SOC 300: Chapter 11

9 August 2023
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medicalization
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process by which problems or issues not traditionally seen as medical come to be framed as such
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sick role
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concept describing the social rights and obligations of a sick individual
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U.S. health care coverage (4 types)
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fee-for-service, health maintenance organizations, Medicare, Medicaid
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Whitehall Study
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social factors greater influence on health than health care systems
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selection theory
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theory to explain why people with higher SES have better health (that this relationship is spurious, that it is a false relation between decrease income and increase morbidity)
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drift expansion
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theory to explain why people with higher SES has better health (that uses reverse causality; health causes social position)
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psychological interpretation
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theory to explain that social position causes health (that stigma of low SES causes stress)
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materalistic interpretation
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theory to explain that social position causes health (that eating healthy and seeing good doctors cost money)
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fundamental causes interpretation
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theory to explain that social position causes health (that high status people have more resources and information)
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morbidity
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illness in a general sense
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mortality
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death
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Diagnostic and Statistical Manual (DSM)
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provide standard categorization of mental disorders and definition (in third edition, diagnostic v. dynamic psychiatry)
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Reproductive technology has increased the number of multiple births, which leads to the ethical issue of:
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whether to abort some of the embryos.
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Poor diet during adolescence can be detrimental to growth potential because:
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it is one of the periods in life in which a growth spurt takes place
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After mental illness became "medicalized," what was one major change that occurred?
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Medication replaced counseling.
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Physicians in ancient Rome tended to have lower prestige. This was because:
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the surgeons evolved from barbers.
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Poor children can be covered medically by:
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both Medicaid and the State Children's Health Insurance Plan.
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____________ results from inadequate growth during gestation or a curtailed period of gestation.
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Low birth weight.
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The "drift explanation" of the relationship between health and socioeconomic status (SES) states that:
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genetics and biology affect SES so that people who are healthier have an easier time maintaining a high SES
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The Whitehall Study found that men in lower ranks had which of the following risk factors?
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higher stress levels
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According to existing studies, why did the elderly who received more Social Security have higher mortality rates than the elderly who received less Social Security and had to work part-time?
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Working had a positive impact on their longevity due to social interaction.
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The eradication of African river blindness (onchocerciasis) illustrates the connection between:
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health and economic development.
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Being made to wait in order to see a doctor is evidence of the
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power and prestige of doctors in our society
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During World War II, the U.S. economy suffered, and due to imposed price and wage controls, employers were often in the position of not being able to offer raises to employees despite long hours and hard, sometimes hazardous, work. Instead, many companies began to offer free health care as a benefit to make up the difference. This is often cited as the origin of
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employer-based healthcare system
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Health maintenance organizations (HMOs) were an early attempt to control health care costs. In this model, the provider - the doctor - receives a capitation, which is a fee per person and not a fee per treatment. The major shortcoming of this approach is that
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it may lead to undertreatment.
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How did the development of licensing standards in the nineteenth century affect the medical profession?
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Licensing standards made the medical profession more exclusive and gave doctors more economic power.
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In general, how has the Internet affected the doctor-patient relationship?
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Patients can research their symptoms prior to meeting with a physician and may (or may not) be able to speak more knowledgeably about their condition and possible treatments.
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In his interview with Dalton Conley, Jeffrey Sachs explains that malaria has been a major cause of economic failure in Africa, but not in Asia. Morbidity is very high with malaria, and it can literally destroy an entire village. From what we have learned about socioeconomic status and its relation to health, it is clear that malaria is an impediment to improved SES, and in that way it is linked to inequality. One of the major reasons why malaria is a big problem in Africa and not in Asia has to do with
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the absence of a mixed animal-crop system, which prompted a different predator-prey relationship between mosquitoes, on the one hand, and primates and humans, on the other.
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In the United States, the infant mortality rate is highest for which of the following groups?
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African Americans
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In the text, the discussion about the "height gap" describes how taller men benefit from their height. When Mayan Indians were studied, those who came to the United States gained height after 15 years, due in part to healthier lifestyles. This leaves open the question of why Dutch men are the tallest in the world. One theory holds that is about inequality, something we have studied. In the United States, the gap between rich and poor is huge, but in the Netherlands, that gap is far smaller. What problem in health care does this problem highlight in the link between health and inequality?
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The psychological stress induced by inequality exacts a toll via stress reactions.
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Kimberly is a successful television producer who is married to an attorney and has two children. She overhears a conversation at work about the dangers of bisphenol A (BPA) exposure from the use of certain types of plastic bottles. Over the next couple of weeks, she does some research on the Internet and contacts her family doctor to ask questions. Ultimately, she learns that you can buy products made without BPA, so she replaces all her family's plastic drink cups and bottles with non-BPA products. The fact that Kimberly learned about BPA dangers and then was able to research the subject and take action to protect her family is an example of which interpretation of the theory that social position causes health outcomes?
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fundamental causes interpretation
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Paul is a successful manager earning a six-figure income at a Fortune 500 company. At age 48, he receives a diagnosis of multiple sclerosis, with an uncertain prognosis. Over the course of the next nine months, Paul finds it increasingly difficult to do basic tasks - driving, typing, and even walking become daily challenges. As his disease progresses, he has good days and bad days, but he is eventually terminated from his job, leaving him unemployed and his family of five suddenly in a position of having to sell their house and seriously downsize. Gradually, friends he has had over the years stop calling. Invitations to social functions taper off. Paul and his family have been "downgraded" in their socioeconomic status, and one reason might be attributable to the drift theory. In this model it is argued that
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health causes social position
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Recently, your friend has had a scare with the discovery of a lump on her body. As she shares the experience of her visit to a medical doctor, she tells you that after being seen following a biopsy (which was benign), the doctor and the staff simply went ahead and scheduled a few future appointments. She tells you how difficult it was to try and stop these "auto-bookings" as she called them. Within the medical profession, this approach to health care is common and refers to
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supplier-induced demand
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The importance of the Whitehall Study was to show that
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social factors such as where a person lives, what a person does for a living, and how much a person earns have a great influence on health.
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The recent passage of the Patient Protection and Affordable Care Act (ACA) was a lengthy political battle, between Congress and the president. While it appears that the major forces that eventually led to its passage were rooted in politics, the "back story" of the process involved health insurance companies, who saw the act as an opportunity to increase revenues. In what way does the ACA represent a shift in the relationship between doctors and patients?
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The ACA further reduces the power that doctors have
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There has been a lot of interest lately in the effects of gluten in our diet. Celiac disease, a known, well-understood problem, affects a moderate number of people worldwide. Gluten intolerance, though, is more widespread, not well known or understood, and difficult to evaluate clinically (whereas celiac disease is quite straightforward to test for). Diet fads come and go, and a gluten-free diet is popular these days. But a recent, very thorough clinical study has found that even when subjects were given a strictly controlled placebo diet, they reported a worsening of symptoms that agreed with commonly reported symptoms of persons complaining of gluten intolerance generally. This is an example of
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how people learn the sick role and behave appropriately
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Until 2012, the Diagnostic and Statistical Manual of Mental Disorders (DSM) labeled transgender persons as mentally ill, an example of medicalization. Following the most recent revision (the fifth), the DSM now uses the term Gender Identity Dysphoria, which means instead of being designated as mentally ill, transgender persons suffer a "marked incongruence between one's experienced/expressed gender and assigned gender." This shift is both welcomed and a surprise, largely because it is a reversal of what change in the DSM that took place in the 1980s?
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the removal of social context in favor of the biomedical model
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What factors, besides access to drug therapies, are key to fighting diseases in developing countries?
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proper nutrition and clean water
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What have studies shown about the overall health of blacks and whites with similar incomes and education levels?
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blacks have worse health than whites regardless of income levels
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What is the paradox of the use of antibiotics to fight bacterial infections?
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Antibiotics are very effective at fighting bacterial infections, but their increased use led to the development of antibiotic-resistant strains of bacteria
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Which of the following are problems in the U.S. health insurance market that the Affordable Care Act sought to address (choose all that apply)?
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the elimination of strong individual health insurance market, slow the rapid decline in health care costs due to fee for service, decrease Medicaid eligibility requirement, create a robust individual health insurance market
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Which of the following is a professional norm for doctors?
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the intimate but objective nature of their conversation with patients
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Which of the following is an accepted explanation for higher mortality rates among men?
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Men are less likely than women to see a doctor for seemingly minor injuries or illnesses that can become more serious if not treated.
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Which of the following is an example of medicalization?
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Viewing a drug addiction as a disease that can be treated
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Which of the following were part of the process that gave doctors more power as medical professionals in the transition from the nineteenth to the twentieth century (choose all that apply)?
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doctors ceased to be employees of hospitals, hospitals began to regulate doctors, state licensing boards controlled the types of doctors permitted to practice
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Which of the following would be considered a form of morbidity (choose all that apply)?
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failure to take daily vitamins, lower back pain that makes movement difficult