Trakia Journal of Sciences, Vol. 19, Suppl. 1, 2021 49
Trakia Journal of Sciences, Vol. 19, Suppl. 1, pp 49-56, 2021
Copyright © 2021 Trakia University
Available online at:
http://www.uni-sz.bg
ISSN 1313-3551 (online) doi:10.15547/tjs.2021.s.01.007
ENVIRONMENT AND HEALTH LIFESTYLES:
STRUCTURAL AND INTERSECTIONAL ASPECTS OF HEALTH AND
ILLNESS IN MEDICAL SOCIOLOGY
N. Georgieva-Stankova*
Regional Development Department, Economics Faculty, Trakia University, Stara Zagora, Bulgaria
ABSTRACT
Purpose and Methods: The paper traces the effects of the environment and other structural factors on
individual health and illness, as analysed theoretically by Medical Sociology. More particularly, it focuses
on the interplay between structural factors in sociology and individual agency, i.e. the extent to which one’s
health is a matter of personal choice or affected by macrosocial factors, such as living conditions, social
status, race/ethnicity, gender, age and etc. Results: An imaginary debate between an expanded economic view
on health (Becker 1979) and a sociological perspective (Cockerham 2013) is staged to weigh out different
standpoints and the insistence on the primacy of either of the factors. William Cockerham’s health lifestyles
(2013) is analysed (an extension of the traditions of Max Weber and Pierre Bourdieu), as an interplay between
life chances and life choices, stressing the primacy of structural factors, without disregarding individual
agency, however, within the confines of particular structural restrictions. Discussion and conclusion:
Criticism of Becker’s economic health perspective is provided. Additionally, the intersectionality of
structural factors is examined and their mutual co-determination. Finally, a claim is made for the need to
connect environmental health with preventive medicine.
Key words: environment, health lifestyles, Medical Sociology, structure and agency, intersectionality
INTRODUCTION
Socio-economic and ecological factors are
inherently related to individual health and social
wellbeing. The Covid-19 pandemic has made
explicit more than ever our health’s dependence
on external, ecological factors, the cost of human
violations of the environment, the vulnerability of
particular social groups, as well as the mutual
interconnectedness of individuals in terms of
disease spread and prevention.
MATERIALS AND METHODS
Medical Sociology is the discipline that studies
the effects of environmental and other structural
factors on individual and group health. Some of
__________________________
*Correspondence to: Nadezhda Georgieva-
Stankova, Economics Faculty, Trakia University,
Student Campus 6000; telephone: +359 42 699 413;
e-mail: nadezhda.georgieva@trakia-uni.bg
the key questions it engages in in recent years
have been related to the interplay between social
structure and individual agency, i.e. the extent to
which one’s health can be treated as a matter of
personal choice or affected by macrosocial
factors, such as living conditions, social status,
race/ethnicity, gender, age and etc. The purpose
of the article is to explore theoretically this
problem by comparing paradigmatic differences
between two disciplines: Health Economics and
Medical Sociology, with an emphasis on the
existing ones within Medical Sociology. For this
end, an imaginary debate between an expanded
economic view on health (Becker 1979)(1) and a
sociological perspective (Cockerham 2013)(2)
will be staged to weigh out different standpoints
concerning the primacy of either of these factors.
William Cockerham’s health lifestyles (2013)(2)
will be analysed (an extension of the traditions of
Max Weber and Pierre Bourdieu), as an interplay