Transcript Chapter 13
Health, Medicine, Disability and Aging Chapter Outline Health Medicine Disability Aging Death and Dying 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. Life Expectancy The average age at death of the members of a population. Life expectancy in the United States was 47 years in 1900. In 2009, it was 78 years. The maximum average human life span is the average age of death for a population under ideal conditions. It is currently about 85 years. Leading Causes of Death INSERT TABLE 13.1 HERE (PG. 309) Polling Question Do you currently smoke cigarettes? a. b. Yes No Life Expectancy, Selected Countries INSERT FIGURE 13.1 HERE (PG. 310) 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 Public Health System The public health system is composed of government run programs that ensure access to clean drinking water, basic sewage and sanitation services, and inoculation against infectious diseases. The health-care system is composed of a nation’s clinics, hospitals, and other facilities for ensuring health and treating illness. Global Inequities AIDS is the leading cause of death in the poverty- stricken sub-Saharan Africa Global inequality influences people’s exposure to different health risks People with HIV/AIDS, 2009 INSERT FIGURE 13.2 HERE (PG. 311) Infant Mortality The number of deaths before the age of 1 year for every 1000 lives births in a population in 1 year. Health Indicators, Selected Countries, 2009 INSERT TABLE 13.2 HERE (PG. 312) 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. Racial and Ethnic Inequalities in Health Care Racism also affects health Health status of some African Americans is somewhat lower than European Americans even within the same income category African Americans at all income levels tend to live in racially segregated neighborhoods with fewer health facilities Experience of racism induces psychological distress Gender Inequalities in Health Care Gender bias exists in: Medical research: More research has focused on “men’s diseases” (cardiac arrest) than “women’s diseases” (breast cancer). Medial treatment: Women undergo fewer kidney transplants, cardiac procedures, and other treatments. Gender Inequalities in Health Care Women live longer and thus have greater lifetime risk of disability and chronic illness; yet more is spent on men’s health than women’s health 40% more poor women than poor men and poverty is related to health Health and Politics: Conflict and Functionalist Perspectives We spend more on health care than any other country but all other postindustrial societies have healthier populations A high level of social inequality Nature of American health care system where some are privileged (wealthy) and others are disadvantaged (poor) 4 Problems with HMOs: Strategies to Pursue Profit 1. 2. 3. 4. Avoid covering sick people and people who are likely to get sick. Minimize the cost of treating sick people they can’t avoid covering. Inflate diagnoses to maximize reimbursements. Keep overhead charges high. Advantages of Private and ForProfit Health Care They are so profitable, they can invest large sums of money into research and development, latest diagnostic equipment, higher salaries to attract best medical researchers on planet Main supporters of current system are the stockholders Medicine A social institution devoted to prolonging life by fighting disease and promoting health. Society shapes medical practice every bit as much as it influences health processes. The Professionalization of Medicine Professionalization, is the process by which people gain control and authority over their occupation and their clients. It results in professionals enjoying high occupational prestige and income and considerable social and political power The Sick Role Playing the sick role, according to Talcott Parsons, involves the nondeliberate suspension of routine responsibilities, wanting to be well, seeking competent help, and cooperating with health-care practitioners at all times. Alternative Medicine The most frequently used types of alternative medicine are chiropractic, acupuncture, massage therapy, and various relaxation techniques. Alternative medicine is used mostly to treat back problems, chronic headache, arthritis, chronic pain, insomnia, depression, and anxiety. Placebo Effect The positive influence on healing of strong belief in the effectiveness of a cure. Research shows that strong belief in the effectiveness of a cure can by itself improve the condition of about a third of people suffering from chronic pain or fatigue. Holistic Medicine Holistic medicine emphasizes disease prevention. Holistic practitioners treat disease by taking into account the relationship between mind and body and between the individual and his or her social and physical environment. Social Construction of Disability Impaired people are considered deficient in physical or mental capacity. Disabled people are incapable of performing within the range of “normal” human activity. Rehabilitation Rehabilitation involves: Curing disabilities to the extent possible through medical and technological intervention. Trying to improve the lives of the disabled by means of care, training, and education. Integrating the disabled into “normal” society. Ablism Prejudice and discrimination against disabled people. Historical example: Belief among 19th-century 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. Challenging Prejudice and Discrimination Idea of the normality of disability has partly supplanted the rehabilitation ideal Rather than regarding themselves as deviant, they think of themselves as inhabiting a different but quite normal world Age Stratification Age stratification refers to social inequality between age cohorts. The very young are often at the bottom of the stratification system. Facing poverty and famine, parents sometimes abandoned children. Many developing countries are overflowing with orphans and street children. Gerontocracy A gerontocracy is a society ruled by elderly people. In South Korean corporations when a new manager starts work, everyone in the department who is older than the new manager may resign or be reassigned. In the United States, median income gradually rises with age, reaching its peak in the 45–54 age cohort. 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 age-based 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 Aging and Poverty The “old old” are most likely to suffer physiological decline, life-threatening diseases, social isolation, and poverty. Economic inequality between elderly women and men is the result of women’s lower wages when they are young. The elderly most likely to be poor include the “old old” , women, African Americans and people in rural areas. 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. Ageism Ageism is prejudice and discrimination based on age. Examples: Elderly men are stereotyped as “grumpy” and elderly women as “haggard”. Polling Question I don't value older people in our society as much as younger people. a. b. c. d. e. Strongly agree Agree somewhat Unsure Disagree somewhat Strongly disagree Death and Dying In traditional societies most people accepted death. Most people believed in life after death. The dying were not isolated. Because the dying had experience giving emotional support to other dying people, they accepted death as part of life. 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. The Business of Dying Funerals were a $20-billion-a-year industry in 1999. The average undertaker’s bill in the late 1990s was $4,700. Adding expenses such as flowers and cemetery charges, the average funeral and burial bill grew to $7,800. Why Are Funerals Expensive? 1. Big corporations have supplanted small family operations in the funeral industry. • Concentration of ownership lowers competition and results in higher prices. 2. People are vulnerable when their loved ones die, and much of the funeral industry takes advantage of their vulnerability. 1. Life expectancy is: a. b. c. d. the average age at death of the members of a population the maximum human life span the maximum average human life span the mortality rate Answer: a Life expectancy is the average age at death of the members of a population. 2. When sociologists measure the health of a population, they typically examine: a. b. c. d. rates of illness rates of death rates of physical fitness a. and b. only Answer: d When sociologists measure the health of a population, they typically examine rates of illness and rates of death. 3. The effect of social forces on life expectancy is given by: a. b. c. d. the maximum human life span the average age at death of the members of a population the difference between the maximum average human life span and life expectancy all of the above Answer: c The effect of social forces on life expectancy is given by the difference between the maximum average human life span and life expectancy. 4. Which of the following is not a source of gender inequality in health status in the U.S.? a. b. c. d. gender bias in medical research gender bias in medical treatment women’s greater lifetime risk of functional disability and chronic illness due to the fact that women live longer than men all of these are a source of gender inequality in health status in the U.S. Answer: d All of the following are a source of gender inequality in health status in the U.S.: gender bias in medical research gender bias in medical treatment women’s greater lifetime risk of functional disability and chronic illness due to the fact that women live longer than men 5. Poor people in the U.S. are less healthy than rich people because they are more likely: a. b. c. d. to do physical labor in which accidents are common to be exposed to violence to be exposed to environmental hazards all of these choices Answer: d Poor people in the U.S. are less healthy than rich people because they are more likely to do physical labor in which accidents are common, to be exposed to violence and to be exposed to environmental hazards. 6. The leading cause of death in sub-Saharan Africa is: a. b. c. d. AIDS SARS cancer heart disease Answer: a The leading cause of death in sub-Saharan Africa is AIDS. 7. The main supporters of the current United States health-care system are: a. b. c. d. the stockholders of private health-insurance companies physicians and other health professionals a majority of Americans, according to recent surveys a. and b. only Answer: d The main supporters of the current United States health- care system are the stockholders of private healthinsurance companies and physicians and other health professionals. 8. Ablism involves: a. b. c. d. curing disabilities to the extent possible through medical and technological intervention prejudice and discrimination against disabled people the largely unintended neglect of the conditions of disabled people b. and c. only Answer: d Ablism involves prejudice and discrimination against disabled people and the largely unintended neglect of the conditions of disabled people. 9. Disabled people are incapable of performing within the range of "normal" human activity. a. b. True False Answer: a Disabled people are incapable of performing within the range of "normal" human activity. 9. Which of the following theories explains age stratification in terms of competition for power and wealth between age cohorts? a. b. c. d. e. functionalist theory conflict theory symbolic interactionism essentialist theory postmodern theory Answer: b Conflict theory explains age stratification in terms of competition for power and wealth between age cohorts. 10. Economic inequality between elderly women and men is largely the result of: a. b. c. d. women’s lower earning power when they are young social isolation general physiological decline all of these choices Answer: a Economic inequality between elderly women and men is largely the result of women’s lower earning power when they are young. 11. Which of the following theories explains age stratification in terms of the distinct functions that industrialization created for different age cohorts? a. b. c. d. functionalist theory conflict theory symbolic interactionism essentialist theory Answer: a Functionalist theory explains age stratification in terms of the distinct functions that industrialization created for different age cohorts.