1. Physical and Mental Illness
Chapter 10
Medical Care:
Physical and Mental Illness

2. The Problem In Sociological Perspective
Not just biology
Social component
Industrialization and lifestyle
Greater affluence
Iatrogenesis
Illness caused by medical care staff
Changing ideas about health and illness

3. The Social Organization of Medicine as a Social Problem
An explosion in medical costs
Reasons for the explosion in costs

4. Medicine for profit: a two-tier system of medical care
Medicine for profit is also known as a fee-for-service
system.
Two-tier system of medical care:
one for those who can afford insurance
another for those who cannot

6. Medicine for profit: cesarean delivery
Why have cesarean births increased?
Profit
Convenience
Technology
Preference
A Feminist Controversy
Central issue is the relative power of women

8. Physical Illness as a Social Problem
Life expectancy and infant mortality
Determines how healthy or ill a society is as a whole.
Infant Mortality Rate (IMR)
Number of babies who die before 1 year of age, per 1,000 live births
Lifestyle
Heroic an Preventive Medicine
Quick care: Emergency Rooms and Drugstores
Uneven Distribution of Doctors

11. Mental Illness as a Social Problem
Measuring mental illness
The social nature of mental illness
How we define mental illness is a matter of dispute

12. A two-tier system of mental health delivery
the illness
the medical delivery system
Deinstitutionalization
The release of hospitalized mental patients into the community

13. Symbolic Interactionism
Determining the meaning of symptoms and behavior
People from different backgrounds interpret health & illness differently
The significance of definitions
Views and meanings of health and illness change
Conflicting Referral Networks
Depersonalization

14. Functionalism Customs or social institutions fulfills social needs.
Free-for-Service Means Profits
It is difficult for doctors to make money if people are not sick
A self-correcting system

16. Conflict Theory
Argues that the U.S. medical system is not self-correcting.
The poor are more often sick—they lack sufficient income and high-quality education, food, housing, jobs, and medical services

17. Colliding Interests of Doctors and Patients
Medicaid
Colliding Interests of Doctors and Patients
Doctors represent the dominant class
Patients are the subordinate class
Women’s Reproductive Organs
Hysterectomies

18. An Overview of Physical Health Problems
Historical changes in health problems
6 of the 10 leading causes of death have remained the same according to Figure 10-9.
Several of the top killers in both centuries are caused primarily by lifestyle and environmental pollution.

20. Infectious diseases The decline in infectious diseases
Stronger immunities, clean water, better food
The resurgence of infectious diseases
Develop new strains that are resistant

21. How Disease Is Related to Behavior and Environment: the Case of HIV/Aids
Background
Example of the relationship between behavior, environment, and disease
The disease no longer discriminates
A global epidemic
30 million people have died
33 million people around the world are infected now
3 million more people are being infected each year

22. HIV/Aids in the United States
Antiretroviral drugs (ARVs)
Halt the progression of AIDS
Combination of ARVs and education caused AIDS deaths in the U.S. to decrease
Race/ethnicity—higher rates of HIV/AIDS
Ominous changes
HIV virus mutates rapidly . 22

24. Social Inequalities in Physical Illness
Poverty and health
Economic factors largely determine who will be healthy and who will be sick
Occupational health hazards
lower-class working environments
Reducing Inequalities: Health Care Reform

25. Social Inequalities in Mental Illness
Social class and mental illness
People’s emotional well-being declines with decreases in social class.
Four explanations for the greater emotional problems of the poor:
The Drift Hypothesis
The Genetic Hypothesis
The Socialization Hypothesis
The Environmental Hypothesis

27. Social Class Differences in Mental Health Care
Different types of therapies
Consequences of ability to pay
Type of therapy tied to a person’s ability to pay, not illness
Talk therapy
Pharmaceutical straitjacket 27

29. Prepaid Medical Care: The Example of Managed Care
Health Maintenance Organization (HMO)
The positive side
Profits and a conflict of interest

30. Physician Assistants Training Physicians Home health care
Strategy for controlling costs
Training Physicians
Medical schools graduate about 16,000 physicians a year.
Home health care
Less expensive and often more humane
Preventative Medicine

31. Domiciliary Care Home health care, or domiciliary care
Treatment given within a patient’s home
Less expensive and often more humane
May involve profiteering
Another approach: create domiciliary programs for mentally ill

32. Preventive Medicine Preventable deaths
Three types of preventive medicine:
Primary prevention
Secondary prevention
Tertiary prevention
Food and health
Proper nutrition and exercise
Immunizations
Preventing drug abuse and homicide
Eating ourselves to death