Fiona Poland

The Power to Care

One of our main aims is to increase health professionals’ awareness of what power they have or can gain access to and to consider how that power might best be used in the interests of their clients. In this chapter we show how the distribution and exercise of power affects the visibility and the value given to different forms of health care work.

PROFESSIONAL EMPOWERMENT AND TEACHING SOCIOLOGY TO HEALTH CARE PROFESSIONALS

The teaching of the social and behavioral sciences as disciplines within the education and training of health care professionals is a relatively new phenomenon in the United Kingdom. The push for their inclusion in medical, nursing, midwifery and radiography curricula is a consequence of major changes in the system and service of health care in Britain, which lent a greater urgency to the professionalization of these occupations. This, in turn, called for professional and educational validating bodies to fundamentally reorganize courses, to raise their academic level, and to encourage widespread research into learning styles, continuing professional development, and alternative educational delivery modes such as open and distance learning. In teaching sociology across a range of newly developed health care courses we have had to consider the dynamics of United Kingdom health care education that prompted their development. This paper is based on our experiences in designing, implementing, and evaluating such courses.

Working for Health

Work has profound effects on us. Occupations are so important to adults that they affect our health. The nature and conditions of work influence how we give and receive health care. Some kinds of work are highly visible and their effects fairly evident. Working on a building site is labour intensive, dirty, outdoor work. Domestic work is less visible, but informal caring work can be labour intensive, dirty, indoor work. The emotional and health consequences of different kinds of work can be even more invisible. Not having full-time paid work can reduce opportunities to exercise control over whether we live and work in environments which are more or less likely to enhance our health chances. Distinctions drawn between more visible and less visible forms of work have consequences for how work is organised, distributed and rewarded, and attitudes toward housework and care work.

Learning to Care: A Lifetime of Socialisation

Throughout life we learn how to become members of different kinds of group, ranging from family groups, through groups of friends, to school and work groups. We learn each group’s language, its values and its practices. We learn how to work and play in groups. In the company of other people our own identity emerges and we learn further how to interact with others.

Welfare, Ill-fare, How Fair?

State welfare systems were established when public expenditure was assumed to be an inevitable part of economic growth. By the 1980s welfare spending had come to be seen by governments globally as a burden, and new ways of funding public health and welfare services had to be considered

Beliefs, Moralities and Ideologies of Care

People hold a range of everyday ideas about why we stay healthy and what makes us ill. These are known as ‘lay’ concepts or models of health and illness. Professionals also possess more detailed ‘expert’ models and concepts. There is inevitably a mix of lay and expert models in both perspectives. Professionals are, after all, also people with particular cultural background influences and experiences, and non-professionals are not ignorant of complex reasons for illness and health.

The Basis of Informal Care: Families and Households

People do things in, for and because of families. Families are like miniature societies in controlling and distributing resources, particularly those connected with health and caring. However, we cannot assume that we know what a family is and what families do. Even though families are found in most societies throughout the world they are not organised in the same way. It is difficult to describe a typical family setting. Parenting styles and household amenities differ according to variations in family types, class, ethnic background and local circumstances. Comparisons between societies in terms of how they organise their family life show us a great deal about how the rest of that society works.

Common and Uncommon Cultures

Most modern societies have to deal with issues arising from the variety among peoples which is a consequence of increasing travel and the growth of communications. The concept of ethnicity is a useful way to differentiate between people in terms of their cultural heritage. The right to be counted as a member of a community is based on perceptions of shared cultural heritage. However, ideas that some ethnic groups are ‘outsiders’ may be used to legitimise decisions to exclude them from full citizenship and also to limit their share in the political, economic and health resources of a society.

Modelling Health Care Sociologically

In previous chapters we have examined ways in which social processes create patterns of empowerment or disempowerment, inclusion or exclusion, visibility or invisibility, and can structure inequalities. We began with general sociological insights and built a more detailed analytical understanding of ways in which such patterns are reflected in experiences of health and illness, health work and health outcomes. We now put the pieces of the jigsaw together to construct a sociological map for the area within which humans experience health and illness

Equal and Unequal Opportunities

In most societies some groups of people have more access to material resources, to health and to respect than others. Most health and care resources are taken up in dealing with disadvantaged groups. As we have indicated inequality and the lack of political resources to remedy inequalities are central to meeting health care needs.