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Health Care and Aging


Health Care and Aging CHAPTER 15 – PowerPoint PPT presentation

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Title: Health Care and Aging

Chapter 15
  • Health Care and Aging

Health Care as a Social Institution
  • The American propensity for personal health is
    embedded in culture. Americans tend to respond
    aggressively to their health-care needs.

The Nature of the Health Care System
  • The health-care system embraces the professional
    services, organizations, training academies, and
    technological resources committed to the
    treatment, management, and prevention of disease.
  • By 2018, Americans will spend over 4 trillion on
    health care, up from approximately 200 billion
    in 1960.

The Components of the Health-care System
  • Physicians
  • Although physicians constitute only about 10
    percent of health-care workers in the United
    States, they establish the working framework for
    everyone else.
  • Nurses
  • Possibly as a result of this initial orientation,
    nursing experiences frequent controversy
    regarding education, professional roles, and

The Components of the Health-care System
  • Hospitals
  • Hospitals provide specialized medical services to
    a variety of inpatients and outpatients.
  • Patients
  • People usually enter the health-care system only
    because others defined them as ill or injured.

Theoretical Perspectives and the Health Care
System Functionalism
  • Talcott Parsons first proposed a view of sickness
    that was distinctively sociological rather than
    merely medical.
  • Health problems are a threat to society.
  • If people are sick and cannot fulfill their
    roles, society will not function smoothly.

Theoretical Perspectives and the Health Care
System Functionalism
  • Society responds in two ways
  • Society defines sham sickness as a form of
    deviant behavior.
  • Society institutionalizes legitimate patterns of
    behavior for a sick role.

The Sick Role
  1. The sick are permitted to withdraw temporarily
    from other roles or at least reduce their
    involvement in them.
  2. It is assumed that the sick cannot simply will
    the sickness away.

The Sick Role
  • The sick are expected to define their condition
    as undesirable.
  • The sick are expected to seek and to follow the
    advice of competent health-care providers.

Theoretical Perspectives and the Health Care
System Conflict Theory
  • The concerns of conflict theorists are
  • an alternative explanation of the medical
    professions prestige,
  • an explanation of the high income and status of
  • the professional and economic problems of nurses,
  • and the inequality of health care and the power
    of the pharmaceutical industry.
  • The same political and economic forces that
    determine the nature of capitalism determine the
    nature of the medical institution.

Theoretical Perspectives and the Health Care
System Symbolic Interactionism
  • The socialization process of most physicians
    begins early.
  • Medical students acquire technical knowledge and
    skills and learn to diagnose and treat illness,
    as well as learning to accept the beliefs, norms,
    values, and attitudes associated with the medical
  • Sickness and illness are social labels that
    can stigmatize people.

Focus on Theoretical Perspectives Health Care in
the United States
Global Health Care Health Care in the Developed
  • Of the highly developed countries of the world,
    the United States is the only one without
    national health insurance for all its citizens.
  • (Shame on us.)
  • The United States has the dubious distinction of
    having the most expensive health care and one of
    the worst performing health-care systems in the
    developing world.

Global Health Care Health Care in the Developed
  • Americans spend over 7,000 per person for health
    care annually. (The total population expense
    averaged out per person)
  • U.S. health-care expenditures as a share of GDP
    are the highest in the world (16 percent)
  • Despite its high price tag, the United States
    finishes last on access to medical care,
    organizational efficiency, equity of treatment,
    and health results, next to last on quality care.

Global Health Care Health Care in the Developed
  • The United States shows its best performance on
    preventive and patient-centered care.
  • Its low scores on chronic care management and
    coordinated care drag it down to next-to-last on
    quality overall.
  • Lack of insurance and cost are the biggest
    barriers to health-care access for Americans.

Global Health Care Health Care in the Developed
  • The United States ranks at the bottom of the
    seven countries on efficiency of delivery, while
  • the United Kingdom and Australia rank first and
    second, respectively.
  • The United States performs poorly in terms of
    national health-care expenditures, administrative
    costs, information technology, re-admittance to
    hospital, and duplicative medical testing.

Global Health Care Health Care in the Developed
  • The United States ranks last on almost all
    indicators of equal access to treatment.
  • The United States ranks dead last on each of the
    measures of health outcomes.

Per Capita Health Expenditures
Health Care Expenditures as a Share of GDP
National Rankings on Key Health Indicators
Percentage of Persons Not Covered by Health
Insurance in the United States by Age 2009
The Graying of America A Global Context
  • The proportion of the worlds population
    sixty-five and older is increasing at a rate of
    about 6 percent annually, whereas the worlds
    population as a whole has a growth rate under 2
  • The global population of the elderly (sixty-five
    years or over) will triple from some 516 million
    today to 1.53 billion in 2050.
  • The elderly, who account for less than 8 percent
    of the population, will comprise 16 percent of
    the worlds population by 2050.

The Graying of America Aging in the United States
  • An age cohort consists of persons born during the
    same time period in a particular population
    (example baby boomers).
  • The important thing about an age cohort is that
    its members pass through life together.
  • The age cohort of persons sixty-five years and
    over37 million strongcomprises 12 percent of
    the total U.S. population.

The Graying of America Aging in the United States
  • What accounts for the rapid growth in the number
    of older Americans?
  • The maximum size of the elderly population at any
    given time is due primarily to the number of
    births sixty-five or more years ago.
  • Another factor in the growth of the elderly
    population is the decline in the death rate.
  • Immigration has had its effect through the
    massive preWorld War I immigration into the
    United States.

Percentage of the U.S. Population 65 and Over
Projected Growth of Senior Population (2000-2030)
The Graying of America Aging in the United States
  • The dependency ratio is the proportion of persons
    in the dependent ages (under fifteen and over
    sixty-four) in relation to those in the
    economically active ages (fifteen to sixty-four).
  • A higher dependency ratio indicates that each
    worker has to support more dependent people a
    lower ratio indicates that each worker has fewer
    people to support.

Age Stratification
  • Age stratificationthe age-based unequal
    distribution of scarce desirables in a society.

Age Stratification
  • The poverty line is drawn at a higher dollar
    amount for the elderly than for younger
  • Although the elderly spend proportionately more
    on health care and housing than younger people
    do, the federal government assumes a lower cost
    of living for the elderly.
  • The existence of a small percentage of
    high-income older people gives the false
    impression that most elderly people are
    economically well-off.

Age Stratification
  • The elderly who are members of racial or ethnic
    minority groups are generally in worse condition
    than older white Americans.
  • Unquestionably, this disparity is intimately
    linked to the lifetime of prejudice and
    discrimination experienced by these racial and
    ethnic groups.
  • Because women the world over live longer than
    males, there is a global trend toward the
    feminization of poverty among the elderly.

Age Stratification
  • Social gerontologythe scientific study of the
    social dimensions of aginghas in the past blamed
    the elderly for their situation in much the same
    way that Americans in general have blamed the
    poor for their plight.
  • Ageisma set of beliefs, attitudes, norms, and
    values used to justify age-based prejudice and
  • Stereotypes are ideas based on distortion,
    exaggeration, and oversimplification and applied
    to all members of a social category.

Ageism and Health Care
  • Stereotypes are ideas based on distortion,
    exaggeration, and over simplification applied to
    all members of a category.
  • Most elderly people are not senile.
  • Old age is not a sexless period for the majority
    of those over 65.
  • There are few age differences in job-related
  • Most elderly people are able to learn new things
    and can enthusiastically adapt to change.