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SOC243 Week 1.doc

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University of Toronto St. George
William Magee

SOC243- Lecture 1 January-09-13 7:06 PM Brief intro to Social Epidemiology and Medical Sociology • Studies of the social causes of illness predate sociology as a discipline. • Fredrich Engles→ "Conditions of the working class in England" 1844 (activist orientation) before full fledged Marxian Theory. (Deals with why groups of people are in certain situations). • Rudolph Virchow→ started soon after, not published systematically until after 1870's due to work in biology (professional orientation) more Public Health. One of the first people to write from a biological perspective about social causes of illness. (Deals with what needs to be done, social policy changes, what government can do). • Medical sociology developed as a unique field in the 1950's. • Talcott Parsons→ first major theory in medical sociology, focus on medicine as an institution of social control. Was a functionalist (institutions develop to serve functions. Institution processes ill people, makes them well then puts them back into the system. Keeps the system functioning because illness can be a threat to social order). • Epidemiology focuses on the "how's " of the disease (focus on illness as a medical phenomenon). Dr. John Snow and the Cholera Epidemic of 1850's London • Went to areas to get info about where people were sick and charted it on maps and found clusters. Hypothesized that something in those areas, shared by people, is causing this disease. Stopped people from using local well and the number of new cases overtime dropped. • Inductive reasoning: starts with observation and moves toward generalizations theories. Bottom-up approach involves searching for patterns or regularities (or irregularities). • Deductive reasoning: works from the general to the specific. Top down approach. Narrow a theory about a topic to a specific hypothesis (to be tested). Epidemiologic Triangle: An Aid for Inductive Reasoning about Infectious Disease • • Agent- Distribution- Mutation. • Environment- ex: distribution and communion of hosts. • Host resistance. Sociology in Medicine (and Public Health) • Sociologists help health care providers/researchers with studies that answer questions about the causes of disease, illness and treatments. • Ex: studies of "patient compliance". • Critique of sociology in medicine (by sociology of medicine): it’s "a well financed government effort to cope with the problems of industrial society"- Alvin Gouldner. Sociology of Medicine • Research and analysis of the medical environments (ex: hospitals). Focuses on the place of medicine/healthcare in the political economy. • Analysis of historical trends( ex: defining role of technology, organizational practices in relation to epidemiological trends). Asks questions of interest to sociologists in general (ex: about power and control) • Typically undertaken from a "critical perspective" that challenges dominant views (ex: views of the medical profession). Eras, Ages and Epidemiological Transitions(s): A Long-term (Western) Perspective • Age of pestilence (people getting a lot of infections) and famine. • Age or receding pandemics (the ET). • Age of degenerative disease (the ET). • New rise of infectious disease (the ET). • Age of delayed degenerative diseases. • Most famous European epidemic, the Black Plague, took place in the 14th century. Age of Pestilence and Famine: Waves of Plagues • The Black Death→ In 4 years (1346-50) estimates to have killed 1 in 3 people in Western Europe (from 25%-50%, min. 25 million deaths). • Seems to be the same bacteria responsible for earlier plagues (Y.pestis), such as 6th century "Justinian Plague". Recent genetic research traces origins of bacteria to China. • Seemed to disappear in Europe until the Middle Ages/Black Death. Environment/Resistance-related Developments Associates with the Rise of Pestilence/Disease • Developmen
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