Chapter 14

1. Chapter 14 Education and Medicine

2. Education vs. Schooling • Education • The social institution through which society provides its members with important knowledge, including basic facts, job skills, and cultural norms and values • Schooling • Formal instruction under the direction of specially trained teachers

3. Functions of Schooling • Socialization • Primary schooling • Basic language and mathematical skills • Secondary schooling • Expansion of basic skills to include the transmission of cultural values and norms • Cultural innovation • Educational systems create as well as transmit culture • Social integration • Brings a diverse nation together • Social placement • The enhancement of meritocracy

4. Functionalism: Latent Functions of Schools • Latent functions are hidden, unintended, unstated goals or consequences • Latent functions of schools include: • Schools as child-care providers • Schools consume considerable time & energy- activity thus fostering conformity • Engages young people at a time in their lives when jobs are not plentiful • Sets the stage for establishing relationships & networks • Link between particular schools and career opportunities

5. Critical Analysis • Functionalism overlooks that the quality of schooling is far greater for some than for others • U. S. Educational system reproduces the class structure in each generation • System transforms privilege into personal worthiness and social disadvantage into personal deficiency

6. Conflict Analysis:Schooling and Social Inequality • Social control • Mandatory education laws encouraged compliance, following directions, and discipline • Hidden curriculum: Subtle presentations of political or cultural ideas in the classroom • Learning the importance of race and gender • Standardized testing • Is it biased based on race, ethnicity, or class • Tracking • Assigning students to different types of education programs • Does it segregate students into winners and losers? • Inequality between schools • Public vs. Private schools • Parochial schools – operated by Roman Catholic Church • Suburban vs. Urban districts

7. Critical Analysis • Social conflict approach minimizes the extent to which schooling upward social mobility for talented men and women from all backgrounds • Today’s college curricula (including sociology courses) challenges social inequity on many fronts

8. Access to Higher Education • Money is largest stumbling block to higher education • Even for state-sponsored schools • Family income is still best predictor for college attendance • Families making at least $75,000 send 64% of their children to college • Families making under $10,000 send 21.1% of their children to college • On average, a person with a college degree will add almost $500,000 to his or her earnings over a lifetime • A woman with a bachelor’s degree will earn two-and-a-half times as much as a woman with eight or fewer years of schooling

9. Credentialism • Evaluating a person on the basis of educational degrees • Diplomas and degrees are viewed as evidence of ability • Over-education is often the case when people are overqualified for the job at hand

10. Problems in Schools • Many believe that a so called “State of Emergency” best characterizes our system of education today • School discipline • Many believe schools need to teach discipline because it isn’t addressed within the home setting • Violence in schools • Students and teachers are assaulted • Weapons are brought to school • Society’s problems spill into schools • What is the answer? • Adjust attitudes so learning is the focus • Skillful and committed teaching • Firm disciplinary standards enforced • Administrative and parental support

11. “Cooling Out” the Poor • Transforming Disadvantages Into Deficiency • Just as schools can transform social privilege into personal merit, they can transform social disadvantages into personal deficiency • Cooling out • The self-fulfilling prophecy by which poor students end up settling for no more than society offered them when they were first born • Some believe that community colleges play an important part in the cooling out process • Allowing students to fail in community college allows society to point the finger at them and ask them to accept personal responsibility for “blowing their opportunities” • Are the students at fault here, or is the educationalsystem guilty of not caring enough?

12. Theodore Sizer’s Ways in Which Bureaucratic Schools Undermine Education • Rigid uniformity • Insensitive to cultural character of community • Numerical ratings • Success defined in terms of numbers on test scores • Rigid expectations • Age and grade level expectations • Specialization • Many courses, many teachers • No one teacher knows a student • Little individual responsibility • Little empowerment to learn on one’s own • Don’t upset or accelerate learning for fear of disrupting system

13. The “Silent” Classroom • The norm is to not talk in class, and students can get upset at others who talk “too much” • No matter what the class size only a handful of students speak • Passivity is the norm and it is seen as deviant to speak up in class • What makes a difference • Female instructors tend to call on men and women equally, whereas male instructors tend to call on men • Reasons • Students are conditioned to listen • Instructors come to class with lectures prepared and students do not wish to get sidetracked

14. Apathy in Education • Many students expect learning to be delivered and don’t realize they are part of the process • Apathy is high among students • Reasons: • Television • Parents • Schools • Other students • High tech may hold one key for sparking interest • Bringing multimedia into the classroom

15. Academic Standards • A Nation at Risk - 1983 governmental commission • Troublesome findings concerning what students are and are not learning in school • 40% of those screened could not draw inferences from written materials • 33% of those screened could complete multi-step mathematical problems • Other insights: • Functional illiteracy – a lack of reading and writing skills needed for everyday living • Lack of interest in the importance of education apathetic attitudes toward classes, course materials, doing assignments, and attendance • Belief that good grades need not be “earned,” but rather just rewarded (as if they had a right to them)

16. Academic Standards • Global performance • U.S. Eighth graders still placed 17th in the world in science and 28th in mathematics • Recommendations from A Nation at Risk • All schools should require several years of English, math, social studies, general science & computer science • No more “social promotion” of failing students from grade to grade • Teacher training and salaries should improve

17. School Choice • Introduction of competition to public schools and giving parents options might force all schools to do a better job • Critics charge that these programs erode our nation’s commitment to public education especially in inner city schools • Magnet schools – schools that offer special facilities and programs to promote educational excellence in a particular area, i.e. Arts, computers,foreign language, etc • Charter schools – public schools that are given more freedom to try out new policies and programs • Schooling for profit – school systems operated by private profit-making companies (including public schools)

18. Mainstreaming • Integrating Students With Special Needs Into the Overall Educational Program • Five million students are classified as mentally or physically disabled • Many of the five million receive marginal classroom experiences • Inclusive education maintains that it is good to integrate all children • Mainstreaming needs to be approached with a measure of common sense • In cases where one has to serve the severe and profound populations, a segregated classroom may be best

19. 21st Century Schooling • Computers and other high-tech tools will become increasingly important • The amount and quality of high-tech equipment may become one of the new marketing tools for schools to out-perform one another • Computers, however, only hold part of the answer. We need humans to put into place a program that aims at providing high quality education • Will the education system play a role in dividing people into two groups in the future • Those literate and illiterate in computer skills • Will we become a country of “haves” and “have nots” divided along lines of high-tech competencies

20. Medicine and Health

21. Health A state of complete physical, mental, and social well-being (World Health Organization) • Health is as much a social as a biological issue for sociologists • Illness have their roots in the organization of society

22. How Society Shapes the Health of People • Cultural patterns define health • What is considered “healthy” is what people hold to be morally good • Cultural standards of health change over time • A society’s technology affects people’s health • Social inequality relates to health

23. Health: a Global Survey • Health in history • Industrialization changed the patterns of health, medical care • Health in low-income countries • One billion people (globally) have serious illness due to severe poverty • Poor sanitation, malnutrition and minimal medical care • Health in high-income countries • Infectious disease is less of a threat, concentrate on chronic illnesses

24. 1900 Influenza and pneumonia Tuberculosis Stomach/intestinal diseases Heart disease Cerebral hemorrhage Kidney disease Accidents Cancer Disease of infancy Diphtheria 2000 Heart disease Cancer Stroke Lung disease (non-cancerous) Accidents Diabetes Pneumonia and influenza Alzheimer’s disease Kidney disease Blood disease Leading Causes ofDeath in the US

25. Who Is Healthy? • Epidemiology – The study of how health and disease are distributed throughout a society’s population • Factors include • Age • Gender • Social class • Race

26. Age & Gender • Death is now rare among young people • Accidents and AIDS are two exceptions • Across the life course, women fare better than men • Men have higher death rates for accidents, suicide and violence • Our cultural conception of masculinity pressures men • “Coronary prone behavior”

27. Class and Race • Infant mortality rates are twice as high for poor as for wealthy • The poorest in America can die from diseases that strike children in countries like the Vietnam and Lebanon • African Americans are three times more likely to be poor compared to whites • Poverty condemns people to live in crowed unsanitary conditions that breed infectious disease • Life expectance for white children born in 2000 is six years greater than for African Americans • Poverty also breeds stress and violence • In 1999, 2,674 African American males were killed by others of their own race

28. Cigarette Smoking • Most preventable hazard to health • As of 1999, 24% of Americans smoke • Generally speaking, smokers tend to be divorced, separated, unemployed, in the military and have less education • 430,000 men & women die prematurely each year as a direct result of smoking • That number exceeds the combined death toll from alcohol, cocaine, heroin, homicide, suicide, auto accidents & aids

29. Eating Disorders • An intense form of dieting or other unhealthy methods of weight control driven by the desire to be very thin • Obesity is also an eating disorder • 95% of those suffering from anorexia and bulimia are women, white and affluent • The beauty myth tells women to exaggerate the importance of physical attractiveness to the point of risking their health • Pressures come from society, parents, the media, as well as women themselves

30. Sexually Transmitted Diseases (STDs) • The 1960’s saw a rise in STD rates • Led to the sexual revolution • Gonorrhea & syphilis • Easily treated with antibiotics • Genital herpes • Treatable but incurable • AIDS – Acquired Immune Deficiency Syndrome • Caused by human immunodeficiency virus – HIV • Incurable, almost always fatal • Specific behaviors increase risk: anal sex, sharing needles and drug use

31. Ethics & Death • When is a person dead? • When an irreversible state involving no response to stimulation, no movement or breathing, no reflexes, and no indication of brain activity • Do people have the right to die? • 10,000 people in the US are in a permanent “vegetative state” • What about mercy killing? • Thousands face terminal illnesses that will cause horrible suffering • Right to die: When a person with an incurable disease has a right to forgo treatment which may prolong their life • “Active” euthanasia a person may enlist the services of a physician to bring on a quick death

32. The Medical Establishment • The medical establishment focuses on combating disease and improving health • The rise of scientific medicine • AMA – American Medical Association founded in 1847 • By early 1900’s state boards agreed to certify only AMA approved • M.D.s & D.O. (Osteopaths) on one level • Other healers kept tradition but occupy lesser role • Chiropractors, herbalists, midwives, etc.

33. Holistic Medicine • Holistic medicine is an approach to health care that emphasizes prevention of illness and takes into account a person’s entire physical and social environment • Concerned with the following: • Patients are people: Concern for the environment in which the person lives and their lifestyle • Responsibility, not dependency: Favors an active approach to health encouraging patients take health-promoting behaviors • Personal treatment: Favoring a more personal relaxed environment, such as the person’s home

34. Medicine in Socialist Societies • China • Government controls most health care operations • “Barefoot doctors” in rural areas, traditional healing arts, acupuncture, medicinal herbs and holistic concern • Russian Federation • Medical care is in transition, but it is held the all citizens have a right to basic medical care • Tax funds are used to provide care • Disparities in medical care increase among segments of the population

35. Medicine in Capitalist Societies • Sweden (1891) • Socialized medicine: Compulsory, comprehensive government medical care system offered to all • Great Britain (1948) • Duel system of medicine: National Health Service for all citizens and may they also may purchase private services • Canada (1972) • Also a duel system: A single-payer model for all citizens government program (insurance company), Like Britain, may purchase private services • Japan • Physicians have private practice • Paid like much of Europe, combination of government programs (80% of costs) and private insurance

36. Medicine in the US • Direct fee system • The patient pays directly for services provided by doctor and hospitals • Comprised of: • Private Insurance • Public Assistance • Medicare • Medicaid • Health Maintenance Organizations (HMO)

37. Medicine in the US • Private insurance • 63% of Americans have access to medical care benefits through their work or union • 8% purchase private coverage on their own • Few programs pay all medical costs • Public insurance programs • Medicare for those over 65, Medicaid for those in poverty and for veterans • 24% of Americans receive medical attention via some form of government program, though many also have some private insurance • Health Maintenance Organizations (HMO) • An organization that provides comprehensive medical care to subscribers for a fixed fee • Preventive approach to health; Makes a profit if subscribers stay healthy

38. Functional Analysis: Talcott Parsons • Talcott Parsons’ the “sick role” • Illness suspends routine duties • A sick person must want to get well • A sick person must seek competent help • The doctor patient relationship as hierarchical • Critical Analysis: Parsons’ work links illness and medicine to the broader organization of society, but it also supports the idea that doctors, rather than patients, bear primary responsibility for health.

39. Interactionist Analysis • Health and medical care are socially constructed by people in everyday interactions • Socially constructing illness • How people define a medical situation may actually affect how they feel • Socially constructing treatment • Understanding how people construct reality in the examination room is as important as mastering the medical skills required for treatment • Critical Analysis: This paradigm reveals the relativity of sickness and health, but seems to deny that there are any objective standards of well being.

40. Conflict Analysis • Points out the connection between health and social inequality. • Access to care • The access problem is more serious in the US than in other industrialized societies because our country has no universal medical care system. • The profit motive • Some conflict analysts argue that the real problem is the character of capitalist medicine itself. • Medicine as politics • Scientific medicine frequently takes sides on significant social issues. • Critical Analysis: Conflict theory minimizes the improvements in health brought about by the present system.

41. Looking Ahead: Health in the 21st Century • The health of Americans overall will continue to improve into the next century, but certain health problems will continue to plague US society. • The US falls short in addressing the health of marginalized members of our society. • Problems of health are far greater in the poor societies of the world than they are in the US