Introduction to Public Health Sociology

Public health sociology as a behavioral Science 

• Behavioral Science is a branch of science (such as psychology, sociology, or anthropology) that deals primarily with human action and often seeks to generalize about human behavior in society .

Many public health challenges – including preventable diseases, smoking, and mental ill-health – are more often behavioural and sociological than medical in nature. The reason behind this is that they often arise from behaviours that are underpinned by social and structural determinants.

For example, obesity and Type 2 diabetes often arise as a result of the poor diets that we have, which are influenced by the obesogenic environment that we live in. Although these behavioural and social factors are often the leading influences on our health outcomes, they attract only a fraction of the attention or resource that goes into clinical treatment.

In order to effectively prevent poor health, we need an approach that takes account of the whole person, social context, and wider aspects such as education, employment, social norms, and the built and online environment. 

This would be a comprehensive systems approach that draws on multiple behavioural and social sciences, including psychology, behavioural economics, sociology and anthropology.

It aims to better enable the public health system to maximise the contribution of behavioural and social sciences to improving and protecting the public’s health and wellbeing, improve value to the public purse, and reduce health inequalities. 

As a high-level guide, it provides a framework and brings together a suite of relevant resources from a range of disciplines in one place

In recent years, the contributions of behavioural and social sciences to improving the health of the public have gained more prominence. 

However, they are still underutilised in practice and insufficiently integrated when applied to public health, and the workforce that is qualified to provide this behavioural and social science input remains small.

Lets look over some areas in  which we can apply concept of sociology 

• Body mind interactions
• Community behaviour
• Physician-patient/health service provider consumer role and behavior
• Doctor-patient/Service provider consumer interactions
• Social and cultural issues in health care
• Health policy and economics

In this way sociology is important in public health practice.

We might wonder how we can considered sociology as a part of behavioral science. There are lots of evidences which prove that sociology as a part of behavioural science .The paramount thing to understand is sociology is one of the branches of behavioral science.Sociology used different kinds of scientific method , so it is considered as branch of science and generally sociology deals with the study of behaviour of human is social setting .Thus sociology is considered as part of behavioral science.To brush up the idea sociology being part of behavioral science the following mentioned bullets might help;

• It helps to understand practices and behaviors
• It involves the systematic analysis and investigation of human behavior through the study of the past, controlled and naturalistic observation of the present
• Concern with the understanding, prediction, and control of behavior.
• It studies man as behaving individual
• Studies how individual reacts to his social conditions.
• Studies nature and characteristic of individual  in society.
• It also discovers the fundamental conditions of social stability and social change
• It analyses the influence of economic ,political, technological, cultural and other forces and factors on individual and his life.

Other examples that illustrates Public helath sociology as a part of behavioral sciences;

• Sociology is a science that looks human behaviour in groups.Sociologists maintain objectivity, perspective and imagination,.
• Sociologists use scientific method to study politics, race,culture, socioeconomic issues ,
• All interacting with each other in social setting causing group behaviour,
• Sociology uses different questions of human behaviour. Example; Why health or illness is promoted or complicated by type of food we eat.
• Sociology helps to understand why people are refusing to use certain kinds of health facilities  
• Sociology studies man as behaving individual
• Sociology studies nature and characteristics of individual in society
• Systematic analysis and investigation of human behaviour through the study of past,controlled and naturalistic observation 
• Sociology analyses the influences of economic,politics,technological,cultural and other forces and factors on individuals and his life.

Therefore, Public Health Sociology or simply a sociology is a science .AS it use scientific method of research, data collection. Sociological methods are both qualitative and quantitative methods.

Most of the Sociological investigations related with the behaviour of man in group.

For Example; The socioeconomic status of group is afefcted by complex components such as education and occupation that are part of total life course of individuals within group.

To sum up, in sociological appproaches to public healt, the role of social and behavioral factors in health and illness is central.Thus, Public Health sociology is apart of behavioral science.

Social Psychology and its application in public health

Psychology 

• A definition of psychology would include:
• Scientific study of mental  & physiological processes
• Scientific study of human behaviour
• Study of individual differences
• Encompasses physiological, personality, pathological and unconscious issues
• It is the science of mental processes and the effects on behaviour
• Behaviour therefore has a strong biological basis – unconscious, unreflexive and uncontrollable

Social psychology 

• Social psychology is the scientific study of how people’s thoughts, feelings, and behaviors are influenced by the actual, imagined, or implied presence of others (Allport 1998).
• By this definition, scientific refers to the empirical method of investigation. The terms thoughts, feelings, and behaviors include all of the psychological variables that are measurable in a human being.
• The statement that others may be imagined or implied suggests that we are prone to social influence even when no other people are present, such as when watching television, or following internalized cultural norms.
• Social psychology is the study of human experience within social contexts. That is, how the people around us impact our thoughts, feelings, and behaviors.
• Social psychology is the study of how people and groups interact.
• Social psychology is a branch of psychology that studies how individuals think, feel about and affect one anothers’ thought, emotions and conduct
• It analyses the ways in which social circumstances and personal interpretations influence an individual’s behavior in a group setting

Some common areas dealt in Social psychology 

• Social perception and cognition
• Cognitive dissonance
• Attitude and behavior
• Persuasion
• Self concept
• Self presentation
• Interpersonal relationships
• Social influence (conformity, compliance, obedience)
• Group dynamics/Social relationships (norms, roles, relations, social identity, intergroup behavior, crowds, conflict, cooperation, aggression)

History of social psychology 

• •The discipline of social psychology began in the United States at the dawn of the twentieth century.
• •Attitudes and a variety of small group phenomena were the most commonly studied topics in this era.
• •During World War II, social psychologists studied persuasion and propaganda for the US military.
• •After the war, researchers became interested in a variety of social problems, including gender issues and racial prejudice.
• •In the 1960s, there was growing interest in a variety of new topics, such as cognitive dissonance, bystander intervention (to prevent sexual assaults, harassments, racism etc), and aggression.
• •During the years immediately following World War II, there was frequent collaboration between psychologists and sociologists (Sewell 1989).
• •However, the two disciplines have become increasingly specialized and isolated from each other in recent years, with sociologists focusing on macro variables (such as social structure) to a much greater extent.
• •Nevertheless, sociological approaches to social psychology remain an important counterpart to psychological research in this area.
• •Social psychology reached maturity in both theory and method during the 1980s and 1990s.
• •Modern researchers are interested in a variety of phenomena, but attribution, social cognition, and self-concept are perhaps the greatest areas of growth.
• •Social psychologists have also maintained their applied interests, with contributions in health and environmental psychology, as well as the psychology of the legal system.

Two Main Areas of Study in Social Psychology 

1. Social Cognition--making sense of the social environment
2. Social influence--how behavior is affected by situation and other people

Social Cognition/Thinking 

• How do we explain people’s behaviour?
• How do we form our beliefs and attitudes?
• How does what we think affect what we do?
• How can attitudes be influenced and behaviour changed?

Social Cognition 

The mental processes that people use to make sense out of their social environment. It includes:

1. Person perception
2. Attribution
3. Attitudes
4. Cognitive dissonance
5. Prejudice

Research methods in social psychology 

• Experimental methods
• Correlational methods
• Observational methods

Role of psychology in public health 

• •It gives framework for understanding behavior and environment : Psychology gives a framework for understanding how behavior and the environment interact to produce certain health outcomes, and also a framework for understanding how we might change those outcomes.
• •It helps in socialization and behavior change: how we can change what people learn in families and communities, and ultimately how it affect whole regions through policies that promote health.
• •It helps to learn about leadership and group dynamics: Learn about leadership, dealing with groups and encouraging people to move in certain directions
• It helps in understanding and solving psychological and social problems :
• Social psychologists tackle issues that can have a significant impact on individual health and well-being, from understanding why bullying behavior and aggression take place to analyze why people sometimes fail to help individuals in need. Social psychologists focus on societal concerns that have a powerful influence on individual wellbeing as well as the health of society as a whole, including problems such as substance use, crime, prejudice, domestic abuse, public health, bullying, and aggression.
• It helps in developing evidence based public health programs and treatment approaches:
• The research that social psychologists perform can and does have a powerful influence on our understanding of various aspects of mental health and wellbeing. For example, research on conformity has contributed to our understanding of why teenagers sometimes go to such great lengths to fit in with their social group—sometimes to the detriment of their own health and wellness.
• As a result, psychologists are able to develop public health programs and treatment approaches aimed at helping teenagers resist potentially harmful behaviors such as smoking, drinking, and substance use.
• It helps in reducing morbidity and mortality due to key public health problems of present world :
• The leading contemporary causes of mortality are attributable to behaviors such as tobacco use, alcohol consumption, poor diet, and lack of physical activity meaning that major advances in human health and well-being require the development of a sophisticated understanding of human behavior.

Domains of Public Health 

1. Thematic Domain
2. Public Health Core Action Domain
3. Health Intervention Domain

Thematic Domain 

• Nutrition
•  environmental health
• life style, 
• reproductive health,
•  MCH
• communicable and non communicable diseases

Public Health Core Action Domain 

• health promoting action,
• health risk factors, injuries and disease prevention actions,
• health protecting actions,
• epidemic control actions, and
• actions leading to early detection, treatment and compliance to treatment regime

Health Intervention Domain 

• Health education
• Health promotion strategy
• Policy and legal interventions
• Community organization and participation

Sociology in PH Domain

 •Public health thematic domain :

1.Nutrition:

• Human resource development begins from the stage of conception of the child and could relate to the following developmental stages : pre-natal, post­ natal, infancy, childhood, teenage, youth, adult and old age.
• During these stages the most Important aspect to be attended to is health and nutrition of the child.
• These would take care of the rest of the development 
• Sociological and social anthropological studies of food have characteristically focused on food cultures and the collective character of eating patterns among social groups (Douglas 1984, Murcott 1988).
• In contrast to behavioral approaches, sociological approaches study group eating patterns and aim to explain patterns in relation to their socio cultural contexts (Mennell et al. 1993, Murcott 1995).
• In these fields,  explaining collective eating patterns have emphasized cultural and symbolic expressions of food use, where eating patterns are understood to reflect systems of meaning constructed by people.

2.Environmental health 

• Sociologists have applied a broad notion of environment as a context for social action, in which ‘the environment’ is basically everything that is not part of a human body, a product of human agency, or a human construction.
• They analyzed the interactions between society and the environment usually focusing upon how to manipulate the natural environment for the benefit of human kind, e.g. to manage water or food supplies or to enhance human health.

Sociology in PH core action domain 

• Communities come in all shapes and sizes. They include people who live in the same area as well as those with a common social identity.
• Communities differ in their access to and control over the social determinants of health.
• Health promoting ,heath risk factors and disease prevention actions ,health protecting  actions ,epidemic control actions: these are  often done through community development processes, in which
• People and communities become more  empowered when they take part in gaining more control over the decisions and actions that affect their health.
• Knowing how to take social actions that improve health within one’s community is an important part.
• Another increasing  focus is: the importance of health promotion and health education based on behavior change techniques to achieve risk reduction.

Sociology in PH intervention domain 

• Community take a meaningful role in defining their priorities for health, as well as making decisions, planning, and implementing strategies to improve health.
• Sociology have  analyzed   the etiology and distribution of health and illness which help to  structure  adequate health policies.
• A sociologist studies processes that create, maintain, and sustain a social system, such as a health care system in a particular country   concerning with the processes regulating and shaping the health care system.

Components of Public Health Sociology 

• (a) social stratification
•  (b) ethnicity and caste system, 
• (c) family and kinship, 
• (d) peer groups,
•  (e) community dynamics, 
• (f) social organizations, and
•  (g) social control

Social Stratification

• Stratification is a social  pattern based on ranking of individuals and social positions in terms of the distribution of the desirable elements , both material and emotional , which society has to offer.
• Social stratification is the study of social inequality, which refers to unequal access to power and privilege in a society.
• Social differences arises in people when they are placed in different classes in such a way that the very fact of belonging of class will determine the nature of the rank they occupy in society and the power they wield from their respective positions.

Four General Types of stratification

1. System of slavery;    human beings as equivalent to household pets or appliances.
2. Castes ; hereditary systems of ranks usually religiously dictated that are fixed and immobile, mostly in Hindu religion.
3. Estates; associated in feudal society in which peasants require to work in land leased to them by nobles in exchange for military protection and other services.
4. Social Classes;  social ranking based on economic position. Here achieved characteristics can influence mobility. Social classes are strongly explained by Marxist theories

Stratification may be by:

1 Property wealth and income–  Rich class and poor

2Birth :-    Brahman, Chhetri, Vaishya and Sudra

3.Religion:–  Hindu, Buddhist, Christian, Muslim etc.

4.Education:-  Educated and uneducated

5.Intelligence:- gifted and slow.

6.Race :- White and Black

7.Political right:-  Ruler and Ruled.

8.Nature of Occupation:-  Agriculturist, Industrialist etc.

9.Language:  Between the languages 

Characteristics of social stratification

• According to sociologist M.M Tumin (1969)It is social.It is ancient process.It is universal process

• It is a universal and  found in every society
• It may be achieved or ascribed (ascribed or inherited as in the caste of the Hindu caste system, or it can be achieved by applying personal skill, as in the case with societies that make room for social mobility)
• It has different forms in different time and places
• Social norms and values govern it
• Social indicator of inequality
• The factors relating to differentiation may either be ascribed or inherited as in the caste of the Hindu caste system, or it can be achieved by applying personal skill, as in the case with societies that make room for social mobility.
• Stratification may be made vertically or horizontally. (Vertical stratification means that the different classes are placed in degrees of vertical ascendance and decadence, just as it occupies a higher or lower position. Horizontal stratification is more or less subdivision within the same rank or station of life. It helps to understand the distinction between sets of persons who may be altogether belonging to the same stratum of a society).

Ethnicity and caste system

Definition :

•   According to Risely caste is a collection of families bearing a common name claiming a common descent from a mythical ancestor professing to follow the same hereditary calling and regarded by those who are competent to give an opinion as forming a single homogeneous community.
•  According to Maclver and Page “when status is wholly predetermined so that men are born to their lot without any hope of changing it, then the class takes the extreme form of caste. “

Characteristics of caste system

• Based on inborn membership
• A segmental division of society
• Social and religious hierarchy, status is ascribed or innate
• A rigid system with membership unalterable
• Restricts on food habit, occupations, social
• relationships, sexual intercoarse among its members
• Endogamy (rule of marry within own caste)
• Belief of purity and impurity based on Hinduism
• Special civil or social or religious rights or restrictions
• found eg impure castes to live in outskirts of the city,
• sudras not allowed to read the sacred literature

Ethnicity

• A social term that overlaps with concepts of race, nationality, class and religion
• An ethnic group or an ethnicity is a category of people who identify with each other based on similarities such as common ancestry, language, history, society, culture or nation.
• Ethnicity is usually an inherited status based on the society in which one lives. Membership of an ethnic group tends to be defined by a shared cultural heritage, ancestry, origin myth, history, homeland, language or dialect, symbolic systems such as religion, mythology and ritual, cuisine, dressing style, art or physical appearance.
• It concerns the relationship between groups whose members consider each other culturally distinctive
• A group feeling or realization of people belonging to special cultural group
• A distinct category of population in a larger society whose culture is usually different from other
• Ethnicity refers to a sense of belonging and identification with a particular heritage

Characteristics of ethnic group

• A distinct collective identity
• Own traditional social structure
• Own language, religion, tradition, culture and civilization
• Traditional homeland or geographical area
• Written or oral history 
• Having we feeling

Major ethnic groups of Nepal

• Himalayan region– Sherpa, Thakali, Bhote, Dolpa,Lopa, Jirel, Chhantyal, Hyolmo, Tangbe, Lepcha
• Hilly region– Brahmin Chhetri, Thakuri, dalit castes , Gurung, Magar, Rai, Limbu, Sunuwar, Tamang, Chepang, Newar,
• Terai– Meche, Koche, Dhimal, Satar, Rajnbanshi,Tharu, dom etc

Family and Kinship

Family

• A group with common ancestors
• A kinship group united by blood or marriage
• A married couple with or without children
• An unmarried couple with children ??
• One person with children
• “Two or more persons related by blood, marriage or adoption and residing together in a household” US Bureau of the Census
• A kinship grouping which provides for the rearing of children and for certain other human needs
• A family is the basic unit of the social group.

Kinship

• Kinship is a culture’s system of recognized family roles and relationships that define the obligations, rights, and boundaries of interaction among the members of a self-recognizing group.

Types of Kinship: 

Kinship is of two types:

(i) Affinal Kinship:

• The bond of marriage is called affinal kinship. When a person marries, he establishes relationship not only with the girl whom he marries but also with a number of other people in the girl’s family. Moreover, it is not only the person marrying who gets bound to the family members of the girl but his family members also get bound to the family members of the girl.

(ii) Consanguineous Kinship:

• The bond of blood is called consanguineous kinship. The consanguineous kin are related through blood whereas the affinal kin are related through marriage. The bond between parents and their children and that between siblings is consanguineous kinship. Siblings are the children of the same parents
• Thus, son, brother, sister, uncle, nephew and cousin are consanguineous kin. i.e., related through blood. In this connection it may be pointed out that blood relationship may be actual as well as supposed.

Functions of Kinship

• Significant role in socialization of individuals
• Maintains group solidarity

• Influences on social, economic, cultural, political and religious activities
• The bond of kinship creates strong obligations between related persons than those of strangers

Peer Groups

• •In sociology, a peer group is both a social group and a primary group of people who have similar interests (homophily), age, background, or social status. The members of this group are likely to influence the person’s beliefs and behavior. Peer groups contain hierarchies and distinct patterns of behavior.
• •In a high school setting for example,18 year olds are a peer group with 14 year olds because they share similar and paralleled life experiences in school together. In contrast, teachers do not share students as a peer group because teachers and students fall into two different roles and experiences.

Purpose of Peer Groups

• Satisfy certain belonging needs

• Influence social, cognitive and psychological development
• Influence development of morals and values
• Interaction provides instruction on acceptable behavior.
• Social Support – resources provided by others in times of need
•  Validation for the self

• Encouragement to try new things
• Opportunities for comparison
•  Enable self-disclosure and provide identity

Types of Peer

• Relationship
• Friendships(Causal, close, platonic)
• Cliques (groups)
• Gang (mob, team)
• Dating Relationships

Community Dynamics

• Community – a group of People
• Dynamics – Self-Motivated Person, Active Person, Energetic Person, known as “Dynamics for Development of the Community”
• Community-Dynamics is the process of change and development within communities .
• Community Dynamics which strive to bring about positive social change through community-based programming

Types of Social Dynamics According to Comte

According to comte there are three types of social progress:

(i) Physical Progress

• By physical progress we mean the progress in outward living conditions, like housing, agricultural and industrial production etc. physical progress provides base for social progress. It is the most fundamental progress of mankind. In its absence no other kind of progress is possible. Physical progress is the first rung in the ladder of social progress.

(ii) Intellectual Progress:

• By intellectual progress we understand the processes of social cohesion and social disintegration; and also the forces which lead to social disruption and disorder. Comte believed that if our intellect can be made to accept the importance of social cohesion, our selfish feelings will automatically turn into altruistic desires. The increase in feeling of altruism would in turn lead to great strides in social progress.

(iii) Moral Progress:

• In his book Positive Polity, Comte attached great importance to moral progress. He regarded the feeling element to be of higher value than the intellectual element. He gave more importance to morality in comparison with intellect. Deviating from his general philosophy, Comte began to regard morality to be the highest.

Functions of Social Dynamics

• Synergy
• More resources for problem solving
• Improved creativity and innovation
• Improved quality of decision making
• Greater commitments to tasks
• Increased motivation of member
• Better control and work discipline
• More individual need satisfaction
• Synchronization of efforts

Social Organization

• In sociology, a social organization is a pattern of relationships between and among individuals and social groups.
• Characteristics of social organization can include qualities such as sexual composition, spatiotemporal cohesion, leadership, structure, division of labor, communication systems, and so on.

Examples of social organizations

• Political organization- state, government
• Economic organization- factory
• Financial organization- bank
• Educational organization- school/college

Salient aspects of Social Organization

• They are not functioning in the same way in all societies
• They are not found in equal number everywhere
• It is also a function of the division of labor of specialized activities
• They are universal in nature eg family, government, religion etc
• When the number of social organizations increases
• more and more single-purpose organizations come to be established.
• Further, due to social changes, an organization having
• many functions may lose or transfer some of them to
• other multi-purpose organizations. Eg family, schools,
• cinema hall, sports club etc
• Some salient aspects of social

Social Control

• Social control refers to the control of society over the individual.
• Some social control implies a system of device through which society controls the activities of individual members.
•  Mannheim – “Social control as the sum of those methods by which a society tries to influence human behaviour to maintain a given order”.
•  Ogburn and Nimkoff – “The patterns of pressure which a society exerts to maintain order and established rules”.

Nature of Social Control

1. Social control denotes some kind of influence.

2. It is essentially use by the society or community.

3. It is implement for promoting the welfare of all the individuals or of the group as a whole.

4. The social control is an old as human society.

5. It is universal.

NEED FOR SOCIAL CONTROL

• To maintain the old order
• Social security
• Cooperation plays a very significant
• To control individual behavior
• To check cultural maladjustment
• To establish social unity

Types of Social Control

 Society makes use of various means of social control depending upon the time and social situation for the realization of its purpose.

1.  Formal control:

•  Law, legislation, military force, police force, administrative devices, political, educational, economic (industry) etc.

2. Informal control

•  Public opinion, sympathy, sense of justice, norms, values, folkways, mores, customs, religion, morality, fashion, etc.

Political

•  The political leaders show the way for the masses to follow the path taken by great man of their past.
•  The path influences the political and other economic fields to the fellow man.

Law

•  The society grows in size and complexity consisting of number of organizations, institutions and structures.
•  Informal means of social control are no longer sufficient to maintain social order and harmony. Therefore the law provides uniform norms, rights,responsibilities and penalties throughout a social system.
•  Laws are formulated by legally authorized bodies or agencies to control the deviated behaviour.

Norms

•  An important feature of a group is that it has a set of values which controls and modifies of a group of individuals.
•  The interaction among the members in a group leads to development of rules related to behaviour. Such rules of a group behaviour are called social norms.
•  It is highly impossible to imagine a society without norms.
•  It is a agencies to control the human behaviour.

Values

•  Social values and norms explain the way in which social processes operate in a given society.
•  They are the social sources of patterned interaction. Values account for the stability of the social order.
•  It provide the general guidelines for conduct that what is right and important for the society.
•  Thus, values such as respect for human dignity, sacrifice, helpfulness, co-operation, individuality, etc., guide our behaviour in various ways.
•  In doing so, they facilitate social control.

Folkways

•  The word means literally “the ways of the folk”. ‘Folk’ means people and ‘Ways’ refers to their behavioural habits.
•  It means the accepted ways of behaviour in society.
•  It arise automatically, spontaneously and unconsciously within the group.
•  These are socially approved and have some degree of traditional sanction.
•  The ways of eating, dressing, walking, working, expressing love and affection etc., represent folkways.
•  Taking three meals a day, walking on the left side of the road, regular brushing of the teeth, washing cloths, taking bath regularly, respect the elders, etc.

Mores

•  The mores represent another category of norms.
•  Some folkways are become more compulsive and regulative in character.
•  These folkways which become regulators of behaviour are normally referred to as ‘mores’.
•  Mores to those folkways which are considered by the group to be essential for its welfare and existence.
•  It is specking the truth, don’t commit adultery, don’t tell lies, don’t disrespect of god, etc