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SOCA02 Lec 9.docx

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University of Toronto Scarborough
Sheldon Ungar

SOCA02 Health: UN definition - A state of complete physical, mental and social well-being - What could this really mean? o 1 in 4 suffer mental illness in lifetime Health is as much social as biological - Related to o Social inequalities o Technology o Social resources o Social constructionism  We construct a lot of health and illness Life expectancy over time Health and stratification - Rich live upstream o When river was going through city, wanted to live upstream of this  Poor people had dumping in their water  Living upstream = the richer you are o Toronto vs. countryside  People are healthier in the city  Tend to live longer  In countryside, there are pesticides, carcinogens  In city there is high-tech medicine o Race  Related to poverty – poorer live near toxic sites  Blacks have higher death rates because they tend to live near toxic sites - Income and obesity o Bottom 20% tend to be 5x more likely to be obese than the top 20%  Same with heart attacks, etc.  Bottom 20%  diet is worst, tend to live on carbohydrates  Richer people tend to have gym memberships; more access to working out, trainers, etc. - Women died more of open-heart surgery o Men had bigger arteries, etc. Disease ecology - We create a lot of diseases - “we are major engineers of viral traffic but are unaware of it” o Pathways: e.g. dengue  Used to be non-existent in humans  Is now in humans because in Southern Americas – got rid of fields where mice lived; they started moving into houses and carried dengue fever  When in a field, people have little contact with mice  Species lose homes and go around to find food - Population density o Viruses need a reservoir or die out  Viruses are more deadly  Usually live in a species of some sort  E.g. monkeys o When they are killed and eaten  jump to humans o Stepping off a plane…  If there was a virus on a ship and is out on water for 2 weeks  Once it hits everyone on the ship, loses reservoir and dies  Viruses don’t die off anymore in travel because travelling is so fast  Move mosquitoes all over the world through tires – always water in the tires. This is how dengue gets around o We create pathways - War o Napoleon  Lost more troops to disease than to fighting  Men are in close quarters – unhygienic, bad conditions and close qurters o 1918 Spanish Flu  Killed between 50-100 000 people in the world Scientific Control of Disease past century - US Surgeon General in 1967 claims contagious diseases will be wiped out… o Vaccines o Antibiotics  Medical miracles at the time  Antibiotics works at first but diseases come back stronger Shift in epidemiology - 1880 – 1991 o Leading causes of death are different at these times o Pneumonia is the only one during both times - Cause for deaths – contagious diseases to slow killing diseases - Cancer, stroke, heart attack, diabetes Overstate the role of science - Vs. social factors TB death rates over time - One of the reasons it is gone is because of antibiotics - Antibiotics become wide-spread used by 1950 o TB was already in free fall without science – other things went on o Antibiotics did not end it Beyond science/medicine… - Improved nutrition o Adequate, safe food  Refrigeration  Cooking at high temperatures - Improved hygiene o Clean water o Plumbing o Bathing In other words… rich is better - Same with pollution – rich nations able to clean up while third-world cannot - Can clean up better, can afford more, have healthcare as backup Social resources and actions (rich vs. poor) - TB… o Deaths worldwide o ~3 million a year - Tends to occur in poorer parts of the world - MDR (antibiotic resistance) – multiple drug resistance o New York – contained  Epidemic was contained since it is a richer city o Russia  Still have MDR TB  Treated with a lot of antibiotics – akin to chemo  Suppress immune systems for transplant – body will not reject drug o To get better, need to get sick first o Antibiotics are bad for TB  When starting and stopping, virus keeps coming back - Not as much money comes in with antibiotics, therefore, drug companies make drugs for widespread use not for sick people – make more money that way - Observed therapy – watch you take the drug. Even give a free meal - Suppress immune system so body will not reject drug but it is easier for diseases Antibiotic resistance social vs. medical - Bacteria inevitably develop some resistance - Can take up to 2 weeks of treatment for antibiotics - Social – social overuse -  Prophylactic  Used as contraceptive - Use In factory farming o Too much in environment – go to animals o Slaughter after a few days to o Lots of food eaten has bits of antibiotics in it - Overprescribe to patients o With viral infections, antibiotics do nothing o If have a virus that develops into lung infection  need antibiotics o Keep prescribing because patients want them o Give more ability for virus to adapt Global anti-polio campaign - Disease of fear in the 50s – boil the water - Only small packets of polio left in the world – like smallpox  kept in labs in US and Russia - At the verge of controlling polio Social constriction of health (and illness) - Focus on individual behaviour o Vs. social conditions Social construction of cancer - Focus on o Smoking, diet, exercise, personality o Link to diet is limited  Eating junk all the time increases chance of dying o Personality – “Carcinogenic personality” Questions about cancer - How much do lifestyle factors predict? - Besides cancer – link is not as strong o 50% die of lung cancer - Smoking is not a guarantee of cancer - Food does a small amount – same as with heart disease - Social distribution of cancer o Blacks higher cancer rates  Live right near toxic dumps  Good evidence for this o Tendency is to blame individual and lifestyle because is easier for society - Risk society o “chemical soup”  China “cancer villages”  Admit there are areas where rates are very high  Attention to disease socially constructed - Amount of media attention to an issue is often unrelated to its “objective” seriousness
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