2.1 Physical and Mental Health

COVID-19

• World Health Organization (WHO) and social problems
  • Health: a state of complete physical, mental, and social well-being
  • The study of social problems is inherently intertwined with the study of health
  • Pandemic: a worldwide disease outbreak
• COVID-19 is a pandemic
  • Death rate: the number of people per 100,000 in a population that die in a specific period
  • Contact tracing: focuses on identifying contacting people exposed to others with positive test results
  • Positivity rate: the percentage of positive results for every 100 tests
  • The first reported cases were identified in the Wuhan, Hubie province of China

Overview of Global Health

Classifying Countries

• When comparing health outcomes, sociologists generally classify countries by level of economic development
  • High-income country: a country with a relatively high gross national income per capita
  • Aka “most-developed countries”
  • Middle-income country: a country with a relatively low gross national income per capita
  • Aka “less-developed countries” or “developing countries”
  • Low-income country: one of the poorest countries in the world
  • Aka “least-developed countries”
• Figures such as life expectancy and cause of death vary significantly between countries with different levels of wealth

Key Concepts

• Life expectancy: the average number of years that individuals born during a \n specific year can expect to live
  • Japan (84 years) versus Central African Republic (53 years)
  • Higher in high-income countries
• Mortality: death
  • Noninfectious versus infectious disease
  • Vary globally, often correlated with a country’s level of economic development
• Infant mortality rate: the number of deaths of infants under 1 year of age per 1,000 live births
  • Averages 4 to 48 deaths/1,000 live births around the globe
  • Under-5 mortality rate: the number of deaths of children under age 5 per 1,000 live births
  • Both of these rates are much higher in low- and middle-income countries than in high-income countries
• Maternal mortality rate: the number of deaths from complications associated with pregnancy, childbirth, and unsafe abortion
  • More than 94% of maternal deaths occur in low-income countries
  • 
• Herd immunity: the point at which enough people in a population have been exposed to or immunized from an infectious agent to stop its spread

Globalization and Health

• Globalization
  • International organizations monitor and report outbreaks of disease, disseminate guidelines for controlling and treating disease, and share medical knowledge and research findings
  • Global travel is the primary means through which illnesses are transmitted between countries
  • International trade agreements influence health
  • Access to range of goods including tobacco and processed foods
  • Globesity is a consequence of growing middle-class in poor countries
    • Globesity: the high prevalence of obesity around the world
• Medical tourism: a global industry that involves traveling, primarily across international borders, for the purpose of obtaining medical care
• Medical tourism takes place for three main reasons:
  • To obtain medical treatment that is not available in their home country
  • To avoid waiting periods for treatment
  • To save money on the cost of medical treatment

Applying Sociological Theories

Structural-Functionalist Perspective

• Health care is a social institution that functions to maintain the well-being of individuals and the society
• Failures in the health care system are dysfunctions that impact large numbers of people and other social institutions such as the economy
• Social change impacts health, and health concerns impact social change
• Latent dysfunctions: unintended or unrecognized consequences
  • Use of antibiotics in agriculture and the connection to antimicrobial resistance among humans

Conflict Perspective

• Socioeconomic status or social class, power, and profit motive have an impact on illness and health care
• Health care industrial complex
  • Powerful groups and wealthy corporations influence health-related policies and laws
  • 600 million was spent by health industry in 2019 lobbying Congress
  • Pharma corporations decide which drugs and products to develop

Symbolic Interactionist Perspective

• Meanings, definitions, and labels influence health, illness, and health care
• Meanings are learned through interaction with others and through media messages and portrayals
• Society or groups come to decide and agree what social conditions are defined as illnesses or diseases
• Medicalization: labeling behaviors and conditions as medical problems
  • Individual experiences of distress into shared experiences of illness
  • Eg. childbirth, menopause, death, etc.

Health Disparities in the United States

• Health disparity: a preventable difference in exposure to disease or injury or in opportunities to achieve optimal health across social groups
• Social stratification: systems of social inequality by which a society divides people into groups with unequal access to wealth, material and social resources, and power
  • Socioeconomic status or social class
  • Educational attainment, occupation, and household income
  • Low socioeconomic status and poor communities linked to:
    • Lower life expectancy and leading causal factor of poor health
    • Greater stress and fewest resources to cope
    • Hospitals more likely to be understaffed and lack life-saving equipment
    • COVID-19 deaths in U.S. are higher in low-income counties
    • Food deserts: areas that lack access to grocery stores
  • Health also affects socioeconomic status and ability to pursue education, employment training, and employment itself
  • Race/ethnicity
  • Income, education, housing, toxins, and access to healthcare
    • Black Americans, Native Americans, and Alaska Natives have lower than average health outcomes
  • COVID-19 disproportionately impacts underserved groups
    • Overcrowded and collective-living arrangements
    • Employed in essential jobs
    • Higher rates of chronic conditions
  • Hispanic Paradox
    • Hispanic cultural values promote family and community closeness, and traditional healthy diets which control for risk factors
  • Gender
  • Men have more access to social power, privileges, resources, and opportunities but lower life expectancy
    • Greater exposure to occupational hazards
    • Social norms encourage risk-taking behaviors
    • Less likely to seek health care and disclose symptoms
    • Less likely to take COVID-19 seriously and take precautions
    • Higher rates of antisocial personality disorder, and alcohol abuse
  • Women’s health is impacted by gender inequalities
    • Economic, political, and spousal inequalities
    • Higher rates of depression and anxiety

Mental Illness: The Hidden Epidemic

• Mental health: psychological, emotional, and social well-being
• Mental illness: all mental disorders characterized by sustained patterns of abnormal thinking, mood, or behaviors that are accompanied by significant distress and/or impairment in daily functioning
  • Stigma: a discrediting label that affects an individual’s self-concept and disqualifies that person from full social acceptance
  • Stigma surrounding mental illness is partly due to misconceptions about their causes, such as that mental illness is caused by personal weakness, or results from engaging in immoral behavior
  • The media often reinforces violent stereotypes through selective news reports and stereotypical portrayals in fictional crime shows and dramas
• Extent and impact of mental illness
  • In 2019, nearly 1 in 5 adults had a mental illness in the past year
  • The highest prevalence was among 18- to 25-year-olds
  • About 65% received treatment
  • Almost half of adolescents (13-18) had been diagnosed with a mental disorder in their lifetime
  • Depression and anxiety are the most common in U.S. and around globe
  • Untreated mental illness has many social consequences
  • Suicide is the 10th leading cause of death in the U.S. and second leading cause of death among 10- to 34-year-olds
• Mental illness among college students
  • In 2019, 1 in 3 college students had been diagnosed or treated for a mental \n health condition in the past year
  • 24% had been diagnosed for depression
  • 22% had been diagnosed for anxiety
  • 12% had been diagnosed for panic attacks
  • More than 1 in 4 college students reported that anxiety affected their academic performance; 1 in 5 reported that depression affected their academic performance
• Treatment of mental illness
  • Deinstitutionalization: the shift during the 1960s from in-patient care to community-based mental health centers and drug therapies
  • Legislation passed prohibiting committing people to psychiatric hospitals against their will unless they posed a danger to themselves
  • Community-based mental health centers have not adequately met mental health care needs as millions of Americans go without care
  • Criminalization of mental illness: the view that correctional facilities have replaced the mental health asylums of the past

Strategies for Action

• Improving health in middle- and low-income countries
  • Access to adequate nutrition, clean water, and sanitation
  • Increase immunizations and distribute mosquito nets to prevent malaria
  • Provide access to quality reproductive care and family planning services
  • Provide women education and income-producing opportunities
• Improving mental health care
  • Eliminate stigma surrounding mental illness
  • Improve access to mental health services
  • Recruit more mental health professionals
  • Improve health insurance coverage
  • Expand mental health screening
  • Make mental health screenings a standard practice reimbursed by insurance companies
  • Support the mental health needs of college students