SOC Chapter 12

Health Defined

• Health is a state of complete physical, mental, and social wellness.
• Age, gender, social class, and race all have an effect on health in the United States.

Social Epidemiology

• Social epidemiology is the study of the distribution of diseases and health throughout a society’s population.
• Social epidemiologists analyze the link between health and the social environment, particularly with respect to age, gender, social class, and race.

Age and Health

• In the developed world, including the US, death is rare among the young.
• The U.S. infant mortality rate is only 6.9 per 1,000 births.
• In general, children and young adults are healthy; in 2005, only 6% of adults aged 18-44 rated their health as fair or poor.
• In contrast, 30% of adults over 75 believed their health to be poor.

Gender and Health

• In the U.S., women are expected to live an average of 80.4 years, while men live only 75.2 years.
• Men are more likely to abuse alcohol and tobacco.
• Men work at riskier jobs.
• Women are more likely to get preventative health care.

Social Class and Health

• Social class has a direct effect on health, which is related to the ability to pay.
• Studies show that a higher socioeconomic status leads to longer, healthier, and happier lives.
• When asked to rate their health, only 23.4% of people with an income of $20,000 or less reported excellent health, compared to 46.3% of people making $50,000 or more.

Neighborhoods

• Neighborhoods can also have an effect on health.
• Neighborhoods that are poor, poorly educated, unemployed, and have single mothers with little government assistance adversely affect the health of the people living there.
• High crime rates and drug abuse also affect neighborhood health.

Environmental Justice

• Environmental justice studies the impact of environmental factors on social classes.
• The poor often live in environmentally dangerous areas that experience regular interaction with toxins, unclean water, and air pollution.

Race and Health

• On average, whites live longer than blacks in the U.S.
• In 2005, the life expectancy of whites was 78.3 years and blacks 73.2 years.
• 24.9% of blacks and 21.8% of Hispanics live below the poverty level, compared to 8.3% of whites.
• Minorities also have higher rates of infant mortality.

The Medicalization of American Society

• Health and healthcare influence people’s lives.
• Talcott Parsons believes that sickness can become a social role; a sick role is the expected behaviors and responsibilities appropriate for someone who is ill.
• Physicians can label sickness, giving them great power in society.
• Medicalization is the idea that the medical community is the center of many aspects of American society.
• There is a belief in American society that pills and other medical interventions will cure everything.
• Szasz argues that many mental illnesses are really a means of social control.

Health in the United States: Living Off the Fat of the Land

• The United States is in the grips of an obesity epidemic.
• Obesity is an unhealthy accumulation of body fat.
• Shopping for healthier food takes more time, effort, and money than getting fast food.
• Fast food, in contrast, is convenient and inexpensive, despite being unhealthy.

Childhood Obesity

• A 2006 study determined that the increase of childhood obesity was a direct result of the availability of energy-dense foods and drinks combined with a lack of ‘energy expenditure.’
• School lunches tend to offer high-calorie foods.
• Often dual-income and single-parent families lack time to make nutritious food.
• Television, computers, and video games are many children’s primary modes of entertainment.

Stigmatization of the Obese

• Overweight children and adults are often targets of scorn and ridicule among their peers.
• This can cause discrimination against obese children and adults.
• Studies showed that obese individuals believed that other members of society treated them unfairly and discriminated against them, which contributed to poor self-esteem and psychological well-being.

Obesity and Race

• Research shows that African Americans have a substantially higher rate of obesity than whites.
• Studies show that socio-economic class plays a major role in the relationship between race and obesity.
• Black communities are almost 4 times as likely as white communities to have obesity rates greater than 25%.

Healthcare

• Healthcare is the care, service, or supplies related to a person’s health.
• There are many issues related to a person’s health studied by sociologists.
• Only 40% of Americans are satisfied with their health care system.
• Cost is the complaint of many people.
• The United States has the most expensive system in the world; however, over 15% of Americans have no health insurance.

The Uninsured

• In 2005, nearly 15 million people in the U.S. were uninsured; more than 34 million of these were under the age of 44.
• Many of these people either didn’t make enough income to pay for insurance or had parents who didn’t make enough.
• In the U.S., the uninsured are sicker, receive inferior care, and are more likely to die prematurely.

Cost of Services

• In the U.S., the cost of health care went from 28 billion in 1960 to 2.3 trillion in 2007.
• The high cost is mostly related to medical technology and prescription drugs, the high number of uninsured, and the aging of the population.

Costs of Services: Why Universal Healthcare Has Not Been Adopted

1. The Constitution limits the power of the state, so national health care is looked on as a form of welfare and threatens our freedom.
2. The working class and labor unions fail to support legislation that would provide universal health care.
3. Private health insurance companies strongly oppose the idea of national health care.

Healthcare – An International Comparison

According to the World Health Organization, the 5 characteristics of a good and fair health system are:

1. Overall good health (low infant mortality rates and high life expectancy).
2. A fair distribution of good health across the entire population.
3. A high level of overall responsiveness.
4. A fair distribution of responsiveness.
5. A distribution of financing health care – the cost evenly distributed based on an ability to pay.

International Comparison Continued

• After creating the list, the WHO compared health systems of 191 of the world’s countries.
• The U.S. was 1st overall in responsiveness or responding to the desires of consumers.
• The U.S. was 1st in per-capita cost.
• However, other variables were much lower.
• The U.S. is the only wealthy democracy on earth without universal health care.
• The U.S. overall came in 37th in the world.

Healthcare and the Elderly – Medicare

• Most of the elderly have access to Medicare, which is a government-run social insurance program that provides health coverage for people 65 and older.
• Medicaid is a form of government health insurance designed for the poor and disabled.
• The cost of Medicare is increasing with the “graying of the U.S.” The elderly now account for 13% of the population.

Aging: The Graying of the United States

• The population of the U.S. has experienced a long trend toward aging.
• Persons aged 65 and over comprised about 4% of the population in 1900; in 2002, it was 12 percent. As baby boomers go into retirement, the numbers will increase significantly.

Aging and Demographic Change in the United States

• Gerontology is the study of aging and the elderly.
• The elderly have been broken down into:
  • Young old: people between the ages of 65 and 75.
  • Old old: people over the age of 75.

Life Expectancy

• Life expectancy has dramatically increased.
• At the beginning of the 20th century, it was 47.3 years.
• In 2007, life expectancy for men was 75.2 years and for women 80.4 years.
• Vaccines for many infectious diseases helped increase life expectancy.
• More importantly, public health measures helped increase life expectancy.

Origins of the Baby Boomers

• After WWII, social and economic restraints were removed when men returned from war, leading to a ‘boom’ in childbirths.
• A period of prosperity resulted in 78.2 births between 1946 through 1964.
• A decline in fertility was related to the birth control pill in 1960.

The “Sandwiched” Generation

• “Sandwiched” generation is a generation that takes care of both its children and its elderly parents.
• The baby boomers and subsequent generations probably will be sandwiched as life expectancy is longer and child bearing later.
• These trends may keep families closer together.

Gender and Aging: Where are the Men?

• There is more emphasis in Japan and other societies on aging women as compared to aging men.
• Data from the Philippines, Singapore, Taiwan, and Thailand suggest a relative equality of satisfaction with income for elderly men and women.

Concerns About Aging

• Biological Changes
  • As you age, biological changes take place, and your senses also decline.
  • Senses of vision, hearing, taste, smell, and touch become weaker.
  • In 2006, among individuals over 65, 17% reported failing sight and 11.4% reported trouble hearing.

Ageism

• Ageism is prejudice and discrimination based solely on age.
• The workplace is the main forum for ageism.
• It is illegal for most jobs to discriminate on the basis of age.
• The mass media are major sources of ageism; when a society values youth and beauty, older females are discriminated against.

Functionalism and Aging

• Functionalists suggest that elderly people begin to shed their old social roles and begin to take on new roles.
• Disengagement theory states that reduced interaction between older persons and others is unavoidable, mutual, and acceptably to both the individual and society.
• Society disengages people from important positions as they get older so that the social system does not get disrupted.

Symbolic Interactionism and Aging

• Symbolic interactionists study how factors like the environment and relationships with others affect how people experience aging.
• Activity theory states that life satisfaction depends on maintaining an involvement with life by developing new interests, hobbies, roles, and relationships.

Conflict Theory – Aging and Inequality

• Conflict theorists examine how power and economic forces influence aging in society.
• By placing a negative stigma on the elderly, society segregates the elderly from others.
• Social programs such as social security and Medicare may be related to the fact that the elderly are the most likely to vote.

Healthcare Reform in the United States

• US healthcare has traditionally been based on the ability to pay. The greater one's income, the more likely they will have health coverage.
• Healthcare reform was passed in 2010 by the Obama administration and the Democrats.
• While it is still controversial, it has the potential to cover almost everyone with healthcare.