ASU Medical Sociology 3600 Midterm Study
John Henryism
"steel driving man"- a race against man and machine, he won but heart gave out - the strong behavioral predisposition to cope actively with social stressors, the feeling that one can control the environment through hard work/determination -Sherman James - found the combination of high stress and prolonged high-effort coping with stress is linked with higher risk for hypertension
Stigma and Discrimination Towards People with Mental Illness
- Discrimination: differential treatment in the context of work, family, friendships, and relationships - Emotional reactions: someone who feels anxiety in the presence of a person with mental illness - Stereotypes: the belief that someone hospitalized for mental illness represents a violence risk - Attitudes: disfavoring the social acceptance and inclusion of people with mental illness
Influences of SES on health
- Income influences spending power for good housing, diet, medical care, stress-relieving activities - Occupation influences responsibility and autonomy at work, physcial activity, hazard/health risks - Education influence skills/knowledge for acquiring social, psychological and economic resources
Examples of epidemics/pandemics across the globe
- Zika Virus in South America (2015-2016) - Ebola Virus in Western Africa (2013-2016)
Reactions to Stress
- an inability to manage the social, psychological, and emotional aspects of life can cause a physiological reaction to stressful circumstances -allostatic load
Social Epidemiology and Insights on Social Inequality from Nancy Krieger
- biological expression of social inequality: how people literally embody and biological express experiences of economic and social inequality (link between racial and gender discrimination w/ blood pressure) - "embodiment" (1) bodies tell stories about the conditions of our existence (2)bodies tell stories that oten match people's stated accounts (3) bodies tell stories that people can't or won't tell, either because they're unable, forbidden, or choose not to tell
Obesity
- considered a disease by AMA in 2013 -36% of Americans - highest in US but is increasing in other developing countries - varies significantly by race/ethnicity -increasing among children - varies significantly by level of education
Gender differences in patterning of mental illness
- depressive and anxiety disorders- women -personality and substance-related disorders- men - women internalize (turn inward on themselves - men externalize (substance use and personality disorders that are upsetting to others)
Leading Causes of Disease in Developing Nations
- have disease originating from poor sanitation and malnutrition - tend to have high birth and death rates; young population
Heart Disease, Risk Factors, and the Framingham Heart Study
- heart disease has been the leading cause of death in the US since mid 1960s -Study identified: smoking leading cause of sudden cardiac death, exercise reduces risk, more men than women, obesity increases - highest in southeastern US
Life expectancy in the US
- higher for women, but the gap has narrowed -infant mortality at an all time low -persistent disparity in black vs. white expectancy, but the gap has narrowed - humans are the only species on earth in which one sex has a universal survival advantage
Race as a Social Construction
- humans fairly genetically homogenous -the rise and expansion of European colonialism left a brutal/bloody history of exploitation and enslavement
David R Williams and the Study of Racial Disparities in Health
- identification of perceived racism and discrimination as stressors that influence health disparities between AA's and whites in US -Racism: beliefs, attitudes, institutional arrangements, and acts that tend to denigrate individuals or groups because of phenotypic characteristics
Truth about health lifestyles
- include behaviors like smoking, drinking, and alcohol consumption - they influence whether and how severely one becomes ill - they can be positive or negative - they are influenced by one's social environment
Epidemiologists
- like detectives who investigate people/settings where illness originates - form a logical chain of inferences to explain factors contributing to illness in society
Male Female Gap in Life Expectancy
- likely due to both biological and social-psych factors - women report more illness and disability than men and spend more days at home sick; male death rates exceed those of F at all ages - Women use more medical/preventative care and spend greater time caring for self/others - men more risky behavior (driving fast, alcohol, violent sports - Men have higher death rates from unitentional injuries - Women have greater morbidity and are more likely to report having chronic conditions ( have 2 or more chronic conditions)
Informal care
- long term care services provided by informal caregivers, including family and friends - almost half of family caregivers performed medical/nursing tasks for care recipients with multiple physical and cognitive conditions
People with higher education levels
- more likely to be employed and have fulfilling/rewarding jobs - less economic hardship (they have more money) - less likely to smoke, more likely to exercise, get checkups, appropriate drinking - less social stressors - have control over their lives and health - more social support
The lower social classes
- more likely to have crowded living conditions, poor diet, inferior housing -face increase exposure to violence, alcoholism and problem drinking, smoking, drug abuse - less likely to have access to quality healthcare -disadvantaged in mental health with higher raters of schizophrenia, depression and anxiety disorders
The Whitewall Cohort Study
- one of the first studies to examine relationships between social class and health -followed British male civil servants - found a strong relationship between grade levels of civil servant employment and mortality rates
major areas of investigation in medical sociology
- social facets of health and disease - social behavior of health care personnel and their patients - social functions of health organizations and institutions - the relationship of health care delivery systems to other systems
Social context &/or social environment
- the immediate physical and social setting in which people live - the culture to which one belongs and in which one is educated - the people and institutions with which one interacts
Medical sociology development
- the term medical sociology was coined by physicians in the early 1900's who recognized that social behaviors were related to health - Lawrence Henderson (a physician) changed careers to study sociology and join the newly established sociology department at Harvard - in 1951, Talcott Parsons developed the concept of the sick role to describe how people behave in Western Societies when they become sick - Research funded by the National Institute of Mental Health in the 1950s established social factors to mental illness and care-seeking behavior
Race/Ethnicity and Health
-Black americans have higher rates of mortality , earlier onset of many diseases, comorbidity/impairment -Hispanics have higher mortality than whites from liver disease, diabetes, homicide, and AIDS -Black infants have almost twice as high an infant mortality rate as white infants
Health
-complete physical, mental, and social well-being -the ability to funtion; have good social relationships with friends/family -more than simply the absence of disease of injury
Native Americans and Alaska Natives
-disease of the heart, malignant neoplasm, unintentional injuries, and diabetes are leading causes of American Indian and Alaska Native deaths -life expectancy 5.5 years less than US all races population -NA's high prevalence of alcoholism
Transgender Health Disparities
-endorse a lifetime suicide attempt and ideation compared to non-transgender patients - Report social stressors(violence, discrimination, child abuse)
John Snow- The Father of Field Epidemiology
-in 1854, an epidemic of cholera erupted in London that killed 616 people - he believes sewage dumped onto the river or into cesspools near town wells could contaminate the water supply, leading to a rapid spread of disearse - studies the cholera outbreak by marking each residence on a spot map - traced the outbreak to people who drank water from the Broad Street pump
The Growing Aging Population Increases Burden on the US Economic System
-increased social security payments increased medical care insurance costs -increased uncovered out of pocket medical expenses like long term care and medications
In order for a social variable to qualify as a cause of sickness and mortality it must meet which criteria?
-influence multiple diseases -affect diseases through multiple pathways of risks -be reproduced over time -involved access to resources that can be used to avoid risks
Opportunities and Challenges of the Aging Population in US Society
-lower fertility and mortality rates, declining childhood mortality, improved medical care,nutrition and health lifestyles, sanitation, and housing -aged population will be healthier, better educated, and more affluent than any in US history -increased healthcare costs, greater demands for long-term care services like home health care, nursing home, and assisted living
Impact of Racism on Health
-racism is a determinant of racial/ethnic health inequalities -strong associations between racial discrimination and adult health outcomes
Social determinants of health
-social practices and conditions (lifestyles, living situations, environment) - social class position (income, education, occupation) - government, political and religious factors - poverty and economic conditions - stressful circumstances
Epidemiology
-studies of the origin and distribution of health problems in populations - the "science of epidemics" and studies of the spread of disease
Erving Goffman
-symbolic interactionalism and dramturgy -impression management:thepreparation of one's role and compelling others to react to us in the ways that we wish, to do this we obtain info from- a person's appearance, past experience with similar individuals, the social setting, and the information a person communications about themselves through words and actions - our sense of self is a sacred object; challenges/failurs to project our view of self are distressing
Link and Phelan (1995) propose that medical sociologists must contextualize individually based risk factors by
-using an interpretive framework to understand why people come to be exposed to risk or protective factors -determine the social conditions under which individual risk factors are related to disease
Three Eras in the Evolution of Modern Epidemiology
1. Sanitary Statistics and Miasma (poisoning by bad soil, air and water; clustering of morbidity and mortality associated with drainage sewage and sanitation) - first half of the 19th century 2. Infectious Disease Epidemiology(germ agents isolated in labs relate one to one to specific diseases; transmission is interrupted through quarantine, vaccines, and antibiotics - Late 19th century through first half of the 20th century 3.Chronic Disease Epidemiology ("black box" paradigm: exposure related to outcome w/o necessity for intervening factors or pathogenesis; disease is prevented by controlling risk factors by modifying lifestyle behaviors) - Later half of the 20th century
Racial discrimination affects health through multiple pathways
1. restricted access to social resources such as employment, housing and education 2. negative affective/cognitive and other patho-physiological processes 3. allostatic load and other patho-physiological processes 4.reduced uptake of healthy behaviors (ex. exercise) and/or increased adoption of unhealthy behaviors (substance misuse) either directly as stress coping or indirectly via self-regulation 5. direct physical injury caused by racist violence
Leonard Pearlin
1. stressful experiences don't spring out of a vacuum but typically can be traced back to surrounding social structures, including systems of stratification associated with age, race/ethnicity, gender and social class 2. people occupy statuses and roles within society and social institutions that, when problematic and filled with conflict, can produce considerable stress; social roles are sources of hardship and privilege, threat and security, conflict and harmony 3. a salient feature of sociological stress research is the social distribution of stressors, personal and social resources, and health
Peggy Thoits 5 points about social stress
1.the impact of stress on health is substantial 2. Exposure to stress is unequally distributed in society; certain people and groups experience more than others 3. Members of racial/ethnic minority groups are burdened by addition stress from discrimination 4. Exposure to stress can occur across the life course and contribute to differences in health between social groups 5. The impact of stress on health is reduced for those with high mastery, self-esteem, and social support
Medical sociology, as a subdiscipline, began gaining strength:
After WWII with the infusion of large amounts of federal funding for research
In the case of the sick role, illness is seen as __________, and its undesirable nature reinforces the motivation to be healthy.
Deviance
Ellis Monk: The Cost of Color
Discrimination is a key aspect of stigma and represents a stressor, which may lead to pernicious physiological responses that cause or exacerbate a variety of physical and mental health outcomes -medium skin tone less discrimination to light and dark skin
Socioeconomic Status
Education, income and occupation are factors _ American sociologists use measures of SES to study social class and its relation with health -characteristics present across the lifecourse
The lower class is disadvantaged with respect to physical, but not mental health.
False
The well-educated are more likely to smoke and less likely to exercise than their less-educated counterparts.
False
Leading Causes of Disease- Developed Nations
Improvements in medial technology and living conditions associated with development led to declines in certain diseases like flue and pneumonia; people now live longer lives due to lower death rates from many disease
Unlike infectious diseases, chronic diseases typically are ___ and ___.
Long term and incurable
The health impact pyramid
Most to least important Socioeconomic Factors Changing the context to make Individual's default decisions healthy Long lasting protective interventions Clincical interventions Counseling and Education
The scholar who first provided a major theoretical approach for medical sociology was
Parsons
Changes in lifestyle patterns over the past decades has meant that coronary heart disease is now concentrate more among which group?
Poor/lower class
Fundamental cause of disease
SES represents a this because it embodies access to resources and impacts multiple risk factors and multiple disease outcomes 1. Influences multiple diseases 2. Affects these diseases through multiple pathways of risk 3. Is linked to disease and mortality across historical periods 4. Involves access to resources that can be used to avoid/minimize disease risks and consequences
Leading Causes of Disease in Modern Societies
Smoking, excessive consumption of calories and animal fats,s tress and inadequate physical activity
The cause(s) of the social gradient is most likely related to differences between socioeconomic groups and classes in:
Some combination of: -self esteem and stress levels -the effects of income inequality -deprivation through the life course -health lifestyles and social support
According to Michel, Foucault, the development of modern medicine transformed perceptions of disease from something beyond the boundaries of knowledge to something to be scientifically studied and controlled
True
Order of social class
Upper class (extreme wealth Upper-Middle Class- well educated high level Lower-Middle Class- teachers, small business owners Working Class- skilled, lower-level workers Lower Class- less skilled, long term unemployment
Social class
a group of people who share the same amount of wealth, status and power in society
The World Health Organization defines health as
a state of complete physical, mental, and social well-being
self-esteem
an attitude of approval or disapproval with regard to oneself
"Graying" of the Population
an increasing share of the US population is elderly young old: 65-74 economically independent, healthy, active, and engaged old old: 75-84 icreased life expectancy will strengthen oldest old: 85 and older fastest growing segment of the elderly population
Sexual Orientation
an inherent or immutable enduring emotional, romantic or sexual attraction to other people
Transgender
an umbrella term for people whose gender identity and or expressions is different from cultural expectations based on the sex they were assigned at birth, does not imply sexual orientation
Psychological aging
changes in memory, intelligence, reason skills, and creativity -Alzheimer's disease and dementia are diseases that attack the brain and result in a progressive lose of mental capacity; not a normal part of aging
Gender Dysphoria
clinically significant distress caused when a person's assigned birth gender is not the same as the one with which they identify
Biological aging
declining vision, wrinkles, and decline of muscle mass
Looking Glass Self- Charles H. Cooley
describe how our self concepts are the results of social interaction in which we see ourselves reflected in other people 1. we see ourselves in our imagination as we think we appear to the other person 2. we see in our imagination the other persons judgement of ourselves 3. as a result of what we see in our imagination about how we are viewed by the other person, we experience feelings of satisfaction, pride, or humiliation -an individual's perception as a social object depends on the reactions of other people
Hispanic paradox
evidence of such; Hispanic groups are characterized by low SES, but better than expected health and mortality outcomes
Traumatic events
extreme situations, including natural disasters, that cause great stress and anxiety
Walter Bradford Cannon
fight or flight health=obtaining homeostasis
____ involve access to resources that can be used to avoid risks or to minimize the consequences of disease once it occurs.
fundamental social causes of disease
Rise in life expectancy
improved medical care, nutrition and health lifestyles, sanitation, and housing have combined over the course of more than a century to help prolong lives for most Americans
Decline in deaths from infectious diseases in the second half of the nineteenth century was mainly due to
improvements in diet, housing, and public sanitation
In quantitative studies, what variables are used to measure SES?
income, occupational prestige and education
Pandemics
infections diseases that spread across continetns through the effects of globalization, urbanization and global warming; social behavior and lifestyle can be identified as disease risk factors
Social Epidemiology
investigates social determinants of population distributions of health, disease, and wellbeing; explicit focus on social factors rather than as mere background to biomedical phenomena
Asian Americans
lowest age-adjusted mortality rate of any racial/ethnic group -highest levels of income, education and employment of any group
Social aging
norms, values, and roles that are culturally associated with chronological age -Age identity: some peoplle feel younger or older than their actual age caused by social experienced such as role transitions and off-time events, stress and adversity, and serious illness and poor mental health
Crude mortality (death) rates
number of deaths during year divided by the number of population residents
Incidence
number of new cases of disease during a time period
Prevalence
number of people with disease (cases) divided by the number of people with disease in population
Gender Identity
one's most innermost concept of self as male, female, a blend, or neither
Mastery
perception that one's life chances are under their control rather than fatalistically ruled
Chronic Strains
relatively enduring conflicts of everyday life such as debt and financial strain
Psychiatric epidemiology
research established social factors as related to mental illness and care-seeking behavior; August Hollingshead and Frederick Redlich were among the first sociologists to link social class with risk for mental disorders
Vulnerability in the Aging
results from an interaction between the resources available to individuals and communities and the life challenges they face. sources include: -poverty and race -social networks and a lack of social support -personal limitation -physical location
A social class is a category or group of people who:
share similar levels of wealth, status and power
Social Gerontology
social aspects of aging
The finding that even the upper middle middle class lives shorter than the uppermost class, and that every class lives longer than the one directly below it is evidence of what?
social gradient in mortality
Life events
stressful changes such as divorve, marriage, or losing one's job
Emile Durkheim
suicide
Lifecourse perspectives
take into account how health status at any given age reflects not only contemporary conditions but embodiment of prior living circumstances, in utero onward
Aging
the biological, psychological, and social processes that affect people as they grow older
Gereontology
the comprehensive study of aging and the problems faced by older persons
social support
the degree to which individuals have acces to social resources through relationships
Gender Expressions
the external appearance of one's gender identity, usaly expressed through behavior, clothing, haircut or voice, which may or may not conform to social defined behaviors and characteristics typically associated with being either masculine or feminine
Graying
the increasing share of the population is elderly- 65 and older
Gender Transition
the process by which some people strive to more closely align their internal knowledge of gender with its outward appearance; people can socially transition through dress, names, and behavior or undergo physical transitions to modify their bodies through medical interventions -paucity of knowledgeable providers -lack of insurance coverage -unfriendly office environments - perceived stigma for both the patients themselves and the providers of transgender healthcare
Lifecourse epidemiology
the study of long term effects of later health or disease risk of physical or social exposures during gestation, childhood, adolescence, young adulthood and later adult life
Life Course
the transitions and stages people experience during their lives
Psychiatric Epidemiology
uses the tools of epidemiology and bio statistics to understand the occurrence and distribution of mental behavioral disorders across people, space and time, and to investigate the causes and consequences of these disorders in order to develop more effective strategies to treat and prevent them and to promote mental health