Medicalization Defined in Empirical Contexts – A Scoping Review

Document Type: Review Article

Authors

Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands

Abstract

Background
Medicalization has been a topic of discussion and research for over four decades. It is a known concept to researchers from a broad range of disciplines. Medicalization appears to be a concept that speaks to all, suggesting a shared understanding of what it constitutes. However, conceptually, the definition of medicalization has evolved over time. It is unknown how the concept is applied in empirical research, therefore following research question was answered: How is medicalization defined in empirical research and how do the definitions differ from each other?

 
Methods
We performed a scoping review on the empirical research on medicalization. The 5 steps of a scoping review were followed: (1) Identifying the research question; (2) Identifying relevant studies; (3) Inclusion and exclusion criteria; (4) Charting the data; and (5) Collating, summarizing and reporting the results. The screening of 3027 papers resulted in the inclusion of 50 empirical studies in the review.

 
Results
The application of the concept of medicalization within empirical studies proved quite diverse. The used conceptual definitions could be divided into 10 categories, which differed from each other subtly though importantly. The ten categories could be placed in a framework, containing two axes. The one axe represents a continuum from value neutral definitions to value laden definitions. The other axe represents a continuum from a micro to a macro perspective on medicalization.

 
Conclusion
This review shows that empirical research on medicalization is quite heterogeneous in its definition of the concept. This reveals the richness and complexity of medicalization, once more, but also hinders the comparability of studies. Future empirical research should pay more attention to the choice made with regard to the definition of medialization and its applicability to the context of the study

Keywords

Main Subjects


  1. Davis JE. Medicalization, Social Control, and the Relief of Suffering. In: Cockerham W, ed. The New Blackwell Company to Medical Sociology. Singapore: John Wiley & Sons Ltd; 2010:211-241.
  2. Busfield J. The concept of medicalisation reassessed. Sociol Health Illn. 2017;39(5):759-774. doi:10.1111/1467-9566.12538
  3. Zola IK. Medicine as an institution of social control. Sociol Rev. 1972;20(4):487-504. doi:10.1111/j.1467-954X.1972.tb00220.x
  4. Illich I. Limit to Medicine. Medical Nemesis: the Expropriation of Health. London - New York: Marion Boyars; 1995 [1976].
  5. Barker KK. A ship upon a stormy sea: the medicalization of pregnancy. Soc Sci Med. 1998;47(8):1067-1076. doi:10.1016/s0277-9536(98)00155-5
  6. Oakley A. The Captured Womb: A History of the Medical Care of Pregnant Women. Oxford: Basil Blackwell Publisher Ltd; 1984.
  7. McHugh MC, Chrisler JC. The wrong prescription for women: how medicine and media create a "need" for treatments, drugs, and surgery. Santa Barbara: Praeger; 2015.
  8. Wentzell E. How did erectile dysfunction become "natural"? A review of the critical social scientific literature on medical treatment for male sexual dysfunction. J Sex Res. 2017;54(4-5):486-506. doi:10.1080/00224499.2016.1259386
  9. Riska E. Aging men: Resisting and endorsing medicalization. In: Kampf A, Marshall BL, Petersen A, eds. Aging Men, Masculinities, and Modern Medicine. London: Routlegde; 2013:71-85.
  10. Vainionpää K, Topo P. The construction of male menopause in Finnish popular magazines. Crit Public Health. 2006;16(1):19-34. doi:10.1080/09581590600601882
  11. Conrad P. Medicalization and social control. Annu Rev Sociol. 1992;18(1):209-232. doi:10.1146/annurev.so.18.080192.001233
  12. Ballard K, Elston MA. Medicalisation: a multi-dimensional concept. Soc Theory Health. 2005;3(3):228-241. doi:10.1057/palgrave.sth.8700053
  13. Conrad P. The shifting engines of medicalization. J Health Soc Behav. 2005;46(1):3-14. doi:10.1177/002214650504600102
  14. Earp BD, Sandberg A, Savulescu J. The medicalization of love. Camb Q Healthc Ethics. 2015;24(3):323-336. doi:10.1017/s0963180114000206
  15. Sadler JZ, Jotterand F, Lee SC, Inrig S. Can medicalization be good? Situating medicalization within bioethics. Theor Med Bioeth. 2009;30(6):411-425. doi:10.1007/s11017-009-9122-4
  16. Hofmann B. Medicalization and overdiagnosis: different but alike. Med Health Care Philos. 2016;19(2):253-264. doi:10.1007/s11019-016-9693-6
  17. Abraham J. Pharmaceuticalization of society in context: theoretical, empirical and health dimensions. Sociology. 2010;44(4):603-622. doi:10.1177/0038038510369368
  18. Clarke AE, Shim JK, Mamo L, Fosket JR, Fishman JR. Biomedicalization: Technoscientific Transformations of Health, Illness, and U.S. Biomedicine. Am Sociol Rev. 2003;68(2):161-194. doi:10.2307/1519765
  19. Bell SE, Figert AE. Medicalization and pharmaceuticalization at the intersections: Looking backward, sideways and forward. Soc Sci Med. 2012;75(5):775-783. doi:10.1016/j.socscimed.2012.04.002
  20. Conrad P. Medicalization: Changing Contours, Characteristics, and Contexts. In: Cockerham W, ed. Medical Sociology on the Move. Dordrecht: Springer Science + Business Media; 2013:195-214.
  21. Buffel V, Dereuddre R, Bracke P. Medicalization of the uncertainty? An empirical study of the relationships between unemployment or job insecurity, professional care seeking, and the consumption of antidepressants. Eur Sociol Rev. 2015;31(4):446-459. doi:10.1093/esr/jcv004
  22. Buffel V, van de Straat V, Bracke P. Employment status and mental health care use in times of economic contraction: a repeated cross-sectional study in Europe, using a three-level model. Int J Equity Health. 2015;14:29. doi:10.1186/s12939-015-0153-3
  23. Moloney ME, Konrad TR, Zimmer CR. The medicalization of sleeplessness: a public health concern. Am J Public Health. 2011;101(8):1429-1433. doi:10.2105/ajph.2010.300014
  24. Hislop J, Arber S. Understanding women's sleep management: beyond medicalization-healthicization? Sociol Health Illn. 2003;25(7):815-837.
  25. Rafalovich A. Attention deficit-hyperactivity disorder as the medicalization of childhood: challenges from and for Sociology. Sociol Compass. 2013;7(5):343-354. doi:10.1111/soc4.12034
  26. Singh I, Wessely S. Childhood: a suitable case for treatment? Lancet Psychiatry. 2015;2(7):661-666. doi:10.1016/s2215-0366(15)00106-6
  27. Ekman I. Beyond medicalization: Self-injuring acts revisited. Health (London). 2016;20(4):346-362. doi:10.1177/1363459316633280
  28. Gøtzsche PC, Jørgensen KJ, Krogsbøll LT. General health checks don't work. BMJ. 2014;348:g3680. doi:10.1136/bmj.g3680
  29. Shostak S, Conrad P, Horwitz AV. Sequencing and its consequences: path dependence and the relationships between genetics and medicalization. AJS. 2008;114 Suppl:S287-316.
  30. Levac D, Colquhoun H, O'Brien KK. Scoping studies: advancing the methodology. Implement Sci. 2010;5:69. doi:10.1186/1748-5908-5-69
  31. Arksey H, O'Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19-32. doi:10.1080/1364557032000119616
  32. Freese J, Peterson D. Replication in social science. Annu Rev Sociol. 2017;43(1):147-165. doi:10.1146/annurev-soc-060116-053450
  33. Barker KK. Electronic support groups, patient-consumers, and medicalization: the case of contested illness. J Health Soc Behav. 2008;49(1):20-36. doi:10.1177/002214650804900103
  34. Barker KK. Listening to Lyrica: contested illnesses and pharmaceutical determinism. Soc Sci Med. 2011;73(6):833-842. doi:10.1016/j.socscimed.2011.05.055
  35. Barker KK. Mindfulness meditation: do-it-yourself medicalization of every moment. Soc Sci Med. 2014;106:168-176. doi:10.1016/j.socscimed.2014.01.024
  36. Clarke JN, Lang L. Mothers whose children have ADD/ADHD discuss their children's medication use: an investigation of blogs. Soc Work Health Care. 2012;51(5):402-416. doi:10.1080/00981389.2012.660567
  37. Clarke JN. Medicalisation and changes in advice to mothers about children's mental health issues 1970 to 1990 as compared to 1991 to 2010: evidence from Chatelaine magazine. Health Risk Soc. 2013;15(5):416-431. doi:10.1080/13698575.2013.802295
  38. Vainionpää K, Topo P. The making of an ageing disease: the representation of the male menopause in Finnish medical literature. Ageing Soc. 2005;25(6):841-861. doi:10.1017/S0144686X05003946
  39. Bell AV. Beyond (financial) accessibility: inequalities within the medicalisation of infertility. Sociol Health Illn. 2010;32(4):631-646. doi:10.1111/j.1467-9566.2009.01235.x
  40. Padamsee TJ. The pharmaceutical corporation and the 'good work' of managing women's bodies. Soc Sci Med. 2011;72(8):1342-1350. doi:10.1016/j.socscimed.2010.10.034
  41. Bransen E. Has menstruation been medicalised? Or will it never happen. Sociol Health Illn. 1992;14(1):98-110. doi:10.1111/1467-9566.ep11007176
  42. Williams SJ, Seale C, Boden S, Lowe P, Steinberg DL. Medicalization and beyond: the social construction of insomnia and snoring in the news. Health (London). 2008;12(2):251-268. doi:10.1177/1363459307086846
  43. Becker G, Nachtigall RD. Eager for medicalisation: the social production of infertility as a disease. Sociol Health Illn. 1992;14(4):456-471.
  44. Gammell DJ, Stoppard JM. Women's experiences of treatment of depression: Medicalization or empowerment? Can Psychol. 1999;40(2):112-128. doi:10.1037/h0086831
  45. Holmqvist M. Medicalization of unemployment: individualizing social issues as personal problems in the Swedish welfare state. Work Employ Soc. 2009;23(3):405-421. doi:10.1177/0950017009337063
  46. Hyde A, Treacy MM, Scott AP, et al. Social regulation, medicalisation and the nurse's role: insights from an analysis of nursing documentation. Int J Nurs Stud. 2006;43(6):735-744. doi:10.1016/j.ijnurstu.2005.10.001
  47. Westfall RE, Benoit C. The rhetoric of "natural" in natural childbirth: childbearing women's perspectives on prolonged pregnancy and induction of labour. Soc Sci Med. 2004;59(7):1397-1408. doi:10.1016/j.socscimed.2004.01.017
  48. Arney J, Rafalovich A. Incomplete syllogisms as techniques of medicalization: The case of direct-to-consumer advertising in popular magazines, 1997 to 2003. Qual Health Res. 2007;17(1):49-60. doi:10.1177/1049732306293778
  49. Barker KK. Mindfulness meditation: do-it-yourself medicalization of every moment. Soc Sci Med. 2014;106:168-176. doi:10.1016/j.socscimed.2014.01.024
  50. Elston MA, Gabe J, Denney D, Lee R, O'Beirne M. Violence against doctors: a medical (ised) problem? The case of National Health Service general practitioners. Sociol Health Illn. 2002;24(5):575-598. doi:10.1111/1467-9566.00309
  51. Adams J. Medicalization and the market economy: Constructing cosmetic surgery as consumable health care. Sociol Spectr. 2013;33(4):374-389. doi:10.1080/02732173.2013.732895
  52. Coveney CM, Nerlich B, Martin P. Modafinil in the media: metaphors, medicalisation and the body. Soc Sci Med. 2009;68(3):487-495. doi:10.1016/j.socscimed.2008.11.016
  53. Hogle LF. Chemoprevention for healthy women: harbinger of things to come? Health. 2001;5(3):311-333. doi:10.1177/136345930100500303
  54. Jacob JD, Gagnon M, McCabe J. From distress to illness: a critical analysis of medicalization and its effects in clinical practice. J Psychiatr Ment Health Nurs. 2014;21(3):257-263. doi:10.1111/jpm.12078
  55. Parry DC. "We wanted a birth experience, not a medical experience": exploring Canadian women's use of midwifery. Health Care Women Int. 2008;29(8):784-806. doi:10.1080/07399330802269451
  56. Kilty JM. ‘It’s like they don’t want you to get better’: Psy control of women in the carceral context. Fem Psychol. 2012;22(2):162-182. doi:10.1177/0959353512439188
  57. Lee E, Macvarish J, Sheldon S. Assessing child welfare under the Human Fertilisation and Embryology Act 2008: a case study in medicalisation? Sociol Health Illn. 2014;36(4):500-515. doi:10.1111/1467-9566.12078
  58. Malacrida C. Medicalization, ambivalence and social control: mothers' descriptions of educators and ADD/ADHD. Health (London). 2004;8(1):61-80. doi:10.1177/1363459304038795
  59. Merianos AL, Vidourek RA, King KA. Medicalization of female beauty: a content analysis of cosmetic procedures. Qual Rep. 2013;18(46):1-14.
  60. Neiterman E. Sharing bodies: the impact of the biomedical model of pregnancy on women's embodied experiences of the transition to motherhood. Healthc Policy. 2013;9(Spec Issue):112-125.
  61. Polonijo AN, Carpiano RM. Representations of cosmetic surgery and emotional health in women's magazines in Canada. Womens Health Issues. 2008;18(6):463-470. doi:10.1016/j.whi.2008.07.004
  62. Schierenbeck I. Medicalization of sickness absence. Work. 2010;37(3):241-250. doi:10.3233/wor-2010-1076
  63. Torres JMC. Medicalizing to demedicalize: Lactation consultants and the (de)medicalization of breastfeeding. Soc Sci Med. 2014;100:159-166. doi:10.1016/j.socscimed.2013.11.013
  64. Venn S, Meadows R, Arber S. Gender differences in approaches to self-management of poor sleep in later life. Soc Sci Med. 2013;79:117-123. doi:10.1016/j.socscimed.2012.09.037
  65. Binney EA, Estes CL, Ingman SR. Medicalization, public policy and the elderly: social services in jeopardy? Soc Sci Med. 1990;30(7):761-771. doi:10.1016/0277-9536(90)90199-3
  66. Fainzang S. The other side of medicalization: self-medicalization and self-medication. Cult Med Psychiatry. 2013;37(3):488-504. doi:10.1007/s11013-013-9330-2
  67. McLeod JD, Pescosolido BA, Takeuchi DT, White TF. Public attitudes toward the use of psychiatric medications for children. J Health Soc Behav. 2004;45(1):53-67. doi:10.1177/002214650404500104
  68. Selin J. Implementation of substitution treatment in Finland: Beyond rationalisation and medicalisation. Nord Stud Alcohol Drugs. 2011;28(1):29-42. doi:10.2478/v10199-011-0003-6
  69. Boero N. All the news that’s fat to print: The American “obesity epidemic” and the media. Qual Sociol. 2007;30(1):41-60. doi:10.1007/s11133-006-9010-4
  70. van Brummen B, Griffiths L. Working in a medicalised world: the experiences of palliative care nurse specialists and midwives. Int J Palliat Nurs. 2013;19(2):85-91. doi:10.12968/ijpn.2013.19.2.85
  71. Harvey K. Medicalisation, pharmaceutical promotion and the Internet: a critical multimodal discourse analysis of hair loss websites. Social Semiotics. 2013;23(5):691-714. doi:10.1080/10350330.2013.777596
  72. Norris P, Horsburgh S, Lovelock K, et al. Medicalisation or under-treatment? Psychotropic medication use by elderly people in New Zealand. Health Sociol Rev. 2011;20(2):202-218. doi:10.5172/hesr.2011.20.2.202
  73. Thomas-MacLean R. Memories of treatment: the immediacy of breast cancer. Qual Health Res. 2004;14(5):628-643. doi:10.1177/1049732304263658
  74. Melick ME, Steadman HJ, Cocozza JJ. The medicalization of criminal behavior among mental patients. J Health Soc Behav. 1979;20(3):228-237.
  75. Rafalovich A. Relational Troubles and Semiofficial Suspicion: Educators and the Medicalization of "Unruly" Children. Symb Interact. 2005;28(1):25-46. doi:10.1525/si.2005.28.1.25
  76. Oinas E. Medicalisation by Whom? Accounts of Menstruation Conveyed by Young Women and Medical Experts in Medical Advisory Columns. Sociol Health Illn. 1998;20(1):52-70. doi:10.1111/1467-9566.00080
  77. Calnan M. Women and medicalisation: an empirical examination of the extent of women's dependence on medical technology in the early detection of breast cancer. Soc Sci Med. 1984;18(7):561-569. doi:10.1016/0277-9536(84)90071-6
  78. Brubaker SJ. Denied, embracing, and resisting medicalization: African American teen mothers' perceptions of formal pregnancy and childbirth care. Gend Soc. 2007;21(4):528-552.
  79. Chang VW, Christakis NA. Medical modelling of obesity: a transition from action to experience in a 20th century American medical textbook. Sociol Health Illn. 2002;24(2):151-177. doi:10.1111/1467-9566.00289
  80. Hislop J, Arber S. Understanding women's sleep management: beyond medicalization-healthicization? Sociol Health Illn. 2003;25(7):815-837.  
  81. Moreira T. Sleep, health and the dynamics of biomedicine. Soc Sci Med. 2006;63(1):54-63. doi:10.1016/j.socscimed.2005.11.066
  82. Moloney ME, Konrad TR, Zimmer CR. The medicalization of sleeplessness: a public health concern. Am J Public Health. 2011;101(8):1429-1433. doi:10.2105/ajph.2010.300014
  83. Williams SJ, Seale C, Boden S, Lowe P, Steinberg DL. Medicalization and beyond: the social construction of insomnia and snoring in the news. Health (London). 2008;12(2):251-268. doi:10.1177/1363459307086846