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Lecture 5

Lecture 5 Oct. 4th.docx

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Gail Coulas

Sociology 3HH3: Sociology of Health Oct. 4 2012 Lecture 5: Midterm Info & Recap of Concepts & Social Ep/Ep & 8 Major Measures to Assess Disease Incidence/Prevalence Notes: - Midterm o October 18th o 30% o 2 hours: 7-9pm o Readings  Segall 1-7  Rapheal Recap: - Epidemiology o Science of tracing the bio patterns of disease o How do I create health? o How we get our formal defs of disease - Social Ep o Studies social construction of health and illness - Incidence o # of new cases o Over the same length of time (a year, 6 months whatever) o Over the same amount of people (per 1000, per 100 000 whatever) - Prevalence o Existing cases of a disease (new and old) o What is the cure rate?  Are the tactics we use working? - Morbidity Data o Amount & type of disease/illness o Data from med services institutions o Know when we are in an epidemic  Epidemic that has gone global = pandemic - Mortality Data o The # of deaths in a pop o Trace the # of people that should die  Is it abnormal?  What are the causes? - Example: Social Ep: First Nations began dying of Small Pox after Euros arrived o Euros had developed immunity in Europe o 6 mil – 10 mil FNs died o FN’s who had never come in contact with Euros were dying  How was it being transferred?  HBC Blankets o Was a principle commodity traded for fur pelts by Euros o Disease lived on wool blankets  Ex. Of Social Ep - Morbidity AND Mortality o Put the 2 together and understand disease  Used to classify diseases  Compare and contrast btw cities and nations  SARS in t.o. vs. SARS in China o Cross-cult and longitudinal analysis  Measure and trace disease patterns Using these Concepts: Main Causes of Death (in order) - 1900 o Influenza /Pneumonia o TB o Gastritis o Heart Disease o Kidney o Accidents  Got infected? Not much we can do for you o Cancer o Early Infancy Death - 2000 o Heart disease o Cancer o Stroke o Accidents  Preventable, but in the top 4 o Pneumonia o Diabetes o Suicide o AIDS - Use Morbid/Mortal to get these data - Use this data to figure out what is diff in soc o Social ep  What was going on then vs. now  What patterns of life are shifting so that these disease patterns have shifted?  A lot of these are lifestyle diseases  If we lived better, a lot of these could be reduced dramatically o Issue: Calling something a “lifestyle” issue  Careful because can BLAME the victim  May be lifestyle but is it socially caused or individually caused  Careful about victim blaming o Try to make it into a social issue o What is it about soc that is making you act like that? o (sociology NOT psychology – psych would say – what is it about YOU that is making you act like that) Variables we look at for disease and illness: Social Ep: 8 Major Measures to Assess Disease Incidence/Prevalence - What do I look at to analyze what is going on in that society that might have caused these issues? o Issues i.e. heart disease, cancer etc. - Look at these major measures (in order): 1. Infant Mortality Rate o Used to discuss wellness and disease o Number of children born in a given year that live to reach their first birthday  How many kids per 100 000 reach their first bday o One of the most consistent measurements done to assess health or wellness of any one nation  Used to compare and contrast health of one nation to another o “Provides measures of the deaths of all infants in a geo area under the age of 1”  How many survive the age of one  Have to be consistent about area and measurement (per 100, per 100 000 etc) o Provides an approximate measure of a soc’s sanitation and medical efforts  Indicator of pre and post natal care  What was the state of the health of the ma b4 preg, after preg and how did that affect child?  Healthy ma = healthy baby o Issue with using rates  CDC  Japan is the healthiest o 5-6% Infant Mortality Rate (5-6% died in a given year)  U.S. not so good o 9% o Has more people without healthcare than we have in our whole country o The most expensive healthcare in the world  Spend twice as much as Canada  Japan spends WAYY less  Indicates that money isn’t always the answer when it comes to health  World Fact Book  Different #s  U.S. o 5.9%  Why diff?  How did they get these numbers?  What is going on with these rates?  Issue is that some countries don’t count the deaths of a premature baby o So as to appear healthier  Don’t count till “viable”  Another issue: Version Control o Keep their version consistent by juggling 3s  Different sources will have different facts  How do you deal with this in paper? o What is consistent?  THE RANKING  Didn’t matter about the number, Japan was always #1, Canada always above U.S., U.S. always in the middle o Answer is  This is my source – your number might be diff but the ranking is the same so my argument still holds  Social Ep: Pockets of people in country where it isn’t always the same  Social determinants of health o Diff ppl have diff rates of disease  U.S. average rate of InfMortality is 11% for white amers, 22% for black amers o Race/ethnic diff in U.S.  What is going on to cause that?  Canada o IM rate lowest in PEI and Nova Scotia  NW Territories the worst  Had 4.2 in 2005  15.5 in 2009 o What happened to change that in those 4 years?  Nunavut was 10 in 2005, now up to 15 2. Sex & Gender o Sex vs. gender  Sex is bio determined  Cannot be changed (without surgery)  Gender is socially constructed  Can be changed o Consistent thing in Gender Health: Women are sicker but men die quicker  When Men get sick, they die  At every stage of life, men more likely to die o Men die 5-7 years earlier than females  Why male life insurance more expensive  When Women get sick, they get better  They have problems all along  Are women really sicker or do they just seek health more?  Are men dying quicker or do they just not seek help when they need it?  Are we socially constructing masc and fem so we seek health in a diff way?  Difference increases in less developed cultures  More and more women ill than men  Look first at is there a bio diff?  Certain health problems affect m & f differently o Alcoholism  More destructive to female organs o Reproductive changes make a baseline health harder to read on females  Then look is there a socially constructed diff?  Because of kids, they are more away of what can go wrong or right  Woman will stop and pay attn. to more sickness than a man will o More apt to go to doc, to finish prescription, to do what doctor says  Men slower at identifying symptoms and seeking health  As women have achieved more equality, same social resp as men, they are beginning to die from the same diseases as men  Gap is getting closer together  Used to be more men die from accidents, stroke & heart disease (stress diseases caused by workforce) o Now more women dying of these o Shows us that something in the world of work is bad for our health  NA’s work more hours per year than almost any other country in the world  Japan works more but in the work world they give you breaks o Take time to exercise, take naps, recreation etc.  People don’t even take lunch breaks anymore in T.O. o We need to get ahead! o Get there early, stay late, don’t take vacation times  Diseases that we have are because of the way our roles are constructed  Parental leave o Doesn’t look good in NA for men to stay home with baby  Something about the way we construct our roles cause us to be healthy or not o Sexist bias in the med data  When first starting looking at heart disease years ago  Where to get a big pop to study? o Use military base  Comparing data to general pop o This isn’t really consistent with what the docs are telling us o Why?  Younger, more fit on military base  Also, mostly MALE!  So went to pop and got a big sample of men o Figured out why they are dying of heart disease etc.  Then see heart disease in pop o Men: first heart attack as a warning, you can change your lifestyle o Women: first heart attack was fatal  Why?  Because sampled only men  When did sample women, found they had totes diff symptoms for heart disease than men o No pain in left arm  Now women see symptoms as signs of heart
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