Culture and Health  Culture-bound syndrome: Disease or illness that cannot be understood apart from its specific social context  Anorexia nervosa  Medical practitioners are being trained to recognize cultural beliefs related to medicine

Sociological Perspectives on Health and Illness  Health: “State of complete physical, mental, and social well-being, and not merely the absence of disease and infirmity” (Leavell and Clark)  Health and illness are socially constructed  Can be considered by how it varies in different situations or cultures

Functionalist Perspective  “Being sick” must be controlled so not too many people released from societal responsibilities  Sick role: Societal expectations about attitudes and behavior of a person viewed as being ill  Physicians function as “gatekeepers” for the sick role

Conflict Perspective  Medicalization of society: Growing role of medicine as major institution of social control  Greatly expanded domain of expertise  Problems viewed using a medical model  Retains jurisdiction over health care

Conflict Perspective  Inequities in Health Care  Obvious inequities exist in health care  Brain drain: Immigration to U.S. and other industrialized nation of skilled workers, professionals, and technicians  Dramatic differences in infant morality rate: Number of deaths of infants under one year old per 1,000 live births in given year

Interactionist Perspective  Examine roles played by health care professionals and patients  Asserts patients may play an active role in positive or negative health

Labeling Approach  The designations healthy and ill generally involve social definition  Homosexuality noteworthy medical example of labeling  Can view variety of life experiences as illnesses or not

Table 15-1: Sociological Perspectives on Health and Illness

Social Epidemiology and Health  Social epidemiology: Study of distribution of disease, impairment, and general health status across a population  Incidence: Number of new cases of a specific disorder occurring within a given population during a stated period of time, usually a year

Social Epidemiology and Health  Prevalence: Number of cases of specific disorder that exist at a given time  Morbidity rates: Disease incidence figures presented as rates or number of reports per 100,000 people  Mortality rate: Incidence of death in a given population

Social Class  People in lower classes have higher rates of mortality and disability  Appear to be cumulative  Less able to afford quality medical care  Conflict theorists: capitalist societies care more about maximizing profits than they do about the health and safety of industrial workers

Race and Ethnicity  Health profiles of racial and ethnic groups reflect social inequality in U.S.  Poor economic and environmental conditions manifested in high morbidity and mortality rates  African Americans have higher infant mortality rates when compared to whites  Mexican Americans may use curanderismo: form of holistic health care and healing

Gender  Women experience higher prevalence of many illnesses but tend to live longer  Lower rate of cigarette smoking  Lower alcohol consumption  Lower rate of employment in dangerous occupations  Women more likely to seek treatment

Age  Most older people in U.S. have at least one chronic illness  Older people vulnerable to certain types of mental health problems  Older people use more health services than younger people

Health Care in the United States  Health care costs have skyrocketed  In 2000, amount spent on health care equaled that spent on education, defense, prisons, farm subsidies, food stamps, and foreign aid

Physicians, Nurses, and Patients  Physicians have position of dominance with patients and nurses  Leads to dehumanizing physician-patient encounters  Publicity about malpractice suits and high medical costs further strained relationship  Controlled interactions with nurses  Increasingly, patients turning to media for health care information

Alternatives to Traditional Health Care  At least one of three adults in U.S. attempts to maintain good health or respond to illness through alternative health care techniques  Holistic medicine: Therapies in which the health care practitioner considers person’s physical, mental, emotional, and spiritual characteristics

The Role of Government  In 1946 Hill-Burton Act: first subsidies for building and improving hospitals  1965: Medicare and Medicaid established  Programs greatly expanded federal involvement in health care financing  1983: Government instituted cost-control program  2010: Affordable Care Act offered health insurance coverage for people of all ages

Sociological Perspectives on the Environment  Environment people live in has noticeable effect on their health  Increases in population, together with economic development, have serious environmental consequences

Effects of Growth and Development  Human ecology: Interrelationships between people and their spatial settings and physical environments  Stresses trade-offs inherent in every decision that alters the environment

Conflict Perspective of the Environment  Growing share of human and natural resources of developing countries redistributed to core industrialized nations  Industrialized nations of North America and Europe account for 12% of population but responsible for 60% of worldwide consumption  Snailberg: “treadmill of production”

Ecological Modernization  Ecological modernization: focus on alignment of environmentally favorable practices with economic self-interest through constant adaptation and restructuring  Macro level: reintegrating industrial waste back into the production process  Micro level: reshaping individual lifestyles

Environmental Justice  Environmental justice: legal strategy based on claims that racial minorities are subjected disproportionately to environmental hazards  Poor people and people of color more likely to be victimized by everyday consequences of built environment

Environmental Issues  Three broad areas of concern  Air pollution  Water pollution  Global Warming

The Impact of Globalization  Globalization can be good and bad  Industrialization increased pollution  Allows multinationals to reap resources of developing countries for short-term profit  Multinational corporations have incentive to carefully consider cost of natural resources  Environmental refugees: people who have been displaced by rising seas, destructive storms, expanding deserts, water shortages, and high levels of toxic pollutants

Environmentalism  1970: 25 million people turned out to observe first Earth Day  Citizens marched on behalf of specific environmental causes  Congress established the EPA  The Clean Air, Clean Water, and Endangered Species acts followed

Environmentalism  Looking at the Issue  Earth Day now on calendars of city councils, zoos, and museums worldwide  Increasingly, efforts to publicize concerns moving to Internet  General public has mixed reaction to environmental issues  Question the scientific arguments behind theory of global warming

Environmentalism  Applying Sociology  Troubled that most powerful environmental organizations predominantly white, male- dominated, and affluent  Conflict perspective:  Disproportionate exposure of the poor and minorities to environmental pollutants can act as disincentive for others to take action  Many environmental movements do not include the poor and minorities