schaefer10e ppt ch19
Post on 13-Sep-2014
277 views
DESCRIPTION
TRANSCRIPT
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 1
SOCIOLOGYRichard T. Schaefer
Health andMedicine
19
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 2
19. The Economy and Work
• Culture and Health• Sociological Perspectives on Health and
Illness• Social Epidemiology and Health• Health Care in the United States• Mental Illness in the United States• Social Policy and Health
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 3
Culture and Health
• Culture contributes to differences in medical care and how health is defined• Culture also influences the relative incidence of a disease or disorder.
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 4
Sociological Perspectives on Health and Illness
• Functionalist Approach– “Being sick” must be controlled so
that not too many people are released from their societal responsibilities
– Sick role: societal expectations about attitudes and behavior of a person viewed as being ill
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 5
Sociological Perspectives on Health and Illness
• Conflict Approach– Critical of growing role of medicine as
major institution of social control– The Medicalization of Society
• Interactionist Approach– Studies the roles played by health
care professionals and patients– Asserts patients may play an active
role in positive or negative health
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 6
Sociological Perspectives on Health and Illness
• Labeling Approach– The designations healthy and ill
generally involve social definition– Disagreements continue in the
medical community over whether a variety of life experiences are illnesses
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 7
Sociological Perspectives on Health and Illness
Figure 19-1. Infant Mortality Rates in Selected Countries, 2004
Source: Haub 2004
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 8
Sociological Perspectives on Health and Illness
Table 19-1. Major Perspectives on Health and Illness
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 9
Social Epidemiology and Health
• 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
– Prevalence: number of cases of a specific disorder that exist at a given time
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 10
Social Epidemiology and Health
• Social Epidemiology and Health– 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
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 11
Social Epidemiology and Health
• Social Class– Studies show people in lower classes
have higher rates of mortality and disability• Crowded living conditions• Substandard housing• Poor diet• Stress• Unable to afford quality health care
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 12
Social Epidemiology and Health
• 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
• Gender– When compared with men, women
live longer
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 13
Social Epidemiology and Health
Figure 19-2. Percentage of People without Health Insurance, 2001
Source: Haub 2002:23
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 14
Social Epidemiology and Health
• 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
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 15
Health Care in the United States
• A Historical View– During the 1830s and 1840s, “self-
help” was emphasized• Strong criticism of “doctoring”
– Eventually, medical profession controlled the market for its services and the various organizations that govern medical practice, financing, and policymaking
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 16
Health Care in the United States
• Physicians, Nurses, and Patients– Physicians have position of
dominance in dealing with nurses and patients
• Alternatives to Traditional Health Care– Holistic medicine
• Therapies that consider the person’s physical, mental, emotional, and spiritual characteristics
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 17
Health Care in the United States
• The Role of Government– In 1965, government subsidized
health care programs• Medicare for the elderly• Medicaid for the poor
– Medicare had huge impact on health care system• Some hospitals “dumped” unprofitable
Medicare patients until practice was banned in 1987
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 18
Health Care in the United States
Figure 19-3. Availability of Physicians by State
Source: Bureau of the Census 2004:101
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 19
Health Care in the United States
Figure 19-4. Total Health Care Expenditures in the United States, 1970— 2014 (projected)
Sources:Center for Medicare and Medicaid Services 2005 (2005—2014 data); Health Care Financing Administration 2001 (1970—1990 data)
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 20
Mental Illness in the United States
• Mental illness– Brain disorder that disrupts a person’s
thinking, feeling, and ability to interact with others
– People in U.S. traditionally maintained a negative and suspicious view of those with mental disorders
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 21
Mental Illness in the United States
• Theoretical Models of Mental Disorders– Medical Model: Mental illness rooted in
biological causes that can be treated through medical intervention
– Labeling Theory: Mental illness is not an “illness” since the individual’s problems arise from living in society and not from physical maladies
• Devalues mentally ill patients
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 22
Mental Illness in the United States
• Patterns of Care– Historical confinement of the insane
or mentally ill to public institutions– Community-based outpatient care
most prevalent now• Legislation has made it easier to commit
mentally-ill homeless involuntarily
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 23
Social Policy and Health
• Financing Health Care Worldwide– The Issue
• Industrialized nations face issues related to the accessibility and affordability of health care
– The Setting• The U.S. is the only Western industrial
democracy that does not treat health care as a basic right
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 24
Social Policy and Health
• Financing Health Care Worldwide– Sociological Insights
• Conflict theorists suggest health care system resists basic change
– Those who receive substantial wealth and power through an existing institution have strong incentive to keep things as they are
• Health care system undergoing “corporatization”
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 25
Social Policy and Health
• Financing Health Care Worldwide– Policy Initiatives
• Major reforms occurring in U.S. without legislative reform
– As of 1997, managed care plans enrolled 85% of all workers, up from 52% in 1993
– There are growing concerns about the quality of health care provided by managed care plans
McGraw-Hill © 2007 The McGraw-Hill Companies, Inc. All rights reserved.
Slide 26
Social Policy and Health
Figure 19-5. Government Expenditures for Health Care, Selected Countries
Source: World Bank 2005a:100--102