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  1. 1. Introduction to Sociology: Health and Medicine
  2. 2. Introduction ● The World Health Organization (WHO) defines health as "a state of complete physical, mental and social well-being, and does not consist only of the absence of disease or infirmity" ● What it means to be healthy can vary from culture to culture and is often connected with advances in technology and cultural patterns of race, class, gender, and sexual inequalities. ● In some cultures, larger body sizes are seen as a sign of healthiness as it indicates an individual has a preponderance of food. ● In other cultures, largeness is more closely associated with unhealthy lifestyles (e.g., lack of exercise, poor eating habits, etc.). Advances in technology have also expanded the idea of what it means to be healthy. ● Health care (or healthcare) is an industry associated with the prevention, treatment, and management of illness along with the promotion of mental and physical well-being through the services offered by the medical and allied health professions. ● Medical Sociology is concerned with the distribution of healthcare services globally, in particular inequalities in healthcare, and how conceptions of health have changed over time.
  3. 3. Health Disparities ● While technology has advanced the practice of medicine and generally improved health, not all people have the same access to health care or the same quality of health care. ● In the United States, health disparities are well documented in racial minority populations such as African Americans, Native Americans, Asian Americans, and Hispanics. ● They are also well-documented based on income differences and among sexual minority populations.
  4. 4. Causes of Health Disparities ● There is debate about what causes health disparities between dominant and subordinate groups. However, it is generally accepted that disparities can result from three main areas: – From the differences in socioeconomic and environmental characteristics of different ethnic and racial groups. – From the barriers certain minority groups encounter when trying to enter into the health care delivery system. – From the quality of health care different minority groups receive.
  5. 5. Health Insurance ● Health insurance is a type of insurance whereby the insurer pays the medical costs of the insured if the insured becomes sick due to covered causes or accidents. ● Researchers have demonstrated that access to health insurance will have a limited impact on health disparities due to the importance of varied types of social, psychological, material, symbolic, and political resources in the overall construction, maintenance, and challenge of health inequalities.
  6. 6. Private Insurance and Free-Market Health Care ● Private insurance refers to health insurance provided by a non-governmental organization, usually a privately owned or publically traded corporation. ● Private insurance as the primary provider of health care in a developed nation is really only found in the United States as of 1973. ● Advocates of the private model argue that this approach to health care has the following benefits: – Some economists argue that the free market is better able to allocate discretionary spending where consumers value it the most. – Advocates also point to the remarkable advances in medical technology that have accompanied the private insurance/free-market approach to health care. – Advocates also argue that private industry is more efficient than government, which can be quite susceptible to bloat and bureaucracy.
  7. 7. Private Insurance and Free-Market Health Care ● Despite these possible benefits, the private insurance approach is not without its drawbacks. – As noted above, private insurance can be a boon to those who can afford the cutting edge technology. But the flipside to this boon is that the United States, the only mostly-private health delivery system in a developed country, is below average among developed nations by almost every health measure, including: infant mortality, life expectancy, chronic diseases and cancer survival rates. – Another significant criticism of the private system is that it ends up being more costly than publicly funded systems. – Most experts believe that significant market failure occurs in health markets, thereby leading free market insurance models to operate inefficiently. – When a claim is made, particularly for a sizeable amount, the use of paperwork and bureaucracy can allow insurance companies to avoid payment of the claim or, at a minimum, greatly delay it. – Health insurance is often only widely available at a reasonable cost through an employer-sponsored group plan. This means that unemployed individuals and self-employed individuals are at an extreme disadvantage and will have to pay for more for their health care. – Health Maintenance Organizations or (HMO) types of health insurance are often criticized for excessive cost-cutting policies that include accountants or other administrators making medical decisions for customers. – As the health care recipient is not directly involved in payment of health care services and products, they are less likely to scrutinize or negotiate the costs of the health care they receive.
  8. 8. Publicly Funded Health Care ● An alternative to private health insurance and the free-market approach to health care is publicly funded health care. ● Publicly funded medicine is health care that is paid wholly or mostly by public funds (i.e., taxes). ● Proponents of publicly funded medicine cite several advantages over private insurance or free-market approaches to health care: – Publicly funded approaches provide universal access to health care to all citizens, resulting in equality in matters of life and death. – Publicly funded health care reduces contractual paperwork. – Publicly funded health care facilitates the creation of uniform standards of care. – Publicly funded health care may help reduce illnesses associated with job loss. As many people in the US rely on their jobs for health insurance, losing their jobs increases stress and, as a result, increases illness. – It is also the case that publicly funded systems result in a reduction in the percentage of societal resources devoted to medical care; meaning public systems cost less than private systems.
  9. 9. Publicly Funded Health Care ● Publicly funded health care is not without its criticisms. Some purported disadvantages of the public system include: – Some critics argue there is a greater likelihood of lower quality health care than privately funded systems. However, because of the universal accessibility of health care, this claim is generally not true. – Another criticism of publicly funded health care is that there is less motivation for medical innovation and invention and less motivation for society's most skilled people to become doctors, because of the lower amount of monetary compensation. – Price no longer influences the allocation of resources, thus removing a natural self-corrective mechanism for avoiding waste and inefficiency (though the redundancy of the private system - competing insurers - often results in more inefficiency than a single, public system). – Health care workers' pay is often not related to quality or speed of care. Thus very long waits can occur before care is received. – Because publicly funded medicine is a form of socialism, many of the general concerns about socialism can be applied to this approach. – People are afraid that they can't choose their own doctor. The state chooses for them. This also tends to be an over-exaggerated and ill- founded concern as there is some degree of freedom in choosing medical practitioners in public systems.
  10. 10. Countries with Universal Healthcare
  11. 11. Obesity ● Obesity is a condition in which the natural energy reserve of humans, which is stored in fat tissue, is expanded far beyond usual levels to the point where it impairs health. ● While cultural and scientific definitions of obesity are subject to change, it is accepted that excessive body weight predisposes to various forms of disease, particularly cardiovascular disease.
  12. 12. Causes of Obesity ● Obesity is generally a result of a combination of factors: – Genetic predisposition – Energy-rich diet – Limited exercise and sedentary lifestyle – Weight cycling, caused by repeated attempts to lose weight by dieting – Underlying illness – Certain eating disorders – Poverty