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Health, Medicine, Disability and Aging

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Title: Health, Medicine, Disability and Aging


1
Chapter 14
  • Health, Medicine, Disability and Aging

2
Chapter Outline
  • Health and Medicine
  • Defining and Measuring Health
  • Health and Politics The United States in
    Comparative Perspective
  • Disability
  • Aging
  • Theories of Age Stratification
  • Social Problems of Elderly people

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
    Europes population.
  • The plague still ranks as the most devastating
    catastrophe in human history.

4
Sociological Issues of Health, Medicine, and
Disability
  1. Health risks are always unevenly distributed.
  2. Health problems change over time.
  3. Medical professions have gained substantial
    control over health issues and promoted their own
    approach to well-being.

5
Leading Causes of Death, United States, 1900
Cause of Deaths
1. Pneumonia/influenza 11.8
2. Tuberculosis 11.3
3. Diarrhea/other intestinal 8.3
4. Heart disease 8.0
5. Stroke 6.2
6
Leading Causes of Death, United States, 1900
Cause of Deaths
6. Kidney disease 5.2
7. Accidents 4.2
8.Cancer 3.7
9. Senility 2.9
10. Bronchitis 2.3
7
Leading Causes of Death, United States, 2001
Cause of Deaths
1. Heart disease 28.9
2. Cancer 22.9
3. Stroke 6.8
4. Chronic lung disease 5.1
5. Accidents 4.0
8
Leading Causes of Death, United States, 2001
Cause of Deaths
6. Diabetes 2.9
7. Pneumonia/influenza 2.6
8. Alzheimer disease 2.2
9. Kidney disease 1.6
10. Blood poisoning 1.3
9
Leading Causes of Death, United States, 2001
Cause of Deaths
11. Suicide 1.2
12. Liver diseases 1.1
13. Homicide 0.8
14. High blood pressure 0.8
15. Lung inflammation 0.7
10
Life Expectancy, Selected Countries
11
Life Expectancy
  • Maximum average human life span - average age of
    death for an entire population under ideal
    conditions.
  • Life expectancy - average number of years a
    person can actually expect to live.

12
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

13
Number of People with HIV/AIDS, 12/31/02
14
Health Indicators 19992002
United States Japan Canada Zambia
Physicians/ 100K pop. 279 193.2 229.1 6.9
Nurses/ 100K pop. 972 744.9 897.1 113.1
Children immunized against measles 92 94 96 90
15
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.

16
Leading Causes of Death Ratios, 2000
Female Male African American White
Heart disease 1.02 0.90
Cancer 0.90 0.94
Stroke 1.53 0.96
Lung disease 1.00 0.50
Accidents 0.52 1.08
17
Polling Question
  • Do you currently smoke cigarettes?
  • Yes
  • No

18
Gender Inequalities in Health Care
  • More research has focused on mens diseases
    (cardiac arrest) than on womens diseases
    (breast cancer).
  • Women undergo fewer kidney transplants, various
    cardiac procedures, and other treatments than men.

19
Gender Inequalities in Health Care
  • Women live longer than men and experience greater
    lifetime risk of functional disability and
    chronic illness and have a greater need for
    long-term care.
  • There are 40 more poor women than poor men in
    the United States.

20
Prescription Drug Costs in 8 Rich Countries, 2002
21
Problems with HMOs
  1. Some HMOs avoid covering sick people and people
    who are likely to get sick to keep costs down.
  2. Minimize the cost of treating sick people they
    cant avoid covering.
  3. Inflate diagnoses to maximize reimbursements.
  4. Keep overhead charges high.

22
Administrative Costs as of Health-Care Spending
23
HMOs Improve the Quality of Care, 1998
24
Recent Challenges to Traditional Medical Science
  • Patient Activism
  • Alternative Medicine - chiropractic therapy,
    acupuncture, massage therapy, and various
    relaxation techniques
  • Holistic Medicine - emphasizes disease prevention

25
Social Construction of Disability
  • 400 years ago - Catholic Church declared
    left-handed people servants of the Devil and
    burned them at the stake.
  • 19th century - Western scientists and reformers
    sought rehabilitation of the disabled.

26
Social Construction of Disability
  • 1933 - Nazis engineered the sterilization and
    killing of the mentally deficient and the
    physically deviant, including the blind and the
    deaf.
  • 1920s to 1970s - In America Native American
    women were subjected to federally funded forced
    sterilization.

27
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.

28
Age Stratification
  • Sociologists call a category of people born in
    the same range of years an age cohort.
  • Age stratification refers to social inequality
    between age cohorts.
  • Gerontocracies were societies in which elderly
    men ruled.

29
Child Poverty by Race and Ethnicity
30
Median Income and Percent Poor
31
Age Stratification Functionalist Theory
  • Age stratification reflects the importance of
    each age cohorts 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.

32
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.

33
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.

34
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Elderly as of U.S. Population, 19002050
37
Polling Question
  • The government should pay for all prescription
    medication for the elderly in our society.
  • Strongly agree
  • Agree somewhat
  • Unsure
  • Disagree somewhat
  • Strongly disagree

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
A Shortage of Caregivers
  • Workers are hard to find and hard to keep
  • The work is difficult and pays little.
  • Government requires 2 weeks of preemployment
    training for direct-care aides but Congresss
    1996 welfare reform discourages such training for
    former welfare recipients.

40
Ageism
  • Ageism is prejudice and discrimination based on
    age.
  • Examples
  • Elderly men are stereotyped as grumpy and
    elderly women as haggard.

41
Euthanasia
  • Involves a doctor prescribing or administering
    medication or treatment that intended to end a
    terminally ill patients life.
  • Public opinion polls show about 2/3 of Americans
    favor physician-assisted euthanasia.

42
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.

43
Elderly and Poverty
  • Among the elderly, poverty is most common for
  • those 85 and older
  • Women
  • African Americans
  • people living alone
  • people living in rural areas.

44
People Who Died under Oregons Death with Dignity
Act
Physician-Assisted Suicide Other Deaths
Average Age Average Age 69 74
Race White 97 97
Asian 3 1
Other 0 2
Sex Male 55 50
Female 45 50
45
People Who Died under Oregons Death with
Dignity Act
Marital Status Physician-Assisted Suicide Other Deaths
Married 47 49
Widowed 22 33
Divorced 25 14
Never Married 6 4
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
  • the fertility rate

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

49
  • 2. Which of the following is not a major social
    cause of illness and death?
  • human-environmental factors
  • lifestyle factors
  • factors related to the public health system
  • factors related to the health care system
  • none of these choices (that is, all the factors
    listed above are major social causes of illness
    and death)

50
Answer e
  • All the factors listed below are major social
    causes of illness and death
  • human-environmental factors
  • lifestyle factors
  • factors related to the public health system
  • factors related to the health care system

51
  • 3. What strategies do health maintenance
    organizations (HMOs) use to maximize profits?
  • They avoid covering sick people and people who
    are likely to get sick.
  • Their doctor-compensation formulas reward doctors
    for withholding treatments that are unprofitable.
  • They keep overhead charges high.
  • All of these choices.

52
Answer d
  • Health maintenance organizations (HMOs) use the
    following strategies to maximize profits
  • They avoid covering sick people and people who
    are likely to get sick.
  • Their doctor-compensation formulas reward doctors
    for withholding treatments that are unprofitable.
  • They keep overhead charges high.

53
  • 4. Disabled people are incapable of performing
    within the range of "normal" human activity.
  • True
  • False

54
Answer a
  • Disabled people are incapable of performing
    within the range of "normal" human activity.

55
  • 5. Ablism involves
  • curing disabilities to the extent possible
    through medical and technological intervention
  • prejudice and discrimination against disabled
    people
  • the largely unintended neglect of the conditions
    of disabled people
  • prejudice and discrimination against disabled
    people, and the largely unintended neglect of the
    conditions of disabled people

56
Answer d
  • Ablism involves prejudice and discrimination
    against disabled people, and the largely
    unintended neglect of the conditions of disabled
    people.

57
  • 6. Which of the following theories explains age
    stratification in terms of competition for power
    and wealth between age cohorts?
  • functionalist theory
  • conflict theory
  • symbolic interactionism
  • essentialist theory
  • postmodern theory

58
Answer b
  • Conflict theory explains age stratification in
    terms of competition for power and wealth between
    age cohorts.

59
  • 7. _________________ is prejudice and
    discrimination against elderly people.

60
Answer ageism
  • Ageism is prejudice and discrimination against
    elderly people.

61
  • 8. _________________ involves a doctor
    prescribing or administering medication or
    treatment that is intended to end a terminally
    ill patient's life.

62
Answer euthanasia
  • Euthanasia involves a doctor prescribing or
    administering medication or treatment that is
    intended to end a terminally ill patient's life.

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