Health Care
Chapter
19: Sociology, Schaefer, 1995-2012
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Health
vs. Health Care Delivery
Organized
in all societies (International Health Care Comparison, 2013)
Social/Cultural
basis
- Who
is sick?
- What
to do about it?
- Defining Disease-Cultural factors (Anorexia)
- Medicalization
of Society
- Endemic vs. Epidemic (The
Guinea worm)
- Epidemiology (transmission of
disease and modern society, impact of spread)
- Acute vs. Chronic Illness
- Causes: Germs, Lifestyle, Social
Conditions
- SES
- Gender
- Age
- Race
- Technology
Physical-Mental
Health
Health
Industry
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Doctors-Hospitals-Insurance
Professionalization of Medicine
- Shaman
- Greeks: 4 humors (blood, bile,
water, air)
- Role of the clergy as practitioners
- Physician as menace
- Renaissance (1400's)==>science
- New technology: microscope...germs
- Hospitals and specialized care
- Hand washing (Ignaz
Semmelweis (Hungarian physician) advocated hand washing to prevent spread
of infections in the 1850s. His work was ignored until the 1890s.)
- Pasteur and Bacteria (1850's)
- Doctors as germ seekers/fighters
(or?)
- AMA: 1847
- Control
of medical education (see also)
- Pharmacological
revolutions
- Doctors and hospitals-post WWII:
Insurance (see also)
- Now-deprofessionalization?
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Sickness-Disease-Illness
Sick Role (What you are): Functionalism
- Deviance, but the individual is not held personally responsible.
- Relieved of social responsibilities
- Desire to get well
- Seek competent medical help
Doctors
as "gatekeepers" for the "sick role": insure order, doctor
as "parent."
Focus
on acute vs. chronic illness
Other
elements of the Functionalist perspective
- Freedom to choose
- Profit-competition-advances
- Self-correcting: emergence of
HMO's, Medicare, Medicaid, Prescription drug plans, "Independent Living
Centers."
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Disease: What you have (Conflict:
Interest Groups)
- Focus of the doctor as a scientist
is on the objective reality of the disease
- Look for Signs and Symptoms
- Objective versus the subjective
concerns of the patient
- Treat the disease vs. the person
- Expert knowledge
- Alienation (for patient)
Other Elements of the Conflict Perspective
- Health and Health Care as resource
- In the early 1900s the Carnegie
Corporation did an analysis of medical schools to determine which of them
should receive funding. Their analysis led to:
- the closing of three-quarters
of the black medical schools in the country
- the closing of most of
the alternative medical schools that accepted female students
- the creation of tough
state licensing laws that made it impossible for midwives to deliver
babies
- Fee-for-Service:
- Power to Heal = Power to exploit:
Dependency
- Responsibility for health-
Professional vs. Individual
- Brain-Drain: lack of health care
providers in developing nations
- Industry-Technology-Competition
- Heroic Methods
- Miracle Cures vs public
health
- Intervention vs. prevention
- Duplication, Consolidation,
and Costs
- Artificial Scarcity
- Medicalization
of Society (see also)
- Medicine as an institution
of social control
- Deviance: pharmacological
solutions
- Normalcy
- EDL: Medical Model--restricts
access to discussion and decision-making
- Growth of institutions (12.5% of GDP in 1990--17.8% in 2015) and restrictions on who can provide care
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Illness: How you feel (Interactionism:
Symbols and Meaning)
Other Elements of the Interactionist
Perspective
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Labeling Theory
- Designating as Sick: Social Impact
- Stigma
- Social consequences
- Self-identity (AIDS)
- Life experiences as illness:
ADD, Sluggish Cognitive Tempo, Chronic Fatigue Syndrome, homosexuality (APA dropped in 1974)
Mental
Illness (Medical vs Social Models)
Disability: social roles and definitions
- Blindness: The Making of Blind
Men (Robert Scott)
- Outsiders in a Hearing World (Paul Higgins)
- Physical disability and access
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Change:
- Government intervention: National
Health Care-Affordable Care Act
- Costs (DRGs and Dumping)
- Alternative Medicine
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URL: http://www.umsl.edu/~keelr/010/health.html
Owner: Robert O. Keel rok@umsl.edu
References and
Credits for this Page of Notes
Last Updated:
Monday, April 23, 2018 10:24 AM