Chapter 14: Health and Medicine

Figure 14.1 Health Expenditure as Percentage of GDP, 2007

Figure 14.2 Percentage of People Under 65 Who Get Private Health Insurance Through Workplace by Economic Status

Figure 14.3 Percentage of Uninsured by Race and Hispanic Origin

Sociology of Medicine

Central notions: • Social inequalities are important in explaining

health and illness in modern societies.• Medicine is a system of social regulation.

Medicine

• Medicine: A field of science devoted to diagnosing and treating various bodily ailments as well as a social institution that provides opportunities for studying the ways in which cultural processes act as a form of social regulation or control over the body.

Social Constructs of Health & Medicine

• Health: The normal functioning of an organism.

• Examples of health depend on a given society’s definition of which functions are “normal,” reflecting the society’s concept of the good life.

Disease

• Disease: A general lack of comfort.

• Examples of disease depend on a given society’s definition of what is “comfortable,” reflecting the society’s concept of the good life.

Health and Disease

• A society’s conception of health necessarily tends to involve a moral description of “the good life.”

• The description of the average is often used as a measure of morality.

Figures 14.4 and 14.5 Adults and Children with HIV/AIDS

Figure 14.6 Deaths of Adults and Children Due

to AIDS, 2005

Figure 14.7 Sub-Saharan Africa HIV/AIDS Statistics

Medicalization of Deviance

• Medicalization of Deviance: The process by which medicine has taken over some of the functions previously attributed to religion and the law in terms of defining what is normal or desirable versus what is deviant.

Sick role

• As defined by Talcott Parsons, a role governed by social expectations.

• On the one hand, the sick role is a form of deviance insofar as it enables a person to ignore his or her social obligations and responsibilities; on the other, it is legitimate if the individual expresses a desire to be well again and seeks out appropriate treatment.

Stigma

• A label that changes the way an individual is viewed in society, typically in a negative manner.

• For example, because AIDS has become associated with homosexuals and drug users, it carries a stigma—despite the fact that its sufferers include newborn babies.

American Medical Association

• Established in 1847• Founders adhered to the medical belief

system dubbed allopathy• In the early decades of the twentieth century,

the AMA achieved a dominant position in the medical profession

Biomedical Model

• The dominant set of beliefs, values, and assumptions in Western medicine.– Assumes a separation between mind and body– Treatment concentrates on the body as if it were

a machine– Takes very little account of social, psychological,

or behavioral factors

Physical Reductionism

• Physical reductionsim: The process by which the medical model and medical professionals exclude social, psychological, and behavioral dimensions of illness in favor of concentrating solely on the individual’s body and bodily functions.

Alternative Medicine

• Alternative medicine: Forms of treatment that fall outside of conventional scientific medicine, including prayer, homeopathy, and acupuncture.

Emile Durkheim

• According to Durkheim, variations in certain mortality rates, such as suicides, could be regarded as signs of whether a society had a healthy or “pathological” level of social integration.

Durkheim

• Durkheim hypothesized that both excessive individualism and excessive social integration were pathological.

Durkheim

• The two most common forms of pathological integration in modern society were those in which individuals were left without moral support, giving rise to “egoistic suicide,” and those in which individuals were given too little guidance about attainable norms and thus were likely to have unrealistic goals, resulting in “anomic suicide.”

Civic Community

• Civic community: A sense of solidarity within a society.

• Term coined by Robert Putnam• He measured it on the basis of individuals’

involvement in public life.• Civic community suggests that a relationship

exists between social integration and the health and success of an individual.

Morbidity Rates vs. Mortality Rates

• Morbidity rates: The amount of illness in a given society during a particular time frame. These rates are not strictly biological statistics but, rather, are closely related to social inequalities.

• Mortality rates: The number of deaths in a given society in a particular time frame. These rates are also closely linked to social factors.

Life expectancy

• A measure that refers to the average number of years individuals are expected to live.

• Social factors, such as nutrition, housing, unsanitary living conditions, types of occupation, family situation, and lifestyle affect life expectancy.

Life expectancy in the U.S.

• Black Americans have a significantly lower life expectancy than white Americans. Why?

Life expectancy: BlacksWhites in 1920 45.3 54.9 in 2002 72.3 77.7

Reason for disparity

• Higher infant mortality among blacks• The rate for blacks is now 2.4 times that for whites• Even allowing for greater poverty and other material

inequalities, experts are now suggesting that some of the difference may be attributable to the stress of racial discrimination and minority status experienced by black mothers.

Gender differences

• Women are more likely than men to consult a doctor and use medically prescribed drugs.– It may be that women are more willing than men to

express and report their symptoms to others.– It may also be that women are socialized in ways that lead

them to be more focused on health matters.– There may also be a difference in the “vocabulary of

illness” available to women compared to men.

Figure 14.8

Relationship Among

Environmental Change, Climate Change,

Ecological Change, &

Child Health

Study Questions• What is the difference between the

sociological and medial approaches to health and illness? What evidence supports the sociological argument that health is a social construction?

• Explain why health and disease are moral as well as medial concepts.

• Explain Talcott Parsons’s perspective on sickness as a form of deviance. Under what circumstances is this deviance legitimate? What have been the main criticisms of Parsons’s model of the sick role?

Study Questions (cont.)• How did the American Medical Association help the

medical profession establish a monopolistic control over the field of health and the treatment of illness in the United States? What medical belief system did its first members adhere to? How did the AMA’s rise to dominance create gender, race, and class disparities in the medial profession?

• Briefly describe the main components of the biomedical model. What criticisms have been directed against it?

Study Questions (cont.)• According to Emile Durkheim, what is the

relationship between social integration and mortality rates? What did he consider a “pathological” level of integration, and which two forms of such integration were most common in modern society? How did his study contradict the conventional wisdom about suicide?

• What social factors contribute to the lower average life expectancy and high infant mortality rate among black Americans?

• Why are women more likely than men to seek medical consultation and to take medically prescribed drugs? How do doctors contribute to this pattern?