Medical Sociology
Sociology 329
Spring 2012
Dr. Kimberlee B. Holland
2047 JFSB
(801) 422-3461
kimberlee_holland@byu.edu
Class: 12:05-2:30 pm T/TH
Room: B030 JFSB
Office Hours: 11:00-11:50 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. 2012. The Sociology of Health, Healing, and
Illness, Seventh Edition. (New Jersey: Prentice-Hall).
T. R. Reid. 2010. The Healing of America: A Global Quest for Better, Cheaper, and
Fairer Health Care. (Penguin)
Assigned articles- 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.?
In the words of Eliot Friedson, “Medical sociology stresses the way in which men shape
and organize the knowledge, perception, and experience of illness, and much of the
substance of illness behavior, its management and treatment. While man is a biological
organism, he responds to himself and others in terms of social meanings he assigns to his
experience with the physical and biological world…it stands to reason that proper
understanding of specifically human rather than generally “animal” illness requires
careful and systematic study of the social meanings surrounding illness.”
Evaluation:
Grading will be based upon assigned reading quizzes, 1 book test, 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 occasionally on the assigned readings.
Quizzes cannot be made-up unless your absence is university approved.
Book Test:
A test, worth 50 points, will given in class to assess whether or not you read and
understood T.R. Reid’s book, The Healing of America. The test 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:
(3) Social Epidemiology
Skloot, Rebecca. 2010. The Immortal Life of Henrietta Lacks
(6) Health Behavior
Campbell, T. Colin. 2006. The China Study: The Most Comprehensive Study of
Nutrition Ever Conducted and the Startling Implications for Diet, Weight Loss,
and Long-term Health.
(7) Experiencing Illness and Disability
Mukherjee, Siddhartha. 2010. The Emperor of All Maladies: A Biography of
Cancer .
Nuland, Sherwin B. 1995. How We Die: Reflections of Life’s Final Chapter.
Conrad, Peter. 2007. The Medicalization of Society: On the Transformation of
Human Conditions into Treatable Disorders.
(8) Physicians and the Profession of Medicine
Goldberg, Paul. 2012. How We Do Harm.
Gawande, Atul. 2011. The Checklist Manifesto: How to Get Things Right.
Gawande, Atul. 2003. Complications: A Surgeon’s Notes on an Imperfect Science.
(9) Medical Education and the Socialization of Physicians
Groopman, Jerome. 2007. How Doctors Think.
Conley, Frances K. 1999. Walking Out on the Boys.
(14) The Health Care System of the United States
Peterson, Melody. 2009. Our Daily Meds: How the Pharmaceutical Companies
Transformed Themselves into Slick Marketing Machines and Hooked the Nation
on Prescription Drugs.
Abramson, John. 2008. Overdosed America: The Broken Promise of American
Medicine.
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 one of the following controversial
medical issues:
(6) Issue #1. Should the Government Regulate the Sale, Advertisement, and
Distribution of Junk food?
(7) Issue #2. Should Addiction to Drugs Be Labeled a Brain Disease?
(14) Issue #3. Should Health Care for the Elderly Be Limited?
Specific instructions about the debate group project will be handed out in class.
Research Paper:
Towards the end of the term, 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. 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 Reading Quizzes
“The Healing of America” Test
Book Club Presentation
Debate Group Project
Paper Approval
Medical Sociology Paper
Exams
4@
1@
1@
1@
1@
1@
3@
20 points
50 points
100 points
50 points
20 points
100 points
100 points
80
50
100
50
20
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.
Apr
T
24
Overview of the Syllabus
Introduction to Medical Sociology &
The Sociological Imagination
READ FOR TODAY:
Weiss and Lonnquist, Chapter 1
“The Need for a New Medical Model.”
“Pre-Med’s New Priorities.”
TH 26
May T
1
Sociological Theory
The Development of Scientific
Medicine
READ FOR TODAY:
Weiss and Lonnquist, Chapter 2
Optional: “The Structure of Scientific
Revolution.”
Social Epidemiology
READ FOR TODAY:
Weiss and Lonnquist, Chapter 3
READ FOR TODAY:
“Poverty and Ill Health.” (Quiz #1)
“For Good Health, It Helps to be Rich and
Rich and Important.” (Quiz #1)
TH 3
Society, Disease, and Illness
READ FOR TODAY:
Weiss and Lonnquist, Chapter 4
“Heart Attack in Women: Different
Symptoms, Higher Risk of Death.”
READ FOR TODAY:
“Alzheimer’s- The Case for Prevention.”
“Why We are Still Losing the Winnable
Cancer War.”
“51% on Meds for Chronic Woes.”
T
8
TH 10
T
15
TH 17
Social Stress
Midterm #1 (In Class)
Health Behavior
READ FOR TODAY:
Weiss and Lonnquist, Chapter 5
READ FOR TODAY:
Weiss and Lonnquist, Chapter 6
“The Do or Die Decade.” (Quiz #2)
“In Your Face.”(Quiz #2)
“Why We Overeat.” (Quiz #2)
“Just Say ‘No’ Again.” (Quiz #2)
Debate #1
READ FOR TODAY:
“If You Feel O.K., Maybe You Are O.K.”
“Is Health Promotion Relevant Across
Culture and the Socioeconomic
Spectrum?”
Experiencing Illness and Disability
READ FOR TODAY:
Weiss and Lonnquist, Chapter 7
“Professionalized Service and Disabling
Help.”
Debate #2
READ FOR TODAY:
“Medicalization” (Quiz #3- all 4)
“The Shifting Engines of Medicalization.”
“On Being Sane in Insane Place.”
“Not All Deviations are ‘Disorders’”
T
22
Physicians and the Profession of
Medicine
READ FOR TODAY:
Weiss and Lonnquist, Chapter 8
Physicians and the Profession of
Medicine
READ FOR TODAY:
“The Surprising Reason Why Heavy Isn’t
Healthy.”
“Fixing Hospitals.”
“More Than 75% Fear Hospital Infection.”
“Intermountain Healthcare Joins Data
E-sharing Network.”
Medical Education and the
Socialization of Physicians
READ FOR TODAY:
Weiss and Lonnquist, Chapter 9
“Utah Must Boost Support for Medical
Education.”
“Medical Guesswork.”
Paper Approval DUE
TH 24
T
29
TH 31
Jun
T
5
Medical Education and the
Socialization of Physicians
READ FOR TODAY:
Reid, Pgs. 1-50
“One in 16 U.S. Surgeons Consider
Suicide.”
Nurses, Mid-level Health Care
Practitioners, and Allied Health
Workers
READ FOR TODAY:
Weiss and Lonnquist, Chapter 10
“Disruptive Physician Behavior.”
Midterm #2 (In Class)
The Physician-Patient Relationship:
Background and Models
READ FOR TODAY:
Reid, Pgs. 51-100
Weiss and Lonnquist, Chapter 12
The Physician-Patient Relationship:
Background and Models
READ FOR TODAY:
“Dishonest Doctors: Why Physicians Lie.”
The Health Care System of the United
States
READ FOR TODAY:
Weiss and Lonnquist, Chapter 14
Reid, Pgs. 101-150
Debate #3
READ FOR TODAY:
“Pills, Power, People.”
“The Price of Life.”
Obamacare
READ FOR TODAY:
Reid, Pgs. 151-200
“The Politics of Health Reform.”(Quiz #4)
“Putting a Premium on Health.” (Quiz #4)
“The Case for Killing Granny.” (Quiz #4)
Medical Sociology Paper DUE
TH 7
Comparative Health Care Systems
“Healing of America” Book Test
READ FOR TODAY:
Weiss and Lonnquist, Chapter 17
Reid, Pgs. 201-272
“Health and Society.”
T
12
TH 14
Reading Day (No Class)
FINAL (3:00-5:00 pm 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.”
20) “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.”
21) “The Last Abortion Clinic” (2005)
DVD 3324
"The headlines today are filled with speculation about changes in the U.S. Supreme Court and
what those changes might mean for abortion--an issue that has divided the country for more
than 30 years. Heated rhetoric from both sides continues to be heard in courtrooms and on the
campaign trail. But while attention is often focused on the arguments, there is another story
playing out in local communities. Pro-life advocates have waged a successful campaign to
reduce abortions in many places throughout the country. By using state laws to regulate and
limit abortion and by creating their own clinics to offer alternatives to women, they have
changed the facts on the ground. FRONTLINE investigates the steady decline in the number
of physicians and clinics performing abortions, and focuses on local political battles in states
like Mississippi, where only a single clinic performs the controversial procedure."
22) “Coke on the Rocks” (2006) DVD 4851
“Documentary on the current challenges facing the Coca-Cola Company, as it tries to survive
within an increasingly fitness-oriented beverage market. Interviews with parents, students,
nutrition experts, and activists about the movement to ban Coke products and other sugarheavy sodas from public schools are included. Comments from Coca-Cola officials who insist
the company can continue dominating the marketplace in the 21st century are also included.”
23) “The Mystery of Chi” (2000)
(?)
“In this video, Bill Moyers spends his time touring Beijing with David Eisenberg. Eisenberg was a
graduate of Harvard Medical School and was an intern in a Boston hospital, but he also had
extensive experience with traditional Chinese medicine (and speaks Chinese well enough to
carry on simultaneous conversations with the informants and with Moyers). One emphasis
throughout the film is the importance of chi (vital energy) to Chinese medicine/thought in
general. For the Chinese, the human body is based on energy: when these energies are in
balance, one is healthy, and when they are out of balance, one is unhealthy. Eisenberg and
Moyers go to several different places and look at several different therapies used to either
bring the body back into balance, or to strengthen the action of the chi itself.”
24) “Post Mortem: Death Investigation in America” (2011) pbs.org
“Popular television shows portray death investigators as high-tech sleuths wielding the most
sophisticated tools of 21st century science. An unprecedented collaborative investigation by
FRONTLINE, ProPublica and NPR found a very different reality: A dysfunctional system in
which there are few standards, little oversight and the mistakes are literally buried. In state
after state, reporters found autopsies -- our final physical exam -- conducted by doctors who
lacked certification and training. An increasing number of the 2.5 million Americans who die
each year go to the grave without being examined at all.”
Note: I have not vetted many of the “Netflix” movies.