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Lecture 12

Lecture 12 Nov 29th.docx

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McMaster University
Gail Coulas

Sociology 3HH3: Sociology of Health Nov. 29 2012 Lecture 12: Medicalization – Health Care Pluralism & Final Review Note: - Essay Returned – Monday 1:30-1:45 in ABB 164 Health Care Pluralism - Ethno medicine – biomedicine o Ethno medicine is biomedicine o Reality is that most western socs have a situation of helath care pluralism  Origin of the treatment isn’t as relavent as the peopl’s belief in that treatment as we saw with the placebo effect - Health care subculture o Diff groups of healers  Each group has its own way of describing health and of treating it  Each has diff organization – own subculture  Can be indigenous e.g. First Nations Healing or can be importing into a soc e.g. techniques imported from Asia  Clineman – futher subdivides cults into three main groups  Sometimes overlap, sometimes integration o 1. Popular sector  Lay, non-professional, non-specialist domain  Who do we first ask for help  Includes all therapeutic options people use without payment or consulting healers/professionals  Self-treatment and self-med  Help from fam or friend  Help from community o Self-help group o Church o Yoga groups o New age movements etc  Get credible advice. It works, you don’t go any further  The ill individual can consult another lay person who has special experience of their particular disorder  Can get treatment for people they think have their same condition o I went to doc he said __, you should try __  Don’t care about their professional opinion – care about their disorder o People with experience of an illness o Experience of a life event (having a kid) o Paramedical professional that you know as a friend or acquaintance  Friend who is a nurse etc. o 2. Professional sector  Dominated by biomedicine  What most of the population would recommend as legitimate healing  Controls most of the big organizations o 3. Folk sector  Some are considered legitimate, some aren’t  Really what matters is the person seeking help’s belief  Tends to be esp large in non-industrial countries  Certain individuals specialize in certain froms of healing considered secular or sacred or a mixture  Usually considered an intermediate group btw the 2 others  Sometimes go btw the two o Could be like the church – 1 o Could be like naturopaths – 2  Status can rise and fall with soc  Heterogeneous group with focus  Most of them are holistic – focus on the individual as a whole person o Don’t sep person from culture o Don’t sep biomed from psych  Most share basic cult values and world views of community in which they live  E.g. Japan – very much dominated by its major relig which says the body is sacred. Your resp in your life is to keep the body sacred. Ideal model for integrating social determinants of health  Generally folk healers have very little formal training  Advantages over biomed  Often folk healers are holistc – involve the whole fam in the treatment and diagnosis o Provides a very effective primary health care team o Not dealing with parts o Very often involve family in the healing process  Often have a shared world view with the people who come to them o Believe in the same things – makes you more comfortable o More informal than biomed o Use of everyday, pragmatic language in the process o Understand what is going on, makes sense to you o Treatment makes sense to you o Better able to define and treat illness in the ways that the person is comfortable with  Vs. Prof  Folk talk about how often biomed docs are sep from the people they heal by SES o Diff gender, education, ethic, cult o Not dealing with someone you can realt to in any way o Incredible formal distance – see that as a huge disadvantage  Don’t treat the person as a whole  Can tell people what has happened to them, bbut only folk can explain why!  Rela is marked by great distress and suspicion o Con’t occupational battle btw folk and prof  At one pt, NAmer was unique in that they banned everything but biomed o At the same time, Euro made biomed the top of the pyramid but integrated other types as well  E.g. royal family goes to naturopaths o NAmer is strange in that they outlawed everyone else  Controlled choices for a long time  Biomed tends to lump all folk healers in one group o Quacks, gonna take your money and do you harm o Social change  Is occurring, most of it from pressure  As immigration con’t and pop becomes more diverse, people bring their healers with them  A lot of pressure on gov’t to bring other healers in  Not covered by OHIP or anything o Almost an elite aspect to our system because a lot of people can’t afford it  Reality is that more and more people are increasingly blending diff types of med  Make their own decisions about what proportions of each they have in their lives  Only shifted in the last 30 years in NAmer  Internalltionaly – been going on for a long time  1970s – WHO pushes a lot of initiatves to blend folk and prof o Save a ton of money and give more healthcare to a wider population  PBA – professional Birth attendents  Against the whole medicalized procedure around birth  Reality is that 2/3 of the world’s babies are delivered by PBAs – midwives without “prof” training o Groups of Folk Sector Healers  CAM – Complimentary/Alternative Medicine  Have a lot to offer  Have their own prof schools  Often have a biological base  Approach healing in a tot diff way from  Not a part of biomed o But maybe should be taken a bit more seriously  Beginning to consistently overlap both the folk and prof o Becoming really strong in our soc o Not uncommon for people to go to some kind of alt healer  People who go to cam o Feel that biomed at times is not the best source of health  Bc biomed treats the symptoms, not the cause o Feel cam looks at cause to keep you halthy  Preventative  Biomed against alternate care o Reality is that when they do research on people who use CAM, usually don’t throw biomed out = create a blend of biomed and cam that works for them  Usually don’t go to cam until biomed doesn’t have the answer thye need o A lot of skeptics  Our soc is totally based on the bleife of biomed  Believe a lot of the myths about CAM  Believe a lot of the myths about the people that use cam  Reality is that it is a normal cross section of the pop – not a bunch of outliers  Data disputes any q that this group is more likely to be poor, gullible, superstisious  Group of normal Canadians looking for a diff answer o E.g. Blend  People taking chemo go to a naturopath to help them keep down food  Chemo to stop cancer, naturopath to cure the side effects of chemo  Biomed has had a virtual monopoly on edu in NAmer. Euro – CAM almost totally integrated o E.g. in Netherlands, Germany etc.  Integrating natural remedies into their health regime  Biomed docs get special training in natural medicine o U.S.  About 500 million visits a year to CAM practitioners  400 million to traditional  Therefore more to CAM than traditional  Bc insurance companies agree that more cost effective – will cover CAM o Canada  Experiencing growth and acceptance of diff types of cam care  Wide array of indigenous and religious healing groups  What is offered to you really depends on the ethnocult of your city o Rela btw Biomed and CAM  Rela has not had a good history  A lot of the myths about alt med have stopped people from being involved  If you look at the hist – rela of over hostility  Occupational turf war – biomed wanted a monoplogy, gov’t gave them
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