Transcript Slide 1

CHAPTER 14

How

are schooling and health linked to social inequality in the United States?

What

changes in schooling and health have taken place in the United States in recent generations?

Why

do people in poor nations have little access to schooling and medical care?

• •

EDUCATION

The social institution through which society provides its members with important knowledge, including basic facts, job skills, and cultural norms and values

SCHOOLING

Formal instruction under the direction of specially trained teachers

Schooling and Economic Development

• The extent of schooling in any society is tied to its level of economic development • Low-income countries have little schooling • 1/3 rd write of the world’s people cannot read or • Global comparisons made between – India – Japan – United States

The Functions of Schooling

• Structural-functional analysis: – Socialization – Cultural innovation – Social integration – Social placement – Latent functions

• CRITICAL REVIEW – Overlooks how the classroom behavior of teachers and students can vary from one setting to another – Says little about many problems of the educational system and how schooling helps reproduce the class structure in each generation

SCHOOLING AND SOCIAL INTERACTION

THE SELF FUL-FILLING PROPHECY

People who expect others to act in certain ways often encourage that very behavior

• • Jane Elliott – “Blue Eyes”

CRITICAL REVIEW

– People do not just make up beliefs about superiority and inferiority – These beliefs are built into a society’s system of social inequality

SCHOOLING AND SOCIAL INEQUALITY

• Social-conflict challenges structural functional idea that schooling develops everyone’s talents and abilities • Three ways schooling causes and perpetuates social inequality –

Social control

Standardized testing

Tracking

Assigning students to different types of educational programs

Public and Private Schools

• Parochial “Of the Parish” – Catholic schools • Protestant private schools – Christian Academies • Students in private schools outperform those in public schools – Smaller classes, demanding coursework, greater discipline • Public Schools – Difference in funding between rich and poor communities result in unequal resources

• Schools in more affluent areas offer better schooling than in poor communities • Social Capital – Students whose families value schooling – Read to their children – Encourage the development of imagination • Home environment is an important influence on school performance • Differences in home and local neighborhood matter most in children’s learning

Access to Higher Education

• 67% of US high school graduates enroll in college immediately after graduation • Crucial factor affecting access is income • Economic differences is reason for education gap between minorities and whites • Completing college brings rewards – Higher earnings

Greater Opportunity: Expanding Higher Education

• US world leader in providing college education to its people • • Education is the key path to better jobs – Government makes money available to help certain categories of people pay for college

Community Colleges

– Low cost provides access to millions – Special importance to minorities – Attracts students from all over the world – Priority of faculty is teaching, not research

Privilege and Personal Merit

• • Schooling transforms social privilege into personal merit

Credentialed Society

Society that evaluates people based on schooling

• Process helps those who are already advantaged and hurts those who are already disadvantaged • CRITICAL REVIEW – Social-conflict overlooks the extent to which schooling provides upward mobility to the talented from all backgrounds and changes social inequality on many fronts

PROBLEMS IN THE SCHOOLS

• Discipline and Violence – Schools do not create violence – Spills in from surrounding society • Student Passivity – TV and iPods claim more of young people’s time than schooling • Five ways bureaucracy undermine education – Rigid uniformity – Numerical ratings – Rigid expectations – Specialization – Little individual responsibility

• Passivity common among college and university students • Four teaching strategies that can bring students to life in classrooms – Calling on students by name when they volunteer – Positively reinforcing student participation – Asking analytical rather than factual questions and giving students time to answer – Asking for student’s opinions even when no one volunteers an answer

• Dropping Out – Quitting before earning even a high school diploma – Leaves young people unprepared for work and high-risk of poverty • Least common among whites • More likely among African Americans and Hispanics • Causes – Trouble with the English language – Work to support family

• Academic Standards – Functional Illiteracy • A lack of the reading and writing skills needed for everyday living • Nation at Risk • US spend more on schooling than almost any other country – US placed 16 th in science and 19 th in math • Cultural values play a part in how hard students work at their schooling

RECENT ISSUES IN U.S.

School Choice

EDUCATION

– Create a market for education so parents and students can shop for best value • Magnet Schools – Offer special facilities and programs to promote educational excellence • Charter Schools – Public schools that are given more freedom to try new policies and programs • Schooling for Profit – School systems operated by private profit-making companies rather than government

• •

Home Schooling

– Parents do not believe public education is doing a good job – Students who learn at home outperform those who learn in school

Schooling People With Disabilities

– Resulted from persistent efforts by parents and other concerned citizens –

Mainstreaming

Including students with disabilities in the education program

• Inclusive Education

• •

Adult Education

– Many return to advance a career or train for a new job

The Teacher Shortage

– Final challenge for US schools – Factors • Low salaries • Frustration • Retirement • Rising enrollment and reductions in class size

• •

MEDICINE

The social institution that focuses on fighting disease and improving health

HEALTH

A state of complete physical, mental, and social well-being

Health and society

• Society affects health in four major ways: – Cultural patterns define health – Cultural standards of health change over time – A society’s technology affects people’s health – Social inequality affects people’s health

HEALTH: A GLOBAL SURVEY

• •

Health in Low-Income Countries

– Poverty cuts decades off of life expectancy – Poor sanitation and malnutrition

Health in High-Income Countries

– Industrialization raised living standards – Better nutrition – Safer housing – Medical advances in science to control infectious disease

Health in the United States

• • •

Social Epidemiology

The study of how health and disease are distributed throughout a society’s population

Age and Gender

– Death now rare among young people – AIDS changing this trend – Male aggression

Social Class and Race

– Poverty – Infant mortality twice as high for the disadvantaged

Cigarette Smoking

– Tops list of preventable health hazards in US – Many smoke to cope with stress – 440,000 die prematurely yearly • Exceeds alcohol, cocaine, heroin, homicide, suicide, auto accidents, and AIDS – $83 billion dollar industry • Increased marketing abroad where there is less regulation of tobacco – Ten years after quitting, ex-smoker’s health is as good as someone who never smoked

Eating Disorders

An intense type of dieting or other unhealthy method of weight control driven by the desire to be very thin

Anorexia Nervosa

• Dieting to the point of starvation –

Bulimia

• Binge eating followed by induced vomiting to avoid weight gain –

Obesity

• 2/3 rd of US adults are obese • Limit physical activity and raise risk of serious diseases • Live in a society in which most people have sedentary jobs

Sexually Transmitted Diseases

Venereal Disease

Gonorrhea and Syphilis

• Cured easily with antibiotics –

Genital Herpes

• 45 million adults in US and is incurable –

AIDS

• Most serious of all sexually transmitted diseases • Incurable and almost always fatal • Risk behaviors are anal sex, sharing needles, use of any drug including alcohol • Education most effective weapon

Ethical Issues Surrounding Death

• •

Defined as an irreversible state involving no response to stimulation, no movement or breathing, no reflexes, and no indication of brain activity

Euthanasia

Assisting in the death of a person suffering from an incurable disease

– “Right to die” one of today’s most difficult issues – Supporters view circumstances when death preferable to life – Critics cite abuse

• Emerged as a social institution as societies became more productive and people took on specialized work

Holistic Medicine

An approach to health care that emphasizes prevention of illness and takes into account a person’s entire physical and social environment

• Three foundations of holistic health care – Treat patients as people – Encourage responsibility, not dependency – Provide personal treatment

Paying for Medical Care: A Global Survey

• • •

People’s Republic of China

– Government controls most health care

Russian Federation

– Transforming from state-dominated to more of a market system

Sweden

Socialized Medicine

A medical care system in which the government owns and operates most medical facilities and employs most physicians

• • •

Great Britain

– Also established socialized medicine

Canada

– “single-payer” model of care that provides care to all Canadians – Less state of the art technology – Responds more slowly, people may wait months to receive major surgery

Japan

– Approach medical care like Europe – Most medical expenses paid through the government

Paying for Medical Care: US

Direct-fee system

A medical care system in which patients pay directly for the services of physicians and hospitals

• Rich can buy best medical care in the world • Poor are worse than European counterparts • No national medical care program – Culture stresses self-reliance – Political support for national medical program not strong – AMA and insurance industry strongly and consistently oppose national medical care

• • •

Private Insurance Programs

– 68% of US population has private insurance

Public Insurance Programs

Medicare

pays costs for people over age 65 –

Medicaid

pays for the poor

Health Maintenance Organizations

– An organization that provides comprehensive medical care to subscribers for a fixed fee – Criticized for refusing to pay for medical procedures they consider unnecessary – Congress currently debating the extent to which patients can sue HMO’s to obtain better care

The Nursing Shortage

• Fewer people are entering the nursing profession – Today’s young women have a wide range of job choices – Nurses are unhappy with their working conditions • Hopeful sign – Increase in salaries – Recruitment of more minorities

Theoretical Analysis of Health and Medicine

• • Structural-Functional Analysis: Role Theory – –

The Sick Role

Patterns of behavior defined as appropriate for people who are ill

Physician’s Role

• Use specialized knowledge and expect patient’s to follow “doctor’s orders” to complete treatment

CRITICAL REVIEW

– Sick-role concept applies to acute conditions – Sick person’s ability to assume the sick role depends on person’s resources – Illness is not completely dysfunctional

Symbolic-Interaction Analysis: The Meaning of Health

The Social Construction of Illness

Our response to illness is based on social definitions

Psychosomatic disorders

When state of mind guides physical sensations

The Social Construction of Treatment

Doctor’s tailor their physical surroundings and their behavior so that others see them as competent and in charge

• CRITICAL REVIEW – Implies that there are no objective standards of well-being

Social-Conflict and Feminist Analysis

– Points out the connection between health care and social inequity • Access to care – Capitalism provides excellent health care for the rich at the expense of the rest of the population • The Profit Motive – Real problem is not access to medical care but capitalist medicine itself – Profit motive turns doctors, hospitals, and the pharmaceutical industry into multibillion-dollar corporations – Society tolerant of doctor’s financial interest in tests and procedures they order

• Medicine as Politics – Scientific medicine takes sides on significant social issues • Medical establishment opposes government medical programs • Recently allowed women to join ranks of physicians • Racial and sexual discrimination kept women and people of color out of medicine • Scientific medicine explains illness in terms of bacteria and viruses ignoring poverty, racism, and sexism • CRITICAL REVIEW – Minimizes the advances in US health brought about by scientific medicine and higher living standards