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McMaster University
Health, Aging and Society
Elena Neiterman

CHAPTER TWO Introduction: -the purpose of this chapter is to describe and analyze critically the methodologies used in the construction of knowledge in the 4 theoretical paradigms: structural functionalism, conflict theory, symbolic interactionism, and feminist and anti-racist theory Positivism: -this is most often associated with structural functionalism and it’s distinguished by 3 fundamental presuppositions:  Sociology is a science that seeks to describe the social world in series of universal causal laws  This science sees human behaviour as objectively measurable through such methods as survey research and experimental designs  Social facts are to be treated as things because they determine human social behaviour and attitudes through the norms that regulate human behaviour -much of the sociology of medicine falls within this including studies of:  Who seeks medical services and how frequently  What role is played by such social factors as social norms for defining mental and physical illness  How important social support from family and friends is in preventing, minimizing, or helping to adjust to illness  What significance the quality of life – work, recreation, community, physical activity, occupational conditions – plays in the health and well-being of people -positive studies analyze the relationships between social facts & various sorts of health-related variables -From chapter 1…Model A, health-related variables are dependent and in Model B, the health-related variable is the independent variable -Model B research might be studies that examine the impact of changes in health status. Some socio- psychological and demographic variables that may be selected for study are age, sex, gender role, marital/family status etc. -In these models, a variable can be causal in one study and caused in another. Before causal connections can be determined and verified, at least 4 conditions must be met which are:  That there is an association between the variables  That there is evidence that one variable precedes the other in a time sequence  That other, potentially intervening, variables can be eliminated  That the relationship makes theoretical sense -causal relationships may involve more than 2 variables (known as multivariate analysis) -path modelling analysis involves assumptions about the time sequence of a number of variables that either affect the dependent variable directly or affect other variables and through them the dependent variable (refer to figure 2.1) Epidemiology: -epidemiology is the study of the causes and distribution of disease (example of positivist methodology) -the purpose of epidemiology is to understand disease patterns in order to minimize or alleviate their effects, it is not sociology. However to the extent that social labelling of disease, social relations, and social structural positions of people are considered relevant subjects for the analysis of disease incidence and prevalence -Sir John Snow is said to have done the first epidemiological research when he noted that a good proportion of the people who became ill with cholera had drunk water from the same water pump CHAPTER TWO -Sir Percival Pott discovered that scrotal cancer was prevalent among chimney sweeps. Further research led him to the conclusion that the extensive bodily exposure to soot, which was a necessary part of the work of a chimneysweeper, was implicated in the development of cancer in the scrotum. -most important example of epidemiological research concerns AIDS (dependent variable):  Late spring of 1981, doctors in LA noticed a medical mystery  They treated 5 young homosexual men for PCP (very rare infection) but these men also had other ‘opportunistic infections’ which had only been seen normally in organ transplant patients whose immune systems had been intentionally depressed to aid the body’s adoption of the new organ  June 1981, doctors reported this finding in an article and at the same time in New York, a doctor called the CDC about an unusual number of cases of Karposi’s sarcoma (KS).  July 1981, MMWR reported 26 cases of KS that had been diagnosed in NY and California (26 men were homosexual, which 4 had PCP, 8 of the men died within 2 years of the diagnosis)  CDC established an epidemiological research program deisgned to investigate the prevalence and incidence of KS and PCP. They chose to examine hospital records, tumour registries, and the records of medical doctors in certain cities selected because of their differeing proportions of homosexuals  They interviewed patients about their sexual behaviour, drug use and medical history which led to doctords discovering a use of ‘poppers’ as sexual stimulants  After delayed analysis these findings were noticed, which stated that diseased men: had more sexual partners, were more likely to frequent bathhouses, had histories of syphilis and Hepatitis, aand were more frequent users of marijuana and cocaine  Conclusions of the study were: the disease could be transmitted through the blood or semen, patients tended to engage in frequent, anonymous sex, and these sex practices often produced abrasions that exposed them to small amounts of blood, semen and feces  A year after questions were brought up, 216 cases were reported to the CDC (88 patients had died)  Later AIDS had spread rapidly to women and children or all ages -the operating definition for AIDS includes:  The patient must be under 60 years old  Have a specific diagnosed disease such as PCP or KS that suggests an underlying cellular immune deficiency  The disease had to occur without the presence of an immune deficiency that could be ascribed to another factor -Recent research on the spread of AIDS demonstrates a more theoretically based historical materialist epidemiology (compatible with conflict theory) Type II AIDS, characterized by a much closer male-female ratio is the typical ‘type’ in less-developed countries Conflict Theory: -social conflict theory predicates behavioural patterns on power differences in society resulting from class, gender, and other inequities. -the poor are more likely to be ill, have a shorter life expectancy than those with more resources, more likely to suffer malnutrition etc. -people who stand in different positions in the social structure have correspondingly different levels of health and different rates of health-care use -conflict theorists tend to believe that: CHAPTER TWO  Sociological research – indeed, all knowledge – is limited by the perspective derived from the place i
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