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Health and Illness
Chapter 14
The Components of the Health-care System
The health-care system embraces the professional services, organizations, training
academies, and technological resources committed to the treatment, management,
and prevention of disease.
1.
Physicians
– Although physicians constitute only about 10 percent of health-care workers in
the United States, they establish the working framework for everyone else.
2.
Nurses
– Possibly as a result of this initial orientation, nursing experiences frequent
controversy regarding education, professional roles, and compensation.
3.
Hospitals
– Hospitals provide specialized medical services to a variety of inpatients and
outpatients.
4.
Patients
– People usually enter the health-care system only because others defined
them as ill or injured.
Sociology and the Study of Medicine and Health
• Medicine is a society’s standard way of dealing with illness
and injury.
– Profession, a bureaucracy, and a big business
• Study how medicine is influenced by ideals of professional
self-regulation, the bureaucratic structure, and the profit
motive.
• How illness and health are related to cultural beliefs,
lifestyle, and social class.
– “Sickness” and “illness” are social labels that can stigmatize people.
Theoretical Perspectives and the Health Care
System: Symbolic Interactionism
• Health is affected by Cultural Beliefs.
– Ex. Hearing voices and seeing visions
• “Sickness” and “Health”: We are provided with guidelines to
determine whether we are healthy or sick.
• Sociologists analyze the effects that people’s ideas of health and
illness have on their lives and even how people determine that
they are sick.
– Health is a human condition measured by four components:
• Physical, mental, and social, and spiritual.
• Health is state of complete physical, mental, and social wellbeing
Theoretical Perspectives and the Health Care System:
Functionalism
Talcott Parsons first proposed a view of sickness that was
distinctively sociological rather than merely medical.
 Health problems are a threat to society.

Society must set up ways to control sickness
 If people are sick and cannot fulfill their roles, society
will not function smoothly.

Society must develop a system of medical care andmake
rules to keep too many people from “being sick”
The Sick Role
A social role that you are forced to play when you are not well.
1.The sick are permitted to withdraw temporarily from other
roles or at least reduce their involvement in them
2.It is assumed that the sick cannot simply will the sickness
away.
3. The sick are expected to define their condition as undesirable.
4.The sick are expected to seek and to follow the advice of
competent health-care providers.
Defining Health and Illness
• Our bodies are social objects—it is important
to understand the role that health (and illness)
plays in our lives as social beings.
• Health (and illness) are social constructs.
What it means to be healthy or sick is
determined by a society!
Types of Illnesses
• Acute diseases have a sudden onset, may be
briefly incapacitating, and are either curable or
fatal.
• Chronic diseases develop over a longer time
period and may not be detected until
symptoms occur later in their progression.
Approaches to Medical Treatment
• Curative or crisis medicine is the kind of
health care that treats a problem after it has
already started.
• Preventative medicine is a kind of health care
that tries to prevent or delay a problem. This
can include making lifestyle changes.
Approaches to Medical Treatment (cont’d)
• Palliative care is the kind of health care that
focuses on symptom and pain relief—it is not
intended to provide a cure. This is typically
used for critically ill or dying patients.
Medicalization of Health and Illness
• Medicalization is the process where some
issues that used to be seen as personal
problems are redefined as medical issues.
Epidemiology
• Epidemiologists study
patterns of disease to
understand illnesses,
how they spread, and
how to treat them.
• Epidemic: when a significantly higher than
expected number of cases of a disease occurs
within a population
• Pandemic: when a higher than expected number
of cases of a disease also spans a large geographic
reion, as in multiple countries or continents
Social Inequality, Health, and Illness
• Socioeconomic status (SES) impacts people’s
ability to access better heath care, tests, and
medications, and also to afford better nutrition.
Higher SES individuals often live longer and feel
better than lower SES individuals.
The Problem of Food Deserts
• Food desert: a community in which the
residents have little or no access to fresh,
affordable, healthy foods, usually located in
densely populated, urban areas
Intersections of Class, Race, and Gender
• Racial and gender inequalities are
compounded by economic inequalities–
minorities and women are more likely to be in
poverty.
• Deprivation amplification occurs when the
risks we already have because of our
background or heredity are amplified by social
factors.
– Examples: minorities are more likely to be
exposed to harmful surroundings; men are more
likely to hold hazardous jobs.
Medicine as a Social Institution
• The American Medical Association, through its
standards and regulations:
– transmits norms and values of medicine and
medical knowledge.
– regulates, licenses, and legitimizes practitioners.
– polices itself and
encroachment on
its power.
Medicine as a Social Institution (cont’d)
• Doctor-patient relations are greatly influenced
by the structure of the institution.
• The way that we interact with doctors is what
gives them status and power—the norms of
the situation emerge from the way we
behave!
Medicine as a Social Institution (cont’d)
• The sick role describes actions and attitudes
expected from someone who is ill.
– Functionalist Talcott Parsons suggests that being
sick is a form of deviance (it’s different from the
norm).
– You often get excused from your normal
responsibilities, but you have new responsibilities,
like seeking treatment and trying to get better.
Issues in Medicine and Health Care
• Health-care reform is a current issue that we
hear a lot about in the media. The premise is
that we need to provide better, more
affordable health care to all people.
Issues in Medicine and Health Care (cont’d)
• One reason for health-care reform is to
eliminate rescission—a policy that allows
insurance companies to cancel people’s
coverage after they get sick.
Issues in Medicine and Health Care (cont’d)
• Cultural competence: acknowledgment and
incorporation of a person’s cultural
background as part of the treatment process
– This is important because a patient’s beliefs will
shape his approach to health care.
• Complementary medicine: treatments,
practices, or products that can be used in
conjunction with conventional Western
medicine
Issues in Medicine and Health Care (cont’d)
– Alternative medicine: treatments,
practices, or products that can be used
instead of conventional Western medicine
Issues in Medicine and Health Care (cont’d)
• Integrative medicine combines conventional
medicine with complementary practices that
are proven to be safe and effective.
Issues in Medicine and Health Care
• In an effort to eliminate disorders, eugenics is
an attempt to manipulate the gene pool to
improve humans through medical science.
• In using processes like eugenics, it is important
to consider bioethics—the moral or ethical
issues related to scientific or medical
advancements.
So What? Why Study Health and
Illness?
• Understanding the link between social
structures and the individual helps us
understand process and health outcomes.
• Thinking about our values and cultural context
helps us understand the way people perceive
the health of individuals, society, and the
planet.
Theoretical Perspectives and the Health Care
System: Conflict Theory
• The same political and economic forces that determine the
nature of capitalism determine the nature of the medical
institution.
– Primary focus is the struggle over scarce resources.
• The concerns of conflict theorists are issues of inequality
within the health care system.
• Health comes with wealth
– Globally
Conflict Perspective
High-Income Nations
• Infant mortality rate – number of babies who die in
their first year of life for each thousand births
–Low – less than 10 deaths for every 1,000
births
• Life expectancy at birth – number of years people in a
society can expect to live
–Longer - on average into their seventies or
early eighties
Conflict Perspective
High-Income Nations
• Chronic diseases – an illness that has a long-term
development
–More prevalent in high-income countries
–In U.S., a high fat diet and little physical
work result in 2/3 of adults as overweight
Conflict Perspective
Low-Income Nations
• Poverty and poor health
– Poverty and malnutrition
– Poverty and lack of safe drinking water
– Poverty and poor sanitation
• Acute disease-illness that strikes suddenly
– Infectious diseases
Focus on Theoretical Perspectives: Health Care
in the United States
Theory in Everyday Life
Health Care in the United States:
A system in Crisis?
U.S. Health Care System
• Direct-fee system – medical care system in
which patients or their insurers pay directly
for the services of physicians and hospitals
• Obama tried to overhaul health care system Obamacare
• Issues are access and soaring costs
• 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: one for those who can
afford insurance, and another for those who cannot
• The Haves
Can afford individually, or through employer provided
health plans, insurance adequate to meet demands of
system
• The Have Nots
Cannot either individually, or through employment,
afford adequate insurance
The Cost Problem
Health care costs were 2.2 trillion in 2007
• Six reasons behind the soaring cost:
1. Spread of private insurance
2. Specialization of doctors
3. More high technology
4. Lack of preventive care
5. Aging population
6. More lawsuits
7. *Corporate Greed
Health Care Reform in the United
States
• A large majority of Americans believe that the
U.S. health-care system requires reform.
• -Obamacare
• -What will Trump do?
• Moreover, almost three-fourths of Americans
approve of a government-backed healthcare
program for children, and almost 60 percent
prefer a universal health-care system.
Why is there a need for health-care
reform?
1. Too expensive
2. Limited access to medical care
3. Quality of life
4. Aging population
The Health Reform Road Taken
• Obama 2010 Health Reform
– requires most citizens and legal residents to purchase
health insurance
– penalizes employers with more than fifty employees
who do not offer some form of health coverage
– extends coverage to some 32 million uninsured
people through Medicaid, particularly providing health
coverage for all uninsured children
– includes subsidies for purchasing health insurance
provided by the government to lower-income families
– establishes health-insurance exchanges designed to
promote more competitive insurance coverage rates