Chapter 11 Notes
Health & Medicine
The Black Death
-the Plague killed 1/3 of Europe's population in 2 years. The only people who survived
were the Pope because he sat between two large fires to breathe pure air, rich people
who could afford to move, and jews who washed their hands before meals, bathe once
a week and conduct burials soon after death.
-health risks are unevenly distributed. Women and men, upper and lower classes, rich
and poor countries and privileged and disadvantaged members of racial and ethnic
groups are exposed to health risks to varying degrees. This suggests that health is not
just a medical issue but also a sociological one. The first task we set ourselves here is
to examine the sociological factors that account for the uneven distribution of health in
-Second, the story of the Black Death suggests that health problems change over time.
Epidemics of various types still break out, but there can be no Black Death where
sanitation and hygiene prevent the spread of disease. Today we able to treat many
infectious diseases such as tuberculosis and pneumonia with antibiotics. Twentieth-
century medical science developed these wonder drugs and many other life-saving
therapies. Medical successes allow people to live longer than they used to.
Life expectancy: the average age of death of the members of a population
-In Canada, life expectancy in 1831 was 40 years for men and 42 years for women In
contrast, a Canadian girl born in 2006 can hope to live to 83, a boy to 78. Yet, because
of such increased life expectancy, degenerative conditions such as cancer and heart
disease have an opportunity to develop in a way that was not possible a century ago.
(degenerative means organs degenerate over time some shit like that yolo)
-The story of the black death raises a third issue, too. We cannot help being struck by
the superstition and ignorance surrounding the treatment of the ill in medieval times.
Remedies were often herbal but also included earthworms, urine and animal excrement.
People believed it was possible to maintain good health by keeping body fluids in
balance. Therefore, cures that released body fluids were common. These included hot
baths, laxatives and diuretics which increase the flow of urine. If these treatments didn't
work, bloodletting was often prescribed. No special qualifications were needed to be a
doctor, Barbers doubled as doctors.
-The backwardness of medieval medical practice and the advantages of modern
scientific medicine can easily be exaggerated. For example, medieval doctors stressed the importance of prevention, exercise, a balanced diet, and a congenial environment in
maintaining good health.
-Conversely, one of the great short-comings of modern medicine is its emphasis on
high-tech cures rather than on preventive and environmental measures. Therefore, in
the final section of this chapter, we investigate how the medical professions gained
substantial control over health issues and promoted their own approach to wellbeing
and how those professions have been challenged in recent years.
Health and Inequality
-according to the World Health Organization, health is "a state of complete physical,
social and mental well-being, and not merely the absence of disease or infirmity."
-when it comes to measuring the health of a population, sociologists typically examine
the negative: rates of illness and death. They reason that healthy populations
experience less illnesses and longer life than unhealthy population.
-avoidable social causes deprive people of life. Social causes have a big and variable
impact on illness and death.
The social cause of Illness and Death
1. Human Environmental Factors-divisions such as social class, occupation and
nationality often correspond to sharp differences in the surroundings in which people
work and live. Some environments foster good health, while others impose added risks
for poor health. Eg: the introduction of sour gas wells and logging operations around the
reserves of the Lubicon First Nation in Alberta resulted in a dramatic increase in illness.
More than one in three members of the Lubicon population suffers from such health
problems as tuberculosis, respiratory difficulties and cancer at rates far above the
national average. Environmental racism is located near First Nations communities or
areas populated by the poor, the politically marginalized, or certain visible minority
groups also contributes to low levels of health. Eg: the pulp-and-paper industry's
mercury poisoning of the english-Wabigoon river system in western Ontario near the
Manitoba border led to the virtual destruction of the Grassy Narrows Indian's way of life
and means of livelihood. "Patterns of atmospheric cycling have made the North a
dumping ground for industrial chemical that are never used there. The chemicals
bioaccumulate, delivering a higher level of toxic concentration to each level up the food
chain. As a result, the breast milk of Inuit mothers is 10 times as contaminated as that of
southern Canadian women".
Environmental Racism: the tendency to heap environmental dangers on the
disadvantaged 2. Lifestyle Factors-smoking, excessive use of alcohol and drugs, poor diet, lack of
exercise and social isolation are among the chief lifestyle factors associated with poor
health and premature death. For example, smoking is associated with lung cancer,
cardiovascular disease, strokes, emphysema, spontaneous abortion, premature birth
and neonatal death. In Canada, about 50 000 deaths a year are caused by smoking and
other use of tobacco products. Unmarried people also have a greater change of dying
prematurely than do married people. Social isolation is a particularly big problem among
older people who retire, lose a spouse and friends and cannot rely on family members
or state institutions for social support. They are more prone to fall into a state of
depression, which contributes to ill health.
3. Factors related to the public health and health care systems. The state of a
nation's health depends partly on public and private efforts to improve people's well-
being and treat their illnesses. The public health system compromises government-
run programs that ensure access to clean drinking water, basic sewage and sanitation
services and inoculation against infectious diseases. The absence of a public health
system is associated with high rates of disease and low life expectancy. The health
care system comprises a nation's clinics, hospitals and other facilities for ensuring
health and treating illness. The absence of a system that ensures its citizens access to
a minimum standard of health care is also associated with high rates of disease and
shorter life expectancy.
-Exposure to all three sets of social causes of illness and death listed above is strongly
related to country of residence, class, race and gender.
Country of residence
-HIV/AIDS is the leading cause of death in the poverty-stricken part of Africa south of
the Sahara desert. 0.5% of North America has AIDS whereas 5% of sub-Saharan
Africa has it. The case of AIDs illustrates global inequality influences the exposure of
people to different health risks.
-biomedical advances do increase life expectancy, but partially. Vaccines against
infectious diseases have done much to improve health and ensure longer life. However,
the creation of a sound public health system is even more important in this regard. If a
country can provide its citizens with clean water and a sewage system, epidemics
decline in frequency and severity while life expectancy increases.
-industrialized countries started developing their public health systems in the mid-
nineteenth century. More than 1/6th of the world's people do not have access to a
sanitary water supply.
-Japan, Canada, and the U.S are rich countries so they have low infant mortality. (the annual number of deaths before the age of one for every 1000 live births.
Class Inequalities and Health Care
-In Canada, on average, people with low income die at a younger age than do people
with high income. Canadians enjoy a lower rate of illness and longer life expectancy at
each step up the income ladder. Poverty is associated with high rates of tobacco and
alcohol consumption, obesity, physical inactivity and violence.
5 Reasons why Health deteriorates as move down the class hierarchy
1. High Stress and the inability to cope with it-People in lower classes experience
relatively high stress levels because of their difficult living conditions. Stress has been
linked to a variety of physical and mental health problems, including high blood
pressure, cancer, chronic fatigue, violence, and substance abuse. People higher up in
the class structure are often able to turn stress off by taking off days from work or going
on vacation. Mishaps aside, lower class families must endure greater crowding; poorer
dwelling quality; working conditions that are more noxious, dangerous and unpleasant'
and longer hours of work to make ends meet.
2. Differences in the earliest stages of development that have lifelong
consequences-Inequalities at the start of life have strong health consequences for a
lifetime. Poor nutrition during pregnancy, stress, maternal smoking and misuse of drugs
and alcohol, insufficient exercise and inadequate prenatal care typically lead to
suboptimal fetal development. This is more common for mothers with low income.
3. Lack of knowledge- People are all less educated and who have less exposure to
educated advisers tend to have less knowledge about healthy lifestyles. For example,
they are less likely to know what constitutes a nutritious diet.
4. Unequal access to health resource-A large number of poor Canadians live in areas
that have inferior medical services. Eg: there are fewer hospitals, physicians and nurses
per capita in rural areas than in urban areas. As well, the quality of preventive,
diagnostic and treatment facilities is generally superior in urban areas. Moreover, many
low-and middle-income Canadians have limited or no access to eye care, dentistry ,
mental health counselling and prescription drugs.
5. Environmental expose-Poor people are more likely than rich niggas to be exposed
to environmental risks that have a negative impact on their health.
Racial Inequalities in Health Care
-the life expectancy of Status Indians is seen to eight years shorter than that of non-
Aboriginal Canadians, and illegal drug use is high among Aboriginal peoples. Despite the health risks to both the mother and the developing fetus, more than half of Indian
women and three-quarters of Inuit women smoke during pregnancy, compared with
about 20 percent for all women in Canada.
-Such health disparities are partly due to economic differences among racial groups.
Researchers have also begun to emphasize how racially marginalized groups are
subject to negative health outcomes because of the cumulative effects of social
exclusion based on race.
-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
lead to unequal health service utilization and differential health status.
Gender Inequalities in Health Care: The Feminist Contribution
• Gender bias exists in medical research. Public health systems have been slower