Sociology, Tenth Edition Health and Medicine Sociology, Tenth Edition

Sociology, Tenth Edition Health A state of complete physical, mental, and social well-being (World Health Organization) Health is as much a social as a biological issue for sociologists Illness have their roots in the organization of society Sociology, Tenth Edition

Society Shapes the Health of People in 5 Major Ways Cultural patterns define health What is considered “healthy” is what people hold to be morally good Cultural standards of health change over time A society’s technology affects people’s health Social inequality relates to health Sociology, Tenth Edition

Health: a Global Survey Health in history Industrialization changed the patterns of health, medical care Health in low-income countries One billion people (globally) have serious illness due to severe poverty Poor sanitation, malnutrition and minimal medical care Health in high-income countries Infectious disease is less of a threat, concentrate on chronic illnesses Sociology, Tenth Edition

Global Map 21-1 The Availability of Physicians in Global Perspective Sociology, Tenth Edition

Leading Causes of Death: U.S.A. 1900 Influenza and pneumonia Tuberculosis Stomach/intestinal diseases Heart disease Cerebral hemorrhage Kidney disease Accidents Cancer Disease of infancy Diphtheria 2000 Heart disease Cancer Stroke Lung disease (non-cancerous) Accidents Diabetes Pneumonia and influenza Alzheimer’s disease Kidney disease Blood disease Sociology, Tenth Edition

Sociology, Tenth Edition Who Is Healthy? Social epidemiology – how health and disease are distributed throughout a society’s population Factors include Age Gender Social class Race Sociology, Tenth Edition

National Map 21-1 Quality of Health across the United States Sociology, Tenth Edition

Sociology, Tenth Edition Age & Gender Death is now rare among young people Accidents and aids are two exceptions Across the life course, women fare better than men Men have higher death rates for accidents, suicide and violence Our cultural conception of masculinity pressures men “Coronary prone behavior” Sociology, Tenth Edition

Sociology, Tenth Edition Class and Race Infant mortality rates are twice as high for poor as for wealthy The poorest in America can die from diseases that strike children in countries like the Vietnam and Lebanon African Americans are three times more likely to be poor compared to whites Poverty condemns people to live in crowed unsanitary conditions that breed infectious disease Life expectance for white children born in 2000 is six years greater than for African Americans Poverty also breeds stress and violence In 1999, 2,674 African American males were killed by others of their own race Sociology, Tenth Edition

Sociology, Tenth Edition Cigarette Smoking Most preventable hazard to health By 1999, 24% of Americans smoke Generally speaking divorced, separated, unemployed, in the military & less schooling a person has tend to be smokers 430,000 men & women die prematurely each year as a direct result of smoking That number exceeds the combined death toll from alcohol, cocaine, heroin, homicide, suicide, auto accidents & aids Sociology, Tenth Edition

Sociology, Tenth Edition Eating Disorders An intense form of dieting or other unhealthy methods of weight control driven by the desire to be very thin 95% of those suffering from anorexia and bulimia are women, white and affluent The beauty myth tells women to exaggerate the importance of physical attractiveness to the point of risking their health Pressures come from society, parents, the media, as well as women themselves Sociology, Tenth Edition

Sexually Transmitted Diseases “Sexual revolution” of the 1960’s saw a rise in std rates; Generated a sexual counter-revolution Gonorrhea & syphilis Easily treated with antibiotics Genital herpes Treatable but incurable Aids – acquired immune deficiency syndrome Caused by human immunodeficiency virus – HIV Incurable, almost always fatal Specific behaviors increase risk: anal sex, sharing needles and drug use Sociology, Tenth Edition

Figure 21-1 Life Expectancy for U.S. Children Born in 2000 Sociology, Tenth Edition

Sociology, Tenth Edition Ethics & Death When is a person dead? When an irreversible state involving no response to stimulation, no movement or breathing, no reflexes, and no indication of brain activity Do people have the right to die? 10,000 people in the u.S.A. Are in a permanent “vegetative state” What about mercy killing? Thousands face terminal illnesses that will cause horrible suffering “Right to die” a person with an incurable disease has a right to forgo treatment which may prolong their life “Active” euthanasia a person may enlist the services of a physician to bring on a quick death Sociology, Tenth Edition

Sociology, Tenth Edition Figure 21-3 Types of Transmission for Reported U.S. AIDS Cases as of 2001 Sociology, Tenth Edition

The Medical Establishment The social institution focuses on combating disease and improving health The rise of scientific medicine AMA – American Medical Association founded in 1847 By early 1900’s state boards agreed to certify only AMA approved M.D.s & D.O. (Osteopaths) on one level Other healers kept tradition but occupy lesser role Chiropractors, herbalists, midwives, etc. Sociology, Tenth Edition

Sociology, Tenth Edition Holistic Medicine Holistic medicine – an approach to health care that emphasizes prevention of illness and takes into account a person’s entire physical and social environment Patients are people Concern for the environment in which the person lives and their lifestyle Responsibility, not dependency Favors an active approach to health encouraging patients take health-promoting behaviors Personal treatment Favoring a more personal relaxed environment, such as the person’s home Sociology, Tenth Edition

Medicine in Socialist Societies China Government controls most health care operations “Barefoot doctors” in rural areas, traditional healing arts, acupuncture, medicinal herbs and holistic concern Russian federation Medical care is in transition, but it is held the all citizens have a right to basic medical care Tax funds are used to provide care Disparities in medical care increase among segments of the population Sociology, Tenth Edition

Medicine in Capitalist Societies Sweden (1891) Compulsory, comprehensive government medical care system offered to all “socialized medicine” Great Britain (1948) Duel system of public health services (national health service) for all citizens and may also purchase private services Canada (1972) A single-payer model for all citizens government program (insurance company) But, like Britain , purchase private services Japan Physicians have private practice Paid like much of Europe, combination of government programs (80% of costs) and private insurance Sociology, Tenth Edition

Figure 21-4 Extent of Socialized Medicine in Selected Countries Sociology, Tenth Edition

Sociology, Tenth Edition Medicine in the U. S. Direct fee system The patient pays directly for services provided by doctor and hospitals Private insurance 63% of Americans have access to medical care benefits through their work or union 8% purchase private coverage on their own Few programs pay all medical costs Public insurance programs Medicare for those over 65, Medicaid for those in poverty and for veterans 24% of Americans receive medical attention via some form of government program, though many also have some private insurance Health maintenance organizations An organization that provides comprehensive medical care to subscribers for a fixed fee Preventive approach to health; Makes a profit if subscribers stay healthy Sociology, Tenth Edition

Sociology, Tenth Edition Theoretical Analysis Structural-functional analysis Talcott Parsons’ the sick role Illness suspends routine duties A sick person must want to get well A sick person must seek competent help The doctor patient relationship as hierarchical Symbolic-interaction analysis We socially construct our ideas of health and illness; How we define it becomes real We socially construct our ideas of treatment Social-conflict analysis Issues of: Limited access, the profit motive, and the politics of medicine Interests of one group versus others Sociology, Tenth Edition