Chapter 9 of Social Problems

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Lorne Tepperman

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Chapter 9 Health Issues Introduction Much social construction and labelling also go into perceiving and dealing with illness and disease Aronowitz calls our attention to the process of framing disease, which he considers an underappreciated mechanism for the social patterning of health Epidemiologists have focused on material and psychosocial causes of illness Aronowitz, however, argues for the need to note the ways we generally recognize, define, name and classify disease states and assign them to a cause or set of causes These framing effects influence: o Beliefs about health and illness o Patterns of consumption and other behaviours o Perceptions of what interventions and policies work o Class, ethnic, and other social dynamics o Clinical and public health practices The Thomas Dictum proves correct about sick as well as healthy behaviour: what we believe to be true is true in its consequences In one sense, illnesses are personal problems that we face: we alone feel the physical and neurological pains Health and illness are also social problems for several reasons o Many diseases and illnesses are common o Health and health-care resources are unequally divided throughout society Medical sociology: the field of sociology that examines the social context of health, illness and health care Involves the social factors that promote illness and contribute to health inequalities Other areas focus on the practice of medicine and explore the social construction of illness and health, the economics and politics of health-care delivery, and the features of physician-patient interaction o Inequalities in health and health care are social problems because improving the health of the whole population will need the efforts of governments and other large institutions Defining and Measuring Health Definitions of Health and Illness Biomedical view of medicine: a medical perspective that emphasizes Western scientific principles, defines health as the absence of illness, views the human body as a machine that sometimes requires repair, and promotes the use of therapeutic intervention to cure disease and injury th This view has dominated industrial societies since early in the 20 century Health is a passive, default state of normalcy, illness, an active problem in need of treatment The symptoms of biologically identical illnesses vary with differences in personal history, socio-economic condition, and cultural background, leading doctors to treat the patient rather than simply the disease Well being: a positive state of existence characterized by happiness, prosperity, and the satisfaction of basic human needs, and not simply the absence of negative conditions, such as illness or injury Health: a state of complete physical, mental and social well being - WHO Health Canadas meaning of health: a state of social, mental, emotional, and physical well-being that is influenced by a broad range of factors, including: o Biology and genetics o Personal health practices and coping skills o The social and physical environments o Gender o Socio-economic factors (income and education o Cultural practices and norms Biopsychosocial view of health and illness: a medical perspective that considers health and disease as products of the interaction between body, mind, and environment Measuring Health and Illness Epidemiology: an applied science that examines the causes, distribution, and control of disease in a population o Use various techniques to study the patterns of health and illness in society, drawing on the knowledge of many disciplines (medicine, public health, sociology, psychology, and economics) Life expectancy: the average number of years remaining to a person at a particular age, given current age specific mortality rates o Global life expectancy has increase dramatically because of advances in medicine, public health and technolofy o 50 years ago, it was 47; by 2005, it was 65 o Important disparities in life expectancy still exist between rich and poor nations Mortality rate: the death rate of a given disease or population, typically measured as deaths/year/1000 people Maternal mortality rate: the number of deaths of women due to complications during pregnancy, childbirth, or abortion, typically measured as deaths/year/1000 live births As a result of the wide availability of contraceptive technology, the number of abortions continues to fall The maternal mortality rate is a problem clearly linked to global poverty Infant mortality rate: number of deaths of children under one year of age/ 1000 live births Under-five mortality rate (U5MR): number of deaths of children under 5 years of age/1000 live births Both are statistical indicators of population health, focusing on societys youngest and most vulnerable members Morbidity rate: the extent of disease in a population, reported by incidence (the number of new cases in a given population during a given period) and/or its prevalence (the total number of cases of a disease in the population at a particular point in time) Diseases also can be classified as: o Endemic: constantly present within a population o Epidemic: being a local or national outbreak o Pandemic: an epidemic of international or global proportions Morbidity rates vary according to social variables such as sex/gender, racial grouping, and social class Threats to Canadian and Global Health The AIDS Pandemic AIDS is the leading cause of death among adults 15-29, and the 4 leading cause of death overall HIV is transmitted via the exchange of bodily fluids Infection occurs mainly through unprotected sexual intercourse, sharing of intravenous needles, prenatal transmission, infusion of tainted blood products, and, rarely, breast milk SARS, Pandemic Influenza, and the Globalization of Infectious Disease Malaria is a disease almost exclusive to the worlds poorest nations Tuberculosis, once thought to be wiped out, has made a comeback in recent year The WHO also estimates that, every year, somewhere in the world a new infectious disease emerges that is previously unknown in humans and for which we have no natural immunity A striking example of how present-day globalization has increase the risks posed by emergent communicable viruses is the 2003 outbreak of SARS The epidemic has been called a product of globalization because its rapid spread was promoted by the movement of people along international air travel and trade routes Major influenza outbreaks occur in human populations about 3 or 4 times per century Mental Health and Mental Illness Mental health: the capacity for individuals to fell, think, and act in ways that enhance the quality of daily functioning, the range and depth of social relationships, and the ability to adapt to both positive and negative life changes Mental disorder: a condition characterized by alternations in thinking, mood, or behaviour (or some combination thereof) associated with significant distress and impaired functioning over an extended period of time Mental illness: clinical diagnosis of mental disorder requiring medical and/or psychotherapeutic treatment Mental illnesses and disorders should not be confused with the momentary feelings of loneliness, sadness, or emotional agitation that we all experience Mental disorders and illnesses are social problems because they often interrupt the normal functioning of families, groups, and other social institutions At the same time, their causes are still poorly understood American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) Most
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