Health and Medicine

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Health and Medicine

• Health and Society
• Health A Global Survey
• Health in the United States
• The Medical Establishment
• Theoretical Analysis of Health and Medicine
• Looking Ahead Health and Medicine in the
  Twenty-First Century

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Health

• Health- is a state of complete physical, mental,
  and social well being.
• According to the World Health Organization (WHO)
• The major theme of this chapter
• Health is as much a social as a biological issue
  because well being and illness have their roots
  in the organization of society.

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Health and Society

• 1. Cultural patterns define health- Standards in
  health vary from society to society. Today in the
  U.S. the rich foods that people consume are
  responsible for almost two-thirds of adults being
  over weight.
• Health is sometimes a matter of having the same
  disease as ones neighbors.
• 2. What is considered healthy often is the same
  as what people define as morally good. Members
  of our society third a competitive way of life is
  healthy because it fits our cultural mores.
• Thus, ideas about good health amount to a form of
  social control that encourages conformity to
  cultural norms.

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• 3. Cultural standards of health have change over
  time. In the early twentieth century, some
  physicians warned women not to go to college
  because higher education strained the female
  brain. Others denounced masturbation as a danger
  to health. Today, on both counts, we know
  differently.
• 4. A societys technology affects peoples
  health. In poor countries infectious diseases
  are rampant because of malnutrition and poor
  sanitation. As industrialization raises living
  standards, people become healthier. But
  industrial technology also creates health
  hazards. High-income countries tax the worlds
  resources and create pollution.

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• 5. Social inequality affects peoples health.
  All societies distribute resources unequally.
  Therefore, some people are healthier than others.
  This pattern starts at birth, with infant
  mortality highest among the poor. Poor people
  also live fewer years than rich people.

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Health in History

• Many hunting and gathering people had fairly
  healthful diets, eating a range of vegetation
  and, when available lean meat.
• With the discovery of agriculture, food became
  more plentiful.
• Social inequality also increased and the wealthy
  had better health while the peasants and slaves
  lived in crowded, unsanitary shelters.
• In the growing cities of medieval Europe, human
  waste and other refuse piled up in the streets,
  spreading infectious diseases and plagues that
  periodically wiped out entire towns.

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Health in Low-Income Countries

• The WHO reports that 1 billion people around the
  worldone in sixsuffer from serious illness
  caused by poverty.
• In impoverished countries sanitary drinking water
  is as hard to come by as a balanced diet. Unsafe
  water is a major cause of the infectious diseases
  that imperil both adults and children.

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• Poverty breeds disease, which inturn undermines
  peoples ability to work. When medical
  technology curbs infectious disease, the
  populations of poor nations soar. Without
  resources to ensure the well being of the people
  they have now, poor societies cal ill afford
  large populations.
• Ultimately, programs to lower death rates in poor
  countries will succeed only if they are coupled
  with programs to reduce birth rates.

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Health in High-Income Countries

• Industrialization dramatically changed patterns
  of human health in Europe, although at first not
  for the better. By 1800, as the Industrial
  Revolution took hold, factories offered jobs that
  drew people from all over the countryside.

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• In 1854, for example, John Snow mapped the street
  addresses of Londons cholera victims and found
  they all drank contaminated water for the well in
  Golden Square. Not long after that scientists
  linked cholera to a specific bacterium and
  developed a vaccine against the deadly disease.
  Using scientific technology early
  environmentalists campaigned against age-old
  practices such as discharging raw sewage into
  rivers used for drinking water.
• By the early twentieth century, death rates from
  infectious diseases had fallen sharply.
• Now the leading cause of death in the U.S. is
  Heart disease and stroke.

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Who is Healthy?Age, Gender, Class and Race

• Social epidemiology- the study of how health and
  disease are distributed throughout a societys
  population.
• Women fare better in terms of health than men.
  They have a slight biological advantage that
  renders them less likely than men to die before
  or immediately after birth. Our culture also
  promotes masculinity and pressures men to be
  competitive, repress emotions, and take up
  hazardous behaviors such as the smoking of
  cigarettes and drinking alcohol to access.

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• Infant mortalitythe death rate among children
  under one year of ageis twice as high as poor
  children vs. children from wealthy families.
• Poverty among African Americans currently three
  times the rate of whites helps explain why black
  people are more likely to die in infancy and, as
  adults, are more likely to suffer the effects of
  violence, drug abuse, and poor health.
• About 20 of the U.S. populationmore than 50
  million peoplecannot afford a healthful diet or
  adequate medical care.

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Cigarette Smoking

• The popularity of cigarettes peaked in 1960, when
  almost 45 percent of U.S. adults smoked. By
  1999, only 24 percent of U.S. adults were still
  lighting up.

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• Some 430,000 men and women die prematurely each
  year as a direct result of cigarette smoking,
  which exceeds the combined death toll from
  alcohol, cocaine, heroin, homicide, suicide,
  automobile accidents and AIDS. Smokers also
  suffer from more minor illnesses such as the flu,
  and pregnant women who smoke increase the
  likelihood of spontaneous abortions, prenatal
  death, and low-birth weight babies. Even
  non-smokers who are exposed to cigarette smoke
  have a higher risk of smoking-related diseases.

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Eating Disorders

• An Eating disorder an intense from of dieting or
  other unhealthy method of weight control driven
  by the desire to be very thin.
• Research shows that most college-age women
  believe
• 1. guys like girls thin,
• 2. being thin is critical to physical
  attractiveness, and
• 3. they are not as thin as men would like.
• Our idealized image of beauty leads many young
  women to diet to the point of risking their
  health.

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Sexually Transmitted Diseases

• Sexual activity can transmit more than fifty
  kinds of infections, or venereal diseases.
  Because many people in our culture associate sex
  with sin, they regard venereal disease not only
  as illnesses but also as marks of immortality.
  During the sexual revolution of the 1960s
  infection rates rose as people began sex activity
  earlier and had a greater number of partners. As
  a result STDs are an exception to the decline of
  infectious diseases in the U.S. In the late
  1980s STDs especiallyAIDSgenerated a sexual
  counter-revolution that discouraged casual sex.

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Gonorrhea and Syphilis

• Gonorrhea and syphilis are caused by microscopic
  organisms that are almost always transmitted by
  sexual contact.
• About 360,000 cases of gonorrhea and 36,000 cases
  of syphilis were recorded in 1999.
• Gonorrhea and syphilis can be cured easily with
  antibiotics such as penicillin. Therefore
  neither disease is a major health problem in the
  U.S

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Genital Herpes

• Genital herpes is a virus that infects as many as
  45 million adults in the U.S. Herpes is
  incurable. People with genital herpes may
  exhibit no symptoms or they may experience
  periodic, painful blisters on the genitals
  accompanied by fever and headache.
• Although not fatal to adults, it can be deadly to
  newborns, and a woman with active genital herpes
  can transmit the disease during a vaginal
  delivery. Therefore women with herpes, usually
  give birth by Cesarean section.

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AIDS

• The most serious of all sexually transmitted
  diseases is acquired immune deficiency syndrome,
  or AIDS. Identified in 1981, it is incurable and
  almost always fatal.
• AIDS is caused by the human immunodeficiency
  virus (HIV), which attacks white blood cells, the
  core of the immune system. AIDS renders a person
  vulnerable to a wide range of other diseases that
  eventually cause death.

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Ethical Issues Surrounding Death

• The ability to prolong the lives of terminally
  ill people is forcing us to confront a number of
  ethical issues surrounding death and the rights
  of the dying.

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When Does Death Occur?

• Medical and legal experts in the U.S. now define
  death as an irreversible state involving no
  response to stimulation, no movement or
  breathing, no reflexes, and no indication of
  brain activity.

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Do People Have a Right to Die?

• Federal law requires hospitals, nursing homes,
  and other medical facilities to honor a patients
  desire if spelled out in a living will.

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What about Mercy Killing?

• Euthanasia- assisting in the death of a person
  suffering from an incurable disease. Euthanasia
  poses ab ethical dilemma, being at the same time
  an act of kindness and a form of killing
• The right to die is one of todays most difficult
  questions.

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• Supporters of active euthanasiaallowing a dying
  person to enlist the services of a physician to
  bring on a quick deathargue that there are
  circumstances that make death preferable to life.
  Critics counter that permitting active
  euthanasia invites abuse. They fear that
  patients will be pressured to end their lives in
  order to spare family members the burden of
  caring for them or the high cost of
  hospitalization.

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The Medical Establishment

• Medicine is the social institution that focuses
  on combating disease and promoting health.
• In agrarian societies, health practitioners,
  including herbalists and acupuncturists, play a
  central part in improving health.
• In industrial societies, medical care falls to
  specially trained and licensed healers, from
  anesthesiologists to X-ray technicians.

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The Rise of Scientific Medicine

• The American Medical Association (AMA) was
  founded in 1847 and symbolized the growing
  acceptance of a scientific medicine.

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Holistic Medicine

• Holistic Medicine- an approach to health care
  that emphasizes prevention of illness and takes
  into account a persons entire physical and
  social environment.
• 1. Patients are people
• Holistic practitioners extend the bounds of
  conventional medicine, taking an active role in
  combating poverty, environmental pollution, and
  other dangers to public health.

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• 2. Responsibility, not dependency
• Practitioners encourage health-promoting
  behavior. Holistic favors an active approach to
  health rather than a reactive approach to
  illness.
• 3. Personal treatment
• Holistic practitioners locations favor, as much
  as possible, a personal and relaxing environment
  such as a home.
• Holistic care does not oppose scientific medicine
  but shifts the emphasis from treating disease
  toward achieving the greatest well-being for
  everyone.