Social Theory & Health

, Volume 16, Issue 2, pp 111–126 | Cite as

Envisaging the healthcare sector as a field: moving from Talcott Parsons to Pierre Bourdieu

  • Fran CollyerEmail author
Original Article


Sociology has a long history of researching health, yet its theorisation of the health system, as a system or structured set of interlinked practices and institutions, has more recently been neglected. This stands in contrast to the prominence of the term in the policy literature. The importance of the concept of a system is demonstrated through a brief historical examination of the conceptual apparatus available within the discipline, beginning with the work of Talcott Parsons. It is proposed that the under-theorisation of the term makes it difficult to explain social action, specifically how social action might be shaped by the structures of the social system, and indeed, how social action might influence, and bring about change in the system itself. The paper proposes Bourdieu’s concept of the field as an appropriate replacement, demonstrating its greater utility for theorising the role of social structure in shaping healthcare practices and for modelling the healthcare sector itself.


Health care Parsons Bourdieu Capital Field System 


  1. Ahmad, R. 2013. Working with Pierre Bourdieu in the tourism field making a case for ‘third world’ tourism. Cultural Studies 27 (4): 519–539.CrossRefGoogle Scholar
  2. Albrecht, G.L. 2001. Rationing health care to disabled people. Sociology of Health & Illness 23 (5): 654–677.CrossRefGoogle Scholar
  3. Andersen, H. 2000. Functionalism. In H, ed. H. Andersen, and L.B. Kaspersen, 213–234. Oxford: Classical and Modern Social Theory Blackwell.Google Scholar
  4. Andersen, P., S. Jørgensen, and E. Larsen. 2011. For the sake of health! Social Theory and Health 9 (1): 87–107.CrossRefGoogle Scholar
  5. Bloom, S. 2002. The Word as Scalpel. New York, NY: Oxford University Press.Google Scholar
  6. Bourdieu, P. 1984. Distinction (trans: Nice, R.). Cambridge: Polity.Google Scholar
  7. Bourdieu, P. 1990. The Logic of Practice. Cambridge: Polity Press.Google Scholar
  8. Bourdieu, P. 1991. Language and Symbolic Power. Cambridge: Polity.Google Scholar
  9. Bourdieu, P. 1992. The Rules of Art: Genesis and Structure of the Literary Field. (trans. Susan Emanuel). Cambridge: Polity Press.Google Scholar
  10. Bourdieu, P. 1993a. Sociology in Question. (trans: Nice, R.) London: Sage.Google Scholar
  11. Bourdieu, P. 1993b. The Field of Cultural Production: Essays on Art and Literature. Cambridge: Polity.Google Scholar
  12. Bourdieu, P. 1999. Site effects. In The Weight of the World: Social Suffering in Contemporary Society, eds. Bourdieu, P. and A. Accardo. Stanford: Stanford.Google Scholar
  13. Bourdieu, P. 2000. Pascalian Meditations. Stanford: Polity.Google Scholar
  14. Bourdieu, P. 2006. The forms of capital. In Education, Globalisation and Social Change, ed. H. Lauder, P. Brown, J.-A. Dillabough, and A.H. Halsey. Oxford: Oxford University Press.Google Scholar
  15. Bourdieu, P., and L. Wacquant (eds.). 1992. An Invitation to Reflexive Sociology. Cambridge: Polity Press.Google Scholar
  16. Brown, B., P. Crawford, B. Nerlich, and N. Koteyko. 2008. The habitus of hygiene. Social Science and Medicine 67: 1047–1055.CrossRefGoogle Scholar
  17. Bury, M. 1997. Health and Illness in a Changing Society. London: Sage.Google Scholar
  18. Carpenter, M. 2000. It’s a small world. Sociology of Health & Illness 22 (5): 602–620.CrossRefGoogle Scholar
  19. Ceci, C., and M.E. Purkis. 2011. Means without ends. Sociology of Health & Illness 33 (7): 1066–1080.CrossRefGoogle Scholar
  20. Clabo, L.M. 2008. An ethnography of pain assessment and the role of social context on two postoperative units. Journal of Advanced Nursing 61 (5): 531–539.CrossRefGoogle Scholar
  21. Cohen, P. 1968. Modern Social Theory. London: Heinemann.Google Scholar
  22. Cohen, J., L.D. Hazelrigg, and W. Pope. 1975. De-Parsonizing Weber. American Sociological Review 40: 229–241.CrossRefGoogle Scholar
  23. Coleman, J.S. 1988. Social capital in the creation of human capital. American Journal of Sociology 94 (Supplement): S95–S120.CrossRefGoogle Scholar
  24. Collyer, F.M. 1997. The port Macquarie base hospital: Privatisation and the public purse. Just Policy 10: 27–39.Google Scholar
  25. Collyer, F.M. 1998. Privatisation and Australian hospitals. Health Issues 56: 12–14.Google Scholar
  26. Collyer, F.M. Wettenhall, R.W. and McMaster, J. 2003. The privatisation of public enterprises: Australian research findings. Just Policy December (31): 14–23.Google Scholar
  27. Collyer, F.M. 2007. A sociological approach to workforce shortages: Findings of a qualitative study in Australian hospitals. Health Sociology Review 16 (3–4): 248–262.Google Scholar
  28. Collyer, F.M. 2012. Mapping the Sociology of Health and Medicine: America, Britain and Australia Compared. Houndmills, Basingstoke: Palgrave Macmillan.CrossRefGoogle Scholar
  29. Collyer, F.M. Willis, K. Franklin, M. Harley, K. and Short, S. 2015a. Healthcare choice: bourdieu’s capital, habitus and field. Current Sociology 63 (5): 685–699.CrossRefGoogle Scholar
  30. Collyer, F.M. (ed.). 2015b. Karl Marx and Frederich Engels: Capitalism, health and the healthcare industry. In The Palgrave Handbook of Social Theory in Health, Illness and Medicine, 35–58. UK: Palgrave Macmillan.CrossRefGoogle Scholar
  31. Connell, R.W. 1979. The concept of role and what to do with it. Australian and New Zealand Journal of Sociology 15 (3): 7–17.CrossRefGoogle Scholar
  32. Dahrendorf, R. 1959. Class and Class Conflict in Industrial Society. Stanford: Stanford University Press.Google Scholar
  33. Doyal, L., and I. Pennell. 1983. The Political Economy of Health. London: Pluto Press.Google Scholar
  34. Duckett, S. 2007. The Australian Health Care System. South Melbourne, Victoria: Oxford University Press.Google Scholar
  35. Esping-Andersen, G. 1990. The Three Worlds of Welfare Capitalism. Cambridge: Polity Press.Google Scholar
  36. Everett, J. 2002. Organisational Research and the Praxeology of Pierre Bourdieu. Organisational Research Methods 5 (1): 56–80.CrossRefGoogle Scholar
  37. Faulkner, A. 1997. Strange bedfellows’ in the laboratory of the NHS? Sociology of Health & Illness 19 (19B): 183–208.CrossRefGoogle Scholar
  38. Frankenburg, R. 1974. Functionalism and after? International Journal of Health Services 4 (3): 411–427.CrossRefGoogle Scholar
  39. Fries, C.J. 2009. Bourdieu’s reflexive sociology as a theoretical basis for mixed methods research. Journal of Mixed Methods Research 3 (4): 326–348.CrossRefGoogle Scholar
  40. Gouldner, A.W. 1970. The Coming Crisis of Western Sociology. New York: Basic Books.Google Scholar
  41. Grineski, S.E. 2011. Why parents cross for children’s health care. Social Theory and Health 9: 256–274.CrossRefGoogle Scholar
  42. Habermas, J. 1984. Theory of Communicative Action, vol. 1. Boston: Beacon Press and Cambridge Polity Press.Google Scholar
  43. Hartley, H. 2002. The system of alignments challenging physician professional dominance. Sociology of Health & Illness 24 (2): 178–207.CrossRefGoogle Scholar
  44. Hetzel, B. 1974. Health and Australian Society. Ringwood, Victoria: Pelican Books.Google Scholar
  45. Homans, G. 1964. Bringing men back in. American Sociological Review 29: 808–818.CrossRefGoogle Scholar
  46. Jackson, J. 1998. Contemporary criticisms of role theory. Journal of Occupational Science 5 (2): 49–55.CrossRefGoogle Scholar
  47. Joudrey, R., and K. Robson. 2010. Practising medicine in two countries. Sociology of Health & Illness 32 (4): 528–544.CrossRefGoogle Scholar
  48. Kurunmäki, L. 1999. Professional vs financial capital in the field of health care. Accounting, Organizations and Society 24: 95–124.CrossRefGoogle Scholar
  49. Lamont, M., and A. Lareau. 1988. Cultural capital. Sociological Theory 6 (2): 153–168.CrossRefGoogle Scholar
  50. Luck, J., J.W. Peabody, L.M. DeMaria, C. Alvarado, and R. Menon. 2014. Patient and provider perspectives on quality and health system effectiveness in a transition economy. Social Science and Medicine 114: 57–65.CrossRefGoogle Scholar
  51. Luhmann, N. 1984. Social Systems. Stanford, CA: Stanford University Press.Google Scholar
  52. McDonald, R. 2009. Market reforms in English primary medical care. Sociology of Health & Illness 31 (5): 659–672.CrossRefGoogle Scholar
  53. Meyer, S., B. Gibson, and P. Ward. 2015. Niklas Luhmann: Social systems theory and the translation of public health research. In The Palgrave Handbook of Social Theory in Health, ed. F.M. Collyer, 340–354. Houndmills Basingstoke: Illness and Medicine Palgrave Macmillan.Google Scholar
  54. Michielsen, J., D. John, N. Sardeshpande, and H. Meulemans. 2011. Improving access to quality care for female slum dwellers in urban Maharashtra, India. Social Theory and Health 9 (4): 367–392.CrossRefGoogle Scholar
  55. Moore, R. 2008. Capital. In Pierre Bourdieu: Key Concepts, ed. M. Grenfell, 101–117. Durham: Acumen.Google Scholar
  56. Morgan, M., S. Deedat, and C. Kenten. 2015. ‘Nudging’ registration as an organ donor. Current Sociology 63 (5): 714–728.CrossRefGoogle Scholar
  57. Murtagh, M., and J. Hepworth. 2003. Menopause as a long-term risk to health. Sociology of Health & Illness 25 (2): 185–207.CrossRefGoogle Scholar
  58. Navarro, V. 1986. Crisis, Health, and Medicine. New York and London: Tavistock.Google Scholar
  59. Nolan, A., and S. Smith. 2012. The effect of differential eligibility for free GP services on GP utilisation in Ireland. Social Science and Medicine 74: 1644–1651.CrossRefGoogle Scholar
  60. Offe, C. 1985. Disorganized Capitalism. Cambridge: MIT Press.Google Scholar
  61. Owens, B.R. 2010. Producing Parsons’ reputation. Journal of the History of the Behavioral Sciences 46 (2): 165–188.CrossRefGoogle Scholar
  62. Parsons, T. 1978. Health and disease. In Action theory and the human condition, ed. T. Parsons, 66–81. New York: Free Press.Google Scholar
  63. Parsons, T. 1970. On building social system theory. In Daedalus the Making of Modern Science: Biographical Studies, vol. 99, no. 4: 826–881.Google Scholar
  64. Parsons, T. 1951. The Social System. New York: The Free Press.Google Scholar
  65. Pescosolido, B., and J. Kronenfeld. 1995. Health, illness, and healing in an uncertain era. Journal of Health and Social Behavior 35: 5–33. Extra Issue.CrossRefGoogle Scholar
  66. Pillsbury, B. 1982. Policy and evaluation perspectives on traditional health practitioners in national health care systems. Social Science and Medicine 16: 1825–1834.CrossRefGoogle Scholar
  67. Pinto, R., S. da Silva, and R. Soriano. 2012. Community health workers in Brazil’s unified health system. Social Science and Medicine 74: 940–947.CrossRefGoogle Scholar
  68. Putnam, R.D. 1993. Making Democracy Work. Princeton, NJ: Princeton University Press.Google Scholar
  69. Rhynas, S.J. 2005. Bourdieu’s theory of practice and its potential in nursing research. Journal of Advanced Nursing 50 (2): 179–186.CrossRefGoogle Scholar
  70. Roemer, M. 1977. Systems of Health Care. New York: Springer.Google Scholar
  71. Scambler, S., and P. Newton. 2011. Capital transactions, disruptions and the emergence of personal capital in a lifeworld under attack. Social Theory and Health 9: 130–146.CrossRefGoogle Scholar
  72. Scheid, T.L. 2000. Rethinking professional prerogative. Sociology of Health & Illness 22 (5): 700–719.CrossRefGoogle Scholar
  73. Strandbakken, P. 2000. Conflict Theory. In Classical and Modern Social Theory, ed. L.B. Kaspersen, and H. Andersen, 251–262. Oxford: Blackwell.Google Scholar
  74. Turner, B. (ed.). 1986. Talcott Parsons: Theorist of Modernity, 205–215. London: Sage.Google Scholar
  75. Wacquant, L. 1992. Toward a social praxeology. In An Invitation to Reflexive Sociology, ed. L. Wacquant, and P. Bourdieu. Cambridge: Polity Press.Google Scholar
  76. Willis, E. 1983. Medical Dominance. Sydney: Allen and Unwin.Google Scholar
  77. Willis, K., and S. Elmer. 2007. Society, Culture and Health. South Melbourne: Oxford University Press.Google Scholar
  78. Wrong, D. 1994. The Problem of Order. New York: The Free Press.Google Scholar

Copyright information

© Macmillan Publishers Ltd 2017

Authors and Affiliations

  1. 1.Department of Sociology and Social Policy, RC Mills A26University of SydneySydneyAustralia

Personalised recommendations