1. Slide 1 Richard T. Schaefer 1 st Edition Slide 1 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. chapter seventeen Sociology in Modules Health and the Environment

2. Slide 2 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Module 51: Sociological Perspectives on HealthModule 51: Sociological Perspectives on Health Module 52: Social Epidemiology and Health Module 53: Health Care in the United States Module 54: Sociological Perspectives on the EnvironmentModule 54: Sociological Perspectives on the Environment Health and the Environment 17

3. Slide 3 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. █ Won’t the environment eventually threaten everyone, no matter how much organic food they consume? A Look Ahead █ What defines a healthy environment? █ How does health care vary from one social class to another?

4. Slide 4 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Culture and Health █ Culture-bound syndrome: Disease or illness that cannot be understood apart from its specific social context –Anorexia nervosa Medical practitioners are being trained to recognize cultural beliefs related to medicine Module 51

5. Slide 5 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Module 51 Table 51-1: Cultural Challenges to Medicine

6. Slide 6 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Sociological Perspectives on Health and Illness █ Health: “State of complete physical, mental, and social well-being, and not merely the absence of disease and infirmity” (Leavell and Clark 1965:14) Health is relative, and we can view it in a social context Module 51

7. Slide 7 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Figure 51-1: Infant Mortality Rates in Selected Countries Module 51

8. Slide 8 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Functionalist Approach █ “Being sick” must be controlled so not too many people are released from their societal responsibilities –Sick role: Societal expectations about attitudes and behavior of a person viewed as being ill –Physicians function as “gatekeepers” for the sick role Module 51

9. Slide 9 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Conflict Approach █ Medicalization of society: Growing role of medicine as major institution of social control –Greatly expanded domain of expertise –Problems viewed using a medical model –Retains jurisdiction over health care Module 51

10. Slide 10 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Conflict Approach █ Inequities in Health Care –Obvious inequities exist in health care –Brain drain: Immigration to U.S. and other industrialized nation of skilled workers, professionals, and technicians –Dramatic differences in infant morality rate: Number of deaths of infants under one year old per 1,000 live births in given year Module 51

11. Slide 11 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Interactionist Approach █ Studies roles played by health care professionals and patients █ Asserts patients may play an active role in positive or negative health Module 51

12. Slide 12 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Labeling Approach █ The designations healthy and ill generally involve social definition –Homosexuality noteworthy medical example of labeling –Can view variety of life experiences as illnesses or not Module 51

13. Slide 13 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Table 51-2: Sociological Perspectives on Health and Illness Module 51

14. Slide 14 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. 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 a specific disorder occurring within a given population during a stated period of time, usually a year Module 52

15. Slide 15 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Social Epidemiology and Health █ Prevalence: Number of cases of specific disorder that exist at a given time █ Morbidity rates: Disease incidence figures presented as rates or number of reports per 100,000 people █ Mortality rate: Incidence of death in a given population Module 52

16. Slide 16 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Social Class █ People in lower classes have higher rates of mortality and disability –Appear to be cumulative –Less able to afford quality medical care –Link between health and economic mobility Module 52

17. Slide 17 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Race and Ethnicity █ Health profiles of racial and ethnic groups reflect social inequality in U.S. –Poor economic and environmental conditions manifested in high morbidity and mortality rates –African Americans have higher death rates –Mexican Americans may use curanderismo: Form of holistic health care and healing Module 52

18. Slide 18 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Gender █ Women experience higher prevalence of many illnesses but tend to live longer –Lower rate of cigarette smoking –Lower alcohol consumption –Lower rate of employment in dangerous occupations –Women more likely to seek treatment Module 52

19. Slide 19 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Age █ Most older people in U.S. 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 Module 52

20. Slide 20 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Figure 52-1: People Living with HIV Module 52

21. Slide 21 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Figure 52-2: Percentage of People without Health Insurance Module 52

22. Slide 22 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Figure 52-3: Availability of Physicians by State Module 52

23. Slide 23 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Research Today █ The AIDS Epidemic –Do the people you know take few risks sexually because of the danger of becoming infected with the AIDS virus? If not, why not? –Aside from obvious humanitarian reasons, why should the U.S. help countries in the fight against AIDS? Module 52

24. Slide 24 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Health Care in the United States █ Health care costs skyrocketed in 35 years –In 2000, amount spent on health care equaled that spent on education, defense, prisons, farm subsidies, food stamps, and foreign aid combined Module 53

25. Slide 25 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. A Historical View █ “Popular health movement” of the 1830s and 1840s emphasized preventive care and “self-help” –AMA institutionalized authority through programs of education and licensing –By 1920s, physicians controlled hospital technology, division of labor of health personnel, and other health professions Module 53

26. Slide 26 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Physicians, Nurses, and Patients █ Physicians have position of dominance with patients and nurses –Leads to dehumanizing physician-patient encounters –Publicity about malpractice suits and high medical costs further strained relationship –Controlled interactions with nurses –Increasingly, patients turning to media for health care information Module 53

27. Slide 27 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Figure 53-1: Total Health Care Expenditures in the United States, 1970-2019 (projected) Module 53

28. Slide 28 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Research Today █ Medicine, Retail Style –Have you ever been treated at an in-store clinic? If so, were you satisfied with the care you received? Was the price reasonable? –Evaluate the emergence of clinics from a functionalist and then a conflict perspective. On balance, do you think these clinics are a benefit to society? Module 53

29. Slide 29 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Alternatives to Traditional Health Care █ At least one of three adults in U.S. attempts to maintain good health or respond to illness through alternative health care techniques –Holistic medicine: Therapies in which the health care practitioner considers person’s physical, mental, emotional, and spiritual characteristics Module 53

30. Slide 30 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Figure 53-3: Use of Complementary and Alternative Medicine Module 53

31. Slide 31 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. The Role of Government █ In 1946 Hill-Burton Action provided first subsidies for building and improving hospitals –1965: Medicare and Medicaid established –Programs greatly expanded federal involvement in health care financing 1983: Government instituted cost-control program Module 53

32. Slide 32 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. The Role of Government █ Expansion of health insurance coverage enacted by Congress in 2010 raised hope of improved health care –Costs of the legislation, Tea Party members warned, would lead to higher taxes Module 53

33. Slide 33 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Sociological Perspectives on the Environment █ Environment people live in has noticeable effect on their health –Increases in population, together with economic development, have serious environmental consequences Module 54

34. Slide 34 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Effects of Growth and Development █ Human ecology: Interrelationships between people and their spatial settings and physical environments 1.Environment provides resources essential for life 2.Environment serves as a waste repository 3.Environment “houses” our species Module 54

35. Slide 35 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Conflict View of the Environment █ Growing share of human and natural resources of developing countries redistributed to core industrialized nations –Environmental justice: Legal claims that racial minorities are disproportionately subjected to environmental hazards Poor and oppressed bear brunt of environmental pollution Module 54

36. Slide 36 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Environmental Problems █ Three broad areas of concern –Air pollution –Water pollution –Global Warming Module 54

37. Slide 37 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Sociology in the Global Community █ The Mysterious Fall of the Nacirema –Have you ever visited a foreign culture and been struck by something that seemed odd to you but perfectly normal to everyone else? –If we could step back and take an objective look at what we are doing to the environment, would our society change for the better? Why or why not? Module 54

38. Slide 38 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. The Impact of Globalization █ Globalization can be good and bad for the environment –Industrialization increased pollution –Multinational corporations have incentive to carefully consider cost of natural resources –Environmental refugees are one reflection of interplay between globalization and environment Module 54

39. Slide 39 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Environmentalism █ Understanding the Issue –1970: 25 million people turned out to observe first Earth Day –Citizens marched on behalf of specific environmental causes –Congress established the EPA –The Clean Air, Clean Water, and Endangered Species acts followed Module 54

40. Slide 40 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Environmentalism █ Understanding the Issue –Earth Day now on calendars of city councils, zoos, and museums worldwide –Increasingly, efforts to publicize concerns moving to Internet –General public has mixed reaction to environmental issues –Largest environmental organizations became increasingly bureaucratic Module 54

41. Slide 41 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Environmentalism █ Applying Sociology –Troubled that most powerful environmental organizations predominantly white, male- dominated, and affluent –Conflict perspective: major organizations accept funding from powerful corporations including oil and chemical companies –Environmental movement aroused resistance Module 54

42. Slide 42 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Environmentalism █ Initiating Policy –Economic downturn of 2008- 2010 provided mixed blessing –Reduced use of fossil fuels –Established funds for creating green-collar jobs –Environmentalism moved to a bigger stage –People increasingly reluctant to ignore environmental issues Module 54

43. Slide 43 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Figure 54-1: Increase in Carbon Dioxide Emissions Module 54

44. Slide 44 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Figure 54-2: The Environment Versus the Economy Module 54

45. Slide 45 © 2011 The McGraw-Hill Companies, Inc. All rights reserved. Figure 54-3: Are U.S. Teens Green Enough? Module 54