Health, Illness and Society: Key Models, Concepts and Research Examples

If you are studying Health in AQA A level Sociology, this part of the course is really about one big question: is health mainly biological, or is it shaped by society too?

Sociologists do not deny that disease can be physical and real. What they add is that ideas about health, illness, disability, treatment and the body are also shaped by culture, class, inequality, gender and power. The thinkers below help you see those debates more clearly.

Defining Health

The World Health Organisation: health is more than not being ill

The World Health Organisation defines health as a state of physical, mental and social well-being, not just the absence of disease. That definition matters because it immediately pushes students beyond the narrow biomedical idea that health is only about curing physical illness. It opens the door to social explanations of health, such as the effects of stress, poverty, relationships and inequality.

Blaxter: people do not all mean the same thing by “health”

Mildred Blaxter is useful because she showed that ordinary people define health in different ways. In her work on lay concepts of health, health could mean the absence of disease, a kind of reserve or resilience, or a more positive state of fitness and vitality. That is a good example of the social construction of health: health is not understood in exactly the same way by everyone.

A simple way to use Blaxter in an essay is to compare two students. One might say “I’m healthy because I’m not ill.” Another might say “I’m healthy because I feel energetic, exercise regularly and cope well with stress.” Blaxter helps explain why both answers make sense sociologically.

The Biomedical Model

What the biomedical model argues

The biomedical model sees illness as a problem inside the body. Disease is explained through infection, injury, malfunction or abnormal biology, and treatment is handed over to medical professionals. This model is strong when dealing with acute illness, surgery, broken bones or infection because it is scientific, testable and often very effective.

Its main limitation

Its weakness is that it can ignore the wider social causes of illness. It can explain how a disease works in the body, but it is much less effective at explaining why some groups have much poorer health chances than others. That is where the social model becomes more useful.

Parsons and the Sick Role

What Parsons argued

Talcott Parsons argued that illness is not only biological. It is also a social role. In his “sick role”, the ill person gains two main rights: they are temporarily exempt from normal duties and they are not blamed for their illness. But these rights are conditional. The person must see illness as undesirable, try to recover, and seek competent medical help. Parsons also saw doctors as gatekeepers who regulate access to this role.

Example you can use

A student off school with flu fits Parsons quite well. They are excused from lessons, not blamed for being ill, expected to rest, and expected to follow medical advice so they can return to normal life. Parsons helps explain why society is more accepting of some illnesses than others.

Why students should evaluate Parsons

Parsons works best for short-term illness. He is much less convincing for chronic illness, disability or mental health conditions where recovery may be uncertain. Even the later discussion of the sick role notes that it is now often used as a negative reference point because changing patterns of long-term illness make it harder to apply neatly today.

Medicalisation and Iatrogenesis

Illich: medicine can expand too far

Ivan Illich is central to the idea of medicalisation, where more and more parts of ordinary life come to be treated as medical issues. He argued that medicine does not simply cure illness. It can also create dependence and extend medical control over everyday life.

His best-known example: iatrogenesis

Illich used the term iatrogenesis to describe harm caused by medicine itself. He identified clinical iatrogenesis, where treatment causes injury or side effects, but also wider social and cultural harm, where people become over-dependent on medical experts and less able to deal with pain, ageing or death themselves.

A clear example would be unnecessary treatment that produces harmful side effects, or the wider tendency to treat ordinary life experiences such as ageing or sadness as medical problems needing expert management. That is exactly the sort of trend Illich was warning about.

Oakley and the Medicalisation of Childbirth

What Oakley focused on

Ann Oakley is especially useful for showing how a natural life process can be medicalised. Her work on childbirth traced the way pregnancy and birth became increasingly controlled by medical professionals, particularly male obstetricians, and questioned whether many routine interventions were really supported by strong evidence.

Example from the research

One helpful example is Oakley’s attention to women’s own experience of childbirth. A later summary of her work refers to detailed interviews with 55 women, highlighting how women’s voices can differ from the assumptions built into clinical care. This makes Oakley especially useful for showing that the patient’s experience can be pushed aside by professional authority.

Oakley therefore links strongly to medicalisation, the social construction of the body, and criticism of the clinical gaze, because her work shows how women’s bodies can be treated as objects to be managed rather than experiences to be listened to.

Social Models of Health

McKeown: health improved because society improved

Thomas McKeown is often used against an overly simple biomedical view. His big claim was that the long-term decline in mortality was driven much more by better living conditions, especially nutrition, than by curative medicine. Later historians have debated parts of his thesis, but there is broad agreement that one key part of it was right: curative medicine played only a limited role in reducing mortality before the mid-twentieth century.

Example from McKeown

The easiest example to remember is this: if death rates were already falling before modern high-tech medicine became dominant, then something else must have mattered. McKeown pointed to improvements in the standard of living, especially food and the broader social environment. That makes him very useful in essays evaluating the biomedical model.

Navarro: class and politics shape health

Vicente Navarro pushed the social explanation further by linking health to class power, welfare systems and political choices. In his work on OECD countries, he compared different political traditions and looked at how they related to income inequality, welfare redistribution, employment, service provision and population health, including infant mortality.

A good example from Navarro is that health inequalities are not just about personal behaviour. They are also shaped by how much a society redistributes income, how secure work is, and how far governments fund health and family services. That makes his work ideal for a social model answer.

Wilkinson and Pickett: inequality itself is unhealthy

Richard Wilkinson and Kate Pickett argue that societies with bigger income gaps tend to have worse health and social outcomes. Their key point is that inequality matters not only because some people are poor, but because large status differences damage trust, cohesion and well-being across society. Their later review states that the evidence for harmful effects of large income differences is strong.

A simple example is to compare two affluent societies. Even if both are rich overall, the more unequal one may still have worse social and health outcomes because inequality increases insecurity, comparison and stress. That is why Wilkinson and Pickett are so often used in sociology essays on health inequalities.

Disability, Impairment and the Social Model

Oliver: disability is created by barriers

Mike Oliver is the key thinker for the social model of disability. He argued that the problem should not be seen mainly as something wrong with the individual body. Instead, the focus should shift to disabling environments, barriers and cultures. Oliver explicitly said the social model tries to switch attention away from individual limitations and onto the barriers society creates.

Example from Oliver

A clear example is lack of access. If a wheelchair user cannot enter a building, the social model says the main problem is not the person’s body, but the inaccessible environment. Oliver’s discussion also points to wider barriers in transport, education, culture and employment, showing that disability is produced across society, not in one isolated place.

Shakespeare: Oliver is powerful, but incomplete

Tom Shakespeare accepts that the social model was politically powerful, but argues it can become too rigid if it separates impairment and disability too sharply. His critique focuses on three issues: impairment, the impairment/disability dualism, and identity. He argues that bodies, pain and limitation cannot be written out of the story completely.

Example from Shakespeare’s critique

One of his strongest examples is that activists may publicly say people are “disabled by society, not by their bodies”, while privately still having to deal with aches, pains, infections and fatigue. Shakespeare’s point is not that social barriers do not matter. It is that a full explanation of disability must include both social oppression and the lived reality of impairment.

Goffman and Stigma

What Goffman argued

Erving Goffman is useful for understanding the social experience of illness and disability. He argued that some conditions become stigmatised, meaning they are treated as deeply discrediting and can become a person’s master status. In other words, the condition becomes the first thing other people notice.

Example from the research

Goffman distinguished between discrediting conditions that are visible, such as a stammer or skin condition, and discreditable conditions that can be hidden, such as epilepsy, HIV or depression. That distinction is very helpful for analysing how some illnesses or impairments are immediately judged by others, while others involve the stress of concealment.

This is one reason Goffman is so useful for answers on disability, body image, and the social meaning of illness. He shows that health is not only about symptoms. It is also about how others respond to you.

Giddens and the Social Construction of the Body

What Giddens argued

Anthony Giddens helps students understand the social construction of the body. He argued that in late modern society the body becomes part of an ongoing identity project. People use their bodies through fashion, exercise, diet and lifestyle choices to express who they are and who they want to be.

Example from the research

The Open University summary of Giddens gives very clear examples: people use fashion and exercise, and modern culture is heavily focused on constructing “healthy bodies” through gym memberships, dieting manuals, supplements and self-care routines. This is a strong example of how the body becomes something to be worked on and displayed.

Giddens therefore links well to questions about the body, health culture, and the pressure individuals feel to manage themselves. He helps explain why modern health is often tied to image, lifestyle and personal responsibility.

Pulling the Debate Together

What these studies show overall

Taken together, these thinkers show three big ways of thinking about health. The biomedical model is strongest when explaining disease and treatment inside the body. The social model is strongest when explaining why health is unequal and shaped by class, stress, work, housing and power. The complementary and holistic approach gains attention where people feel mainstream medicine is too narrow or too impersonal.

The line of argument that usually scores well

A strong sociology answer usually argues that health is both biological and social, but that purely medical explanations are too limited on their own. WHO and Blaxter widen the definition of health. Parsons shows illness is socially regulated. Illich and Oakley question medical authority. McKeown, Navarro and Wilkinson and Pickett show that social conditions and inequality shape health outcomes. Oliver, Shakespeare and Goffman show that disability and illness are also social experiences, not just biological facts. Giddens adds that even the body itself is shaped by identity and culture.

Final Exam Note

The easiest way to improve an A level answer on this topic is to move from naming a thinker to using a concrete example. Instead of writing “Oliver says disability is socially constructed”, write about inaccessible transport, buildings and institutions. Instead of writing “Illich criticised medicine”, refer to clinical, social and cultural iatrogenesis. Instead of writing “Goffman talks about stigma”, use his difference between visible and hidden conditions. That is what turns basic knowledge into developed sociological explanation.

Check your knowledge

Complete the following MCQ on different aspects of definitions of what sociologist mean by health and the social construction of the body below.