SYLLABUS
SOC 5250
FALL 2013
SOCIOLOGY OF HEALTH AND ILLNESS
Class meets Mondays at 4:00 to 6:30 pm in RH 408
Instructor: Dr. Anna Zajacova
Email: zajacova@uwyo.edu
Office: 421 Ross Hall
Office hours: _____________________
COURSE DESCRIPTION:
This seminar provides a graduate-level introduction to Sociology of Health and Illness, also
referred to as Medical Sociology. We will focus on the most fundamental and sociologically
relevant topics in this field. The topics can be divided into two broad groups: social
determinants of health and illness, and social responses to health and illness. The first
group of topics, covered during the first half of the semester, will introduce the notion of
health as socially influenced, as opposed to determined individually as is the typical
perspective in the medical model. The second part of the class, starting in week 7, will
discuss how people construct the notions of health and illness, how sick individuals
perceive their illness and navigate health care, and finally the U.S. health care system. For
this last topic, we will consider the broad political-economic context that gave rise to the
American health-care system and also compare the U.S. system to other countries’ health
care delivery structures.
Naturally, there are numerous interesting topics in medical sociology we won’t have time to
cover within these two broad areas; we therefore leave the last two weeks for additional
topics chosen by you (the students) where you become an expert and teach the class.
COURSE OBJECTIVES:
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To understand how social factors influence health and shape health inequalities in
populations.
To consider the complex social responses to health and illness issues
To strengthen the ability to read complex theoretical and empirical papers and
incorporate their arguments into a unified understanding of discussed topics.
To improve students’ writing skills through systematic writing exercises and final
research paper.
To develop critical thinking and evaluation skills to analyze complex social
arrangements related to health and medicine.
To gain expert knowledge in one (student-selected) topic of interest, and the ability
to transmit this knowledge to colleagues at the graduate level.
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SYLLABUS
SOC 5250
FALL 2013
COURSE STRUCTURE:
This graduate seminar requires attendance during all class sessions. The classes will be
mostly discussion-based; therefore, students are expected to complete all required reading
prior to class in order to fully participate. Students will be asked to summarize papers,
integrate their arguments with discussed materials, and pose questions from the readings.
The instructor will provide brief lectures to supplement reading materials.
REQUIRED BOOKS:
1. Clark, David P. (2010). Germs, Genes, and Civilization: How Epidemics Shaped
Who We Are Today. Pearson.
2. Abraham, Laurie K. (1994). Mama Might Be Better Off Dead: The Failure of Health
Care in Urban America. University Of Chicago Press
3. Fadiman, Anne. (2012). The Spirit Catches You and You Fall Down: A Hmong
Child, Her American Doctors, and the Collision of Two Cultures. Farrar, Straus and
Giroux
4. Starr, Paul. (1982). The Social Transformation of American Medicine: The Rise of a
Sovereign Profession and the Making of a Vast Industry. Basic Books.
5. Gruber, Jonathan, and Nathan Schreiber. (2011). Health Care Reform: What It Is,
Why It’s Necessary, How It Works. Hill and Wang.
GRADING:
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Regular (about weekly) “prep” writing (15%). To help you read new material and
prepare for the class discussion, I will email you some questions to answer during the
week before class. These will be relatively straightforward questions and their point will
not be to demonstrate mastery of the material but rather to begin thinking about it and
incorporate the new material to older topics.
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Class participation (25%). Attendance during all class sessions is an important part
of this seminar. Moreover, you will be called on to actively participate. That means you
will have had to do all reading beforehand so you can pose questions, actively talk
through difficult issues, etc.
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Regular (about weekly) “reaction” writing (25%). After class, I will assign more
complex items and questions for you to discuss. These will be about 3-6 pages long
mini-papers or homeworks, if you will. Their aim is to solidify your understanding of the
material we’ve discussed in class, as well as to practice writing skills.
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Independent research project, presentation, and paper (35%). At the end of the
semester, each student will become an expert on one topic of their choice. Students
will select readings, learn about the topic, prepare about 20-30 minute lecture to
present in class, and in parallel prepare a paper (12-20 pages) on this topic. We will
begin discussing these topics mid-semester. Everything will be done in steps and I will
keep providing regular feedback throughout the process.
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SYLLABUS
SOC 5250
FALL 2013
SCHEDULE OF CLASSES
Please note: the schedule and readings are subject to change.
CLASS 1 (8/26): INTRODUCTION TO SOCIOLOGY OF HEALTH AND ILLNESS.
Overview of the course; introduction to the field of medical sociology (approaches, areas of
interest, history of).
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Bird, Chloe E., Peter Conrad, and Allen M. Fremont. (2000). “Medical Sociology at the
Millennium.” Pages 1-10 in Handbook of Medical Sociology, 5th edition. Prentice-Hall.
Weiss, Gregory L., and Lynne E. Lonnquist. (2012). The Sociology of Health, Healing,
and Illness. Pearson. Chapter 1, pages 1-10.
Cockerham, William C. (2012). Medical Sociology, 12th edition. Pearson. Chapter 1,
pages 1-13.
Syme, S. Leonard, and Irene H. Yen. (2000). “Social Epidemiology and Medical
Sociology: Different Approaches to the Same Problem.” Pages 365-376 in Handbook of
Medical Sociology, 5th edition. Prentice-Hall.
o Focus on the introduction and discussion sections; scan the rest.
Supplemental reading.
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House, James. (2001.) “Understanding Social Factors and Inequalities in Health: 20th
Century Progress and 21st Century Prospects.” Journal of Health and Social Behaviors
43:125-143.
PLEASE NOTE: SEPTEMBER 2 IS LABOR DAY; CLASSES ARE EXCUSED
CLASS 2 (9/9): EPIDEMIOLOGICAL TRANSITION; MEASURING HEALTH
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Omran, Abdel R. (1971). The Epidemiologic Transition: A Theory of the Epidemiology
of Population Change. The Milbank Memorial Fund Quarterly, 49(1): 509-538.
o Pay special attention to Propositions 2, 3, and 4.
Fries, James. (1980). “Aging, Natural Death, and the Compression of Morbidity.”
NEJM 303(3): 130-135.
Clark, David P. (2010). Germs, Genes, and Civilization: How Epidemics Shaped Who
We Are Today. Pearson.
o We will discuss chapters 1, 3, 4, 10, and 11.
Mirowsky, John, and Catherine E. Ross. (2003). Education, Social Status, and Health.
Aldine De Gruyter.
o Section on measuring health, pages 32-49.
Supplemental reading.
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Idler, Ellen, and Yael Benyamini. (1997). “Self-Rated Health and Mortality: A Review of
Twenty-Seven Community Studies.” Journal of Health and Social Behavior 38(1): 2137.
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SYLLABUS
SOC 5250
FALL 2013
CLASS 3 (9/16): SOCIAL DETERMINANTS OF HEALTH: SOCIOECONOMIC STATUS
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Link, Bruce. G., and Jo Phelan (1995). “Social Conditions as Fundamental Causes of
Disease.” Journal of Health and Social Behavior (Extra Issue): 80-94.
 Ross, Catherine, and John Mirowsky. (2010). “Why Education Is the Key to
Socioeconomic Differentials in Health” Pp. 33-51 in Handbook of Medical Sociology, 6th
edition, Chloe E. Bird, et al. Vanderbilt University Press.
 Marmot, Michael. (2004). “Introduction.” In The Status Syndrome: How Social Standing
Affects Our Health and Longevity.” Holt Paperbacks.
o Only selected pages.
 Abraham, Laurie K. (1994). Mama Might Be Better Off Dead: The Failure of Health
Care in Urban America. University Of Chicago Press, chapters 1, 2, 8, 9
Supplemental readings
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Phelan, Jo C., Bruce Link, Ana Diez-Roux, Ichiro Kawachi, Bruce Levin. 2004.
’Fundamental Causes’ of Social Inequalities in Mortality: A Test of the Theory”. Journal
of Health and Social Behavior 45:265-285.
Link, Bruce G., Jo C. Phelan, Richard Miech, and Emily L. Westin. (2008). “The
Resources That Matter: Fundamental Social Causes of Health Disparities and the
Challenge of Intelligence.” Journal of Health and Social Behavior 49:72-91.
CLASS 4 (9/23): SOCIAL DETERMINANTS OF HEALTH: SEX AND RACE
GENDER
 Rieker, Patricia P., Chloe E. Bird, and Martha E. Lang. (2010). “Understanding Gender
and Health: Old Patterns, New Trends, and Future Directions.” Pp. 52-74 in Handbook
of Medical Sociology, 6th edition, Chloe E. Bird, et al. Vanderbilt University Press.
 Verbrugge, Lois M. (1989). “The Twain Meet: Empirical Explanations of Sex Differences
in Health and Mortality.” Journal of Health and Social Behavior 30:282-304.
RACE
 Williams, David R. and Chiquita Collins. (1995). “US Socioeconomic and Racial
Differences in Health: Patterns and Explanations.” Annual Review of Sociology 21:349386.
 Williams, David R., and Chiquita Collins. (2001). “Racial Residential Segregation: A
Fundamental Cause of Racial Disparities in Health.” Public Health Reports 116: 404416.
 Abraham, Laurie K. (1994). Mama Might Be Better Off Dead: The Failure of Health
Care in Urban America. University Of Chicago Press, chapter 12.
Supplemental reading.
AGE
 Himes, Christine. 2002 “Elderly Americans.” Population Bulletin Vol.56, No.4.
Washington, DC: Population Reference Bureau.
 Lynch, Scott M. 2003. “Cohort and Life-Course Patterns in the Relationship Between
Education and Health: A Hierarchical Approach.” Demography 40(2):309-331.
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SYLLABUS
SOC 5250
FALL 2013
RACE
 Hummer, Robert E. 1996. “Black-White Differences in Health and Mortality: A Review
and Conceptual Model.” The Sociological Quarterly 37:105-125.
 Bamshad, Mike. 2005. “Genetic Influences on Health: Does Race Matter?” Journal of
the American Medical Association 294:937-946.
CLASS 5 (9/30): SOCIAL STATUS, HEALTH BEHAVIORS, LIFE STYLES, AND HEALTH
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Centers for Disease Control. (2013). Health Behaviors of Adults: United States, 20082010. Available online at http://www.cdc.gov/nchs/data/series/sr_10/sr10_257.pdf.
o Read only the introductory text to each chapter.
William C. Cockerham. 2005. “Health lifestyle Theory and the Convergence of Agency
and Structure.” Journal of Health and Social Behavior, 46: 51-67.
Lantz, Paula M., James S. House, et al. (1998). "Socioeconomic factors, health
behaviors, and mortality: results from a nationally representative prospective study of
US adults." JAMA 279(21): 1703-1708.
Pampel, Fred C., Patrick Krueger, and Justin T. Denney. (2010). “Socioeconomic
Disparities in Health Behaviors.” Social Science and Medicine 53: 29-40
Marmot, Michael. (2004). “Men and Women Behaving Badly?” In The Status Syndrome:
How Social Standing Affects Our Health and Longevity.” Holt.
o Focus primarily on pages 43-47; scan the previous pages.
Supplemental reading
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Pampel, Fred. C., and Richard G. Rogers. (2004). “Socioeconomic Status, Smoking,
and Health: A Test of Competing Theories of Cumulative Advantage.” Journal of Health
and Social Behavior 45:306-321.
Stewart MJ, Greaves L, Kushner KE, et al. (2011). “Where There Is Smoke, There is
Stress: Low-Income Women Identify Support Needs and Preferences for Smoking
Reduction.” Health Care for Women International 32(5):359-83.
CLASS 6 (10/7): STRESS, SOCIAL SUPPORT, AND HEALTH
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Pearlin, Leonard I. (1989). “The Sociological Study of Stress.” Journal of Health and
Social Behavior 30:241-56.
Turner, R. Jay, Blair Wheaton, and Donald A. Lloyd. (1995). “The Epidemiology of
Social Stress.” American Sociological Review, 60(1): 104-125.
o Focus only on intro and conclusions
Sapolsky, Robert M. (1998.) Why Zebras Don’t Get Ulcers. W.H. Freeman and Co.
Chapter 15, “The View from the Bottom,” pages 287-308.
Cohen, Sheldon, William J. Doyle, David P. Skoner, Bruce S. Rabin, and Jack M.
Gwaltney. (1997). “Social Ties and Susceptibility to the Common Cold.” JAMA
277:1940-1944.
Janice K. Kiecolt-Glaser, Timothy J. Loving, Jeffrey R. Stowell, et al. (2005). “Hostile
Marital Interactions, Proinflammatory Cytokine Production, and Wound Healing.“
Archives of General Psychiatry, 62(12):1377-1384.
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SYLLABUS
SOC 5250
FALL 2013
Supplemental reading
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Parker-Pope, Tara. (2010.) “Is Marriage Good for Your Health?” New York Times,
April 18 2010.
CLASS 7 (10/14): THE SOCIAL CONSTRUCTION OF HEALTH AND ILLNESS
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Armstrong, Elizabeth M. (1998). “Diagnosing Moral Disorder: The Discovery and
Evolution of Fetal Alcohol Syndrome.” Social Science & Medicine 47:2025-2042.
Lantz, Paula M., and Karen M. Booth. (1998). “The social construction of the breast
cancer epidemic.” Social Science & Medicine 46:907-18.
Conrad, Peter and Kristin K. Barker. “The Social Construction of Illness: Key Insights
and Policy Implications.” Journal of Health and Social Behavior 51(1):S67-S79.
Fadiman, Anne. (2012). The Spirit Catches You and You Fall Down: A Hmong Child,
Her American Doctors, and the Collision of Two Cultures. Farrar, Straus and Giroux.
Chapters 1-5, pages 3-59.
Supplemental reading
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Brown, Phil. 1995. “Naming and Framing: The Social Construction of Diagnosis and
Illness.” Journal of Health and Social Behavior (Extra Issue): 34-52.
CLASS 8 (10/21):: SICK ROLE, MEDICALIZATION
 Parsons, Talcott. (1951.) “Social Structure and Dynamic Process: The Case of Modern
Medical Practice.” Pages 428-465 in The Social System. The Free Press.
 Conrad, Peter. 1992. “Medicalization and Social Control.” Annual Review of Sociology
18:209-232.
 Zola, Irving K. (1972.) “Medicine as an Institution of Social Control.” Sociological
Review 20:487-504.
 Conrad, Peter. (2005). “The Shifting Engines of Medicalization.” Journal of Health and
Social Behavior 46:3-14.
CLASS 9 (10/28):): BEING A PATIENT, PATIENT-DOCTOR INTERACTION
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Leventhal, H. (2001). “Illness Behavior and Care Seeking.” Pp. 7185-7190 in
International Encyclopedia of the Social & Behavioral Sciences. Editors-in-Chief: Neil
J. Smelser and Paul B. Baltes
Mechanic, David. (1992). “Health and Illness Behavior and Patient-Practitioner
Relationships.” Social Science and Medicine 34 (12): 1345-1350.
o Read pages 1345-47; briefly scan the rest
Rier, David A. (2010). “The Patient’s Experience of Illness.” Pp. 163-178 in Handbook
of Medical Sociology, 6th edition, Chloe E. Bird, et al. Vanderbilt University Press.
Conrad, Peter, and Stults, Cheryl. (2010). “The Internet and the Experience of Illness.”
Pp. 179-191 in Handbook of Medical Sociology, 6th edition, Chloe E. Bird, et al.
Vanderbilt University Press.
Trillin, Alice S. (1981). “Of Dragons and Garden Peas: A Cancer Patient Talks to the
Doctors.” New England Journal of Medicine 304(12): 699-701.
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SYLLABUS

SOC 5250
FALL 2013
Fadiman, Anne. (2012). The Spirit Catches You and You Fall Down: A Hmong Child,
Her American Doctors, and the Collision of Two Cultures. Farrar, Straus and Giroux.
Chapters 6-9, pages 60-118.
Supplemental reading
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Mechanic, David, and Sharon Meyer. (2000). “Concepts of Trust among Patients with
Serious Illness.” Social Science and Medicine 51:657-668.
CLASS 10 (11/04): TRAJECTORY OF THE MEDICAL PROFESSION
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Starr, Paul. (1982). The Social Transformation of American Medicine. Basic Books.
o Introduction and Chapters 1, 2, 3, and 6.
Cockerham, William C. (2010). “The Physician in a Changing Society.” Pp. 247-263 in
Medical Sociology, 11th edition. Upper Saddle River, NJ: Prentice Hall.
Stein, Leonard I. (1967). "The doctor-nurse game." Archives of General Psychiatry
16(6):699-712.
Supplemental reading
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Light, Donald W. (2010.) “Health-Care Professions, Markets, and Countervailing
Powers.” Pages 270-281 in Handbook of Medical Sociology, 6th edition, edited by
Chloe E. Bird, Peter Conrad, Allen M. Fremont, and Stefan Timmermans. Vanderbilt
University Press.
CLASS 11 (11/11): THE US HEALTH CARE SYSTEM
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Morone, J. A. (2005). “Morality, Politics, and Health Policy.” In Policy Challenges in
Modern Health Care. D. Mechanic, L. B. Rogut, D. C. Colby and J. R. Knickma, eds.
Rutgers, NJ, Rutgers University Press: 13-25.
Friedman, Eric A., and Adashi, Eli Y. (2010). “The Right to Health as the Unheralded
Narrative of Health Care Reform.” JAMA 304(23): 2639-2640
Burdys, Grace. (2010). “Medical Care.” Pages 109-132 in Unequal Health: How
Inequality Contributes to Health or Illness, 2nd ed. Rowman and Littlefield.
Cockerham, William C. (2010). “Health Care Delivery and Social Policy in the United
States.” Pp. 307-330 in Medical Sociology, 11th edition. Upper Saddle River, NJ:
Prentice Hall.
CLASS 12 (11/18):): THE US HEALTH CARE SYSTEM AND REFORM
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Gruber, Jonathan, and Nathan Schreiber. (2011). Health Care Reform: What It Is, Why
It’s Necessary, How It Works. Hill and Wang.
Finkelstein, Amy, et al. (2012). “The Oregon Health Insurance Experiment: Evidence
from the First Year.” The Quarterly Journal of Economics 127(3): 1057-1106.
o Only sections I and II and Conclusions
Additional reading TBD.
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SYLLABUS
SOC 5250
FALL 2013
CLASS 13 (11/25): STUDENT-SELECTED TOPICS
CLASS 14 (12/02): STUDENT-SELECTED TOPICS
ADDITIONAL TOPICS
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Neighborhood impact on health
Environment and health
Social networks and health/health behaviors (effects on smoking, obesity)
The Latino health paradox
Mental health (inequalities, social construction of, stigma of, etc.)
Social control in medicine
Medical errors
Evidence-based medicine
Adherence (compliance, causes/consequences, doctor-patient relationship)
Socialization of physicians (medical education)
The hospital as a social institution
Other medical professions, power, autonomy (nursing, allied health professions)
Alternative and complementary medicine
Experience of health and illness
Management of chronic illness
Addiction
Obesity (epidemic, social construction of, stigma, politics, doctor-patient)
Caregiving (gender, health effects of)
Disability studies
Death, dying, and bereavement
Mind-body connection
Religion, spirituality, and health
Health social movements (AIDS activism, ‘race for the cure’)
Ethics
Bioethics
Gene-environment interaction and health
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SYLLABUS
SOC 5250
FALL 2013
Students' rights and responsibilities:
Please refer to the University of Wyoming Regulation 8-30 for information
concerning your rights and responsibilities as a University of Wyoming student.
Students with disabilities:
If you have physical, learning, or psychological disability that requires accommodations,
please let me know as soon as possible. You will register with, and provide documentation
of your disability to, University Disability Support Services (UDSS) in SEO, room 109 Knight
Hall, 766-6189, TTY: 766-3073.
Academic Honesty:
The University of Wyoming is built upon a strong foundation of integrity, respect and trust.
All members of the University community have a responsibility to be honest and the right to
expect honesty from others. Any form of academic dishonesty is unacceptable to our
community and will not be tolerated. Attempts at cheating or plagiarism will result in a
grade of F (0 points) for the assignment or exam, lowered final grade, or additional
repercussions.
Suspected violations of standards of academic honesty should and will be reported to the
instructor, department head, or dean. University regulations regarding academic honesty
can be found at: http://uwadmnweb.uwyo.edu/legal/universityregulations.htm.
Note on classroom etiquette:
Appropriate behavior is expected of all students, in order to facilitate a supportive learning
environment. Any activities not related to the class material must be conducted outside of
the classroom, including any online networking, or in-person communication. Cell phones
must be turned off and no conversation or texting is acceptable.
Complaints:
Student Complaints should be addressed through the following chain of authority:
1.
2.
3.
4.
Instructor (Dr. Anna Zajacova)
UW Sociology Department Chair (Dr. Donna Barnes)
UW Dean of Arts and Sciences (Dr. Oliver Walter)
UW Vice President for Academic Affairs (Dr. Myron Allen)
Please note: I reserve the right to make changes to the syllabus during the semester.
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