Chapter 20 Health and Medicine

Chapter Outline Health and Medicine in Global Perspective Issues of Healthcare in the United States Medicine and Technology

Health and Medicine in Global Perspective Health care is distinct from health. Health care refers to medical services Health is the state of being of one individual or an entire society. Social scientists use the following to measure the health of an entire society: Infant mortality rates Maternal death rates Life expectancy

Health and Medicine in Global Perspective The health of a society is also measured through access to health care. The following criteria are used to compare nations from a global viewpoint: Access to medical care Quality of medical care Doctor-to-patient ratios

The Importance of Water Supply Contaminated water is the leading cause of infant death throughout the world. Creating a safe water supply is one of the most important ways to improve global health. Safe water is creating by: Separating human from animal waste Removing sewage from irrigation channels

Issues of Health Care in the United States In September 2009, President Obama set forth an argument for health care as a right. The social justice argument for health care reform in the United States is based on comparisons between the U.S. and other industrialized nations. To date, there is no single system that other nations have adopted for delivering universal health care.

Medicine and Technological Change Throughout history, limitations on food production, together with lack of medical knowledge, have placed limits on the size of populations. In England, the bubonic plague, known as the Black Death, was responsible for a drastic drop in the population in 1348 and for the lack of population growth in the 17th century. In 1625 35,417 residents of London died of the plague.

Long-Term Population Trends in England and Wales, 1000–1800

Medicine and Technological Change During the 19th century, scientific research resulted in the discovery of the causes of many diseases. They learned about hygiene, sterilization, and other principles of public health, especially the need to separate drinking water from waste water. Rates of infant mortality decreased dramatically, births began to outnumber deaths, and life expectancy increased.

Infant Mortality Rates for Selected Countries

Hospital: From Poorhouse to Healing Institution The first hospitals were religious centers for the care of the sick and the poor. During the Renaissance, hospitals became public facilities. When the nonmedical tasks of hospitals disappeared, the hospital became an institution for medical care and research.

Early Hospitals This painting by Jan Beerblock (1739–1806) depicts the sick wards in Sint-Janshospital in Bruges, Belgium, a bleak forerunner of modern hospital organization.

Medicine and Social Change The development of medical technologies, together with the practice of requiring patients to pay for hospital services, has led to a crisis in American medical care. The high cost of medical care has become a major public issue. Over 40% of Americans have inadequate medical insurance, or none at all.

Social Epidemiology Epidemiology is the study of how diseases originate and spread in human populations and how societies can develop better public health systems. Social epidemiology looks for the fundamental causes of health problems in basic social conditions that are often the precursors of health problems.

Transmission Categories of Adults and Adolescents With HIV/AIDS

Sex of Adults and Adolescents With HIV/AIDS Diagnosed During 2007

Diseases related to Water, Sanitation and Hygiene

Race, Income, and Obesity

Cardiovascular Diseases Death Rates, by Cause of Death, United States, (per 100,000 population) Year Tuberculosis Cancer Cardiovascular Diseases 1900 194.4 64 345.2 1910 153.8 76.2 371.9 1920 113.1 83.4 364.9 1930 71.1 97.4 414.4 1940 45.9 120.3 485.7 1950 22.5 139.8 510.8 1960 6.1 149.2 521.8

Cardiovascular Diseases Death Rates, by Cause of Death, United States, (per 100,000 population) Year Tuberculosis Cancer Cardiovascular Diseases 1970 2.6 162.8 496 1980 0.9 183.9 436.4 1990 0.7 203.2 368.3 2000 0.3 200.5 340.4 2001 194.4 323.9 2002 193.8 318.3

Death Rates, by Cause of Death, United States, (per 100,000 population) Year Influenza and Pneumonia Motor Vehicle Accidents 1900 202.0 NA 1910 155.9 1.8 1920 207.3 10.3 1930 102.5 26.7 1940 70.3 26.2 1950 31.3 23.1 1960 37.3 21.3

Death Rates, by Cause of Death, United States, (per 100,000 population) Year Influenza and Pneumonia Motor Vehicle Accidents 1970 30.9 26.9 1980 24.1 23.5 1990 32 18.8 2000 24.3 15.2 2001 21.8 15.4 2002 22.9 15.5

Quick Quiz

1. Doctors and medical technology began increasing the life span markedly about three centuries ago. have always done more good than harm in promoting health and well-being. only started to become extremely relevant in curing sick people and extending the life in the 20th century. were far more important than public health measures in improving the health status of our society during the 19th century.

Answer: c Doctors and medical technology only started to become extremely relevant in curing sick people and extending the life in the 20th century.

2. People from which categories are currently at greatest risk of HIV infection? Latinos, homosexuals, men whites, homosexuals, women African Americans, homosexuals, men All categories are at equal risk.

Answer: c The categories currently at greatest risk of HIV infection are: African Americans, homosexuals, and men.