slides

1. The Symbolic Interactionist Perspective
19.1 Explain why health and illness are culturally relative, not absolute matters.
• The Role of Culture in Defining Health and Illness
• The Components of Health

2. The Role of Culture in Defining Health and
Illness
• People are defined by cultural guidelines
• “Sickness” and “health” are a matter of cultural
definition

3. The Components of Health
• Physical
• Mental
• Social
• Spiritual

4. Figure 19.1 A Continuum of Health and Illness
A graphic representation of four components of wellness on continua.
Source: World Health Organization 1946; modified by the author.

5. The Functionalist Perspective
19.2 Summarize the sick role: its elements, ambiguity, gatekeepers, and gender differences.
• The Sick Role
• Elements of the sick role
• Ambiguity in the sick role
• Gatekeepers to the sick role
• Gender differences in the sick role

6. The Conflict Perspective
19.3 Explain how health care is part of the struggle over scarce resources.
• Global Stratification and Health Care
• Establishing a Monopoly on U.S. Health Care

7. Global Stratification and Health Care
Global stratification in
health care is starkly
evident in this photo
of mental health
patients in a "mental
health center" in
Mogadishu, Somalia.

8. Figure 19.2 How Many Babies Die Before Their
First Birthday?
Bar chart comparing
the infant mortality
rates of several
nations with the U.S.
Note: Infant mortality is the number of babies that die before their first birthday, per
1,000 live births. Belgium, Czech Republic, and Greece have lower infant mortality rates
than that of the United States, but they have been dropped from the source.
Source: By the author. Based on Statistical Abstract of the United States 2017:Table 1349.

9. Down-to-Earth Sociology
José’s Old Kidney: The International Black Market in Human
Body Parts
The human organs on
which the international
black market depends
come from the poor.
This photo was taken in
Lahore, Pakistan, after
a raid on a clandestine
clinic. The police found
ten people who had
just had a kidney
removed.

10. Establishing a Monopoly on U.S. Health Care
Forget Oprah and Weight
Watchers. So much more
effective--and easier--in
the 1800s. Just swallow
"sanitized" tape worms and
eat all you want. No ill
effects from these "friends
of fair form" (slender
shape), says this ad, which
provides marvelous insight
into health care at this
time.

11. Historical Patterns of Health
19.4 Discuss changes in causes of death and whether Americans were healthier in the past.
• Physical Health
• Mental Health

12. Figure 19.3 The Top Ten Causes of Death in
the United States, 1900 and Now
Bar chart showing what changed
in the typical causes of death in
100-plus years.
Sources: By the author. 1900 data
from CDC 2009. Current data from
Statistical Abstract of the United
States 2017:Table 129.

13. Mental Health
• Glorifying the past
• More mental illness today is perception, not reality
• Hard to measure

14. Issues in Health Care (1 of 2)
19.5 Discuss medical care as a right or a commodity, increasing costs, social inequality, lawsuits, incompetence, fraud,
conflict of interest, depersonalization, sexism, racism, the medicalization of society, physician-assisted suicide, and
attempts to reduce cost.
• Medical Care: A Right or a Commodity?
• Skyrocketing Costs
• Social Inequality
• Reducing Inequalities: Health Care Reform
• Malpractice Lawsuits and Defensive Medicine
• Medical Incompetence

15. Issues in Health Care (2 of 2)
• Depersonalization: The Medical Cash Machine
• Conflict of Interest
• Medical Fraud
• Sexism and Racism in Medicine
• Medicalization of Society
• Medically Assisted Suicide
• Reducing the Costs of Medical Care

16. Medical Care: A Right or a Commodity?
• A right means equal access to all
• A commodity means the rich will have access and the
poor will be denied
• In the U.S. medical care is a commodity

17. Figure 19.4 The Soaring Cost of Medical Care:
Annual Costs per American
Note: This is the national medical bill divided by the total population. Each year, in addition to insurance
payments, the average American pays $919 out-of-pocket (Statistical Abstract of the United States 2017:Tables
14, 144). The average family of four lays out $3,676 a year, plus whatever they pay for insurance.
Source: By the author. Based on Statistical Abstract of the United States 2017:Table 146 and earlier years.

18. Social Inequality and Reducing Inequalities
Health Care Reform
• Social Inequality
• A two-tier system
• Reducing Inequalities: Health care reform
• The Affordable Care Act and its aftermath

19. Figure 19.5 What Having a Baby Used to Cost
This was the total
of a typical
hospital bill for
childbirth in the
early 1960s.

20. Figure 19.6 Income and Days Sick in Bed
Bar graph depicting relative proportion of sick days claimed per year according to income.
representative sample of adults age 18 and over was asked some form of this question.
Source: By the author. Based on Centers for Disease Control and Prevention 2016a:Table A-9.
1
A nationally

21. Malpractice Lawsuits and Defensive
Medicine
• From “people make mistakes,” to “I wonder if this is
the one who is going to turn around and sue me.”

22. Medical Incompetence
• Each day in the United States, there are about a dozen
wrong-patient, wrong-side, or wrong-procedure
surgeries
• 1 percent of doctors account for one-third of all medical
malpractice claims

23. Depersonalization: The Medical Cash Machine
• Patient as object
• Feelings are overpowered by the need to be efficient

24. Conflict of Interest
• Lack of objectivity
• The conflict between need and profit

25. Medical Fraud
• White collar crime; beyond loss of money
• A scam not likely to be caught

26. Sexism and Racism in Medicine
• Downplaying women’s complaints
• Unnecessary hysterectomies
• Racism and surgery

27. The Medicalization of Society
• Medical treatment for everything
• Theoretical perspectives
• Symbolic Interactionism
• Functionalism
• Conflict Perspective

28. Medically Assisted Suicide
• Euthanasia, active versus passive

29. Reducing the Costs of Medical Care
• HMOs (Health Maintenance Organizations)
• DRGs (Diagnostic-Related Groups)
• Pay-as-you-go clinics
• Group care
• Off-site health clinics

30. Thinking Critically About Social Life
Who Should Live, and Who Should Die? The Dilemma of
Rationing Medical Care
Advanced medical
technology is a major
reason for the high costs of
medical care. These two
patients are undergoing
dialysis, a treatment for
kidney failure, at a cost of
$65,000 a year each. The
annual bill for the 650,000
dialysis patients in the U.S.
is $42 billion.

31. Threats to Health
19.6 Discuss threats to health: alcohol and nicotine, medical errors, HIV/AIDS, weight, disabling
environments, medical experiments, globalization of disease, and treatment or prevention.
• Alcohol and Nicotine
• Medical Errors
• HIV/AIDS
• Weight: Too Much and Too Little
• Disabling Environments
• Medical Experiments: Callous and Harmful
• Chicken Bones and the Globalization of Disease

32. Alcohol and Nicotine (1 of 6)
Table 19.1 What Drugs Do High School Seniors Use?
Blank
In the Past Month? In the Past Year?
Alcohol 33.2% 55.6%
How many have been drunk? 20.4% 37.3%
Marijuana/Hashish 22.5% 35.6%
Nicotine (cigarettes) 10.5% NA
E-cigarettes 12.5% NA
OxyContin 3.4% NA
Amphetamines 3.0% 6.7%
Adderall NA 6.2%
Ritalin NA 1.2%

33. Alcohol and Nicotine (2 of 6)
Table 19.1 [continued]
Blank
In the Past Month? In the Past Year?
Tranquilizers 1.9% 4.9%
Barbiturates (sedatives) 1.5% 3.0%
Hallucinogens superscript 1 1.4% 4.3%
Ecstasy (MDMA) 0.9% 2.7%
LSD 1.0% 3.0%
Cocaine 0.9% 2.3%
Steroids 0.7% 1.0%
Heroin 0.2% 0.3%
than LSD.
Source: By the author. Based on Johnston et al 2017:Tables 6, 7.
1
Hallucinogens
1
Other

34. Alcohol and Nicotine (3 of 6)
Moderate drinking of
alcohol brings health
benefits. Heavy drinking
harms health. Excessive
drinking also leads to
other forms of harm,
such as what you see in
this photo.

35. Alcohol and Nicotine (4 of 6)
Table 19.2 What Drugs Do Full-Time College Students Use?
Blank
In the Past
Month?
Men
In the
Past
Month?
Women
In the Past
Year? Men
In the
Past Year?
Women
Alcohol 63.9% 62.7% 78.7% 79.2%
How many have been drunk? 44.4% 34.4% 64.1% 60.0%
Marijuana 25.5% 18.5% 40.2% 36.6%
Nicotine (cigarettes) 15.5% 8.8% 24.9% 17.2%
Amphetamines 6.6% 2.7% 13.2% 7.7%
Adderall NA NA 14.8% 8.1%
Ritalin NA NA 3.2% 1.2%
Cocaine 2.8% 0.7% 6.4% 3.0%

36. Alcohol and Nicotine (5 of 6)
Table 19.2 [continued]
Blank
In the Past
Month? Men
In the Past
Month? Women
In the Past
Year? Men
In the Past
Year? Women
Hallucinogens superscript 1
1.9% 1.1% 4.8% 2.0%
Ecstasy (MDMA) 0.8% 0.7% 5.0% 3.7%
LSD 0.7% 0.8% 4.9% 2.0%
Tranquilizers 1.6% 1.6% 5.1% 3.8%
OxyContin NA NA 3.2% 0.4%
Barbiturates (sedatives) 0.4% 1.4% 2.4% 2.2%
Heroin 0.0%** 0.1% 0.3% 0.1%
than LSD.
** Not actually zero, but too small to show up.
NA = Not Available.
Source: By the author. Based on Johnston et al. 2016: Tables 8-2, 8-3.
1
Hallucinogens
1
Other

37. Alcohol and Nicotine (6 of 6)
A Joe Camel ad. He has
since been banned from
advertising.

38. Figure 19.7 Who Is Still Smoking?
Bar graph
showing the
decrease in both
male and female
smokers over
time in the U.S.
Note: The first year these data were reported was 1965; 1970 and 1980 are averages of the closest
preceding years where data were available.
Source: By the author. Based on Statistical Abstract of the United States 1996:Table 222; 2017:Table
214; CDC 2017.

39. Medical Errors
• Using a checklist
• Federal Center for Patient Safety

40. Figure 19.8 The Path of AIDS in the U.S.
Bar graph showing changes in the number of AIDS diagnoses and deaths in the United States over time.
Source: By the author. Based on CDC 2003:Table 21; 2016b:Tables 1a, 12a.

41. Figure 19.9 AIDS: A Global Glimpse
Bar graph showing the prevalence of AIDS in various parts of the world.
Source: By the author. Based on UNAIDS 2016; Haub et al 2016.

42. Figure 19.10 How Americans Get AIDS
Pie charts depicting the
differing proportions in sources
of AIDS for males and females.
Note: There is another
category, “Other,” consisting of
blood transfusions and
unknown, but it is too small to
show: just 36 males and 15
females.
Source: CDC 2016b:Table 1a.

43. Figure 19.11 New Diagnoses of HIV by Race–
Ethnicity
Pie charts showing disproportion in HIV-positive status across racial-ethnic groups in
the United States.
Note: Data are for 2015, the latest year available.
Source: By the author. Based on Figure 12.4 of this text and CDC 2016b:Table 1a.

44. HIV/AIDS
With HIV/AIDS devastating
swaths of Africa, attention-
getting devices are being
used to increase awareness
of the need to use condoms.
This photo of a mannequin
wearing a hat made of red
condoms was taken in
Durban, South Africa.

45. Weight: Too Much and Too Little
• Harmful to be obese
• Helpful to be slightly overweight

46. Disabling Environments
• Dangerous occupations
• Toxic substances
• Pollution

47. Medical Experiments: Callous and Harmful
(1 of 2)
• The Tuskegee syphilis experiment
• The Guatemalan experiment
• Cold War experiments
• Playing God

48. Medical Experiments: Callous and Harmful
(2 of 2)
These men were
among the 399 men in
the syphilis
experiment that ran
for 40 years in the
segregated South. This
photo was taken in the
1950s in Tuskegee,
Alabama.

49. Chicken Bones and the Globalization of
Disease
• The threat of disease
• The potential for superbugs
▪ Example: Ebola
• Failing to contain disease in poverty nations
• Travel and the spread of disease globally
• Predicting disease outbreaks?

50. Treatment or Prevention?
19.7 Explain why it is difficult to change the focus from the treatment of illness to the
prevention of illness.
• Lifestyle
• Down a road to disease and illness
… or to health and wellness

51. The Future of Medicine
19.8 Discuss how alternative medicine and technology are likely to affect the future of
medicine.
• Alternative (Nontraditional) Medicine
• Technology

52. Alternative Medicine
• Eastern influence
• Mind-body approach

53. Technology
Telemedicine, a result of
changing technology, is
becoming more common.
In these photos from
France, you can see a
family doctor guiding a
consultation with a
medical specialist.