Transcript Age Stratification

Chapter 14
Health, Medicine,
Disability and Aging
Chapter Outline
• Health and Medicine
• Defining and Measuring Health
• Health and Politics: The United States in
Comparative Perspective
• Disability
• Aging
• Theories of Age Stratification
• Social Problems of Elderly people
The Black Death
• In 1346, rumors reached Europe of a plague
sweeping the East.
• The epidemic spread along trade routes to
China and Russia.
• Within 2 years, the Black Death, killed 1/3 of
Europe’s population.
• The plague still ranks as the most devastating
catastrophe in human history.
Sociological Issues of Health,
Medicine, and Disability
1. Health risks are always unevenly
distributed.
2. Health problems change over time.
3. Medical professions have gained
substantial control over health issues
and promoted their own approach to
well-being.
Leading Causes of Death,
United States, 1900
Cause
% of Deaths
1. Pneumonia/influenza
11.8
2. Tuberculosis
11.3
3. Diarrhea/other intestinal
8.3
4. Heart disease
8.0
5. Stroke
6.2
Leading Causes of Death,
United States, 1900
Cause
% of Deaths
6. Kidney disease
5.2
7. Accidents
4.2
8.Cancer
3.7
9. Senility
2.9
10. Bronchitis
2.3
Leading Causes of Death,
United States, 2001
Cause
% of Deaths
1. Heart disease
28.9
2. Cancer
22.9
3. Stroke
6.8
4. Chronic lung disease
5.1
5. Accidents
4.0
Leading Causes of Death,
United States, 2001
Cause
% of Deaths
6. Diabetes
2.9
7. Pneumonia/influenza
2.6
8. Alzheimer disease
2.2
9. Kidney disease
1.6
10. Blood poisoning
1.3
Leading Causes of Death,
United States, 2001
Cause
% of Deaths
11. Suicide
1.2
12. Liver diseases
1.1
13. Homicide
0.8
14. High blood pressure
0.8
15. Lung inflammation
0.7
Life Expectancy,
Selected Countries
Life Expectancy
• Maximum average human life span average age of death for an entire
population under ideal conditions.
• Life expectancy - average number of
years a person can actually expect to
live.
Social Causes of Illness and
Death
• Human-environmental factors Cancer causing pollutants in the air and
water.
• Lifestyle factors - cigarettes, alcohol,
drugs, diet, social isolation
• Public health and health-care
systems - access to clean water, basic
sewage, immunizations
Number of People with HIV/AIDS,
12/31/02
Health Indicators 1999–2002
Physicians/
100K pop.
Nurses/
100K pop.
% Children
immunized
against
measles
United
States
Japan
279
193.2
229.1
6.9
972
744.9
897.1
113.1
92
94
96
90
Canada Zambia
Reasons for Health Inequity
• The poor are more likely to be exposed
to violence, high-risk behavior and
environmental hazards.
• The poor cannot afford adequate health
care.
Leading Causes of Death:
Ratios, 2000
Female:
Male
African American:
White
Heart disease
1.02
0.90
Cancer
0.90
0.94
Stroke
1.53
0.96
Lung disease
1.00
0.50
Accidents
0.52
1.08
Polling Question
•
Do you currently smoke cigarettes?
A. Yes
B. No
Gender Inequalities in
Health Care
• More research has focused on “men’s
diseases” (cardiac arrest) than on
“women’s diseases” (breast cancer).
• Women undergo fewer kidney
transplants, various cardiac procedures,
and other treatments than men.
Gender Inequalities in
Health Care
• Women live longer than men and experience
greater lifetime risk of functional disability and
chronic illness and have a greater need for
long-term care.
• There are 40% more poor women than poor
men in the United States.
Prescription Drug Costs in 8 Rich
Countries, 2002
Problems with HMOs
1. Some HMO’s avoid covering sick
people and people who are likely to
get sick to keep costs down.
2. Minimize the cost of treating sick
people they can’t avoid covering.
3. Inflate diagnoses to maximize
reimbursements.
4. Keep overhead charges high.
Administrative Costs as %
of Health-Care Spending
“HMOs Improve the Quality of
Care,” 1998
Recent Challenges to
Traditional Medical Science
• Patient Activism
• Alternative Medicine - chiropractic
therapy, acupuncture, massage therapy,
and various relaxation techniques
• Holistic Medicine - emphasizes disease
prevention
Social Construction of
Disability
• 400 years ago - Catholic Church
declared left-handed people servants of
the Devil and burned them at the stake.
• 19th century - Western scientists and
reformers sought rehabilitation of the
disabled.
Social Construction of
Disability
• 1933 - Nazis engineered the sterilization and
killing of the mentally “deficient” and the
physically “deviant,” including the blind and
the deaf.
• 1920s to 1970s - In America Native American
women were subjected to federally funded
forced sterilization.
Ablism
• Prejudice and discrimination against disabled
people.
– Historical example: Belief among 19thcentury Western educators that blind
people were incapable of high-level or
abstract thought.
• Ablism involves the largely unintended
neglect of the conditions of disabled people.
Age Stratification
• Sociologists call a category of people
born in the same range of years an age
cohort.
• Age stratification refers to social
inequality between age cohorts.
• Gerontocracies were societies in which
elderly men ruled.
Child Poverty by Race and
Ethnicity
Median Income and Percent
Poor
Age Stratification:
Functionalist Theory
• Age stratification reflects the importance of
each age cohort’s contribution to society.
– In preindustrial societies, the elderly were
important for knowledge and wisdom.
– With industrialization, function of the
elderly became less important and their
status declined.
Age Stratification:
Conflict Theory
• Age stratification stems from
competition and conflict.
• Young people may participate in a
revolutionary overthrow and seize
power.
• The elderly may organize politically to
decrease disadvantages and increase
advantages in life.
Age Stratification:
Symbolic Interactionist
• Focus on the meanings people attach to agebased groups and age stratification.
• One study examined movies from 1940-1980.
– Young people were portrayed as leading
active, vital lives.
– Elderly women were portrayed as
unattractive, unfriendly, and unintelligent.
Elderly as % of U.S.
Population, 1900–2050
Polling Question
•
The government should pay for all
prescription medication for the elderly in our
society.
A. Strongly agree
B. Agree somewhat
C. Unsure
D. Disagree somewhat
E. Strongly disagree
A Shortage of Caregivers
• In 2001, home-care agencies and
nursing homes employed 2.1 million
caregivers in the United States.
• The U.S. Bureau of Labor Statistics
expects a 58% rise in demand for such
workers between 1998 and 2008.
A Shortage of Caregivers
• Workers are hard to find and hard to keep:
– The work is difficult and pays little.
– Government requires 2 weeks of
preemployment training for direct-care
aides but Congress’s 1996 welfare reform
discourages such training for former
welfare recipients.
Ageism
• Ageism is prejudice and discrimination
based on age.
• Examples:
– Elderly men are stereotyped as
“grumpy” and elderly women as
“haggard”.
Euthanasia
• Involves a doctor prescribing or
administering medication or treatment
that intended to end a terminally ill
patient’s life.
• Public opinion polls show about 2/3 of
Americans favor physician-assisted
euthanasia.
Euthanasia
• Between 33% and 60% of American doctors
say they would be willing to perform
euthanasia if it were legal.
• Nearly 30% of American doctors have
received a euthanasia request, but only 6%
say they complied.
Elderly and Poverty
• Among the elderly, poverty is most
common for:
– those 85 and older
– Women
– African Americans
– people living alone
– people living in rural areas.
People Who Died under Oregon’s
Death with Dignity Act
Average Age
Race
White
Asian
Other
Sex
Male
Female
Physician-Assisted
Suicide
Other
Deaths
69
97
3
0
55
45
74
97
1
2
50
50
People Who Died under Oregon’s
Death with Dignity Act
Physician-Assisted
Suicide
Other
Deaths
Married
47
49
Widowed
22
33
Divorced
25
14
Never Married
6
4
Marital Status
Quick Quiz
1. Life expectancy is:
a. the average age at death of the
members of a population
b. the maximum human life span
c. the maximum average human life
span
d. the mortality rate
e. the fertility rate
Answer: a
• Life expectancy is the average age at
death of the members of a
population.
2. Which of the following is not a major social
cause of illness and death?
a. human-environmental factors
b. lifestyle factors
c. factors related to the public health system
d. factors related to the health care system
e. none of these choices (that is, all the
factors listed above are major social
causes of illness and death)
Answer : e
•
All the factors listed below are major social
causes of illness and death:
– human-environmental factors
– lifestyle factors
– factors related to the public health
system
– factors related to the health care
system
3. What strategies do health maintenance
organizations (HMOs) use to maximize
profits?
a. They avoid covering sick people and
people who are likely to get sick.
b. Their doctor-compensation formulas
reward doctors for withholding treatments
that are unprofitable.
c. They keep overhead charges high.
d. All of these choices.
Answer: d
•
Health maintenance organizations (HMOs)
use the following strategies to maximize
profits:
– They avoid covering sick people and
people who are likely to get sick.
– Their doctor-compensation formulas
reward doctors for withholding
treatments that are unprofitable.
– They keep overhead charges high.
4. Disabled people are incapable of
performing within the range of
"normal" human activity.
a. True
b. False
Answer : a
• Disabled people are incapable of
performing within the range of
"normal" human activity.
5. Ablism involves:
a. curing disabilities to the extent possible
through medical and technological
intervention
b. prejudice and discrimination against
disabled people
c. the largely unintended neglect of the
conditions of disabled people
d. prejudice and discrimination against
disabled people, and the largely
unintended neglect of the conditions of
disabled people
Answer: d
• Ablism involves prejudice and
discrimination against disabled
people, and the largely unintended
neglect of the conditions of disabled
people.
6. Which of the following theories explains
age stratification in terms of
competition for power and wealth
between age cohorts?
a. functionalist theory
b. conflict theory
c. symbolic interactionism
d. essentialist theory
e. postmodern theory
Answer: b
• Conflict theory explains age
stratification in terms of competition for
power and wealth between age cohorts.
7. _________________ is prejudice and
discrimination against elderly people.
Answer: ageism
•
Ageism is prejudice and
discrimination against elderly people.
8. _________________ involves a
doctor prescribing or administering
medication or treatment that is intended
to end a terminally ill patient's life.
Answer: euthanasia
• Euthanasia involves a doctor
prescribing or administering medication
or treatment that is intended to end a
terminally ill patient's life.