The Symbolic Interactionist Perspective

     Let’s begin, then, by examining how culture influences health and illness. This takes us to the heart of the symbolic interactionist perspective.

The Role of Culture in Defining Health and Illness

Suppose that one morning you look in the mirror and see strange blotches covering your face and chest. Hoping against hope that it is not serious, you rush to a doctor. If the doctor said that you had "dyschromic spirochetosis," your fears would be confirmed.


      Now, wouldn’t everyone around the world draw the conclusion that your spots are symptoms of a disease? No, not everybody. In one South American tribe this skin condition is so common that the few individuals who aren’t spotted are seen as the unhealthy ones. They are even excluded from marriage because they are "sick" (Ackernecht 1947; Zola 1983).

      Consider mental "illness" and mental "health." People aren’t automatically "crazy" because they do certain things. Rather, they are defined as "crazy" or "normal" according to cultural guidelines. If an American talks aloud to spirits that no one else can see, and takes direction from them, he or she is likely to be defined as insane–and, for everyone’s good, locked up. In some tribal societies, in contrast, someone who talks to invisible spirits might be honored for being in close contact with the spiritual world–and, for everyone’s good, be declared a shaman, or spiritual intermediary, who would then diagnose and treat medical problems.

      "Sickness" and "health," then, are not absolutes, as we might suppose. Rather, they are matters of definition. Around the world, each culture provides guidelines that its people use to determine whether they are "healthy" or "sick." As discussed in the Cultural Diversity box, those guidelines also tell you what your illness is. This is another example of how the social construction of reality plays a vital role in our lives.

Box 19.1: Around the World
"You Don’t Know What Empacho Is? What Kind of a Doctor Are You?"

The Components of Health

      Back in 1941, international "health experts" identified three components of health: physical, mental, and social (World Health Organization 1946). They missed the focus of our previous chapter, however, and I have added a spiritual component to Figure 19.1. Even the dimensions of health, then, are subject to debate.

      If we were to agree on the components of health, we would still be left with the question of what makes someone physically, mentally, socially, or spiritually "healthy." Again, as symbolic interactionists stress, these are not objective matters but, rather, matters whose definitions vary from culture to culture. In a pluralistic society, they even differ from one group to another.

      As with religion in the previous chapter, then, the concern of sociologists is not to define "true" health or "true" illness. Instead, it is to analyze the effects that people’s ideas of health and illness have on their lives, and even the ways in which people determine that they are sick.