Chapter 12 - Health and Illness

Health

State of complete physical, mental, and social well-being, not merely the absence of disease

Patterns of Health and Illness

-degenerative diseases such as heart disease replaced infectious diseases as the primary cause of death

-Preventive medicine drew attention to factors such as poverty and malnutrition

-Modern psychiatry emphasized the roles of the social environment in psyschological healing

-Medicine became more bureaucratic and administrative in the regulation and delivery of healthcare

Sociology of Health and Medicine

Dominated by 4 areas of study

1. Implication of demographic changes

2. Health inequalities among different groups

3. The social context of healthy lifestyles

4. Ethical implications of new health technologies 

Epidemiological Transition Theory

1. Famine/infection diseases/parasitic diseases were the primary causes of death

2. Decline in epidemics, but infections diseases remains the primary cause of death

3. Rates decline further, degenerative diseases take over mortality rates

4. 20th/21st centuries, new rise of infectious diseases (COVID, Ebola, H1N1, etc)

Contemporary patterns of mortality in Canada

Reflects the epidemiological transition

-7/10 official causes of death in Canada in 2018 were degenerative diseases

-Top 3 causes of death (cancer, stroke, heart disease) account for more than half of all deaths, and the top 10 causes are responsible for 71% (stats can)

-For both men and women, the two leading causes of death are cancer and heart disease

• Third leading cause of death for women is strokes, but for men it is accidents

• Men are also more likely to die from suicide or liver disease

• Younger people are far more likely to die of suicide or accidents, older people more likely to die of degenerative diseases

Smoking is the most preventable disease

Tobacco and alcohol are major industries, government benefits from them, so they are less likely to be heavily regulated

Functionalist Perspective

Talcott Parsons - Viewed illness as a dysfunction for the individual and society

-Sickness is a dysfunction of society because people cannot fulfill their roles (as students, employees, or parents)

-Sick Role Concept - Patterns of behaviours defined as appropriate for those who are sick

Characteristics;

• Exempt from normal social responsibilities

• Not responsible for their condition

• Sick person must want to get well

• Should seek competent help, and cooperate with health professionals to hasten recovery

• Physicians are ‘gate keepers’ who maintain society’s control over people who enter the sick role

Critique - Too much responsibility placed on the sick person

Acute vs Chronic Illness

Acute Illness - Illness of limited duration from which a person recovers or dies

Chronic Illness - long term or permanent condition that may or may not be fatal (multiple sclerosis, arthritis, cystic fibrosis)

Conflict Perspective

Looks at the political, economic, and social forces that affect health, healthcare, and patients

-Who gets funding for research? What are their links? e.g., gay rights lobby for research on AIDS

-AIDS research received 10x funding of breast cancer research

Feminist Perspective

Linked to child-birth, menopause, PMS, and contraception

-These phases have been defined as ordinary in their lives; women (midwives) cared for each other

-19th century male physicians defined this as being medical, taking over women's health and claiming exlcusive jurisdiction over a wide range of conditions that were redefined as medical problems

-Healing becomes “men’s work”

-American society for Plastic and Reconstructive Surgery - Defined small breasts as being a disease because it produced negative psychological health outcomes like negative self-image, self worth, lack of beauty and lack of femininity 

Symbolic Interactionist Perspective

Focus on the meaning of illness, how it is not only a physical condition but also socially constructed; e.g., AIDS

Sickness is the pathology of the body, but illness is attached to the mental and physical experience of it

-Those suffering from AIDS are blamed because it is associated with gay sex, drug use, and promiscuous heterosexual sex

-Example of illness as stigma; rejected suffer discrimination and prejudice

Age Factor for Health

As we age, our level of health decreases

-Senile Dementia - diseases such as Alzheimer that involve a progressive impairment of judgement or memory

Sex Factor for Health

Pattern; before the 20th century, women died younger than men

-Women now have a higher life expectancy

• Engage in less risky work and risky behaviour

• More likely to seek out healthcare

Convergence/narrowing of age and sex difference in life expetancy

-Women’s occupation is becoming more and more like men’s

-Women engaging in more risky behaviours and life stykes

-Research on women’s health does not equal research on men’s health

Social Class

Lower social class = poorer health than those of higher classes

-Low-income Canadians suffer from diseases like emphysema, high blood pressure, and functional health problems

-issues with poverty; lower quality food, higher alcohol abuse, higher smoking, poor housing, hazardous employment, psychological stress from poverty, etc

Healthcare in Canada

Universal Healthcare System - All medical serves paid via taxes

-Universality (everyone gets it)

-Comprehensiveness (covers all necessary parts)

-Accessibility (redistribution if income from rich provinces to poor provinces)

-Portability (cross-province coverage)

-Public Administration (handled by the government, nonprofit)

Rise of healthcare costs in Canada is a result of an aging population that requires more care (due to the baby boom generation which is now elderly)

Healthcare in the United States

Us spends most amount of healthcare per capita, but has a low life expectancy

-Spend so much on a very few amount of people, majority therefore not able to afford good healthcare

Only industrialized nation that does not have a universal healthcare system

-16% of citizens have no coverage (no private insurance)

Canadians have a better healthcare system and therefore more healthy (lower infant mortality rate, higher life expectancy)

Morbidity vs Mortality

Morbidity - Prevalence and patterns of disease in a population

Mortality - The incidence and patterns of death in a population

Healthy Immigrant Effect

Recent immigrants tend to have better health than people who were born in Canada, but after a few years (especially for women and racialized groups), their health becomes similar to those who are Canadian-born

Social Selection/Causation Hypothesis

Social Selection Hypothesis - People with mental disorders may drift into lower levels of socioeconomic status

Social Causation Hypothesis - Stresses associated with a lower socioeconomic status contribute to development of mental disorders