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