Health, Medicine, Disability, and Aging: Understanding the Impact on Society

1. Chapter 13 Health, Medicine, Disability and Aging

2. Chapter Outline • Health • Medicine • Disability • Aging • Death and Dying

3. The Black Death • In 1346, rumors reached Europe of a plague sweeping the East. • The epidemic spread along trade routes to China and Russia. • Within 2 years, the Black Death, killed 1/3 of Europe’s population. • The plague still ranks as the most devastating catastrophe in human history.

4. Life Expectancy • The average age at death of the members of a population. • Life expectancy in the United States was 47 years in 1900. In 2009, it was 78 years. • The maximum average human life span is the average age of death for a population under ideal conditions. • It is currently about 85 years.

5. Leading Causes of Death • INSERT TABLE 13.1 HERE (PG. 309)

6. Polling Question • Do you currently smoke cigarettes? • Yes • No

7. Life Expectancy, Selected Countries • INSERT FIGURE 13.1 HERE (PG. 310)

8. Social Causes of Illness and Death • Human-environmental factors - Cancer causing pollutants in the air and water. • Lifestyle factors - cigarettes, alcohol, drugs, diet, social isolation • Public health and health-care systems - access to clean water, basic sewage, immunizations

9. Public Health System • The public health system is composed of government run programs that ensure access to clean drinking water, basic sewage and sanitation services, and inoculation against infectious diseases. • The health-care system is composed of a nation’s clinics, hospitals, and other facilities for ensuring health and treating illness.

10. Global Inequities • AIDS is the leading cause of death in the poverty-stricken sub-Saharan Africa • Global inequality influences people’s exposure to different health risks

11. People with HIV/AIDS, 2009 • INSERT FIGURE 13.2 HERE (PG. 311)

12. Infant Mortality • The number of deaths before the age of 1 year for every 1000 lives births in a population in 1 year.

13. Health Indicators, Selected Countries, 2009 • INSERT TABLE 13.2 HERE (PG. 312)

14. Reasons for Health Inequity • The poor are more likely to be exposed to violence, high-risk behavior and environmental hazards. • The poor cannot afford adequate health care.

15. Racial and Ethnic Inequalities in Health Care • Racism also affects health • Health status of some African Americans is somewhat lower than European Americans even within the same income category • African Americans at all income levels tend to live in racially segregated neighborhoods with fewer health facilities • Experience of racism induces psychological distress

16. Gender Inequalities in Health Care • Gender bias exists in: • Medical research: More research has focused on “men’s diseases” (cardiac arrest) than “women’s diseases” (breast cancer). • Medial treatment: Women undergo fewer kidney transplants, cardiac procedures, and other treatments.

17. Gender Inequalities in Health Care • Women live longer and thus have greater lifetime risk of disability and chronic illness; yet more is spent on men’s health than women’s health • 40% more poor women than poor men and poverty is related to health

18. Health and Politics: Conflict and Functionalist Perspectives • We spend more on health care than any other country but all other postindustrial societies have healthier populations • A high level of social inequality • Nature of American health care system where some are privileged (wealthy) and others are disadvantaged (poor)

19. 4 Problems with HMOs: Strategies to Pursue Profit • Avoid covering sick people and people who are likely to get sick. • Minimize the cost of treating sick people they can’t avoid covering. • Inflate diagnoses to maximize reimbursements. • Keep overhead charges high.

20. Advantages of Private and For-Profit Health Care • They are so profitable, they can invest large sums of money into research and development, latest diagnostic equipment, higher salaries to attract best medical researchers on planet • Main supporters of current system are the stockholders

21. Medicine • A social institution devoted to prolonging life by fighting disease and promoting health. • Society shapes medical practice every bit as much as it influences health processes.

22. The Professionalization of Medicine • Professionalization, is the process by which people gain control and authority over their occupation and their clients. • It results in professionals enjoying high occupational prestige and income and considerable social and political power

23. The Sick Role • Playing the sick role, according to Talcott Parsons, involves the nondeliberate suspension of routine responsibilities, wanting to be well, seeking competent help, and cooperating with health-care practitioners at all times.

24. Alternative Medicine • The most frequently used types of alternative medicine are chiropractic, acupuncture, massage therapy, and various relaxation techniques. • Alternative medicine is used mostly to treat back problems, chronic headache, arthritis, chronic pain, insomnia, depression, and anxiety.

25. Placebo Effect • The positive influence on healing of strong belief in the effectiveness of a cure. • Research shows that strong belief in the effectiveness of a cure can by itself improve the condition of about a third of people suffering from chronic pain or fatigue.

26. Holistic Medicine • Holistic medicine emphasizes disease prevention. • Holistic practitioners treat disease by taking into account the relationship between mind and body and between the individual and his or her social and physical environment.

27. Social Construction of Disability • Impaired people are considered deficient in physical or mental capacity. • Disabled people are incapable of performing within the range of “normal” human activity.

28. Rehabilitation • Rehabilitation involves: • Curing disabilities to the extent possible through medical and technological intervention. • Trying to improve the lives of the disabled by means of care, training, and education. • Integrating the disabled into “normal” society.

29. Ablism • Prejudice and discrimination against disabled people. • Historical example: Belief among 19th-century Western educators that blind people were incapable of high-level or abstract thought. • Ablism involves the largely unintended neglect of the conditions of disabled people.

30. Challenging Prejudice and Discrimination • Idea of the normality of disability has partly supplanted the rehabilitation ideal • Rather than regarding themselves as deviant, they think of themselves as inhabiting a different but quite normal world

31. Age Stratification • Age stratification refers to social inequality between age cohorts. • The very young are often at the bottom of the stratification system. • Facing poverty and famine, parents sometimes abandoned children. • Many developing countries are overflowing with orphans and street children.

32. Gerontocracy • A gerontocracy is a society ruled by elderly people. • In South Korean corporations when a new manager starts work, everyone in the department who is older than the new manager may resign or be reassigned. • In the United States, median income gradually rises with age, reaching its peak in the 45–54 age cohort.

33. Age Stratification: Functionalist Theory • Age stratification reflects the importance of each age cohort’s contribution to society. • In preindustrial societies, the elderly were important for knowledge and wisdom. • With industrialization, function of the elderly became less important and their status declined.

34. Age Stratification:Conflict Theory • Age stratification stems from competition and conflict. • Young people may participate in a revolutionary overthrow and seize power. • The elderly may organize politically to decrease disadvantages and increase advantages in life.

35. Age Stratification: Symbolic Interactionist • Focus on the meanings people attach to age-based groups and age stratification. • One study examined movies from 1940-1980. • Young people were portrayed as leading active, vital lives. • Elderly women were portrayed as unattractive, unfriendly, and unintelligent.

36. Elderly as % of U.S. Population, 1900–2050

37. Aging and Poverty • The “old old” are most likely to suffer physiological decline, life-threatening diseases, social isolation, and poverty. • Economic inequality between elderly women and men is the result of women’s lower wages when they are young. • The elderly most likely to be poor include the “old old” , women, African Americans and people in rural areas.

38. A Shortage of Caregivers • In 2001, home-care agencies and nursing homes employed 2.1 million caregivers in the United States. • The U.S. Bureau of Labor Statistics expects a 58% rise in demand for such workers between 1998 and 2008.

39. Ageism • Ageism is prejudice and discrimination based on age. • Examples: • Elderly men are stereotyped as “grumpy” and elderly women as “haggard”.

40. Polling Question • I don't value older people in our society as much as younger people. • Strongly agree • Agree somewhat • Unsure • Disagree somewhat • Strongly disagree

41. Death and Dying • In traditional societies most people accepted death. • Most people believed in life after death. • The dying were not isolated. • Because the dying had experience giving emotional support to other dying people, they accepted death as part of life.

42. Euthanasia • Involves a doctor prescribing or administering medication or treatment that intended to end a terminally ill patient’s life. • Public opinion polls show about 2/3 of Americans favor physician-assisted euthanasia.

43. Euthanasia • Between 33% and 60% of American doctors say they would be willing to perform euthanasia if it were legal. • Nearly 30% of American doctors have received a euthanasia request, but only 6% say they complied.

44. The Business of Dying • Funerals were a $20-billion-a-year industry in 1999. • The average undertaker’s bill in the late 1990s was $4,700. • Adding expenses such as flowers and cemetery charges, the average funeral and burial bill grew to $7,800.

45. Why Are Funerals Expensive? • Big corporations have supplanted small family operations in the funeral industry. • Concentration of ownership lowers competition and results in higher prices. • People are vulnerable when their loved ones die, and much of the funeral industry takes advantage of their vulnerability.

46. Quick Quiz

47. 1. Life expectancy is: • the average age at death of the members of a population • the maximum human life span • the maximum average human life span • the mortality rate

48. Answer: a • Life expectancy is the average age at death of the members of a population.

49. 2. When sociologists measure the health of a population, they typically examine: • rates of illness • rates of death • rates of physical fitness • a. and b. only

50. Answer: d • When sociologists measure the health of a population, they typically examine rates of illness and rates of death.