Download Sociology In Practice

Aging & Health
The Graying of
Society
Health Defined
• According to the World Health
Organization, health is “a state of
complete physical, mental, and social
well-being and not merely the
absence of disease or infirmity.”
Social Epidemiology
• Social epidemiology is the study of the
distribution of diseases and health
throughout a society’s population.
• Social epidemiologists want to find a
link between health and the social
environment.
Age & Health
• In the United States, unlike other
areas of the world, death among the
young is rare.
• For the most part, children and young
adults are generally healthy.
• With this in mind, more people as
they age, experience more and more
serious health problems.
Gender & Health
• In the United States, women are expected to
live an average of 80.4 years, while men
live only 75.2 years.
• Sociologists attribute many factors to this
trend.
– For example, men have higher testosterone
levels than women, which may make men
more likely to abuse alcohol and tobacco,
driving aggressively, and engage in other lifethreatening behaviors.
• Men and women differ in their desire
for health care.
• Women are twice as likely to get
preventative care and have regular
checkups, while men are less likely to
discuss health issues with their
doctors.
Social Class & Health
• Sociologists believe that one’s social class
has a direct effect on his or her health,
particularly in the United States.
• Studies show that a higher socioeconomic
status leads to longer, healthier and
happier lives.
• Sociologist Jason Schnittker agues that
income improves health because more
money means that affordable health care
and basic needs are met.
Neighborhoods
• Neighborhoods can also have an effect
on health.
• Neighborhoods that house poor,
poorly educated, unemployed, and
single mothers with little government
assistance adversely affect the health
of the people living there.
• Similarly, people living in
neighborhoods with high crime and
drug use also report poor health.
• These threatening environments can
lead to stress, which can in turn lead to
more serious health problems.
Race & Health
• In 2005, the life expectancy of whites
was 78.3 years, while African
Americans were expected to live only
to 73.2 years.
• Social class plays a role in explaining
why whites are living longer.
• In the United States, 24.9% of African
Americans and 21.8% of Hispanics live
below the poverty level, while only 8.3%
of whites are impoverished.
• Minorities also have higher rates of
infant mortality.
• In a study by Bhagat Singh Thind, et.
Al, non-whites living in Newark, NJ
were found to have more babies with
low birth weight, which increases the
risk of infant mortality, than white
women.
• Possible factors contributing to this included
drug and alcohol abuse, smoking, and not
receiving pre-natal care.
• In an effort to help the women in these poorer
communities, the government created programs
like Healthy Start.
• Infant mortality rates are down, but the mothers
still live in communities that put their children at
risk.
The Medicalization of American
Society
• One way to consider the sociology of
health is to look at how health and health
care influence people’s lives.
• Talcott Parsons believed that sickness
can become a sick role.
• A sick role is the expected behaviors
and responsibilities appropriate for
someone who is ill.
• For example, part of an ill person’s role
is to go to the doctor in an attempt to get
rid of the illness.
• Physicians have a primary position in
society, allowing them to label sickness
and health, which gives them great
power over those whom they come in
contact.
• This has led to what many consider the
medicalization of American society, or
the idea that the medical community is
the center of m any aspects of American
society.
• Americans tend to believe that we can
find the right pill for anything.
• Our society believes that if you take a
pill, all will be okay.
The Myth of Mental Illness
• Dr. Thomas Szasz wrote The Myth of
Mental Illness which suggests that
mental illness is not really a disease at
all.
• In fact, the diagnosis of mental illness is
often used as a means of social control.
• Paula Caplan argues that the Diagnostic
and Statistical Manual of the American
Psychiatric Association, used for the
diagnosis of all mental illness, relies on
personal ideology and political
maneuvering.
• America has many issues associated with
the medicalization of our society.
• Keeping this in mind, let’s look at obesity.
Health in the United States:
Living off the Fat of the Land
• With employment, health care and food
often only a phone call or a key stroke
away, the United States should be a
country of healthy citizens.
• However, all affluent nations face a host
of health concerns, including obesity, an
unhealthy accumulation of body fat.
• Although it is a relatively new
phenomenon, the United States is in the
grips of what some are calling an
obesity epidemic.
• Food options in the United States run the gamut
from healthy (organic arugula) to unhealthy
(bacon cheddar cheeseburgers).
• Many U.S. consumers prefer the latter.
• Shopping for healthier food takes more time,
effort and money.
• Fast food is convenient and inexpensive,
making it hugely popular, despite being
unhealthy.
Childhood Obesity
• A 2006 study determined that the increase
in childhood obesity was a direct result of
the availability of energy-dense foods
and drinks combined with a lack of
energy expenditure.
• That is children are getting bigger
because they are taking in more calories
than they are burning.
Challenges facing Children:
•
Kids today face many challenges in
keeping their weight down:
1. School lunches are higher in calories
2. Dual-income or single parent families
create a need for pre-packaged meals
that are unhealthy
3. Television, computers, and video games
keeps children entertained, and
sedentary.
Stigmatization of the Obese
• Another consequence of childhood obesity is
that overweight children are often targets of
scorn and ridicule among their peers
(bullying).
• Numerous studies have shown that people hold
prejudicial attitudes towards obese people.
• This perception can cause discrimination
against an obese person.
• This loss of status can have harmful
psychological, economic and physical
consequences.
Obesity and Race
• Research has shown that African
Americans have a substantially higher
rate of obesity than whites.
• Poverty also plays a role in obesity.
Why are the poor more likely to be
obese?
• Michael Pollan points to the high cost of
healthier food options.
• Unhealthy, inexpensive foods are often
necessary for those who cannot afford healthier
food options.
• A lack of education about nutrition can lead
people to make uninformed choices about what
they eat.
• Add that to floundering health care system, and
you have a recipe for an obesity problem.
Health Care
• There are many other issues in the sociology of
health other than obesity.
• One important issue to consider is health
care.
• It seems that during every election cycle,
health care– care, services, or supplies
related to a person’s health—is always one of
the major issues.
The Uninsured
• In 2005, nearly 45 million people in the United
States were uninsured.
• Of the 45 million people, more than 34 million
were under the age of 44.
• Many of these people either didn’t make
enough income to pay for insurance or had
parents who didn’t make enough.
• In the United States, the uninsured “are sicker,
receive inferior care, and are more likely to
die prematurely.
Cost of Services
• The U.S. government has historically
rejected plans for universal health care
unless they apply to senior citizens.
• Why the constant rejection? According
to sociologist Jill Quadagno, three
reasons explain this practice.
Quadagno’s Rationale for Rejected
Universal Health Care:
1. The Constitution states that power of the state
must be limited. Providing national health
care is viewed as a form of welfare, which
threatens our freedom.
2. The working class and labor unions fail to
support legislation that would provide
universal health care.
3. Private health care companies strongly
oppose the idea of national health care.
• Although many of the U.S. health care
companies are private firms that are
provided through a person’s employer
or medical union, there are some
public forms of health care.
• Medicare and Medicaid provide the
elderly, veterans, poor and disabled
with insurance.
Health Care- An International
Comparison
• In 2000, the World Health Organization
(WHO) released a report that identified
five characteristics that a good and fair
health system should have.
WHO Good & Fair Health System
Criteria:
1. Overall good health (low infant mortality rates
and high life expectancy)
2. A fair distribution of good health (low infant
mortality and high life expectancy across the
entire population)
3. A high level of overall responsiveness
4. A fair distribution of responsiveness
5. A fair distribution of financing health care
(the health care costs are evenly distributed
based on a person’s ability to pay)
A Global Look at Health Care Systems
in 2005
Country
Per Capita
Costs
Life
Expectancy
Male
Life
Expectancy
Female
Infant
Mortality
United
States
Canada
Australia
United
Kingdom
Finland
Japan
$6,347
75.2
80.4
6.9
$3,460
$2,999
$2,580
79
78.5
77.1
82.7
83.3
81.1
5.4
5
5.1
$2,523
$2,474
75.6
78.6
82.5
85.5
3
2.8
Health Care and the Elderly--Medicare
• Most of the U.S. elderly population has
access to Medicare-a government-run
social insurance program that provides
health coverage for people 65 and older.
• People ages 65 or over qualify for
coverage if they are U.S. citizens or have
been legal residents for five continuous
years.
• The program covers hospital stays, skilled
nursing facilities, doctor visits and
outpatient hospital services or allows
people the option of receiving their benefits
through private insurance plans.
• There is also assistance to pay for
prescription drugs, which helps seniors on
tight budgets get the health care they need.
Health Care and the Elderly--Medicare
• Those who have never worked and are
poor are eligible for Medicaid, a form of
government health insurance designed for
the poor and disabled.
Aging: The Graying of the United
States
• The population of the United States has
experienced a long trend of “graying”
from 1900 to the present.
• Persons aged 65 or older comprised
about 4% of the population in the year
1900; in 2002 it was over 12%.
Baby Boomers
• As baby boomers go into retirement,
these numbers are going to skyrocket.
• The Census Bureau estimates that by
2050, persons over the age of 65 will
make up more than 20% of the total
population.
Aging and Demographic Change in
the United States
• Concerns about the increasing
percentage of elderly people in society
have drawn the attention of
psychologists, medical professionals
and sociologists.
• The study of aging and the elderly is
officially known as gerontology.
• The elderly have been broken down into
two major cohorts: “young old” and the
“old old”.
• The “young old” consist of people
between the ages of 65 and 75.
• The “old old” refers to those over the
age of 75.
Life Expectancy
• Medical advances and higher
standards of living dramatically increase
life expectancy.
• At the beginning of the 20th century, the
average life expectancy was 47.3 years.
• In 2007, life expectancy for men reached
75.2 while women’s life expectancy was
80.4 years.
• The development of vaccines for many
infectious diseases, such as measles,
diphtheria and smallpox, virtually
eliminate these diseases, allowing many
more people to live longer, healthier
lives.
The “Sandwiched” Generation
• The baby boomer generation (people
born between 1946-1964) is unique in
that it is the first “sandwiched”
generation—it takes care of its children
and its elderly parents.
• Most future generations will probably
also be sandwiched between their
children and their parents because of
longer lives and delays in
childbearing.
• This can keep families close together.
• The elderly can help their adult children
in times of crisis by watching their
grandchildren, providing temporary
housing, giving loans, and offering
advice to their adult children.
• This allows the elderly to stay involved
in family life and increases overall life
satisfaction.
Gender and Aging: Where are the
men?
• According to sociologists John Knodel and
Mary Beth Ofstedal, concerns about gender
inequality have taken too much precedence,
and the situation of elderly men is not being
considered.
• The Second World Assembly on Aging
produced a report that is almost solely
concerned with the situation of aging women
called the “Madrid International Plan of
Action”.
• Knodel and Ofstedal were taken aback by
the asssembly’s “willingness to
acknowledge that the relationship
between gender and aging varies across
settings and over time.”
• Although it is a noble goal to promote
gender equality and empowerment of
women, a one-sided view of the situation
fails to actually promote gender equality.
• Knodel and Ofstedal suggest that
research should also examine the
“experiences of older men and women
within the context in which they live.”
Concerns about Aging
1. Biological changes
2. Ageism prejudice and discrimination
based solely on age
How do health and aging affect
stratification?
• Race, age, social class and gender
affects health.
• Example: people from higher social
classes have better access to health care
compared with members of society’s
lower class, so they generally have
better health.
What theories exist about the aging
process?
• Functionalism as people grow older, they
reduce their interactions with others—a
practice hat is unavoidable, mutual and
acceptable to the individual and society
• Conflict Theory society places a negative
stigma on the elderly, which segregates them
from others
• Symbolic Interactionism successful aging
encompasses health, psychological wellbeing, role integration and social
engagement.
What are the advantages and disadvantages of the
health care system in the US for the elderly?
• Advantages the health care system
compensates the elderly for the years of hard
work they put on the job; it gives retired
persons access to good and reliable health
care
• Disadvantages the growing elderly
population means the costs for health care
will continue to rise, and current resources
may not last long enough to provide health
care for future elderly populations.