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SOC479H1 Lecture Notes - Health Maintenance Organization, Infant Mortality, Social Class

4 pages77 viewsWinter 2007

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Black death originated in asia and spread through trade routes, killed a third of Europes
o Cause of the plague was a bacillos that spread from lice to rats to people.
Life expectancy the average age at death of the members of a population
o Canada’s = 83 for women
o 78 for men
Health The ability of an individual to achieve his potential and to respond positively to the
challenges of the environment. The basic resources of health are income, shelter and food.
Rate of illness and death are examined to measure health of population
Jeanne Louise Clement died at 1997 at age of 122, oldest age.
Since 1840, life expectancy has grown by 2.5 years per decade
In 2006, highest life expectancy was 82 years in Japan and by 2050, it is expected to be 92 years
Swaziland has shortest life expectancy of 33 years, and in other sub-saharan African countries
life expectancy is lower than 50 years.
3 social causes of illness and death are:
o Human Enironmental factors: How environment are shaped for human activity. Social
class, occupation and nationality correspond to different sorroundings in which people
work and live. Some environment factors good health while others impose added risk.
Environmental racism also contributes to lower health eg. Dumping industrial chemicals,
Inuits have 10 times more contaminated breast milk.
o Lifestyle factors = smoking, alcohol and drug use, poor diet, lack of exercise and social
isolation. Death of a spouse also increases the risk. Unmarried spouses have social
isolation and are more likely to die prematurely.
o Factors related to Public Health Care systems lack of public health and health care
system are associated with lower life expectancy and illness.
Public health system = comprimises government programs that ensure access to clean drinking
water, basic sewage and sanitation services and inoculation against infectious diseases.
Composed of nations clinics,hospitals and other facilities to ensure health.
HIV/AIDS is leading cause of death in urban Haiti and sub Saharan Africa
Infant mortality = number of deaths before the age of one for every 1000 live births in a
population in one year.
People with low income die at a younger age
Poverty is associated with smoking, alcohol consumption, obescity, physical inactivity, but
behavioural factors are weak predictor of health status compared to socioeconomic factors.
5 reasons for deteriorating health as we move down the class hierarchy are:
o High stress & inability to cope with it > people in lower class experience high stress
because of their deprived and difficult living condition, also live and work in dangerous
and unpleasant conditions
o Differences is the earliest stages of development that have life long consequences =
equalities of the start of life, eg. Poor circumstances during pregnancy such as poor
nutrition, can affect health in later life.
o Lack of knowledge = Less educated people have less knowledge about healthy lifestyle,
this contributes to illness which makes it harder for them to escape poverty.
o Unequal access to health resources = poor people live in rural areas that have inferior
medical services. (less nurses, doctors, physicians)
o Environmental exposure = poor people are more likely to be exposed to environmental
risk which have negative impact on their life.
o There are racial inequalities in helth care eg. Higher member of aboriginal people suffer
from poor health than other Canadians.
o There is also a gender bias in medical research and treatment. (research has been on
mens diseases like heart attack rather than womens diseases like breast cancer.
o Women are at higher risk of poverty after divorce, which may contribute to ill health.
Since women live longer they suffer higher rate of morbidity, because of high
rate of complication associated with pregnancy and child brirth.
o Morbidity = acute and chronic illness.
o US spends more than Canada and japan on health care but still has higher rate of infant
mortality and shorter life expectancy than Canada and japan. This is because gap
between rich and poor is greater in the US, higher the level of inequality the more
unhealthy the population.
Could be because cost of health is really high in US
Americans pay more for prescription drugs than anyone else in the world
In countries other than U.S. prescription prices are regulated by the
6th of americans have no access to health care and another sixth lacks
adequate coverage.
o Health Maintenance organization are privately owned companies that administer
medical treatment in return for regular payments from employers and employee, about
85% of employee receive their medical treatment through HMO
o HMO employs 4 main strategies to keep high profits
Avoid covering sick people and people who are likely to get sick
Minimize the cost of treating sick people they cant avoid and give reqards to
doctors for withholding treatment.
Routinely inflate diagnoses to maximize reimbursements
Have high overhead charges.
The supporters of the U.S. private health care systems are stockholders of insurance companies
and health professionals.
Large proportion of American Public support are extreme reforce in the health care system.
Socializde Medicine = Gov’t directly control the financing and organization of health services,
directly pay provider, guarantees equal access to health care and allows some private care for
individuals who are willing to pay for their medical expenses.
Canada doesn’t have true system of socialized medicine in that gov’t does not employ physicians
rather physicians are independednt practitioners who are paid on fee-for-service basis that
submit claim directly to provincial health insurance plan.
Pommy Douglas is father of medicine.
In countries with socialized medicine, the government (1) directly controls the financing and
organization of health services, (2)directly pays providers, (30) guarantees equal access to health
care, and (4) allows some private care for individuals who are willing to pay for their medical
Tommy Douglas is Canada’s ‘father of medicare’. One negative of Canadas health care system is
the waiting time for services.
Medicalization of Deviance = tendency for medical detivation of deviant behaviour to become
more prevalent over time.
What used to be defined as a ‘badness’ is now defined as ‘sickness’ .. eg, violence is medicated,
heroin addict is to seek the help of a methadone program etc.
Vietnam veterans had a campaign to recognize their posttraumatic stress disorder in the APA’s
manual (DSM) which was successful
Number of mental disorders classified by DSM has grown significantly and it is estimated that 1
in 5 canadians will be affected by mental illness at some time of their lives.
Most common mental disorder is depression
o Affects 1 in 4 women
o 1 in 10 men
4 main reasons for increase in classification of mental disorders are:
o People are experiencing more stress and depression than ever before
o Number of disorders increased because powerful organizations demands it (Prozac
o We may be encouraged to turn our problems into medical and psychological conditions
sometimes without inquiring deeply into the disadvantages of doing so. ADD example
o Various professional organizations have promoted them. Eg. Therapists trivialised the
term PTSD as children exposed to movies like Batman
Pressionalization = process by which people gain control and authority over their occupation
and their clients.
Most people in Toronto who had SARS as of June 12, 2003 caught it in the hospital.
Hospital infectious is 4th leading cause of death in Canada
Hospital infectious occur due to the lack of cleaning staff and nurses are too few.
Mutations in bacterias to antibiotic has created super germs
Sick Role = Involves non deliberate suspension of routine responsibilities, wanting to be will,
seeking competent help and cooperating with health care practitioners of all times.
Older Canadians and low income earner questions doctors treatment and baby boomers and
younger generation are even less likely to follow doctors advice uncritically.
Most widely used health alternative is chiropractor and is used by 1 in 10 Canadians.

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