Abstract/Details

Classification and the social construction of disease in medical systems: A historical comparison of syphilis and HIV/AIDS in the United States


2008 2008

Other formats: Order a copy

Abstract (summary)

Classifying patients to diagnose and treat disease, ensure access to medical care, adhere to standards of quality, contain costs, and fulfill contractual obligations is critical to the delivery of healthcare. While classification is a fundamental standardizing process in healthcare, as a social process it is the product of negotiations, organizational processes, and moral conflict often hidden in bureaucratic and professional modus operandi. By comparing the early twentieth century case of syphilis to the contemporary case of HIV/AIDS, the dissertation shows how symptomological, etiological, and financial classification have been developed and deployed in the context of a transforming twentieth century American medical system; how those deployments have been sustained, modified, and/or undermined over time; and, ultimately, how classifications influence the social construction of disease through the creation of social problems and their solutions. The layering of classifications over time can facilitate the unintended and obscured persistence of categories and criteria, impacting the day-to-day practice of sorting patients, treatments, and experts. The aim of the dissertation is to study the social process of classification in its everyday operation in the interplay between discourse and practice to understand what healthcare providers actually do with the classifications they are handed, including the adaptation of classifications to local situations that, ultimately shape the way syphilis and HIV/AIDS are integrated into medical practice itself. As a result of looking at classification this way, I show how symptoms, diseases, patients, treatments, and medical care providers are dynamic objects of classification that contribute to collective definitions of disease and influence how medicine and public health organize activity in changing technological, administrative, and moral contexts.

Indexing (details)


Subject
Public health;
Sociology;
Classification;
Social psychology;
Disease;
Human immunodeficiency virus--HIV;
Acquired immune deficiency syndrome--AIDS;
Comparative studies
Classification
0573: Public health
0626: Sociology
Identifier / keyword
Health and environmental sciences; Social sciences; Classification; HIV/AIDS; Medical systems; Social construction; Syphilis
Title
Classification and the social construction of disease in medical systems: A historical comparison of syphilis and HIV/AIDS in the United States
Author
Culyba, Rebecca J.
Number of pages
328
Publication year
2008
Degree date
2008
School code
0163
Source
DAI-A 69/11, Dissertation Abstracts International
Place of publication
Ann Arbor
Country of publication
United States
ISBN
9780549899181
Advisor
Heimer, Carol A.
Committee member
Espeland, Wendy; Stinchcombe, Arthur
University/institution
Northwestern University
Department
Sociology
University location
United States -- Illinois
Degree
Ph.D.
Source type
Dissertations & Theses
Language
English
Document type
Dissertation/Thesis
Dissertation/thesis number
3336513
ProQuest document ID
288199450
Copyright
Database copyright ProQuest LLC; ProQuest does not claim copyright in the individual underlying works.
Document URL
http://search.proquest.com/docview/288199450
Access the complete full text

You can get the full text of this document if it is part of your institution's ProQuest subscription.

Try one of the following:

  • Connect to ProQuest through your library network and search for the document from there.
  • Request the document from your library.
  • Go to the ProQuest login page and enter a ProQuest or My Research username / password.