According to theorists working in the symbolic interactionist perspective, health and illness are socially constructed. Symbolic interactionist researchers investigate how people create meaning during social interaction, how they present and construct the self (or "identity"), and how they define situations of co-presence with others. One of the perspective's central ideas is that people act as they do because of how they define situations.
Constructivist grounded theory emphasizes the development of an interactive relationship and mutual construction of knowledge between researcher and participants. Symbolic interactionists believe that objects have meaning only through people's interactions with them in the environment, that the meanings people have for things develops through social interaction and that those meanings are handled and modified by a constant and ongoing interpretive process by individuals.
An example of the social construction of health the the Rate of Perceived Exertion, or RPE. This scale measures the intensity of a person's workout on a scale of 0 to 10. This scale was developed by Gunnar Borg, and it is used by medical professionals to assess a person's health in a variety of ways.
In essence, interactionists focus on the specific meanings and causes people attribute to illness. The term "medicalization" of deviance" refers to the process that changes "bad" behavior into "sick" behavior. A related process is "demedicalization", in which "sick" behavior is normalized again. Medicalization and demedicalization affect who responds to the patient, how people respond to the patient, and how people view the personal responsibility of the patient.
An example of medicalization is illustrated by the history of how our society views alcohol and alcoholism. During the 19th century, people who drank too much were considered "bad, lazy people." They were called drunks, and it was not uncommon for them to be arrested or run out of a town. Drunks were not treated in a sympathetic way because, at that time, it was thought that it was their own fault that they could not stop drinking (Figure 1). During the latter half of the 20th century, however, people who drank too much were increasingly defined as people with a disease or a genetic predisposition to addiction. With alcoholism defined as a disease and not a personal choice, alcoholics came to be viewed with more compassion and understanding. Thus, "badness" was transformed into "sickness".
While interactionism does acknowledge the subjective nature of diagnosis, it is important to remember who benefits the most when a behavior becomes defined as illness. Pharmaceutical companies make billions of dollars treating illnesses such as fatigue, insomnia, and hyperactivity that may not actually be illnesses in need of treatment, but opportunities for companies to make more money.