Health, Medicine, Disability and Aging

Chapter OutlineHealthMedicineDisabilityAgingDeath and Dying

The Black DeathIn 1346, rumors reached Europe of a plague

sweeping the East. The epidemic spread along trade routes to

China and Russia. Within 2 years, the Black Death, killed 1/3 of

Europe’s population. The plague still ranks as the most devastating

catastrophe in human history.

Life ExpectancyThe average age at death of the members of

a population. Life expectancy in the United States was 47

years in 1900. In 2009, it was 78 years.The maximum average human life span is

the average age of death for a population under ideal conditions. It is currently about 85 years.

Leading Causes of DeathINSERT TABLE 13.1 HERE (PG. 309)

Polling Question Do you currently smoke cigarettes?

a. Yesb. No

Life Expectancy, Selected CountriesINSERT FIGURE 13.1 HERE (PG. 310)

Social Causes of Illness and DeathHuman-environmental factors - Cancer

causing pollutants in the air and water.Lifestyle factors - cigarettes, alcohol, drugs,

diet, social isolationPublic health and health-care systems -

access to clean water, basic sewage, immunizations

Public Health SystemThe public health system is composed of

government run programs that ensure access to clean drinking water, basic sewage and sanitation services, and inoculation against infectious diseases.

The health-care system is composed of a nation’s clinics, hospitals, and other facilities for ensuring health and treating illness.

Global InequitiesAIDS is the leading cause of death in the

poverty-stricken sub-Saharan AfricaGlobal inequality influences people’s

exposure to different health risks

People with HIV/AIDS, 2009INSERT FIGURE 13.2 HERE (PG. 311)

Infant MortalityThe number of deaths before the age of 1

year for every 1000 lives births in a population in 1 year.

Health Indicators, Selected Countries, 2009INSERT TABLE 13.2 HERE (PG. 312)

Reasons for Health InequityThe poor are more likely to be exposed to

violence, high-risk behavior and environmental hazards.

The poor cannot afford adequate health care.

Racial and Ethnic Inequalities in Health CareRacism also affects health

Health status of some African Americans is somewhat lower than European Americans even within the same income category

African Americans at all income levels tend to live in racially segregated neighborhoods with fewer health facilities

Experience of racism induces psychological distress

Gender Inequalities in Health CareGender bias exists in:

Medical research: More research has focused on “men’s diseases” (cardiac arrest) than “women’s diseases” (breast cancer).

Medial treatment: Women undergo fewer kidney transplants, cardiac procedures, and other treatments.

Gender Inequalities in Health Care

Women live longer and thus have greater lifetime risk of disability and chronic illness; yet more is spent on men’s health than women’s health

40% more poor women than poor men and poverty is related to health

Health and Politics: Conflict and Functionalist PerspectivesWe spend more on health care than any other

country but all other postindustrial societies have healthier populationsA high level of social inequalityNature of American health care system where

some are privileged (wealthy) and others are disadvantaged (poor)

4 Problems with HMOs: Strategies to Pursue Profit1. Avoid covering sick people and people who

are likely to get sick. 2. Minimize the cost of treating sick people

they can’t avoid covering.3. Inflate diagnoses to maximize

reimbursements.4. Keep overhead charges high.

Advantages of Private and For-Profit Health CareThey are so profitable, they can invest large

sums of money into research and development, latest diagnostic equipment, higher salaries to attract best medical researchers on planet

Main supporters of current system are the stockholders

MedicineA social institution devoted to prolonging life

by fighting disease and promoting health. Society shapes medical practice every bit as

much as it influences health processes.

The Professionalization of MedicineProfessionalization, is the process by which

people gain control and authority over their occupation and their clients.

It results in professionals enjoying high occupational prestige and income and considerable social and political power

The Sick RolePlaying the sick role, according to Talcott

Parsons, involves the nondeliberate suspension of routine responsibilities, wanting to be well, seeking competent help, and cooperating with health-care practitioners at all times.

Alternative MedicineThe most frequently used types of alternative

medicine are chiropractic, acupuncture, massage therapy, and various relaxation techniques.

Alternative medicine is used mostly to treat back problems, chronic headache, arthritis, chronic pain, insomnia, depression, and anxiety.

Placebo EffectThe positive influence on healing of strong

belief in the effectiveness of a cure.Research shows that strong belief in the

effectiveness of a cure can by itself improve the condition of about a third of people suffering from chronic pain or fatigue.

Holistic MedicineHolistic medicine emphasizes disease

prevention. Holistic practitioners treat disease by taking

into account the relationship between mind and body and between the individual and his or her social and physical environment.

Social Construction of DisabilityImpaired people are considered deficient in

physical or mental capacity.Disabled people are incapable of performing

within the range of “normal” human activity.

RehabilitationRehabilitation involves:

Curing disabilities to the extent possible through medical and technological intervention.

Trying to improve the lives of the disabled by means of care, training, and education.

Integrating the disabled into “normal” society.

AblismPrejudice and discrimination against disabled

people.Historical example: Belief among 19th-

century Western educators that blind people were incapable of high-level or abstract thought.

Ablism involves the largely unintended neglect of the conditions of disabled people.

Challenging Prejudice and DiscriminationIdea of the normality of disability has partly

supplanted the rehabilitation idealRather than regarding themselves as deviant,

they think of themselves as inhabiting a different but quite normal world

Age StratificationAge stratification refers to social inequality

between age cohorts.The very young are often at the bottom of the

stratification system.Facing poverty and famine, parents sometimes

abandoned children.Many developing countries are overflowing

with orphans and street children.

GerontocracyA gerontocracy is a society ruled by elderly

people. In South Korean corporations when a new

manager starts work, everyone in the department who is older than the new manager may resign or be reassigned.

In the United States, median income gradually rises with age, reaching its peak in the 45–54 age cohort.

Age Stratification: Functionalist TheoryAge stratification reflects the importance of

each age cohort’s contribution to society.In preindustrial societies, the elderly were

important for knowledge and wisdom.With industrialization, function of the elderly

became less important and their status declined.

Age Stratification:Conflict TheoryAge stratification stems from competition and

conflict.Young people may participate in a

revolutionary overthrow and seize power.The elderly may organize politically to

decrease disadvantages and increase advantages in life.

Age Stratification: Symbolic InteractionistFocus on the meanings people attach to age-

based groups and age stratification.One study examined movies from 1940-1980.

Young people were portrayed as leading active, vital lives.

Elderly women were portrayed as unattractive, unfriendly, and unintelligent.

Elderly as % of U.S. Population, 1900–2050

Aging and PovertyThe “old old” are most likely to suffer

physiological decline, life-threatening diseases, social isolation, and poverty.

Economic inequality between elderly women and men is the result of women’s lower wages when they are young.

The elderly most likely to be poor include the “old old” , women, African Americans and people in rural areas.

A Shortage of CaregiversIn 2001, home-care agencies and nursing

homes employed 2.1 million caregivers in the United States.

The U.S. Bureau of Labor Statistics expects a 58% rise in demand for such workers between 1998 and 2008.

AgeismAgeism is prejudice and discrimination

based on age. Examples:

Elderly men are stereotyped as “grumpy” and elderly women as “haggard”.

Polling Question I don't value older people in our society as

much as younger people.a. Strongly agreeb. Agree somewhatc. Unsured. Disagree somewhate. Strongly disagree

Death and DyingIn traditional societies most people accepted

death.Most people believed in life after death.The dying were not isolated. Because the dying had experience giving

emotional support to other dying people, they accepted death as part of life.

EuthanasiaInvolves a doctor prescribing or

administering medication or treatment that intended to end a terminally ill patient’s life.

Public opinion polls show about 2/3 of Americans favor physician-assisted euthanasia.

EuthanasiaBetween 33% and 60% of American doctors

say they would be willing to perform euthanasia if it were legal.

Nearly 30% of American doctors have received a euthanasia request, but only 6% say they complied.

The Business of DyingFunerals were a $20-billion-a-year industry in

1999.The average undertaker’s bill in the late

1990s was $4,700. Adding expenses such as flowers and

cemetery charges, the average funeral and burial bill grew to $7,800.

Why Are Funerals Expensive?1. Big corporations have supplanted small

family operations in the funeral industry.• Concentration of ownership lowers

competition and results in higher prices.

2. People are vulnerable when their loved ones die, and much of the funeral industry takes advantage of their vulnerability.

1. Life expectancy is:a. the average age at death of the members of

a populationb. the maximum human life spanc. the maximum average human life spand. the mortality rate

Answer: aLife expectancy is the average age at death

of the members of a population.

2. When sociologists measure the health of a population, they typically examine:

a. rates of illnessb. rates of deathc. rates of physical fitnessd. a. and b. only

Answer: d When sociologists measure the health of a

population, they typically examine rates of illness and rates of death.

3. The effect of social forces on life expectancy is given by:

a. the maximum human life spanb. the average age at death of the members of

a populationc. the difference between the maximum

average human life span and life expectancyd. all of the above

Answer: c The effect of social forces on life

expectancy is given by the difference between the maximum average human life span and life expectancy.

4. Which of the following is not a source of gender inequality in health status in the U.S.?

a. gender bias in medical researchb. gender bias in medical treatmentc. women’s greater lifetime risk of functional

disability and chronic illness due to the fact that women live longer than men

d. all of these are a source of gender inequality in health status in the U.S.

Answer: d All of the following are a source of gender

inequality in health status in the U.S.: gender bias in medical research gender bias in medical treatment women’s greater lifetime risk of functional

disability and chronic illness due to the fact that women live longer than men

5. Poor people in the U.S. are less healthy than rich people because they are more likely:

a. to do physical labor in which accidents are common

b. to be exposed to violencec. to be exposed to environmental hazardsd. all of these choices

Answer: d Poor people in the U.S. are less healthy

than rich people because they are more likely to do physical labor in which accidents are common, to be exposed to violence and to be exposed to environmental hazards.

6. The leading cause of death in sub-Saharan Africa is:

a. AIDSb. SARSc. cancerd. heart disease

Answer: aThe leading cause of death in sub-Saharan

Africa is AIDS.

7. The main supporters of the current United States health-care system are:

a. the stockholders of private health-insurance companies

b. physicians and other health professionalsc. a majority of Americans, according to recent

surveysd. a. and b. only

Answer: dThe main supporters of the current United States

health-care system are the stockholders of private health-insurance companies and physicians and other health professionals.

8. Ablism involves:a. curing disabilities to the extent possible

through medical and technological intervention

b. prejudice and discrimination against disabled people

c. the largely unintended neglect of the conditions of disabled people

d. b. and c. only

Answer: d Ablism involves prejudice and

discrimination against disabled people and the largely unintended neglect of the conditions of disabled people.

9. Disabled people are incapable of performing within the range of "normal" human activity.

a. Trueb. False

Answer: aDisabled people are incapable of

performing within the range of "normal" human activity.

9. Which of the following theories explains age stratification in terms of competition for power and wealth between age cohorts?

a. functionalist theoryb. conflict theoryc. symbolic interactionismd. essentialist theorye. postmodern theory

Answer: bConflict theory explains age stratification in

terms of competition for power and wealth between age cohorts.

10.Economic inequality between elderly women and men is largely the result of:

a. women’s lower earning power when they are young

b. social isolationc. general physiological declined. all of these choices

Answer: a Economic inequality between elderly

women and men is largely the result of women’s lower earning power when they are young.

11. Which of the following theories explains age stratification in terms of the distinct functions that industrialization created for different age cohorts?

a. functionalist theoryb. conflict theoryc. symbolic interactionismd. essentialist theory

Answer: aFunctionalist theory explains age

stratification in terms of the distinct functions that industrialization created for different age cohorts.