Chapter 15: Health and
Healthcare
Objectives (slide 1 of 3)
15.1 Defining Health
• Illustrate how culture-bound syndromes impact
health in different cultures.
15.2 Global Health
• Compare and contrast life expectancy and cause of
death in high-, middle-, and low-income countries.
15.3 Health in the United States: Demographic
Factors
• Describe changes in life expectancy in the United
States over the last century.
• Identify demographic factors related to health and
longevity.
Objectives (slide 2 of 3)
15.4 Health in the United States: Life Style Factors
• Illustrate how life style choices affect health and life
expectancy.
• Describe important life style trends and their impact on
morbidity and mortality.
15.5 Health Care in the United States
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Distinguish scientific medicine from alternative medicine.
Analyze trends in health care costs.
Describe health care delivery systems in the United States
Discuss factors affecting both cost and quality of health care
in the United States
Objectives (slide 3 of 3)
15.6 Global Health Care
• Contrast spending on health care in the United
States with other countries and identify some of
the key differences in health care systems of
different nations.
15.7 Theoretical Perspectives on Health and
Health Care
• Illustrate key differences in the theoretical
perspectives of health and medicine.
15.8 Health Care: Future Possibilities
• Identify likely trends in the future of health care.
Defining Health
• Health: Defined by the World Health
Organization (1946) as a state of complete
mental, physical, and social well-being
• Culture-bound syndrome: A conception of
disease or ill health that is limited to a small
number of cultures and is shaped by culture
• Medical sociology: Focuses on the
phenomena of health and illness, the social
organization of health care delivery, and
different access to medical resources
The Impact of Income on Health
• Life expectancy: The average number of years
people are expected to live
• Infant mortality rate: An age-specific death rate;
the number of deaths of infants younger than 1
year of age per 1,000 live births in a given year
• Causes of death: Categories of reasons
attributed for deaths on birth certificates
Major Health Problems in
Different Countries
• Leading causes of death vary by income.
– High-income countries (primarily chronic diseases):
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Cardiovascular disease
Cancers
Diabetes
Dementia
– Middle-income countries:
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Chronic diseases
TB
HIV/AIDS
Road traffic accidents
– Low-income countries (primarily infections diseases):
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Lung infections
Diarrheal diseases
HIV/AIDS
Malaria and TB
Complications of pregnancy and childbirth
Demographics
• Demographics: The study of populations
• Demographic characteristics:
Characteristics of populations such as
age, sex, race, and ethnicity
Social Epidemiology
• Social epidemiology: The study of the
distribution of mortality (death) and
morbidity (disease) in a population
• Epidemiology: Refers to an outbreak of a
disease within a population
Health Demographics in the
United States
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Age
Sex
Race/ethnicity
Social Class
Disability
• Disability: A reduced ability to perform
tasks expected of a normal person at that
stage in life
• Stigma: A distinctive social characteristic
or attribute identifying its owner as
socially unacceptable or disgraced
Mental Illness and
Psychological Disorders
• Psychological disorder: A psychological
condition that is deviant, may cause harm
to oneself or others, and may cause
psychological distress
• Psychological disorders are the leading
cause of disability in the United States
and Canada for people ages 15-44.
Health in the United States: Life
Style Factors
• Life style behaviors contribute greatly to health.
These include eating habits, smoking, the use of
alcohol, unprotected sexual activity, drug abuse,
and other factors. Diseases related to life styles kill
more people than communicable diseases, and
more than 1/7th of our gross domestic product
(GDP) is spent attempting to cure diseases which
could be prevented by changes in life style.
Smoking
• Smoking rates vary dramatically by
gender, age, race/ethnicity, education,
and poverty status.
Diet, Exercise, and Nutrition
• Sociology of the body: The study of how
our bodies are shaped by our social
experiences, values, and culture, as well
as ways in which our bodies affect those
experiences
• Weight categories are based on BMI.
Eating Disorders
• Eating disorder: An extreme effort to control weight
through unhealthy means
• Anorexia nervosa: An intense fear of becoming fat and
a distorted image of one’s own body, leading someone
to drastically reduce body weight through starving
• Bulimia nervosa: Binge eating followed by self-induced
vomiting
• Binge eating disorder: Occurs when the person engages
in recurrent binge eating (eating too much at a sitting)
• Muscle dysmorphia: A condition in which males see
themselves as smaller than they are and work very hard
to gain muscle mass
Alcohol and Drugs
Alcohol
• Binge drinking:
Consuming four or more
alcoholic drinks per
occasion for women or
five or more for men
Drugs
• Reported use of
marijuana and cocaine
by college students both
dropped significantly
between 1980 and
2010.
Firearms
• In 2010, there were 30,923 deaths from
firearms in the United States.
• Firearm-related deaths are due to:
– Suicides (19,308)
– Assaults (11,015)
– Accidents (600)
Unsafe Sex and Sexually
Transmitted Diseases
• HPV (human papillomavirus): The most
commonly sexually transmitted infection
• AIDS (acquired immune deficiency
syndrome): The final stage of HIV
infection in which people have badly
weakened immune systems
• HIV (human immunodeficiency virus): A
lentivirus that weakens the immune
system, leading AIDS.
Motor Vehicle Accidents
• Vehicular accidents are more likely when
the driver is:
– Distracted
– Impaired
– Very young or very old
Health Care in the United States
Scientific Medicine
• Medicine: The social
institution that focuses
on maintaining health
and preventing or
treating disease
Holistic/Eastern Medicine
• Alternative medicine:
Approaches to medicine
that fall outside scientific
medicine
• Holistic medicine:
Medicine that considers
the whole person,
including physical, mental,
and spiritual needs, and is
an alternative to scientific
medicine
The Economics of Health Care
• Issues in US health care costs:
– Aging population
– New technology
Preventive Care
• Cost-saving measures reduce eventual
expenditures.
• Cost-effective measures lead to increased
benefits in the form of quality-adjusted life
year (QALY), a measurement of 1 for one
additional year of life at optimal health, but
between 0 and 1 for an additional year of life
with an adverse condition causing pain or
reducing participation in activities.
Who Pays and Who Has Access?
• Third-party payer: Someone other than the health
care provider or the patient who pays for the service
• Fee-for-service: A method of payment in which
providers are paid for each visit, each operation, and
so on
• Health maintenance organization (HMO): A prepaid
health care plan that delivers comprehensive care to
members through designated providers
• Managed care: A program in which physicians no
longer have complete freedom to decide what
services are provided to patients but must first
approve those services for payment with a third-party
payer
Health Care Costs
Around the World
• The United States spends considerably
more per capita on health care than other
Western industrialized countries
• In 2010, the United States spent 17.6% of
GDP and $8,233 per capita for health.
This was roughly 60% higher than the
next-highest per-capita expenditures of
Norway ($5,400) and Switzerland
($5,300).
Different Health Care Systems
• In universal health care, health care is
regarded as a right and is available to
everyone.
• Socialized medicine: A health care system
in which the government owns most of
the medical facilities and employs most of
the physicians
Functionalist Perspective:
The Sick Role
• The structural functional view sees medicine
as an institution having positive functions for
society.
• Sick role: A set of societal expectations for
the behavior and attitudes of someone who
is ill
– Variations:
• Conditional sick role
• Incurable disease/terminal illness
• Illegitimate role
Conflict Perspective: Social
Inequality (slide 1 of 2)
• The conflict perspective argues that:
– Quality of health care in the United States is
less than in many other countries.
– This is due to inequality, limiting access to
health care for the uninsured poor.
– The domination of health care by the
medical profession allows them to maximize
profits at the expense of the rest of society.
Conflict Perspective: Social
Inequality (slide 1 of 2)
Infant Mortality Rates for Selected
Countries
• Means test: A qualification procedure to
determine whether someone’s wealth
and income are sufficiently low to qualify
them for some form of federal support
• Two-tier medical system: Provides one
level of care for the rich and a lesser level
of care for the poor
Symbolic Interactionism
• Symbolic interactionism views physical
and mental health as statuses that must
be achieved through negotiation and
collaboration with others.
Health Care: Future Possibilities
• Three trends in health care are likely to
continue in the future:
– Continued increases in the use of technology
– Rising costs
– The domination of the health care system by
physicians