SOCIOLOGY: A Brief Introduction Richard T. Schaefer SOCIOLOGY: A Brief Introduction Sixth Edition McGraw-Hill © 2006 The McGraw-Hill Companies, Inc. All rights reserved.

POPULATION, COMMUNITIES, AND HEALTH 15 POPULATION, COMMUNITIES, AND HEALTH Demography: The Study of Population World Population Patterns How Did Communities Originate? Urbanization Types of Communities

POPULATION, COMMUNITIES, AND HEALTH 15 POPULATION, COMMUNITIES, AND HEALTH Sociological Perspectives on Health and Illness Social Epidemiology and Health Social Policy and Population: Financing Health Care Worldwide

Demography: The Study of Population Fertility: level of reproduction in a society Demography: scientific study of population Sociologists focus on social factors that influence population rates and trends.

Demography: The Study of Population Malthus’s Thesis and Marx’s Response Malthus held that world’s population was growing more rapidly than the available food supply Argued food supply increases in an arithmetic progression, whereas population expands by geometric progression Malthus advocated population control

Demography: The Study of Population Malthus’s Thesis and Marx’s Response Marx saw no special relationship between world population and the supply of resources If society were well ordered, increases should lead to greater wealth, not hunger and misery Linked overpopulation to unequal distribution of resources

Demography: The Study of Population Studying Population Today Census: enumeration, or counting of a population Vital Statistics: records of births, deaths, marriages, and divorces gathered through a registration system maintained by government

Demography: The Study of Population Elements of Demography Death Rate: number of deaths per 1,000 population in a given year Infant Mortality Rate: number of deaths of infants under one year of age per 1,000 live births in a given year.

Demography: The Study of Population Elements of Demography Life Expectancy: median number of years a person can be expected to live under current mortality conditions Growth Rate: difference between birth and deaths, plus the difference between immigrants and emigrants.

World Population Patterns Demographic Transition Change from high birthrates and death rates to relatively low birth rates and death rates Typically viewed as a three-stage process: Pre-transition stage Transition stage Post-transition stage

World Population Patterns The Population Explosion Momentum toward growing world population well-established Developing nations face prospect of continued population growth, since substantial proportion of their population is approaching child bearing years Population Pyramid: special type of bar chart that shows distribution of population by gender and age

World Population Patterns

World Population Patterns Figure 15.1: Demographic Transition

World Population Patterns Figure 15.2: Population Structure of Afghanistan and the United States, 2005

Fertility Patterns in the United States The Baby Boom The baby boom was not a return to large families, but rather decrease in number of childless marriages and one-child families The baby boom represents the most recent period of high fertility in the United States

Fertility Patterns in the United States Stable Population Growth Fertility rate of the U.S. remained low over the last two decades Still experiencing population growth Momentum built into our age structure by the postwar population boom Continued high rates of immigration

Fertility Patterns in the United States Stable Population Growth Zero Population Growth (ZPG): state of a population in which the number of births plus immigrants equals the number of deaths plus emigrants

Population and Migration Migration: relatively permanent movement of people with the purpose of changing their place of residence. Migration usually describes movement over a sizable distance, rather than from one side of a city to another.

How Did Communities Originate? Early Communities Early communities were very dependent on physical environment for their food supply Horticultural societies, where people cultivated food rather than merely gathering fruits and vegetables, led to dramatic changes in human social organization

How Did Communities Originate? Preindustrial Cities Had only a few thousand people living within their borders Characterized by relatively closed class systems and limited mobility Status based on ascribed characteristics, and education limited to elite

How Did Communities Originate? Preindustrial Cities Remained small due to: Reliance on animal power Modest levels of surplus Problems in transportation and storage of food Hardships of migration to the city Dangers of city life

How Did Communities Originate? Industrial and Postindustrial Cities Industrial City: Based on very different principles of social organization than preindustrial cities More open class system and social mobility

How Did Communities Originate? Industrial and Postindustrial Cities Postindustrial City: Global finance and electronic flow of information dominate the economy Urbanism: relatively large and permanent settlement leads to distinctive patterns of behavior

Urbanization Functionalist View: Urban Ecology Human Ecology: interrelationships between people and their spatial settings and physical environments Urban Ecology: focuses on relationships as they emerge in urban areas

Urbanization Functionalist View: Urban Ecology Concentric-Zone Theory: center, or nucleus, of a city is the most highly valued land and each succeeding zone surrounding the center contains other types of land which are valued differently Zones illustrate or define growth of urban area over time

Urbanization Functionalist View: Urban Ecology Multiple-nuclei theory: all urban growth does not radiate out from a central district Metropolitan area may have several centers of development reflecting urban need or activity

Urbanization Figure 15.3: Ecological Theories of Urban Growth

Urbanization Conflict View: New Urban Sociology New urban sociology: considers the interplay of local, national, and worldwide forces and their effects on local space World Systems Analysis: certain industrialized nations hold a dominant position at the core of global economic system

Urbanization Conflict View: New Urban Sociology Poorer developing countries are on periphery of global economy Peripheral countries tend to be exploited by core nations

Urbanization

Types of Communities Central Cities Urban Dwellers Gans distinguishes five types of people found in our cities: Cosmopolites Unmarried and childless people Ethnic villagers The deprived The trapped

Types of Communities Central Cities Urban Dwellers Defended neighborhood refers to people’s definitions of their community boundaries Issues Facing Cities Crime Pollution Schools Inadequate transportation

Types of Communities Asset-Based Community Development (ABCD Approach) Leaders, policymakers and advocates first identify community’s strengths and then seek to mobilize those assets Helps communities recognize human resources they might otherwise overlook

Types of Communities Suburbs Any community near a large city Three social factors differentiate suburbs from cities: Less dense than cities Private space More exacting building codes

Types of Communities Suburbs Suburban Expansion Suburbanization most dramatic population trend in the United States during 20th century Diversity in the suburbs The suburbs contain significant number of low-income people from all backgrounds

Types of Communities Rural Communities 21% of U.S. population live in rural areas Farm residents now represent less than 1% of U.S. population Shift to single, large business also creates problems

Culture and Health Culture contributes to differences in medical care as well as how health is defined Culture can also influence the relative incidence of a disease or disorder.

Sociological Perspectives on Health and Illness State of complete physical, mental, and social well-being Not merely the absence of disease and infirmity Represents ideal rather than precise condition

Sociological Perspectives on Health and Illness Functionalist Approach Being sick must be controlled so that not too many people are released from their societal responsibilities at any one time Sick role: Societal expectations about attitudes and behavior of a person viewed as being ill Physicians function as “gatekeepers” for the sick role.

Sociological Perspectives on Health and Illness Conflict Approach Critical of growing role of medicine as major institution of social control Argues that medicine is a regulating mechanism and manifests social control by: Expanding its domain of expertise Retaining jurisdiction over many health care procedures

Sociological Perspectives on Health and Illness Conflict Approach Inequities of Health Care Poor areas tend to be underserved Brain drain: immigration to U.S. and other industrialized nations of skilled workers, professionals, and technicians desperately needed in home countries

Sociological Perspectives on Health and Illness Interactionist Approach Studies the roles played by health care professionals and patients Asserts that patients may play an active role in the positive or negative outcomes of their health

Sociological Perspectives on Health and Illness Labeling Approach The designations healthy and ill generally involve social definition by others Disagreements continue in the medical community over whether a variety of life experiences are illnesses or not

Culture and Health Figure 15.4: Infant Mortality Rates, 2002

Social Epidemiology and Health Social Epidemiology: study of distribution of disease, impairment, and general health status across a population Incidence: number of new cases of specific disorder occurring within given population during stated period of time, usually a year Prevalence: total number of cases of specific disorder that exist at given time

Social Epidemiology and Health Social Class Clearly associated with differences in morbidity and mortality rates Class linked to health by: Crowded living conditions Substandard housing Poor diet Stress Lack of health insurance

Social Epidemiology and Health Race and Ethnicity Health profiles of racial and ethnic groups reflect social inequality evident in United States Poor economic and environmental conditions manifested in high morbidity and mortality rates for these groups

Social Epidemiology and Health Figure 15.5: Percent of People without Health Insurance, 2003

Social Epidemiology and Health Gender When compared with men, women live longer, but as a group appear to be in poorer health than men Women live longer due to: Lower rate of cigarette smoking Lower consumption of alcohol Lower rates of employment in certain occupations

Social Epidemiology and Health Age Most older people in the United States have at least one chronic illness Older people vulnerable to certain types of mental health problems Older people use more health services than younger people

Social Policy and Health Financing Health Care Worldwide The Issue In many developing nations, health care issues center on very basic needs of primary care Industrialized nations face issues related to the accessibility and affordability of health care

Social Policy and Health Financing Health Care Worldwide The Setting The U.S. is only Western industrial democracy that does not treat health care as basic right National Health Insurance: general term for legislative proposals that focus on ways to provide the entire population with health care services Opponents of national health insurance insist it would be costly and lead to significant tax increases.

Social Policy and Health Financing Health Care Worldwide Sociological Insights Conflict theorists suggest that health care system resists basic change Those who receive substantial wealth and power through the workings of an existing institution have strong incentive to keep things as they are The health care system undergoing “corporatization”

Social Policy and Health Financing Health Care Worldwide Policy Initiatives Major changes occurring More people enrolled in managed care plans, which limit patient’s choice of physicians and treatments but cover most medical costs There are growing concerns about the quality of health care provided by managed care plans Many industrial countries paying greater attention to unequal health care delivery