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• 1/3rd of the world’s people cannot read or

write• 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 16th in science and 19th in math

• Cultural values play a part in how hard students work at their schooling

RECENT ISSUES IN U.S. EDUCATION

• School Choice– 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• 2/3rd 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