Health, Health Care, and Disability

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Health, Health Care, and Disability

• Chapter 10

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Medicine and Social Transformation

• As societies have developed, medicine has taken
  on a scientific role.
• Medicine men vs. doctors
• Disease has always affected society.
• Black Plague
• Malaria
• AIDS

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Medicalization of Society

• Simple processes have become complex
• Birth
• Problems are now diseases
• Addictions
• Mental disorders
• Obesity

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Health, Health Care, and Medicine

• Health is a state of physical, mental, and social
  well-being.
• Disease is a pathology that upsets bodily
  functions
• Health care is any activity intended to improve
  health.
• Medicine is an institutionalized system for the
  scientific diagnosis, treatment, and prevention
  of illness.

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Widespread Disease

• Epidemicwidespread outbreak
• Pandemicworldwide outbreak
• Life expectancyestimate of the average lifetime
  of people born in a given year
• Infant Mortality Ratenumber of deaths per 1,000
  births in a given year (below 1 year old)

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Social Epidemiology

• Study of the causes and distribution of health,
  and disease in a population
• Disease agents insects, bacteria, nutrient
  agents, pollutants, and temperature.
• Environment - physical, biological and social
  environments.
• Human host -demographic factors such as age,
  sex, and race/ethnicity.

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Demographic Factors Age

• Rates of illness and death are highest among the
  old and the young.
• After age 65, rates of chronic diseases and
  mortality increase rapidly.
• Chronic diseases are long term or lifelong and
  develop gradually or are present from birth.
• Acute diseases strike suddenly and cause dramatic
  incapacitation and sometimes death.

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Demographic Factors Sex

• Prior to the 20th century, women had lower life
  expectancies because of high mortality rates
  during pregnancy and childbirth.
• Women now live longer than men.
• For babies born in the United States in 2003,
  life expectancy at birth was 74.8 years for males
  and 80.1 years for females.
• Males tend to engage in more risky activities and
  lifestyles choices

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Demographic Factors Race/Ethnicity and Social
Class

• According to a study by the Stanford Center for
  Research in Disease Prevention, people have a
  higher survival rate if they live in
  better-educated or wealthier neighborhoods.
• People of color are more likely to have incomes
  below the poverty line, and the poorest people
  receive less preventive care and less management
  of chronic diseases.
• Engage in poor health activities

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Highest Causes of Preventable Deaths

1. Tobacco
2. Poor diet/lack of exercise
3. Alcohol
4. Bacteria/viruses
5. Pollution
6. Motor vehicles
7. Firearms
8. Sexual behavior
9. Illegal drugs

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Lifestyle Factors Alcohol and Tobacco

• Chronic heavy drinking or alcoholism can cause
  permanent damage to the brain or other parts of
  the body.
• Also lead to nutritional issues which causes
  further problems
• On average, Americans consume 22 gallons of beer
  a year

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Lifestyle Factors Alcohol and Tobacco

• Tobacco is responsible for about one in every
  five deaths in this country.
• More addictive than heroin
• Environmental smoke (second hand) continues to be
  damaging, even though smoking rates have dropped.
• This especially affects those who carpool and in
  the office.

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Stay Healthy

• Exercise and proper diet.
• Eat three meals.
• Sleep.
• Stay away from things that have negative effects.

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Health Care in the US
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The Flexner Report

• Conducted to professionalize medicine.
• As a result, white women and people of color were
  largely excluded from medical education for the
  first half of the 20th century.
• Flexner report did sets standards for medical
  training and professionalize medicine.

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Medical Care in the U.S.

• Private Health Insurance cited as the main
  reason for medical inflation, gives doctors and
  hospitals an incentive to increase costs.
• Public Health Insurance
• Medicareover 65
• Medicaidin need of medical benefits
• Projections call for Medicaid spending to double
  and Medicare spending to triple in the next few
  years.

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Medical Care in the U.S.

• Health Maintenance Organizations provide total
  care with an emphasis on prevention.
• Must choose from certain physicians
• Managed care monitors and controls health care
  providers' decisions, insurance company has the
  right to refuse to pay for treatment.
• Need referrals to see specialists

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Implications of Advanced Medical Technology

• Create options that alter human relationships
  (prolonging life after consciousness is lost).
• Increase the cost of medical care.
• Raise questions about the very nature of life
  (invitro fertilization, cloning, stem cell
  research).

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Other Countries

• Single Payer System (socialized medicine)
• Government funded
• Health care providers bill government, not
  insurance companies
• Non profit
• Government does not always authorize all
  procedures
• Limited options

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Holistic and Alternative Medicine

• Holistic medicine focuses on prevention of
  illness and disease and is aimed at treating the
  whole person rather than just the part or parts
  in which symptoms occur.
• Alternative medicine includes healing practices
  inconsistent with dominant medical practice.

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Sociological Perspectives on Health and Medicine
Functionalist The sick role People who are sick are exempt from obligations, but must want to get well and seek competent help.
Conflict Inequalities in health and health care Problems in health care are rooted in the capitalist system, exemplified by the medicalindustrial complex.
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Sociological Perspectives on Health and Medicine
Interactionist Social construction of illness People socially construct health and illness, and how both should be treated.
PostmodernistThe clinical gaze Doctors observe patients to gather information, thus appearing to speak wisely.
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Persons Not Covered by Health Insurance, by State
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Disability

• Disability refers to a reduced ability to perform
  tasks one would normally do at a given stage of
  life and that may result in or discrimination.
• Estimated 49.7 million people in the U.S. have
  one or more physical or mental disabilities.
• Less than 15 of persons with a disability are
  born with it.
• Accidents, disease, and war account for most
  disabilities in this country.

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of U.S. Population With Disabilities
Characteristic
With a disability 20.8
Severe 13.7
Not severe 7.0
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Labeling the Disabled

• How disabled people are labeled results from
  three factors
• their degree of responsibility for their
  impairment
• the apparent seriousness of their condition
• the perceived legitimacy of the condition.

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Disabilities and Employment Status