Health & Health Care

Week 4: Health & Health Care

Essential Question

  • How does social location (where a family lives, as well as their social identities such as gender, race, socioeconomic status, age, ability, religion, and sexual orientation) affect their health and well-being?

Assessment

  • Describe how social structures such as the media, the economy, and public policies interact with family groups to contribute to the complexity of family outcomes. (Outcome # 2)

Learning Objectives for This Week

  1. Explain how socially constructed ideas affect health.

  2. Describe the advantage of understanding disparities related to social characteristics (race, gender, etc.).

  3. Explain why people with mental illness or substance abuse disorders are less likely to get medical care and support.

  4. Relate the challenges of meeting basic needs like sleep, exercise, and good diet to family health.

  5. Describe the difference between a health care system and health insurance.

  6. Examine how family structure, geography, and income level overlap to affect health care access.

  7. Analyze the role of capitalism in the opioid crisis.

  8. Apply theoretical concepts related to health care to one’s own observations and experiences.

  9. Describe the multi-directional relationship between social structures and a family’s access to health care.

  10. Analyze health and access to health care from an equity perspective.

Chapter 7 Summary — Health, Health Care, and Families

7.1 Chapter Reading Guide

Overview

  • This chapter explores how health is socially constructed and shaped by stigma, intersectionality, and structural inequality. Topics include mental illness, substance use, sleep, diet, and the opioid epidemic.

Learning Objectives

  • Explain how social constructions affect health outcomes.

  • Understand health disparities by race, gender, and other identities.

  • Explore barriers to care for mental illness and substance use.

  • Connect basic needs (sleep, diet, exercise) to family health.

  • Analyze how family definitions affect access to care.

  • Examine how geography, income, and family structure intersect.

  • Understand the opioid crisis and its impact on families.

  • Apply theory to personal observations and experiences.

Key Terms

  • Health: Complete physical, mental, and social well-being.

  • Health disparities: Preventable differences in health outcomes.

  • Health equity: Equal access to health benefits for all.

  • Health insurance: Coverage for medical expenses.

  • Mental health: Emotional well-being and coping ability.

  • Mental illness: Disorders affecting mood, thinking, and behavior.

  • Opioid: Pain-blocking substances that can cause euphoria.

  • Stigma: Negative attitudes toward marginalized identities.

  • UN Declaration of Human Rights: Global document affirming health as a human right.

7.2 The Social Construction of Health

Key Concepts

  • Health is shaped by societal beliefs, not just biology.

  • Definitions of illness vary across cultures and time.

  • In the U.S., access to care is tied to employment, income, and family status.

  • Stigma affects how illness is perceived and treated.

Mental Health and Stigma

  • Mental illness is often stigmatized and misunderstood.

  • Social and self-stigma can prevent treatment and support.

  • Media representation and cultural bias reinforce shame.

Case Studies

  • Lung Cancer: Stigmatized as a "smoker's disease," leading to delayed care and underfunding.

  • COVID-19 Testing: Carmen Quinero’s story illustrates how insurance gaps and policy loopholes harm low-income families.

Structural Power

  • Cisgender men dominate medical research, shaping what’s considered “normal.”

  • Women and nonbinary people face misdiagnosis and dismissal.

  • Chronic conditions like fibromyalgia are under-researched and poorly understood.

7.3 Health Equity for Families

Global Comparisons

  • The U.S. performs well in cancer survival but poorly in access and prevention.

  • The U.S. spends more per capita but ranks low in basic health outcomes.

Key Metrics

  • Same-day appointments: Less accessible in the U.S.

  • Hospital admissions: Higher for preventable conditions.

  • Years of Life Lost (YLL): U.S. lags behind peer nations.

7.4 Social Determinants of Health

  • Health is shaped by where people live, work, and learn.

  • Disparities linked to race, gender, income, education, and geography.

Health by Identity

  • Race/Ethnicity: Black, Native American, and Mexican American families face higher mortality and disease rates.

  • Socioeconomic Status (SES): Lower income and education levels correlate with worse health outcomes.

  • Gender/Sexual Identity: LGBTQ+ individuals face economic instability and limited access to culturally competent care.

7.5 Health and Health Insurance

Global vs. U.S. Systems

  • Most industrialized nations offer universal health care.

  • The U.S. ranks poorly in infant mortality and health equity despite high spending.

U.S. Health Spending

  • Health care costs have increased tenfold since 1980.

  • Insurance access is tied to employment and income.

Insurance Breakdown (2017)

  • Employer-based: 56%

  • Direct purchase: 16%

  • Medicaid: 19.3%

  • Medicare: 17.2%

  • Military: 4.8%

ACA and Civil Rights

  • The Affordable Care Act (ACA) of 2010 expanded access and banned discrimination.

  • Section 1557 prohibits bias based on race, sex, disability, and more.

Medicaid and Medicare

  • Medicare: For people aged 65 or older; covers approximately 50% of costs.

  • Medicaid: For low-income individuals; coverage varies by state.

  • Oregon’s Medicaid program is called the Oregon Health Plan (OHP).

7.6 Looking Ahead: Keeping Your Family Healthy

Holistic Health Factors

  • Health includes access to:

    • Nutritious food

    • Exercise

    • Sleep

    • Education

    • Social connection

    • Safe environments

    • Substance use prevention

Structural Barriers

  • Families face unequal access due to laws, policies, and systemic bias.

  • Past and present inequities shape current health outcomes.

Advocacy and Activism

  • Organizations like Health Care for ALL Oregon and Physicians for a National Health Program promote universal care.

  • Aligning with the UN Declaration of Human Rights is a path toward equity.

7.7 Going Deeper

Additional Resources

  • Health People: Social determinants of health

  • PsychCentral: Mind-body connection

  • The Lancet (2017): U.S. health care inequality series

  • The Daily podcast + NPR article: Childhood obesity treatment

  • ACA’s 10 essential health benefits

  • CDC sleep disparity data

  • AHRQ report on uninsured adults

Reflective Questions

  • How do socially constructed ideas affect health?

  • What is the value of understanding disparities by race, gender, etc.?

  • Why are people with mental illness or substance use disorders less likely to receive care?

  • What challenges prevent families from meeting basic health needs?

  • How does family structure affect access to care?

  • How do geography and income level overlap in shaping health?

  • What role does capitalism play in the opioid epidemic?

  • What changes would you propose to improve family health in the U.S.?

Key Terms Recap

  • Health: Complete well-being.

  • Health disparities: Preventable differences in health outcomes.

  • Health equity: Equal access for all.

  • Health insurance: Coverage for medical expenses.

  • Mental health: Emotional and behavioral well-being.

  • Mental illness: Disorders affecting mood and behavior.

  • Opioid: Pain-blocking substances.

  • Stigma: Negative attitudes toward marginalized identities.

  • UN Declaration of Human Rights: Global affirmation of health as a human right.