Ch.1 Overview- Medical sociology

The Health Insurance Portability and Accountability Act (HIPAA)

(1996) regulates the handling of patient data and privacy.

Michel Foucault (1973) describes the development of modern medicine and notes two diverging trends:

1. Medicine of the species, which gives a strong emphasis to classifying diseases, diagnosing and treating patients, and finding cures; and 2. Medicine of social spaces, which was concerned with preventing disease, especially through government involvement in matters of public hygiene. He argues that modern medicine rejects supernatural explanations for disease and treats it as an object to be studied, confronted scientifically, and controlled

Bioterrorism: 2 types:

1. Overt - the perpetrator announces responsibility for the event or is revealed by the attack; 2. Covert - characterized by the unannounced or unrecognized release of agents; the presence of sick people may be the first sign of an attack.

Sexually transmitted diseases: There are four factors responsible for dramatic increase in rates:

1. The birth control pill reduced fears of unwanted pregnancy; 2. The ideology of sexual liberation and permissiveness among young urban adults throughout the world; 3. New patterns of migrant employment in developing nations spread STDs acquired in urban areas to the countryside, and; 4. The availability of multiple sexual partners. This last factor is the most important risk factor in exposure to infection.

The Reemergence of Infectious Diseases Three epidemiological transitions in human history (Armelagos and Harper 2010):

1. The first occurred around 10,000 years ago as human societies shifted from hunting and gathering to agriculture. This period is marked by the emergence of novel infectious and nutritional diseases. 2. The second transition is about 200 years ago - improved nutrition and living standards, public health measures, and medical advances in developed societies led to a decline in infectious diseases and a rise in chronic and degenerative diseases. 3. The final transition is just beginning as we see a resurgence of infectious diseases previously thought to be under control. The potential for the spread of infectious diseases has been significantly enhanced in today's world by the globalization of trade and travel.

Medical Sociology

Is an important field of study -it recognizes the critical role social factors play in determining or influencing the health of individuals, groups, and the larger society.

Defining Health:

Laypersons tend to view health as the capacity to carry out their daily activities. Thus, health can be defined as the ability to function.

The public's health (19th century).

Many governments in Western Europe and the U.S. implement public health measures and improvements in public sanitation. This period sees declining mortality rates from infectious diseases and the improvements in population health are mainly due to improvements in diet, housing, public sanitation, and personal hygiene rather than medical innovations (McKeown 1979; Porter 1997).

The Development of Medical Sociology

Most early works were written by physicians focused on the connections between social conditions and health. Early sociologists did not give much attention to matters of health and medicine. -However, federal funding after WWII gave sociomedical research a boost, and early collaborations were often with psychiatry (e.g., the Hollingshead & Redlich 1958 New Haven study, and the 1962 Midtown Manhattan study by Srole et al.).

The biomedical approach: most dominant

The germ theory of disease (late 19th-20th century): Every disease is understood to have a specific pathogenic cause best treated by removing or controlling that cause. Medical practice gives little attention to the social causes of health and instead focuses on treating disease and illness with drugs.

"Whole person" health care (late 20th-21st century)

The transition from infectious diseases to chronic as the leading causes of death (epidemiological transition) around the mid-20th century fosters a recognition that social environment and lifestyle practices influence health. Encourages an emphasis in medicine on treating the "whole person."

Bioethics

This area of study focuses on ethical decisions and practices with respect to medical care, research, and human rights over their bodies. Medical decisions can have profound social implications and may reflect discrimination and prejudice against particular social groups. -Important cases of unethical behavior (e.g., Nazi experiments and the Tuskegee Syphilis Study in Alabama in 1932) have spurred the development of regulations.

Institutional review boards (IRBs)

are responsible for oversight research and deal with issues such as fully informed, voluntary patient consent; acceptable risk-benefit ratios; and guaranteed patient anonymity and confidentiality.

Defining Health: The World Health Organization (WHO)

defines health as a state of complete physical, mental, and social well-being, and not merely the absence of disease or injury.

Michel Foucault (1973)?

describes the development of modern medicine and notes two diverging trends:

The West Nile virus first appeared in New York City in the summer of 1999.

initially puzzled medical personnel and public health officials, since the disease had not been seen before in the Western hemisphere. It ultimately spread throughout the U.S., reaching a peak number of cases and deaths in 2006. This represents an example of the spread of infectious diseases resulting from globalization.

Bioterrorism

is a relatively new threat of infectious diseases. It takes place when people knowingly prepare biological agents or gases and use them to deliberately induce illness and death among other people. two types:

Talcott Parsons

published The Social System in 1951. -He is the first major social theorist to deal with issues of health, illness, and the role of medicine. He takes a structural-functionalist perspective in his approach to understanding society. -He is most important for introducing the concept of the sick role (patterned sets of expectations defining the norms and values appropriate to being sick).

Sexually transmitted diseases

represent the greatest threat to worldwide health.

Contrasting Ideas about Health and Social Behavior: -Primitive humans: However, -Hippocrates of ancient Greece: The Middle Ages:

tended to rely on magic as the fundamental explanation of disease and illness. represents the first attempt to base an understanding of the body on rational thought, and recognizes the contribution of the environment to human well-being. introduces a split in responsibility for human well-being: the Church attends to social needs while physicians focus on physical ailments.

Medical Sociologists study:

the social causes and patterns of health and disease, social behavior of health care personnel and their patients, social functions of health organizations and institutions, and the relationship of health care delivery systems to other social systems.