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chap 19

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York University
SOCI 2050
David Stamos

Sociology Chapter 19 – Health & Medicine Health – according to the World Health Organization, is “the ability of an individual to reach his or her potential and to respond positively to changes in the environment.” Jeanne Louise Calment – French woman died at 122. More than half a billion people in 32 countries (most in sub-saharan Africa) have a life expectancy less than 50 years. The social causes of illness and death 3 types of social causes Human-environmental factors: Divisons like social class, occupation and nationality. Environmental racism is the tendancy to heap environmental dangers on the disadvantaged.(north example of dumping and inuit mothers having 10 times more contaminated breastmilk) Lifestyle factors: Smoking, alcohol&drugs, poor diet, no exercise, social isolation are among the factors associated with poor health and premature death. Unmarried people have a greater chance of dying prematurely than do married people because of social isolation. Factors related to the public health and health care systems: nations health depends partly on public health system and private efforts to improve peoples well being and treat their illnesses. Health care system is composed of a nation’s clinics, hospitals, and other facilities for ensuring health and treating illness. Country of Residence HIV/Aids is the leading cause of death in the poverty stricken part of Africa, 5% of adult population are living with HIV/Aids while 0.6 North American adults have it and 0.3% of western Europeans have it. There is a positive association between national wealth and good health. Infant Mortality is the 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 than do people with high income, poverty is also associated with high rates of tobacco, and alcohol consumption, obesity, physical inactivity, and violence. Why does health deteriorate as we move down the class hierarchy? 1. High stress and the inability to cope with it.(stress leads to high blood pressure, cancer, substance abuse etc….people in higher class stricter are often able to turn stress off) 2. Differences in the earliest stages of development that have lifelong consequences (Mothers who have low income or little education are more likely to provide such unfavourable starts to life. 3. Lack of knowledge (Less educated people have less knowledge about healthy lifestyles .. eg. Nutritious diet. This makes them more propense to illness. Illness makes it more difficult for poor people to escape poverty.) 4. Unequal access to health resources (poor Canadians live in areas that have inferior medical services.. fewer nurses, physicians, and hospitals per capita.) 5. Environmental exposure (poor people are more likely to be exposed to environmental risks…. Dumpsites, factories, oil refineries, mines) Racial Inequalities in Health Care Non Aboriginal Canadians have a 7-8 year longer lifespan than Indians and drug use is high among aboriginal peoples. Social exclusion influences health > labour market segregation, high unemployment, low occupation status, substandard housing, dangerous or distressed neighbourhoods, homelessness, dangerous worksites, extended hours, multiple jobs, and experience with everyday forms of racism. Gender inequalities in Health Care: The feminist Contribution Feminists scholars have brought health inequalities based on gender > Gender bias exists in medical research (public health systems issue men’s health issues more than women, therefore more research focused on men’s diseases(cardiac arrest), than women’s diseases(breast cancer) Gender bias also exists in medical treatment (women undergro fewer kidney transplants, cardiac procedures etc.) Women live longer than men do and therofre experience greater lifetime risk of functional disability and chronic illnesss, and greater need for long term care. The low status of woman in less developed countries results in their nutrition being deprived and having less access to medical care than do men. Women therefore suffer high rates of mortality and morbidity. Morbidity refers to acute and chronic illness. Canadian women face a higher risk than men do of poverty after divorce and of widowhood Comparative Health Care from Conflict and Functionalist Perspectives. The American case shows that spending more money on health care does not always improve the health of a nation. One reason for this is because of the gap between rich and poor in the USA being so high. Another reason could be that healthcare is unusually high in the USA. ‘ In the USA only seniors, poor and veterans receive medical benefits from the gov’t under Medicare. American gov’t pays about 45% of all medical costs out of taxes. Roughly 50 million Americans lack health insurance and another 50 million lack adequate coverage. Private Health Insurance Most people who have private health insurance obtain it through their employers or unions. 85% of employees receive their health coverage through health maintenance organizations. HMOs have 4 strategies to keep shareholders happy, but these four lower the average quality of health care in the U.S. 1. Some HMOS avoid covering sick people and people who are likely to get sick, keeping their costs down. 2. HMOs try to minimize the cost of treating sick people they can’t avoid covering. 3. There have been allegations that some HMOs routinely inflate diagnoses to maximize reimbursements 4. HMOS keep overhead charges high, ad
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