Chapter 11 Age and Health Inequalities

Chapter Outline  The Structures of Aging and Health Care  Age Differentiation and Inequality  Explanations for Age Stratification  Health and Health Care  The U.S. Health Care System

Status of Young People  People under age 18 are assumed to be too immature to make appropriate life decisions.  Rate of teen unemployment is very high.  Disproportionately represented in crime and accident statistics.

Status of People 65 and Older  People are living longer and, on the whole, remaining healthy as they age.  Many will suffer loss of income as they age especially if they are single women or in a minority group.  Discrimination in hiring and employment based solely on age is not legal, but it happens.

Status of People 65 and Older  Older people are more likely to vote and some groups represent the concerns of older people.  Ageist stereotypes can harm the elderly.  Social integration tends to decline as we age.

Changing Levels of Poverty among Youth and the Elderly

Theories of Age Stratification  Structural Functional - Older people disengage for good of self and society.  Conflict - older people are excluded so that senior positions open up for younger adults.  Modernization - status of older people has decreased because traditional bases of power have eroded.

Comparison of 3 Explanations of Age Stratification Major Assumptions Structural- Functional Theory Age groups cooperate for common good Conflict TheoryAge groups compete for scarce resources Modernization Theory Changes in institutions alter the value of special resources that age groups hold (land, labor, and knowledge)

Comparison of 3 Explanations of Age Stratification Conclusions about youth Structural- Functional Theory Young people’s exclusion from full social participation is for good of self and society Conflict TheoryYoung people are excluded so others may benefit Modernization Theory Status goes down because labor not necessary

Comparison of 3 Explanations of Age Stratification Conclusions about old age Structural- Functional Theory Older people disengage voluntarily Conflict TheoryOlder people are excluded so that senior positions open up for younger adults Modernization Theory Status of older people has decreased because traditional bases of power have eroded

Modernization Theory Reasons older people have low status in modern societies: 1. The accelerating pace of technological change favors the young. 2. Declining importance of tradition-based resources—such as land. 3. Their relatively low productivity.

Gender and Health  Women live longer than men, but report more health problems.  Men are more likely to die at a younger age in spite of their good health.

Health and Life Expectancy, United States, 2001 Life Expectancy at Birth % Reporting Fair or Poor Health Male74.49 Female White77.28 Black PoorNA21 Near PoorNA16 Not PoorNA6

Social Factors and Male Health  The male role encourages risk talking that can end in accidents.  Men are less inclined to take care of their health than are women.  Men are more likely to die of stress- related diseases like heart attack and stroke.

Social Class and Health  The higher one’s social class, the longer one’s life expectancy and the better one’s health.  Environmental, economic, and psychosocial factors appear to play the largest part in class advantage regarding health.

Race and Health  When researchers control for income, minorities face obstacles to maintaining good health because they are minorities.  African Americans are 3 times as likely as Whites to be without health insurance.  Language barriers separate Hispanics from health care.

Physicians’ Income and Prestige  Structural-functional - high rewards are commensurate with talent and training.  Conflict perspective - the medical profession reflects the interests of the elite classes.  The AMA is a powerful lobby in supporting independent physicians fee- for-services payments.

Changing Status of Physicians Reflects several social and economic forces.  Group practices are more common.  Public has grown increasingly critical of physicians.  Fees and treatments are increasingly regulated by insurance companies and government agencies.

Nurses  Ongoing struggle between doctors and nurses reflects gender conflicts in society at large.  Nurses have increasingly pushed for higher educational standards for nurses.  More women have decided to become doctors.

Physicians and Registered Nurses: Income, Sex, and Race Physicians Registered Nurses Median net income $160,000* $44,840 % female29.3%93.1% % African American 5.6%9.9%

Medical Care: Who Pays?  Americans paid an average $340 per person to doctors and hospitals in  By 1998 that figure had risen to $2,115 per person.

Who Pays the Bills?  Private insurance covers about 70 % of Americans today.  Government programs include Medicare for people over 65 and Medicaid for the economically disadvantaged.  The uninsured in America make up about 16% of the population.