Sociology lecture 2
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This document discusses the sociological perspectives on health and disease. It covers several key topics, including the medical model of disease which focuses only on biological factors, the myths that more medical care is always better and can cure every disease, and the increasing lifespan in developed nations due more to public health than medicine. It also examines the study of illness, mortality, help-seeking behaviors, treatment utilization, doctor-patient relationships, alternative medicine, and the organization of medical care. The document provides sociological insights into how health, disease, and medical care are influenced by social as well as biological factors.
Sociology lecture 2
- 1. Stephen Hansell, Ph.D. Department of Sociology Institute for Health Research http://sakai.rutgers.edu shansell@rci.rutgers.edu 609-203-2830
- 2. 210 Class 2 – Topics in Medical
- 3. I. Medical model of disease A. Looks only at biological aspects of disease 1. Tremendous advances in last 100 years (artificial organs) (40% of the people that go to doctors do not get the right treatment. it maybe psychological, cultural etc) 2. Used by most health professionals 3. But ignores social aspects of disease a. Example: offset problem
- 4. II. Myth that more medical care is always better A. Example: Iatrogenic disease (disease caused by the treatment) (15% of the ppl get a bacterial infection in the hospital, mostly MRSA) B. majority of medical treatments have never been scientifically tested - fact eg. hormone replacement therapy to reduce the symptoms of menopause and ppl thought that it prevented heart disease but it infact increased the chances of heart disease and the chances of cancer
- 5. III. Myth that medical care can cure every disease A. Self limiting diseases (come and go by themselves and the best medicine cannot cure eg common cold) (flu epidemic killed the most people (20 mil) in reported history- we do not know if the virus changed or if the humans adapted or did it kill all the vulnerable people) 1. Diseases that go away by themselves 2. Diseases that modern medicine cannot cure
- 6. IV. Huge increase in average lifespan in the US A. Lifespan increased from age 40 to 77 in 20th century 1. Not due to advances in medical science (best one Asprin, but did not keep more people alive) (advances in clean water, and best one clean food, the invention of refrigeration) clean air 2. Mostly due to advances in nutrition and public health (the big increase is the decrease in infant mortality)
- 7. V. Great success in reducing acute infectious diseases A. Effective vaccines available for many infectious diseases (mumps, measels, chicken pox, polio, small pox and treatments for malaria and tb) (vaccinations for chicken pox is not as good) B. But new infectious diseases are appearing as fast as the old ones disappear
- 8. VI. Little progress in reducing "diseases of civilization“ A. Chronic diseases (disease for the rest of ur life) such as heart disease, cancer relatively high in the US, stroke, diabetes, blocked arteries B. Other killers - obesity, smoking, drinking, stress, lifestyle, environmental pollution, B. Caused mostly by unhealthy lifestyle C. Caused in part by environmental pollution D. Caused a little bit by genetics
- 9. VII. Study of morbidity (illness) A. Epidemiology 1. The distribution of health and illness in a population 2. Illness is not evenly distributed in the population B. Etiology 1. What causes illness (an etiologist studies what causes the disease)
- 10. C. Gender example: women report more illness than men 1. Theories: (women are sicker then men) a. Women more likely to notice minor problems b. Women more willing to report health problems (men have the macho factor) c. If you control for reproductive problems, there would be no sex difference d. Women really are sicker
- 11. VIII. Study of mortality (death) A. Death is not evenly distributed in the population B. Example: women live longer than men (by about 10 years) C. Theories: a. Genetic b. Women lead less stressful lives c. Women seek medical treatment for minor problems before they become life threatening
- 12. IX. Study of patient help seeking A. How people: 1. Perceive a health problem 2. Define a problem 3. Decide to seek help 4. Decide what kind of help to get (bar tenders are therapists)
- 13. X. Study of utilization of treatment services A. Medical treatment does not always go to those who need it most 1. Example: small area variations in surgery in Vermont (only 8 hospitals in all of Vermont) (some areas of vermont have a lot more hospital beds per person than other areas) B. Fads in medical treatment 1. Example: tonsillectomies (vary between 13 and 151 /10,000 ppl in different hospitals)
- 14. XI. Doctor-patient relationships A. Good communication between doctors and patients is crucial to effective diagnosis and treatment B. But good communication takes time and costs $$ (doctors listen on an avg of 1.8 mins)
- 15. XII. Traditional medical treatment vs. alternative healers A. Alternative healers are increasingly popular (cz they are cheaper and are more pleasant and more satisfying) B. A short list: 1. Self-help groups 2. Chiropractic medicine (ease neck, back and shoulder pain... mostly massage) 3. Dietary and exercise groups (Weight Watchers) 4. Religious groups and faith healers
- 16. XIII. Organization of medical care A. Complex, changing fast B. Alphabet soup of treatment options: 1. HMO (health maintenance organization) 2. PPO (preferred provider organization) 3. IPO (individual provider organization) C. Managed Care
- 17. Stephen Hansell, Ph.D. Department of Sociology Institute for Health Research http://sakai.rutgers.edu shansell@rci.rutgers.edu 609-203-2830