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Medical Sociology - Exam 1
Terms in this set (62)
Social Determinants of Heath
...Refers to social practices and conditions (lifestyles, living and work situations), class position, stressful circumstances, poverty, and discrimination, along with economic/political/religious factors that affect the health of individuals positively or negatively
Development of Medical Sociology
Early on was studied by Physicians, not sociologists
Not until after WW2 when gov. funding entered the field
Landmark study in 1958 Social Class and Mental Illness, showed evidence that social factors correlate to mental disorders and the manner in which people received care. Helped form the establishment of community Mental Health Centers.
Talcott Parson: The Social System (Sick Role)
Described patterns of set of expectations defining the norms and values appropriate to being sick for the person and as well as those the person interacts with.
First to discuss the controlling function of medicine in a large social system, in the context of classical sociological theory
Important in the emergence of medical soc as an academic field
Practical Application versus Theory
Robert Stratus stated that there was two parts...
Sociology in medicine and sociology of medicine
Sociology of Medicine
Research and analysis primarily motivated by a medical problem
Sociology in Medicine
Research and analysis of the medical health Environment From a Sociological perspective
State of complete physical, mental, and social well-being, and not merely the absence of disease or injury.
Michel Foucalt (1973) Two distinct trends in medicine
Medicine of the species and Medicine of social spaces
Medicine of the species
Defined as strong emphasis in Western Europe on Classifying diseases, diagnosing and treating patients, and finding cures.
Set up clinics and the study of the body
Medicine of social spaces
How to prevent disease.
Required more gov. involvement in regulating daily life (especially public hygiene)
The Germ Theory of Disease and the Search for "Magic Bullets"
Magic bullets being the point for the research of antibiotics to be shot into the body
responsible for first antibiotic - penicillin
Return to the "Whole Person"
Whole person being physicians having to focus on things beyond a singular disease or germ, focus on problems in living
Factors stemming beyond a biological matter.
The Reemergence of Infectious Diseases (term for reemerging infectious diseases)
We are now in the third era of epidemiological transition, and once previous controlled diseases are now re-emerging
Factors to change in Infectious Diseases
Globalization, urbanization, and global warming
Worlds leading infectious disease amplifier
Multiple partner sexual intercourse
Ethical/unethical decisions in medicine can have profound social implications and may reflect discrimination or injustice/prejudice against a socioeconomic group.
Health Insurance Portability and Accountability Act (HIPAA)
Regulates handling of patient data and privacy, concerns still exist
the branch of medicine which deals with the incidence, distribution, and possible control of diseases and other factors relating to health.
Development of Epidemiology - Recognition from the germ theory
1. Biological agents: bacteria, viruses, or insects
2. Nutritional agents: fats, carbs, as producers of cholesterol
3. Chemical agents: gasses and toxic chemicals that pollute the environment
4. Physical Agents: climate/vegetation
Social Agents: occupation, social class and class based lifestyles
US Poor face barriers in life
Typically worse health
Are treated within the welfare framework of Medicine
Live in disadvantaged urban and rural places
Socioeconomic Status or social class
is the strongest and most consistent predictor of a person's health and life expectancy across the life regardless to access.
5 models of Social Class
2. Upper middle
3. Lower middle
4. Working class
Socioeconomic Status in the US (SES)
Education (most important in SES)
Richard Wilkinson's "Income equality hypothesis"
Blames degree of inequality among classes within a society for health inequalities. Overall societies wealth is less important
Equality of Care in Britain
After WW2, socialized medicine was introduced
Provided equal care to classes
Only the access to care was equalized
Black Report in 1980 by British gov. determined health inequalities were not decreasing among different social classes despite increased welfare services
The Social Gradient in Mortality
Whitehall studies conducted by Marmot
Showed social class differences in mortality among British male civil gov. employees.
Highest occupational rank had lowest percentage of deaths (vice versa)
Possible reasons for gradient include difference between classes in:
Self-esteem and stress levels
Effects of income inequality
Deprivation through life course
Health lifestyles and social support
Use of preventative health services
5 features of neighborhoods that can affect health:
5 features of neighborhoods that can affect health:
1. Physical environment
2. Surroundings at work, home, and play
3. Services provided to support people
4. Sociocultural aspects of the neighborhood
5. Reputation of an area
SES as a Fundamental Cause of Sickness and Mortality
1. Influences multiple diseases
2. Affects these diseases through multiple pathways of risk
3. Reproduced over time
4. Involves access to resources that can be used to avoid risks or minimize the consequences of disease it occurs
A heightened mind-body reaction to a stimuli fear or anxiety in the individual
Starts with a situation people find threating or burdensome
Assumes that behavior is self-directed on the basis of common understanding symbolized by language that is shared, communicated, and manipulated by interacting human beings in social situations
The same crisis will not produce the same effect uniformly in all people
Outcome of a situation depends on an individuals definition of that situation and how they come to terms with it.
Symbolic Interaction Cooley
"Looking glass self" has three basic components
1. We see ourselves in our imagination as we think to appear to others
2. We see in our imagination in the other persons judgement of oneself
3. Our imagination about how we are viewed by the other person, we experience some sort of feeling.
Goffman (life as theatre)
Information is communicated in social interactions through:
A persons appearance
A persons experience with other similar induvial
A persons owns words and actions (impression MGMT)
Study called Suicide illustrated how society reacts to stressful situations where people are forced to respond to conditions not of their choosing.
Result of stress brought from separation of a strongly integrated induvial from his or her group
Sudden changes induce a chronic lack of regulation and lead to a state of restlessness in which norms no longer bind one to society
People feel themselves so strongly integrated into a demanding society that their only escape seems to be suicide.
Linked increased incidence of disease in the US and several Western European countries to downturns in the economy
Recessions represent periods where obtaining the basic necessities of life and self satisfaction are more difficult and stressful
Disruption of usual lifestyle causes mental illness in vulnerable people
Exposes people with mental illness by reducing the resources they need to cope.
Physiological Responses to Stress
Physiological changes in the body, as a result to stressful situations effects the autonomic and neuroendocrine systems.
General Adaption Syndrome (Selye 1956)
After an initial alarm reaction, a second stage of resistance to prolonged stress was initiated
If stress continued and pituitary and adrenal defenses were consumed, a person enters the 3rd stage.
This stage is premature aging due to wear and tear on the body
Mechanic identities adaptability as the key variable in whether a person will eventually suffer organic damage.
Adaption to these circumstances is based on
an individuals perception of life situations, combined with his or her degree of preparation by society to cope.
Lenoard Pearlin (1989) identified 2 major social stressors
Personal belief that allows one to view the world with confidence, faith in the predictability of events, and a notion that things will most likely work out reasonably well.
Research shows the harmful impact of the accumulation of several events in a person's life.
Further research needed to determine...
1. Whether any event (pleasant or un) induces stress or if only unpleasant ones do
2. Whether the rate of change or desirability of change has a greater impact
Significance of the degree of impact on individual lives and the area of life impacted by change
Social Readjustment Rating Scale (Holmes and Rahe)
Total value of life change units mounts, probabilities of a serious illness increase.
Doesn't distinguish between stressful events and stressful situations leading to events
Fails to account for intervening variables such as social support or mastery of an event.
Actively undertaken by a person who feels ill for the purpose of defining that illness and seeking relief from it. Blame for a reason of why a normal behavior is altered.
Actively undertaken by individuals for the purpose of maintaining or enhancing their health, preventing health problems, or achieving a positive body image.
Collective patterns of health related behaviors based on choices from options available to people according to their life chances
First half of the 20th century
Dominant approach to health was mass vaccination and then extensive use of antibiotics to combat infection.
Post Medical ERA
Physical well-being is threatened by social and environmental factors that cannot be directly improved by medicine.
Class related set of durable dispositions at act in a particular ways
Serves as a set of perceptions that routinely guides and evaluates a person's set choices and options.
People of a particular social class tend to share similar lifestyles because they typically have a similar upbringing and experiences in life.
Members of the same social class share similar lifestyles
Lifestyle reflects what available in a social class
What you're familiar with in your social class that reflects your lifestyle choices
Activity undertaken by a person who feels ill for the purpose of defining that illness and seeking relief from it
Factors promoting self care...
1. Shift in disease patterns from acute to chronic illnesses and accompanying need for care
2. Dissatisfaction with professional medical care that is depersonalized
3. Recognition of the limits of modern medicine
4. Increasing awareness of alternative healing processes
5. Heightened consciousness of the effects of lifestyles on health
A desire to be in control of one's health when feasible
High seeking behavior often involves interaction between several variables acting in combination to influence specific outcomes in specific social situations even though research tends to focus on once variable at a time
Age and Gender
Use of health services greatest among the elderly
Women more likely to visit doctors than men
Influence on physician utilization appears limited to providing a cultural context for decision making within social networks
People belonging to close and exclusive groups are either:
More likely to seek care if it is consistent with cultural beliefs/practices and vice versa
Ethnicity and Health Insurance Coverage
Recent health reforms will change health insurance coverage rates
The uninsured are mostly the working poor
Employers do not provide insurance
Earn to much to qualify for Medicaid
Cannot afford private insurance
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