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This chapter explores the concepts of health, healthcare, and disability from a global perspective. It discusses social epidemiology, recent medical innovations, paying for medical care in the US, the US healthcare system, implications of advanced medical technology, the sick role, and sociological perspectives on health and medicine. Additionally, it examines social inequalities based on disability and strategies for living with a disability.
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Chapter 14 Health, Health Care, and Disability
Chapter Outline • Health in Global Perspective • Health in the United States • Health Care in the United States • Sociological Perspectives on Health and Medicine • Disability • Health Care in the Future
Health, Health Care, and Disability • Health is a state of complete physical, mental, and social well-being. • Health care is any activity intended to improve health. • Disability is a reduced ability to perform tasks one would normally do at a given stage of life.
Health in Global Perspective • Life expectancy: AIDS has cut life expectancy by 5 years in Nigeria, 18 years in Kenya, and 33 years in Zimbabwe • Infant mortality rate: 149 infants under 1 year of age die per 1,000 live births in Sierra Leone, 196 die in Angola, and 122 die in Malawi.
Social Epidemiology • Study of the causes and distribution of health, and disease in a population. • Studies: • Disease agents – insects, bacteria, nutrient agents, pollutants in the air and temperature. • Environment - physical, biological and social environments. • Human host -demographic factors such as age, sex, and race/ethnicity.
Recent Medical Innovations • Bloodless surgery - operations are performed using combinations of iron supplements and vitamins, large doses of a blood-building drug rather than blood transfusions. • Robotdoc - computer-controlled robot used in hip replacement surgery.
Paying for 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: projections call for Medicaid spending to double and Medicare spending to triple in the next few years.
The U.S. Health Care System • Health Maintenance Organizations: provide total care with an emphasis on prevention. • Managed care: monitors and controls health care providers' decisions, insurance company has the right to refuse to pay for treatment.
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).
The Sick Role • The sick are not responsible for their condition. • The sick are temporarily exempt from their normal role obligations. • The sick must want to get well. • The sick must seek help from a medical professional to hasten their recovery.
Disability • Estimated 48 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.
Social Inequalities Based on Disability • Workers with a severe disability earn 50% (men) and 64% (women) of what workers without disabilities earn. • Only 26% of Latinos/as with a severe disability are employed; those who work earn 80% of what non-Latino white persons with a severe disability earn.
Living With a Disability Strategies: • Avoidance - deny condition to maintain hopeful images of the future and elude depression. • Vigilance - actively seek knowledge and treatment so they can respond to the changes in their bodies.