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Chapter 14

Health, Healthcare, and Disability

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Health is not simply the absence of disease but is now a broader definition:

– Health – a state of complete physical, mental, and social well-being

PhysicalSocialPsychological

– Health care – any activity intended to improve health

– Medicine – an institutionalized system for the scientific diagnosis, treatment, and prevention of illness

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• Life expectancy• refers to an estimate of the average lifetime of

people born in a specific year

• Infant mortality rate• the number of deaths of infants under 1 year of

age per 1,000 live births in a given year

• Differences in life expectancy and infant mortality rates insufficient or contaminated food lack access to pure, safe water inadequate sewage and refuse disposal lack of information about maintaining health lack of qualified physicians

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rank countrylifespan

1995-2000lifespan

2000-2005lifespan

2010-2015lifespan

2020-2025lifespan

2045-2050

1. Japan 80.5 81.5 83.3 84.9 88.0

2. Sweden 79.3 80.1 81.1 82.1 84.6

3. Iceland 78.9 79.4 80.3 81.1 83.1

4. Australia 78.7 79.2 80.1 81.0 83.0

5. Israel 78.3 79.2 80.6 81.6 83.5

6. Switzerland 78.6 79.1 80.0 80.9 82.9

7. France 78.1 79.0 80.3 81.5 84.0

8. Canada 78.5 79.0 80.0 80.8 82.8

9. Norway 78.1 78.9 80.2 81.2 83.7

10. Belgium 77.9 78.8 80.2 81.4 83.8

11. Spain 78.1 78.8 79.7 80.6 82.6

12. Italy 78.2 78.7 79.7 80.6 82.5

13. Austria 77.7 78.5 80.1 81.2 83.6

14. Malta 77.6 78.5 80.3 81.6 84.0

15. Greece 78.0 78.5 79.5 80.4 82.4

16. Netherlands 77.9 78.3 79.3 80.2 82.2

17. Cyprus 77.8 78.3 79.2 80.2 82.2

18. United Kingdom 77.2 78.2 79.8 81.1 83.0

19. Germany 77.3 78.2 79.7 81.0 83.4

20. Singapore 77.1 78.1 79.7 80.9 82.9

21. Finland 77.2 78.0 79.7 81.0 83.0

22. New Zealand 77.2 78.0 79.0 80.0 82.0

23. Luxembourg 77.0 77.9 79.5 80.8 82.8

24. USA 76.5 77.5 79.2 80.7 82.6

25. Barbados 76.4 77.2 78.4 79.3 81.4

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– Social epidemiology – the study of the causes and distribution of health, disease, and impairment through a population

• Disease agents:– Biological agents (insects, bacteria, and viruses)

– Nutrient agents (fats and carbohydrates)

– Chemical agents (gases and pollutants in the air)

– Physical agents

• Environment:– Physical (geography and climate)

– Biological (presence of absence of known disease agents)

– Social (socioeconomic status, occupation, and location of home)

• Human Host:– Demographic factors (age, sex and race/ethnicity))

– Physical condition– Habits and customs– Lifestyle

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Chronic diseases – illnesses that are long term or lifelong and that develop gradually or are present from birth

Acute diseases – illnesses that strike suddenly and cause dramatic incapacitation and sometimes death

Two of the most common sources of chronic disease and premature death in the United States

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Age• Chronic disease incidence increase rapidly after age

65• 20 % of the population will be at least 65 by 2050• The number of persons aged 85 or over will have

tripled from 4 million in 1995 to 12 million in 2050

Sex• (2000) Life expectancy at birth was 74.2 years for

males and 79.9 years for females• Gender roles and gender socialization may

contribute to the difference in life expectancy between men and women

Race/Ethnicity and Social Class• Socioeconomic factors trump race as influencers of health• People with lower incomes are more likely to be employed

in jobs that expose them to danger and illness

Health in the United States

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Lifestyle Factors• Drug use and abuse• A drug is any substance - other than food and

water – that, when taken into the body, alters its functioning in some way

• Therapeutic• Recreational

– Alcohol• Adults consume more beer than milk or coffee• Among people who drink, 10 % account for 50%

the total alcohol consumption– Nicotine (Tobacco)

• Responsible for about 1 in every 5 deaths in this country

• Is more addictive than heroin

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This is Bryan Curtis. He started smoking when he was 13 years old. He then began to smoke about 2 packs a day and died just after his 34th birthday of lung and liver cancer. Also pictured is his wife and 2-year-old son

Smoking cigarettes is your choice.

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• Illegal Drugs

• Marijuana is the most extensively used illegal drug in the United States

• About 23 million people over the age of 12 in the United States report that they have used cocaine at least once

• People who use cocaine over extended periods of time have high rates of infection, heart problems, internal bleeding, hypertension, stroke, and other neurological and cardiovascular disorders than do nonusers

Taking drugs is a voluntary action on a person’s part.

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• Sexually Transmitted Diseases

• Having sex is a lifestyle choice• gonorrhea, syphilis, genital herpes, HIV, HPV, AIDS,

ARTAnti-Retroviral Therapy

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Facial Wasting

Buffalo Hump

Protease Paunch

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Holistic Medicine

• An approach to health care that focuses on prevention of illness and disease and is aimed at treating the whole person – body and mind – rather than just the parts in which symptoms occur

Alternative Medicine

• healing practices inconsistent with dominant medical practice

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FunctionalistPerspective:

The Sick Role

(Parsons)People who are sick . . .

1) are not responsible for their condition2) temporarily exempt from normal roles and obligations3) must want to get well4) must seek competent help from a medical professional

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ConflictPerspective:

Inequalities in Health and Health Care

• ability of all to obtain health care• how race, class and gender inequalities affect health• power relationships between doctors and other

healthcare workers• role of profit in the health care system

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Symbolic InteractionistPerspective:

The Social Construction of Illness

• we socially construct health and illness and how both should be treated

• the social definition of illness leads to the stigmatization of individuals who suffer from the disease

• medicalization refers to the process whereby non-medical problems become defined and treated as illnesses or disorders.

• demedicalization (the reverse of this process)

• homosexuality• childbirth• menopause

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Disability knows no economic boundaries

According to disability rights advocates, “disability must be thought of in terms of how society causes or contributes to the problem – not in terms of what is ‘wrong’ with the person with a disability.”

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Questions?Comments?