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
  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
    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