Health and Society (Chapter 11, "You May Ask Yourself")

A review of the social issues surrounding health, wellness and access to healthcare, particularly in America. Appropriate for 100-level sociology courses. If you like it, feel free to use it!
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"You May Ask Yourself" second edition (2011), D. Conley, W.W. Norton - Chapter 11
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*** This is only my "reworking" of pre-packaged PPT files included textbook published by W.W. Norton. Some materials copyright by W.W.Norton.

1. Health and Society
Chapter 11
You May Ask Yourself

2. The Rise of Medicine
•Why we think doctors are special:
•Universally valued product
•High moral calling to do good
•Professionalism
•Individual objectivity
•Impression management

3. Power of Doctors
•Doctors have the power to:
•construct their own pay rates.
•create demand for their products.
•regulate themselves.
•prescribe medications.
•“medicalize” conditions.

4. Medicalization
•Medicalization - the process by which
problems or issues not traditionally seen as
medical came to be framed as such.
•Pregnancy and childbirth
•Alcoholism
•Depression
•Nutrition

5. Biomedical Culture
•Historically, doctors weren’t powerful.
•Rome - slaves, poor freedmen, or
foreigners.
•England - rose from barber profession.
•Russia - payed about 75% of industrial
workers’ wages.

6. Biomedical Culture
•Reasons for Rise of Biomedical Culture
•Ability to offer “health” or actual increase in
years lived.
•Exclusion of other health frameworks
through licensing
•Legal authority through licensing
•Increased importance of larger institutions
(like hospitals)

7. Decline of Doctors?
•Reasons for loss of power in recent years:
•Rise of HMOs
•Rise of external regulations
•Patient Bill of Rights (1998)
•EMTALA (1986)
•COBRA (1985)
•HIPAA (1996)
•Rise of other forms of medicine
•Improved technology

8. Being Sick...
•The Sick Role (Talcott Parsons)
•Two Rights:
•Exemption from normal social roles
•Lack of accountability for illness
•Two Obligations:
•Try to get well.
•Seek the assistance of qualified individuals.

9. Social Construction of
Illness
•Religious views and practices:
•Seizures, faith healing, fire-cupping, coin rubbing.
•Medicalization:
•Alcoholism (don’t blame the victim)
•Understanding of pathologies:
•Cancer, obesity, heart disease (blame the victim)

10. Fire-cupping

11. Fire cupping bruises

12. Coin rubbing

13. Health related PSAs

14. U.S. Healthcare System
•Types of Coverage:
•Fee-for-service
•Health Maintenance Organizations (HMOs)
•Public Insurance
•State Children’s Health Insurance Programs
(SCHIP or KCHIP in Kentucky)
•Uninsured or Private Pay

15. Morbidity and Mortality
•Morbidity - illness in a general sense
•Mortality - death
•Whitehall Study:
•Men only
•Universal health access
•Who you are, where you live, how much you
earn, and what you do for a living all impact
health.

16. Born Unequal
•Gender differences:
•More boys than girls born, but higher infant
mortality for male babies.
•Sex ratios: 1.05 in US; 1.12 in China.
•Multiple Births
•IVF - multiple implanted embryos
•Ovulation increasing medications - more
fertilized eggs.

17. Post-Birth Health
Inequalities
•Low birth weight:
•Less than 5 pounds, 8 ounces.
•Caused by:
•Intrauterine growth restriction (IGR)
•Premature birth
•Prenatal health
•Mother’s health

18. Race and Health
•Life expectancy
•Infant mortality
•Disease prevalence:
•African Americans - heart disease and cancer
•Native Americans - cirrhosis and suicide
•Hispanics - diabetes and HIV/AIDS
•Racism as possible cause.

19. US Infant Mortality Rates

20. Socioeconomic Status
•Selection theory - spurious relationship
•Drift explanation - health causes social position
•Social determinants - social status determines
health
•Psychosocial - social class relative to those
around them.
•Materialist - differential access to health is
determined by SES.
•Fundamental - how social factors shape illness

21. Socioeconomic Status
•“Natural” Experiments through Policy Change
•Compulsory education - mid-1900s
•Each year of school decreased odds of death
by 3.6%.
•Social Security policy - 1977
•Lower Social Security payments led to
longer life.
•Due in part to continued workforce
participation.

22. Marital Status
•Married people tend to live longer,
especially men.
•Reasons:
•Health as precursor for marriage.
•Marriage decreases unhealthy behaviors.

23. Sex and Health
•Women live longer than men.
•Reasons:
•Disease prevalence differences.
•Healthcare-seeking behaviors.

24. Sex & Race Combined
•Much more profound impact than either
factor alone.
•Reasons:
•Racism
•Lower SES
•More dangerous jobs

25. Family Structure
•Larger families have higher childhood mortality.
•Supervision
•Closely-spaced families have higher childhood mortality.
•Supervision, maternal health.
•First-born children are more likely to die in childhood.
•Less experienced parents, unintended pregnancies,
mortality “creates” firstborns.

26. Mental Health
•Diagnostic Statistical Manual (DSM)
•DSM-I: 1952 - 60 disorders, standardized the
canon
•DSM-II: social context was important
•DSM-III: removed social context, followed
medical model
•DSM-IV: 400 disorders, necessary for medical
billing and insurance reimbursement.

27. Global Health
•Waterborne Illnesses
•Malaria
•Vaccines
•AIDS