Medical Sociology
Sociology 329
Winter 2011
Dr. Kimberlee B. Holland
2036 JFSB
422-3461
kimberlee_holland@byu.edu
Office Hours: 10:45-11:15 am T/TH, or by appointment
Academic Honesty
In keeping with the principles of the BYU Honor Code, students are expected to be
honest in all of their academic work. Academic honesty means, most fundamentally, that
any work you present as your own must in fact be your own work and not that of
another. Violations of this principle will result in a failing grade in the course and
additional disciplinary action by the university.
Students are also expected to adhere to the Dress and Grooming Standards. Adherence
demonstrates respect for yourself and others and ensures an effective learning and
working environment. It is the university’s expectation, and my own expectation in class,
that each student will abide by all Honor Code standards. Please call the Honor Code
Office at 422-2847 if you have questions about those standards.
Required Texts:
Gregory L. Weiss and Lynne E. Lonnquist. 2009. The Sociology of Health, Healing, and
Illness, Sixth edition. (New Jersey: Prentice-Hall).
Nestle, Marion. 2007. Food Politics. (London: University of California Press).
Groopman, Jerome. 2008. How Doctors Think. (Boston: Houghton Mifflin Company).
Assigned articles are available on Blackboard.
Course Description:
This course examines the social and structural factors which influence health, healing,
and illness. Particular emphasis is given to: (1) the influence of the social environment
on health and illness; (2) health and illness behavior; (3) health care practitioners and
their relationships with patients; and (4) the health care system.
As medical sociologists, we will explore several questions basic to the medical field.
Who gets sick? What is “illness”? Which “diseases” and “illnesses” receive research
funding? Why are most nurses female? Are physicians socialized into a particular way
of viewing medicine? What is the “best” health care system? Who decides what
constitutes “death”? Is there a health care “crisis” in the U.S.?
Evaluation:
Grading will be based upon 4 assigned readings quizzes, 2 book tests, 1 book club
presentation, 1 debate group project, 1 paper, and 3 exams.
Assigned Reading Quizzes:
As noted in the class schedule, I will quiz you on Nestle’s book and a few of the articles
on Blackboard. Quizzes cannot be made-up unless your absence is university
approved.
Book Tests:
Two smaller tests will be given in class to assess whether or not you read and understood
Marion Nestle’s book, Food Politics and Jerome Groopman’s book, How Doctors Think.
Tests cannot be made-up unless your absence is university approved.
Book Club Presentation:
At the beginning of the semester you will have to the opportunity to join one of the
following book clubs:
#1 Skloot, Rebecca. 2010. The Immortal Life of Henrietta Lacks.
#2 Gawande, Atul. 2003. Complications: A Surgeon’s Notes on an Imperfect Science.
#3 Reid, T. R. 2010. The Healing of America: A Global Quest for Better, Cheaper,
and Fairer Health Care.
Each club is required to meet together 3 times to discuss, argue, and grapple with their
book’s core themes- especially as they relate to the sociology of medicine. Then, as
assigned in the course schedule, each club will present to the class a summary of their
book along with the sociological insights garnered in club meetings. Additional
instructions will be handed out in class.
Debate Group Project:
You will have the opportunity in this class to debate (in teams of 2-3) one of the
following controversial medical issues:
Issue #1. Should the Government Regulate the Sale, Advertisement, and
Distribution of Junk food?
Issue #2. Should Addiction to Drugs Be Labeled a Brain Disease?
Issue #3 Does the Health Care Delivery and Research Benefit Men at the Expense
of Women?
Issue #4 Should the United States Adopt a Single-Payer Plan to Fund National
Health Insurance?
Issue #5 Is the Pharmaceutical Industry Responsible for the High cost of
Prescription Drugs?
Specific instructions about the debate group project will be handed out in class.
Research Paper:
Towards the end of the semester, once you have gained a basic understanding of medical
sociology, you will be expected to write a 5-7 page research paper where you will explain
a medical phenomenon in sociological terms. Specific guidelines for the paper will be
handed out in class. Topic approval is mandatory. To receive full credit the paper must
be typed in 12 pt font, double-spaced, stapled and written in ASA style (see attached
guidelines). Papers cannot be e-mailed. You must turn in a hard copy. Papers can
be turned in late but you will be penalized 5 points a day.
Exams:
Three exams (2 midterms, 1 final) will be given based on the chapters and class
discussions covered to that point. The exams generally include multiple choice and short
answer questions. Text readings and class discussions will help you prepare for the
exams.
Extra Credit:
Approximately 30 points of extra credit will be offered throughout the course. You may
write up to two critiques (1-2 pages typed, double-spaced) on any of the movies
described in the back of the syllabus (10 points each). In addition, for all of you excellent
class attendees, there will be 3-4 opportunities throughout the semester for a little extra
credit just for engaging in a couple of classroom activities. Ahh, to think it actually does
pay to come and hang out with us all!
Grades:
Assigned Readings Quizzes
Nestle Test
Groopman Test
Book Club Presentation
Debate Group Project
Paper Approval
Medical Sociology Paper
Exams
4@
1@
1@
1@
1@
1@
1@
3@
10 points
50 points
50 points
100 points
50 points
10 points
100 points
100 points
40
50
50
100
50
10
100
300
Total 700
Grades:
Grades will be assigned based on total points accumulated as follows:
A
658 – 700
A- 630 – 657
B+ 609 – 629
B 581 – 608
BC+
C
C-
560 – 580
539 – 559
511 – 538
490 – 510
D+
D
DE
469 – 489
441 – 468
420 – 440
000 – 419
Schedule:
The following course schedule is a guideline not a contract. Exam, quiz, and discussion
dates may change throughout the semester. Schedule changes may or may not be announced on
Blackboard; however, all schedule changes WILL be announced in class.
Jan
T
4
TH 6
T
Overview of the syllabus
Introduction to Medical Sociology
READ FOR TODAY:
Weiss and Lonnquist, Chapter 1
11
READ FOR TODAY:
Nestle, Chapters 1-2 (Quiz #1)
TH 13
T
18
TH 20
T
The Development of Scientific
Medicine
READ FOR TODAY:
Weiss and Lonnquist, Chapter 2 (Opt.)
Optional: “The Structure of Scientific
Revolution.”
Social Epidemiology
READ FOR TODAY:
Nestle, Chapters 3-4
“Poverty and Ill Health.”
“For Good Health, It Helps to be
Rich and Important.”
READ FOR TODAY:
Weiss and Lonnquist, Chapter 3
25
TH 27
READ FOR TODAY:
Nestle, Introduction
Society, Disease, and Illness
READ FOR TODAY:
Nestle, Chapters 5, 9
TEST #1 (Marion Nestle’s Book Chapters)
Feb
T
1
READ FOR TODAY:
Weiss and Lonnquist, Chapter 4
“Viewing Bodily Imperfection as a Health
Problem.” (Quiz #2)
“Alzheimer’s- The Case for Prevention.”
(Quiz #2)
“Why We are Still Losing the Winnable
Cancer War.” (Quiz #2)
DEBATE ISSUE #1
TH 3
BOOK CLUB #1 PRESENTATION
T
8
TH 10
Social Stress
READ FOR TODAY:
Weiss and Lonnquist, Chapter 5 (Opt.)
Health Behavior
READ FOR TODAY:
Weiss and Lonnquist, Chapter 6
MIDTERM EXAM #1 (Available in the
Testing Center Feb 10, 11, and 12)
T
READ FOR TODAY:
“Just Say No Again.”
“Is Health Promotion Relevant Across
Culture and the Socioeconomic
Spectrum.”
15
TH 17
Experiencing Illness and Disability
T
NO CLASS (Monday Instruction)
22
READ FOR TODAY:
Weiss and Lonnquist, Chapter 7
“Professionalized Service and Disabling
Help.” (Quiz #3)
READ FOR TODAY:
“The Shifting Engines of Medicalization”
TH 24
DEBATE ISSUE #2
Mar T
1
Physicians and the Profession of
Medicine
READ FOR TODAY:
Weiss and Lonnquist, Chapter 8
Groopman (entire book)
TEST #2 (Groopman’s Book)
READ FOR TODAY:
“Fixing Hospitals”
TH 3
BOOK CLUB #2 PRESENTATION
T
DEBATE ISSUE #3
8
TH 10
Medical Education and the
Socialization of Physicians
READ FOR TODAY:
Weiss and Lonnquist, Chapter 9 (Opt.)
“Medical Guesswork”
T
Nurses, Mid-level Health Care
Practitioners, and Allied Health
Workers
READ FOR TODAY:
Weiss and Lonnquist, Chapter 10 (Opt.)
15
PAPER TOPIC APPROVAL DUE
TH 17
READ FOR TODAY:
“Disruptive Physician Behavior”
T
22
The Physician-Patient Relationship:
Background and Models
READ FOR TODAY:
Weiss and Lonnquist, Chapter 12
MIDTERM EXAM #2 (Available in the
Testing Center Mar 24, 25, and 26)
TH 24
T
39
The Health Care System of the United
States
READ FOR TODAY:
Weiss and Lonnquist, Chapter 14 (Opt.)
RESEARCH PAPER DUE @ the beginning
of class
TH 31
DEBATE ISSUE #4
Apr
T
READ FOR TODAY:
“Pills, Power, People” (Quiz #4)
“The Price of Life” (Quiz #4)
5
DEBATE ISSUE #5
TH 7
Comparative Health Care Systems
READ FOR TODAY:
Weiss and Lonnquist, Chapter 17 (Opt.)
BOOK CLUB #3 PRESENTATION
T
MOVIE EXTRA CREDIT DUE
12
TH 14
READING DAY
T
FINAL (7:00-10:00 pm)
19
FINAL (In Class)
Movie List:
1) “Rx for Survival” (2006) Nursing Learning Center- 130 SWKT
“Over the past 150 years, stunning breakthroughs in public health have enabled humans to live
longer, healthier and more productive lives. But the benefits of public health have yet to be
extended to many of the poorest nations in the developing world. Meanwhile, in the past two
decades, infectious diseases that had nearly been conquered, such as tuberculosis, have come
surging back, while devastating new diseases such as AIDS, SARS and West Nile Virus have
emerged…This program examines the most critical health threats facing the world today…”
2) “The Tobacco Conspiracy” (2005) DVD 2837
“This France-Canada co-production goes behind the scenes of the huge tobacco industry, whose
economic power has been expanding for five decades at the expense of public health. A gripping
investigation covering three continents, Nadia Collot’s film exposes the vast conspiracy of a
criminally negligent industry that conquers new markets through corruption and manipulation…”
3) “Remaking American Medicine” (2006) Nursing Learning Center- 130 SWKT
“Examines critical health care issues facing America today, including patient safety, medical and
medication errors, hospital-acquired infections, family-centered care and the effective
management of chronic disease. The program focuses on the advances being made in improving
the quality of patient care and features profiles of providers and patients who are working together
to change the way health care is provided in the United States.”
4) “The Alternative Fix” (2003) DVD 1595
“Frontline examines the controversy over complementary and alternative medical treatments.
Through interviews with staunch supporters, skeptical scientists and observers on both sides
of the debate. These popular treatments are facing increased scrutiny as the first real studies
of their effectiveness are published.”
5) “The Uninsured” (2000)
VC 12296
“Corporate cost-cutting and other business imperatives are making today’s healthcare insurance
either unavailable or unaffordable for America’s working families – 44 million at last count.
Where can America’s uninsured turn for healthcare? Pulitzer Prize-winning journalist
Hedrick Smith reports on how such states as California, Texas and Tennessee are dealing with
the desperate needs of the uninsured and their children.”
6) “Critical Condition” (2007)
Nursing Learning Center- 130 SWKT
“Investigation on the health care crisis in America that follows a diverse group of uninsured
individuals as they battle critical illnesses without proper care.”
7) “Selling Sickness” (2004) DVD 2280
“Documentary examines the pharmaceutical industry’s marketing of antidepressants with
particular emphasis on the firm GlaxoSmithKline. It explores the unhealthy relationships
between society, medical science and the pharmaceutical industry as they promote miracle
cures – selling not just drugs but also the latest diseases that go with them…”
8) “Unnatural Causes” (2008) DVD 4418
“A four-hour documentary series arguing that ‘health and longevity are correlated with
socioeconomic status, people of color face an additional health burden, and our health and
well-being are tied to policies that promote economic and social justice…’”
9) “Big Bucks, Big Pharma” (2006) DVD 2749
“Big Bucks, Big Pharma pulls back the curtain on the multi-billion dollar pharmaceutical industry
to expose the insidious ways that illness is used, manipulated, and in some instances created,
for capital gain. Focusing on the industry’s marketing practices, media scholars and health
professionals help viewers understand the ways in which direct-to-consumer (DTC)
pharmaceutical advertising glamorizes and normalizes the use of prescription medication, and
works in tandem with promotion to doctors…”
10) “The Age of AIDS” (2006) DVD 3560
“…Reveals the astounding spread of the infection (AIDS) to over 70 million infections in 2006.”
11) “Food, Inc.” (2008)
DVD 5291
“An unflattering look inside America's corporate controlled food industry.”
12) “Sicko” (2007) Netflix
Michael Moore’s expose on the American healthcare system.
13) “Super-Size Me” (2004)
Netflix
“While examining the influence of the fast-food industry, Morgan Spurlock personally explores
the consequences on his health of a diet of solely McDonald's food for one month.”
14) “Sick Around America” (2009) pbs.org
“As the worsening economy leads to massive job losses—potentially forcing millions more
Americans to go without health insurance—FRONTLINE travels the country examining the
nation's broken health care system and explores the need for a fundamental overhaul. Veteran
FRONTLINE producer Jon Palfreman dissects the private insurance system, a system that not
only fails to cover 46 million Americans but also leaves millions more underinsured and at risk of
bankruptcy.”
15) “Food Fight” (2008)
Netflix
“A fascinating look at how American agricultural policy and food culture developed in the 20th
century, and how the California food movement rebelled against big agribusiness to launch the
local organic food movement.”
16) “King Corn” (2007)
DVD 4710
“King Corn is a feature documentary about two friends, one acre of corn, and the subsidized crop
that drives our fast-food nation. In King Corn, Ian Cheney and Curt Ellis, best friends from college
on the east coast, move to the heartland to learn where their food comes from. With the help of
friendly neighbors, genetically modified seeds, and powerful herbicides, they plant and grow a
bumper crop of America's most-productive, most-subsidized grain on one acre of Iowa soil. But
when they try to follow their pile of corn into the food system, what they find raises troubling
questions about how we eat-and how we farm.”
17) “Lake of Fire” (2006)
Netflix
Examines both sides of the abortion debate.
18) “The Business of Being Born” (2008)
Netflix
“Birth: it's a miracle. A rite of passage. A natural part of life. But more than anything, birth is a
business. Compelled to find answers after a disappointing birth experience with her first child,
actress Ricki Lake recruits filmmaker Abby Epstein to explore the maternity care system in
America. Focusing on New York City, the film reveals that there is much to distrust behind
hospital doors and follows several couples who decide to give birth on their own terms. There is
an unexpected turn when director Epstein not only discovers she is pregnant, but finds the life of
her child on the line. Should most births should be viewed as a natural life process, or should
every delivery be treated as a potential medical emergency?”
19) “Generation Rx” (2008)
Netflix
“For decades, scores of doctors, government officials, journalists, and others have extolled the
benefits of psychiatric medicines for children. GENERATION RX presents "the rest of the story"
and unveils how this era of unprecedented change in Western culture really occurred - and what
price has been paid by our society.”
Note: I have not vetted many of the “Netflix” movies.