Transcript Health and Medicine - Madison County Schools

HEALTH AND MEDICINE
Sociology, Eleventh Edition
WHAT IS HEALTH?
Sociology, Eleventh 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 has roots in the organization of society.
Sociology, Eleventh Edition
SOCIETY SHAPES THE HEALTH
OF PEOPLE IN 4 MAJOR WAYS
1. Cultural patterns define
health.
•
•
Standards vary.
What is considered “healthy” is
what people hold to be morally
good. Ex. homosexuality is “sick”
2. Cultural standards of health
change over time. Ex. smoking
3. A society’s technology affects
people’s health .
4. Social inequality relates to
health. Ex. Rich = healthier
Sociology, Eleventh Edition
HEALTH: A GLOBAL SURVEY
Sociology, Eleventh Edition
HEALTH IN HISTORY
• With only simple technology, our
ancestors could do little to improve
health.
• Hunters and gatherers – food
shortages  abandoning children.
• ½ died by 20; few lived until 40.
• Agriculture – food more plentiful; elites
better health than peasants & slaves.
• Medieval Europe – human waste piled
up in streets, spreading infectious
diseases and plagues periodically
wiped out entire towns.
Sociology, Eleventh Edition
HEALTH IN LOW-INCOME COUNTRIES
• In the poorest countries, most
people die before reaching their
teens.
• One billion people (globally) have
serious illnesses due to poverty.
• Poor sanitation, malnutrition and
minimal medical care  makes
infectious diseases the most
common cause of death.
• When medical technology does
control infectious disease, the
populations of poor nations rise.
Sociology, Eleventh Edition
HEALTH IN HIGH-INCOME COUNTRIES
• Industrialization  overcrowded cities
 poor sanitation.
• Factories polluted the air.
• Accidents in the workplace became
common.
• Industrialization  gradually improved
health.
• Better nutrition & safer housing.
• Industrialization  increase in
infectious diseases like the flu &
chronic diseases.
• Today, infectious disease is less of a
threat, concentrate on chronic
illnesses, such as cancer, heart
disease and stroke.
Sociology, Eleventh Edition
HEALTH IN THE
UNITED STATES
Sociology, Eleventh Edition
NATIONAL MAP 21-1 (P. 554)
HEALTH ACROSS THE UNITED STATES
AVERAGE HEALTH VARIES FROM PLACE TO PLACE THROUGHOUT THE U.S. THIS MAP SLOWS THE
RESULTS OF A SURVEY THAT ASKED PEOPLE ACROSS THE COUNTRY ABOUT THEIR PERSONAL
HEALTH, INCLUDING THEIR SMOKING HABITS, NUTRITIONAL DIET, AND FREQUENCY OF ILLNESS.
LOOKING AT THE MAP, WHAT PATTERN DO YOU SEE? CAN YOU EXPLAIN IT?
SOURCE: AMERICAN DEMOGRAPHICS, OCTOBER 2000, P. 50. REPRINTED WITH PERMISSION
FROM AMERICAN DEMOGRAPHICS. © 2004 BY CRAIN COMMUNICATIONS, INC.
LEADING CAUSES OF DEATH: U.S.A.
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1900
Influenza and
pneumonia
Tuberculosis
Stomach/intestinal
diseases
Heart disease
Cerebral hemorrhage
Kidney disease
Accidents
Cancer
Disease of infancy
Diphtheria
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2000
Heart disease
Cancer
Stroke
Lung disease (noncancerous)
Accidents
Diabetes
Pneumonia and
influenza
Alzheimer’s disease
Kidney disease
Blood disease
Sociology, Eleventh 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, Eleventh 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
stress & heart disease
• “Coronary prone behavior”
Sociology, Eleventh Edition
CLASS & RACE
• Infant mortality rates are twice as high
for the poor as for the wealthy.
• The poorest in America can die from
diseases that strike children in
countries like the Vietnam and
Nigeria.
• African Americans are three times more
likely to be poor compared to whites.
• Poverty condemns people to live in
crowded unsanitary conditions that
breed infectious disease.
• Life expectancy for white children born
in 2000 is six years greater than for
African Americans.
• Poverty also breeds stress and violence.
Sociology, Eleventh Edition
FIGURE 21-1 (P. 556)
LIFE EXPECTANCY OF U.S. CHILDREN BORN IN 2003
BOTH GENDER AND RACE HAVE A POWERFUL EFFECT ON LIFE
EXPECTANCY.
Sociology, Eleventh Edition
SOURCE: HOYERT, KUNG, & SMITH (2005).
CIGARETTE SMOKING
• Most preventable cause of death.
• By 2003, 22% of Americans smoke.
• Generally speaking divorced,
separated, unemployed, in the
military & less schooling a person
has tend to be smokers.
• 440,000 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, Eleventh Edition
http://www.youtube.com/watch?v=x4c_wI6kQyE
DISCUSSION QUESTION
• Do you agree with city-wide indoor
smoking bans?
• What are the pros/cons?
• Should a ban be implemented at a
state or national level?
Sociology, Eleventh Edition
MYTH OF BEAUTY
• The beauty myth tells women to
exaggerate the importance of
physical attractiveness to the
point of risking their health.
• Stereotypes in the US…
• Slender=successful, attractive
• Overweight=lazy, sloppy & even
stupid
• Most college women believe
“guys like thin girls”.
• Pressures come from society,
parents, the media, as well as
women themselves.
Sociology, Eleventh Edition
http://www.youtube.com/watch?v=XpaOjMXyJ
Gk
http://www.youtube.com/watch?v=iYhCn0jf46U
EATING DISORDERS
• An intense form of dieting
or other unhealthy methods
of weight control driven by
the desire to be very thin.
• Few women meet our
unrealistic standards of
beauty and develop a low
self-image.
• 95% of those suffering from
anorexia and bulimia are
women, white and affluent.
OBESITY
• Two-thirds of U.S. adults are
overweight, making it the most
widespread health problem in
the US related to eating.
• Obesity can limit physical activity
and it raises the risk of a number
of serious diseases.
• Social causes of obesity
• Lack of physical ability
• Poor diet
• The typical US diet involves
too much salty and fatty
food.
Sociology, Eleventh Edition
NATIONAL MAP 21-2 (P. 559)
OBESITY ACROSS THE UNITED STATES
ACCORDING TO THE GOVERNMENT, TWO-THIRDS OF U.S. ADULTS ARE OVERWEIGHT, MEANING THAT THEY ARE
AT LEAST 10 POUNDS OVER A HEALTHY WEIGHT. ABOUT HALF OF ALL OVERWEIGHT PEOPLE ARE CLINICALLY
OBESE, WHICH MEANS THEY ARE AT LEAST THIRTY POUNDS OVERWEIGHT. THIS MAP SHOWS THE SHARE OF
THE POPULATION THAT IS OBESE FOR COUNTIES ACROSS THE U.S. LOOKING AT THE MAP, WHAT CAN YOU SAY
ABOUT THE REGIONS THAT HAVE THE HIGHEST RATES OF OBESITY?
SOURCE: TIME (JUNE 4, 2004). COPYRIGHT © 2004 TIME, INC. REPRINTED BY PERMISSION.
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 (affects about 50
million or 1/5 of US adults).
• AIDS – acquired immune deficiency
syndrome
• Caused by human immunodeficiency
virus – HIV
• Early stages – no symptoms
• Incurable, almost always fatal
• Specific behaviors increase risk: anal
sex, sharing needles and drug use
Sociology, Eleventh Edition
FIGURE 21-2 (P. 562)
TYPES OF TRANSMISSION FOR REPORTED U.S. AIDS CASES AS OF 2003
THERE ARE SEVERAL WAYS IN WHICH PEOPLE CAN BE INFECTED WITH HIV.
SOURCE: CENTERS FOR DISEASE CONTROL AND PREVENTION (2004).
GLOBAL MAP 21-1 (P. 561)
HIV/AIDS INFECTION OF ADULTS IN GLOBAL PERSPECTIVE
64% OF ALL GLOBAL HIV INFECTIONS ARE IN SUB-SAHARAN AFRICA. IN COUNTRIES SUCH AS BOTSWANA AND
SWAZILAND, MORE THAN ONE-THIRD OF PEOPLE BETWEEN THE AGES OF 15 AND 49 ARE INFECTED WITH
HIV/AIDS. THIS VERY HIGH INFECTION RATE REFLECTS THE PREVALENCE OF OTHER SEXUALLY
TRANSMITTED DISEASES AND INFREQUENT USE OF CONDOMS, TWO FACTORS THAT PROMOTE
TRANSMISSION OF HIV. ALL OF SOUTHEAST ASIA ACCOUNTS FOR ABOUT 17% OF GLOBAL HIV INFECTIONS.
IN CAMBODIA, 2 TO 3 PERCENT OF PEOPLE AGED 15 TO 49 ARE NOW INFECTED. ALL OF NORTH AND SOUTH
AMERICA TAKEN TOGETHER ACCOUNT FOR 8% OF GLOBAL HIV INFECTIONS. IN THE U.S., 0.6% OF PEOPLE
AGED 15 TO 49 ARE INFECTED. THE INCIDENCE OF INFECTION IN MUSLIN NATIONS IS EXTREMELY LOW BY
WORLD STANDARDS.
SOURCE: POPULATION REFERENCE BUREAU (2003, 2005); AND UNITED NATIONS (2004); MAP PROJECTION
FROM PETERS ATLAS OF THE WORLD (1990).
Sociology, Eleventh 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”.
• Euthanasia (mercy killing) – assisting
in the death of a person suffering
from an incurable disease.
• Living wills help clear up the
situation.
Sociology, Eleventh Edition
TERRI SCHIAVO
• 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.
• Belgian twin brothers
http://www.yout
ube.com/watch?
v=htZagt1Szcw
THE MEDICAL
ESTABLISHMENT
Sociology, Eleventh Edition
THE RISE OF
SCIENTIFIC MEDICINE
• Medicine - 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 doctors.
• M.D.s & D.O. (Osteopaths) on one level
• Other healers kept tradition but occupy
lesser role.
• Chiropractors, herbalists, midwives, etc.
• US doctors typically use scientific
medicine.
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.
1. Patients are people
Concern for the environment in
which the person lives and their
lifestyle.
2. Responsibility, not dependency
Favors an active approach to
health encouraging patients take
health-promoting behaviors.
3. Personal treatment
Favoring a more personal relaxed
environment, such as the person’s
home.
Sociology, Eleventh Edition
MEDICINE IN SOCIALIST SOCIETIES
Socialized medicine –
medical systems are
owned and operated by the
government.
China
• Government controls most
health care operations.
• “Barefoot doctors” in rural
areas, traditional healing
arts, acupuncture, medicinal
herbs and holistic concern.
• Russian Federation
• Tax funds are used to provide
care.
• Disparities in medical care
increase among segments of
the population.
Sociology, Eleventh 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 practices.
• Paid like much of Europe, combination of government
programs (80% of costs) and private insurance.
FIGURE 21-3 (P. 568)
EXTENT OF SOCIALIZED
MEDICINE IN SELECTED
COUNTRIES
OF ALL HIGH-INCOME
COUNTRIES, THE U.S. HAS
THE SMALLEST PERCENTAGE
OF GOVERNMENT-PROVIDED
MEDICAL CARE.
SOURCE: U.S. CENSUS BUREAU (2004) AND
WORLD BANK (2005).
MEDICINE IN THE U. S.
• Direct fee system
• The patient pays directly for services provided
by doctor and hospitals.
• Private insurance
• 60% 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 - over 65, Medicaid - poverty and for
veterans.
• 27% 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.
THEORETICAL ANALYSIS OF
HEALTH AND MEDICINE
Sociology, Eleventh Edition
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.
• Criticisms of Parsons’ approach:
• It says little about prevention.
• It places doctors rather than people in
charge of health
• It assumes sick people can afford to take
time off from work.
SYMBOLIC INTERACTION ANALYSIS
• Focuses on the meaning
people attach to health and
illness
• We socially construct our
ideas of health and illness;
how we define it becomes
real.
• We socially construct our
ideas of treatment.
• Likely to cover psychosomatic
disorders.
Sociology, Eleventh Edition
SOCIAL CONFLICT ANALYSIS
• Focuses on how patterns of health
and illness are seen mostly as a
product of social inequality.
• Issues of:
• Limited access, the profit
motive, and the politics of
medicine
• Interests of one group versus
others.
• Capitalism fails to support human
health because quality of care is
dependent on income.
Sociology, Eleventh Edition
FIGURE 21-4 (P. 571)
SELF-ASSESSMENT OF
PHYSICAL HEALTH BY FIRSTYEAR COLLEGE STUDENTS,
1985-2004
SINCE 1985, A SMALLER SHARE
OF STUDENTS HAVE
DESCRIBED THEIR HEALTH AS
“ABOVE AVERAGE.”
SOURCE: ASTIN ET AL. (2002) AND SAX ET AL.
(2004).
Sociology, Eleventh Edition
HEALTH AND MEDICINE:
LOOKING AHEAD
Sociology, Eleventh Edition
FUTURE OF HEALTH AND MEDICINE
• Increase the improvements
in U.S. Health.
• Individuals taking
responsibility of their own
health.
• Double standard of health
between rich and poor
people.
• Health problems are
greater in low-income
countries.
Sociology, Eleventh Edition