1. Sociology, Tenth Edition
Health and Medicine
Sociology, Tenth Edition

2. 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

3. 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

4. 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

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

6. 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

7. 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

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

9. 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

10. 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

11. 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

12. 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

13. 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

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

15. 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

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

17. 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

18. 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

19. 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

20. 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

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

22. 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

23. 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