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