Social Problems

1
Social Problems

• Health, Illness and Health Care

2
What is health?

• a state of complete physical, mental, and social
  well-being (WHO)
• a state of social, mental, emotional, and
  physical well-being that is influenced by a broad
  range of factors, including biology and genetics,
  personal health practices and coping skills, the
  social and physical environments, gender,
  socio-economic factors such as income and
  education, and cultural practices and norms
  (Health Canada)

3
Measures of health and illness

• Life expectancy globally has gone from 45 years
  (1950s) to 65 years (2005)
• Global disparities
• Japan 82 years vs. Botswana 37 years
• Canada women 82 years, men 77 years
• Mortality rates
• Maternal mortality (linked to poverty)
• Infant mortality and under-5 mortality highest in
  develping world
• Morbidity Rate extent of disease measured by
  incidence and prevalence

4
Threats to health according to text

• AIDS and HIV
• SARS and other pandemics
• Infectious diseases like malaria
• Mental illness, substance abuse and suicide
• Obesity

5
Top ten global risks to health according to WHO
(2002)

• Being underweight and malnutrition
• Unsafe sex
• High blood pressure
• Tobacco consumption
• Alcohol consumption
• Unsafe water, sanitation and hygiene
• Iron deficiency
• Indoor smoke form solid fuels
• High cholesterol
• Obesity

6
Health problems of high vs. low income nations

• In 2002, 60 of child deaths in low income
  countries due to being underweight (approx. 3
  million/year)
• Sanitation, water and hygiene also major issues
• In high income countries, major problems are high
  cholesterol, high blood pressure and obesity
• But distinction is blurring i.e. changing
  consumption patterns in low income nations are
  leading to Western problems like high
  cholesterol, heart disease for undernourished
  populations due to fatty, sugary or salty foods

7
HIV/AIDS

• 2005 40.3 million globally HIV positive (25.8
  million in Sub-Saharan Africa (current) vs.
  60,000 since 1985 in Canada)
• AIDS 25 million deaths since 1981
• Leading cause of death 15-59 worldwide
• In U.S. more than 1 million living with AIDS/HIV
  currently and .5 million have died since 1985
• 73 of all new cases are male and 49 are African
  American
• New treatments (i.e. Highly Active Antiretroviral
  Therapy) can control progression of HIV but is
  costly
• AIDS itself is fatal and necessitates lengthy
  hospital or hospice stays

8
Mental illness as a social problem

• In Canada, 1 in 5 will experience mental illness
  at some point in their lives
• Includes depression, anxiety disorder, mood
  disorders
• In U.S. rate is 1 in 4
• Often starts in childhood or adolescence
• Many suffer more than one form of illness
  co-morbidity)
• Serious illness (schizophrenia, bipolar mood
  disorder, major depression) affects up to 6

9
Mental illness (cont.)

• In past institutionalization was common but now
  focus is on medication and therapy
• Deinstitutionalization has become a problem
• Schizophrenia and other serious illnesses can
  lead to prison or homelessness (one 1988 U.S.
  study showed 30 of homeless were previous
  patients and 80 have serious disorder)
• But, how real is some mental illness?
• Read Thomas Szasz The Myth of Mental Illness
  (1960)

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Socio-demographic factors

• Race/ethnicity factors primarily due to the
  stresses of racism (i.e. Feagin Sikes, 1994)
• Class higher among lower class (Williams et al.
  1992, Weitz, 2007) but disagreement over whether
  causes or is caused by mental illness
• Social stress framework stress related to lower
  class life leads to more mental disorders
• Social drift framework mental disorders cause
  downward drift in social class
• Gender depression higher (2x) for women, but
  personality disorders greater for men
• Difference linked to differential gender
  socialization

11
Health Care

• Canada spends approx. 10 of GDP on health care,
  similar to other OECD countries
• We spend much less than U.S.
• 3003/person vs. 5635/person
• But despite higher spending/person in U.S.,
  Canada has higher life expectancy and lower
  infant mortality
• Funded through combination of taxes and premiums
• Medicare operates according to 5 basic
  principles universality, comprehensiveness,
  portability, accessibility, and public
  administration (not for profit)
• See Canadas Health Care System (2005)

12
Health Care Problems

• Costs are increasing
• Long wait times
• Unmet needs (about 1.5 million Canadians in
  1998-9)
• Shortages of doctors, nurses and other health
  care professionals esp. in rural areas
• For many, dental and prescription meds not
  covered
• Also, other services like vision care,
  physiotherapy, psychological counseling,
  long-term home care etc. not covered
• Lack of coverage in minor areas leads to
  greater long term problems

13
Health Care in other OECD countries

• Most are struggling with health care funding
• Britain going through 10 year overhaul of health
  care system because of lack of access and long
  wait times and personnel shortages
• Sweden most doctors are salaried public
  employees but great discrepancies in workloads
• U.S. 15 of population not covered
• Inequality 7.2 of those with income of 75000
  vs. 27.6 with income of 25000 or less

14
Structural Functionalist perspective

• Illness is a threat to a smoothly functioning
  society
• Prevents members from fulfilling social roles
• Parsons sick role
• Sick people not responsible for being
  incapacitated
• Exempt from usual obligations
• Must want to get better
• Should seek help from and obey professional
• But, problem of chronic illness today

15
Conflict perspective

• Economic and social inequality in health status
  within nations and globally
• Health care delivery rooted in the capitalist
  system, produced and sold by the
  medical-industrial complex
• Physicians, hospitals and pharmaceuticals have a
  monopoly over expertise, access and medication

16
Symbolic Interactionist perspective

• Health and illness are social constructions
• Social-cultural factors influence how people
  define and experience physical and mental health
• Menopause (the change) is one example of how a
  natural biological process has been medicalized
  and constructed as a physical disorder in N.
  American society
• Autism may be another

17
Social Construction of Autism

• Today, some are asking the question, Is autism a
  disorder, or just a neurological difference?
• The video below indicates that the disorder
  could just be a social construction a
  difference that has been medicalized (and listed
  in the DSM IV as a mental disorder )and
  stigmatized.
• CBC Report on Autism
• http//www.cbc.ca/news/background/autism/
• Watch Positively Autistic (CBC, March 17, 2009)

18
See also

• Amanda Baggs In My Language in which she looks
  at societys treatment of autistic people as an
  issue in social justice.
• Only when the many shapes of personhood are
  recognized will justice and human rights be
  possible. (A. M. Baggs, 2007)