FROM THE WESTERN TO THE MURDER MYSTERY: THE SOCIOLOGICAL IMAGINATION OF C. WRIGHT MILLS

More than half a century after its emergence as a formal field of study, medical sociology remains an important substantive area within our discipline, wide ranging in its appeal and the plethora of topics it engages. Tangible indicators, including the increase in the number of medical sociology journals and the number of medical sociology courses offered in colleges and universities across the country (Bloom 2000), point to the continued interest in this field. The vitality of medical sociology stems in part from the fact that today's health sector is an extraordinarily broad and vibrant arena of society (Weiss and Lonnquist 2000). Major topics of current interest have included the medicalization of society, sociocultural responses to health and illness, patterns of physician-patient interactions, health services utilization, alternative healers and alternative health practices, and comparative health care systems. The array of topics of analysis in our field continues to expand; recently emerging areas of interest include the social effects of health care technology, medical ethics, managed care, and health care reform. Indeed, it is an exciting time to be a medical sociologist. In the Call for Papers distributed for this special issue, we announced that we hoped to explore health- and illness-related topics that should continue to be influential into the new millennium. Further, we specifically encouraged submission of various formats and lengths not typically included in Sociological Spectrum or similar publications. Thus, this collection is unique in its conceptual essays, and methodological and theoretical notes. As suggested by the special issue's title, we hold a broadened view of medical sociology, a view also encouraged by scholars such as Conrad (2001), Weiss and Lonnquist (2000), and Charmaz and Paterniti (1999), that encompasses a sociology of health, healing and illness, as well as of medicine. Although not all inclusive, the organizational schema of the special issue reflects the broad range of topics that scholars who responded to our Call for Papers, our special issues reviewers, and we, as co-editors, considered particularly relevant to medical sociologists at this point in time.     

Job matching and return to work: Occupational rehabilitation as the link

Return to work after injury or illness is important for the worker and the employer. Medical providers manage and treat the worker with the illness or injury. Except in cases of focused specialists, the medical professional's role is to take care of a patient, rather than empower a worker. As much as there is promotion of the workers compensation health care system to be similar to sports medicine, there are significant dissimilarities. One major barrier is that the medical caregivers do not know the demands of jobs as they would know the details of sports. Thus, there is a gap in returning a worker to function as the medical professional cannot accurately match the worker to specific jobs. A new model of job function matching, based on research and skills of occupational rehabilitation professionals, is proposed to bridge the gap between the medical community, the employers and the workers.     

In Celebration of Virginia Olesen's Uncanny Sociological Eye

Symbolic interactionism dwells deep in the intellectual bones of Ginnie Olesen, manifest in sundry ways across a long and ambitious academic career. Here, we briefly sketch her background and then trace her scholarship featuring her interactionist and feminist contributions in four main areas: professional socialization, women, health and healing studies, qualitative methods/feminist methodologies, and the sociology of emotions/interactionist social psychology of illness. We conclude with cherished memories.     

The business of becoming a professional sociologist: Unpacking the informal training of graduate school

While one can be labeled a sociologist in name by fulfilling formal institutional requirements, that is only part of the necessary work involved in graduate training. What is also required is mastering the informal professional culture associated with academic sociology. In this paper, we offer practical advice about informal norms in graduate school—norms we know now that we wish we’d known then. Our reflections upon our own experiences in graduate school are guided by our common research and teaching interests in informal organizational culture. What is the potential salience of informal norms, such as particularistic relations with faculty and graduate students, ceremonial versus actual practices regarding research and teaching, and emotional labor around one’s work, for better understanding the professional socialization of graduate study in sociology? Our emphasis here is to offer advice on how to navigate the graduate school realities these norms present. We also believe that sociologists should turn a more focused eye on the profession, one in which the presence of such norms is readily acknowledged and more formally considered for the benefit of teaching graduate students.     

Taming predators through photography

In this article we examine an innovative application of visual communication and social science methods, moving the study of indigenous media from the purely academic realm into pediatric health research. Through Video Intervention/Prevention Assessment (VIA), children and adolescents who share a medical condition create visual narratives of their lives with chronic disease to show and tell their illness experiences to health care providers. Clinicians routinely plan medical management with limited knowledge of how patients interact with disease in their “real life” physical, psychological, and social environments. VIA asks young patients to teach clinicians the realities of day‐to‐day life with illness, yielding unique insights that can guide the development of more realistic, more humane, and ultimately more effective medical care. We describe the VIA methodology, a pilot study of asthma, and the illness experiences shown and told by VIA Asthma participants. Not only did VIA generate useful research findings, it also produced visual documents of the child's illness experience that can serve as tools for influencing policy, advocating for patients, and educating health care providers, patients, and their families.     

Explanatory models for disability: perspectives of health providers working in Malawi

Health providers’ understanding of disability determines how disabled people are treated, and hence it is imperative to address conceptualisations of disability, as this will contribute to better opportunities and realisation of human rights for disabled people. This article will use data from a qualitative study exploring conceptualisations of disability by 22 health service providers from the total health care system in Malawi, including the professional sector (e.g. medical doctors and nurses) and the folk sector (healers and indigenous practices). We will discuss how these perceptions influence the lives of disabled people, using the case of a health service user with physical and speech impairment as an example. Our data show that health providers largely conceptualise disability according to the medical model for disability, contributing to the exclusion of disabled people. The bio-psycho-social model for disability, largely absent as an explanatory model for disability among our informants, is the most inclusive and rights based.     

Well balanced: 8 steps to wellness for adults with mental illness and diabetes

Serious mental illness places a tremendous burden on clients, their families, and behavioral and medical health care providers. The co-occurrence of diabetes with mental illness may further compromise daily functioning. Psychiatric nurses can make a significant difference in improving the health and medical outcomes of this client population. A partnership was developed between the University of Rochester School of Nursing and the Western New York Care Coordination Program to evaluate a novel nursing model for adults with both serious mental illness and diabetes mellitus. The Well Balanced program incorporated health promotion, disease management, nursing care management, and evidence-based practice guidelines into 8 Steps to Wellness for a community-based mental health population. During a 16-visit intervention period, psychiatric nurses interacted with 74 clients. As a result of the program, clients experienced improvements in health risk status and in their hemoglobin A1C and reported high satisfaction with the Well Balanced program.     

Knowledge,boundaries, and bodies: Social construction between medical sociology and science and technology studies

Medical sociology and science and technology studies (STS) emerged from different positions, but often closely related concerns, within the broad discipline of sociology. Their interface and areas of overlap have mostly been shaped by theoretical positions broadly considered “social constructionist.” Taken together, these perspectives provide empirical and theoretical tools to analyze important questions about how social inequalities, forms of scientific knowledge, and patterns of human health come to be produced and feedback into one another. Examining their intersection enables sociological questions such as: How is medical and public health scientific knowledge produced, stabilized, and taken as fact? How are scientific facts about health and illness used, experienced, and challenged? What is the relationship between health inequalities and public health or medical knowledge? This article seeks to briefly trace the important contributions that social constructionist research has made at the interstices of medical sociology and STS, further clarifying the history, points of intersection, and areas of diversion between them. The current COVID-19 pandemic has unveiled the political struggles that constitute public health scientific knowledge and circulation. The interface between STS and medical sociology can help us to make sense of the interrelationships between politics, power inequalities, and public health scientific knowledge.     

The growth of the sociology graduate program at Kent State University

The initial growth of the graduate program in sociology at Kent State University was dominated by the interests, academic training and career goals of particular people who participated in it. Moreover, in 1939, when the program was initiated, its growth closely mirrored the principal concerns of the discipline. Today the program is responsive less to the discipline or particular faculty, and more to political, economic and demographic factors. As a state-funded institution, this university and graduate program are more likely to react to state needs and those of its other public, the students. Her interests include professional socialization and organizational change, particular in the field of health care. His most recent work is research on “belief in a just world” and in the social psychological aspects of gender roles.     

Social support needs of families adopting special needs children

A grounded theory begins to explain parental practices in seeking social support. Interviews with 20 parents who had adopted children with special needs and 5 health care providers indicated that parents lacked awareness of available resources; preferred informal support systems; sought help only when "failing" to solve problems; and perceived that health care providers lacked knowledge of adoption issues, family dynamics, and common health issues. Parents preferred informal to formal supports, and felt upset when formal supports were judged ineffective or non-existent.     

The use of diaries for understanding the experience of health and illness

While diaries as a method have a long tradition in sociological research, few studies to date have demonstrated its value for studying health and illness. This article intends to illustrate the importance of this method for health research. The implications of the use of solicited diaries to conduct research within the field of health and illness are discussed. The contributions that the method can make to sociological research on health and illness are explored, namely the potential to capture the everyday of ill people and their family members. Indeed, this method offers an opportunity to access the experience of illness in a multidimensional approach which is not easy for researchers to catch using other methods. The article aims to present an overview of the significance of the use of diaries in health research and will make a novel contribution to the sociology of health and illness.     

The clinical social worker as a member of the health team in a coronary care unit

In the course of developing a pattern of assistance to the patient about to be discharged from a coronary care unit, the professional health team at the University of California at Los Angeles Hospital anticipates and treats in advance the medical, social, and emotional problems of the patient which might tend to create a crisis at the time of his re-entry into his former world, possibly a new and much-changed world dictated by the nature of his illness. The professional appraisals at UCLA are continually reinforced by the practical and social approaches of the clinical social worker who, by the nature of her training, is able to see the patient's illness in its full social and psychological framework, rather than as an isolated phenomenon.     

Improving Primary Care for Persons with Disabilities: the nature of expertise

It has been well documented that persons with disabilities (PWDs) have a more vulnerable health status than persons without disabilities; yet, they often receive inadequate primary care within the US health care system. This study explores how PWDs think about the health care they receive, particularly how primary care providers facilitate or hinder quality care for PWDs. The findings from this study expand the concept of expertise in health care, suggesting it goes well beyond technical competence of health care providers. For PWDs, expertise is multi-dimensional, not solely the domain of providers and includes having knowledge and using that knowledge within the context of the provider-patient relationship. PWDs identified three distinct areas of expertise: medical/technical, medical/biographical, and systems. Expertise can be brought to health care encounters by both PWDs and providers, and it can be developed through collaboration during interactions between providers and PWDs.     

Relational Troubles and Semiofficial Suspicion: Educators and the Medicalization of “Unruly” Children

Using an interview‐based analysis of the accounts of interactions between educators, parents, and clinicians, this study explores educators' roles in interpreting childhood troubles as the medical phenomenon of attention deficit‐hyperactivity disorder (ADHD). The analysis of interviews shows how children's “personal” troubles become understood as “relational” ones, prompting increasingly sophisticated social responses. I argue that the institution of education, operating in a clinical capacity but lacking the legitimate authority to assign ADHD diagnoses, plays a hybridized, semiofficial role in the medicalization process. This assertion informs a critique of the “informal/official” dichotomy found in the sociology of deviance lexicon, and furthers previous positions in the sociology of mental health that have implicated school representatives in the social construction of behavior disorders.     

Control and responsibility: moral and religious issues in lay health accounts

In sociological work of an empirical nature the concept of control tends to have a taken-for-granted quality. Similarly in the field of medical sociology when control is mentioned in relation to health and illness it is often presented in a unidimensional manner. This article analyses the relationship between control and responsibility for health in the lay accounts of male Glaswegians. Activist and fatalist dimensions were found in their thinking. However, activist thinking was seen to have three strands: personal activism, social activism, and religious activism. Further, fatalistic thinking was not about passive submission but rather the belief that control lay outwith the person in the realm of the social, natural or supernatural worlds. These findings demonstrate the subtle ways in which people relate to issues of control and responsibility in the health realm – a subtlety which is not fully brought out either in the theoretical or empirical work of social scientists researching in the health field.     

The use of mental health care,psychotropic drugs and social services by divorced people: does informal support matter?

This study compares the mental health care, psychotropic drugs and social service use of divorced people (re-partnered or single) with that of married people. This paper questions whether the availability of informal support facilitates or substitutes for formal care seeking. Data from the Divorce in Flanders survey of 2009–2010 are used. Logistic regression analyses are performed separately for women (N = 3450) and men (N = 3020). Greater use of mental health care, psychotropic drugs and social services by single divorced men is explained by their higher need for care, while divorced women (especially single divorced) more frequently contact a general practitioner (GP), a psychiatrist, or a psychologist, regardless of their mental health, socio-economic background and informal support. Women who have support from non-family members are more inclined to use social services and to contact a GP, while support from family members is only positively related to GP consultations. With regard to men, informal support from non-family members positively influences each type of formal care seeking. Our results suggest that non-family members (and only among women, family members as well) can provide help and advice about seeking professional mental health care and social services, but they do not have an influence on psychotropic drug use.     

Behavioral consequences of consumer dissatisfaction with medical care

The effects of consumer dissatisfaction with doctors and medical care services on intentions to seek care and subsequent behavior were estimated using data from four general population studies. Satisfaction was linked to reported intentions regarding care-seeking behavior (choices between self-care and seeking care from a regular doctor or emergency room) in response to both minor and serious medical problems. These results were replicated in two populations with diverse sociodemographic characteristics. Satisfaction scales also predicted subsequent changes in medical care providers and disenrollments from prepaid health plans independent field tests. These results suggest that the behavioral consequences of individual differences in satisfaction with doctors and health care services are noteworthy from both clinical and social perspectives.     

Training for collaboration: collaborative practice skills for mental health professionals

The purpose of the study was to identify skills that mental health practitioners need for successful collaborative practice in medical settings. Known experts in the field of collaborative health care completed a survey designed to elicit their suggestions about what is needed for successful collaborative care practice. Through qualitative analysis, a set of 56 skills was developed. These skills are organized into three general categories of competency: (a) skills for working in a medical setting; (b) skills for working with patients; and (c) skills for collaborating with healthcare providers.     

Developing a Personal Program for Continuing Education

Abstract

The increasing number of field expeditions studying or working abroad each year is currently unparalleled by medical research efforts or data from which health professionals can make meaningful recommendations about how to keep personnel in the field healthy. The medical planning, organizing, and data are presented from a geology expedition to Guatemala involving 25 persons. Only minor medical problems were encountered, and less than 1% of the total person days at risk were lost due to illness. Eight guidelines are presented as a tool to assist any health professional in the planning and preparing of a team for the field.     

Mental Health Consumer and Carer Participation in Professional Education: ‘Getting There Together’ for Children of Parents with Mental Illness and Their Families

Abstract

‘Getting There Together’ is a professional education seminar developed as a collaborative project by professionals, mental health consumers and carers aimed at service providers who work with children of parents with mental illness and their families. The need for such professional education concerning this group is well recognised and the project reported herein was initiated by a reference group of professionals, consumers and carers focusing on children of parents with mental illness in the Eastern region of Melbourne (Victoria, Australia). The project began and continued as a collaborative effort during development and implementation, which ensured the experience, point of view and voice of consumers and carers was central to the material prepared, and at the time of seminar presentations. Seminar participants were from the family welfare, child care and supported housing sectors. Seminar participants found the first person accounts of consumers and carers the most helpful aspects of the seminars because they gave new insights into the experiences of carers and of mental health consumers as parents, as well as an understanding of ‘… the whole family, and how the child fits into the picture’.