Summary
Commentary by Edwin Wouters
Sociology is the study of society, social institutions, and social relationships. It examines how individuals and groups interact within a societal context, and how social structures, such as the family, education, religion, and government, influence behavior and societal outcomes. However, despite a distinctive trait that it always goes beyond strictly individualist perspectives (which often dominate in biomedical sciences), there is not one sociology but many, ranging from interactions between as few as two people to structural forces, movements, and institutions that steer behaviour, all shaping health. Sociology hosts a range of theoretical paradigms, each having a distinctive added value in the study of tuberculosis (TB). Some examples are:
Conflict theory, rooted in the ideas of Karl Marx, provides a critical lens for understanding the complex interplay between social inequality, power dynamics, and health. When applied to TB research, conflict theory provides a framework for understanding how social inequalities and power imbalances contribute to the disease’s prevalence and management. It emphasizes the need for addressing structural factors and advocating for equitable healthcare policies that would effectively help combat TB. This paradigm has been very influential in inspiring the abundance studies on the social determinants of health, including TB.
Structural functionalism views society as a system of interrelated parts working together to maintain stability. It predominantly looks at structures that shape society and individual behaviours. In TB research, functionalism examines how social institutions (e.g., healthcare systems, government policies) function to prevent and control TB. In this way, health systems research and the WHO Building Blocks are heavily influenced by structural functionalist theories.
Symbolic interactionism examines how individuals and groups create and interpret meanings through social interactions. In the context of TB, this paradigm explores how patients and communities perceive and respond to TB symptoms, diagnosis,
and treatment. One of the most important symbolic interactionist theories for TB is the work of Erving Goffman on stigma as a social reality created through social interactions. Goffman’s theory has proven to be extremely relevant to the reality of living with TB in many countries.
These (and other) sociological paradigms provide valuable insights into the complex social dimensions of TB, helping researchers and policymakers develop more effective and equitable public health strategies.
References
For Conflict theory:
Hargreaves, J. R., Boccia, D., Evans, C. A., Adato, M., Petticrew, M., & Porter, J. D. (2011). The social determinants of tuberculosis: from evidence to action. American journal of public health, 101(4), 654–662. https://doi.org/10.2105/AJPH.2010.199505
For Structural functionalism:
Indicators, A. HANDBOOK OF. “Monitoring the building blocks of health systems.”; Geneva, Switzerland: WHO Document Production Services (2010).
For symbolic interactionism:
Goffman, E. (1959). “The presentation of self in everyday life”. Bantam Doubleday Dell Publishing Group.
Daftary A. (2012). HIV and tuberculosis: the construction and management of double stigma. Social science & medicine (1982), 74(10), 1512–1519. https://doi.org/10.1016/j.socscimed.2012.01.027
