Chapter 1

Introduction- What do medical sociologists study?

- Social causes and patterns of health and disease - Social behavior of health care personnel and their patients - Social functions of health organizations and institutions - Relationship of health care delivery systems to other Recognizes the critical role social factors play in determining or influencing the health of individuals, groups, and the larger society in bio-psycho-social context.

II. Models of Health and Social Behavior

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

The Reemergence of Infectious Diseases

-West Nile Virus -Sexually transmitted diseases -Bioterrorism

IV. Medical Sociology

1. Sociology In Medicine -Medical Concerns 2. Sociology of Medicine -Sociological Concerns 3. Sociology of Health and Illness -Critical Concerns

II. Models of Health and Social Behavior 3. Holistic-Contextual Model

1. Structural-Functional Paradigm *Society Works* = function of each element of society generates stability of the whole -> function of medicine in society, medicine as a social institution, sick/healer roles

II. Models of Health and Social Behavior 1. Traditional Medical Model

1. Traditional Medical Model Medicine of the species -Focus of Western Medicine - Cause/Course/Cure -Medical Technology and clinical medicine Germ theory of disease, magic bullets -Biomedical approach: every disease has a specific pathogenic cause best treated by removing or controlling that cause -Medical practice gives little attention to social causes of health and instead focuses on treating disease and illness with drugs

III. Review of Sociological Perspectives 2. Social Conflict Paradigm

2. Social Conflict Paradigm *Society Works for Some at the Expense of Others* = society characterized by social inequality, conflict, change -> criticisms of unequal distribution of health/health care in capitalist society, medicine as a means of social control

II. Models of Health and Social Behavior 2. Social Epidemiologic Model

2. Social Epidemiologic Model Medicine of the social spaces ---Period sees declining mortality rates from infectious diseases (19th c) ✕ Improvements in population's health mainly due to improvements in diet, housing, public sanitation, and personal hygiene instead of medical innovations (McKeown 1979; Porter 1997). -Focus on preventing disease in populations -Promoting healthy environments, lifestyles

II. Models of Health and Social Behavior 3. Holistic-Contextual Model

3. Holistic-Contextual Model "Wholeperson" healthcare (late20th-21st c) ---● Transition from infectious to chronic diseases as leading causes of death (epidemiological transition) around mid-20th century ---● Recognition that social environment and lifestyle practices influence chronic diseases encourages emphasis in medicine on treating the "whole person" -Focus on the health of whole persons in context, health is a result of complex physical, psychological, social, political, economic factors -Bio-Psycho-Social Health

III. Review of Sociological Perspectives 3. Symbolic Interaction Paradigm

3. Symbolic Interaction Paradigm *Society is Perceived * = society is a process/product of interpersonal symbolic interactions, social construction of meanings. -> focus on subjective perceptions of health, illness experience, mind-body connection

Basic Concepts- A. SOCIAL

A. SOCIAL Roles = activities or expectations of individuals in specific social statuses. Relationships = enduring patterns of interaction. Rules - social forces that cause individuals to act in similar ways. Beliefs = ideas about the way things are Values = ideas about the way things should be Norms = expectations about how people are supposed to act in particular circumstances.

B. Defining Health

Bio-Psycho-Social Well-being, Functioning = dealing with the whole person; recognizes and integrates the biological, psychological, and social components of human actions. World Health Organization (WHO) definition: - A state of complete physical, mental, and social well-being, and not merely the absence of disease or injury Laypersons tend to view health as the capacity to carry out their daily activities - Health as the ability to function

VI. Contemporary Topics The Reemergence of Infectious Diseases

Three epidemiological transitions in human history (Armelagos and Harper 2010): ● First - occurred around 10,000 years ago -Marked by the emergence of novel infectious and nutritional diseases ● Second - about 200 years ago -Decline in infectious diseases and a rise in chronic and degenerative diseases ● Third - beginning now -Resurgence of infectious diseases previously thought to be under control

Bioethics

● Area of study focused on ethical decisions and practices with respect to medical care, research, and human's rights over their bodies ● Medical decisions can have profound social implications ● Important cases of unethical behavior, spurring development ● Institutional review boards (IRBs) responsible for oversight of research: ● Health Insurance Portability and Accountability Act (HIPAA) of 1996 ● Also concerned with controversial areas of medical practice and research: -funding of research by pharmaceutical companies, practices such as "ghost-writing" academic articles on the use of medical interventions, stem cell research, use of human genetic material, including cloning, abortion, euthanasia, reproductive technology

II. Models of Health and Social Behavior- Modern medicine and regulation of the body (18th c)

● Michel Foucault (1973) describes development of modern medicine and notes split between two trends: -------● Medicine of the species gave strong emphasis on classifying diseases, diagnosing and treating patients, and finding cures -------● Medicine of social spaces was concerned with preventing disease, especially through government involvement in matters of public hygiene