2. Why Study Health and Illness?
â˘Our bodies are social
objectsâ
it is important to
understand the
role that health (and
illness) plays in our lives
as social beings.
â˘Health (and illness) are
social constructs. What it
means to be healthy or
sick is determined by a
society!
3. Types of Illnesses
â˘Acute diseases have a sudden
onset, may be briefly
incapacitating, and are either
curable or fatal.
â˘Chronic diseases develop
over a longer period of time
and may not be detected until
symptoms occur later in their
progression.
4. Approaches to
Medical Treatment
â˘Curative or crisis medicine is
the kind of health care that
treats
a problem after it has already
started.
â˘Preventative medicine is a kind
of health care that tries to
prevent or delay a problem. This
can include making lifestyle
changes.
5. Approaches to Medical Treatment
(contâd)
â˘Palliative care is the kind of
health care that focuses on
symptom and pain reliefâit is
not intended to provide a cure.
This is typically used for
critically ill or dying patients.
6. Social Construction
of Health and Illness
â˘Medicalization is the process
where some issues that
used to be seen as personal
problems are redefined as
medical issues.
7. Epidemiology
Epidemiology is the study of
disease patterns to understand
illnesses, how they spread, and
how to treat them.
â˘An epidemic happens when a
significantly higher than expected
number of cases of a disease
occurs within a population.
â˘A pandemic is when a higher than
expected number of cases of a
disease also spans a large
geographic region, as in multiple
countries or continents.
8. Social Inequality, Health, and
Illness
â˘Epidemiologists and
sociologists
have noticed a trend: not all
people have equal access
to health or health care.
9. Social Inequality, Health, and Illness
(contâd.)
â˘Socioeconomic status (SES)
impacts peopleâs ability to
access better heath care, tests and
medications, and also to afford better
nutrition. Higher SES individuals often
live longer and feel better than lower
SES individuals.
â˘Food deserts are poor, urban
neighborhoods without grocery
stores. This makes finding healthy
food options difficult.
10. Social Inequality, Health, and Illness
(contâd.)
â˘Race and gender are
compounded by income, as
minorities and women are more
likely to be in poverty. Minorities are
more likely to be exposed to harmful
surroundings; men are more likely to
hold hazardous jobs.
â˘Deprivation amplification occurs
when the risks we already have
because of our background or
heredity are amplified by social
factors.
11. Medicine as a Social Institution
â˘The American Medical
Association, through its
standards and regulations,
â˘transmits norms and values of
medicine and medical knowledge.
â˘regulates, licenses, and legitimizes
practitioners.
â˘polices itself and encroachment on
its power.
12. Medicine as a Social Institution
(contâd.)
â˘Doctor-patient relations are
greatly influenced by the
structure of the institution.
â˘The way that we interact with
doctors is what gives them
status and powerâthe norms
of the situation emerge from
the way we behave!
13. Medicine as a Social Institution
(contâd.)
â˘The sick role describes actions
and attitudes expected from
someone who is ill.
â˘Functionalist Talcott Parsons
suggests that being sick is a form of
deviance (itâs different from the
norm).
â˘You often get excused from your
normal responsibilities, but you have
new responsibilities, like seeking
treatment and trying to get better.
14. Issues in Medicine
and Health Care
â˘Health Care Reform is a
current issue that we hear a lot
about in the media. The premise
is that we need to provide better,
more affordable health care to all
people.
â˘Problems
â˘Who pays for this?
â˘Is it ethical to force people to
purchase insurance or take care of
themselves?
15. Issues in Medicine
and Health Care (contâd.)
One reason for health
care reform is to
eliminate rescissionâa
policy that allows
insurance companies to
cancel peopleâs
coverage after they get
sick.
16.
17. Issues in Medicine
and Health Care (contâd.)
â˘Cultural competence refers to
acknowledgment of a personâs
cultural background as part of the
treatment process.
â˘This is important because a
patientâs beliefs will shape his or
her approach to health care.
18. Issues in Medicine
and Health Care (contâd.)
â˘Other options
â˘Complementary medicine describes
treatments, practices, or products that
can be used in conjunction with
conventional Western medicine.
19. Issues in Medicine
and Health Care (contâd.)
â˘Alternative medicine
describes
treatments, practices, or
products that can be
used instead of
conventional Western
medicine.
20. Issues in Medicine
and Health Care
â˘Integrative medicine combines
conventional medicine with
complementary practices that are proven
to be safe and effective.
21. Issues in Medicine
and Health Care
â˘In an effort to eliminate
disorders, eugenics is an
attempt to manipulate the gene
pool to improve humans through
medical science.
â˘In using processes like
eugenics, it is important to
consider bioethicsâthe moral or
ethical issues related to scientific
or medical advancements.
22. So What? Why Study Health
and Illness?
â˘Understanding the link
between social structures and
the individual helps us
understand process and health
outcomes.
â˘Thinking about our values and
cultural context helps us
understand the way people
perceive the health of individuals,
society, and the planet.
Hinweis der Redaktion
In sociology, the purpose of studying health and illness isnât to treat or cure people like a doctor might. Instead, sociologists try to understand health and illness in a social context. For example, in Victorian times, being overweight was a sign of social status. Now obesity is considered a disease. How has our understanding of weight shaped this change? Whereas peasants were thin because they were underfed, now young women strive to achieve a similar physique. What norms have shifted to accommodate these new outlooks? How will these norms shift in the future?
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Acute diseases can come from viruses or germs, and can become ailments like the flu or a cold. Chronic diseases can come from environmental factors or lifestyle choices, and can include things like obesity or cancer.
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Which kind of medical treatment do you think is most common in the United States? Do you have insurance? If so, does it pay for a gym membership (preventative)? Would it pay for medication to help you lose weight (curative)? Many people believe that preventative medicine would have an initial cost, but would save a lot of money in the long run. What are some reasons that we donât invest more in preventative medicine?
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Hospice is a familiar provider of palliative care. Sometimes there are treatments available, but the expected outcomes are so poor or modest that people prefer to forgo the treatment and pursue a better quality of life for their time remaining. Palliative care makes this possible.
Weâve already mentioned obesity and weight issues. For those of you who are psychology majors, or if you have taken an abnormal psychology course, think about the Diagnostic and Statistical Manual of Mental Disorders (DSM). Homosexuality used to be considered a mental illness. Now, caffeine addiction is listed as diagnosable. People used to have babies at home, whereas now there are doctors, nurses, midwives, offices, wings, and entire hospitals dedicated to the birthing of babies!
Infections are often spread by vector organisms like mosquitoes or ticks. Epidemiology is interesting for many reasons aside from the actual health and illness of people. For instance, how are epidemics or pandemics portrayed in the media?
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Weâll talk more about some of the inequalities in upcoming slides.
Have you ever heard of a concierge doctor? These doctors charge especially high fees (and sometimes annual membership fees), but they guarantee one-on-one time with patients. They sometimes provide a direct cell number to call in emergencies, and offer other services like consultations with teachers to help them understand the needs of the children they tend. Wouldnât it be nice if everyone could access a service like this, regardless of income?
For instance, African Americans are at a greater risk for high blood pressure than other groups. Social factors, like living in a food desert, can increase stress and deny access to healthy food, which amplifies the risk for high blood pressure.
Oftentimes, people who are medically trained in other countries have too many obstacles to come to the United States and begin practicing. Do other cultures treat medical conditions differently than we do in the United States? Of course. Couldnât we learn something from bringing these different ideas in and incorporating them into the options that people in the United States have? However, due to tight regulations from the American Medical Association (AMA), these models are often omitted from health-care options in the United States.
Think of your last doctor visit. Ask students to describe a typical office visit. How long did they wait? How long did they spend with the doctor? How comfortable are they asking questions? Were they able to negotiate the price of their treatment? Did they understand the reasons for the medications they were prescribed? Why are our interactions with doctors different than our interactions with teachers, used car salespeople, or fast-food restaurant workers?
We tend to feel sympathetic for a person who stays home from work because she has the flu. We tell her to stay home, eat chicken soup, and feel better soon. However, what do we do when a person calls out of work every Monday? We might begin to assume that heâs âfaking itâ or is doing something over the weekend that is preventing him from getting up and coming in to work on Monday mornings. When we start feeling like the illness is in the personâs control (âif youâd stop partying on the weekend, youâd be fine on Monday morningâŚâ) then the sick role no longer applies. The sick role is also more difficult when a personâs illness is not visibleâfor instance, if a person is clinically depressed, people may say, âThings arenât that bad, just go to work and deal with it.â
Health care reform isnât new; even Richard Nixon was interested in such reform, in the 1970s. While most people believe fundamentally that all people deserve to have access to health care, there are debates about how to fund programs, who should be covered, and what other programs should be cut or eliminated if we arenât able to fund everything.
The idea of insurance is that we pay for something that we donât need now to ensure that weâll have access to coverage when we need it later. Many people are frustrated when they pay insurance premiums for years without having to use the coverage, only to find out that when they need the coverage later, their policy gets canceled and they have no insurance benefits.
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For instance, if youâre from a culture that believes that taking pills will steal a personâs soul, youâre probably not going to take the medication that your doctor prescribes if it comes in a pill form. Understanding the patientâs background can help a doctor treat the person effectively.
This could include taking an herbal supplement in addition to a prescribed medication. Another example could be a man who takes a medication for hypertension, but also practices yoga every morning to help with stress.
Some people may find that acupuncture relieves their symptoms (like a headache, for instance) better than a medication, so they use alternative medicines. It is difficult to learn about alternative medicines because theyâre not commonly practiced by Western physicians and may be limited by the AMA.
This is becoming more popular; however, there are still relatively few studies being conducted on complementary and alternative forms of medicine. Additionally, insurance providers are less likely to pay for nonconventional services, so patients seeking these kinds of treatment are often left to pay for them out-of-pocket.
Those who have heard of eugenics are most familiar with the term in the context of the Holocaustâwhen doctors or scientists sought to create the âperfect race.â However, eugenics also has a long and troubling history in the United States. What may have begun with good intentions (eliminating a disease or genetic trait that caused people trouble) became a call for forced sterilization, forced removal of individuals from society, and institutionalization of individuals due to poor genetic makeup or undesirable characteristics.
We now have advanced technology that allows us to perform genetic testing or to see embryos at early stages of development. If we see something troubling, what should we do? As individuals we might have an opinion about this, but as sociologists, itâs not our job to answer this question. Rather, we want to understand the social implications for having this technology and for the people who have to make these decisions.
You can remind students of the discussion earlier in the semester about the sociological imagination. Point out that thinking about social and historical context as well as biographical experience helps us to understand social life.
