Health and Medicine

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Health and Medicine
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Health

• A state of complete physical, mental, and social
  well-being (World Health Organization)
• Health is as much a social as a biological issue
  for sociologists
• Illness have their roots in the organization of
  society

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Society Shapes the Health of Peoplein 5 Major
Ways

1. Cultural patterns define health
2. What is considered healthy is what people hold
   to be morally good
3. Cultural standards of health change over time
4. A societys technology affects peoples health
5. Social inequality relates to health

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Health a Global Survey

• Health in history
• Industrialization changed the patterns of health,
  medical care
• Health in low-income countries
• One billion people (globally) have serious
  illness due to severe poverty
• Poor sanitation, malnutrition and minimal medical
  care
• Health in high-income countries
• Infectious disease is less of a threat,
  concentrate on chronic illnesses

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Global Map 21-1 The Availability of Physicians
in Global Perspective
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Leading Causes of Death U.S.A.

• 1900
• Influenza and pneumonia
• Tuberculosis
• Stomach/intestinal diseases
• Heart disease
• Cerebral hemorrhage
• Kidney disease
• Accidents
• Cancer
• Disease of infancy
• Diphtheria

• 2000
• Heart disease
• Cancer
• Stroke
• Lung disease (non-cancerous)
• Accidents
• Diabetes
• Pneumonia and influenza
• Alzheimers disease
• Kidney disease
• Blood disease

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Who Is Healthy?

• Social epidemiology how health and disease are
  distributed throughout a societys population
• Factors include
• Age
• Gender
• Social class
• Race

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National Map 21-1 Quality of Health across the
United States
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Age Gender

• Death is now rare among young people
• Accidents and aids are two exceptions
• Across the life course, women fare better than
  men
• Men have higher death rates for accidents,
  suicide and violence
• Our cultural conception of masculinity pressures
  men
• Coronary prone behavior

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Class and Race

• Infant mortality rates are twice as high for poor
  as for wealthy
• The poorest in America can die from diseases that
  strike children in countries like the Vietnam and
  Lebanon
• African Americans are three times more likely to
  be poor compared to whites
• Poverty condemns people to live in crowed
  unsanitary conditions that breed infectious
  disease
• Life expectance for white children born in 2000
  is six years greater than for African Americans
• Poverty also breeds stress and violence
• In 1999, 2,674 African American males were killed
  by others of their own race

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Cigarette Smoking

• Most preventable hazard to health
• By 1999, 24 of Americans smoke
• Generally speaking divorced, separated,
  unemployed, in the military less schooling a
  person has tend to be smokers
• 430,000 men women die prematurely each year as
  a direct result of smoking
• That number exceeds the combined death toll from
  alcohol, cocaine, heroin, homicide, suicide, auto
  accidents aids

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Eating Disorders

• An intense form of dieting or other unhealthy
  methods of weight control driven by the desire to
  be very thin
• 95 of those suffering from anorexia and bulimia
  are women, white and affluent
• The beauty myth tells women to exaggerate the
  importance of physical attractiveness to the
  point of risking their health
• Pressures come from society, parents, the media,
  as well as women themselves

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Sexually Transmitted Diseases

• Sexual revolution of the 1960s saw a rise in
  std rates Generated a sexual counter-revolution
• Gonorrhea syphilis
• Easily treated with antibiotics
• Genital herpes
• Treatable but incurable
• Aids acquired immune deficiency syndrome
• Caused by human immunodeficiency virus HIV
• Incurable, almost always fatal
• Specific behaviors increase risk anal sex,
  sharing needles and drug use

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Figure 21-1 Life Expectancy for U.S. Children
Born in 2000
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Ethics Death

• When is a person dead?
• When an irreversible state involving no response
  to stimulation, no movement or breathing, no
  reflexes, and no indication of brain activity
• Do people have the right to die?
• 10,000 people in the u.S.A. Are in a permanent
  vegetative state
• What about mercy killing?
• Thousands face terminal illnesses that will cause
  horrible suffering
• Right to die a person with an incurable disease
  has a right to forgo treatment which may prolong
  their life
• Active euthanasia a person may enlist the
  services of a physician to bring on a quick death

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Figure 21-3 Types of Transmission for Reported
U.S. AIDS Cases as of 2001
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The Medical Establishment

• The social institution focuses on combating
  disease and improving health
• The rise of scientific medicine
• AMA American Medical Association founded in
  1847
• By early 1900s state boards agreed to certify
  only AMA approved
• M.D.s D.O. (Osteopaths) on one level
• Other healers kept tradition but occupy lesser
  role
• Chiropractors, herbalists, midwives, etc.

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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
• Patients are people
• Concern for the environment in which the person
  lives and their lifestyle
• Responsibility, not dependency
• Favors an active approach to health encouraging
  patients take health-promoting behaviors
• Personal treatment
• Favoring a more personal relaxed environment,
  such as the persons home

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Medicine in Socialist Societies

• China
• Government controls most health care operations
• Barefoot doctors in rural areas, traditional
  healing arts, acupuncture, medicinal herbs and
  holistic concern
• Russian federation
• Medical care is in transition, but it is held the
  all citizens have a right to basic medical care
• Tax funds are used to provide care
• Disparities in medical care increase among
  segments of the population

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Medicine in Capitalist Societies

• Sweden (1891)
• Compulsory, comprehensive government medical care
  system offered to all socialized medicine
• Great Britain (1948)
• Duel system of public health services (national
  health service) for all citizens and may also
  purchase private services
• Canada (1972)
• A single-payer model for all citizens government
  program (insurance company)
• But, like Britain , purchase private services
• Japan
• Physicians have private practice
• Paid like much of Europe, combination of
  government programs (80 of costs) and private
  insurance

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Figure 21-4 Extent of Socialized Medicine in
Selected Countries
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Medicine in the U. S.

• Direct fee system
• The patient pays directly for services provided
  by doctor and hospitals
• Private insurance
• 63 of Americans have access to medical care
  benefits through their work or union
• 8 purchase private coverage on their own
• Few programs pay all medical costs
• Public insurance programs
• Medicare for those over 65, Medicaid for those in
  poverty and for veterans
• 24 of Americans receive medical attention via
  some form of government program, though many also
  have some private insurance
• Health maintenance organizations
• An organization that provides comprehensive
  medical care to subscribers for a fixed fee
• Preventive approach to health Makes a profit if
  subscribers stay healthy

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Theoretical Analysis

• Structural-functional analysis
• Talcott Parsons the sick role
• Illness suspends routine duties
• A sick person must want to get well
• A sick person must seek competent help
• The doctor patient relationship as hierarchical
• Symbolic-interaction analysis
• We socially construct our ideas of health and
  illness How we define it becomes real
• We socially construct our ideas of treatment
• Social-conflict analysis
• Issues of
• Limited access, the profit motive, and the
  politics of medicine
• Interests of one group versus others