This document discusses several key topics in sociology of medicine and health, including different perspectives on defining health and illness, the concept of the "sick role", and factors that influence health outcomes and access to healthcare. It also examines issues related to the medicalization and stratification of health, as well as threats to health such as HIV/AIDS, weight issues, drugs and harmful medical experiments.
A presentation by Karen Nelson, MBA, MSW, RSW, of the Ottawa Hospital, made to social workers at their 2013 Annual Meeting. A very thorough overview with significant research supporting the link between Social Determinants of Health and healthcare outcomes.
A presentation by Karen Nelson, MBA, MSW, RSW, of the Ottawa Hospital, made to social workers at their 2013 Annual Meeting. A very thorough overview with significant research supporting the link between Social Determinants of Health and healthcare outcomes.
introduction
Sociology and psychology in public health
Theories of sociology and psychology
Sociological and psychology methods, investigations and interventions.
Developing interventions to change health-related behaviour and;
Conclusion
The basic sociological concepts and its relevance to health and nursing:
• Definition of Social science/Sociology- pg 2 in Pretoruis & pg 3 in Du Toit
• Sociologist- pg 8 in Pretoruis
• Anthropology- pg 7 in Du Toit
• Definition of a Social perspective- pg 10 in Du Toit
• Sociological imagination- pg 9 in Du Toit.
• Medical sociology.
• Definition of Social interaction- pg 80 in Du Toit
• Society- definition in Reader, characteristics,
• Community- definition in Reader, characteristics,
• Urban and rural communities (interaction and differences)
• Social structures (Status: ascribed, achieved, master; Position and role: role set, role strain, role conflict)- pg 85 in Du Toit
• Social groups- pg 125 in Du Toit
• The family: functions pf 172, transformation, alternative forms,
• Social institutions - pg 189 in Du Toit
• Social stratification- pg 103 in Du Toit
• Social relationships (Primary & Secondary relationship characteristics) - pg 96-98 in Du Toit
Produced by California Newsreel with Vital Pictures. Presented by the National Minority Consortia.
Public Engagement Campaign in Association with the Joint Center for Political and Economic Studies Health Policy Institute.
introduction
Sociology and psychology in public health
Theories of sociology and psychology
Sociological and psychology methods, investigations and interventions.
Developing interventions to change health-related behaviour and;
Conclusion
The basic sociological concepts and its relevance to health and nursing:
• Definition of Social science/Sociology- pg 2 in Pretoruis & pg 3 in Du Toit
• Sociologist- pg 8 in Pretoruis
• Anthropology- pg 7 in Du Toit
• Definition of a Social perspective- pg 10 in Du Toit
• Sociological imagination- pg 9 in Du Toit.
• Medical sociology.
• Definition of Social interaction- pg 80 in Du Toit
• Society- definition in Reader, characteristics,
• Community- definition in Reader, characteristics,
• Urban and rural communities (interaction and differences)
• Social structures (Status: ascribed, achieved, master; Position and role: role set, role strain, role conflict)- pg 85 in Du Toit
• Social groups- pg 125 in Du Toit
• The family: functions pf 172, transformation, alternative forms,
• Social institutions - pg 189 in Du Toit
• Social stratification- pg 103 in Du Toit
• Social relationships (Primary & Secondary relationship characteristics) - pg 96-98 in Du Toit
Produced by California Newsreel with Vital Pictures. Presented by the National Minority Consortia.
Public Engagement Campaign in Association with the Joint Center for Political and Economic Studies Health Policy Institute.
Transition from allopathic to integrated medical practiceLouis Cady, MD
This is the keynote lecture of the series of three lectures that Dr. Cady presented to the World Link Medical seminar in Salt Lake City, Utah on June 1, 2012.
HealthcareChapter 191Health Care in .docxpooleavelina
Healthcare
Chapter 19
1
Health Care in the US
Medicine refers to a society’s organized ways of dealing with illness and injury
In the U.S. medicine is a profession, a bureaucracy and a big business.
Sociologists also examine how illness and health are related to cultural beliefs, lifestyle and social class
Health is a state of complete physical, mental and social well-being.
Health care is any activity intended to improve health
2
The Social Construction of Health
Cultural meaning
Which illnesses are stigmatized?
Which illnesses are disabilities?
Which illnesses are contested?
Social Construction of Illness Experience
Definition of illness is linked to social construction of reality
Social Construction of Medial Knowledge
Medical knowledge reflects and reproduces inequalities
3
Factors Affecting Health
Social epidemiology
Disease agents (biological, nutrient, chemical)
The environment (physical, biological, social)
Human host
Demographic Factors
Age, Sex, Race and Ethnicity, Social Class
Lifestyle Factors Affecting Health
Alcohol / tobacco
Illegal drugs
Sexually Transmitted Diseases
4
Functionalism – Talcott Parsons
Functionalism: the positive functions of the health care system are the prevention and treatment of disease.
The Sick Role (Talcott Parsons)
5
Functionalism – Eliot Freidson
Eliot Freidson
Variations in the sick role to exist
Social treatment depends on seriousness of disease
Stigmatization impacts treatment
Illness label is not objectiveAssigned SeriousnessIllegitimate (Stigmatized)Conditional LegitimateUnconditional LegitimacyMinor deviation“Stammer”“A cold”“Pockmarks”Serious deviation“Epilepsy”“Pneumonia”“Cancer”
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Conflict Perspective
Conflict perspective: the inequality inherent in our society is responsible for the unequal access to medical care.
Minorities, the lower classes, and the elderly, particularly elderly women, have less access to the health care system than Whites, middle & upper classes, and middle-aged.
7
Symbolic Interaction
Symbolic interactionists hold that illness is partly socially constructed.
The definitions of illness and wellness are culturally relative—sickness in one culture may be wellness in another.
Medicalization and demedicalization
8
Problems in U.S. Health Care
The World Health Organization ranks the U.S. 37th out of 191 countries according to its health care performance.
When comparing health care systems we examine
Universal coverage
Portability
Geographic accessibility
Comprehensive benefits
Affordability
Financial efficiency
Consumer choice
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Problems in U.S. Health Care
Traditional Medicine
Private Insurance
Government Insurance
Medicaid
Medicare
Managed Care
Complementary and Alternative Medicine (CAM)
10
Problems in U.S. Health Care
Inadequate Health Insurance Coverage
Universal Health Care – a system of health care, typically financed by the government that ensures health ...
Social Determinants of Health InequitiesRenzo Guinto
Lecture given during the pre-APRM workshop on Social Determinants of Health and Global Health Equity, September 11, 2012, Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur
Clients Presentation Your client can make up whatever they want.WilheminaRossi174
Clients Presentation: Your client can make up whatever they want. They can be as dramatic as they want to be. Have fun with it!
Subjective Data (4 points): (Review History questions in power point and on page 534-535 of text.)
Objective Data (4 points):
Inspection: What is the shape and size of the abdomen? Any masses or pulsations upon inspection? Skin smooth? Striae, scars, lesions?
Auscultation: Bowel Sounds Present in all 4 quadrants? Hypoactive, Normoactive, etc. Any bruits upon auscultation?
Percussion: Tympany in all 4 quadrants?
Palpation: Abdomen soft, firm? Any enlarged organs? Masses? Tenderness?
Any other objective data you found important to document?
Describe 2 Actual/Potential Risk Factors (2 points):
CHAPTER 15
15.1 INTRODUCTION
Although in some cases behavioral and psychiatric/mental are grouped under the same broad
category, behavioral health problems are generally effectively treated on an outpatient basis with
combination psychotherapy and pharmacotherapy (medications). Behavioral health professionals
are licensed by the state in which they reside to practice, and they collaborate on the management
of clients’ behavioral problems. These professionals include psychiatrists, psychologists,
psychiatric nurse practitioners, social workers, family counselors, and drug/alcohol and mental
health counselors (Parker, 2002). Such chronic problems as dementia and mental retardation are
considered psychiatric/mental problems rather than behavioral.
There is a distinct interconnectedness between mental health and health in general. The WHO
defines health as, “a state of complete physical, mental, and social well-being, and not merely the
absence of disease and infirmity” (WHO, 2001b, p. 1). Mental health on the other hand is defined
as, “a state of well-being in which the individual realizes his or her own abilities, can cope with the
normal stress of life, can work productively and fruitfully, and is able to make a contribution to his
or her community … it is determined by socioeconomic and environmental factors and it is linked
to behavior” (WHO, 2001a, p. 1; WHO 2010, p. 1). For example, people are generally resilient
enough ...
10. 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
12. Issues in Health Care
Depersonalization
Emphasis on Efficiency instead of bedside manner
Malpractice Suits & Defensive Medicine
Average 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
13. 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
14. 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
15. Blacks have higher rates of HIV/AIDS, accidents,
cancer, diabetes, sickle cell anemia
Causes of these rates:
– Genetic differences (accounts for little)
– Physical exertion (manual labor)
– Psychological distress (discrimination)
– Dietary consumption
– Poorer medical care
15
16. Women have higher rates of depression, anxiety, &
autoimmune diseases; lower rates of alcohol & drug
dependency; longer life expectancy
Causes for Gender differences:
– Biological risks
– Differing social factors (occupation, unpaid
labor, risk-taking)
– Psychosocial symptoms/care
– Health reporting (men less likely to report)
16
17. 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
19. 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 on
Research & Development
>50% of all bankruptcies due to unpaid medical bills
-WHO ranked HC systems worldwide: #1 France, #2
Italy… #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