Illness Social Construction
Construction of society is sophistic and combining social factors from different levels either large or small. Illness is one of the assignable portion of it. It is not only constructed by its symptoms, which means the intuitive pathological understanding. Construction of illness is constituted in social ideological sphere with extra derivative labels created in different cultures context, particular social phenomena, political situations and so on. Influence, meaning, and modes of illness during this process should not be ignored. Simultaneously, culture influence the experience and manifestation of illness in different societies through forming different understanding and attitude of it. This consequence has led to diversity of universal understanding of the same illness and patients’ lives.
First, illness is initially constructed at pathological level. People pay attention to its symptoms, order of severity, risk of life, and price of treatment cost, out of concern of health. Anthropologist Appadurai had proposed the conception of “Scape” in 1990, if considering illness as a sort of “scape”, the flow of understanding of people about it is not only constructed by the clinical symptoms, but also the external factors from the society. However, disease presents a complicated meaning and is endowed derivative labels gradually. This derivative meaning is usually the product of the association of illness with certain social phenomena, specific groups of people, and particular cultures background.
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“Medical knowledge about illness and disease is not necessarily given by nature but is constructed and developed by claims-makers and interested parties. ” As they claimed that illness is a social designation not entire nature product.?Peter&Barker, 2010, p.68?In the article “Stigma HIV/AIDS, Mental Illness, and China’s Nonpersons”, the author analyzed the development history of AIDS and mental illness in China since the last century, and the living status of patients. Through historical analysis, due to the world political situation decades ago, AIDS was stigmatized under the dual effects of the conservative cultural background and national policy in China. Improper sexual intercourse, homosexuality, especially gay men, and foreign capitalism were tied with AIDS. Compared with other diseases, AIDS became a shameful and unspeakable secret in Chinese society.
China’s Ministry of Health had released a research report which claimed four main sources of HIV infection in China. Imported blood products, foreigners, hospital infections, prostitutes, and gays. Those who represent the voice of the mainstream medical profession claim that, “owing to the influence of corrupt capitalist thoughts and lifestyles, prostitution is spread across the country, more and more people are infected with venereal disease. Specifically, a minority of prostitute like to hang out and sleep with foreigners.” (Arthur, 2011, P.100) Mainstream voice and official point of view divided HVI patients from different levels, and labeling additional tags of them in social level. Under influence of this propaganda, many people started to connected AIDS with “wicked” capitalism ideology, while patients supposed to have sexual deviance.
Therefore, compared with other diseases, AIDS has become a distinct social symbol, which represents sexual deviance, western capitalism and homosexuality. These labels turn into the proof that some patients are not worthy of sympathy. People who infected HIV through blood selling are more likely to exposure their conditions, commercial sex workers and homosexuality were holding opposite attitude.?ibid?The metaphorical connotations of illness are different in every nation. Some illness is repressive, shameful or pitiful in society, some are not. Diversity of the metaphorical connotations reflect difference of ideology in social construction. This difference makes illness a measure of personal identity, such as education, family, hobbies, and origin.
The whole process of disease definition is like a record, which truly reflects the current state of thought and atmosphere of society. These processes converge in some areas and varied in others. For example, at first AIDS was seen in most countries as great scourges and homosexuality in a derogatory sense. Depression received less understood in Eastern countries than western areas now. “People enact their illness and endow it with meaning”, while illness constructed socially.?Peter&Barker, 2010, p.71?
Second, culture influence the experience and manifestation of illness in societies through forming understanding and attitude of it. Based on the fear of unknown diseases, the conservative attitude towards sex in Chinese society, and the conflicting ideas to “foreign products from the West” and homosexuality. Government policy did not make much positive influence. The stigmatization of AIDS in China has affected the experience and treatment of many patients since the last century. In this process, most people have a deep misunderstanding of AIDS. The government has not fulfilled its responsibility for the correct popularization of science and AIDS, while a series of panic-provoking rumors have been circulated in the society. In a sense, the official policy of the Chinese government has aggravated people’s fear of HIV, “moral panic and crisis of trust” in Chinese society in the face of its HIV/AIDS epidemic (Arthur, 2011, P.101)
Many patients dare not expose their condition, it would very likely lose jobs if they exposure. For example, a man named Haitian who lived in Beijing had been infected HIV in 1999. When he confessed his testing result to his wife and gay identity, although his wife was shocked and angry, she still chose not to divorce with him because she thought it was a shame. Siblings and neighbors would laugh at her if she divorced. Thus, this couple continued to live in the same house for 6 years with using separate tablewares and towels. (Arthur, 2011, P.104) In China, divorce and homosexuality are both two negative social label for a person. Homosexuality was excluded from the psychiatric column by China’s official medical materials until 1997. Another example of AIDS patients is the villages in Henan province, most of the patients were infected through blood transmission in the time that blood selling trend sweeping China, especially in undeveloped regions. Infection origin made villagers more likely to exposure their patient identity, but received little understanding. Even the whole village will be isolated in social networks, including their children who might have to quit school.
Culture influence of illness experience is an important part of social construction. Even today, although the divorce rate in China is increasing year by year, many people still hold the idea that divorce is always the wrong choice. Homosexuality and sexual freedom are still not recognized by the mainstream society and the elderly, even many young generations think that sexual infection is shameful. Therefore, when HIV is closely associated with sex, homosexuality, and drugs for various historical reasons, the stigmatization of AIDS can be said inevitable. That’s why the experience and manifestation of AIDS presents a shameful, isolated and not be exposed situation. Analogous metaphorical connotations of illness is “obesity metaphors, such as ‘obesity as sinful’”.
Culture shape understanding of people to illness. In addition to the pain and treatment difficulties caused by shameful patient identity, AIDS and some other mental illness patients with their families have presented a phenomenon of isolation by the mainstream social groups, which Arthur calls “nonpersons”. Their patient identities seems to have become a symbol of “abnormal”, which has been excluded from the normal social networks. In the context of modern Chinese culture—a developing country that focusing on modernization and economic growth, and a government that preferring collectivist culture rather than individualism, rights of minorities are easily to be ignored.
Social policies and cultural influences are bidirectional, illness experiences and manifestations of disease are also reflected through policies. Whether an illness is defined as negative based on the social labels that added to the it, which in turn affects people’s social attitudes and policy implications. In terms of social constructivism, the presentation of disease is not only the patient and illness itself, but also the epitome of the entire society. Different metaphors of illness come from the inequitable structure of social construction. The stigmatization of HIV/AIDS and other illness stems from the indifference and discrimination against minorities. The root causes of discrimination could originate from gender, race, sexual orientation, as long as it is not welcomed by the mainstream groups in the overall social environment, it may face this problem.
In conclusion, illness is constructed socially, because society endows it extra connotations from the ideology of current social situation besides its basic clinical characteristics. These connotations vary and originate from different social context, cultural ideology and political environment. Culture influences the experience and manifestation of illness in societies through forming understanding and attitude of it. Stigmatization of AIDS patients is a typical example that how culture impose shameful labels in social identity based on contradiction to special characteristics from patients. This manifestation is an epitome of society, representing the understanding and attitude to a certain group of people under the particular cultural context through the vehicle of illness.