Chapter 14 Health, Medicine, Disability and Aging
Chapter Outline • Health and Medicine • Defining and Measuring Health • Health and Politics: The United States in Comparative Perspective • Disability • Aging • Theories of Age Stratification • Social Problems of Elderly people
The Black Death • In 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.
Sociological Issues of Health, Medicine, and Disability • Health risks are always unevenly distributed. • Health problems change over time. • Medical professions have gained substantial control over health issues and promoted their own approach to well-being.
Life Expectancy • Maximum average human life span - average age of death for an entire population under ideal conditions. • Life expectancy - average number of years a person can actually expect to live.
Social Causes of Illness and Death • Human-environmental factors - Cancer causing pollutants in the air and water. • Lifestyle factors - cigarettes, alcohol, drugs, diet, social isolation • Public health and health-care systems - access to clean water, basic sewage, immunizations
Reasons for Health Inequity • The poor are more likely to be exposed to violence, high-risk behavior and environmental hazards. • The poor cannot afford adequate health care.
Polling Question • Do you currently smoke cigarettes? • Yes • No
Gender Inequalities in Health Care • More research has focused on “men’s diseases” (cardiac arrest) than on “women’s diseases” (breast cancer). • Women undergo fewer kidney transplants, various cardiac procedures, and other treatments than men.
Gender Inequalities in Health Care • Women live longer than men and experience greater lifetime risk of functional disability and chronic illness and have a greater need for long-term care. • There are 40% more poor women than poor men in the United States.
Problems with HMOs • Some HMO’s avoid covering sick people and people who are likely to get sick to keep costs down. • Minimize the cost of treating sick people they can’t avoid covering. • Inflate diagnoses to maximize reimbursements. • Keep overhead charges high.
Recent Challenges to Traditional Medical Science • Patient Activism • Alternative Medicine - chiropractic therapy, acupuncture, massage therapy, and various relaxation techniques • Holistic Medicine - emphasizes disease prevention
Social Construction of Disability • 400 years ago - Catholic Church declared left-handed people servants of the Devil and burned them at the stake. • 19th century - Western scientists and reformers sought rehabilitation of the disabled.
Social Construction of Disability • 1933 - Nazis engineered the sterilization and killing of the mentally “deficient” and the physically “deviant,” including the blind and the deaf. • 1920s to 1970s - In America Native American women were subjected to federally funded forced sterilization.
Ablism • Prejudice 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.
Age Stratification • Sociologists call a category of people born in the same range of years an age cohort. • Age stratification refers to social inequality between age cohorts. • Gerontocracies weresocieties in which elderly men ruled.
Age Stratification: Functionalist Theory • Age 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 Theory • Age 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 Interactionist • Focus 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.
Polling Question • The government should pay for all prescription medication for the elderly in our society. • Strongly agree • Agree somewhat • Unsure • Disagree somewhat • Strongly disagree
A Shortage of Caregivers • In 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.
A Shortage of Caregivers • Workers are hard to find and hard to keep: • The work is difficult and pays little. • Government requires 2 weeks of preemployment training for direct-care aides but Congress’s 1996 welfare reform discourages such training for former welfare recipients.
Ageism • Ageism is prejudice and discrimination based on age. • Examples: • Elderly men are stereotyped as “grumpy” and elderly women as “haggard”.
Euthanasia • Involves 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.
Euthanasia • Between 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.
Elderly and Poverty • Among the elderly, poverty is most common for: • those 85 and older • Women • African Americans • people living alone • people living in rural areas.
1. Life expectancy is: • the average age at death of the members of a population • the maximum human life span • the maximum average human life span • the mortality rate • the fertility rate
Answer: a • Life expectancy is the average age at death of the members of a population.
2. Which of the following is not a major social cause of illness and death? • human-environmental factors • lifestyle factors • factors related to the public health system • factors related to the health care system • none of these choices (that is, all the factors listed above are major social causes of illness and death)
Answer : e • All the factors listed below are major social causes of illness and death: • human-environmental factors • lifestyle factors • factors related to the public health system • factors related to the health care system