1. Chapter 20 Health Care

2. Chapter Outline The Structure of Health Care in the U.S. Theoretical Perspectives on Health Care Health and Sickness in America: A Picture of Diversity Attitudes Toward Health and Illness The Health Care Crisis in America Death and Dying

3. Theoretical Perspectives on Health Care Functionalists: health care system has positive and negative functions in society. Conflict theory: health care reflects the inequalities in society. Symbolic interactions and the role of perceptions: illness, wellness, and health care are socially constructed.

4. Perspectives on the Sociology of Health: Fundamentalist Theory Central PointThe health care system has both positive and negative functions Fundamental Problem Uncovered The health care system produces some negative functions Policy ImplicationsPolicy should decrease negative functions of health care system for minority groups, the poor, and women

5. Perspectives on the Sociology of Health: Conflict Theory Central PointHealth care reflects the inequalities in society Fundamental Problem Uncovered Excessive bureaucratization of the health care system and privatization lead to excess cost Policy ImplicationsPolicy should improve access to health care for minority racial-ethnic groups, the poor, and women

6. Perspectives on the Sociology of Health: Symbolic Interaction Central PointIllness is partly socially constructed Fundamental Problem Uncovered Patients are patronized and infantilized Policy Implications Doctors, nurses, and other medical personnel should periodically take the sick role of the patient, as an instructional device

7. Social Factors in Illness Race-ethnicity, social class, gender, and age are major factors in disease and health. White women live longest, and Black men the shortest. The mortality rate of Native Americans is one and a half times that of the general population.

8. Social Factors in Illness Hispanics contract tuberculosis at 4x the rate of Whites. The more money one makes, the more healthy one perceives oneself to be. The lower one's social class status, the greater are one's chances of tuberculosis, heart disease, cancer, arthritis, and infant mortality.

9. Role of Gender in Illness Older women are more likely to suffer from stress, overweight, hypertension, and chronic illness than older men. There is still a tendency for the male- dominated profession to regard the problems of women as nonmainstream and "special".

10. Social Attitudes and Stigma and Illness If one has an illness that he or she might have done more to prevent, than that person is blamed for the illness. A person who is HIV positive, is partly blamed, heavily stigmatized and treated as a social outcast. Stigmatization also is a factor for those with chronic fatigue syndrome.

11. Health Care Crisis in America Modern medicine in America is a highly structured, high-status profession. High costs, malpractice suits and abuse of the fee for service system have resulted in a health care crisis. Programs for large HMO's and national universal health insurance have met defeat in Congress.

12. The Right to Die Two guidelines: 1. The physician must explain the options available to sustain life to the patient or close family members who have the right to refuse “heroic” treatment. 2. The physician may honor the living will of the patient.