Sociology: Your Compass for a New World Robert J. Brym and John Lie Wadsworth Group/Thomson Learning © 2003

Health, Medicine, and Aging Chapter 15

The Social Causes of Illness and Death WThe Social Causes of Illness and Death Include: W Human-environmental Factors W Lifestyle Factors  Factors Related to the Public Health and Healthcare Systems WAll Three Factors Are Related to Country of Residence, Class, Race, and Gender.

Life Expectancy, Selected Countries (in years) Europe (1600) 35 Japan (2000) 81 U.S.A. (2000) 77 China (2000) 71 Russia (2000) 67 India (2000) 61 Ethiopia (2000) 46 Niger (2000) 41 U.S.A. (1900) 47 Source: Population Reference Bureau (2000); Tuljapurkar, Li, and Boe (2000). U.S.A. (2050 projected) 83.9 Japan (2050 projected) 90.9

The Social Distribution of Health Risks WHealth Risks Are Higher in W Lower Classes W Poor Countries W Underprivileged Racial and Ethnic Groups WIn Some Respects Related to Health, Men Are in a More Advantageous Position Than Women

Mortality Rate by Group Income Group Income HighLow Mortality Rate (deaths per 1,000 population in a year) Low High Median income More income results in big declines in mortality at low income levels. More income results in small declines in mortality at high income levels.

The U.S. Healthcare System WThe U.S. Has the World’s Most Advanced Healthcare System WThe Average Health Status of Americans Is Lower Than That of People in Other Rich Postindustrial Countries Because W The Level of Social Inequality Is Higher in the U.S. W The Healthcare System in This Country Makes It Difficult for Many People to Receive Adequate Care

“HMOs improve the quality of care,” U.S.A., 1998 (in percent) Percent Opinion Source: National Opinion Research Center (1999).

Consequences of Medical Success WMedical Successes Create New Problems WThey Allow People to Live Longer Than They Used To, Giving Degenerative Diseases Like Cancer and Heart Disease the Chance to Spread WMedical Successes Also Raise New Questions About When and How People Should Be Allowed to Die

The Social Significance of Aging and Death WPeople Attach Different Meanings to Aging and Death in Different Societies and Historical Periods WThe Stages of Life Vary in Number and Significance Across Societies WSo Does Anxiety About Death

Aging in America WThe population of the U.S. is aging and by 2040 over a fifth of Americans will be 65 or over. WThe fastest growing age cohort among the elderly is composed of people 85 years and older. WThe ratio of men compared to the number of women falls with age.

Aging and Poverty WPoverty Is Less Widespread Among People Over 65 Than Among People Younger Than 45 WAmong the Elderly, Poverty Is Most Widespread for W Those 85 and and Older W Women W African Americans W People Living Alone  People Living in Rural Areas

Median Income and Percent Poor by Age Cohort, U.S.A., 1998 Thousands of dollars Age Cohort Source: U.S. Bureau of the Census (1998: 475, 478). Percent poor x x x x x x Percent poor Median income

Elderly As Percent of U.S. Population, (projected) Percent of population Year Source: U.S. Administration on Aging (1999 )

Population Age 65+, U.S.A., 1998 Source: American Association of Retired People (2000: 8)

The Medicalization of Deviance WOver Time, Medical Definitions of Deviance Have Become More Common WThe History of Psychiatry Shows That Social Values and Political Compromise Are at Least As Important As Science in Determining the Classification of Mental Disorders

An Example of the Medicalization of Deviance Source: Conrad and Schneider (1992 [1980]: 59). Percent of respondents who considered anecdote indicative of mental illness Year

The Rise of Medical Science WMedical Science Came to Dominate the Healthcare System Partly Because It Proved to Be So Successful in Treating the Ill WDominance Was Assured by Doctors Excluding Competitors and Establishing Control Over Their Profession and Their Clients.

Challenges to Medical Science W Several Challenges to Traditional Scientific Medicine Promise to Improve the Quality of Healthcare in the U.S. And Globally Including WPatient Activism WAlternative Medicine WHolistic Medicine