Transcript Chapter 10 Medical Care: Physical and Mental Illness Social Problems: A Down-To-Earth Approach, Tenth Edition by James M.

Chapter 10
Medical Care:
Physical and Mental Illness
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
The Problem In Sociological Perspective
• Not just biology
 Social component
• Industrialization and lifestyle
 Greater affluence
• Iatrogenesis
 Illness caused by medical care staff
• Changing ideas about health and illness
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
The Social Organization of Medicine as a
Social Problem
• An explosion in medical
costs
• Reasons for the explosion
in costs
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
•
Medicine for profit: a two-tier system of medical care
 Medicine for profit is also known as a fee-for-service
system.
Two-tier system of medical care:
1. one for those who can afford insurance
2. another for those who cannot
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
• Medicine for profit: cesarean delivery
• Why have cesarean births increased?
 Profit
 Convenience
 Technology
 Preference
• A Feminist Controversy
 Central issue is the relative power of women
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
Physical Illness as a Social Problem
• Life expectancy and infant mortality
 Determines how healthy or ill a society is as a
whole.
• Infant Mortality Rate (IMR)
• Number of babies who die before 1 year of age, per
1,000 live births
• Lifestyle
• Heroic an Preventive Medicine
• Quick care: Emergency Rooms and Drugstores
• Uneven Distribution of Doctors
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
Mental Illness as a Social Problem
• Measuring mental illness
• The social nature of mental illness
 How we define mental illness is a matter of dispute
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
•
A two-tier system of mental health delivery
1. the illness
2. the medical delivery system
 Deinstitutionalization
• The release of hospitalized mental patients into the
community
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
Symbolic Interactionism
• Determining the meaning of symptoms and behavior
 People from different backgrounds interpret health &
illness differently
• The significance of definitions
 Views and meanings of health and illness change
• Conflicting Referral Networks
• Depersonalization
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
Functionalism
• Customs or social institutions fulfills social
needs.
• Free-for-Service Means Profits
 It is difficult for doctors to make money if
people are not sick
• A self-correcting system
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
Conflict Theory
• Argues that the U.S. medical system is not selfcorrecting.
• The poor are more often sick—they lack sufficient
income and high-quality education, food, housing,
jobs, and medical services
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
• Medicaid
• Colliding Interests of Doctors and Patients
 Doctors represent the dominant class
 Patients are the subordinate class
• Women’s Reproductive Organs
 Hysterectomies
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
An Overview of Physical Health Problems
• Historical changes in health problems
 6 of the 10 leading causes of death have remained the
same according to Figure 10-9.
 Several of the top killers in both centuries are caused
primarily by lifestyle and environmental pollution.
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
•Infectious diseases
 The decline in infectious diseases
 Stronger immunities, clean water, better
food
 The resurgence of infectious diseases
• Develop new strains that are resistant
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
How Disease Is Related to Behavior and
Environment: the Case of HIV/Aids
• Background
 Example of the relationship between behavior,
environment, and disease
 The disease no longer discriminates
• A global epidemic
 30 million people have died
 33 million people around the world are infected now
 3 million more people are being infected each year
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
• HIV/Aids in the United States
 Antiretroviral drugs (ARVs)
• Halt the progression of AIDS
• Combination of ARVs and education caused
AIDS deaths in the U.S. to decrease
 Race/ethnicity—higher rates of HIV/AIDS
• Ominous changes
 HIV virus mutates rapidly
.
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
Social Inequalities in Physical Illness
• Poverty and health
• Economic factors largely determine who will be healthy
and who will be sick
• Occupational health hazards
 lower-class working environments
• Reducing Inequalities: Health Care Reform
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
Social Inequalities in Mental Illness
• Social class and mental illness
 People’s emotional well-being declines with decreases in
social class.
• Four explanations for the greater emotional
problems of the poor:
 The Drift Hypothesis
 The Genetic Hypothesis
 The Socialization Hypothesis
 The Environmental Hypothesis
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
• Social Class Differences in Mental Health
Care
 Different types of therapies
• Consequences of ability to pay
 Type of therapy tied to a person’s ability to pay, not illness
 Talk therapy
 Pharmaceutical straitjacket
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
Prepaid Medical Care: The Example of
Managed Care
• Managed Care
 Health Maintenance Organization (HMO)
• The positive side
• Profits and a conflict of interest
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
Physician Assistants
• Strategy for controlling costs
Training Physicians
•Medical schools graduate about 16,000 physicians
a year.
•Home health care
 Less expensive and often more humane
 Preventative Medicine
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
Domiciliary Care
•Home health care, or domiciliary care
 Treatment given within a patient’s home
 Less expensive and often more humane
 May involve profiteering
 Another approach: create domiciliary programs
for mentally ill
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved
Preventive Medicine
• Preventable deaths
• Three types of preventive medicine:
 Primary prevention
 Secondary prevention
 Tertiary prevention
• Food and health
 Proper nutrition and exercise
• Immunizations
• Preventing drug abuse and homicide
• Eating ourselves to death
Social Problems: A Down-To-Earth Approach, Tenth Edition by James M. Henslin
©2011 Pearson Education, Inc. All rights reserved