INTRODUCTION

Medical sociology is a sub discipline of sociology that studies social causes and consequences of health and illness, (Cocker ham, 2004). Major areas of investigation include social aspects of health and illness, the social behaviour of health care workers and the people who utilize their services, the social functions of health organizations and institutions, the social patterns of health services, the relationship of health care delivery systems to other social systems, and the health policy. In other words, Medical sociology observes various elements of social structure within the areas of mental and physical health care, and the framework for the regulation of the health care system. It explains the rules of the social process guiding physician-patient relationships in the process of administering care.

What makes medical sociology important is the significant role social factors play in determining the health 0f individuals, groups and the larger society. Social conditions and situations not only cause illness, but they also help prevent it.

Medical sociologists have employment opportunities both within and outside academia. Medical sociologists work not only in university sociology departments, medical, nursing, and public health schools and various other health related professional schools, but also in research organizations and government agencies.

DEFINITION OF BASIC TERMINOLOGIES.

Health: It is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity, (WHO). In other words, health can be defined as the state of optimum capacity for effective performance of value task.

Disease: A particular abnormal condition that negatively affects the structure or function of part or all of an organism. Diseases are often constructed as medical conditions that are associated with specific signs and symptoms.

Illness: A person’s experience of ill-health, sometimes when no disease can be found.

The difference between disease and illness is that disease is what affects the organ of the body and can be medically constructed whereas, illness is what man has.

Sickness: A state of being ill.

Patient: A person receiving treatment.

Hospital: A health care institution providing patient treatment with specialized medical and nursing and medical equipments.

Institution: An institution is an organized body form by human beings in order to achieve a common goal.

SOCIOLOGY AND HOW IT IS RELATED TO MEDICINE.

Sociology, the queen of all social sciences is the newest and the most exciting discipline in social sciences. It emerged from the turmoil of Western Europe particularly the French and industrial revolutions that pervaded Europe in 18^th and 19^th centuries. It founding fathers include August Comte, Emile Durkheim, Max Weber, Karl Marx and Herbert Spencer. These scholars were worried about the political and economic revolutions, social and gender inequalities as well as religious instability of their time and attempted to analyze the society by highlighting the various strategies that would be put in place to surmount disorder and restore social order. This provides impetus into the origin of society as an academic discipline.

By way of definition, sociology as an academic discipline focuses on social order and the analysis of social groups and the society in general. In simple terms, sociology is the science of the society. Sociologists in this context are interested in analyzing how human beings interact with one another (in health institutions) and the forces that determine social order. It is noteworthy that in their quest for understanding human behaviours sociologists employ scientific methodology.

Sociology is related to the field of medicine in the following undisputed facts:

1. The incidence of illness to a larger extent is determined by social and cultural factors. As a result of this, knowledge of these factors in the etiology of illness cannot be under-stressed.
2. Sociology equips us with the knowledge of understanding attitudes that may constrain or facilitate the treatment process.
3. Sociology provides a careful study of all those who are relevant in providing support during treatment and post-treatment phases.
4. It also helps us to understand and appreciate the various actors in the treatment setting such as pharmacists, laboratory technicians etc.

The study of these issues and many more definitely brings in to focus the relationship between sociology and medicine.

MEDICAL SOCIOLOGY: TOWARDS DEFINITION.

Medical sociology addresses a wide range of key issues and especially the interplay between social factors and health. It involves the application of sociological knowledge and concepts to social issues of health and illness. It considers the social and cultural factors on disease and illness processes as well as the organization and delivery of health care. According to Timuola (2014), medical sociology studies social behaviour and society by observing medical groups, organizations and other patterned network of interaction through which society achieves a healthy population.

APPROACHES TO MEDICAL SOCIOLOGY

Basically, there are two approaches to the study of medical sociology. Firstly, medicine is seen as a social institution which one should study and test sociological hypothesis. Secondly medicine is perceived as an applied enterprise seeking to minimize the suffering of humans and improve quality of life.

MAJOR CONCERN OF MEDICAL SOCIOLOGY.

Medical sociology is basically concerned with:

1. Explaining how people respond to diseases with a view of defining it in a predictable way from the perspective of their culture and social class within a particular culture.
2. Looking at how disease in a population is located among social groups.
3. Describing how societies prescribe means of treating diseases.
4. Investigating how social institutions give their support to the medical organizations in their bid to treat the sick.

MEDICAL CARE AND HEALTH CARE.

Medical care has to do with essential provisions and services that are employed in the management and treatment of disease conditions and illness such as drugs, needles, syringes, reagents, hospitals, clinics, pharmacies, nurses, doctors etc. Health care on the other hand, encompasses all the essential requirements that are needed to keep people healthy. Health care needs include food security, proper hygiene, housing, sanitation, income, education and so on. In this way, medical care is basically curative while, health care is preventive.

THEORIES IN MEDICAL SOCIOLOGY

Theories in medical sociology generally may be divided into the following:

Structural functionalist theory: This theory may be compared with an analogy between a biological organism and the society. The perspective argues that sickness, health and health institutions can be analyzed with the framework of a dynamic social system. For instance, the illness of a particular member of the society may be traced to lack of family members to play their crucial role to keep the person healthy which may or may not be as a result of poverty. Whatever may be the cause of the illness, the sick member’s illness behavior has implication not only for himself but also for other members of the family, his peer group and the larger society.

The Marxist theory: This theory was pioneered with the works of Karl Marx who lived between 1818-1920. Marx saw the power relations and the divergent aspects of the social structure which can result to illness. He emphasized the role of power ideologies and economic system in health care. In this regard, proponents of this theory believe that power structure or ideology or economic system of any society cannot be divorced from the nature of its health care delivery.

Middle range theories: This paradigm is represented by the view of Geffman (1971) who believed that the social situations have greater implications for human behavior whether in health or sickness. For instance, fuel scarcity in a city at any given point in time may account for morbidity or sometimes mortality.

MODELS OF DISEASES.

According to WHO, health is a complete state of physical, social, mental wellbeing and not necessary the absence of disease or infirmity, (cited in Lewis 1953). Disease on the other hand has been defined as a form of deviation from normal functioning which has undesirable consequences because it produces personal discomfort or adversely affects the future health status of individuals, (Mechanic).

It is important to note that the concepts health, diseases and illness, generally speaking are amplified by the belief of a people, (Erinosho, 2015).

Basic models of disease include:

1. Medical model: This model argues that disease is a function of biological discontinuity, and as such a discontinuity can be linked to the malnutrition of a part of the human organism. Disequilibrium in a human organism can occur if a part of the organism fails to perform its function effectively and efficiently.      
2. Psychological theory: This theory is about an appraisal of the contributions of psychiatrists and psychologists in the understanding of the etiology of mental disorder. Sigmund Freud (1914) was the psychoanalyst who propounded this theory to explain the role of psychology in the etiology of mental diseases by analyzing the unconscious drives in human beings.
3. Culture–bond theory of diseases: This theory highlights the interplay between culture and diseases. This explains that disease conditions can be managed more effectively through an informed knowledge of the cultural context and the patient’s background. E.g. Obesity, sickle cell, hypertension, suicide etc.

Lambo (1955) of Nigeria and Yap (1951) of Hong Kong did a lot of works among their people on the cultural dimensions of health and ill-health. They submit that health and diseases are to a larger extent, determine by culture of a people. The evidence of disease is therefore usually attributed to witchcraft, sorcery and mystical forces.

4. socio–environmental theory: The social factors such as income, education, occupation, and environmental cushions within which man lives and functions can to a larger extent, account for the etiology of health and disease. Behavioural patterns can also determine health and illness.

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