Health Influences of the Environment

lumebiagicrson

macionis_c9.pptx

Home >Social Science homework help >Health Influences of the Environment

Chapter 9 Physical and Mental Health

Tracking the Trends: Mental and Physical Health

People who are obese are at risk for a host of medical problems.

In 1960, about 13% of adults were obese; the obesity rate soared above 30% by 2000 and has continued to increase.

Q. What do you think are some of the reasons for this trend?

Health and Illness: A Global Perspective

Health is the state of complete physical, mental, and social well-being

Infant mortality rate: Number of babies, of every 1,000 born, who die in their first year of life

Life expectancy at birth: Number of years people in a society can expect to live

Chronic disease: An illness that has a long-term development

Health and Illness: A Global Perspective

High-Income Nations

Infant mortality is low, about 5 deaths for every 1,000 births

Life expectancy is high

In U.S., 76 years for males; 81 for females

People die in old age of a chronic disease such as heart disease, cancer, or stroke

In U.S., a high fat diet and little physical work result in 2/3 of adults who are overweight

Global Map 9.1 Infant Mortality in Global Perspective

Health and Illness: A Global Perspective

Low-Income Nations

1 billion people suffer serious illness due to poverty

malnutrition

lack of safe drinking water and poor sanitation

Infant mortality is higher

Life expectancy is lower

Acute disease: illness that strikes suddenly

Ebola, malaria, cholera, typhoid, measles, diarrhea

Rich and Poor Compared: The AIDS Epidemic

Social epidemiology: how health and disease are distributed throughout a society’s population

Epidemic: disease that spreads rapidly

AIDS

Africa has 15% of the world’s population and 71% of HIV cases.

Rich and Poor Compared: The AIDS Epidemic

Why are the world’s poorest nations so hard hit by AIDS?

Poor have weakened health

Poor countries have fewer resources for education and prevention programs

Cultural patterns and AIDS

Rich and Poor Compared: The AIDS Epidemic

AIDS in the United States

U.S. accounts for just 3% of HIV cases

More than 600,000 have died from AIDS

Obama administration has asked for $30 billion annually to fight AIDS

Drug treatments delay onset of full-blown AIDS among people with HIV

Primarily a disease of the poor

Figure 9-1 Deaths from AIDS in the United States

African Americans and Hispanics, who together represent 30% of the U.S. population, account for 56% of all AIDS deaths

Non-Hispanic African Americans are 10x more likely than non-Hispanic whites to become infected; Latinos are 3x times as likely

Paying for Health Care Socialist Systems

The People’s Republic of China

Government administers health care

Barefoot doctors

Blends modern scientific medicine with traditional healing arts

Acupuncture

Medicinal herbs

Cancer and heart disease risks: 53% of men smoke (but only 2% of women)

Paying for Health Care Socialist Systems

The Russian Federation

Health care is still mostly under government control

Doctors are paid less

72% of doctors are women

Economic decline led to declining health

Figure 9-2 Life Expectancy Index for Selected Countries

Life expectancy in the United States is greater than what is typical of lower-income nations but less than that found in many other high-income nations.

Paying for Health Care Capitalist Systems

Socialized medicine: a medical care system in which the government owns and operates most medical facilities and employs most physicians.

Sweden

Health care as a basic right for all citizens

Funded through taxation (= very high taxes)

Physicians are salaried government employees

Paying for Health Care Capitalist Systems

Great Britain

Dual system

Socialized system of health care (since 1948)

Market-based system

National Health Service is funded by tax dollars and covers all British citizens

Private health care for those who can pay

Paying for Health Care Capitalist Systems

Canada

Not state-controlled, but a single-payer system

Government sets fees and pays physicians

Japan

Physicians and hospitals operate privately in a market system

Government programs and private insurance pay the majority of health care costs

Figure 9-3 Extent of Socialized Medicine in

Selected Countries

Most high-income countries tax the population to distribute the cost of health care over the entire population, with people who earn more paying more in taxes.

The U.S. provides government support but treats medical care mostly as a product to be purchased on the open market.

Health Care in the United States: A System in Crisis?

Why the current focus on health care?

U.S. ranks lower than most other high-income countries in health of the population

U.S. spends more per person for health care than any other country

Health in the U.S. reflects economic inequality.

Direct-fee system: medical care system in which patients or their insurers pay directly for the services of physicians and hospitals

The Cost Problem

Health care costs were $2.8 trillion in 2012

Six reasons behind the soaring cost:

Spread of private insurance

Specialization of doctors

More high technology

Lack of preventive care

Ageing population

More lawsuits

Controlling Costs

Pre-admission testing

Out-patient treatment

Regulating the length of hospitalization

Who Pays?

Most people rely on health insurance:

Private Insurance Programs

64% of the population covered by traditional insurance

86% receive insurance through an employer

14% buy it on their own

Health Maintenance Organizations (HMOs)

Private insurance organizations that provide medical care to subscribers for a fixed fee

Focus on controlling costs by disease prevention

Managed care; use of primary care physician

24% of the population enrolled in HMOs

Who Pays?

Government Insurance Programs

Medicare, part of social security for those 65+

15.7% of the population in Medicare in 2012

Medicaid, serves poor people with special needs and families with dependent children

16% of the population enrolled in Medicaid

Veterans receive care in government-operated hospitals

The Coverage Problem

Medical insurance does not cover all the cost of serious accident or illness

48 million people lacked any coverage in 2012

Fewer jobs provide health insurance

The 2010 Health Care Law: The Affordable Care Act

All families now pay an insurance tax.

Insurance companies can no longer drop existing customers because they get sick.

Insurance companies cannot set caps.

Parents can include children up to age 26 on insurance.

Insurance companies cannot refuse coverage due to preexisting health issues.

All families are required to have insurance.

People who do not buy insurance will be subject to penalties.

Health: Class, Ethnicity, and Race

Poverty harms health

Poor nutrition

Unsafe environment

Higher accident rate

Race and health

Prenatal care

Racial bias and health

Life expectancy

Figure 9-4 Life Expectancy of U.S. Children Born in 2011

National Map 9.1 Life Expectancy across the United States

Health: The Importance of Gender

Women have a higher life expectancy than men

Way in which culture defines masculinity

Gender also works against women:

Lower social standing affects health care research

Gender stereotypes distort medical treatment

Health: The Importance of Gender

Eating Disorders

90% of those with eating disorders are women

Women’s value in terms of physical attractiveness

Role of the mass media

People with Disabilities

Disability: a physical or mental condition that limits a person’s everyday activities

Physical disability may become a master status where others see only the disability

Technology and changing attitudes improve quality of life

High poverty rate

Legislation: Americans with Disabilities Act

Nursing Shortage

100,000 nursing positions currently unfilled

Increase in need for nurses going forward:

More illnesses can be treated with new technologies

More outpatient services

Increasing focus on preventive care

More people have health care; Affordable Care Act

Ageing population

Not enough teachers

Women have wider range of job options

High stress

Mental Health and Illness

Mental disorder: psychological or behavioral condition that causes distress and reduces a person’s ability to participate in everyday life

Mental disorders are common

Nearly half of adult Americans suffer from some form of mental illness during their lifetime; mild to severe

Mental Health and Illness

Types of Mental Disorders

DSM IV – Diagnostic and Statistical Manual of Mental Disorders, prepared by American Psychiatric Assn.

Many disorders have biological and social causes

Mental Illness: A Myth?

Thomas Szasz – an illness is real only if it affects the body in a way we can see.

Responding to “difference” with medical labels that stigmatize a person can do harm.

Mental Health and Class

Robert Faris and Warren Dunham study (1939) linked poverty and mental illness

Cause and Effect? Goes both ways:

Mental illness reduces ability earn a living

Poverty breeds stress and social isolation that increase risk of mental disorders

Mental Health, Race and Ethnicity

By themselves, are not determinant

Native Americans have a higher rate

Asian Americans, a slightly lower rate

Link to poverty applies

Treatment Strategies

Treating mental illness is a recent phenomenon

Dorothea Dix (1840) advocated humane care rather than “containment.”

Psychotherapy: An approach to mental health in which patients talk with trained professionals to gain insight into the cause of their problems

Psychoactive drugs (1950s)

Treatment Strategies

Deinstitutionalization: the release of people from hospitals into local communities.

Community Mental Health Centers Construction Act of 1963

From institutions to outpatient centers

Not enough were built

Only 42% of people with mental illness receive regular treatment (63% with serious disorder)

Mental Illness on Campus

30% of college students report being so depressed they could not do their work

84% claim they are overwhelmed at times

Most serious problem is suicide

Psychoactive drugs make it possible to attend college but some may not take their medications properly or may be overwhelmed by demands of college work.

Structural-Functional Analysis: Health and Social Roles

Illness is a social problem because it interferes with the ability to perform societal roles in families and at work.

Sick role: pattern of behavior expected of people defined as ill

Social institutions are linked

Criticism: Health is more complex than being “sick” or “well.”

Symbolic-Interaction Analysis: The Meaning of Health

“Health” and “illness” are partly socially defined; the definitions

differ among societies

change over time

State of mind can affect health of the body

Criticism: Ignores structural factors that play a part in the reality of health; tends to assign blame for poor health to people themselves.

Social-Conflict Analysis: Health and Inequality

Health is linked to inequality

Access to care is critical

U.S. has no guaranteed access to care for all

1/3 struggle to pay medical costs; 15% lack insurance

Capitalism: profit motive over healthcare needs

Criticism: Overlooks fact that U.S. health has improved dramatically. Healthcare systems in more equal societies provide little incentive to develop new treatments.

Feminist Theory: Health and Gender

Risk of illness is greater for women due to increased risk of poverty

Only 34% of physicians are women; research geared to men.

Same rates of mental illness as men, but more likely to be labeled as mentally ill

Cultural definitions of “masculinity” can lead to stress and social isolation for men.

Criticism: Ignores fact that women’s health has improved dramatically; longer lives.

Conservatives: Free-Markets Provide the Best Care

Choice allows people to select doctors and insurance

Do not support the Affordable Care Act

Competition improves quality and value for consumers

Competition leads to innovation and improvements in the health care industry

Individual responsibility for one’s health

Liberals: Government Must Ensure Universal Care

Health care is a right

Combination of health care for profit with access for all

Support the Affordable Care Act

Some would support a larger government role, as in Canada or Great Britain.

Costs would be offset by having a healthier, more productive population.

The Radical Left: Capitalism is Unhealthy

Problem is the inequality of health care.

To improve health, one must:

Remove the profit motive from health care

Replace capitalism with socialism