Socio-Cultural Factors Influencing Illness Behaviour Among Undergraduates

Reader Impact Factor Score
[Total: 0 Average: 0]

Published on International Journal of Social, Politics & Humanities
Publication Date: December, 2019

Aniche Alexander, N. & John Asogwa
Department of Sociology/ Psychology, Godfrey Okoye University
Department Of Public Administration, Enugu State University Of Science and Technology
Enugu, Nigeria

Journal Full Text PDF: Socio-Cultural Factors Influencing Illness Behaviour Among Undergraduates (A Study of Enugu State University Agbani Campus).

Abstract
This research work was carried out to study the socio-cultural factors influencing illness behaviour among undergraduate in Enugu State University Agbani Campus Enugu State. A survey research design was used for this study which led to the selection of a sample size of 120. This sample size was a fair representation of the entire population. The sample size of 120 was selected using cluster sampling and simple random sampling technique. Questionnaire was used as the instrument of quantitative data collection. The data was analyzed using frequency distribution tables, and simple percentages. Qualitative data via-interview method was also collected to corroborate the findings with the quantitative data. From the research findings it was discovered that the respondents have positive illness behaviour despite several factors affecting their illness behaviour. The researcher recommends that appropriate measures should be taken for improvement.

Keywords: Socio-cultural factors, Influencing illness behaviour, Qualitative data via-interview method & Positive illness behaviour.

1. Introduction
In the early years of scientific medicine, most clinicians and researchers thought only in terms of single causes; specific agents that cause specific diseases (National academy of sciences 2001). For example an infection was considered to result only from the proliferation of bacteria while other kinds of ill health resulted from viruses, toxins, accidents or flaws in a person’s genetic makeup. More recent research carried out by National academy of science on health and behavior and research by BMC public health 2014 highlighted the relationship between health and behavioral, psychological and social variables. Similarly it was long recognized that specific behaviours were associated with increased risk of specific diseases and related conditions (National academy of sciences 2001).
Our perception of the world today is deeply influenced by socio-cultural factors that we may or may not (as is often the case) be aware of. Examples of these cultural aspects include concepts of religious beliefs, material culture, attitudes, societal status and perception of the time. These factors could alter our priorities, which in turn, may cause serious health issues for students as in the case of this work. As socio-cultural factors affect our perception of the world so has socio-cultural factors influenced the behavior we put up when we are ill which is known as “illness behavior”. Different social and cultural factors influence the decisions that are made at each stage of the process of health and illness. The patients progress through each of the stages are influenced by his combination of social characteristics.
At times, one’s social characteristic may play a dominant role, however, a combination of factors must be considered in understanding a patient and the choices he may make from the recognition of initial symptoms through the decision to seek care, and the encounter with health care deliverers, to the final stage of health maintenance. The patient’s social context plays an important role in the choices that he makes.
The concept of illness behavior transcends mere behavior when ill. It incorporates or connotes the sequence of actions an individuals or social groups take when affected by illness situation. It provides a useful way of understanding and describing the many psycho-social influences that affect how people monitor their bodies, define and interpret their symptoms, come to view themselves as sick and disabled, take remedial actions and use lay and professional sources of help (Mechanic 1978).

1.1 Statement of the Problem
Every society has its own traditional beliefs and practices related to health care. Some practices are effective whereas others may be harmful or ineffective. These beliefs and practices are linked to culture, environment, and education. Health workers must have concern for the community’s cultural values and beliefs so that they can utilize the harmless practices for effective use as well as eliminate harmful practices. This problem is relatively found in Madonna University Okija Campus as health workers show no or less concern about the student’s cultural values and beliefs. There should be times when health workers out of concern call for health orientation to clear the students on the harms some cultural practices, value or belief causes to their health.
All people, whether rural or urban, have their own beliefs and practices concerning health and diseases. Social and psychosocial factors increase the risk of illness and influence the way that a person defines and reacts to illness. Cultural background influences entry into the health care system and personal health practices. All these are applicable to the undergraduates of Madonna University Okija.
Unlike those in the health profession, doctors, nurses, pharmacist etc who usually see disease or ill health as abnormal and purely detrimental to society, sociologist see disease/ill health from two perspectives (in terms of being detrimental and having some advantages to the society). Diseases are not only pathological, but also have some socio-cultural functions. These include;
(1) Ill health often lowers the self esteem/social ranking status of the victim especially in cases of stigmatized disease e.g. VVF (Vesico Vaginal Fistula) Chicken Pox, T.B. etc.
(2) Ill health/disease situation involves or generates heavy economic loss to society. This is because, sick persons do not engage in productive activities. Based on the study “socio-cultural factors influencing illness behaivour among undergraduates of Madonna University Okija Campus” ill health, could cause less productivity in academic activities.
(3) It grinds social interaction to a halt, when many people are sick, social function and activities do not hold.
(4) Some would seek permission to go home as an opportunity to leave school as the school does not allow or permit free entry and exist. Even when they go home, they do not treat the sickness at all, or they treat ill health in a hurry as a date is assigned by the school for their return. And after their return in no time they become ill again.
(5) Some would not go to the school clinic as they see the school clinic as not well equipped to trust their health.
(6) Ill health/disease situation could result to death. This is especially where it is not properly managed.
Note that there are positive illness behaviour and negative. But my concern in this research work is the problems of negative illness behaviour. In other words, this study is interested in bringing together the general behaviour of Madonna under graduates toward attaining positive illness behaviour and also the improvement of the health care system in the school for proper utilization of health services.

1.3 Research Questions
The following research questions are put forward to guide this study.
(1) What are the major patterns of illness behaviour among undergraduates of ESUT?
(2) How does this existing patterns of illness behaviour in ESUT Agbani Campus affect access to health services and health status of the students.
(3) What are the factors that stimulate the patterns of illness behaviour among undergraduates of ESUT Agbani Campus (MUO)?
(4) What are the consequences of the prevailing patterns of illness behaviour among undergraduates of ESUT Agbani Campus?
(5) What measures/solutions/remedies could be put in place to improve illness behaviour and Health seeking behaviour among undergraduates of ESUT Agbani Campus?

1.4 Objectives of the Study
The general objective of this study is narrowed down to assessing the socio-cultural factors that affect illness behaviour amongst undergraduates of Madonna University Okija Campus. The specific objective shall then be broadened to aim at studying the following;
(1) To determine the major patterns of illness behaviour amongst the undergraduates of students of Enugu State University Agbani Campus.
(2) To determine how these existing patterns of illness behaviour among the undergraduates of ESUT affect access to health services and health status of the people.
(3) To know the socio-cultural factors affecting illness behaviour of undergraduates of ESUT.
(4) To determine the perceived health risk among undergraduate of ESUT.
(5) To identify those measures that are required to improve the nature of illness behaviour amongst the undergraduates of ESUT.

1.5 Adaptation Theory
The basic assumption that illness is deviant has been questioned (Twaddle 1973) illness is a social as well as a biological and cultural event. Deviance as a framework for analysis of illness behaviour has limited value in answering questions regarding what causes illness (Twaddle 1973:756). Social control and deviance in medicine have been incorporated into a model of adaptation to illness (1973:757). The adaptive concept allows for a discussion of noncompliant behaviour, and maladaptation that may occur at any stage in the illness and be affected by cultural, economic and social factors. Twaddle suggests a different terminology for the behaviour surrounding an event of sickness – a ‘sickness career’ – that can be evaluated from a socio-cultural and interactional approach. Illness is a natural part of life. The fact of illness requires that the sick adapt to illness. This adaptation is moulded by society through cultural, social, institution and biomedical mechanisms of interaction (Twaddle 1973). Twaddle (1969) further suggests that illness is a socio-cultural event and sickness is a socio-biological event. We must differentiate the two accurately to describe the complex of actions and interactions in a complex model of behaviour.

2. Socio-Demographic data of the respondent
Table 1: Distribution of respondent by age interval
Age Intervals Frequency Percentage
16 – 19 59 49.58%
20 – 24 53 44.54%
25 – 29 6 5.04%
30 – 34 – 0%
35 – 39 1 0.84%
Total 119 100%
Table 1 shows that, 59(48.58%) of the respondents were of age 16-19, 53(44.54%) were of age intervals of 20-24, 6(5.04%) were of age intervals of 25-29, 30-34 had no respondents while 35-39 had only 1 respondent which is 0.84%.

Table 2: Sex Distribution of Respondents
Sex Frequency Percentage
Male 30 25.2%
Female 89 74.8%
Total 119 100%

Table 2 above shows that 30 respondent representing 25.2% were males while 89 respondents representing 74.8% were females.

Table 3: Distribution of respondents on Religious Affiliation
Religions Frequency Percentage
Christianity 116 97.5%
Islam 3 2.5%
Total 119 100%

Table 3 above on the religious distribution of respondents. It is evident that majority of the respondents 116(97.5%) were Christians, while 3(2.5%) belong to Islam. African traditional religion had no respondent. The above data is not surprising because the area of study (ESUT) is located in predominantly Christian region of south east Nigeria.

Table 4: Respondents Marital Status Distribution
Marital Status Frequency Percentage
Married – 0%
Single 118 99.2%
Divorce 1 0.8%
Total 119 100%

Table 4 above, shows that non of the respondent is married, 118(99.2%) of the respondent are single and 1(0.8%) of the respondent divorced.

Table 5: Respondent’s Course of Study
Course of Study Frequency Percentage
Accounting 40 33.6%
Law 39 32.8%
English 40 33.6%
Total 119 100%

Table 5 above shows that 40(33.6%) of the respondents are in Accounting Department, 39(32.8%) of the respondent are in law faculty while 40(33.6%) of the respondent are in English department.

Table 6: Level of the respondents in their course of study
Level Frequency Percentage
100 39 32.8%
200 40 33.6%
300 20 16.8%
400 20 16.8%
Total 119 100%

Table 6 above, shows that 39(32.8%) of the respondent are in 100 level, 40(33.6%) are in 200 level, 20(16.8%) are in 300 level and 20(16.8%) of the respondent are in 400 level.

Analysis of Research Questions
The researcher asked five questions to guide the course of the research work. The questions will be re-stated and analyzed accordingly.
Research Question 1: What are the major patterns of illness behaviour amongst undergraduates of ESUT?
This research question is answered by questionnaire items 7 and 8. The findings are shown in table 7 and 8.
Table 7: Distribution of respondent by their views on how they assess themselves as sick.
Response Frequency Percentage
Immediately the symptom arise 71 59.7%
Some days after the symptom arise 40 33.6%
After a long time 8 6.7%
Total 119 100%

Table 7 shows that 71(59.7%) of the respondents assess themselves sick immediately the symptom arises 40(33.6%) of the respondents assess themselves as sick some days after the symptom arises while 8(6.7%) of them take that they are seek after a long time. This shows that majority of the respondents assess themselves to be sick immediately the symptom arises.

Table 8: Distribution of respondent by their opinion on what they do when they notice symptoms of illness.
Responses Frequency Percentage
Visit the school clinic 62 51.1%
Seek for exact to go for home treatment 15 12.6%
Use traditional remedy in the hostel 1 0.8%
Tell a friend and follow there advice 5 4.2%
Self medication in the hostel 15 12.6%
Others (pray) 5 4.2%
(Do nothing allow it to go) 12 10.1%
(Call parents) 4 3.4%
Total 119 100%

Table 8 above shows that 62(52.1%) of the respondents visit the school clinic, 15(12.6%) of the respondents seek for exact to go for home treatment, only 1(0.8%) of the respondent use traditional remedy in the hostel, 15(12.6%) of the respondent result to self medication in the hostel 5(4.2%) of the respondent tell their friends and follow their advice. Other opinion from respondent are; 5(4.2%) pray, 12910.1%) do nothing and allow the sickness to go on it’s own while 4(3.4%) call parents and follow their recommendation.

This shows that majority of the respondents prefer to visit the school clinic when they notice any symptom of illness.
Research Question 2: How does the existing patterns of illness behaviour in ESUT Agbani Campus affect access to health services and health status of the student?
This research question is answered by questionnaire items 9, 10 and 11 and is represented in table 9, 10 and 11 below.
Table 9: Distribution of respondent on how often they visit the school clinic
Response Frequency Percentage
Never 41 34.5%
Always 72 60.5%
Sparingly 6 5.0%
Other – 0%
Total 119 100%

Table 9 above show that 41(34.5%) of the respondent has never visited the school clinic; on the other hand 60.5% of the respondent always visited the clinic when they are sick while only 5% of the respondents visit the school clinic sparingly. This shows that majority of the respondents visit the school clinic always.
Table 10: Distribution of some respondents on why they never visited the school clinic (when sick)
Response Frequency Percentage
Our culture forbids visiting the clinic 3 7.3%
It is against my religion – 0%
I patronize traditional medicine 1 2.4%
Others (don’t fall sick) 23 56.2%
(hate the clinic) 14 34.1%
Total 119 100%

Table 10 above shows that out of 41 respondent who picked never in questionnaire item no 9, 7.3% of the respondent gave their reasons to be that their culture forbids visiting the clinic, 2.4% of the respondent patronize traditional medicine, others 56.2% specify that they don’t fall sick while 34.1% specify that they don’t like the school clinic.
This shows that majority of the respondents who have never visited the clinic don’t fall sick.
Table 11: Distribution of respondents according to how their proffered pattern of response to illness affect their health status/recovery.
Response Frequency Percentage
I quickly get better 70 58.8%
I often do not get any relief 10 8.4%
I feel indifferent 9 7.6%
I don’t know 30 25.2%
Total 119 100%

Table 11 above shows that 58.8% of the respondents quickly get better in line with their preferred pattern of illness behaviour, 8.4% often do not get any relief, 7.6% of the respondent feel indifferent while 25.2% of the respondent don’t know how their proffered pattern of response to illness affect their health status/recovery.

Research Question 3: What are the factors that stimulates the patterns of illness behaviour among undergraduates of ESUT?
This research question is answered by questionnaire items 13, 14 and 15 and is represented in table 12, 13 and 14.
Table 12: Distribution of respondents on their assessment of the quality of services they obtain from the school clinic.
Response Frequency Percentage
Very satisfactory – 0%
Moderately Satisfactory 27 22.7%
Very poor/grossly inadequate 2 1.7%
Poor 90 75.6%
Don’t know – 0%
Total 119 100%

Table 12 shows that 22.7% of the respondent access the quality of services obtained from school clinic to be moderately satisfactory, 1.7% or assessed it to be very poor/grossly inadequate, 75.6% assessed it to be poor.
This shows that majority of the respondent assess the quality of services they obtain from the school clinic to be poor.

Table 13: Distribution of respondents by their opinion on features of the school clinic that informed their assessment.
Response Frequency Percentage
Inadequate staff 10 8.4%
Staff are unruly/impolite 1 0.8%
Drugs are usually out of stock 2 1.7%
Poor equipment 5 4.2%
No special units like dental, Eye, Nose, Ear 20 16.8%
Poor standard of infrastructure 3 2.5%
All of the above 78 65.6%
Total 119 100%

Table 13 above shows 8.4% of the respondent opined that there are inadequate staff, 0.8% opined that staff are unruly impolite, 1.7% opined that drugs are usually out of stock, 4.2% opined that there is poor equipment, 16.8% opined that there are no special units like dental, Eye, Nose, Ear, 2.5% opined that the infrastructure is of poor standard and 65.6% opined all of the above to be features that inferred their assessment.
Table 14: Distribution of respondents according to their view on factors that determine their illness response before/on notice of the symptom.
Responses Frequency Percentage
My religious belief 13 10.9%
Influence of friends (peers) in school 15 12.6%
School rules and regulatory 11 9.2%
Family/kinship agreed approach to ill health situation 70 58.8%
Don’t know 10 8.4%
Total 119 100%

From table 14, 10.9% of the respondent take their religious belief to be the factor that determines their illness response before/on notice of the symptom, 10.6% take the factor to be influence of friends (peers) in school, 9.2% take the factor to be school rules and regulatory, 58.8% take the factor to be family/kinship agreed approach to ill health situations while 8.4% don’t know what determines their illness response.
This shows that the major factor that determines the illness response of the respondent before/one notice of the symptom is family/kinship agreed approach to ill health situations.

Research Question 4: What are the consequences of the prevailing patterns of illness behaviour among, under graduates of ESUT Agbani Campus?
This research question is answered by questionnaire items 16, 17 and 18 and is represented in table 15, 16 and 17.
Table 15: Distribution of respondents on whether their pattern of illness behaviour has affected them in anyway.
Response Frequency Percentage
Yes 62 52.1%
No 57 47.9%
Total 119 100%

From table 15, 52.1% of the respondent atleast that their pattern of illness behaviour has affected them, 47.9 are of the opinion that there pattern of illness behaviour has not affected them. This shows that majority of the respondents have been affected by their pattern of illness behaviours.
Table 16: Distribution of respondents who picked ‘Yes’ according to the major positive consequences they encounter/obtain from their illness behaviour.
Response Frequency Percentage
I usually recover fast – 0%
I do not miss lectures – 0%
I do not waste resources travelling – 0%
All of the above 62 100%
None of the above – 0%
Total 62 100%

From table 16, All (100%) of the respondents who picked Yes attest that all the mentioned options are the positive consequences they encounter/obtain from their illness behaviour.
Table 17: Distribution of respondents on likely negative consequences that could arise from negative illness behaviour.
Responses Frequency Percentage
The illness becomes severe 38 31.9%
Cost implication in the & money 13 10.9%
Miss lectures travelling home for further attention 32 26.9%
All of the above 36 30.3%
Total 119 100%

From table 17, 38(31.9%) of the respondent’s illness becomes severe, 13(10.9%) cost implication in time and money, 32(26.9%) miss lectures travelling home for further attention while 36(30.3%) of the respondent are affected negatively by all the options.
This shows that majority of the respondent’s illness becomes severe as a negative consequences of their negative illness behaviour.

Research Question 5: What measures/solutions/remedies could be put in place to improve illness/health seeking behaviour at ESUT?
This research question is answered by questionnaire items 19 and 20 and is represented in table 18 & 19.
Table 18: Distribution of respondents on their thought if illness behaviour of Madonna students could be improve?
Response Frequency Percentage
Yes 110 92.4%
No 9 7.6%
Total 119 100%

From table 18, 110(92.4%) of the respondents think the illness behaviour of ESUT could be improved on while 9(7.6%) of the respondents are on the opposing side.
This shows that majority of the respondents are of the opinion that the illness behaviour of ESUT can be improved on.
Table 19: Distribution of respondents who picked yes on questionnaire 19 on their suggested measures to improve illness behaviour of Madonna students Okija Campus.
Responses Frequency Percentage
Improving the services obtainable at school clinic 17 15.5%
Providing education/enlightenments to students during orientation. 3 2.7%
Adequate/proffer training of clinic staff 4 3.6%
Ensuring that school clinic is adequately stocked with drugs. 7 6.4%
All of the above 79 71.8%
Total 119 100%

From table 19, 17(15.5%) of the respondents suggest improving the services obtainable all the school clinic, 3(2.7%) suggest providing education/enlightenments to students during orientation, 4(3.6%) suggest adequate training of clinic staff, 7(6.4%) suggest adequate training of clinic staff, 7(6.4%) suggest, ensuring that school clinic is adequately stocked with drugs while 79(71.8%) suggest all the mentioned options in improving the health seeking behaviour of the students (undergraduates) of Madonna University Okija Campus.
This shows that majority of the respondents suggested all the options proffered in improving the illness behaviour of Madonna students Okija campus.

3. Interpretation of the Result
In every research undertaken, it is important to discuss the findings. It helps in the comprehension of the topic under study.
Based on the analysis on the responses to be questionnaire, socio-cultural factors influencing illness behaviour among undergraduates of Madonna University Okija evaluated.
It is observed in this study that the undergraduates of Madonna University Okija Campus have positive illness behaviour. This is shown by the number of those who thinks that they are sick immediately the symptom arises, this fact is further enhanced by 52.1% of them who indicated that they visit the school clinic when they notice symptoms of illness shown in table 8 of the distribution tables. Further finding to research question one, show that out of 34.5% of the respondents who have never visited the school clinic, 56.2% of them don’t or have not fallen sick in school as induced in table 9 and 10. All this shows that the undergraduates of Madonna University Okija Campus have positive illness behaviour. The data gotten from an interviewee who has been a medical practitioner in the school clinic for a year and six months showed that the population that visit the school clinic is reasonable when compared to the school population. Therefore research question one, which sets out to find the major patterns of illness behaviour amongst undergraduates of Madonna University Okija Campus has been dealt with both quantitative and qualitative date available showed that they have positive illness behaviour.
Finding to research question 2 indicate that since they have positive patterns of illness behaviour, most of the respondent visit the school clinic as noted earlier and also 58.8% attest to the fact that they quickly get better as induced in table 11.
This finding is in line with what the researcher got from the qualitative data collected through the interview method, that the population that visit the school clinic is proper and that they even get over worked and stressed out although the interviewee complained that most of the students who visit the school, abuse drugs as they don’t complete recommended dose administered to them so they get to return for treatment in no time with a more complicated case.
Therefore since the patterns of illness behaviour of ESUT Agbani campus is positive it has also affected their access to health services positively but for their health status. It is partially positive as some compel to the instructions of health practitioner while others don’t. This finding has answered the research question 2 on how the existing patterns of illness behaviour in ESUT affect access to health services and health status of the students.
Finding to research question 3, indicate that thought their illness behaviour is positive as they notice symptom immediately it arises and visit the school clinic, they access the quality of services they obtain from the school clinic to be poor. 75.6% of the respondents attest to this fact as shown in table 12. The reasons or features which informed their assessment are, inadequate staff, staff are unruly/impolite, Drugs are usually art of stock, poor equipment, No special units like dental, Eye, Nose, Ear, and poor standard of infrastructure. This data gotten from the interviewee confirmed that the work load is much that the medical pracitonal hardly gets time for himself. On the day of the interview with the medical practional at the school clinic, the interviewer observed that there was only a doctor a nurse and a sales representative. The factors that determined the respondents illness response before/on notice of the symptom are religious belief, influence of friends (peers) in school, school rules and regulatory (the school expects a student who is sick to use the clinic and even if you must sign exact to go home for treatment, you must get doctor’s report from the school clinic) and most of all family/kinship agreed approach to ill health situations. This is showed in table 14.
Findings to research question 4, indicates that since the undergraduates of ESUT have positive illness behaviour they have positive consequences attached to it which are quick recovery, not missing lectures and not wasting resources travelling. Also there are negative consequences, arising from negative illness behaviour which are noted to be severity of illness cost implication in time and money, missing lectures resulting from traveling home for treatment as induced in table 17. Therefore research question 4 (four), which is consequences of prevailing patterns of illness behaviour has been dealt with.
Finally, findings on what measures/solutions/remedies are required to improve illness/health seeking behaviour at ESUT. The respondents are of the opinion that the illness behaviour of ESUT students could be improved by improving the services obtainable at school clinic, providing education/enlightenments to students during orientation, adequate/proffer training of clinic staff and ensuring that school clinic is adequately stocked with drugs.

4. Conclusion
Though the undergraduates of ESUT Agbani Campus have positive illness behaviour, the health care system in the school should be looked into indepthly as there is a general saying that health is wealth. Students still leave the campus for home treatment and also take to self medication which can cause complications to health.
In as much as the satisfaction derives from services offered at the school clinic is poor. There are factors that influence the student’s positive illness behaviour. The school clinic is the only one in the campus and the school demands that a sick student goes to the school clinic for treatment except by recommendation of the doctor for home treatment. Also students have been socialized from the family to visit the hospital when sick, this refers to the family/kinship agreed approach to ill health situations and also influence of peer group. Therefore implementation of the recommendations of this study will certainly encourage greater use to health care facilities and health improvement even when it comes to illness behaviour in ESUT Agbani Campus.

5. Recommendations
Based on the researcher has the following recommendations to make and they are as follows;
1. There should be regular health care enlightenments or orientation for student to better understand health management and the need for positive illness as illness can occur anytime and to anyone. This will really go a long way in improving health and illness behaviour. Besides there are lots of medium readily available in the school’s activities thought which this orientation can be done regularly, monthly or per semester e.g. jogging orientation, adoration etc.
2. Improving the services obtainable at school clinic, would increase the number of people who come force treatment rather than leaving school for home treatment. It could pass a wrong message to parents and people outside the school that the school is not capable to handle the health of it’s students. There are ways to improve healthcare services. They are to check and find out some of the major issues that result students leaving the school premises based on health reasons some of these common reason are as such as dental problem, scanning of any part of the body, ear and eye problem etc. If these common problems could be solved in school, it would drastically increase the rate in which students use health care facilities/services in school or rather the school clinic, and also improve positive illness behaviour.
3. More clinic staffs (health workers0 should be employed and placed or shifts that there should be no time where the health workers(s) are not available or enough to attend to patient(s), practitioners in specialized aspects of health, should be employed.

6. References
American Journal of Sociology (c) 1959 the University of Chicago Press.
Becker, H; (1973). Outsiders; Studies in the Sociology of Deviance 2nd Edition, New York Free Press.
Bradbury, R.E., (1987). The Benin Kingdom and Edo-Speaking Peoples of South-Western Nigeria.
David Mechanic (1968). Medical Sociology; A Selective View New York: Free Press.
Erinosho O.A. (1998). Health Sociology, Ogun, Nigeria: Bulwark Consult.
Health and Behaviour: The Interplay of Biological, Behavioural and Societal Influences Washington.
Harallambos M., Holborm M. and Healed R. (2008). Sociology: Themes and perspectives (7th ed). London: Harper Collins Publishers.
Institute of Medicine (US) Committee on Health and Behaviour; Research, Practice and Policy.
Nitte University Journal of Health Science Article on Socio-cultural Perspectives on Health and Illness NujHs Vol. 2, No. 3 September 2012, ISSN 2249-7110.
Shearan, P. and Abraham, C., (1996). The Health Service Model in M. Conner and Nnman (eds) Predicting Health Behaviours. Research and Practice with Social Cognition Models Backingham. Open University Press.
The Psychiatric Foundation of Medicine 1978, Page 587-595. Gerard J. Hunt, Ph.D.