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Chapter 15

SOCI 1F90 Chapter Notes - Chapter 15: Involuntary Euthanasia, Pain Management, The Who


Department
Sociology
Course Code
SOCI 1F90
Professor
Michelle Webber
Chapter
15

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Exploring Sociology Wednesday, February 10, 2016
Chapter 15: Health, Aging, and Disabilities (pg. 386 – 415)
What is Health?
Health – a state of complete physical, mental, and social well-being
Suggests that health is the result of a complex interaction between physical, mental, and social factors
The most common measure of a population’s health is to assess how long the average citizen will live in a given
society
Life Expectancy – the average lifespan of a newborn
An indicator of the overall health of a country
Life expectancy rates can fall because of famine, war, disease, and overall poor health and can
rise when health and welfare programs are initiated
Social Determinants of Health
Sociologists refer to the diverse interactions between health and social factors as the social determinants of health
Social Determinants of Health – the conditions in which people are born, grow, live, work, and age,
including the health care system
These conditions are influenced by a society’s distribution of wealth, power, and social resources
Largely responsible for health inequities – the unfair and avoidable differences in health status seen
within and between countries
Income Inequality and Health
Income and social position influence an individual’s health
Data demonstrates that the higher one’s social standing, economic status, and income are, the better overall one’s
health is
Therefore, all other factors being equal, the wealthier one is the healthier they will be
Canadian research shows:
People with lower socioeconomic states (SES) were less likely to visit a physician compared to others
People on social assistance were fare more likely to be ill that people who were not
Higher rates of diabetes, heart disease, chronic bronchitis, arthritis, mood and anxiety disorders
People living in low-income neighborhoods have higher rates of hypertension, diabetes, smoking, and
other cardiac risk factors
People who live in households with combined incomes of less than $20,000 are almost 3 times more
likely to experience self-reported health than are people with the highest income
Minority Status and Health
Life expectancy is related to minority status
Example 1: a 6 year gap exists between the life expectancies of Aboriginal peoples and the rest of the Canadian
population
Social factors that help to explain these differences include Aboriginal people’s level of poverty, access to
health care facilities, and diet
Cultural factors also play a role; some prefer traditional healing techniques over the use of the health care
system and others report that they experience negative stereotyping when dealing with some health care
professionals
Signs of some improvement
Example 2: immigrant Canadians report health disadvantages
These disadvantages are magnified by age, poverty, and social isolation
No signs of improvement
Gender and Health
Sex and gender play critical roles in defining one’s health
Gender and Sex-based Analysis (GSBA) – an approach that explores sex and gender differences without
assuming differences exist

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Systematically explores biological and sociocultural differences between women and men
The purpose of the GSBA is to promote sex/gender-sensitive health research that expands understanding
of health determinants for everyone regardless of biological or sociological categorizations
The WHO Commission on the Social Determinants of Health concluded that differences in power, privilege, and
opportunity effect people’s health, and that men and women frequently have different access to health resources
Gender, sex, age, ethnicity, religion, and other social factors influence who is most likely to become ill and what
resources are available to cope with the illness once it occurs
Principles of the Canadian Health Care System
The Canadian Health Care System is often referred to as socialized medicine
In socialized medicine, the government owns and operates most medical facilities and employs most
physicians
Canada has socialized insurance, whereby the government pays doctors and hospitals for the services they
provide according to a schedule of fees set by governments in consultation with professional medical
associations
The provinces are responsible for health care administration
Five universal principles of health care have been enshrines in Canadian law:
Universal: the system must cover all Canadians
Accessible: the system must provide reasonable access for everyone and must be unimpeded by financial
or other barriers so that no one can be discriminated against on the basis of age, income, or health status
Comprehensive: the system must cover all medically necessary services
Portable: the system must provide coverage between provinces should a person move
Publicly Administered: the system must be operated by a public body on a not-for-profit basis
In 2003, the federal and provincial governments developed a 10-year plan to strengthen health care in Canada
One of the outcomes was the creation of a Health Care Council that would monitor progress toward
reducing wait times, enhancing primary care, improving diagnostic and medical equipment, and
investigating electronic medical file technologies
Health Care Issues
The three salient issues related to health care in Canada are:
Access
Costs
Expansion of alternative health care
Access
Many Canadians are concerned with unequal access to health care
Wait times are a barrier for some procedures in some provinces
As one way to improve access and efficiency, Ontario has instituted a Web service that allows patients to
view wait times at specific hospitals for specific procedures
Access also means that everyone is treated equally when they need health care, which is not always the case
A significant challenge to Canada’s public health care system came in 2005 with the Supreme Court of Canada’s
decision in the Chaoulli case
Brought to the court by Dr. Chaoulli and his patient, Zeliotis
Zeliotis experienced various health problems for which he received treatment within the public health
care system
However, he had experienced significant waits before obtaining treatment
Chaoulli challenged the prohibition against private insurance because, he argued, it effectively violates
the rights to “life, liberty, personal security”
The Supreme Court concluded that when the government fails to deliver health care in a reasonable
manner and increases the risk of complications and death, it interferes with life and security of the person
Costs
Per capita spending on health care in Canada averaged $5,988
Over 11% of Canada’s GDP was spent on health care

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Health care in Canada is the single largest expense in many provincial budgets
As the population ages, these numbers are expected to rise
Alternative Health Care
Alternative Medicine – those treatments not normally taught in medical schools, used in hospitals, or included in
health care plans (e.g. acupuncture)
The most popular forms of alternative medicine are:
Chiropractic
Massage therapy
Relaxation techniques
Prayer
Acupuncture
Studies found that Canadian doctors highly supported chiropractic care, acupuncture, massage therapy, relaxation
therapy, and biofeedback when used to supplement more traditional biomedical treatments
Alternative health care is used by:
Women more than men
Middle-aged people more than the young or elderly
People with higher educational levels more than those with lower educational levels
People with higher incomes more than those with lower incomes
People with a diagnosed chronic condition more than others
The fact that Canadians are increasingly turning to alternative health care presents a challenge
Alternative health care workers may not undergo the same type of training as the practitioners in our
existing medical model of health care
Alternative health care systems have hidden costs
Many alternative medical treatments lack scientific evidence to establish their effectiveness
Theoretical Perspectives of Health Care
Functionalism
Views health care as an important mechanism through which society administers care and treatment to its citizen
By providing hospitals and trained staff, the health care system is able to treat the ill and, in doing so,
maintain a more stable and harmonious society
Critics point out that while the health care system treats many people effectively and efficiently, it has also been
responsible for harming some people’s health
In this sense, the health care system is not functional for every individual involved, and the system itself
may make people ill
Conflict Theory
Points out that Canada has a two-tier health care system in that the rich can get treatment faster than the poor
simply by going to another country
Assert that the poor must instead wait their turn in an overburdened health care system, at times dying
before they can be treated
Furthermore, evidence of inequality in Canadian health care can be seen in the problems that Aboriginal
people face when they try to access the system from remote locations
Argue that the medical profession legitimates and sanctions its control over people’s health in a process known as
medicalization
Medicalization – the increasing influence of the medical profession in defining what is normal/healthy
and abnormal/ill
Ivan Illich (1926 – 2002)
Popularized medicalization
One of his central insights was how health care professionals, drug companies, medical equipment
companies, and the entire medical establishment have a vested interest in sponsoring sickness to promote
unrealistic health expectations that require more treatments and resources
Also used the term iatorogenesis
Iatrogenisis – term used to describe the sickness and injury caused by the health care system
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