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

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

[2]  Joseph W. McGee,et al.  The Health of Regionville , 1955 .

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

[4]  N H Martin,et al.  Men and machines. , 1973, Journal of clinical pathology.

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

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

[7]  C. Leslie.  Medical pluralism in world perspective. , 1980, Social science & medicine. Medical anthropology.

[8]  H. Schneider,et al.  Economic Man: The Anthropology of Economics. , 1974 .

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

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

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

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

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

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

[15]  K. Knorr-Cetina.  The micro-sociological challenge of macro-sociology : towards a reconstruction of social theory and methodology , 1981 .

[16]  C. Kadushin,et al.  Mental health and the interpersonal environment: a reexamination of some effects of social structure on mental health. , 1983, American sociological review.

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

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

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

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

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

[22]  Charles M. Camic,et al.  The Matter of Habit , 1986, American Journal of Sociology.

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

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

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

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

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

[28]  Magali Sarfatti Larson,et al.  The Rise of Professionalism. , 1979 .

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

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

[31]  P. Benjamin.  The Costs of Medical Care , 1933 .

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

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

[34]  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.

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

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

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

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

[39]  David R. Heise.  Affect control theory: Concepts and model , 1987 .

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

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

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

[43]  Novella Perrin,et al.  Social Change and the Life Course. , 1987 .

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

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

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

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

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

[49]  Mark S. Granovetter.  The Strength of Weak Ties , 1973, American Journal of Sociology.

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

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

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

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

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

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

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

[57]  R. Collins.  On the Microfoundations of Macrosociology , 1981, American Journal of Sociology.

[58]  B. Pescosolido.  MIGRATION, MEDICAL CARE PREFERENCES AND THE LAY REFERRAL SYSTEM: A NETWORK THEORY OF ROLE ASSIMILATION* , 1986 .

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

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

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

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

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

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

[65]  S. Boorman,et al.  Social structure from multiple networks: I , 1976 .

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

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

[68]  D. Ehrlich.  Americans View Their Mental Health. , 1961 .

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

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

[71]  M. Haug,et al.  Elderly Patients and Their Doctors. , 1983 .

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

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

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

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

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

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

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

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

[80]  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.

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

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

[83]  D. R. Heise.  Modeling event structures , 1989 .

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

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

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

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

[88]  P. V. Marsden,et al.  Core Discussion Networks of Americans , 1987 .

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

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

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

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

[93]  A. Furstenberg,et al.  Lay consulation of older people , 1984 .

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

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

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

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

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

[99]  J. Coleman,et al.  Social Capital in the Creation of Human Capital , 1988, American Journal of Sociology.

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

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

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

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

[104]  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.