Handbook of Medical Sociology

A revision of The Handbook of Medical Sociology has appeared about once a decade since its original publication in 1963. Each edition has been comprised of newly commissioned chapters reviewing or developing aspects of medical sociology. As the field of medical sociology grew and diversified, new topics were included and older ones updated, while others continued to be represented by previous editions. When a new editorial team took over the fifth edition (Bird, Conrad, and Fremont 2000), we attempted to maintain the spirit of the earlier editions. We continue this approach in the sixth edition, reflecting changes and new vistas in medical sociology while updating and reconfiguring several perennially important topics.

In 2009, we celebrated the fiftieth anniversary of the Medical Sociology Section of the American Sociological Association. The section has consistently been among the three largest of the ASA’s nearly thirty sections. Medical sociology remains an expanding and vibrant intellectual field, and it is impossible for a single volume to fully represent all the changes and new directions while also covering the discipline’s core topics. For this edition, we asked authors to go beyond literature reviews and focus instead on a number of key questions and issues.

The eight chapters of Part I, “Social Contexts and Health Disparities,” address a long-standing focus of medical sociology: the role of social factors in health and illness. This section focuses on the many ways in which social inequality and social contexts shape health and contribute to the creation and reproduction of health disparities. Taken together, these chapters provide a nuanced perspective on the persistent social patterning of health and longevity.

In Chapter 1, Bruce Link and Jo Phelan address an issue central to medical sociology: how and why social and economic inequality constitutes a fundamental cause of health disparities. This sociological perspective on health disparities was initially developed in response to the risk-factor approach, which directs attention to proximal causes of ill health, particularly modifiable risk factors. Link and Phelan argue that the unequal distribution of socioeconomic resources inevitably produces health inequalities, as those with greater resources are better able to obtain and act upon new and improved information—for example, by consuming healthier diets and avoiding known hazards—in order to protect and enhance their health. Consequently, interventions aimed solely at proximal causes of health disparities will never be sufficient to eliminate these gaps.

In Chapter 2, Ichiro Kawachi brings the social world into the discussion by shifting the focus from the individual to the community, articulating the impact of social capital on health. He conceptualizes the application of resources as a group-level phenomenon, in which individuals, to some extent, perceive the world and act collectively. As advantages accrue and circulate through social networks, these networks themselves become resources, providing information, perceived efficacy, and norms for behavior, all of which can directly and indirectly affect health. This perspective introduces several ways in which opportunities are socially structured, drawing on Granovetter’s concept of “the strength of weak ties” (1973) and Coleman’s work on “informal social control” (1990).

In Chapter 3, Catherine Ross and John Mirowsky argue that education, operating as both human capital and a commodity, is the key factor underlying socioeconomic differentials in health. Education contributes in multiple ways, including by shaping social networks. Ross and Mirowsky note that most U.S. policymakers do not view education as a means of improving population health, despite substantial evidence demonstrating its effectiveness in this area. The authors also review evidence showing that health care alone cannot and does not significantly improve population health.

In Chapter 4, Patricia Rieker, Chloe Bird, and Martha Lang examine patterns and trends in gender differences in health and explore how social and biological factors interact to produce paradoxical outcomes in men’s and women’s health. They introduce the concept of constrained choice as a conceptual framework for understanding how social structures and the contexts in which individuals live shape opportunities for pursuing healthy lives. The authors analyze how structural constraints narrow available choices and propose constrained choice as an alternative framework that moves beyond explanations based solely on socioeconomic disparities and discrimination to account for health disparities, including those arising at the intersection of race, class, and gender.

In Chapter 5, Gina Lovasi, Jimi Adams, and Peter Bearman offer a distinctive perspective on the ways social networks influence health. While earlier work emphasized social capital as a community or network-level resource, these authors examine more broadly how social ties with individuals and organizations affect health outcomes. They illustrate the role of social networks through analyses of social support, sexual behavior, and food consumption, highlighting the complexity of both assessing network effects and leveraging networks to promote health. This chapter also returns attention to the importance of context in shaping the health impacts of social networks.