Sociology of Health and
Illness
Sociology 154
Spring 2006
Contact Information
Professor Drew Halfmann
dhalfmann@ucdavis.edu (please contact me by e-mail rather than phone)
Office Hours: Thursday 1:30-2:30 or by appointment
Office: 2255 Social Science and Humanities
(The Sociology Department is on the corner of 3rd St. and A St.)
Lecture Time and Place: TR 3:10-4:30, Olson 205
Prerequisite: Upper division standing. Previous courses in the social sciences are
recommended.
Course Description:
The course will introduce students to important questions in the sociology of health,
illness and health care, with a major focus on the politics of health. These questions
include: What are the social sources of illness? Why is illness distributed among the
population in the ways that it is? What are the sources of inequality in health status?
What does it mean to be healthy or ill? How are illnesses socially constructed? How
does illness affect people’s identities and the ways that they experience their lives? How
is medicine a form of social control? Has society become more or less “medicalized” and
with what consequences? What are the power relationships between various health care
actors (doctors, nurses, hospitals, insurance companies, HMOs, patients) and what are the
historical sources of these power relationships? What determines the degree to which
health services are funded and provided by the government, employers or private
individuals? Why are so many Americans uninsured? How successful are various
methods of containing medical care costs? What determines the extent to which health
care resources are devoted to promoting health and preventing illness rather than curing
it? How is the health and health care system organized in other countries? Why did
President Clinton’s 1994 attempt to provide universal health insurance coverage fail?
How did the Republican Congress and President Bush succeed in passing a prescription
drug benefit that included some privatization of Medicare?
Welcome to the course. I hope you find it challenging and enjoyable.
Required Texts
1
Chambliss, Daniel F. 1996. Beyond Caring: Hospitals, Nurses, and the Social
Organization of Ethics. Chicago: University Of Chicago Press.
Payer, Lynn. 1996. Medicine and Culture: Varieties of Treatment in the United States,
England, West Germany, and France. New York: Henry Holt and Company.
Soc 154 Course Packet, vol. 1 and Soc 154 Course Packet vol. 2 -- available at Navin’s
Copy Shop, 231 3rd St (at University), 758-2311. Be sure to get both volumes!
The books, but not the course packets, will be on two-hour reserve at Shields Library.
SCHEDULE
Session
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Final
Day
R
T
R
T
R
T
R
T
R
T
R
T
R
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R
T
R
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R
T
S
Date
Mar 30
Apr 4
6
11
13
18
20
25
27
May 2
4
9
11
16
18
23
25
30
Jun 1
6
10
Due Dates
First response paper due
Paper assignment distributed
Paper due
Final exam distributed
Last day for response papers
Final take-home due in my mailbox
by 3:30 pm.
RULES AND REQUIREMENTS
Requirements:
1. Oral and written discussion (10%)
2. 3 2-page Response papers (30%)
3. 10-Page Paper (35%)
4. 6-Page Final take-home exam (25%)
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Lecture and Discussion: You should come to class prepared to discuss the day’s
assigned readings and participate fully. You must attend class, and make thoughtful, ontopic comments based on readings, lectures or media coverage. You will be graded on
both the quality and the quantity of your discussion. In order to facilitate getting to know
each other, I encourage you to fill out a profile at www.thefacebook.com. I may
announce changes to the syllabus or course requirements during the quarter. You are
responsible for keeping up to date with these changes even if you didn’t attend class.
Please turn off cell phones during class and keep late arrivals and departures to a
minimum.
Blog Discussion: You may receive discussion credit by commenting on the class blog.
There is a link to the blog on the course web page. When you enter a comment, please
enter your first name and initial so that I can give you proper credit. You may or may not
want to enter your last name because the blog is public. The blog is meant for discussion
of substantive issues in the course, not for the discussion of class procedures or grading.
If you have a question on these issues, please contact me directly or ask me in class.
Please do not "flame" others on the board. "Flaming" includes derogatory comments,
ridicule, excessive sarcasm, or "shouting"--the use of all capital letters. It also includes
using incendiary terms (“racist”, “sexist”, “naïve”, “ignorant”) to describe classmates or
their positions. Please let me know by e-mail if you notice flaming or other inappropriate
comments. I reserve the right to delete these.
Individual Questions: If you have questions about class material or procedures, please
attend my office hours, ask me after class, or make an appointment by e-mail. Please
refrain from asking questions immediately before class or during break (I am usually
preparing for class at these times).
Assignment submissions: Please submit all written assignments in both hardcopy and
electronic form. Electronic versions should be submitted to
halfmann.course.assignments@gmail.com. Please paste the text of the assignment into
your e-mail. Correct formatting of the electronic submission is not necessary. If you fail
to turn in both a hard copy and electronic copy, there will be a 1/3 letter grade deduction
(i.e. from B to B-). In addition, for all written assignments (this includes response papers,
the mid-term paper, and the final exam), you are required to hand in both your final hard
copy and an earlier, marked-up draft. If you fail to turn in a marked-up draft, there will
be a 1/3 letter grade deduction (i.e. from B to B-).
E-mail policy: In recent years, I have noticed a marked increase in student e-mail
messages. As a result, with the exception of electronic paper submissions, I ask you to
send me e-mail messages only in the following circumstances: 1) to make an appointment
to meet with me 2) to obtain an extension on an assignment (before the assignment is due
and with a legitimate excuse). Please do not send me any other e-mail messages,
including those that ask for clarification of class materials or class procedures (this
should be handled during class, office hours or after class), that notify me of your
absence from class, or that ask what you missed during an absence (please check with
another student). I will only answer e-mails that conform to the e-mail policy.
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Course Web Site: The syllabus, announcements, and other information will be posted
on the course website through my.ucdavis.edu.
Mailing List: I will sometimes make announcements on the course mailing list. You are
responsible for being aware of these.
Reading Assignments: You should complete readings prior to the class period for
which they are assigned. There may be some changes to the syllabus as the quarter
progresses. Students are responsible for all assigned readings whether they are discussed
in class or not. Many of the materials that you will encounter in this course are mainly
aimed at an audience of professional sociologists. As a result, you may find some of
them difficult. When reading these materials, you should focus on identifying the
author’s main theoretical points without getting lost in historical, statistical or other
empirical details.
Response papers: Over the course of the quarter, you are required to turn in three 2page response papers. You may choose the classes for which you turn in response
papers, but the first one must be submitted by the date on the course schedule. You may
also complete up to two extra response papers which will replace your two lowest
response paper grades. Response papers are due at the beginning of the class period for
which the readings were assigned. You should be prepared to discuss the contents of
your response paper during that day’s class. Please see the longer description of the
response papers at the end of the syllabus.
Response paper critiques: During the course of the quarter, we will occasionally discuss
and critique one student’s response paper in class. If you are willing to have your paper
critiqued, please e-mail me the paper on the normal due date with “Critique” in the
subject line (also hand in a hard copy and make an electronic submission). I will then email the paper to the other students in the class and we will discuss it during the next
class meeting. In return for your participation, you will have the opportunity to re-submit
the paper one class meeting after the in-class critique. The opportunity to re-submit will
only apply to papers that are actually critiqued in class.
Paper: You are required to complete one ten-page paper assignment. The topic will be
assigned. The paper must rely solely on assigned and, if you wish, recommended
readings. The paper should be 10 pages, typed, and double-spaced (12-pt. Times Roman
font, 1-inch margins). Please number your pages. Do not exceed the page limit--longer
is not better! The paper is to be completed individually without collaboration, except for
editing by a classmate, friend or the Learning Skills Center.
Final Exam: There will be a take-home final. Students are welcome to turn in the final
early. The final will consist of several essays and will be cumulative. The exam should
be exactly six pages, typed, and double-spaced (12-pt. Times Roman font, 1-inch
margins). Please number your pages. Do not exceed the page limit--longer is not better!
The final is to be completed individually without collaboration.
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Extra Credit: There will be no extra credit papers, assignments, or discussion options
(besides those mentioned above).
Late or Lost Assignments, Incompletes: Late response papers and papers will be
docked 1/3 letter grade (i.e. from B to B-) for each day (including weekends and
holidays) that they are late. Late final take-home exams will be docked one full letter
grade per day. Exceptions to the above will only be made with advanced permission in
the event of a documented emergency (send me an e-mail before the assignment is due!),
or with a written excuse from a doctor, therapist or the UCD Counseling Center (7520871). If you turn in a late paper, please write the day and time when it was submitted on
the front. Please do not ask the department staff for a time stamp. Your electronic
submission will serve as your time stamp. Students are responsible for keeping an extra
copy of all response papers and papers that they hand in. Students are also responsible
for keeping their graded response papers and papers until the end of the quarter in case of
a grading dispute. By university policy, I only grant incompletes when a student has a
serious medical crisis, can document its severity, and has already earned passing grades
on two-thirds of the work required for the course.
Classroom Conduct: It is common for discussion and debate to become spirited in this
class. You have the responsibility to keep your comments professional and courteous.
Please exercise diplomacy, tact, thoughtfulness, self-restraint and respect for others’ point
of view.
Students with Disabilities: I encourage students with disabilities, including “invisible”
disabilities such as chronic diseases, learning disabilities and psychiatric disabilities, to
notify me so that we can discuss accommodations that might be helpful to you.
Academic Integrity: Students are expected to comply with the rules of conduct and
behavior of the University of California-Davis. All students are expected to complete
response papers and papers independently without collaboration (except as mentioned
above). Any cheating or plagiarism will result in a failing grade on the assignment and a
report of the misconduct to the appropriate campus committee. For information about the
student code of conduct, plagiarism and sanctions for violations of academic integrity,
see the Student Judicial Affairs web site (http://sja.ucdavis.edu).
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READINGS
PART 1. SOCIOLOGICAL APPROACHES TO HEALTH, ILLNESS AND
MEDICINE
1. Introduction to the Course.
2. Medical Sociology and the Sociology of Health and Illness
White, Kevin. 2002. “The Development of the Sociology of Health”. Pp. 32-52 in his
An Introduction to the Sociology of Health and Illness. London: Sage Publications.
Bird, Chloe E., Peter Conrad and Allen M. Fremont. 2000. “Medical Sociology at the
Millenium”. Pp. 1-10 in their Handbook of Medical Sociology. Upper Saddle River, NJ:
Prentice Hall.
David Armstrong. 2000. “Social Theorizing About Health and Illness,” Pp. 24-35 in
Albrecht, Gary L., Ray Fitzpatrick, and Susan Scrimshaw. 2000. Handbook of Social
Studies in Health and Medicine. London: Sage Publications.
3. The Social Distribution of Illness
Williams, David. R. 2005. Patterns and Causes of Disparities in Health. Policy
Challenges in Modern Health Care, 115-132, May.
In-class film: “Income, Status and Health”
Recommended
Mirowsky, John, Catherine E. Ross, and John Reynolds. 2000. "Links Between Social
Status and Health Status." in Handbook of Medical Sociology, edited by C. E. Bird, P.
Conrad, and A. M. Fremont. Upper Saddle River, New Jersey: Prentice Hall.
Bruce J. Link and Jo Phelan, “Social Conditions as Fundamental Causes of Disease,”
Journal of Health and Social Behavior 1995 (extra issue): 80-94.
Weitz, Rose. 2004. “The Social Distribution of Illness in the United States”. Ch. 2 in her
The Sociology of Health, Illness, and Health Care: A Critical Approach. Belmont, CA:
Wadsworth/Thomson Learning.
S. Leonard Syme and Lisa F. Berkman, “Social Class, Susceptibility, and Sickness”. Pp
24-29 in Conrad, Peter. 2001 [1976]. The Sociology of Health and Illness: Critical
Perspectives. New York, N.Y.: Worth Publishers.
4. The Social Construction of Health and Illness
Elizabeth M. Armstrong, “Diagnosing Moral Disorder: The Discovery and Evolution of
Fetal Alcohol Syndrome,” Social Science & Medicine 47, no. 12 (1998): 2024-2042.
6
Conrad, Peter. 2002 [1985]. "The Meaning of Medications: Another Look at
Compliance." Pp. 137-48 in Conrad.
Hall, Stephen S. 2005. “The Short of It.” New York Times, Oct. 16
5. Medicalization and Social Control
Zola, Irving Kenneth. 2002 [1972]. “Medicine as an Institution of Social Control”. Pp.
404-413 in Conrad.
Moynihan, Ray, Iona Heath and David Henry. 2002. “Selling Sickness: The
Pharmaceutical Industry and Disease Mongering”. British Medical Journal, April 13, Pp.
886-891.
Recommended
Conrad, Peter and Joseph W. Schneider. 1992. “From Badness to Sickness: Changing
Designations of Deviance and Social Control”. Pp. 17-37 in their Deviance and
Medicalization: From Badness to Sickness. Philadelphia: Temple University Press.
Conrad, P. 1992. "Medicalization and Social Control." Annual Review of Sociology
18:209-232.
Foucault, Michel. 1973. The Birth of the Clinic: An Archaeology of Medical Perception.
New York: Pantheon Books.
6. The Illness Experience
Turner, Bryan S. 1995. “On Being Sick.” Pp. 37-55 in his Medical Power and Social
Knowledge. London: Sage Publications.
Scambler, Graham and Anthony Hopkins. 1986. “Being Epileptic: Coming to Terms
with Stigma.” Sociology of Health and Illness, 8(1):26-43.
Recommended
Charmaz, Kathy. 1991. Good Days, Bad Days: The Self in Chronic Illness and Time.
New Brunswick: Rutgers University Press.
Frank, Arthur W. 2002 [1995]. “The Remission Society”, Pp. 149-152 in Conrad.
PART 2. HEALTH CARE PROVIDERS AND SETTINGS
7. Doctors.
Starr, Paul. 1982. The Social Transformation of American Medicine. New York: Basic
Books, p. 3-29.
McKinlay, John B. and John D. Stoeckle. 2002 [1988]. “Corporatization and the Social
Transformation of Doctoring”. Pp. 175-185 in Conrad.
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McKinlay, John B. and Lisa D. Marceau. 2002 [2000]. “Addendum 2000: The End of
the Golden Age of Doctoring”. Pp. 186-198 in Conrad.
Recommended
Weitz, Rose. 2004. “The Profession of Medicine”. Ch. 11 in her The Sociology of
Health, Illness, and Health Care: A Critical Approach. Belmont, CA:
Wadsworth/Thomson Learning.
Hafferty, Frederic W. and Donald W. Light. 1995. "Professional Dynamics and the
Changing Nature of Medical Work." Journal of Health and Social Behavior 11:132-153.
Gawande, Atul. 2002. “Whose Body Is It Anyway?” Pp. 208-27 in his Complications: A
Surgeon's Notes on an Imperfect Science. New York: Picador.
Gawande, Atul. 2002. “When Doctors Make Mistakes”. Pp. 47-74 in his Complications:
A Surgeon's Notes on an Imperfect Science. New York: Picador.
8. Reaction Paper Workshop
9. The Social Organization of the Hospital, the Professions and Ethics
Chambliss, Daniel F. 1996. Beyond Caring: Hospitals, Nurses, and the Social
Organization of Ethics. Chicago: University Of Chicago Press, all.
10. Alternative Providers
Ted J. Kaptchuk and David M. Eisenberg. 2001. Varieties of Healing, 1: Medical
Pluralism in the United States. Annals of Internal Medicine, 135:189-195.
Ted J. Kaptchuk and David M. Eisenberg. 2001. Varieties of Healing, 2: A Taxonomy
of Unconventional Healing Practices. Annals of Internal Medicine, 135:196-204.
Goldstein, Michael. 2000. “The Emergence of Alternative Medicine.” Pp. 363-372 in
Phil Brown. Perspectives in Medical Sociology. Prospect Heights, Ill.: Waveland Press.
Recommended
Weitz, Rose. 2004. “Other Mainstream and Alternative Health Care Providers”. Ch. 12
in her the Sociology of Health, Illness, and Health Care: A Critical Approach. Belmont,
CA: Wadsworth/Thomson Learning.
Cant, Sarah and Ursula Sharma. 2000. “Alternative Health Practices and Systems” Pp.
426-439 in Gary L. Albrecht, Ray Fitzpatrick, and Susan Scrimshaw. Handbook of Social
Studies in Health and Medicine. London: Sage Publications.
11. Priorities, Prevention and Population Health.
Use the life expectancy calculator at http://www.livingto100.com/.
8
Marmor, T.R., M. L. Barer, and R.G. Evans. 1994. "The Determinants of a Populations
Health: What Can Be Done to Improve a Democratic Nation's Health Status." Pp. 217230 in Why Are Some People Healthy and Others Not: The Determinants of the Health
Of Populations, edited by R. G. Evans, M. L. Barer, and T. R. Marmor. New York: A. de
Gruyter.
Bernstein, Barton J. 2002 [1984]. “The Misguided Quest for the Artificial Heart”. Pp.
352-359 in Conrad.
Recommended
McKinlay, John B. 2002 [1974]. “A Case for Refocussing Upstream: The Political
Economy of Illness.” Pp. 516-529 in Conrad.
Weitz, Rose. 2004. “The Social Sources of Illness”. Ch. 2 in her The Sociology of
Health, Illness, and Health Care: A Critical Approach. Belmont, CA:
Wadsworth/Thomson Learning.
12. The US Medical Care System: Access and Finance
Bodenheimer, Thomas and Kevin Grumbach. 2002. “Paying for Health Care” and
“Access to Health Care”. Chs. 2 and 3 in their Understanding Health Policy: A Clinical
Approach. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division.
Henry J. Kaiser Family Foundation. 2003. Key Facts: Medicaid and the Uninsured.
February.
Henry J. Kaiser Family Foundation. 2003. Fact Sheet: Medicare at a Glance. April
Henry J. Kaiser Family Foundation. 2004. Fact Sheet: The Medicare Prescription Drug
Law. March
Sered, Susan Starr and Rushka Fernandopulle. 2005. “Sick Out of Luck: The Uninsured
in America.” Contexts. Summer.
13. The US Medical Care System: Resources and Rationing
Leichter, Howard M. 1999. "Oregon's Bold Experiment: Whatever Happened to
Rationing?" Journal of Health Politics, Policy and Law. 24:147-161.
In-class film: Health Care Crisis: Who’s at Risk? Companion website:
http://www.pbs.org/healthcarecrisis/
Recommended
Harrison, Stephen and Michael Moran. 2000. “Resources and Rationing: Managing
Supply and Demand in Health Care.” Pp. 493-508 in Gary L. Albrecht, Ray Fitzpatrick,
and Susan Scrimshaw. Handbook of Social Studies in Health and Medicine. London:
Sage Publications.
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Jacobs, Lawrence, Theodore Marmor, and Jonathan Oberlander. 1999. "The Oregon
Health Plan and the Political Paradox of Rationing: What Advocates and Critics Have
Claimed and What Oregon Did." Journal of Health Politics, Policy and Law 24:161-181.
14. The US Medical Care System: Resources, Rationing and Managed Care
Anders, George. 1996. “Turning Doctors into Gatekeepers”, Ch. 5 in his Health Against
Wealth: HMOs and the Breakdown of Medical Trust. Boston: Houghton Mifflin.
Stone, Deborah A. 2002. “Doctoring as a Business: Money, Markets and Managed
Care”. Pp. 283-291 in Conrad.
Mechanic, David. 2001. “The Managed Care Backlash: Perceptions and Rhetoric in
Health Care Policy and the Potential for Health Care Reform.” The Milbank Quarterly.
79:35-54.
15. Comparative Perspectives.
Bodenheimer, Thomas and Kevin Grumbach. 2002. “Health Care in Four Nations.” Ch.
14 in their Understanding Health Policy: A Clinical Approach. New York: Lange
Medical Books/McGraw-Hill Medical Publishing Division.
Marmor, Theodore R. and Jerry L. Mashaw. 2002 [1990]. “Canada’s Health Insurance
and Ours: The Real Lessons, the Big Choices”. Pp. 479-489 in Conrad.
Banks, James, Michael Marmot, Zoe Oldfield, and James P. Smith. 2006. "Disease and
Disadvantage in the United States and in England." JAMA 295:2037-2045.
Recommended
Hacker, Jacob S. 1998. "The Historical Logic of National Health Insurance: Structure and
Sequence in the Development of British, Canadian and U.S. Medical Policy." Studies in
American Political Development 12:57-130.
16. Comparative Perspectives (continued).
Payer, Lynn. 1996. Medicine and Culture: Varieties of Treatment in the United States,
England, West Germany, and France. New York: Henry Holt and Company. (Read
introduction, US, and one other country of your choice.)
PART 4. THE POLITICS OF HEALTH AND HEALTH CARE
17. The Politics of Non-Medical Determinants of Health
Kersh, Rogan and James Morone. 2002. "How the Personal Becomes Political:
Prohibitions, Public Health and Obesity." Studies in American Political Development
16:162-175.
Nestle, Marion and Michael F. Jacobson. 2000. Halting the Obesity Epidemic: A Public
Health Policy Approach. Public Health Reports, 115, pp. 12-24.
10
Recommended
Nestle, Marion. 2002. Food Politics: How The Food Industry Influences Nutrition and
Health. Berkeley: University Of California Press, Pp. 1-66.
Schlosser, Eric. 2002. Fast Food Nation: The Dark Side of the All-American Meal. New
York: Perennial.
18. Health Care Politics
John D. Wilkerson. 2003. The Political Economy of Health in the United States. Annual
Review of Political Science, 6:327-43.
Daniel Beland and Jacob S. Hacker. 2004. Ideas, Private Institutions and American
Welfare State “Exceptionalism”: The Case of Health and Old-Age Insurance, 1915-1965.
International Journal of Social Welfare, 13:42-54.
19. Health Care Politics (continued).
Heclo, Hugh. 1995. "The Clinton Health Plan: Historical Perspective." Health Affairs
14:86-99.
Morone, James A. 1995. “Nativism, Hollow Corporations, and Managed Competition:
Why the Clinton Health Care Reform Failed”. Journal of Health Politics, Policy and
Law 20:391-398.
Recommended
Navarro, Vicente. 1995. "Why Congress Did Not Enact Health Care Reform." Journal of
Health Politics, Policy and Law 20:455-462.
Skocpol, Theda. 1995. “The Rise and Resounding Demise of the Clinton Health Plan,”
Health Affairs 14: 66-85.
Starr, Paul. 1995. “What Happened to Health Care Reform?” The American Prospect.
December 1.
20. Toward the Future
Krugman, Paul. 2006. “The Health Care Crises and What to do About It”. The New
York Review of Books. March 23.
Fuchs, Victor R. and Ezekiel J. Emanuel. 2005. Health Care Reform: Why? What?
When? Health Affairs, 24(6): 1399-1413.
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