Sociology in Modules

1. Sociology in Modules Richard T. Schaefer

2. Culture and Health • Culture-bound syndrome: Disease or illness that cannot be understood apart from its specific social context • Anorexia nervosa • Medical practitioners are being trained to recognize cultural beliefs related to medicine

3. Sociological Perspectives on Health and Illness • Health: “State of complete physical, mental, and social well-being, and not merely the absence of disease and infirmity” (Leavell and Clark) • Health and illness are socially constructed • Can be considered by how it varies in different situations or cultures

4. Functionalist Perspective • “Being sick” must be controlled so not too many people released from societal responsibilities • Sickrole: Societal expectations about attitudes and behavior of a person viewed as being ill • Physicians function as “gatekeepers” for the sick role

5. Conflict Perspective • Medicalization of society: Growing role of medicine as major institution of social control • Greatly expanded domain of expertise • Problems viewed using a medical model • Retains jurisdiction over health care

6. Conflict Perspective • Inequities in Health Care • Obvious inequities exist in health care • Brain drain: Immigration to U.S. and other industrialized nation of skilled workers, professionals, and technicians • Dramatic differences in infant morality rate: Number of deaths of infants under one year old per 1,000 live births in given year

7. Interactionist Perspective • Examine roles played by health care professionals and patients • Asserts patients may play an active role in positive or negative health

8. Labeling Approach • The designations healthy and ill generally involve social definition • Homosexuality noteworthy medical example of labeling • Can view variety of life experiences as illnesses or not

9. Figure 52-1: Infant Mortality Rates in Selected Countries Source: Haub 2010.

10. Table 52-1: Sociological Perspectives on Health and Illness

11. Taking Sociology to Work Lola Adedokun,Independent Consultant, Health Care Research • What social issue or problem do you feel passionate about, and how can sociology help to address it? • Have you ever considered creating your own career path, rather than relying on large institutions to map your future? What might be the benefits of such an approach? The drawbacks?

12. Social Epidemiology and Health • Social epidemiology: Study of distribution of disease, impairment, and general health status across a population • Incidence: Number of new cases of a specific disorder occurring within a given population during a stated period of time, usually a year

13. Social Epidemiology and Health • Prevalence: Number of cases of specific disorder that exist at a given time • Morbidity rates: Disease incidence figures presented as rates or number of reports per 100,000 people • Mortality rate: Incidence of death in a given population

14. Social Class • People in lower classes have higher rates of mortality and disability • Appear to be cumulative • Less able to afford quality medical care • Conflict theorists: capitalist societies care more about maximizing profits than they do about the health and safety of industrial workers

15. Race and Ethnicity • Health profiles of racial and ethnic groups reflect social inequality in U.S. • Poor economic and environmental conditions manifested in high morbidity and mortality rates • African Americans have higher infant mortality rates when compared to whites • Mexican Americans may use curanderismo: form of holistic health care and healing

16. Gender • Women experience higher prevalence of many illnesses but tend to live longer • Lower rate of cigarette smoking • Lower alcohol consumption • Lower rate of employment in dangerous occupations • Women more likely to seek treatment

17. Age • Most older people in U.S. have at least one chronic illness • Older people vulnerable to certain types of mental health problems • Older people use more health services than younger people

18. Figure 53-1: People Living with HIV Source: UNAIDS 2010:23.

19. Figure 53-2: Percentage of Children without Health Insurance Source: Mach and Blumenthal 2010:2.

20. Health Care in the United States • Health care costs have skyrocketed • In 2000, amount spent on health care equaledthat spent on education, defense, prisons, farm subsidies, food stamps, and foreign aid

21. A Historical View • “Popular health movement” of the 1830s and 1840s emphasized preventive care and “self-help” • AMA institutionalized authority through programs of education and licensing • By 1920s, physicians controlled hospital technology, division of labor of health personnel, and other health professions

22. Physicians, Nurses, and Patients • Physicians have position of dominance with patients and nurses • Leads to dehumanizing physician-patient encounters • Publicity about malpractice suits and high medical costs further strained relationship • Controlled interactions with nurses • Increasingly, patients turning to media for health care information

23. Research Today 15.2: Women as Physicians and Surgeons • In your own experience, have you noted a gender difference in the way doctors communicate with patients? Explain. • Why is the quality of a doctor’s communication with patients important? What might be the benefit of female physicians’ superior communication style?

24. Alternatives to Traditional Health Care • At least one of three adults in U.S. attempts to maintain good health or respond to illness through alternative health care techniques • Holistic medicine: Therapies in which the health care practitioner considers person’s physical, mental, emotional, and spiritual characteristics

25. The Role of Government • In 1946 Hill-Burton Act: first subsidies for building and improving hospitals • 1965: Medicare and Medicaid established • Programs greatly expanded federal involvement in health care financing • 1983: Government instituted cost-control program • 2010: Affordable Care Act offered health insurance coverage for people of all ages

26. Figure 54-1: Total Health Care Expenditures in the United States, 1970-2019 (projected) Sources: Centers for Medicare and Medicaid Services 2010: Table 1 (2004–2019 data); Health Care Financing Administration 2001 (1970–1990 data)

27. Figure 54-2: Use of Complementary and Alternative Medicine Source: Barnes et al. 2004, 2008.

28. Sociological Perspectives on the Environment • Environment people live in has noticeable effect on their health • Increases in population, together with economic development, have serious environmental consequences

29. Effects of Growth and Development • Humanecology: Interrelationships between people and their spatial settings and physical environments • Stresses trade-offs inherent in every decision that alters the environment

30. Conflict Perspective of the Environment • Growing share of human and natural resources of developing countries redistributed to core industrialized nations • Industrialized nations of North America and Europe account for 12% of population but responsible for 60% of worldwide consumption • Snailberg: “treadmill of production”

31. Ecological Modernization • Ecological modernization: focus on alignment of environmentally favorable practices with economic self-interest through constant adaptation and restructuring • Macro level: reintegrating industrial waste back into the production process • Micro level: reshaping individual lifestyles

32. Environmental Justice • Environmental justice: legal strategy based on claims that racial minorities are subjected disproportionately to environmental hazards • Poor people and people of color more likely to be victimized by everyday consequences of built environment

33. Environmental Issues • Three broad areas of concern • Air pollution • Water pollution • Global Warming

34. The Impact of Globalization • Globalization can be good and bad • Industrialization increased pollution • Allows multinationals to reap resources of developing countries for short-term profit • Multinational corporations have incentive to carefully consider cost of natural resources • Environmental refugees: people who have been displaced by rising seas, destructive storms, expanding deserts, water shortages, and high levels of toxic pollutants

35. Figure 55-1: Projected Greenhouse Gas Emissions

36. Environmentalism • 1970: 25 million people turned out to observe first Earth Day • Citizens marched on behalf of specific environmental causes • Congress established the EPA • The Clean Air, Clean Water, and Endangered Species acts followed

37. Environmentalism • Looking at the Issue • Earth Day now on calendars of city councils, zoos, and museums worldwide • Increasingly, efforts to publicize concerns moving to Internet • General public has mixedreaction to environmental issues • Question the scientific arguments behind theory of global warming

38. Environmentalism • Applying Sociology • Troubled that most powerful environmental organizations predominantly white, male-dominated, and affluent • Conflict perspective: • Disproportionate exposure of the poor and minorities to environmental pollutants can act as disincentive for others to take action • Many environmental movements do not include the poor and minorities

39. Environmentalism • Initiating Policy • Economic downturn of 2008provided mixed blessing • Reduced use of fossil fuels • Federal government established funds for creating green-collar jobs • Environmentalism moved to a bigger stage • People increasingly reluctant to ignore environmental issues

40. Figure 55-2: The Environment Versus the Energy Production

41. Figure 55-3: Are U.S. Teens Green Enough? Source: Organisation for Economic Co-operation and Development 2009b.