The purpose of these recap discussion boards is to create dialogue and analytical discourse about the material covered in the chapter. In answering the recap discussion questions, you should engage in meaningful discussion with your fellow classmates. Please make sure to pay close attention to the specific due dates for each discussion board. You can contact me directly if you have any questions or post your question on the 'General Questions/Concerns' discussion form on the course site.
Due Dates:
**Initial post due 05/20
Please respond to the following questions with at least 5-7 sentence paragraph responses per question.
**Secondary posts due 05/22
You should respond to at least two of your classmates post by the above due date. Your responses should be substantial, meaning they should be about 5-7 sentences in length and relate to your classmates post in some way. Please review the discussion board rubric on the course site for an elaboration on the grading criteria.
Question:
What are some of the ways in which people in the United States with fewer resources are at greater risk for poor health? Why are certain groups at a particular disadvantage? Are these patterns evident in COVID-19 data? (Please support your answer with evidence by doing some research on the disparities found in current data; please remember that gender is also important when analyzing health-outcomes)
Worth 10 Points:
Chapter Learning Objectives:
To read these particular portions of the chapter, please click on the links below and you will be taken to that section of the book.
19.1 The Social Construction of Health
- Define the term medical sociology
- Understand the difference between the cultural meaning of illness, the social construction of illness, and the social construction of medical knowledge
- Define social epidemiology
- Apply theories of social epidemiology to an understanding of global health issues
- Understand the differences between high-income and low-income nations
19.3 Health in the United States
- Understand how social epidemiology can be applied to health in the United States
- Explain disparities of health based on gender, socioeconomic status, race, and ethnicity
- Give an overview of mental health and disability issues in the United States
- Explain the terms stigma and medicalization
19.4 Comparative Health and Medicine
- Explain the different types of health care available in the United States
- Compare the health care system of the United States with that of other countries
19.5 Theoretical Perspectives on Health and Medicine
- Apply functionalist, conflict theorist, and interactionist perspectives to health issues
Instructions:
For this week, you should review each section in the chapter reading and complete your chapter recap assignment and/or discussion board. You should also review all supplemental readings and/or videos that are provided for you in the module. Please remember that your responses for the chapter recap assignment should be approximately 5 to 7 sentences in length per question set (not individual questions). You should only upload word or pdf files (please DO NOT upload .pages files). Additionally, your discussion board responses are due on Friday (initial response to the discussion prompt) and Sunday (respond to at least TWO of your classmates posts). Your posts should also be approximately 5 to 7 sentences in length per question set (not individual questions). Please let me know if you have any questions concerns about the assignments.
Help:
Please find the assignments rubric under the 'Course Resources' module here: Link
You can also find book resources for your textbook here: Link (Links to an external site.)
I am always here to help so don't hesitate to contact me with any concerns you may have:
Happy learning!!!
Health and Illness: A Global Perspective
Health is the state of complete physical, mental, and social well-being
Infant mortality rate: Number of babies, of every 1,000 born, who die in their first year of life
Life expectancy at birth: Number of years people in a society can expect to live
Chronic disease: An illness that has a long-term development
Race and Ethnicity: Infant mortality rate
Non-Hispanic Black 11.3
Native: 8.3
Hispanic 5
Non-Hispanic White: 4.9
Asian/Pacific Islander: 4.2
6 per 1,000
Somalia 83
Afghanistan 54
Leading causes of death in 2015:
Birth Defects
Preterm Birth
S.I.D.S. (death occur among infants less than 1 year old)
about 1,600 children die each year
Maternal pregnancy complications
Injuries
Life Expectancy in US:
76 Male
81 Female
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Health, United States, National Center for Health Statistics
Heart disease remains the leading cause of death, accounting for 630,000 deaths per year; 1 in every 4.
There was little progress in lowering the U.S. infant mortality rate from 2000 to 2007.
The U.S. spends more on health care per capita than any other country, and health spending continues to increase.
Problems with health in the U.S.
Unequal distribution of health care by race, ethnicity social class and gender
Region and availability of health care.
Health education in the inner city and rural areas.
The Social Organization of Health Care
Copyright © 2017 Cengage Learning. All Rights Reserved.
The U.S. is one of the few industrialized nations that does not provide universal health care.
Some want to keep government from getting in between doctors and patients.
However, giant companies, and the government, already stand between patients and their health care providers.
Tracking the Trends: Obesity
People who are obese are at risk for a host of medical problems.
In 1960, about 13% of adults were obese; the obesity rate soared above 30% by 2000 and has continued to increase.
Q. What do you think are some of the reasons for this trend?
Percentage of population that is obese:
Fiji: 37%
Saudi Arabia: 36%
U.S.: 35%
Mexico: 29%
Russia: 25%
Obesity rates by race:
Non-hispanic white 35%
Black: 48%
Hispanic: 43%
Asian: 12%
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More than one-third (35% or 78.6 million)
The estimated annual medical cost of obesity: 147 billion; cost is usually higher for women
Among non-Hispanic black and Mexican-American men, those with higher incomes are more likely to be obese than those with low income.
Women with higher education/income are less likely to suffer from obesity than lower education/low-income women.
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More dependent on processed foods
High in carbohydrates and refined sugars
Fast food nation
Lack of physical activity
Family dynamics
Busy schedules
Institutionalized means
High fructose corn syrup
Regulations
What do you think?
Reasons for obesity in the U.S.:
More middle aged individuals
Ethnic make-up of communities
Shirt in categories of what obese is
‘moral panic’
Social environment
Des jobs
Technology
Fast food availability
Food deserts
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Has more than doubled in children and quadrupled in adolescents in the past 30yrs
In 2016, one in five children and adolescents were overweight or obese.
Higher risk of heart disease, diabetes, sleep apnea, joint problems and social/psychological problems.
Weight Loss Camps
Rich and Poor Compared: The AIDS Epidemic
Social epidemiology: how health and disease are distributed throughout a society’s population
Epidemic: disease that spreads rapidly
AIDS
Africa has 15% of the world’s population and 71% of HIV cases.
36.9 Million people living with HIV/AIDS
2.6 Million children living with HIV
Politics, Stigma, and the AIDS Epidemic
In the case of AIDS many factors came together to produce a significant delay in the attack on the disease.
Stigmatization of people with AIDS
Reagan administration’s policy of smaller government and greater austerity in social and health programs
Urban politics
Politics in the gay community
Some 34 million people worldwide have HIV/AIDS, and two-thirds of these live in sub-Saharan Africa. Almost two million people, most of them from this region, died in 2010 from HIV/AIDS (World Health Organization, 2011). All these health problems produce high rates of infant mortality and maternal mortality and high death rates. For all these reasons, people in the poorest nations have shorter life spans than those in the richest nations.
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Rich and Poor Compared: The AIDS Epidemic
Why are the world’s poorest nations so hard hit by AIDS?
Poor have weakened health
Poor countries have fewer resources for education and prevention programs
Cultural patterns and AIDS
Rich and Poor Compared: The AIDS Epidemic
HIV/AIDS in the United States
U.S. accounts for just 3% of HIV cases
1.2 Mill; 1 in 8 are unaware of their infection
1 in 4 new HIV infections is among 13-24 year olds
Drug treatments delay onset of full-blown AIDS among people with HIV
MSM, black and poor
Estimated new HIV infections in US, 2015
Deaths from AIDS in the United States
African Americans and Hispanics, who together represent 30% of the U.S. population, account for 56% of all AIDS deaths
Non-Hispanic African Americans are 10x more likely than non-Hispanic whites to become infected; Latinos are 3x times as likely
Health and Inequality
Racial disparities in health mean that African Americans are more likely than Whites to fall victim to various diseases, including
cancer
heart disease
stroke
diabetes
Hispanics contract tuberculosis at a rate seven times that of whites.
Social Class: The lower the social class status of a person or family, the less access available to adequate health care
Copyright © 2017 Cengage Learning. All Rights Reserved.
Health care costs were $2.8 trillion in 2012
Six reasons behind the soaring cost:
Spread of private insurance
Specialization of doctors
‘direct-fee system: health care system in which doctors, technicians and specialists are paid directly for their services either by patients or by insurance companies
‘fee for service model’: practice in which doctors have relatively free range in what they charge for their services. This allows doctors to charge more for services and encourage more diagnostic tests for their patients.
More high technology
‘ghost patients’: practice in which doctor’s charge insurance companies for exams that were never completed on patients that don’t exist.
Often this is couple with the practice of ‘self-referral’ in which doctors refer patients to organizations that provide services in which the doctor has a stake in (either owning the company or being an investor).
Lack of preventive care
Ageing population
More lawsuits
Controlling Costs
Pre-admission testing
Out-patient treatment
Regulating the length of hospitalization
Race and health:
This relationship has been attributed to:
Hazardous working conditions
Poor neighborhoods exposed to pollution
Inadequate and unsafe housing
Diet
Access to health care
Biological factors
Racial pressures which lead to stress and depression
Education:
The higher your education, the better your health (no matter how it is measured—mortality, morbidity or other general health measures).
Schooling might be a more important correlate to good health than is one’s occupation or income.
Educated individuals are more likely to:
Practice a healthier lifestyle
Visit their primary physicians more
Use new medical technologies or medicines.
Be aware of the health consequences of smoking and drinking.
Transmit their healthier lifestyle to their children.
Most people rely on health insurance:
Private Insurance Programs
64% of the population covered by traditional insurance
86% receive insurance through an employer
14% buy it on their own
Health Maintenance Organizations (HMOs)
Private insurance organizations that provide medical care to subscribers for a fixed fee
Focus on controlling costs by disease prevention
Managed care; use of primary care physician
24% of the population enrolled in HMOs
Government Insurance Programs
Medicare, part of social security for those 65+
15.7% of the population on Medicare in 2012
Medicaid, serves poor people with special needs and families with dependent children
16% of the population enrolled in Medicaid
Veterans receive care in government-operated hospitals
Health and Inequality
Gender
Although women live longer on average than men, statistics show that hypertension is more common among men than women until age 55, at which point the pattern reverses.
Disability is understood as a social identity that exists in relationship to other social identities and systems of social power. It is not simply a medical/physical condition.
One of the most significant achievements of the disability rights movement is the Americans with Disabilities Act. This law prohibits discrimination against disabled persons.
Copyright © 2017 Cengage Learning. All Rights Reserved.
While women live longer than men, women experience higher rates of nonfatal chronic conditions.
Men experience higher rates of fatal illness, dying more quickly than women when illness occurs.
These differences have been attributed to 3 factors: genetics, risk taking, and health care.
Though by the age of 75, men die of cancer at twice the rate of women, there is little education for men in cancer self-detection and prevention.
Disability: a physical or mental condition that limits a person’s everyday activities
Physical disability may become a master status where others see only the disability
Technology and changing attitudes improve quality of life
High poverty rate
Health: The Importance of Gender
Eating Disorders
90% of those with eating disorders are women
Women’s value in terms of physical attractiveness
Role of the mass media
Anorexia
What is it?
A medical condition, that is also described as an emotional disorder.
It is characterized by having an obsessive desire to lose weight by refusing to eat.
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Anorexia
Statistics about women with anorexia:
About 30 million individuals suffer from an eating disorder around the world
Only 1 in 10 women will receive treatment for their disorder
95% of individuals that have eating disorders range in age from 12-25
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Anorexia and Men
10-15% of individuals that suffer from anorexia are male.
Men are less likely to seek treatment options because it is seen to be a woman’s disorder.
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Bulimia
Person binge eats, followed by purging shortly after.
Onset is in late teens and can last for years or even be lifelong!
Signs of bulimia::
Eating large portions of food (binging)
Going to the restroom after eating.
Compulsive exercise
Yellow Teeth
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More than 200,000 cases a year
Up to 90% are women and around 10% are men
About 34% are self-harming
1 in 10 bulimics will seek treatment
Relapsing is seen in 30%-50% of bulimics
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Treatment for Bulimia
Support groups
Counseling
Psychotherapy
Being prescribed antidepressants
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“If you look good, you feel good”
The power of social media
Influence of health profiles
Health and physical well-being is promoted through social media
This leads people to want to imitate what social media says they should look like
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Media plays a huge role into the percentage of people who consider plastic surgery.
The Swan, Extreme Makeover, I Want a Famous Face and Dr. 90210.
It is a popular pastime for people to indulge in via People magazine and magazines of the sort.
The photo-shopping of women’s bodies in mainstream media also plays a role in body image and plastic surgery.
Many women believe that plastic surgery is linked to a lifestyle of affluence and social class.
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Theoretical Perspectives of Health Care
Functionalism: the positive functions of the health care system are the prevention and treatment of disease.
As a social institution, health care is also one of the nation’s largest employers and, thus, is integrally tied to systems of work and the economy.
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‘sick role’: social definition of the behavior of and the behavior toward those who society defines as ill:
Those are occupy the sick role:
are not held responsible for being sick
are not responsible for normal duties
are not supposed to like the role
are supposed to seek help to get out of the role
Mental disorder: psychological or behavioral condition that causes distress and reduces a person’s ability to participate in everyday life
Mental disorders are common
1 in 4 adult Americans suffer from some form of mental illness during their lifetime; mild to severe
Types of Mental Disorders
DSM IV – Diagnostic and Statistical Manual of Mental Disorders, prepared by American Psychiatric Assn.
Many disorders have biological and social causes
Robert Faris and Warren Dunham study (1939) linked poverty and mental illness
Cause and Effect? Goes both ways:
Mental illness reduces ability to earn a living
Poverty breeds stress and social isolation that increase risk of mental disorders
Native Americans have a higher rate
Asian Americans, a slightly lower rate
Link to poverty applies
Thoma Szasz: mental illness is a myth
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Treatment Strategies
Treating mental illness is a recent phenomenon
Psychotherapy: An approach to mental health in which patients talk with trained professionals to gain insight into the cause of their problems
Psychoactive drugs (1950s)
Treatment Strategies
Deinstitutionalization: the release of people from hospitals into local communities.
Community Mental Health Centers Construction Act of 1963
From institutions to outpatient centers
Not enough were built
Only 42% of people with mental illness receive regular treatment (63% with serious disorder)
Mental Illness on Campus
30% of college students report being so depressed they could not do their work
84% claim they are overwhelmed at times
Most serious problem is suicide
Psychoactive drugs make it possible to attend college but some may not take their medications properly or may be overwhelmed by demands of college work.
The suicide rate among young adults, ages 15-24, has tripled since the 1950s and Suicide is currently the 2nd most common cause of death among college students. 1,100: number of suicides that occur at colleges every year – that’s roughly 7.5 per 100,000 students.
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Conflict Theory
Conflict perspective: the inequality inherent in our society is responsible for the unequal access to medical care.
Minorities, the lower classes, and the elderly, particularly elderly women, have less access to the health care system than whites, the middle & upper classes, and the middle-aged.
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Symbolic Interaction Theory
Symbolic interactionists hold that illness is partly socially constructed.
The definitions of illness and wellness are culturally relative—sickness in one culture may be wellness in another.
Also, a condition considered optimal in one era may be defined as sickness at another time in the same culture.
Copyright © 2017 Cengage Learning. All Rights Reserved.
Perspectives on Health Care
The Functionalist Perspective
Disease and illness threaten the survival of society because sick people cannot accomplish essential tasks.
The function of the health-care system is to return people to normal social functioning.
The health care system becomes a problem when it fails to return sick people to normal social functioning.
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Illness is a social problem because it interferes with the ability to perform societal roles in families and at work.
Sick role: pattern of behavior expected of people defined as ill
Social institutions are linked
Perspectives on Health Care
The Conflict Perspective
Health and health care are scarce resources that interest groups compete over.
The inequitable distribution of health resources will reflect the overall inequitable distribution of these resources in society.
A problem results when some groups feel that they are not receiving their fair share.
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Health is linked to inequality
Access to care is critical
U.S. has no guaranteed access to care for all
1/3 struggle to pay medical costs; 15% lack insurance
Capitalism: profit motive over healthcare needs
Criticism: Overlooks fact that U.S. health has improved dramatically. Healthcare systems in more equal societies provide little incentive to develop new treatments.
Perspectives on Health Care
The Interactionist Perspective
Illness involves a network of social meanings and social expectations.
Health care can be considered a social problem when it produces stigmatized or devalued self-concepts among consumers of health care.
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“Health” and “illness” are partly socially defined; the definitions
differ among societies
change over time
State of mind can affect health of the body
Feminist Theory: Health and Gender
Risk of illness is greater for women due to increased risk of poverty
Only 34% of physicians are women; research geared to men.
Same rates of mental illness as men, but more likely to be labeled as mentally ill
Cultural definitions of “masculinity” can lead to stress and social isolation for men.
Criticism: Ignores fact that women’s health has improved dramatically; longer lives.
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Social Construction of Drug-Use
Subjectivity
What drugs are good?
What drugs are bad?
Relativity
Culturally motivated drug use
Desensitized to drug use
Drugs and Their Consequences
A drug is any substance that, when consumed, alters one or more of the functions of the human body.
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Most common reasons for drug use:
Therapeutic uses
Recreational uses
Spiritual or psychological uses
Escape
Social conformity
The Extent of Drug Use
Most everyone uses some type of drug, legal or illegal
2014: more than 24 million people age 12 and older (9.2%) had used some illegal drug at least once in the past thirty days
Illegal drug use peaks in the late teens, then declines as people get older
Drugs and Their Consequences
Drug Use and Abuse
Opinions about drug use vary greatly as to whether drug use itself is a social problem.
Much of the concern about drugs of abuse relates to their effects on people:
Dependence
Drug addiction
Tolerance
Cross-dependence
Cross-tolerance
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Abuse, Addiction, and Dependency
Abusing a drug:
violates accepted medical practices
causes mental, physical, or social harm
Addiction is a physical or psychological craving for a drug.
withdrawal symptoms when use stops
Dependency is a state in which a person’s body has adjusted to regular use of a drug.
need to continue using the drug in order to feel comfortable
ADDICTION
People of any age, sex or economic status can become addicted to a drug:
Risk Factors:
Family History of addiction
Lack go parental supervision
Poor social skills
Anxiety, depression and loneliness
Mental Health Issues
Drug experimentation
Peer Pressure
Availability of drugs
Community poverty
General Trends in Drug-use
Those using more drugs are:
Males; more likely to use drugs regularly and to use drugs heavily
Relatively young, especially those free from parental control and responsibilities
Likely to have parents who use legal drugs
More than half of new illicit drug users begin with marijuana
Drug use is increasing among people in their fifties and early sixties
Drug Use and Abuse
The Societal Costs of Drug Abuse
Accidents
Alcohol consumption is associated with fatal traffic, airplane, and occupational accidents.
Crime
In well over half of homicides in the U. S., the victim, the perpetrator, or both were drinking at the time of the crime.
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According to the CDC, 28 people die in motor vehicle crashes that involve alcohol-impaired driver. This is on death every 51 minutes. $44 Billion on alcohol-related crashes.
The Societal Costs of Drug Abuse
Family Problems
Alcoholics are seven times more likely to become separated or divorced from their spouses.
Studies find that 29 to 40% of spouse abusers were drinkers at the time of the attack.
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The Societal Costs of Drug Abuse
Work Problems
People who abuse alcohol or illicit drugs have higher rates of absenteeism, are more likely to jump between jobs, are more likely to be fired and are more likely to be involved in workplace accidents.
Health Problems
Most psychoactive drugs that are taken in large quantities produce severe health problems and even death.
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45
Of all drug users, about 70% are employed and active in the workplace.
1/3 of all employees are aware of illegal sale of drugs in their workplace.
The Extent of Drug Abuse in the United States
Alcohol
Alcoholism is the consumption of alcohol at a level that produces serious personal, social, or health consequences.
People with certain social characteristics are more likely to become alcoholic.
Rates of alcoholism vary by gender, age, religion and socioeconomic status.
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46
Prevalence:
In 2013, 86.8% of people 18+ reported that they drank alcohol at some point in their lifetime; 56.4% drank in the past month; 25% binge drink in the past month.
Alcohol Use Disorders:
16.6 Million Adults 18+ had an AUD in 2013 (10.8 million male)
Youth (12-17) 687K had an AUD (385k female)
Deaths:
Nearly 88k (62k male) die from alcohol-related causes annually; average of 10,000 attributed to driving fatalities.
Globally: 2012 3.3 million deaths or 5.9% of all global deaths.
Alcohol misuse is the fifth leading risk factor for premature death and disability; among people 15-49 it is the first.
Age:
most binge drinkers: 18-34 years
Binge drinks most often: 65+
Income:
Most binge drinkers: $75K+
Binge drinks most often/most per binge: $25K-
Health associations:
Unintentional injuries
Alcohol poisoning
STIs, sexual dysfunction
Unintended pregnancies
High-blood pressure, stroke and cardiovascular diseases liver disease
The Extent of Drug Abuse in the United States
Marijuana and Hashish
Marijuana is a preparation made from a plant of the genus Cannabis, usually consumed by smoking it like tobacco.
The level of marijuana use in the United States is far lower than that of alcohol.
Approximately 18 percent of college students use marijuana on a daily basis, and somewhere between one-third and one-half of all adults have ever used marijuana.
© 2015, 2012, 2010 Pearson Education, Inc. All rights reserved.
Adverse consequences of marijuana use include:
impaired short-term memory, judgment, and motor coordination; ◦
negative academic outcomes, such as performing poorly on exams, achieving lower grade point averages, and dropping out of school; and ◦long-term effects such as increased risk for chronic cough and bronchitis.
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Types of Drugs: Cannabis
Cannabis
Marijuana
Hashish
Accounts for 79% of illegal drug use in the U.S.
Legal for medical purposes in 22 states
77% of U.S. adults support medical marijuana use
How do you feel about marijuana use?
‘Gateway’ drug debate?
Copy-Cat Drugs: ‘Spice’ ‘K2’
Made to look like natural marijuana
Dried plant material and chopped up herbs that are sprayed with active ingredients: synthetic cannabinoids.
Some are 100x stronger than THC: cause hbp, blurred vision, vomiting, seizures, hallucinations, severe anxiety/paranoia and heart attacks
Sold under more than 500 names.
Readily available in some areas; rapid distribution
Addictive properties
Types of Drugs: Stimulants
Stimulants are drugs that elevate alertness, altering a person’s mood by increasing energy.
Caffeine
Nicotine
Amphetamines: Ritalin and Adderall
Cocaine and Crack
Methamphetamines: highly addictive
Widely used in the U.S.
Use can lead to hostility, paranoia, irregular heartbeat, heart failure, seizures and psychotic symptoms
Increase alertness, increased attention and raise blood pressure, heart rate and breathing.
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The Extent of Drug Abuse in the United States
Stimulants
There are enough stimulants produced legally in the United States each year to provide 50 doses to every person.
About one-half of these legal stimulants find their way into the illegal drug trade.
Cocaine, a stimulant derived from coca leaves, has become the third most popular psychoactive drug in the United States after alcohol and marijuana.
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About 1.5 million people are estimated to use cocaine
Those who are 18 to 25 are twice as likely to use cocaine
Mean are more likely to use cocaine
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Types of Drugs: Depressants
Depressants are drugs that slow the operation of the central nervous system.
“Downers”
Alcohol
2.5