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Study Guide 3_Midterm 1.docx

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Boston University
CAS SO 215
Joseph Harris

SO215 Midterm 1 Introduction • Sociological Enterprise- the effort to explore the relationship between individual biography and social structure • Social Structure – patterned institutionalized social status (race, religion, family, law, organizations) • Medical Sociology – focuses on the social causes and consequences of health and illness o social facets of health and disease o social behavior of healthcare personnel and patients o social functions of health organizations and institutions o social patters of utilization of health services o relationship of healthcare systems to other social institutions o politics of social policies related to health • Why is it important? Health is not simply a matter of biology, but involves a number of factors that are cultural, political, economic, and social in nature Epidemiology – study of the origin and distribution of health problems in the population from the collection of data from many different sources. Primary focus is the health problems of social aggregates or large groups of people. • Prevalence: Total number of cases of a health disorder that exist at any given time (includes new and preexisting) o Point Prevalence: number of cases at a certain point in time (day or week) o Period Prevalence: total number during a specified period of time (month or year) o Lifetime Prevalence: number of people who have had the problem during their lifetime at least once • Incidence: number of new cases of a specific health disorder occurring within a given population during a state period of time • Infant Mortality Rate – (total deaths of children<1 year of age of a year / number of live births in that year) x 1000 = Infant Mortality Rate of that year – recorded as # of deaths per 1,000 live births. o Useful as an indicator of standard of living Primary Cause of Death in the US: Heart Disease John Snow and The 1854 Cholera Outbreak • Why Important? Snow is the forefather of epidemiology – shows his approach o Involves investigation of social world to find answers – foundation of modern epidemiology o Disease has SOCIAL CAUSES not just biological o Shows how cultural change happens and one paradigm can replace another o Importance of SES (class) Different Disease Paradigms from Ghost Map • Miasma Theory (Dominant) – smell = disease, disease was spread through odor. Bad smell = bad air • Contagion/Germ Theory – Disease caused by pathogens, spread through water Most believed Miasma Theory – easier to believe because the smell was clearly present and detectable. Pathogens in water could not be seen 2010 Cholera Outbreak in Haiti – caused by human activity – waste pits from a UN peacekeeping troop seeped into nearby river used by villagers • 7000 deaths between October 2010 to January 2012 • Originally thought outbreak was due to climate changes SES and Health • Social Class – category or group of people who have approximately the same amount of wealth, status, and power in a society – ranked in a hierarchical way; helps determine personal opportunities and life experiences US vs Britain US: 5 class system – focuses on broader measure of SES (power and status as well as wealth) o Upper Class – extremely wealth, top corporate execs o Upper Middle Class – affluent, well educated professionals, high level managers o Lower Middle Class – office and sales work, small business owners, teachers, managers o Working Class – skilled and semi-skilled, lower level clerical workers o Lower Class – semi and unskilled, chronically unemployed Britain (European focuses on person’s occupation) • based on differences in employment relationships (decision-making autonomy and job security) and work conditions (promotional opportunities and influence over planning. Moved to a 10 class model Three main components of SES • Income – spending power, housing, diet, medical care • Occupation – status, responsibility at work, physical activity, health risks • Education – person’s skill for acquiring positive social, psychological, and economic resources such as good jobs, nice homes, and health insurance, access to quality healthcare, and knowledge about healthy lifestyles How does SES affect health? Consistent predictor of life expectancy, lower SES = worse health • Social Gradient – higher education, income, occupation = lower mortality Importance of Education to health – most accurate predictor of health, longer life expectancy, less health issues, less worried/depressed SES and other factors (race, gender, age): disadvantage is more extreme in developing nations (LatinAmerica, SouthAsia,Africa), affects male mortality more Is Healthcare enough? NO – medical care alone cannot counter the adverse effects of class position on health (Britain has universal healthcare but can still see disparities in life expectancy) Cannot overcome living conditions and negative lifestyles Common lifestyle choices among the Poor • Less access to health information and resources • Less control over sleeping hours and food choices • More likely to live in a social environment where unhealthy eating, smoking and heavy drinking are normal – risky lifestyle formation probable • Poor are twice as likely to smoke as people with high income SES as a Fundamental Cause of Mortality • Influences multiple diseases (not just a few) • Affects disease outcomes through multiple risk factors • Involves access to resources that can be used to avoid risks/minimize consequences of disease • Be reproduced over time by replacing intervening mechanisms Flexible Resources - money, knowledge, power, social connections, prestige – come with high SES – can either protect health or cause premature mortality • Flexible resources tell us why SES gradients are reproduced over time How do we address these disparities? Advocate policies that encourage medical and health promoting advances while breaking the link between the advances and SES resources. Reduce disparities in SES resources, develop interventions that are more equally distributed. Gender and Health Difference in Morbidity and Mortality Rates? • Women have higher morbidity – higher rates of illness/sickness • Men have high mortality – higher rates of death from prenatal onwards • Women have higher life expectancy Differences in Smoking Effects • Smoking causes a woman to lose 14.5 years and men to lose 13.5 years • Lung Cancer is number one cause of death in types of cancer for women • Women smokers face 25% higher risk of developing heart disease • 2x as likely to get lung cancer • toxins in cigarette smoke appear to affect women disproportionately • women smoke less but still get effected more McKinlay’s Study on gender gap in Heart Disease -Women are not diagnosed with heart disease when showing the same symptoms as men Implications of the study • Health statistics are socially constructed – involve the patientsAND providers • Need to focus more attention on provider/health system side • Significant difference in how men and women are treated – this may help account for disparity in heart disease • Women are treated dif
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