Textbook Notes (369,204)
Canada (162,462)
Sociology (1,513)
SOC102H1 (285)
Teppermann (82)
Chapter

Social Problems CH9 & Reading Sociology P9.docx

12 Pages
117 Views

Department
Sociology
Course Code
SOC102H1
Professor
Teppermann

This preview shows pages 1,2 and half of page 3. Sign up to view the full 12 pages of the document.
Description
Social Problems: Chapter 9 Health Issues Robert Aronowitz & Framing Disease  Framing Disease: the ways we generally recognize, define, name, and classify disease states and assign them to a cause / a set of causes  Framing effects influence perceptions of health, illness, policies, etc. Thomas Dictum  What we believe to be true is true in its consequences Medical Sociology  The field of sociology that examines the social context of health, illness, and health care  Inequalities in health and healthcare are social problems as they require governmental and other large institutions‟ efforts to be solved Defining Health and Illness Biomedical View of Medicine  Health = passive = default = normal  Illness = active = problem in need of treatment  Emphasizes Western scientific principles as Western focus is on curing sick rather than preventing sickness from occurring first  Health is strictly defined in somatic terms Treating the Patient Rather than the Disease  TREND: Growing recognition that an illness‟s symptoms vary with individuals based on: o Personal history o Socio-economic conditions o Cultural background “Well-Being” and “Health”  Well-being: State of existence characterized by happiness, prosperity, satisfaction of basic human needs  Health: AS DEFINED BY WHO: a state of complete physical, mental, and social well-being Biopsychosocial View of Health and Illness  Health and disease are products of the interaction of body, mind, and environment (NOT JUST BIOLOGY ALONE) Measuring Health and Illness Epidemiology  Applied science that examines the causes, distribution, and control of disease in a population Life Expectancy  Average number of years remaining to a person at a particular age, given current age-specific mortality rates  Increased globally thanks to advances in medicine, publich health, and technology  Differences in life expectancy still exist between rich and poor nations  TREND: Gender gap of life expectancy is diminishing o Men gradually catching up to women Mortality Rates  Deaths per year per thousand people in a population  Maternal ~: number of deaths of women due to complications in pregnancy, childbirth, abortion  TREND: increase in availability of contraceptive technology = declining number of abortions  TREND: majority of induced abortions in Canada for women under 30  Infant ~: number of deaths of children under one year of age per 1o00 live births  Under-Five ~: number of deaths of children under five years of age per 1000 live births  All these rates serve as statistical indicators of population health, focusing on different age of society‟s members Morbidity Rate  Extent of disease in a population  Incidence: number of new cases in a given population in a given period of time  Prevalence: total number of cases of a disease in the population at a particular time  Endemic: constantly present in a population  Epidemic: local or national outbreak  Pandemic: international or global outbreak  TREND: morbidity rates vary according to social variables (ex. sex, racial grouping, class) Threats to Canadian and Global Health AIDS Pandemic  AIDS was labeled and dismissed as a disease for them rather than us o Limited to 3 socially marginalized populations: homosexuals, injection drug users, Haitians  TREND: leading cause of death globally among adults 15-59; overall 4 leading cause  TREND: Worldwide – heterosexual intercourse is primary mode of HIV transmission  TREND: Canada – Homosexual intercourse between 2 men primary mode of HIV transmission SARS, Pandemic Influenza, and the “Globalization” of Infectious disease  Malaria is almost exclusive to world‟s poorest nations  Tuberculosis is returning  SARS – product of globalization because it‟s rapid spread was promoted by international travel and trade  Globalization increases the risks of contracting communicable viruses  Thought that SARS was a forerunner to an even larger global pandemic, such as virulent influenza Mental Health and Mental Illness  Mental Health: ability of individuals to feel, think, act in ways that improve the quality of daily functioning, range and depth of social relations, and ability to adapt to life changes  Mental Disorder: alterations in thinking, mood, and/or behaviour associated with significant distress and impaired functioning over an extended period of time  Mental Illness: clinical diagnosis of mental disorder requiring medical/psychotherapeutic treatment  Mental disorders and illnesses are social problems because they interrupt the functioning of families, groups and other social institution  Unknown causes lead to public unease and stigmatization  Most mental illnesses arise from interaction of genetic/biological, psychological, and social/environmental factors  Development of mental illness through stress and breakdown of social order may arise over major social disruptions such as war or natural disasters  Individualistic nature and speeded up pace of life in modern industrialized societies erode traditional sources of social stability, such as family and religion  TREND: Unipolar depressive disorders make up largest category of fatal disabling conditions and are the rd 3 leading cause of lost years of productivity nd  TREND: Depression expected to become world‟s 2 leading cause of disability by 2020; large number of people rely on anti-depressants  TREND: 1 in 5 Canadians likely to have mental disorder at some time in their life  Co-morbidity: the predisposition of an individual with an illness to additional health conditions  Direct costs of treatment: psychological and social work services not covered by public health care  Indirect costs: lost productivity  Additional costs: psychic and social costs to family members caring for sick relatives  TREND: rates of most mental illness higher in women than men; though men more substance dependent  TREND: mental health poorer in marginalized ethnic and cultural groups o Seen higher suicide rates of Aboriginal communities, which is correlated with depression  Social Selection: a correlation suggesting but not proving causation, because a third, unmeasured factor is involved; also known as adverse selectivity  Social selection and downward drift hypotheses thought to explain link between mental disorders and social class o Propose that mental illnesses prevent some people from functioning effectively causing:  More unemployment  Poorer educational outcomes  Increased downward social mobility  Social causation: stresses associated with life in the lower social classes promote frustration and despair while eroding coping abilities, contributing to onset of mental health problems  Social causation theories also proposed to explain link between mental disorders and class International Comparisons: Swine Flu Vaccine  Health experts warned that the poor may lose out as wealthy countries corner strictly limited supplies  Advantage of affluence: majority of limited supplies will go to wealthy countries  WHO negotiated with vaccine producers to secure donations or sales at lower prices for developing countries  Rich countries were asked to donate some of their vaccine stock Obesity  TREND: obesity and excess weight increasing at alarming rate  Primary causes: energy-dense, nutrient-poor diet; sedentary lifestyles; large portion sizes; increased television viewing; urban environment favouring driving over walking  Body Mass Index (BMI): measure of “obesity”  weight (kg) divided by height (m) squared o Overweight if BMI < 25 o Obese if BMI < 30  TREND: Obesity rates increasing especially in Atlantic Canada and Prairie provinces o but after controlling for education and socio-economic status, province/region have not been identified as a separate risk factor for obesity  Direct Costs: health-care expenditure  Indirect Costs: economic output lost due to illness, injury-related work disability, premature death Structural Functionalist  Health is normative, maintained by social institutions o Allows person to function and benefit society  Health care is a social institution responsible for maintaining a society‟s members‟ well-being o Widespread illness can undermine a society and damage social, economic, and political infrastructure  Illness is a form of deviance that threatens the ability of the society to function  The ill must fulfill a “sick role” to allow them to temporarily withdraw from society to recuperate o Sick will not be blamed/at fault provided they try to get well  DURKHEIM: Suicide o We must explain personal health issues like suicide in social-structural terms Conflict Theory  Problems in delivery of healthcare result from capitalist economy o Sees medicine as a commodity that can be produced and sold  People struggle over scarce resources (medical treatments)  ENGELS: The Condition of the Working Class in England o Deplorable conditions of disadvantage in Manchester (ex. substandard housing, lack of sanitation, inadequate diet and clothing, harsh work environment, affected city‟s death rate  VIRCHOW: „father of modern pathology‟ o Root causes of typus epidemic due to regional poverty, poor education, inept gov‟t policies  Health, health care, and research are affected by wealth, status, and power Symbolic Interactionism  Unique meanings and experiences are associated with specific diseases and with being labeled as sick  What constitutes health or sickness varies from culture to culture and is constructed by groups that reflect their needs, values, and beliefs Feminist Theory  Gender and its social construction are important determinants of health  Women‟s health often has been defined and understood on the basis of a male model and male norms o Men have controlled women‟s bodies as physicians  Depression was viewed as women‟s mental health disability and a form of gendered incompetence  TREND: women‟s illnesses and health conditions are often considered more shameful than men‟s o ex. Menopause viewed by some doctors as psychiatric problems, owing to losses and lack of meaningful occupation Social Determinants of Health  The complex causal relationships between various social, economic, and political factors  Major improvements in populations health a result of improved socio-economic conditions, rather than improved individual behaviours  Health inequalities still exist where universal, publicly funded healthcare is provided o Access is not the problem  Materialist approach: disadvantaged populations suffer from higher levels of total exposure to negative conditions  Neo-materialist approach: material conditions important, also social structural contributors (income inequality, systemic racial and gender discrimination, cuts to government social spending)  Social comparison: health inequalities exist even among well-off people  WHITEHALL studies of British civil servants o Groups in question had similar jobs, similar class  difference in health status not due to material deprivation o Accumulated psychological stress, due to different opportunities and varying degrees of control over life decision, affected health o THUS, health policies must harmonize with social policies as health status is closely and subtly related to social environment Key Social Determinants of Health in Canadian Society 1. Early Life: benefits of healthy development begin at earliest stages of life; parenting education, good nutrition 2. Education: educational attainment in adolescent and early adulthood useful in dealing with problems; literacy is a sensitive predictor of health status 3. Food Security: inability to acquire or consume a an adequate diet quality or uncertainty that one can do so 4. Housing: shortage of affordable rental housing cause people to settle for substandard housing conditions (or rent a costly apartment) 5. Employment Security and Work Conditions: women an ethnic minorities fill unskilled manual labour and service industry positions 6. Income Inequality: as one moves up income hierarchy, health status improves; health inequalities exist along the entire income spectrum, even among the richest members of society 7. Social Exclusion: marginalization of some groups in society from economic, social, cultural, and political resources that affect quality of life 8. Aboriginal Status: higher-than-average rates of mortality, infant mortality, suicide, infectious disease, etc; more likely to smoke, abuse alcohol and drugs, etc; less likely to get immunized, exercise 9. Social Safety Net: unemployment insurance benefits, welfare payments, publicly managed pensions, universal healthcare access, support services provided by the state; reduce negative health effects of unemployment, poverty, racial and social exclusion and other social problems 10. Healthcare Services: unequal access to healthcare prevalent among poor and marginalized people Claims-Making and the Social Construction of Health Issues  Social construction perspective reveals ways in which health messages are delivered to us  Messages were selectively delivered and stressed individual blame for health (ignore social determinants)  Medicalization: medical profession comes to be viewed as relevant to non-medical aspects of life  Some authors see media and medical and pharmaceutical industries as medicalizing phenomena (ex. sleep disorders, aggressive behaviour in teens, physical inactivity) as they stand to profit from it  Many supposed health problems have more to do with social / cultural issues than actually health risks Solutions: Public Health Promotion Population Health Perspective  Framework for understanding health and illness in society, highlights importance and benefits of preventive health care (most effective to improve social health indicators but also most economically effective) Primary Prevention  Steps people take to prevent a disease from occurring 1. Immunization 2. Well-functioning public health infrastructure 3. Prudent use of antimicrobial medicines 4. Improving the social determinants of health  Health promotion especially important in developing world to control outbreaks of communicable diseases (ex. AIDS education among sex workers)  Effective public health delivery means adapting to local circumstances and recognizing that the target individuals are whole human beings o Myanmar: women found with condom are imprisoned o Laos: female brothel-owners given incentives to provide condoms and sex education to staff  lead to higher rates of condom usage  Information-sharing between governments is important to ensure early detection and response to control communicable diseases Improving Health in the Developing World: Millennium Development Goals  UN adopted Millennium Development Goals to co-ordinate efforts to eliminate poverty and improve global health by 2015  Goals address population health needs, and issues that affect population health o They address the related issues of peace, security, fundamental freedoms and human rights  5 diseases - pneumonia, diarrhea, malaria, measles, and AIDS - account for over half of all deaths globally among children under 5  Can be prevented with inexpensive interventions  encouraging breast feeding, providing medicines, etc.  Meeting the Goals is slowed by lack of funds o Some countries have not met their goals but are committing to doing so by 2015 o Canada has not commit to the goal, arguing it would be fiscally irresponsible  Meeting Goals also slowed by bias in health research o 90/10 research gap: 90% of global spending on medical and pharmaceutical research aimed at finding treatments for diseases that only affect 10% of wealthiest population Healthcare Reform in Canada  Debate over healthcare reform focuses on access and role of for-profit health services in Canada‟s supposedly universal system  Healthcare access in underserviced areas (esp. northern, remote, Aboriginal communities, northern poor communities, francophone communities in English-speaking Canada) in need of improvement  Efforts underway to reduce bureaucratic obstacles that immigrants face in getting a licence to practice medicine in Canada  can station them in the underserviced areas  Telehealth: use of computer and communication technologies to aid healthcare delivery o Good for sending images, electronically from rural/remote locations for review o Video conferencing for consultation, assessments, observations, etc. Waiting Times: How Long is Too Long?  State must pay for treatment in another jurisdiction if doctors cannot provide timely treatment in home province  concerns healthcare providers  Our society cannot afford to provide immediate, high-quality care to everyone who needs it Causes of Waiting Times  Demography of Waiting: Too many
More Less
Unlock Document

Only pages 1,2 and half of page 3 are available for preview. Some parts have been intentionally blurred.

Unlock Document
You're Reading a Preview

Unlock to view full version

Unlock Document

Log In


OR

Join OneClass

Access over 10 million pages of study
documents for 1.3 million courses.

Sign up

Join to view


OR

By registering, I agree to the Terms and Privacy Policies
Already have an account?
Just a few more details

So we can recommend you notes for your school.

Reset Password

Please enter below the email address you registered with and we will send you a link to reset your password.

Add your courses

Get notes from the top students in your class.


Submit