Sociology Ch 14 - The sociology of medicine health and illness

True or False: Our bodies are social objects

True; it is important to understand the role that health (and illness) plays in our lives as social beings

True or False: What it means to be healthy or sick is determined by society

True

Can infectious diseases be a social issue too?

Yes, as interpersonal contact and vaccination deeply affect how diseases spread

What are social determinants of health?

The social and cultural forces that influence health outcomes, including economic and political systems social norms and policies; and inequalities of class, race, gender and age (and sometimes global climate change)

What is health?

A state of complete, physical, mental, and social well-being and not merely the absence of diseases or infirmity

What is illness?

The abscence of health

What are the two major types of illnesses?

Acute and Chronic Diseases

What is acute disease and examples?

Diseases that have a sudden onset, may be briefly incapacitating, and are either curable or fatal

ex: the common cold, pneumonia, measles

True or False: Acute diseases are often caused by an organism such as a germ, virus, or parasite that infects the body and disrupts the normal function of one or more systems, which can cause it to be contagious

True

What are chronic diseases and examples?

Diseases that develop over a long period of time and many not be detected until late in their profession when symptoms occur

ex: Cardiovascular disease, cancer

Fill in the Blank: Chronic diseases can sometimes be related to ________, _______, and ________ ______

environment, lifestyle, and personal choices

True or False: Most chronic diseases aren’t manageable

False; many chronic diseases are manageable, but others progress and become fatal

True or False: Diseases usually stay in place for a long time

False; diseases that affect us can vary over time and place

What has happened in US health and medicine over time?

In the US, changes in public health and medicine have decreased many acute diseases (like polio) but rates of chronic disease (diabetes, heart disease) have increased 

Where do acute diseases continue to pose significant threats?

Acute diseases continue to pose significant threats to people living in low-income countries, where the top killers still include respiratory infections and diarrheal diseases 

What is the sick role?

The actions and attitudes that society expects from someone who is ill

What are some roles of the sick role?

• Individuals are exempt from regular duties and responsibilities 

• Individuals are not held responsible for their illness 

• Individuals are assigned a new set of duties, which include seeking medical help, recuperating, and making progress toward wellness 

What is medicalization?

The process by which some behaviors or conditions that were once seen as personal problems are redefined as medical issues

What are some conditions that have become medicalized?

Alcoholism, addiction, ADHD, obesity, birth and death

What is the process of medicalization?

Because what constitutes illness can be socially constructed, one problems that were once not considered medical conditions have been transformed into illnesses over time 

Process of Medicalization: Why is understanding medicalization crucial?

Understanding how a disease or condition can be socially constructed helps us see how its meaning and treatment changes over time

What is an example of how medicalization have changed both the meaning of a condition and the individual who suffers from it?

Even birth and death, both natural parts of family life that largely were handled in the home, have become medical conditions that require doctors and hospitals 

What is so important to know about Medicalization?

Medicalization changed both the meaning of a condition and the meaning of the individual who suffers from it

True or False: Theories and treatments of mental illness have varied over the course of human history

True

What are some examples of how mental illness was viewed throughout human history?

• 14th Century London, Bethlem Royal Hospital - mental illness was treated as a moral failing caused by individual weakness and demonic possesion

• 15th century, Colonial America - mental illness caused by the moon during birth, ‘lunacy’

• 20th century America - mental illness though to the be located in particular part of the brain, lobotomy

• 21ast Century America - mental illness thought to be caused by problems w/ brain chem, treatment involves medication to restore health balance

What do we know about mental health now?

While we know now that these earlier theories and solutions are not the cause of mental illness, but it also possible that our current theories about mental health and how to treat it will change over time 

What is epidemiology?

The study of disease patterns to understand the cause of illness, how they spread, and what interventions to take

What does epidemiology use?

The combination of data and using methods from biological and social science to study of patterns of disease

What are the 5 questions that epidemiologists ask when encountering a disease?

• What is it? 

• How is it communicated? 

• How does it develop and how is it distributed? 

• Where will it spread? 

• What interventions are there? 

What is epidemic? (ex?)

The occurrence of disease in which the number of cases a particular disease during a particular time period is significantly higher than might otherwise be expected

ex: America’s opioid epidemic, West African Ebola outbreak

What is a pandemic? (ex?)

The occurrence of disease in which a significantly high number of cases appear and the disease spreads thru an especially large geographical region spanning across many countries and continent

Ex: covid-19

Social Inequality, Health, and Illness: True or False: People w/ higher SES have better health than ppl w/ lower SES

True

Social Inequality, Health, and Illness: How does health and illness have an impact on those with a high SES?

• People can afford more and better health care services (insurance plans, doctor visits, diagnostic tests and treatments, prescription medications)  

• Have greater access to other resources that positively influence their health (better nutrition, cleaner neighborhoods, more preventive practices like exercise)  

• As a group, people with higher SES are better-informed (better educated) health consumers and they generally enjoy more physical well-being than those of lower SES 

• Economic Trend: Ppl w/ an higher SES can expect to live longer lives 

Social Inequality, Health, and Illness: How does health and illness have an impact on those with a Low SES?

• Higher rates of various diseases and chronic illnesses, along with higher death rates and shorter life expectancy 

• Usually little regular access to health care providers, lack the ability to participate in preventive practices, or have trouble affording prescription medications and other recommended procedures 

• The effects of poverty consistently correlate with higher incidences of mental health problems 

• People living in poverty are twice as likely to suffer from depression as those who are not 

Social Inequality, Health, and Illness: Why does race matter?

• Black and Hispanic Americans are less likely to be able to afford health insurance and, consequently, to have access to health care or to engage in regular health practices   

• And when people of color do seek care, they often face racism from health care workers 

•  Members of minority groups are also more often exposed to unhealthful surroundings, whether in the workplace or in residential neighborhoods 

• African Americans have higher rates of death and disease, shorter life expectancies than white Americans 

• NYC Latinos and African Americans live in poorer quality housing, have more asthma problems than Asian, White, and higher-SES racial counterparts 

• Historical experiences impact current practices: Tuskegee Syphilis Experiment 

Social Inequality, Health, and Illness: Why does gender matter?

• Health is one place where gender inequality typically benefits women over men, as women are generally healthier and enjoy a longer life expectancy despite having a lower SES than men 

• Gender impacts experiences w/ physicians 

Social Inequality, Health, and Illness: Why does gender matter: Even though women have healthier and longer life expectancies than men, why are they more likely to die from heart attacks?

• Medical research often uses the male body as the standard, which means treatment effectiveness and risks often differ for men and women

• While women live longer than men, they also are more likely to die from heart attacks in part bc historically wmn have not been screened and treated for heart disease as early or as aggressively as men have 

Social Inequality, Health, and Illness: How does the stereotypes of gender come into play w/ men’s health?

The more strongly men identify w/ stereotypical ideas Abt masculinity, the more likely they are to avoid preventive health care, regardless of their class position 

Social Inequality, Health, and Illness: How did Covid-19 show the disparities and intersections of class, gender, and race in healthcare?

• Older and lower income Americans, poc, and men experience higher death rates from Covid-19, while younger and higher-income Americans, yt ppl, and women experience lower death rates from covid-19 

• Differences in mortality from Covid-19 result from a combo of structural inequalities and micro-level experiences 

• Black ppl in the US are less likely to have adequate health care and are more likely to be “essential workers” who work in jobs that increase their risk of exposure 

Social Inequality, Health, and Illness: Inequalities of Place: What are food deserts?

Communities where the residents have little access to fresh, affordable healthy foods and instead rely on non-grocery outlets for meal choices (ex of deprivation amplification)

Social Inequality, Health, and Illness: Inequalities of Place: True or False: Deep racial disparities exist when it comes to the likelihood of exposure to pollution and toxic chemicals such as lead

True

Social Inequality, Health, and Illness: Inequalities of Place: What is an example of deep racial disparities?

In 2014, Flint, Michigan switched their water source as a cost-cutting measure, exposing the largely poor and black residents of the city to lead

How would a structural functionalist approach medicine and health?

Disease is a threat to social order, and sick ppl cannot fulfill their roles and contribute to society; the health care system should return patients to health and normal functioning as members of society 

How would a structural functionalist view drugs and alcohol addiction?

• Ppl who become addicted to drugs and alcohol may be responding to strains in the social system and their own lives 

• They may adapt by retreating or escaping thru drugs and alcohol 

How would Conflict Theorist approach medicine and health?

• Health and the health care system are valuable resources that are unequally shared in society 

• Conflict may arise among different groups seeking access to and control over these resources 

How would a conflict theorist approach drug and alcohol addiction?

• Those in power can define social policy and create laws regarding medicine and health care 

• People of lower SES are more likely to be scrutinized as problem drinkers or drug addicts and may be unduly punished 

How would a Symbolic Interactionist approach medicine and health?

• The meanings of health and illness are dependent on historical, cultural, and situational contexts 

• Stigma may be attached to certain disease states and to those who suffer from them 

How would a symbolic interactionist view drug and alcohol addiction?

• People learn to use alcohol and drugs in social interactionism are influenced by peers and other groups 

• They may attach different meanings and values to substances and behaviors 

What is the AMA (American Medical Association)?

A trade union that creates the rules and regulations governing medical licensure

What is the AMA responsible for?

• Establishes and transmits the norms and values of medicine and medical knowledge 

• Regulates, licenses, and legitimates the practitioners of medicine 

• Polices various forms of encroachment on its own power 

• Ex: the AMA restricts home births, forcing trained midwives and doulas to operate on the margins of the industry and limiting the options of pregnant women 

True or False: Because institutional diagnoses often override an individuals’ claims and power over their own status, the way we interact w/ doctors don’t matter

False; Because institutional diagnoses often override an individuals’ claims and power over their own status, the way we interact w/ doctors in what gives them status and power - the norms of the situation emerge from the way we behave

Fill in the Blank: Patient interactions have shown that the dynamics between patient and doctor must be established between _______ even though we may think that doctors automatically have more status (and more power) than patients

interactions

What are doctor-patient relations greatly influenced by?

The structure of the institution, social, and geographical influences and their influence in interactions

What has been found about doctors in rural settings?

• Doctors in rural settings are more likely to spend time engaging in emotional labor with their patients than are doctors in urban settings 

•  Doctors in rural settings are more likely to know their patients from their community and interact with them in less instrumental ways, which studies have demonstrated leads to improved patient outcomes 

What does racial and gender bias in doctors result in?

in disparities in health care for wmn and minority groups, particularly in the treatment and management of pain

What does cultural competence involve?

The incorporation of a patient’s cultural background as part of the treatment process

True or False: The recognition that patient’s social beliefs shape their approach to healthcare

True