Western Philosophical Thought and the Delivery of the Public Health System
Improving healthcare behaviors and access to public healthcare has been a key issue of debate among politicians and officials on all levels of the government for quite some time. The ability to improve individual behaviors that result in improved health have an impact on society. The healthcare system is already overwhelmed and there is an urgent need to convince people to take responsibility for their own health by making positive changes in their daily lifestyle. Access to healthcare among certain socioeconomic classes and cultural populations has been an ongoing problem in the public health arena as well. This research takes a multidisciplinary approach to developing public policies that will result in improvements in each of these areas. This research will result in recommendations for policies that will effectively achieve these goals.
In the United States, we are fortunate to have one of the most advanced health care systems in the world. From a technological standpoint, the healthcare system has capabilities to deliver state of the art treatments that both extend and improve the quality of life for many Americans. However, this healthcare system is limited in the delivery of its services both in its capacity to handle the number of patients needing access to it and the elimination of financial and cultural barriers that limit access to the system for many segments of the population. This research will explore the role of sociology and psychology in the delivery of the public healthcare system. The purpose of this study is to find ways to extend delivery to the healthcare system in the United States to currently underserved segments of the population.
Sociology is the discipline that developed from the theoretical writings of several philosophers. These included Emile Durkheim, Karl Marx, Talcott Parsons, and others. The influence of these philosophers led to the development of sociology into a separate scientific discipline. Several key concepts must be considered in the study of sociology as it relates to public health. The first is that the emphasis in sociology is on society, rather than the individual. The field of psychology relates to the actions and motivations of the individual, rather than how they fit into the system.
Society can be viewed as a system that represents the collective actions, thoughts, and feelings of the many individuals within the society. The principles of sociology can be applied to public health. This entails a population-based approach to public health. It requires the ability to access and analyze large amounts of data ("Sociology in Public Health"). Recent improvements in technology have led to improved sociological disciplines in the area of public health. Statistical methods are used to intervene in, control and prevent large-scale actions and processes that have a negative effect on the society.
However, at this point, sociology has played a minor role in the public health arena. Psychology and instituting changes in the individual have been the key methods that have predominated ("Sociology in Public Health"). One example of this are campaigns that are targeted to help change individual behaviors such as losing weight, cutting back on smoking, and controlling diabetes. These factors have a negative impact on the individual, but they also have a negative impact on society as well. The effects of the failure to take appropriate actions in this regards have a negative effect on the healthcare system as well. They create even more crowding in an already overcrowded system. They create additional healthcare costs for the system as well.
Thus far, a psychological approach has been taken to make the changes in individuals that will have an overall impact on the healthcare system. However, there are many concepts from sociology that could be applied to the problems as well. The concepts of social status, social capital, social class dispersion, and principles applied to healthcare organization and financing could have an impact on the ability to curb individual behaviors and the affects that they have on the healthcare system ("Sociology in Public Health").
When one compares industrialized societies to developing societies, the principle can be applied that the wide the gap between classes, the greater the social inequalities. The greater the inequalities, the greater the inequality in access to the services provided to the public, such as healthcare. Socioeconomic status (SES) is a result of several components, such as income, residence, education, and thee occupation in which the individual is engaged ("Sociology in Public Health"). The dynamics of these factors differs, but the overall effect has an impact on the ability of an individual to gain access to the healthcare system.
Previously, we discussed using psychological factors to change behavior in individuals, thus have an affect on the societal impact. A sociological approach to the same problem would be to identify the factors within a certain group that lead to a low SES and that limit access to the healthcare system. Changing the SES of a group is complex and often interventions do not result in rapid change ("Sociology in Public Health"). Changes take place slowly over time. The sociological approach to instituting public health care changes is a long and slow process. Understanding why these inequalities exist is the key to making changes that will result in long-term positive changes in society. Now let us examine some of the key contributors to the development of sociology as a science and to the use of sociological practices as a means to achieve change in the public health care system that include increased access to the system for all citizens.
In order to understand how these ideas developed and to gain a perspective on how western philosophy, in conjunction with the discipline of sociology and psychology work to create changes in society that can be applied to the public health arena, let us examine some of the early contributors to this field.
First and foremost is the work of Emile Durkheim, who is considered by many to be the father of sociology. Durkheim is credited with making sociology and official academic field of study, applying his principles to criminology, suicide, education, and other public social issues (Jones, 2009). The work of Emile Durkheim demonstrates that sociology can be applied to many area of public concern and have played a key role in the development of this thesis that will apply sociological issues to the field of public health. Durkheim's work provides a framework with which to do so.
Frank Boas was an anthropologist who was trained in many other disciplines. He is credited with introducing and empirical approach to anthropology, which had relied on largely qualitative research techniques in the past (Lewis, 2001). Perhaps his most important theory in the area of public health is that of "cultural relativism," which promotes the idea that behavior and beliefs should be evaluated within the context of their own culture.
Sigmund Freud's theories on human development will also ad to the discussion, particularly his focus on how childrearing practices and family relationships provide the foundation for later social interaction and relationships (Poster, 1988). Family relationships and the attitudes and ideals instilled in the children by society as a whole have a profound effect on sociological problems in the public health system today.
Karl Popper asserted that a rigorously critical approach should be applied to governmental and social policy. He believed that an open society could only evolve if individuals could critically evaluate policies and actions, and then that these policies could be changed based on this critique. He supports a process of societal policy and change by means of pubic critique can consensus (Ross, 2003).
Michael Foucault was one of the most famous sociologists for his study of public social institutions. He worked in the areas of psychiatry, medicine, the human sciences and…