Sociology 3HH3: Sociology of Health Oct. 4 2012
Lecture 5: Midterm Info & Recap of Concepts & Social Ep/Ep & 8 Major Measures to Assess Disease
o October 18th
o 2 hours: 7-9pm
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
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)
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?
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)
o Influenza /Pneumonia
o Heart Disease
Got infected? Not much we can do for you
o Early Infancy Death
o Heart disease
Preventable, but in the top 4
- 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
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
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
Japan is the healthiest
o 5-6% Infant Mortality Rate (5-6% died in a given year)
U.S. not so good
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
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
Different sources will have different facts
How do you deal with this in paper?
o What is consistent?
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
o Race/ethnic diff in U.S.
What is going on to cause that?
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
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
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
More destructive to female organs
o Reproductive changes make a baseline health harder to read on
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
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
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
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
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
o Women: first heart attack was fatal
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