Talking about colds and flu: The lay diagnosis of two common illnesses among older British people

• Published in: Social science & medicine (1982) 2011-09, Vol.73 (6), p.922-928
• Main Authors: Prior, Lindsay, Evans, Meirion R., Prout, Hayley
• Format: Article
• Language: English
• Subjects: Aged; Co-occurrence relations; Colds; Colds and Influenza; Colds and Influenza Co-occurrence relations Expert patients Lay diagnosis Lay expertise; Common Cold - diagnosis; Common Cold - epidemiology; Common Cold - prevention & control; Communication; Elderly; Epidemics; Epidemiology; Expert patients; Health care; Health Knowledge, Attitudes, Practice; Humans; Illness; Influenza; Influenza Vaccines; Influenza, Human - diagnosis; Influenza, Human - epidemiology; Influenza, Human - prevention & control; Interviews as Topic; Lay diagnosis; Lay expertise; Medical diagnosis; Medical sociology; Methodology (Data Collection); Older people; Patients; Semantics; Symptoms; United Kingdom; Wales
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2010.09.054

This paper reports on a study of the ways in which 54 older people in South Wales (UK) talk about the symptoms and causes of cold and influenza (flu). The study was designed to understand why older people might reject or accept the offer of seasonal flu vaccine, and in the course of the interviews respondents were also asked to express their views about the nature and causes of the two key illnesses. The latter are among the most common infections in human beings. In terms of the biomedical paradigm the common cold is caused by numerous respiratory viruses, whilst flu is caused by the influenza virus. Medical diagnosis is usually made on clinical grounds without laboratory confirmation. Symptoms of flu include sudden onset of fever and cough, and colds are characterized by sneezing, sore throat, and runny nose, but in practice the symptoms often overlap. In this study we examine the degree by which the views of lay people with respect to both diagnosis and epidemiology diverge with that which is evident in biomedical discourse. Our results indicate that whilst most of the identified symptoms are common to lay and professional people, the former integrate symptoms into a markedly different observational frame from the latter. And as far as causation is concerned it is clear that lay people emphasize the role of ‘resistance’ and ‘immunity’ at least as much as ‘infection’ in accounting for the onset of colds and flu. The data are analyzed using novel methods that focus on the co-occurrence of concepts and are displayed as semantic networks. As well as reporting on its findings the authors draw out some implications of the study for social scientific and policy discussions concerning lay diagnosis, lay expertise and the concept of an expert patient. ► Novel methods of qualitative data analysis that focus on co-occurrence relations in talk. ► Novel methods of data representation that focus on networks of concepts and ideas. ► Contribution to the lay understanding of common illnesses. ► Implications of lay understanding for public health policy.