Beyond Rational Choice: The Social Dynamics of How People Seek Help

JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org. The University of Chicago Press is collaborating with JSTOR to digitize, preserve and extend access to American Journal of Sociology. A classic problem common to sociology and other social sciences revolves around how people make decisions. Some recent approaches start with and revise an individually focused, rational action framework. While this orientation to building transdisciplin-ary, multilevel models provides many insights, it fails to capture essential features of social life. The social organization strategy (SOS) framework presented in this article offers a complementary approach to social action in general and decision making in particular. This orientation, a network and event-centered counterpart to rational choice, rests on fundamental principles that distinguish the discipline of sociology: social interaction is the basis of social life, and social networks provide the mechanism (interaction) through which individuals learn about, come to understand, and attempt to handle difficulties. This approach shifts the focus from individual "choice" to socially constructed patterns of decisions, including consultation with others. Utilization research in medical sociology serves as a case for reviewing theoretical approaches to decision making and provides the background necessary to a theoretical exposition of the SOS approach using data from the National Survey of Access to Medical Care (1975-76). The results support the utility of pursuing the SOS framework.

[1]  Valerie A. Haines,et al.  Social network analysis, structuration theory and the holism-individualism debate , 1988 .

[2]  R. Veatch.  Generalization of expertise. , 1973, Studies - Hastings Center.

[3]  G. Simmel,et al.  Conflict and the Web of Group Affiliations , 1955 .

[4]  C. Kadushin,et al.  The Friends and Supporters of Psychotherapy: on social circles in urban life. , 1966, American sociological review.

[5]  F. Knelman.  The Sociology of Health , 2022 .

[6]  L. Aday.  The Utilization of Health Services: Indices and Correlates. A Research Bibliography 1972. , 1972 .

[7]  I. Press.  Urban illness: physicians, curers and dual use in Bogota. , 1969, Journal of health and social behavior.

[8]  Edna E. Raphael.  Community Structure and Acceptance of Psychiatric Aid , 1964, American Journal of Sociology.

[9]  Michael Hechter,et al.  The contribution of rational choice theory to macrosociological research , 1988 .

[10]  R. Huckfeldt,et al.  Networks in Context: The Social Flow of Political Information , 1987, American Political Science Review.

[11]  B. Wellman,et al.  Different Strokes from Different Folks: Community Ties and Social Support , 1990, American Journal of Sociology.

[12]  S. Boorman,et al.  Social Structure from Multiple Networks. I. Blockmodels of Roles and Positions , 1976, American Journal of Sociology.

[13]  Toni C. Antonucci,et al.  Social network research : substantive issues and methodological questions , 1990 .

[14]  A. Kellerman,et al.  The Constitution of Society : Outline of the Theory of Structuration , 2015 .

[15]  A. Huston.  The Life Course: A Sociological Perspective. , 1987 .

[16]  J. Young.  Medical choice in a Mexican village , 1982 .

[17]  Peter Conrad,et al.  The experience of illness: Recent and new directions , 1987 .

[18]  P. Unschuld.  Western medicine and traditional healing systems: competition, cooperation or integration? , 1976, Ethics in science & medicine.

[19]  David R. Maines,et al.  In Search of Mesostructure , 1982 .

[20]  R. Frank,et al.  Determining provider choice for the treatment of mental disorder: the role of health and mental health status. , 1989, Health services research.

[21]  Michael W. Macy,et al.  Learning Theory and the Logic of Critical Mass , 1990 .

[22]  Peter C. Ordeshook,et al.  Game Theory And Political Theory , 1987 .

[23]  Jack Martin,et al.  The Moral Dimension , 1995 .

[24]  Michael T. Hannan,et al.  Where do organizational forms come from? , 1985 .

[25]  H. Baer,et al.  The organizational rejuvenation of osteopathy: a reflection of the decline of professional dominance in medicine. , 1981, Social science & medicine. Part A, Medical sociology.

[26]  J. S. Long,et al.  Organizational Context and Scientific Productivity , 1981 .

[27]  Robert Huckfeldt,et al.  Social Contexts, Social Networks, and Urban Neighborhoods: Environmental Constraints on Friendship Choice , 1983, American Journal of Sociology.

[28]  Peter Bernholz,et al.  Economic imperialism : the economic approach applied outside the field of economics , 1987 .

[29]  H. Izmirlian.  Structural and Decision‐Making Models: A Political Example , 1969 .

[30]  Lillian Cohen,et al.  Statistical Methods for Social Scientists. , 1954 .

[31]  D. Mechanic.  The role of sociology in health affairs. , 1990, Health affairs.

[32]  J. Long.  A Graphical Method for the Interpretation of Multinomial Logit Analysis , 1987 .

[33]  Dennis C. Mueller,et al.  Public Choice: A Survey , 1976 .

[34]  M. W. Riley,et al.  Aging from Birth to Death , 1984 .

[35]  J. Coleman.  Social Theory, Social Research, and a Theory of Action , 1986, American Journal of Sociology.

[36]  David Knoke,et al.  The Organizational State: Social Choice in National Policy Domains , 1987 .

[37]  Alan Wolfe,et al.  Whose Keeper?: Social Science and Moral Obligation , 1989 .

[38]  C. Fischer.  To Dwell Among Friends , 1982 .

[39]  E. Ostrom.  Microconstitutional Change in Multiconstitutional Political Systems , 1989 .

[40]  L. R. Schwartz.  The hierarchy of resort in curative practices: the Admiralty Islands, Melanesia. , 1969, Journal of health and social behavior.

[41]  H. Schneider.  Economic Man: The Anthropology of Economics , 1989 .

[42]  R. Boudon.  Will sociology ever be a normal science? , 1988 .

[43]  J. Clausen,et al.  Paths to the Mental Hospital , 1955 .

[44]  G. Fine,et al.  NETWORK AND MEANING: AN INTERACTIONIST APPROACH TO STRUCTURE , 1983 .

[45]  S. Bhardwaj,et al.  Medical pluralism and homoeopathy: a geographic perspective. , 1980, Social science & medicine. Medical anthropology.

[46]  H. White,et al.  Control via concentration?: Political and business evidence , 1985 .

[47]  H. F. join.  Dynamics of Medical Practice in a Folk Community , 1970 .

[48]  Vincent Kanade,et al.  Clustering Algorithms , 2021, Wireless RF Energy Transfer in the Massive IoT Era.

[49]  L. Henderson.  On the Social System , 1993 .

[50]  A. Horwitz.  Social Networks and Pathways to Psychiatric Treatment , 1977 .

[51]  Debbie Lee.  Self care. , 2003, British journal of perioperative nursing : the journal of the National Association of Theatre Nurses.

[52]  William A. Corsaro,et al.  "Discussione" and Friendship: Socialization Processes in the Peer Culture of Italian Nursery School Children. , 1988 .

[53]  J. Cassel.  The contribution of the social environment to host resistance: the Fourth Wade Hampton Frost Lecture. , 1976, American journal of epidemiology.

[54]  J. Myers,et al.  Life events, social integration and psychiatric symptomatology. , 1975, Journal of health and social behavior.

[55]  Juliane Jung.  MEDICINE, MAGIC, AND RELIGION. , 1915, British medical journal.

[56]  J. Kirscht,et al.  Understanding and improving patient compliance. , 1984, Annals of internal medicine.

[57]  Aaron V. Cicourel,et al.  Notes on the integration of micro-and macro-levels of analysis , 2014 .

[58]  S. Watkins.  On Measuring Transitions And Turning Points , 1980 .

[59]  P. Killworth,et al.  Informant Accuracy in Social Network Data , 1976 .

[60]  W. Sewell.  Theory of Action, Dialectic, and History: Comment on Coleman , 1987, American Journal of Sociology.

[61]  J. W. Salmon,et al.  The Holistic Alternative to Scientific Medicine: History and Analysis , 1980, International journal of health services : planning, administration, evaluation.

[62]  R. Collins.  Is 1980s Sociology in the Doldrums? , 1986, American Journal of Sociology.

[63]  Mary Anne Devanna.  Men and Women of the Corporation , 1978 .

[64]  A. Cobb.  Part one: Pluralistic legitimation of an alternative therapy system: The case of chiropractic , 1977 .

[65]  John H. Aldrich,et al.  Linear probability, logit and probit models , 1984 .

[66]  Peter V. Marsden,et al.  Introducing Influence Processes into a System of Collective Decisions , 1981, American Journal of Sociology.

[67]  J B McKinlay,et al.  Some approaches and problems in the study of the use of services--an overview. , 1972, Journal of health and social behavior.

[68]  Hilary du Cros,et al.  The Rise of Professionalism , 2007 .

[69]  James C. Niederman,et al.  The Health of Regionville , 1956, The Yale Journal of Biology and Medicine.

[70]  J. Trost.  On Symbolic Interactionism , 2009 .

[71]  A. Abbott.  Transcending General Linear Reality , 1988 .

[72]  Siegwart Lindenberg,et al.  An Assessment of the New Political Economy: Its Potential for the Social Sciences and for Sociology in Particular , 1985 .

[73]  L. Wilson,et al.  Elderly Patients and Their Doctors , 1982 .

[74]  W. Hotchkiss.  The costs of medical care. , 1969, Virginia medical monthly.

[75]  Network Analysis in Ecuador and Nova Scotia: Some Critical Remarks* , 2008 .

[76]  R. Merton.  Social Theory and Social Structure , 1958 .

[77]  M. Gold.  A crisis of identity: the case of medical sociology. , 1977, Journal of health and social behavior.

[78]  G. Gurin,et al.  Americans View Their Mental Health , 1979 .

[79]  E. Suchman.  Sociomedical Variations Among Ethnic Groups , 1964, American Journal of Sociology.

[80]  Charles Tilly,et al.  Big Structures, Large Processes, Huge Comparisons , 1986 .

[81]  R. Burt.  Toward a structural theory of action , 1982 .

[82]  Gary S. Becker,et al.  The Economic Approach to Human Behavior. , 1978 .

[83]  R. Collins,et al.  Dimensions of Microinteraction , 1990, American Journal of Sociology.

[84]  D. McFadden.  Conditional logit analysis of qualitative choice behavior , 1972 .

[85]  Lynn Smith-Lovin,et al.  Affect control theory: An assessment* , 1987 .

[86]  R. Hilbert.  Ethnomethodology and the Micro-Macro Order , 1990 .

[87]  D. Knoke,et al.  Political Networks: The Structural Perspective , 1992 .

[88]  I. Rosenstock.  Why people use health services. , 1966, The Milbank Memorial Fund quarterly.

[89]  Mark S. Granovetter.  Economic Action and Social Structure: The Problem of Embeddedness , 1985, American Journal of Sociology.

[90]  R. Andersen,et al.  Health care in the U.S. : equitable for whom? , 1980 .

[91]  A. Furstenberg,et al.  Lay consultation of older people. , 1984, Social science & medicine.

[92]  R. Collins.  Looking Forward or Looking Back?: Reply to Denzin , 1987, American Journal of Sociology.