encourage a teacher to treat one pupil different from another.

Social class subcultures such as the differences between the norms and values suggests differences in attainment according to some sociologists. Barry Sugarman believed that working class subculture was fatalistic as they accepted the situation and did nothing to improve it, it was present-time orientated as there was no planning for the future. He also suggested concerns with immediate gratification as there was no sacrifices for the future, whereas the middle class saw things differently. These differences contribute to the attitude in education and will lead to lack of enthusiasm and mind-set to succeed.

Other sociologists believe that cultural deprivation such as an absence of certain norms, values, attitudes and skills that are needed for educational success and this is why the working class were also underachieving. However Basil Bernstein believed there are different speech patterns between different classes. He developed the cultural deprivation theory where he suggested that speech patterns of those at the bottom class are inferior. He suggested that working class children adopt a restricted speech code and the education system adopts an elaborated speech code. He also believes that children suffer due to a language barrier, restricting the teacher to be able to teach and the children being unable to learn, which then causes underachievement. Pierre Bourdieu agrees that the working class are discriminated because they are unable to grasps the teachers meaning of grammar, tone, accent and the delivery of teaching.

Bourdieu states that the higher people’s position in the class system, the greater the amount of dominant culture they have. This culture is referred as superior as they have power which forms the basis of the education system. He argues that the higher class cultures are better when compared to the working class, because of the perceived superiority where the middle class believe the working class have themselves to blame for the failure in education. Bourdieu believes that children born into the middle class have a built in advantage as their culture is closer to the school culture which gives them an advantage to succeed, such as their language is closer to the teachers which gives them more of an understanding of what’s being taught. According to Bourdieu the dominant culture are seen as cultural capital, because it is converted into material rewards such as high status jobs and high salaries. He concludes that education is cultural and social reproduction as the education system reproduces the dominant culture which reproduces class system. By doing this is creates education success and failure which justifies the positions of those at the top and bottom. However Bourdieu believes that middle class should not assume that the higher class is better as the failures are measured in exam success, which is in fault with the education system and not the culture. He argues that individuals learn by what they see in life and what they expect, he states that different social groups have different chance and experiences in life. For example studying Spanish art, middle class children can go there and see it, whereas working class have to visualise it.

Diane Reay states that it is the mothers who make cultural capital work for their children as she believes that all mother are active in their children’s education, that working class mother’s work just as hard as middle class mothers. She suggested that middle class mothers had more educational qualification and knew how the system worked and used cultural capital to good effect such as helping with homework. Because of this working class mothers believed that they lacked the knowledge to be able to help with their children. Reay argued that middle class women had more material capital by employing cleaners it allowed them time to help their children, working class women didn’t have this as well as being able to afford private tuition. According to Reay it’s the mothers that help with educational attainment, their effectiveness depends on the amount of cultural capital and this depends on social class.

There is evidence that suggests that working class pupils are discriminated against middle class pupils for example pupils are always being assessed, they’re labelled as able and less able, placed into sets, entered for individual examinations and denied access to parts of school curriculum. It is suggested that middle class children are classed as able which is a disadvantage for working class. Once a pupil has been labelled they tend to respond or interpret that label which is a self-fulfilling prophecy and will continue to see themselves as that label. However it’s argued that this has no effect on pupil’s achievement, they believe that class differences in attainment are due to what happens outside of school. On the other hand others say it is a combination of differences in school as well as outside.

Statistic in 2012/13 show that girls achieve 86.5% in achieving 5+ A*-C grades, compared to boys who achieve 79.6% in achieving 5+ A*-C grades.

Bibliography

Department of Education, (2014, February 14^th). Statistic – national statistics GCSE and equivalent attainment by pupil characteristics. Gov.uk. Available: https://www.gov.uk/government/publications/gcse-and-equivalent-attainment-by-pupil-characteristics-2012-to-2013. Retrieved 23^rd February 2014

Haralambos, M., Richardson, J., Taylor, P., Yeo, A. (2010). Sociology in focus (2^nd ed.). Harlow: Pearson Education Limited.

History learning site. (n.d). Social class and achievement. Available: http://www.historylearningsite.co.uk/social_class_achievement.htm. Retrieved 23^rd February 2014

History learning site. (n.d). Pierre Bourdieu. Available: http://www.historylearningsite.co.uk/pierre_bourdieu.htm. Retrieved 23^rd February 2014

Shepard, J. (2010, December 7^th). Social class has more effect on children than good parenting, study finds. The guardian. Available: http://www.theguardian.com/education/2010/dec/07/social-class-parenting-study. Retrieved 23^rd February 2014