5.3.3

Sociological Explanations

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Marxist and Pluralist Explanations of Unequal Distribution of Healthcare

Sociologists see the unequal distribution of healthcare provision in different ways and offer different explanations. The three main explanation come from Marxist, pluralist and structuralist perspectives.

Marxist approaches

Marxist approaches

  • Tudor-Hart proposes an ‘inverse care law’, whereby the most advantaged gain the most from healthcare even though the disadvantaged need it most.
  • This reflects a pattern of inequality across capitalist societies.
Big business

Big business

  • Marxists argue that healthcare provision supports big business, in terms of pharmaceuticals (drugs), medical technology and private healthcare at the expense of preventative methods such as health education.
Class struggle

Class struggle

  • Healthcare provided via the NHS is viewed as benefitting capitalism by keeping the working classes fit enough to work while giving the impression of fairness and caring in society, disguising the inherit inequalities that capitalism creates and reinforces.
Pluralist approaches

Pluralist approaches

  • The distribution and allocation of healthcare resources result from the bargaining actions of competing groups.
  • Groups include, groups such as the British Medical Association, GPs, health administrators, the government, private healthcare companies and patient groups.

Structuralist Explanations of Unequal Distribution of Healthcare

Sociologists see the unequal distribution of healthcare provision in different way and offer different explanations. The three main explanation come from Marxist, pluralist and structuralist perspectives.

Structuralist approaches

Structuralist approaches

  • Structuralist approaches draw on the Marxist view of social inequality and power distribution in healthcare and structuralist notions of competing interest groups.
Distribution

Distribution

  • How healthcare is distributed depends the outcome of the power struggle between three different and competing interest groups who work within the healthcare system...
Interest groups

Interest groups

  • Dominant interests (the final decision-makers).
  • Challenging interests (who challenge the interests of the dominant group).
  • Repressed interests (whose interests are least likely to have their need met by the existing structure of the healthcare organisation).
Power structure

Power structure

  • Checkland et al. argue that there is little scope for public and patient participation with the NHS structure, and patients are the least powerful group and have the least control over the allocation of healthcare.
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1

Theory & Methods

1.1

Sociological Theories

1.1.1Marxism1.1.2Feminism1.1.3Social Action Theories
1.2

Sociological Methods

1.2.1Types of Data1.2.2Positivism & Interpretivism1.2.3Research Design1.2.4Research Considerations1.2.5Values in Research1.2.6Modernity & Post-Modernity1.2.7Sociology as a Science1.2.8Sociology & Social Policy1.2.9End of Topic Test - Sociology Methods & Theories
1.3

Sources of Data

1.3.1Introduction1.3.2Experiments1.3.3Surveys1.3.4Longitudinal Studies1.3.5Questionnaires1.3.6Types of Questionnaires1.3.7Interviews1.3.8Observation1.3.9Case Studies1.3.10Documents1.3.11Official Statistics1.3.12End of Topic Test - Sources of Data
2

Education with Methods in Context

2.1

Role & Function of the Education System

2.1.1Introduction2.1.2Functionalist Theories2.1.3Marxist & Feminist Theories2.1.4The New Right
2.2

Educational Achievement

2.2.1Social Class: Internal Factors2.2.2Social Class: External Factors2.2.3Social Class: Attitudes to Education2.2.4Social Class: Difference in Achievement2.2.5Gender2.2.6Ethnicity
2.3

Relationships & Processes Within Schools

2.3.1Processes2.3.2Labelling2.3.3Categorisations2.3.4Student Experience2.3.5End of Topic Test -Education with Methods
2.4

Educational Policies

2.4.1Equality2.4.2Privatisation2.4.3Marketisation2.4.4Government Policies by Party2.4.5Globalisation2.4.6End of Topic Test- Educational Policies2.4.7Practice Exam Question - Social Policies
3

Option 1: Culture & Identity

3.1

Conceptions of Culture

3.1.1Culture3.1.2Mass Culture3.1.3Popular Culture3.1.4Global Culture3.1.5End of Topic Test - Culture and Identity
3.2

Identity & Socialisation

3.2.1Identities3.2.2Socialisation3.2.3Secondary Socialisation3.2.4Theories of Socialisation3.2.5End of Topic Test - Identity3.2.6Practice Exam Question - Socialisation & Equality
3.3

Social Identity

3.3.1Social Class3.3.2Upper & Middle Class3.3.3Working & Underclass3.3.4Social Class Evaluation3.3.5Gender3.3.6Changing Gender Identities3.3.7Ethnicity3.3.8Age3.3.9Disability3.3.10Nationality3.3.11End of Topic Test - Social Identity
3.4

Production, Consumption & Globalisation

3.4.1Production & Consumption3.4.2Globalisation3.4.3Evaluation3.4.4End of Topic Test - Production
4

Option 1: Families & Households

4.1

Families & Households

4.1.1Definitions4.1.2Functionalist & New Right Perspectives4.1.3Marxist & Feminist Perspectives4.1.4Postmodernist Perspective4.1.5End of Topic Test - Families & Households4.1.6Practice Exam Question - Function of Family
4.2

Changing Patterns

4.2.1Marriage4.2.2Divorce4.2.3LAT Relationships4.2.4Child-Bearing4.2.5Lone Parenthood4.2.6Diversity4.2.7The Sociology of Personal Life4.2.8Government Policies Post-WW24.2.9End of Topic Test - Changing Patterns
4.3

The Symmetrical Family

4.3.1The Symmetrical Family4.3.2Evaluation
4.4

Children & Childhood

4.4.1Childhood4.4.2Childhood in the UK4.4.3Childhood as a Social Construct4.4.4The Disappearance of Childhood4.4.5Child Abuse4.4.6Domestic Violence4.4.7End of Topic Test - Family & Childhood
4.5

Demographic Trends UK

4.5.1Introduction4.5.2Birth Rates4.5.3Death Rates4.5.4The Ageing Population4.5.5Studies on the Ageing Population4.5.6Migration4.5.7Globalisation4.5.8End of Topic Test - Demographics UK
5

Option 1: Health

5.1

Social Constructions

5.1.1The Body5.1.2Health, Illness & Disease5.1.3Disability5.1.4Models of Health & Illness5.1.5End of Topic Test - Social Constructions
5.2

Social Distribution of Healthcare

5.2.1Social Class5.2.2Gender5.2.3Ethnicity5.2.4Regional
5.3

Provision & Access to Healthcare

5.3.1The NHS5.3.2Inequalities in Provision5.3.3Sociological Explanations5.3.4Inequalities in Access5.3.5Inequalities in Access 25.3.6End of Topic Test - Distribution Health
5.4

Mental Health

5.4.1The Biomedical Approach5.4.2Social Patterns5.4.3Social Constructionist Approach
5.5

The Globalised Health Industry

5.5.1The Functionalist Approach5.5.2The Postmodernist Approach5.5.3The Globalised Health Industry5.5.4End of Topic Test - Mental Health & Globalisation
6

Option 1: Work, Poverty & Welfare

6.1

Poverty & Wealth

6.1.1Types of Poverty6.1.2Types of Poverty 26.1.3Distribution of Wealth UK6.1.4Sociological Theories6.1.5Sociological Theories 26.1.6Distribution of Poverty UK6.1.7End of Topic Test - Poverty & Wealth
6.2

Welfare

6.2.1The Welfare State6.2.2Theoretical Approaches to Welfare
6.3

Labour Process

6.3.1Nature of Work6.3.2Technology & Control6.3.3Work & Life6.3.4The Effects of Globalisation6.3.5Globalisation & Worklessness6.3.6End of Topic Test - Welfare & Labour
7

Option 2: Beliefs in Society

7.1

Ideology, Science & Religion

7.1.1Types of Religion7.1.2Ideology & Belief Systems7.1.3Social Stability & Religion7.1.4Social Change & Religion7.1.5End of Topic Test - Ideology, Science & Religion
7.2

Religious Movements

7.2.1Religious Organisations7.2.2New Religious Movements7.2.3New Age Movements7.2.4Practice Exam Question - Growth of NRMs
7.3

Society & Religion

7.3.1Social Groups & Religion7.3.2Gender & Religion7.3.3End of Topic Test- Religious Movements & Society
7.4

Contemporary Religion

7.4.1Secularisation UK7.4.2Against Secularisation7.4.3Secularisation US7.4.4Fundamentalism7.4.5Economic Development & Religion7.4.6End of Topic - Contemporary Religion
8

Option 2: Global Development

8.1

Development, Underdevelopment & Global Inequality

8.1.1Development8.1.2Underdevelopment & Global Inequality
8.2

Globalisation & Global Organisations

8.2.1Globalisation8.2.2Transnational Corporations & International Agency8.2.3Non-Governmental Organisations (NGOs)
8.3

Aid, Trade, Industrialisation, Urbanisation

8.3.1Development: Aid & Trade8.3.2Development: Industrialisation & Urbanisation8.3.3Development: Environment & War
9

Option 2: The Media

9.1

Contemporary Media

9.1.1New Media9.1.2Control of the Media9.1.3Sociological Approaches: New Media9.1.4Globalisation9.1.5News Selection9.1.6Moral Panics9.1.7End of Topic Test - Contemporary Media
9.2

Media Representations

9.2.1Age9.2.2Social Class & Ethnicity9.2.3Gender9.2.4Sexuality & Disability9.2.5Practice Exam Questions - Presentation of Women
9.3

Audiences

9.3.1Media Theories9.3.2Media Theories 29.3.3Media Representations & Audiences
10

Crime & Deviance

10.1

Crime & Society

10.1.1Functionalism10.1.2Subcultural Theory10.1.3Marxism10.1.4Realism10.1.5Other Approaches10.1.6End of Topic Test - Crime & Society10.1.7Practice Exam Questions - Social Construction
10.2

Social Distribution of Crime

10.2.1Ethnicity10.2.2Gender10.2.3Globalisation & Crime10.2.4Media & Crime10.2.5Types of Crimes10.2.6End of Topic Test - Social Distribution of Crime
10.3

Prevention & Punishment

10.3.1Surveillance10.3.2Prevention10.3.3Punishment10.3.4Victimology10.3.5End of Topic Test - Prevention & Punishment

Practice questions on Sociological Explanations

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  1. 1
    Who proposes an ‘inverse care law’, whereby the most advantaged gain the most from healthcare even though the disadvantaged need it most?Multiple choice
  2. 2
    Marxists argue that healthcare provision supports big business, in terms of:Fill in the list
  3. 3
    Who does __Checkland et al.__ argue has the least control over the allocation of healthcare in the NHS?Multiple choice
  4. 4
    Structuralist approaches draw on:Fill in the list
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Inequalities in Provision

Inequalities in Access