September 21, 2018

Meaning Making and Health

Headshot 3.13 cropcompressBy Karen Sternheimer

Peter Kaufman’s recent post about his experience with stage IV lung cancer is an important reminder that our bodies—particularly as they appear and function at this moment—and our overall health, are temporary.

And yet we often perceive them to be permanent. Why?

We make sense of our health collectively; even the way in which we define illness is rooted in social interactions. As sociologists Peter Conrad and Kristen K. Barker explain in their article "The Social Construction of Illness," culture plays a role in how we view and respond to a condition, and people experience their condition in a social context.

As Peter Kaufman notes in his essay, our culture of individualism encourages us to see ourselves as solely responsible for our health. Yes, our behaviors can often impact health outcomes, but not always. We have a tendency to want blame the afflicted for their illnesses, perhaps to distance ourselves from the reality that we might be sick someday too despite abiding by the latest health recommendations.

These are common questions we ask if someone is seriously ill: Did they lead a healthy lifestyle; meaning did they eat the “right” foods; did they avoid smoking, drinking or eating too much? Did they exercise enough? Once diagnosed, did they research their illness enough to find the right treatment? Take the advice that someone offers on social media to try a particular herb/supplement/new treatment that they heard about online?

All of these questions are ways that we can tell ourselves that we are different from someone who is ill, and that we are in control of our own fate. Those who are ill serve as reminders that illness and health problems can strike anyone, even people who follow social scripts on how to maintain good health.

It is hard for many of us to fathom that modern medicine can’t cure everyone, no matter how hard they might try to get well. In writing about her own experience with breast cancer, journalist Barbara Ehrenrich criticizes the message that so many people who are dealing with illness hear: that positive thinking can will people to get better, no matter the diagnosis. She argues this logic implies that those who cannot overcome the illness somehow didn’t try hard enough, or that their thoughts of anger, frustration, and sadness—understandable in the face of terminal illness—somehow contributed to their disease’s progression.

To believe that individuals are solely responsible for their health circumstances also minimizes the social determinants of health, or the role that our socio-economic status, race, and gender plays in our exposure to stress, access to clean air and water. Our jobs can contribute to poor health, as many occupations can cause or exacerbate health issues. Lower paying jobs that might cause injury might not include adequate health insurance, creating a double-bind for many people.

Ironically, thanks to modern medicine, we might be more likely to take good health for granted and to blame those who are sick for their circumstances. Compared with a century ago, we are much less likely to die from infectious diseases in the U.S. (although people certainly still do, particularly from the flu) and average life expectancy at birth has increased over the past half century overall. Children are far less likely to die in infancy than they were a century ago (from about 100 per 1,000 in 1916 to 5.6 per 1,000 in 2016), and we take for granted that most of them will live to see their eighteenth birthday (in 2014 the child mortality rate in the U.S. was 588 per 100,000, or less than one percent of all people under eighteen).

It is a luxury not to think about one’s health, a luxury that we often overlook until a problem emerges. We tend not to appreciate our organs when they are functioning well, our ability to breathe without assistance, for our hearts to maintain a normal rhythm, or the myriad of other problems that many people face daily.

I am shocked and saddened to learn of what Peter is going through. His experience defies our expectations and the way we commonly make sense of health as a personal endeavor. It is a reminder that we are both social beings and mortal beings too, not as fully in control as we sometimes believe.

Comments

I agree with your mentioning of the social determinants of health. I have a master of public health which emphasizes SDOH and shows how individuals are often not the sole person to blame but rather are influenced by their built environment.

It is important to understand our social health status. Health is sometimes determined by our role, culture, race, and even our environment, One should not take good health for granted. We are given the ability to breath air and have healthy hearts. We should take control of both our social and mortal beings by maintaining good health.

this should be spread by all of more and more by.thanx for the awareness.

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