The hidden diagnosis: How social-economic factors affect health

Irving Zola, a prominent figure in medical sociology, dedicated much of his career to exploring the complex relationship between health, illness, and societal influences. One of his most compelling insights, which deeply resonated with me, was the observation that significant life events—such as childbirth, depression, and ageing—were often treated as medical problems rather than natural experiences or personal challenges. This tendency to medicalise what could otherwise be seen as part of the human condition raised important questions about how societal expectations shaped our understanding of health. For instance, I personally encountered this phenomenon during my struggle with secondary infertility. Insensitive questions and comments caused me to feel intense societal pressure regarding the delayed ability to conceive again, which I didn’t initially perceive as a pressing issue. This pressure manifested not only from family and friends but also from pervasive cultural narratives that equate a woman’s worth with her ability to bear children. Compounding this emotional strain, I also faced significant work-related stress, which led to considerable disruptions in my hormonal balance and resulted in chronic fatigue due to insufficient sleep. Several factors exacerbated the challenges: my demanding job required long hours, leaving little time for relaxation or self-care; a long daily commute heightened my sense of exhaustion; and the constant pressure to meet workplace expectations further contributed to my stress levels. After being diagnosed with a hormonal imbalance, I was faced with the option of medication to regulate my condition. However, I made the conscious choice to decline this route. This decision prompted a critical reflection on Zola’s theories regarding the medicalisation of society. I began to reconsider the sources of my stress, ultimately realising that many of them were intertwined with socio-economic considerations. By relocating closer to my workplace, I significantly reduced my commute and, subsequently, my daily stress levels.

 “While traditional medical sociology focused largely on statistical data and broad societal trends, Zola argued that understanding the human experience of illnesses required listening to individuals’ personal stories, eliminating the error of hasty generalisation, and working on using personal narratives.”

Additionally, I sought less demanding employment, which allowed more time for rest and self-care. These strategic adjustments alleviated my primary stressors and created a more conducive environment for my overall wellbeing. Ultimately, I conceived naturally twice, after addressing these socio-economic factors, further validating Zola’s arguments about the profound influence of social determinants on health outcomes. Through this experience, I became acutely aware of how societal pressures and economic circumstances can shape our perceptions of health and illness, reinforcing that our wellness experiences are not merely individual (biological or genetic) but deeply embedded in the social fabric.

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Another great legacy of Zola’s work was his emphasis on personal narratives in the study of illness. While traditional medical sociology focused largely on statistical data and broad societal trends, Zola argued that understanding the human experience of illnesses required listening to individuals’ personal stories, eliminating the error of hasty generalisation, and working on using personal narratives. As much as numbers and trends are valuable, paying attention to individual patients’ stories will go a long way in addressing the root cause instead of medicalising everything. I could only imagine accepting to go the medication route without eliminating my stressors. Here are a few possible outcomes:

Masked symptoms: One thing about a holistic approach to illnesses is that it could take longer but will address the root cause. Medication may have regulated the hormones, but the underlying stressors could have continued to affect the overall health.

Persistent underlying issues: Failure to address the root causes of the secondary infertility due to hormonal imbalance could have led to ongoing health issues and probably more, as it could morph into something else.

Dependence on medication: Relying solely on medication to regulate hormones without addressing the root cause could have led to a lifelong dependence on drugs rather than addressing the underlying causes of infertility.

Unforeseen contraindications or side effects: Medications can have unintended interactions with other medications, supplements, or even other health conditions, leading to unforeseen contraindications or side effects. These might have been mitigated or avoided altogether by addressing the root causes of the hormonal imbalance.

Call to action

Recognising the impact of stress on hormonal imbalance and taking proactive steps to eliminate the stressors judiciously addressed the root cause of infertility. This holistic approach improved physical health and empowered the individual to take control of their wellbeing. So, what health challenges are you currently experiencing? What are the prognoses? Now, consider your socio-economic factors vis-a-vis possible stressors that could be responsible for it. These stressors can be financial, career, social, physical, emotional, environmental, and intellectual. Identifying your stressor(s) is a step in the right direction towards healing. It’s also noteworthy to take advantage of medicine. Medicine identified the cause of the secondary infertility as hormonal imbalance. This vital information paved the way for a solution. So, this piece is in no way encouraging self-help but sensible analysis and resolution. The case may differ if it is primary infertility. So, let’s be wise and properly guided.

Olayinka Opaleye is a personal well-being specialist and corporate wellness strategist. She can also be reached via email at [email protected], on +234 8100371304, or by clicking on www.linkedin.com/in/olayinkaopaleye.