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Page 81
The Context of Disease
As people and places have moved out of eponymous and loconymous classification, these specific categories are replaced by a general set, what we call the kindness of strangers. By this we mean that the classification system operates a shift away from our being individuals experiencing the world to our being kinds of people experiencing kinds of places. The constructions of social and natural science and of the legal world have moved in. Broken legs and ski resort locations coevolve, as do cancer rates and toxic waste dumps. The classification system, as we shall see in this section, has become a site that holds these constructions together and, through excluding other kinds of story, makes them more real. With the ICD providing the main legitimate means for describing illness, the social, economic, and political stories woven into its fabric become by extension the main legitimate narrative threads for the science of medicine.
Although particular places have moved out, two places have come to play a more significant role in the classification system, the laboratory and the "sociological home." This latter appears in the extra categories developed for ICD-9 as supplemental codes, which in ICD-10 have become fully integrated, what we might call the context codes. Thus housing is one of the conditions that can be broken down and described as part of the classification. In ICD-9 it is described as follows:
V60Housing, household and economic circumstances
V60.0Lack of housing
HobosTransients
Social migrantsVagabonds
Tramps
V60.1Inadequate housing
Lack of heating
Restriction of space
Technical defects in home preventing adequate care
V60.2Inadequate material resources
Economic problemPoverty NOS
V60.3Person living alone
V60.6Person living in residential institution
Boarding school resident
V60.8Other specified housing or economic circumstances
V60.9Unspecified housing or economic circumstances.
(ICD-9, 1: 267)

 
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