Transcript health-care system

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.