1. EDUCATION, HEALTH,
AND MEDICINE
CHAPTER 14

2. How are schooling and health linked to social inequality in the United States?
What changes in schooling and health have taken place in the United States in recent generations?
Why do people in poor nations have little access to schooling and medical care?

3. EDUCATION: A GLOBAL SURVEY EDUCATION SCHOOLING
The social institution through which society provides its members with important knowledge, including basic facts, job skills, and cultural norms and values
SCHOOLING
Formal instruction under the direction of specially trained teachers

4. Schooling and Economic Development
The extent of schooling in any society is tied to its level of economic development
Low-income countries have little schooling
1/3rd of the world’s people cannot read or write
Global comparisons made between
India
Japan
United States

5. The Functions of Schooling
Structural-functional analysis:
Socialization
Cultural innovation
Social integration
Social placement
Latent functions

6. CRITICAL REVIEW
Overlooks how the classroom behavior of teachers and students can vary from one setting to another
Says little about many problems of the educational system and how schooling helps reproduce the class structure in each generation

7. SCHOOLING AND SOCIAL INTERACTION
THE SELF FUL-FILLING PROPHECY
People who expect others to act in certain ways often encourage that very behavior
Jane Elliott
“Blue Eyes”
CRITICAL REVIEW
People do not just make up beliefs about superiority and inferiority
These beliefs are built into a society’s system of social inequality

8. SCHOOLING AND SOCIAL INEQUALITY
Social-conflict challenges structural-functional idea that schooling develops everyone’s talents and abilities
Three ways schooling causes and perpetuates social inequality
Social control
Standardized testing
Tracking
Assigning students to different types of educational programs

9. Public and Private Schools
Parochial “Of the Parish”
Catholic schools
Protestant private schools
Christian Academies
Students in private schools outperform those in public schools
Smaller classes, demanding coursework, greater discipline
Public Schools
Difference in funding between rich and poor communities result in unequal resources

10. Home environment is an important influence on school performance
Schools in more affluent areas offer better schooling than in poor communities
Social Capital
Students whose families value schooling
Read to their children
Encourage the development of imagination
Home environment is an important influence on school performance
Differences in home and local neighborhood matter most in children’s learning

11. Access to Higher Education
67% of US high school graduates enroll in college immediately after graduation
Crucial factor affecting access is income
Economic differences is reason for education gap between minorities and whites
Completing college brings rewards
Higher earnings

12. Greater Opportunity: Expanding Higher Education
US world leader in providing college education to its people
Education is the key path to better jobs
Government makes money available to help certain categories of people pay for college
Community Colleges
Low cost provides access to millions
Special importance to minorities
Attracts students from all over the world
Priority of faculty is teaching, not research

13. Privilege and Personal Merit
Schooling transforms social privilege into personal merit
Credentialed Society
Society that evaluates people based on schooling
Process helps those who are already advantaged and hurts those who are already disadvantaged
CRITICAL REVIEW
Social-conflict overlooks the extent to which schooling provides upward mobility to the talented from all backgrounds and changes social inequality on many fronts

14. PROBLEMS IN THE SCHOOLS
Discipline and Violence
Schools do not create violence
Spills in from surrounding society
Student Passivity
TV and iPods claim more of young people’s time than schooling
Five ways bureaucracy undermine education
Rigid uniformity
Numerical ratings
Rigid expectations
Specialization
Little individual responsibility

15. Passivity common among college and university students
Four teaching strategies that can bring students to life in classrooms
Calling on students by name when they volunteer
Positively reinforcing student participation
Asking analytical rather than factual questions and giving students time to answer
Asking for student’s opinions even when no one volunteers an answer

16. Least common among whites
Dropping Out
Quitting before earning even a high school diploma
Leaves young people unprepared for work and high-risk of poverty
Least common among whites
More likely among African Americans and Hispanics
Causes
Trouble with the English language
Work to support family

17. US spend more on schooling than almost any other country
Academic Standards
Functional Illiteracy
A lack of the reading and writing skills needed for everyday living
Nation at Risk
US spend more on schooling than almost any other country
US placed 16th in science and 19th in math
Cultural values play a part in how hard students work at their schooling

18. RECENT ISSUES IN U.S. EDUCATION
School Choice
Create a market for education so parents and students can shop for best value
Magnet Schools
Offer special facilities and programs to promote educational excellence
Charter Schools
Public schools that are given more freedom to try new policies and programs
Schooling for Profit
School systems operated by private profit-making companies rather than government

19. Schooling People With Disabilities
Home Schooling
Parents do not believe public education is doing a good job
Students who learn at home outperform those who learn in school
Schooling People With Disabilities
Resulted from persistent efforts by parents and other concerned citizens
Mainstreaming
Including students with disabilities in the education program
Inclusive Education

20. Adult Education The Teacher Shortage
Many return to advance a career or train for a new job
The Teacher Shortage
Final challenge for US schools
Factors
Low salaries
Frustration
Retirement
Rising enrollment and reductions in class size

21. HEALTH AND MEDICINE MEDICINE HEALTH
The social institution that focuses on fighting disease and improving health
HEALTH
A state of complete physical, mental, and social well-being

22. Health and society Society affects health in four major ways:
Cultural patterns define health
Cultural standards of health change over time
A society’s technology affects people’s health
Social inequality affects people’s health

23. HEALTH: A GLOBAL SURVEY
Health in Low-Income Countries
Poverty cuts decades off of life expectancy
Poor sanitation and malnutrition
Health in High-Income Countries
Industrialization raised living standards
Better nutrition
Safer housing
Medical advances in science to control infectious disease

24. Health in the United States
Social Epidemiology
The study of how health and disease are distributed throughout a society’s population
Age and Gender
Death now rare among young people
AIDS changing this trend
Male aggression
Social Class and Race
Poverty
Infant mortality twice as high for the disadvantaged

25. Cigarette Smoking Tops list of preventable health hazards in US
Many smoke to cope with stress
440,000 die prematurely yearly
Exceeds alcohol, cocaine, heroin, homicide, suicide, auto accidents, and AIDS
$83 billion dollar industry
Increased marketing abroad where there is less regulation of tobacco
Ten years after quitting, ex-smoker’s health is as good as someone who never smoked

26. Eating Disorders
An intense type of dieting or other unhealthy method of weight control driven by the desire to be very thin
Anorexia Nervosa
Dieting to the point of starvation
Bulimia
Binge eating followed by induced vomiting to avoid weight gain
Obesity
2/3rd of US adults are obese
Limit physical activity and raise risk of serious diseases
Live in a society in which most people have sedentary jobs

27. Sexually Transmitted Diseases
Venereal Disease
Gonorrhea and Syphilis
Cured easily with antibiotics
Genital Herpes
45 million adults in US and is incurable
AIDS
Most serious of all sexually transmitted diseases
Incurable and almost always fatal
Risk behaviors are anal sex, sharing needles, use of any drug including alcohol
Education most effective weapon

28. Ethical Issues Surrounding Death
Defined as an irreversible state involving no response to stimulation, no movement or breathing, no reflexes, and no indication of brain activity
Euthanasia
Assisting in the death of a person suffering from an incurable disease
“Right to die” one of today’s most difficult issues
Supporters view circumstances when death preferable to life
Critics cite abuse

29. THE MEDICAL ESTABLISHMENT
Emerged as a social institution as societies became more productive and people took on specialized work

30. Holistic Medicine
An approach to health care that emphasizes prevention of illness and takes into account a person’s entire physical and social environment
Three foundations of holistic health care
Treat patients as people
Encourage responsibility, not dependency
Provide personal treatment

31. Paying for Medical Care: A Global Survey
People’s Republic of China
Government controls most health care
Russian Federation
Transforming from state-dominated to more of a market system
Sweden
Socialized Medicine
A medical care system in which the government owns and operates most medical facilities and employs most physicians

32. Great Britain Canada Japan Also established socialized medicine
“single-payer” model of care that provides care to all Canadians
Less state of the art technology
Responds more slowly, people may wait months to receive major surgery
Japan
Approach medical care like Europe
Most medical expenses paid through the government

33. Paying for Medical Care: US
Direct-fee system
A medical care system in which patients pay directly for the services of physicians and hospitals
Rich can buy best medical care in the world
Poor are worse than European counterparts
No national medical care program
Culture stresses self-reliance
Political support for national medical program not strong
AMA and insurance industry strongly and consistently oppose national medical care

34. Private Insurance Programs Public Insurance Programs
68% of US population has private insurance
Public Insurance Programs
Medicare pays costs for people over age 65
Medicaid pays for the poor
Health Maintenance Organizations
An organization that provides comprehensive medical care to subscribers for a fixed fee
Criticized for refusing to pay for medical procedures they consider unnecessary
Congress currently debating the extent to which patients can sue HMO’s to obtain better care

35. The Nursing Shortage Fewer people are entering the nursing profession
Today’s young women have a wide range of job choices
Nurses are unhappy with their working conditions
Hopeful sign
Increase in salaries
Recruitment of more minorities

36. Theoretical Analysis of Health and Medicine
Structural-Functional Analysis: Role Theory
The Sick Role
Patterns of behavior defined as appropriate for people who are ill
Physician’s Role
Use specialized knowledge and expect patient’s to follow “doctor’s orders” to complete treatment
CRITICAL REVIEW
Sick-role concept applies to acute conditions
Sick person’s ability to assume the sick role depends on person’s resources
Illness is not completely dysfunctional

37. Symbolic-Interaction Analysis: The Meaning of Health
The Social Construction of Illness
Our response to illness is based on social definitions
Psychosomatic disorders
When state of mind guides physical sensations
The Social Construction of Treatment
Doctor’s tailor their physical surroundings and their behavior so that others see them as competent and in charge
CRITICAL REVIEW
Implies that there are no objective standards of well-being

38. Social-Conflict and Feminist Analysis
Points out the connection between health care and social inequity
Access to care
Capitalism provides excellent health care for the rich at the expense of the rest of the population
The Profit Motive
Real problem is not access to medical care but capitalist medicine itself
Profit motive turns doctors, hospitals, and the pharmaceutical industry into multibillion-dollar corporations
Society tolerant of doctor’s financial interest in tests and procedures they order

39. Medicine as Politics CRITICAL REVIEW
Scientific medicine takes sides on significant social issues
Medical establishment opposes government medical programs
Recently allowed women to join ranks of physicians
Racial and sexual discrimination kept women and people of color out of medicine
Scientific medicine explains illness in terms of bacteria and viruses ignoring poverty, racism, and sexism
CRITICAL REVIEW
Minimizes the advances in US health brought about by scientific medicine and higher living standards