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Health & Medicine

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Health & Medicine Health & Medicine Presentation Transcript

  • Sociology of Medicine and Health  Illness is More than Biology Social structure, social location, lifestyle, etc matter in health outcomes, and in defining health  Medicine = society’s way of dealing with sickness & injuryCopyright © 2010 Pearson Education, Inc. All rights reserved. 1
  • Symbolic Interactionist Perspective  Health and Illness are defined by culture; there are no absolute, universal definitions  Components of Health: Physical Mental Social Spiritual (only in some cultures)Copyright © 2010 Pearson Education, Inc. All rights reserved. 2
  • The Functionalist Perspective The Sick Role  Elements of the Sick Role:  Individual is not responsible for being sick  Individual given hiatus from normal responsibilities  Individual doesn’t enjoy the sick role  Individual gets help to return to normal  Ambiguity: Arbitrary, changing line that defines sick role  Gatekeepers to the Sick Role (doctors, parents, etc)Copyright © 2010 Pearson Education, Inc. All rights reserved. 3
  •  Health is a commodity that rich can buy, not a right provided to everyone  Health is stratified globally: Life Expectancy • 77 years in Most Industrialized Nations • 65 years in Least Industrialized Nations • Longest life expectancy = 80 years in Japan & Canada • Shortest life expectancy = 34 years in Swaziland & Batswana • US life expectancy = 78 years Organs on the Black Market from poor to richCopyright © 2010 Pearson Education, Inc. All rights reserved. 4
  •  Health Stratification within society • Poor have worse health (both physical and mental – more stress, dangerous jobs, less resources) • Poor most likely to use the ER for regular care (lack of insurance) which raises healthcare costs for all patients • Globally, poor sanitation is a major cause of poor health (boiling water & sanitizing utensils significantly reduces disease)  Medicine is a monopoly Professionalization: requires education, regulation, and authority (example of midwives) Expanding business (through Medicalization)Copyright © 2010 Pearson Education, Inc. All rights reserved. 5
  • Copyright © 2010 Pearson Education, Inc. All rights reserved. 6
  • Historical Patterns of Health  Physical Health Leading Causes of Death have changed • Acute Diseases (quick: flu, cold, infections) largely treatable now, but still an issue in Least Industrialized Nations • Most Industrialized Nations die more from Degenerative Diseases (long, drawn-out: heart disease, cancer, ALS) now Healthier now in terms of life expectancy  Mental Health Difficult to assess and measure over time Few resources, insurance often doesnt coverCopyright © 2010 Pearson Education, Inc. All rights reserved. 7
  • Copyright © 2010 Pearson Education, Inc. All rights reserved. 8
  • Threats to Health: HIV/AIDS  Stigma attached to HIV/AIDS  Most sub-Saharan African HIV transmitted through heterosexual sex or pregnancy (largest cause of skipped- generation families in Africa)  Transmitted through bodily fluids (many through hetero sex and sharing needles, not just gay male sex)  Racial differences (blacks have higher rates of HIV) largely due to social factors (drug use, lack of resources) rather than biological factors  No cure for HIV/AIDS, prevention is the best method of control right now Prevention through Education & access to resources (condoms, clean needles) Copyright © 2010 Pearson Education, Inc. All rights reserved. 9
  • Threats to Health Weight: Too Much & Too Little • Increased rates of eating disorders in the US but also most obese nation • Fat used to be a sign of health (thinness was caused by a lack of resources to purchase food) Disabling Environment • Hazardous/Dangerous jobs, living near toxic waste, pollution, working with harmful chemicals Drugs Alcohol: Biological Gender differences exist in effects, but higher rates of alcoholism for men Nicotine: Most lethal recreational drug (Addictive) & Advertising targets youth 10
  • Threats to Health  Harmful Medical Experiments: Tuskegee Syphilis Experiment Cold War Experiments Puerto Rican Pill study: original birth control pill (20x stronger than todays pills) offered to Puerto Rican women – only poor women participated; doctors disregarded reports of negative health consequences; pill was released to 6 million US women and later found to be cancerous Drug companies offer financial compensation for trials, so poor are most likely to participateCopyright © 2010 Pearson Education, Inc. All rights reserved. 11
  • Issues in Health Care Depersonalization  Emphasis on Efficiency instead of bedside manner Malpractice Suits & Defensive MedicineAverage DR earns ≈$250k/yr, but owe ≈$100k for med school, & expensive malpractice insurance → consequently, Drs order more tests to cover themselves which is costly to patients Medical Incompetence (wrong side, wrong patient, wrong procedure, staff infection deaths, utensils left in body, etc) Mistakes kill ≈90,000 patients/yr (6th leading cause of death) Conflict of Interest: allegiance lies elsewhere than with patient  Stock in medication, drug company gifts, owning labs, self-referrals 12
  • Issues in Health Care Medical Fraud White-collar crime (diluting drugs, false reports to Medicare/insurance, harmful side effects not explained, etc) Medicalization Life event redefined as a medical issue (ADD, grief, Restless Leg Syndrome, wrinkles, balding, obesity, ED) Female bodies are medicalized more than male bodies (hysteria of the past, mammoplasty, plastic surgery, PMS, PMDD, birth control, pregnancy, miscarriage, abortion, childbirth, menopause) 13
  • Issues in Health Care Sexism & Racism in medicine • Female patients taken less seriously than males • Forced hysterectomies not uncommon for Mexican women • Less hospitals in black neighborhoods, and of poorer quality Euthanasia • Lot of money spent on last year of life quality- of-life care • Legal in WA & OR 14
  • Blacks have higher rates of HIV/AIDS, accidents,cancer, diabetes, sickle cell anemiaCauses of these rates: – Genetic differences (accounts for little) – Physical exertion (manual labor) – Psychological distress (discrimination) – Dietary consumption – Poorer medical care 15
  • Women have higher rates of depression, anxiety, &autoimmune diseases; lower rates of alcohol & drugdependency; longer life expectancyCauses for Gender differences: – Biological risks – Differing social factors (occupation, unpaid labor, risk-taking) – Psychosocial symptoms/care – Health reporting (men less likely to report) 16
  •  The US spends more money on HC than any other country (but govt pays smallest portion): Germany – 11% Japan – 8% Great Britain – 8% -VS- US 1960s – 5% US Clinton Era – 14% US 2008 – 16% _______________________________________ Inflation 2006 2007 Average Inflation: $100 $103.50 Inflation of HC: $100 $116.00 17
  • Copyright © 2010 Pearson Education, Inc. All rights reserved. 18
  • In US:-$2 trillion spent on HC/yr-Up to 24% of HC costs are spent on administration-Only 10% of drug companies’ expenditures spent onResearch & Development>50% of all bankruptcies due to unpaid medical bills-WHO ranked HC systems worldwide: #1 France, #2Italy… #30 Canada, #34 US-45 million people don’t have health insurance(largest group are college-aged) • This is changing with implementation of Affordable Care Act 19
  • Curbing Costs  HMOs - Health Maintenance Organizations Reduces necessary treatment  Diagnosis-Related Groups “Triage of Funding” Often discharged before recovery  National Health Insurance Various systems in industrialized countries Drs are private employees reimbursed by govt in Canada (creates longer waits, significantly reduces cost) Drs are govt employees in Great Britain (lower salaries)  Rationing Medical CareCopyright © 2010 Pearson Education, Inc. All rights reserved. 20
  •  Alternative Medicine – AKA nontraditional medicine Aromatherapy, acupuncture, herbal remedies, chiropractors, midwifery  Technology Rule of the US: if you have it, use it Weber’s Rationalization & efficiency is part of medical structure in USCopyright © 2010 Pearson Education, Inc. All rights reserved. 21