Why is the United States the last industrial country to adopt a national health care program? Which sociological perspective(s) best explains why public and political support for health

After reading chapter one and reviewing the PowerPoint, you should complete the following tasks:

Answer the following questions in complete sentences (5-7 sentence responses):

Why is the United States the last industrial country to adopt a national health care program? Which sociological perspective(s) best explains why public and political support for health care reform has been difficult to achieve?
How is illness functional in society? What behavior is expected from someone who is sick? ('The Sick Role')
Explain from a conflict perspective how health inequalities are shaped by conflict and competing interests between groups.
In this exercise, you will listen to a podcast on medical history and answer questions about how it demonstrates the social construction of health and illness. The podcast, Sawbones, (http://maximumfun.org/shows/sawbones (Links to an external site.)) is a weekly show where a husband-and-wife team (she’s a medical doctor and he’s a comedian) discuss a variety of topics in medical history, often focusing on a particular disease or a particular treatment.
1. First, choose one of the following episodes of Sawbones.
  - “Birth Control” (http://maximumfun.org/sawbones/sawbones-birth-control (Links to an external site.))
  - “Lobotomy” (http://maximumfun.org/sawbones/sawbones-lobotomy (Links to an external site.))
  - “Hysteria” (http://maximumfun.org/sawbones/sawbones-hysteria (Links to an external site.))
  - “Green Sickness” (http://maximumfun.org/sawbones/sawbones-green-sickness (Links to an external site.))
  - Then, write your answers to the following questions:
  1. Which social factors (class, race, gender, etc.) influenced the treatment or illness you studied? How?
  2. How did conceptions of morality or responsibility factor into the understanding of the illness or treatment? How does this reveal how health and illness are socially constructed?
  3. 3. How did shared understandings of the disease affect public policy about the disease or the afflicted?

Please use this link to upload your work.

Assignment is due on Sunday May 22 by 11:59 pm.

Worth 20 points.

Note: Please only upload word docs or pdf files DO NOT SUBMIT ANY .PAGES FILES

Chapter Learning Objectives:

To read these particular portions of the chapter, please click on the links below and you will be taken to that section of the book.

19.1 The Social Construction of Health

Define the term medical sociology
Understand the difference between the cultural meaning of illness, the social construction of illness, and the social construction of medical knowledge

19.2 Global Health

Define social epidemiology
Apply theories of social epidemiology to an understanding of global health issues
Understand the differences between high-income and low-income nations

19.3 Health in the United States

Understand how social epidemiology can be applied to health in the United States
Explain disparities of health based on gender, socioeconomic status, race, and ethnicity
Give an overview of mental health and disability issues in the United States
Explain the terms stigma and medicalization

19.4 Comparative Health and Medicine

Explain the different types of health care available in the United States
Compare the health care system of the United States with that of other countries

19.5 Theoretical Perspectives on Health and Medicine

Apply functionalist, conflict theorist, and interactionist perspectives to health issues

Instructions:

For this week, you should review each section in the chapter reading and complete your chapter recap assignment and/or discussion board. You should also review all supplemental readings and/or videos that are provided for you in the module. Please remember that your responses for the chapter recap assignment should be approximately 5 to 7 sentences in length per question set (not individual questions). You should only upload word or pdf files (please DO NOT upload .pages files). Additionally, your discussion board responses are due on Friday (initial response to the discussion prompt) and Sunday (respond to at least TWO of your classmates posts). Your posts should also be approximately 5 to 7 sentences in length per question set (not individual questions). Please let me know if you have any questions concerns about the assignments.

Help:

Please find the assignments rubric under the 'Course Resources' module here: Link

You can also find book resources for your textbook here: Link (Links to an external site.)

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Health and Illness: A Global Perspective

Health is the state of complete physical, mental, and social well-being

Infant mortality rate: Number of babies, of every 1,000 born, who die in their first year of life

Life expectancy at birth: Number of years people in a society can expect to live

Chronic disease: An illness that has a long-term development

Race and Ethnicity: Infant mortality rate

Non-Hispanic Black 11.3

Native: 8.3

Hispanic 5

Non-Hispanic White: 4.9

Asian/Pacific Islander: 4.2

6 per 1,000

Somalia 83

Afghanistan 54

Leading causes of death in 2015:

Birth Defects

Preterm Birth

S.I.D.S. (death occur among infants less than 1 year old)

about 1,600 children die each year

Maternal pregnancy complications

Injuries

Life Expectancy in US:

76 Male

81 Female

Health, United States, National Center for Health Statistics

Heart disease remains the leading cause of death, accounting for 630,000 deaths per year; 1 in every 4.

There was little progress in lowering the U.S. infant mortality rate from 2000 to 2007.

The U.S. spends more on health care per capita than any other country, and health spending continues to increase.

Problems with health in the U.S.

Unequal distribution of health care by race, ethnicity social class and gender

Region and availability of health care.

Health education in the inner city and rural areas.

The Social Organization of Health Care

The U.S. is one of the few industrialized nations that does not provide universal health care.

Some want to keep government from getting in between doctors and patients.

However, giant companies, and the government, already stand between patients and their health care providers.

Tracking the Trends: Obesity

People who are obese are at risk for a host of medical problems.

In 1960, about 13% of adults were obese; the obesity rate soared above 30% by 2000 and has continued to increase.

Q. What do you think are some of the reasons for this trend?

Percentage of population that is obese:

Fiji: 37%

Saudi Arabia: 36%

U.S.: 35%

Mexico: 29%

Russia: 25%

Obesity rates by race:

Non-hispanic white 35%

Black: 48%

Hispanic: 43%

Asian: 12%

Obesity in the US

More than one-third (35% or 78.6 million)

The estimated annual medical cost of obesity: 147 billion; cost is usually higher for women

Fast Food World!

Among non-Hispanic black and Mexican-American men, those with higher incomes are more likely to be obese than those with low income.

Women with higher education/income are less likely to suffer from obesity than lower education/low-income women.

Obesity in the US

More dependent on processed foods

High in carbohydrates and refined sugars

Fast food nation

Lack of physical activity

Family dynamics

Busy schedules

Institutionalized means

High fructose corn syrup

Regulations

Do you eat chicken?

What do you think?

Reasons for obesity in the U.S.:

More middle aged individuals

Ethnic make-up of communities

Shirt in categories of what obese is

‘moral panic’

Social environment

Des jobs

Technology

Fast food availability

Food deserts

Childhood Obesity

Has more than doubled in children and quadrupled in adolescents in the past 30yrs

In 2016, one in five children and adolescents were overweight or obese.

Higher risk of heart disease, diabetes, sleep apnea, joint problems and social/psychological problems.

Weight Loss Camps

Rich and Poor Compared: The AIDS Epidemic

Social epidemiology: how health and disease are distributed throughout a society’s population

Epidemic: disease that spreads rapidly

AIDS

Africa has 15% of the world’s population and 71% of HIV cases.

36.9 Million people living with HIV/AIDS

2.6 Million children living with HIV

Politics, Stigma, and the AIDS Epidemic

In the case of AIDS many factors came together to produce a significant delay in the attack on the disease.

Stigmatization of people with AIDS

Reagan administration’s policy of smaller government and greater austerity in social and health programs

Urban politics

Politics in the gay community

Some 34 million people worldwide have HIV/AIDS, and two-thirds of these live in sub-Saharan Africa. Almost two million people, most of them from this region, died in 2010 from HIV/AIDS (World Health Organization, 2011). All these health problems produce high rates of infant mortality and maternal mortality and high death rates. For all these reasons, people in the poorest nations have shorter life spans than those in the richest nations.

Rich and Poor Compared: The AIDS Epidemic

Why are the world’s poorest nations so hard hit by AIDS?

Poor have weakened health

Poor countries have fewer resources for education and prevention programs

Cultural patterns and AIDS

Rich and Poor Compared: The AIDS Epidemic

HIV/AIDS in the United States

U.S. accounts for just 3% of HIV cases

1.2 Mill; 1 in 8 are unaware of their infection

1 in 4 new HIV infections is among 13-24 year olds

Drug treatments delay onset of full-blown AIDS among people with HIV

MSM, black and poor

Estimated new HIV infections in US, 2015

Deaths from AIDS in the United States

African Americans and Hispanics, who together represent 30% of the U.S. population, account for 56% of all AIDS deaths

Non-Hispanic African Americans are 10x more likely than non-Hispanic whites to become infected; Latinos are 3x times as likely

Health and Inequality

Racial disparities in health mean that African Americans are more likely than Whites to fall victim to various diseases, including

cancer

heart disease

stroke

diabetes

Hispanics contract tuberculosis at a rate seven times that of whites.

Social Class: The lower the social class status of a person or family, the less access available to adequate health care

Health care costs were $2.8 trillion in 2012

Six reasons behind the soaring cost:

Spread of private insurance

Specialization of doctors

‘direct-fee system: health care system in which doctors, technicians and specialists are paid directly for their services either by patients or by insurance companies

‘fee for service model’: practice in which doctors have relatively free range in what they charge for their services. This allows doctors to charge more for services and encourage more diagnostic tests for their patients.

More high technology

‘ghost patients’: practice in which doctor’s charge insurance companies for exams that were never completed on patients that don’t exist.

Often this is couple with the practice of ‘self-referral’ in which doctors refer patients to organizations that provide services in which the doctor has a stake in (either owning the company or being an investor).

Lack of preventive care

Ageing population

More lawsuits

Controlling Costs

Pre-admission testing

Out-patient treatment

Regulating the length of hospitalization

Race and health:

This relationship has been attributed to:

Hazardous working conditions

Poor neighborhoods exposed to pollution

Inadequate and unsafe housing

Diet

Access to health care

Biological factors

Racial pressures which lead to stress and depression

Education:

The higher your education, the better your health (no matter how it is measured—mortality, morbidity or other general health measures).

Schooling might be a more important correlate to good health than is one’s occupation or income.

Educated individuals are more likely to:

Practice a healthier lifestyle

Visit their primary physicians more

Use new medical technologies or medicines.

Be aware of the health consequences of smoking and drinking.

Transmit their healthier lifestyle to their children.

Most people rely on health insurance:

Private Insurance Programs

64% of the population covered by traditional insurance

86% receive insurance through an employer

14% buy it on their own

Health Maintenance Organizations (HMOs)

Private insurance organizations that provide medical care to subscribers for a fixed fee

Focus on controlling costs by disease prevention

Managed care; use of primary care physician

24% of the population enrolled in HMOs

Government Insurance Programs

Medicare, part of social security for those 65+

15.7% of the population on Medicare in 2012

Medicaid, serves poor people with special needs and families with dependent children

16% of the population enrolled in Medicaid

Veterans receive care in government-operated hospitals

Health and Inequality

Gender

Although women live longer on average than men, statistics show that hypertension is more common among men than women until age 55, at which point the pattern reverses.

Disability is understood as a social identity that exists in relationship to other social identities and systems of social power. It is not simply a medical/physical condition.

One of the most significant achievements of the disability rights movement is the Americans with Disabilities Act. This law prohibits discrimination against disabled persons.

While women live longer than men, women experience higher rates of nonfatal chronic conditions.

Men experience higher rates of fatal illness, dying more quickly than women when illness occurs.

These differences have been attributed to 3 factors: genetics, risk taking, and health care.

Though by the age of 75, men die of cancer at twice the rate of women, there is little education for men in cancer self-detection and prevention.

Disability: a physical or mental condition that limits a person’s everyday activities

Physical disability may become a master status where others see only the disability

Technology and changing attitudes improve quality of life

High poverty rate

Health: The Importance of Gender

Eating Disorders

90% of those with eating disorders are women

Women’s value in terms of physical attractiveness

Role of the mass media

Anorexia

What is it?

A medical condition, that is also described as an emotional disorder.

It is characterized by having an obsessive desire to lose weight by refusing to eat.

Anorexia

Statistics about women with anorexia:

About 30 million individuals suffer from an eating disorder around the world

Only 1 in 10 women will receive treatment for their disorder

95% of individuals that have eating disorders range in age from 12-25

Anorexia and Men

10-15% of individuals that suffer from anorexia are male.

Men are less likely to seek treatment options because it is seen to be a woman’s disorder.

Bulimia

Person binge eats, followed by purging shortly after.

Onset is in late teens and can last for years or even be lifelong!

Signs of bulimia::

Eating large portions of food (binging)

Going to the restroom after eating.

Compulsive exercise

Yellow Teeth

Bulimia Statistics

More than 200,000 cases a year

Up to 90% are women and around 10% are men

About 34% are self-harming

1 in 10 bulimics will seek treatment

Relapsing is seen in 30%-50% of bulimics

Treatment for Bulimia

Support groups

Counseling

Psychotherapy

Being prescribed antidepressants

“If you look good, you feel good”

The power of social media

Influence of health profiles

Health and physical well-being is promoted through social media

This leads people to want to imitate what social media says they should look like

PLASTIC SURGERY & MEDIA

Media plays a huge role into the percentage of people who consider plastic surgery.

The Swan, Extreme Makeover, I Want a Famous Face and Dr. 90210.

It is a popular pastime for people to indulge in via People magazine and magazines of the sort.

The photo-shopping of women’s bodies in mainstream media also plays a role in body image and plastic surgery.

Many women believe that plastic surgery is linked to a lifestyle of affluence and social class.

Theoretical Perspectives of Health Care

Functionalism: the positive functions of the health care system are the prevention and treatment of disease.

As a social institution, health care is also one of the nation’s largest employers and, thus, is integrally tied to systems of work and the economy.

‘sick role’: social definition of the behavior of and the behavior toward those who society defines as ill:

Those are occupy the sick role:

are not held responsible for being sick

are not responsible for normal duties

are not supposed to like the role

are supposed to seek help to get out of the role

Mental Health and Illness

Mental disorder: psychological or behavioral condition that causes distress and reduces a person’s ability to participate in everyday life

Mental disorders are common

1 in 4 adult Americans suffer from some form of mental illness during their lifetime; mild to severe

Types of Mental Disorders

DSM IV – Diagnostic and Statistical Manual of Mental Disorders, prepared by American Psychiatric Assn.

Many disorders have biological and social causes

Robert Faris and Warren Dunham study (1939) linked poverty and mental illness

Cause and Effect? Goes both ways:

Mental illness reduces ability to earn a living

Poverty breeds stress and social isolation that increase risk of mental disorders

Native Americans have a higher rate

Asian Americans, a slightly lower rate

Link to poverty applies

Thoma Szasz: mental illness is a myth

Treatment Strategies

Treating mental illness is a recent phenomenon

Psychotherapy: An approach to mental health in which patients talk with trained professionals to gain insight into the cause of their problems

Psychoactive drugs (1950s)

Treatment Strategies

Deinstitutionalization: the release of people from hospitals into local communities.

Community Mental Health Centers Construction Act of 1963

From institutions to outpatient centers

Not enough were built

Only 42% of people with mental illness receive regular treatment (63% with serious disorder)

Mental Illness on Campus

30% of college students report being so depressed they could not do their work

84% claim they are overwhelmed at times

Most serious problem is suicide

Psychoactive drugs make it possible to attend college but some may not take their medications properly or may be overwhelmed by demands of college work.

The suicide rate among young adults, ages 15-24, has tripled since the 1950s and Suicide is currently the 2nd most common cause of death among college students. 1,100: number of suicides that occur at colleges every year – that’s roughly 7.5 per 100,000 students.

Conflict Theory

Conflict perspective: the inequality inherent in our society is responsible for the unequal access to medical care.

Minorities, the lower classes, and the elderly, particularly elderly women, have less access to the health care system than whites, the middle & upper classes, and the middle-aged.

Symbolic Interaction Theory

Symbolic interactionists hold that illness is partly socially constructed.

The definitions of illness and wellness are culturally relative—sickness in one culture may be wellness in another.

Also, a condition considered optimal in one era may be defined as sickness at another time in the same culture.

Perspectives on Health Care

The Functionalist Perspective

Disease and illness threaten the survival of society because sick people cannot accomplish essential tasks.

The function of the health-care system is to return people to normal social functioning.

The health care system becomes a problem when it fails to return sick people to normal social functioning.

Illness is a social problem because it interferes with the ability to perform societal roles in families and at work.

Sick role: pattern of behavior expected of people defined as ill

Social institutions are linked

Perspectives on Health Care

The Conflict Perspective

Health and health care are scarce resources that interest groups compete over.

The inequitable distribution of health resources will reflect the overall inequitable distribution of these resources in society.

A problem results when some groups feel that they are not receiving their fair share.

Health is linked to inequality

Access to care is critical

U.S. has no guaranteed access to care for all

1/3 struggle to pay medical costs; 15% lack insurance

Capitalism: profit motive over healthcare needs

Criticism: Overlooks fact that U.S. health has improved dramatically. Healthcare systems in more equal societies provide little incentive to develop new treatments.

Perspectives on Health Care

The Interactionist Perspective

Illness involves a network of social meanings and social expectations.

Health care can be considered a social problem when it produces stigmatized or devalued self-concepts among consumers of health care.

“Health” and “illness” are partly socially defined; the definitions

differ among societies

change over time

State of mind can affect health of the body

Feminist Theory: Health and Gender

Risk of illness is greater for women due to increased risk of poverty

Only 34% of physicians are women; research geared to men.

Same rates of mental illness as men, but more likely to be labeled as mentally ill

Cultural definitions of “masculinity” can lead to stress and social isolation for men.

Criticism: Ignores fact that women’s health has improved dramatically; longer lives.

Social Construction of Drug-Use

Subjectivity

What drugs are good?

What drugs are bad?

Relativity

Culturally motivated drug use

Desensitized to drug use

Drugs and Their Consequences

A drug is any substance that, when consumed, alters one or more of the functions of the human body.

Most common reasons for drug use:

Therapeutic uses

Recreational uses

Spiritual or psychological uses

Escape

Social conformity

The Extent of Drug Use

Most everyone uses some type of drug, legal or illegal

2014: more than 24 million people age 12 and older (9.2%) had used some illegal drug at least once in the past thirty days

Illegal drug use peaks in the late teens, then declines as people get older

Drugs and Their Consequences

Drug Use and Abuse

Opinions about drug use vary greatly as to whether drug use itself is a social problem.

Much of the concern about drugs of abuse relates to their effects on people:

Dependence

Drug addiction

Tolerance

Cross-dependence

Cross-tolerance

Abuse, Addiction, and Dependency

Abusing a drug:

violates accepted medical practices

causes mental, physical, or social harm

Addiction is a physical or psychological craving for a drug.

withdrawal symptoms when use stops

Dependency is a state in which a person’s body has adjusted to regular use of a drug.

need to continue using the drug in order to feel comfortable

ADDICTION

People of any age, sex or economic status can become addicted to a drug:

Risk Factors:

Family History of addiction

Lack go parental supervision

Poor social skills

Anxiety, depression and loneliness

Mental Health Issues

Drug experimentation

Peer Pressure

Availability of drugs

Community poverty

General Trends in Drug-use

Those using more drugs are:

Males; more likely to use drugs regularly and to use drugs heavily

Relatively young, especially those free from parental control and responsibilities

Likely to have parents who use legal drugs

More than half of new illicit drug users begin with marijuana

Drug use is increasing among people in their fifties and early sixties

Drug Use and Abuse

The Societal Costs of Drug Abuse

Accidents

Alcohol consumption is associated with fatal traffic, airplane, and occupational accidents.

Crime

In well over half of homicides in the U. S., the victim, the perpetrator, or both were drinking at the time of the crime.

According to the CDC, 28 people die in motor vehicle crashes that involve alcohol-impaired driver. This is on death every 51 minutes. $44 Billion on alcohol-related crashes.

The Societal Costs of Drug Abuse

Family Problems

Alcoholics are seven times more likely to become separated or divorced from their spouses.

Studies find that 29 to 40% of spouse abusers were drinkers at the time of the attack.

The Societal Costs of Drug Abuse

Work Problems

People who abuse alcohol or illicit drugs have higher rates of absenteeism, are more likely to jump between jobs, are more likely to be fired and are more likely to be involved in workplace accidents.

Health Problems

Most psychoactive drugs that are taken in large quantities produce severe health problems and even death.

Of all drug users, about 70% are employed and active in the workplace.

1/3 of all employees are aware of illegal sale of drugs in their workplace.

The Extent of Drug Abuse in the United States

Alcohol

Alcoholism is the consumption of alcohol at a level that produces serious personal, social, or health consequences.

People with certain social characteristics are more likely to become alcoholic.

Rates of alcoholism vary by gender, age, religion and socioeconomic status.

Prevalence:

In 2013, 86.8% of people 18+ reported that they drank alcohol at some point in their lifetime; 56.4% drank in the past month; 25% binge drink in the past month.

Alcohol Use Disorders:

16.6 Million Adults 18+ had an AUD in 2013 (10.8 million male)

Youth (12-17) 687K had an AUD (385k female)

Deaths:

Nearly 88k (62k male) die from alcohol-related causes annually; average of 10,000 attributed to driving fatalities.

Globally: 2012 3.3 million deaths or 5.9% of all global deaths.

Alcohol misuse is the fifth leading risk factor for premature death and disability; among people 15-49 it is the first.

Age:

most binge drinkers: 18-34 years

Binge drinks most often: 65+

Income:

Most binge drinkers: $75K+

Binge drinks most often/most per binge: $25K-

Health associations:

Unintentional injuries

Alcohol poisoning

STIs, sexual dysfunction

Unintended pregnancies

High-blood pressure, stroke and cardiovascular diseases liver disease

The Extent of Drug Abuse in the United States

Marijuana and Hashish

Marijuana is a preparation made from a plant of the genus Cannabis, usually consumed by smoking it like tobacco.

The level of marijuana use in the United States is far lower than that of alcohol.

Approximately 18 percent of college students use marijuana on a daily basis, and somewhere between one-third and one-half of all adults have ever used marijuana.

Adverse consequences of marijuana use include:

impaired short-term memory, judgment, and motor coordination; ◦

negative academic outcomes, such as performing poorly on exams, achieving lower grade point averages, and dropping out of school; and ◦long-term effects such as increased risk for chronic cough and bronchitis.

Types of Drugs: Cannabis

Cannabis

Marijuana

Hashish

Accounts for 79% of illegal drug use in the U.S.

Legal for medical purposes in 22 states

77% of U.S. adults support medical marijuana use

How do you feel about marijuana use?

‘Gateway’ drug debate?

Copy-Cat Drugs: ‘Spice’ ‘K2’

Made to look like natural marijuana

Dried plant material and chopped up herbs that are sprayed with active ingredients: synthetic cannabinoids.

Some are 100x stronger than THC: cause hbp, blurred vision, vomiting, seizures, hallucinations, severe anxiety/paranoia and heart attacks

Sold under more than 500 names.

Readily available in some areas; rapid distribution

Addictive properties

Types of Drugs: Stimulants

Stimulants are drugs that elevate alertness, altering a person’s mood by increasing energy.

Caffeine

Nicotine

Amphetamines: Ritalin and Adderall

Cocaine and Crack

Methamphetamines: highly addictive

Widely used in the U.S.

Use can lead to hostility, paranoia, irregular heartbeat, heart failure, seizures and psychotic symptoms

Increase alertness, increased attention and raise blood pressure, heart rate and breathing.

The Extent of Drug Abuse in the United States

Stimulants

There are enough stimulants produced legally in the United States each year to provide 50 doses to every person.

About one-half of these legal stimulants find their way into the illegal drug trade.

Cocaine, a stimulant derived from coca leaves, has become the third most popular psychoactive drug in the United States after alcohol and marijuana.

About 1.5 million people are estimated to use cocaine

Those who are 18 to 25 are twice as likely to use cocaine

Mean are more likely to use cocaine

Types of Drugs: Depressants

Depressants are drugs that slow the operation of the central nervous system.

“Downers”

Alcohol

2.5

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