Transcript You May Ask Yourself

You May
Ask Yourself
An Introduction to Thinking Like a Sociologist
Dalton Conley
SECOND EDITION
Chapter 11
Health and Society
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The Rise (and Fall?) of the
Medical Profession
 Doctors have a great amount of
social power, political power, and
prestige for a variety of reasons:
 They offer a universally valued
product—health and longevity.
 There is a limited number of
doctors due to the extensive
education and training and the
strict regulation of the
profession.
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The Rise (and Fall?) of the
Medical Profession
 Doctors are very concerned with
their standing among their peers.
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 People trust doctors with very personal
information and expect individualized
treatment; and doctors use specific
props and scripts to assert their
power.
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What Does It Mean to Be
Sick?
 Talcott Parsons
 He developed the concept of the
sick role, which assigns a sick
person rights and obligations.
 However, this conception is very
individualistic and does not take
into account how social
conditions can affect a person’s
health.
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What Does It Mean to Be
Sick?
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 Like many other seemingly universal
or stable concepts, illness is a
social construct: what it means to
be sick (or healthy) has changed
throughout history and differs from
one place to another.
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The U.S. Health-Care
System
 Unlike many other industrialized
nations, the United States does not
offer universal health care. The four
main types of health-care coverage in
the United States are:
 fee-for-service
 health maintenance organizations
(HMOs)
 Medicare
 Medicaid
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The U.S. Health-Care
System
 Technological advances in medicine
have allowed for:
 the detection of diseases, genetic
anomalies in fetuses which raise
difficult ethical questions and
have major social implications.
 multiple births (often due to
assisted reproductive technology)
and premature births, which present
further medical and ethical
dilemmas.
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Discrepancies in
Health Care
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 There are numerous health
discrepancies between races in the
United States, with whites having
the best outcomes overall. The
starkest differences can be found
between whites and blacks.
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Discrepancies in
Health Care
 While some of the discrepancy is due
to differences in socioeconomic
status, there are still significant
differences between whites and
blacks with the same income and
education level, which implies that
racism plays a role in people’s
overall health.
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Discrepancies in
Health Care
 There are three main theories that
attempt to explain why people with
higher socioeconomic status have
better health:
 selection theory
 drift explanation
 social determinants theory
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Discrepancies in
Health Care
 Selection theory - the
connection between low income
and poorer health – has
mediating factors. For instance,
other factors, like genetics,
might affect both socioeconomic
status and health.
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Discrepancies in
Health Care
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 The drift explanation states
that there is a connection
between income and health. If
you have poor health, you might
be less likely to find gainful
employment.
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Discrepancies in
Health Care
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 Social determinants theory
states that social status can
determine a person’s health.
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Discrepancies in
Health Care
 Married people tend to live longer, but
it is not clear whether marriage actually
benefits a person’s health or if
healthier people tend to get married.
 Women live longer than men, which can be
attributed in part to the types of
illnesses each sex is more susceptible to
as well as to how willing each sex is to
seek medical care.
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Discrepancies in
Health Care
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 Large families and children born
close together are both associated
with higher child mortality rates,
due to greater demands on parents’
financial and emotional resources.
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The Sociology of Mental
Health
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 The Diagnostic and Statistical Manual
(DSM) provides a standard categorization
of mental disorders and their definitions.
 Changes in this manual, particularly
from its second to third editions, have
strongly influenced how mental illness
is understood and treated.
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The Sociology of Mental
Health
 There has been a significant increase in
the use of pharmaceuticals to treat mental
illness. Some negative aspects of this
change include:
 devaluation of the benefits of talk
therapy
 overprescribing or mis-prescribing of
pharmaceuticals
 stigma attached to taking medication for
mental illness
 increasing power of pharmaceutical
companies. which have benefited from the
growth of the diagnostic approach
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Global Health
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 Health disparities between groups within
the United States are dwarfed by the
disparities that exist between the
United States and developing countries.
 Many developing countries
are still struggling to
provide their citizens
with safe drinking water,
sanitation, and basic
health care.
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Global Inequality
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Interview, Jeffrey Sachs
Jeffrey Sachs compares economic
development in India and China.
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Concept Quiz
1. Being made to wait anywhere from
a few minutes to over an hour in
order to see a doctor is evidence of
the ________.
a)
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b)
c)
d)
individualized objectivity demonstrated
by doctors
scarcity of doctors in the United
States
power and prestige of doctors in our
society
problem of supplier-induced demand
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Concept Quiz
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2. Supplier-induced demand in the
health-care industry refers to
_______.
a) doctors creating excess demand for their
services
b) the scarcity of the supply of doctors in
the United States relative to the number
of patients
c) health insurance companies creating
excess demand for doctors’ services
d) patients demanding medical diagnoses and
treatments for a wider range of health
problems
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Concept Quiz
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3. Traditionally, doctors have had
the power to ________.
a)
b)
c)
d)
prescribe medications
set their pay rates
regulate themselves
all of the above
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Concept Quiz
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4.
Dynamic psychiatry focuses on
__________.
a)
identifying the internal conflicts that
produce a mental illness
b)
identifying thoughts, beliefs, and
behaviors that are accompanied by
debilitating negative emotions and trying
to stop or alter those thought patterns or
behaviors
c)
identifying the symptoms of specific
underlying illnesses
d)
none of the above
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Concept Quiz
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5.
Why has there been a rise in the use of
pharmaceutical treatments for mental
illness?
a) Pharmaceutical companies put pressure on the
medical profession to try drug therapies with
their patients.
b) As mental illness has increasingly been linked
with biomedical causes, drug therapies are often
seen as the best treatment option.
c) Insurance companies are often more willing to
reimburse patients for drug therapies than for
many sessions of talk therapy with a counselor or
psychologist.
d) all of the above
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Concept Quiz
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6.
What factors, besides access to
drug therapies, are key to fighting
diseases in developing countries?
a)
b)
c)
d)
moving people from rural to urban areas
proper nutrition and clean water
population control
all of the above
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Discussion Questions
1. Do you currently have health insurance?
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a) yes
b) no
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Discussion Questions
2. Do you think the United States should
adopt a universal health care system?
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a) yes
b) no
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Michael Rich, a doctor with Partners in Health, treats a
tuberculosis patient in Haiti.
You May Ask Yourself, 2nd Edition
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Greek physician Hippocrates (c. 460–377 BCE).
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Actor Hugh Laurie as television physician Gregory House.
Doctors are valued for their objectivity and technical knowledge.You May Ask Yourself, 2nd Edition
What other qualities do patients want in their doctors?
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Actor Jason Alexander as George Costanza.
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Ancient Roman surgical tools. Why did doctors have little
prestige in ancient Rome?
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An 1880s advertisement for a homeopathic cure.
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Alternative medical treatments such as acupuncture have
become increasingly professionalized.
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You May Ask Yourself, 2nd Edition
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A pharmacist explains Medicare insurance options. Why do
some poor and elderly patients decide not to take advantage of
programs such as Medicaid and Medicare?
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Pieter Gijselaar is seven feet tall. In the last 150 years the
Dutch have become the tallest people on earth, and experts
say they are still growing.
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Indian visitors to a New Delhi hospital stand next to a poster
that reads, “Save the girl child, finding out the gender of a fetus
is a sin.” Because of rampant selective abortions, India has
only 927 females for every 1,000 males—far lower than the
You May Ask Yourself, 2nd Edition
worldwide average of 1,050 females.
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Figure 11.1 U.S. Rate of Multiple Births by Mother’s Age
(per 100,000 live births)
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Figure 11.2 U.S. Infant Mortality Rate, 2005
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Figure 11.3 Brain and Lung Cancer Statistics
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Figure 11.4 U.S. Life Expectancy by Gender, 1900–2007
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Figure 11.5 U.S. Life Expectancy by Race, 2007
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A poor farm family in Musala, Kenya. How do family size
and structure affect life outcomes?
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Virginia Tech students mourn after the campus shooting
in April 2007. The vigils helped the community to cope with
depression and anxiety after the murders.
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Kathryn Orrick plays and teaches classical piano, something she
couldn’t do until antidepressant medications helped her out of
depression. While she agrees the medicines should be closely
monitored, especially with new patients, she credits her
You May Ask Yourself, 2nd Edition
treatment for allowing her to live a full life.
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Figure 11.6 Average Life Expectancy Worldwide
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A Panama Canal worker sprays insecticide in an effort to
control the spread of yellow fever and malaria.
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To see more of the conversation with Jeffrey Sachs, please go to
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wwnorton.com/studyspace.
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Figure 11.7 Causes of Death in Children under Five, 2000–2003Copyright © 2011 W.W. Norton & Company
Figure 11.8 Population Living with HIV, 2008
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A medical worker in Beijing, China, disinfects a railway waiting You May Ask Yourself, 2nd Edition
room as part of prevention measures in the fight against SARS.Copyright © 2011 W.W. Norton & Company
You May Ask Yourself, 2nd Edition
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This concludes the Lecture
PowerPoint Presentation for
Chapter 11: Health and Society
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