CH-14 Health, Health Care, and Disability – Sociology in Our Times: The Essentials : Exam Guide

CHAPTER 14 - HEALTH, HEALTH CARE, AND DISABILITY MULTIPLE CHOICE SECTION 1. At one time, health was considered to be simply the absence of disease. However, the World Health Organization (WHO) defines health as the __________. A. state of complete physical, mental, and social well-being B. absence of infection C. absence of sickness, viruses, and physical pains D. state of equilibrium, with all the parts in balance Answer: A 2. A(n) __________ is socially defined and may change over time and between cultures. For example, in the United States, obesity is viewed as unhealthy whereas in other times and places, obesity signalled that a person was prosperous and healthy. A. disease B. disorder C. illness D. addiction Answer: C 3. A(n) __________ is an objective reality. It is a particular destructive process in the body, with specific causes and characteristic symptoms. There are specific medical criteria for identifying it. A. addiction B. disease C. illness D. disorder Answer: B 4. __________ is the term for any activity intended to improve health. A. Holistic medicine B. Healing C. Medicine D. Health care Answer: D 5. __________ is the term for an institutional system concerned with the scientific diagnosis, treatment, and prevention of illness. A. Health care B. Medicine C. Scientific medicine D. Holistic medicine Answer: B 6. __________ refers to an estimate of the average lifetime of people born in a specific year. A. Life expectancy B. Life cycle C. Life span D. Life longevity Answer: A 7. Although it is estimated that only __________ percent of U.S. citizens will die prior to age 60, health experts estimate that in low-income nations such as Zambia, that __________ percent of the people are not expected to see their 60th birthday. A. 5; 85 B. 10; 90 C. 13; 80 D. 19; 75 Answer: C 8. The __________ is the number of deaths of infants under 1 year of age per 1,000 live births in a given year. A. child mortality rate B. infant mortality rate C. first year of life rate D. baby mortality Answer: B 9. The infant mortality rate in some low-income nations is staggering. In fact, almost __________ percent of all children born in low-income nations die before they reach their first birthday. A. 7 B. 14 C. 21 D. 28 Answer: B 10. There are many reasons for the differences in life expectancy and infant mortality rates in low-income countries compared to high-income countries. Which of the following reasons was not identified as a reason for differences in life expectancy? A. insufficient or contaminated food B. lack of access to pure, safe water C. do not have adequate sewage and refuse disposal D. ample qualified physicians and health care facilities Answer: D 11. Over the past 15 years, life expectancy in low-income nations increased on average from 53 to 62 years, and mortality of children under 5 years of age dropped from 149 to 85 per 1,000 live births. An important factor in the increase in life expectancy in low-income nations has been the development of __________. A. better doctor care B. a safe water supply C. healthier diets D. a good exercise program Answer: B 12. The shorter life expectancy of African Americans is primarily due to their higher rate of A. violence in the central cities. B. violence in the South. C. accidents (for example, car deaths). D. life threatening illnesses such as cancer and heart disease. Answer: D 13. Which of the following statements is true? A. There has been an actual decrease in the health of Native American in recent decades. B. The U.S. is only one of two other high-income, developed nations that do not have some form of universal health coverage. C. Epidemiologists focus on the health problems of individuals. D. Sickness is not interpreted by any social scientists to be a specific form of deviance. Answer: B 14. Pharmaceutical companies that hold the patents on various drugs see their products as something that needs to be protected by law, whereas people in human relief agencies around the world are concerned about the fact that __________ of the world’s population does not have access to essential medicines. A. one-fifth B. one-fourth C. one-third D. one-half Answer: C 15. In comparing health care expenditures in Sweden and the United States, we find that __________. A. Sweden spends less per person on health care, but has a lower infant mortality rate than the U.S. B. Sweden spends less on health care but has a higher infant mortality rate C. Sweden has a shorter life expectancy D. the more money spent on health care, the better the people's health Answer: A 16. A child born in the United States in 2000 had a life expectancy of __________. A. 72.5 years B. 75.3 years C. 77.1 years D. 79.8 years Answer: C 17. A TV actor is advertising a drug and states that, “I have had the same affliction and I know what you are going through.” This illustrates _________________ framing. A. intuitive B. sympathetic C. mainstream D. thematic Answer: B 18. Which statement concerning framing prescription drug ads is false? A. A strength is that patients become aware of newer products and certain illnesses of which they were previously not aware. B. A strength is that the TV narrator usually makes great efforts to alert the consumer to the negative effect of the drug. C. A limitation is that some of these ads play down the fact that other drugs may be more effective. D. A limitation is that ads may encourage people who are not good candidates for a particular drug to pressure their physicians to prescribe it anyway. Answer: B 19. __________ is the study of the causes and distribution of health, disease, and impairment throughout a population. A. Sociology of medicine B. Social epidemiology C. Social health D. Social medicine Answer: B 20. In relation to social epidemiology, __________ include(s) biological agents such as insects, bacteria, and viruses that carry or cause disease; nutrient agents such as fats and carbohydrates; chemical agents such as gases and pollutants in the air; and physical agents such as temperature, humidity, and radiation. A. the human host B. the environment C. disease agents D. health coefficients Answer: C 21. In relation to social epidemiology, __________ include(s) the physical (geography and climate), biological (presence or absence of known disease agents), and social (socioeconomic status, occupation, and location of home). A. health coefficients B. disease agents C. the human host D. the environment Answer: D 22. In relation to social epidemiology, __________ take(s) into account demographic factors (age, sex, and race/ethnicity), physical condition, habits and customs, and lifestyle. A. the human host B. disease agents C. health coefficients D. the environment Answer: A 23. __________ are illnesses that are long-term or lifelong and that develop gradually or are present from birth. A. Disabilities B. Acute diseases C. Epidemics D. Chronic diseases Answer: D 24. Older people (over age 65) are more likely to have __________ diseases. A. acute B. epidemic C. chronic D. infectious Answer: C 25. __________ are illnesses that strike suddenly and cause dramatic incapacitation and sometimes death. A. Epidemics B. Acute diseases C. Disabilities D. Chronic diseases Answer: B 26. Younger people are more likely to have __________ diseases. A. acute B. epidemic C. chronic D. disabling Answer: A 27. Two of the most common sources of chronic disease and premature death are __________. A. tobacco use and infectious disease B. AIDS and heart disease C. heart disease and alcohol abuse D. tobacco use and alcohol abuse Answer: D 28. The Census Bureau projects that about __________ percent of the U.S. population will be at least 65 by the year 2050. A. 15 B. 20 C. 25 D. 30 Answer: B 29. The population of persons age 85 and over in 2000 was about 4 million. The Census Bureau projects that by the year 2050, the population of persons age 85 and over will be about __________. A. 8 million B. 12 million C. 20 million D. 25 million Answer: B 30. For babies born in the United States in 2004, life expectancy at birth was __________ for males. A. 79.9 B. 81.7 C. 75.2 D. 83.5 Answer: C 31. For babies born in the United States in 2004, life expectancy at birth was __________ for females. A. 74.2 B. 80.4 C. 81.7 D. 83.5 Answer: B 32. Sociologist Ingrid Waldron notes that gender roles and gender socialization contribute to the differences in life expectancy. Which of the following statements was not a contributing factor to the differences in life expectancy between men and women? A. Young males are more likely than young females to be socialized to engage in risky behavior. B. Men are more likely to be employed in hazardous situations. C. Men are more reluctant to consult doctors than women. D. Women are less likely than men to use the health care system and have early testing for potential health problems. Answer: D 33. According to a study by the Stanford Center for Research in Disease Prevention, researchers identified several reasons why neighbourhoods make a difference in relation to health and mortality. Which of the following reasons was not cited as a reason why neighbourhoods make a difference in relation to health and mortality? A. access to transportation, education, and good jobs B. availability of safe areas to exercise C. adequate numbers of police and fire departments D. availability of grocery stores with nutritious foods Answer: C 34. Although rural Americans make up 20 percent of the U.S. population, only __________ of the nation’s physicians practice in rural areas, and fewer specialists such as cardiologists are available in these areas. A. 2 percent B. 5 percent C. 9 percent D. 12 percent Answer: C 35. A __________ is any substance other than food and water that, when taken into the body, alters its function in some way. A. drink B. juice C. drug D. vitamin Answer: C 36. __________ use occurs when a person takes a drug for a specific purpose. A. Pleasure B. Therapeutic C. Chronic D. Recreational Answer: B 37. A person taking an aspirin for reducing a fever is an example of __________ drug use. A. recreational B. chronic C. pleasure D. therapeutic Answer: D 38. __________ use occurs when a person takes a drug for no purpose other than for achieving a pleasurable feeling or an altered psychological state. A. Recreational B. Chronic C. Therapeutic D. Acute Answer: A 39. People drinking alcoholic beverages together at the local pub is an example of __________ drug use. A. therapeutic B. chronic C. acute D. recreational Answer: D 40. Several factors have been attributed to long-term chronic heavy drinking or alcoholism. Which of the following factors relating to long-term chronic heavy drinking or alcoholism was not identified? A. nutritional deficiencies B. cardiovascular problems C. hearing impairment D. alcoholic cirrhosis Answer: C 41. For alcoholics, the long-term negative health effects include nutritional deficiencies resulting from poor eating habits. Chronic heavy drinking contributes to __________. A. high caloric consumption and high nutritional intake B. low caloric consumption and high nutritional intake C. low caloric consumption and low nutritional intake D. high caloric consumption and low nutritional intake Answer: D 42. __________ is a progressive development of scar tissue that chokes off blood vessels in the liver and destroys liver cells by interfering with their use of oxygen as a result of continued alcohol consumption. A. Alcoholic cirrhosis B. Cardiovascular deficiencies C. Alcoholic deficiencies D. Cardiovascular cirrhosis Answer: A 43. Alcoholic cirrhosis is the __________ most frequent cause of death in the United States. A. third B. fifth C. seventh D. ninth Answer: D 44. As a dependency-producing psychoactive drug, __________ is more addictive than __________. A. heroin; alcohol B. heroin; tobacco (nicotine) C. alcohol; tobacco (nicotine) D. tobacco (nicotine); heroin Answer: D 45. Tobacco (nicotine) is classified as a(n) __________ because it excites central nervous system receptors and activates them to release adrenaline, which raises blood pressure, speeds up the heartbeat and gives the user a temporary sense of alertness. A. depressant B. hallucinogen C. stimulant D. inhalant Answer: C 46. Although the overall proportion of smokers in the general population has declined somewhat since the 1964 Surgeon General warning that smoking is linked to cancer and other serious diseases, tobacco (nicotine) is still responsible for about __________ of the deaths in this country. A. one-third B. one-fifth C. three-fourths D. two-thirds Answer: B 47. Researchers have found that environmental tobacco smoke (the smoke in the air inhaled by nonsmokers as a result of other people’s tobacco smoking), __________. A. affects smokers more so than nonsmokers B. affects female smokers more than it does male smokers C. is especially hazardous for nonsmokers who carpool or work with heavy smokers D. is not as dangerous as once assumed Answer: C 48. __________ is the most extensively used illegal drug in the United States. A. Tobacco B. Marijuana C. Heroin D. Alcohol Answer: B 49. About __________ of people over age 12 have tried marijuana at least once. A. one-fifth B. one-fourth C. one-third D. one-half Answer: C 50. High doses of __________ used during pregnancy can disrupt the development of the fetus and result in congenital abnormalities and neurological disturbances of the fetus. A. tobacco B. alcohol C. heroin D. marijuana Answer: D 51. Compared with non-users, individuals who use __________ over extended periods of time have higher rates of infection, heart problems, internal bleeding, hypertension, stroke, and other neurological and cardiovascular disorders. A. alcohol B. marijuana C. tobacco D. cocaine Answer: D 52. Although most people find sexual activity enjoyable, it can result in transmission of certain sexually transmitted diseases (STDs). Which of the following STDs was not cited as being prevalent in the United States? A. genital herpes B. gonorrhea C. fever blisters D. syphilis Answer: C 53. Regarding gonorrhea and syphilis, which of the following statements is not valid? A. Both STDs can cause cardiovascular problems. B. Both STDs can cause brain damage. C. Both STDs can result in nutritional deficiencies. D. Both STDs can cause death. Answer: C 54. When attempting to treat gonorrhea and syphilis, penicillin __________. A. can cure most cases of both STDs if the disease has not spread B. can not cure most cases of either STD C. is ineffective in treating gonorrhea, but effective in treating syphilis D. is ineffective in treating syphilis, but effective in treating gonorrhea Answer: A 55. When comparing gonorrhea and syphilis to genital herpes, which of the following statements is valid? A. All three STDs can be cured through the use of penicillin. B. Of the three STDs, genital herpes cannot be cured. C. All three STDs are life threatening. D. All three STDs create a painful rash on the genitals. Answer: B 56. AIDS is caused by __________, and is among the most significant health problems that this nation and the world faces today. A. human immunity virus B. human immunodeficiency virus C. high level immunity virus D. acquired human virus Answer: B 57. Regarding AIDS, which of the following statements is not valid? A. AIDS reduces the body’s ability to fight diseases. B. No one actually dies of AIDS. C. The number of AIDS cases has dropped worldwide. D. In the United States, AIDS related deaths have dropped. Answer: C 58. According to the United Nations Joint Programme on HIV/AIDS, of all new cases worldwide, __________ are children. A. 5 percent B. 14 percent C. 25 percent D. 33 percent Answer: B 59. According to the United Nations Joint Programme on HIV/AIDS, more than two-thirds of the people with HIV/AIDS live in __________. A. the United States B. England C. sub-Saharan Africa D. Canada Answer: C 60. Regarding the transmission of HIV (human immunodeficiency virus), which of the following statements is not valid? A. HIV is transmitted through unprotected or inadequately protected sex with an infected partner. B. HIV is transmitted through sharing a hypodermic needle with someone who is infected with HIV. C. An infected mother can pass the virus on to her child through breastfeeding the child. D. HIV can be transmitted through casual contact, such as shaking hands. Answer: D 61. Which of the following states has an obesity rate of over 30 percent of its population A. Colorado B. Mississippi C. New York D. Oregon Answer: B 62. During the nineteenth century, several factors eventually led to reducing the number of medical schools in the United States. Which of the following was not cited as a reason leading to the number of medical schools in the United States? A. Medical school graduates were typically poor. B. There were too many doctors in the profession. C. There were too many “poor student” graduates. D. The federal government began to provide too many funds for medical schools and students. Answer: D 63. The __________ became the catalyst for modern medical education. A. Coleman Report B. Landsteiner Report C. Ford Foundation D. Flexner Report Answer: D 64. Which of the following was not an outcome of the Flexner report? A. All but two of the African American medical schools were closed. B. Only one of the medical schools for women survived. C. White women and people of color were heavily recruited to attend private medical schools. D. White upper-middle calls males became the American model of medical students and physicians. Answer: C 65. The Flexner report did help professionalize medicine. When we compare post-Flexner medicine with the characteristics of professions, we find that it has several characteristics. Which of the following was not a characteristic cited? A. autonomy B. self-regulation C. universal, general knowledge D. altruism Answer: C 66. With professionalization, __________ gained control over the entire medical establishment. A. the American Medical Association B. licensed medical doctors C. insurance companies D. medical schools Answer: B 67. Throughout its history in the United States, medical care has been on a __________. A. fee-for-service basis B. third-party provider basis C. health maintenance organization basis D. managed care basis Answer: A 68. __________ means that patients are billed individually for each service that they receive, including treatment by doctors, laboratory work, hospital visits, prescriptions, and other health-related expenses. A. Third-party provider B. Fee-for-service basis C. Health maintenance organization D. Managed care basis Answer: B 69. Fee-for-service basis resulted in several effects on medicine, which of the following was not identified as an effect on medicine? A. It has created a two-tier system of medicine. B. It is available for those who can afford it. C. It has contributed to remarkable advances in medicine. D. Private insurers pick up large portions of doctor bills. Answer: D 70. __________ are the only high income nations without some form of universal health coverage for all citizens. A. New Zealand and the United States B. The United States and the Union of South Africa C. The United States and Japan D. The United States and Switzerland Answer: B 71. In a __________, patients pay premiums into a fund that in turn pays doctors and hospitals for each treatment that patient receives. A. fee-for-service program B. third-party provider program C. health maintenance organization program D. managed care program Answer: B 72. According to medical sociologist Paul Starr, __________ is the main reason for medical inflation because it gives doctors and hospitals an incentive to increase medical services. A. health maintenance organization B. managed care C. third-party fee-for-service D. Medicare Answer: C 73. In a third-party provider of health care, which of the following statements is valid? A. Patients have an incentive to limit their visits to doctors, but not hospitals. B. Patients usually seek a second opinion on recommended medical procedure. C. Patients usually pay for their own service. D. Patients have no incentive to limit doctor or hospital visits. Answer: D 74. __________ is a nationwide public health insurance program for persons age 65 or older who are covered by Social Security or who are eligible and “buy into” the program by paying a monthly premium. A. Medicaid B. AARP C. Medicare D. Social Supplementary Income Answer: C 75. __________ is a nationwide public health insurance program which is a jointly funded federal-state-local program established to make health care more available to the poor. A. Medicaid B. Medicare C. Social Security D. Social Supplementary Income Answer: A 76. __________ provide, for a set monthly fee, total care with an emphasis on prevention to avoid costly treatment later. A. Managed care programs B. Fee-for-service C. Health Maintenance Organizations (HMOs) D. Third-party servers Answer: C 77. __________ is any system of cost containment that closely monitors and controls health care providers’ decisions about medical procedures, diagnostic tests, and other services that should be provided to patients. A. Fee-for-service programs B. Health maintenance organizations C. Third-party providers D. Managed care Answer: D 78. In most __________ programs, patients choose a primary care physician from a list of participating doctors. A. fee-for-service B. health maintenance organizations C. managed care D. third-party provider Answer: C 79. Despite public and private insurance programs, about __________ of all U.S. citizens are without health insurance or have had difficulty getting or paying for medical care at some time in the last year. A. one-fourth B. one-third C. one-fifth D. one-half Answer: B 80. An estimated 47.0 million people in the United States had no health insurance in 2006—approximately __________ of the nation’s population. A. 10.2 percent B. 15.8 percent C. 20.5 percent D. 25.3 percent Answer: B 81. Three states have more than 20 percent of its population not covered by health insurance. Which is not one of them? A. Florida B. New Mexico C. Ohio D. Texas Answer: C 82. Canada has a(n) __________ system, which is a health care system in which all citizens receive medical services paid for by tax revenues. In Canada, these revenues are supplemented by insurance premiums paid by all taxpaying citizens. A. universal health care B. health maintenance organizations C. fee-for-service medical care D. socialized medicine Answer: A 83. __________ refers to a health care system in which the government owns the health care facilities and employs the physicians. A. Universal health care B. Health Maintenance Organizations C. A fee-for-service system D. Socialized medicine Answer: D 84. In 1946, Great Britain passed the National Health Service Act. The government sets health care policies, raises funds and controls the medical care budget, owns health care facilities, and directly employs physicians and other health care personnel. Great Britain exemplifies a(n) __________. A. universal health care system B. fee-for-service health care system C. socialized medicine system D. health maintenance organization system Answer: C 85. After the communist takeover in China, the government attempted to educate their large public regarding health care and to provide for the treatment of illness and disease. One policy was to develop a large number of __________, who had little medical training but worked under the supervision of trained physicians. A. physician extenders B. physician assistants C. proletariat physicians D. medical technicians Answer: A 86. A __________ is a document stating the person’s wishes regarding the medical circumstances under which his or her life should be terminated. A. living will B. medical contract C. personal pact D. living covenant Answer: A 87. __________ is 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 part or parts in which symptoms occur. A. Traditional medicine B. Preventive medicine C. Conventional medicine D. Holistic medicine Answer: D 88. It is important that people not look solely to medicine and doctors for their health, but rather that people engage in health-promoting behavior. Likewise, medical professionals must not only treat illness and disease but also work with the patient to promote a healthy lifestyle and self-image. This describes the ___________ approach. A. traditional medicine B. conventional medicine C. holistic medicine D. preventive medicine Answer: C 89. Healing practices inconsistent with dominant medical practice taking a holistic approach to health is known as __________. A. alternative medicine B. conventional medicine C. faith healing D. preventive medicine Answer: A 90. If all forms of alternative medicine (including chiropractic, massage, and spiritual) are taken into account, people spend __________ money on unconventional therapies than they do for all hospitalizations. A. much less B. about the same amount of C. less D. more Answer: D 91. According to the __________ approach, if society is to operate as a stable system, it is important for people to be healthy and to contribute to their society. Consequently, sickness is viewed as a form of deviant behavior that must be controlled by society. A. conflict B. symbolic interactionist C. functionalist D. postmodernist Answer: C 92. According to sociologist Talcott Parsons, the sick role has four primary characteristics. Which of the following characteristics was not cited as a sick role characteristic? A. People who get sick are responsible for their condition. B. People who assume the sick role are temporarily exempt from their normal roles and obligations. C. People who are sick must want to get well. D. People who are sick must seek competent help from a medical professional to hasten their recovery. Answer: A 93. According to some analysts, a major weakness of sociologist Talcott Parson’s sick-role model is that it __________. A. does not emphasize the major role of physicians. B. does not explain society’s role in defining sickness. C. does not take into account racial/ethnic, class, and gender variations. D. provides for a societal explanation of illness-related behavior. Answer: C 94. The __________ theory emphasizes the political, economic, and social forces that affect health and the health care delivery system. A. functionalist B. conflict C. symbolic interactionist D. postmodernist Answer: B 95. Among the issues of concern to __________ theorists are the ability of all people to obtain health care; how race, class, and gender inequalities affect health and health care; power relationships between doctors and other health care workers; the dominance of the medical model of health care; and the role of profit in the health care system. A. conflict B. symbolic interactionist C. functionalist D. postmodernist Answer: A 96. According to many __________ theorists, problems in U.S. health care delivery are rooted in the capitalist economy, which views medicine as a commodity that is produced and sold by the medical-industrial complex. A. symbolic interactionist B. functionalist C. conflict D. postmodernist Answer: C 97. The __________ encompasses both local physicians and hospitals as well as global health-related industries such as insurance companies and pharmaceutical and medical supply companies. A. health care-organizational complex B. medical-industrial complex C. organizational-medical complex D. medical-corporate complex Answer: B 98. According to __________ theorists, physicians—who hold a legal monopoly over medicine—benefit from the existing structure because they can charge inflated fees. A. postmodernist B. symbolic interactionist C. conflict D. functionalist Answer: C 99. According to __________ theorists, we socially construct “health” and “illness” and how both should be treated. For example, some people explain disease by blaming it on those who are ill. If we attribute cancer to the acts of a person, we can assume that we will be immune to that disease if we do not engage in the same behavior. A. symbolic interactionist B. functionalist C. postmodernist D. conflict Answer: A 100. The term __________ refers to the process whereby nonmedical problems become defined and treated as illnesses or disorders. A. medicalization B. demedicalization C. non-medicalization D. remedicalization Answer: A TRUE-FALSE SECTION 1. Health involves not only the absence of disease, but also a positive sense of wellness. In other words, health is a multidimensional phenomenon—it includes physical, social, and psychological factors. Answer: True 2. The infant mortality rate is the number of deaths of infants under 5 years of age per 10,000 live births in a given year. The infant mortality rate in some low-income nations is staggering. In fact, almost 44 percent of all children born in low-income nations die before they reach their first birthday. Answer: False Rejoinder: The infant mortality rate is the number of deaths of infants under 1 year of age per 1,000 live births in a given year. The infant mortality rate in some low-income nations is staggering. In fact, almost 14 percent of all children born in low-income nations die before they reach their first birthday. 3. There are many reasons for differences in life expectancy and infant mortality rates between low-income and high-income nations. Many people in low-income countries have insufficient or contaminated food, lack access to safe water, and do not have adequate sewage and refuse disposal. Answer: True 4. African Americans have a shorter life expectancy than whites due to higher rates of violence. Answer: False Rejoinder: African Americans do have a shorter life expectancy but it is due to life-threatening illnesses like cancer and heart disease. 5. Drug ads typically use sympathetic and intuitive framing in order to sell their product. Answer: True 6. Cultural ethnology is the study of the causes and distribution of health, disease, and impairment throughout a population. Typically, the targets of the study are disease agents, the environment, and the human host. Answer: False Rejoinder: The correct field is referred to as social epidemiology. 7. In relation to the study of health, the environment includes the physical (geography and climate), biological (presence or absence of known disease agents), and social (socioeconomic status, occupation, and location of home). Answer: True 8. Acute diseases are illnesses that are long-term or lifelong and that develop gradually or are present from birth; in contrast, chronic diseases are illnesses that strike suddenly and cause dramatic incapacitation and sometimes death. Answer: False Rejoinder: Just the opposite is true: chronic diseases are illnesses that are long-term and that develop gradually or are present from birth; in contrast, acute diseases are illnesses that strike suddenly and cause dramatic incapacitation and sometimes death. 9. People have a higher survival rate if they live in better-educated or wealthier neighbourhoods than if the neighbourhood is low-income and has low levels of income. Among the reasons researchers believe that neighbourhoods make a difference are the availability of safe areas to exercise, grocery stores with nutritious foods, and access to transportation, education, and good jobs. Answer: True 10. Crack cocaine is the most extensively used illegal drug in the United States. Answer: False Rejoinder: Marijuana is the most extensively used illegal drug in the United States. About one-third of all people over age twelve have tried marijuana at least once. Although most marijuana users are between the ages of 18 and 25, use by teenagers has more than doubled during the past decade. 11. In the 1960s and 1970s, the number of cases of sexually transmitted diseases (STDs) increased rapidly with the introduction of the birth control pill, which led to women having more sexual partners and couples being less likely to use barrier contraceptives (such as condoms). Answer: True 12. Contrary to popular belief, a woman who is HIV positive cannot pass the virus on to her child during pregnancy, childbirth, or breast feeding. Answer: False Rejoinder: HIV is transmitted through unprotected (or inadequately protected) sexual intercourse with an infected partner (either male or female), by sharing a contaminated hypodermic needle with someone who is infected, by exposure to blood or blood products (usually from a transfusion), and by an infected woman who passes the virus on to her child during pregnancy, childbirth, or breast feeding. 13. Throughout its history in the United States, medical care has been on a fee-for-service basis: patients are billed individually for each service they receive, including treatment by doctors, laboratory work, hospital visits, prescription, and other health-related expenses. Answer: True 14. The United States has two nationwide public health insurance programs, Medicare and Medicaid. Medicare is a jointly funded federal-state-local program, established to make health care more available to the poor; whereas, Medicaid is a program for persons age 65 or older who are covered by Social Security or who are eligible and “buy into” the program by paying a monthly premium. Answer: False Rejoinder: Descriptions are switched around. Medicaid is a jointly funded federal-state-local program, established to make health care more available to the poor; whereas, Medicare is a program for persons age 65 or older who are covered by Social Security or who eligible and “buy into” the program by paying a monthly premium. 15. Created in an effort to provide workers with health coverage by keeping costs down, health maintenance organizations (HMOs) provide, for a set monthly fee, total care with an emphasis on prevention to avoid costly treatment later. Answer: True 16. An estimated 47.0 million people in the United States had no health insurance in 2006—approximately 15.8 percent of the nation’s population. The middle class constitutes a substantial portion of this category, and it is estimated that 18 million of the uninsured hold full-time jobs. Answer: False Rejoinder: The working poor constitute a substantial portion of the uninsured in the United States, and it is estimated that 18 million of the uninsured hold full-time jobs. They make too little to afford health insurance, but too much to qualify for Medicaid, and their employers do not provide health insurance coverage. 17. The Canadian health care system does not constitute what is referred to as socialized medicine—a health care system in which the government owns the medical care facilities and employs the physicians. Rather, Canada has maintained the private nature of the medical profession. Answer: True 18. Integrated medicine is 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 part of parts in which symptoms occur. Answer: False Rejoinder: The correct term is holistic medicine. Under this approach, it is important that people not look solely to medicine and doctors for their health, but rather that people engage in health-promoting behavior. Likewise, medical professionals must not only treat illness and disease but also work with the patients to promote a healthy lifestyle and self-image. 19. According to the functionalist approach, if society is to function as a stable system, it is important for people to be healthy and to contribute to their society. Consequently, sickness is viewed as a form of deviant behavior that must be controlled by society. Answer: True 20. Functionalists emphasize the political, economic, and social forces that affect health and the health care delivery system. Among the issues of concern to this approach are the ability of all people to obtain health care; how race, class, and gender inequalities affect health and health care; power relationships between doctors and other health care workers; the dominance of the medical model of health care; and the role of profit in the health care system. Answer: False Rejoinder: This describes the conflict theory on health and health care. 21. The medical-industrial complex encompasses local physicians and hospitals as well as global health-related industries such as insurance companies and pharmaceutical and medical supply companies. Answer: True 22. Medicalization may occur on three levels: the conceptual level (use of medical terminology to define the problem), the institutional level (physicians are supervisors of treatment and gatekeepers to applying for benefits), and the interactionist level (physicians treat patients’ conditions as medical problems). Answer: True 23. The removal of certain behavior (such as homosexuality) from the list of mental disorders compiled by the American Psychiatric Association and the deinstitutionalization of mental health patients, are examples of medicalization. Answer: False Rejoinder: These examples are actually referred to as demedicalization, which refers to the process whereby a problem ceases to be defined as an illness or a disorder. 24. In therapeutic communication there is an open and honest communication between the physician and patient. They communicate openly and honestly, feeling free to ask and seek information on both the physical and psychosocial level. Answer: True 25. Mental disorder refers to a reduced ability to perform tasks one would normally do at a given stage of life and that may result in stigmatization or discrimination against the person with disabilities. Answer: False Rejoinder: The correct term is disability. SHORT RESPONSE SECTION 1. Define health, illness, disease, health care, and medicine and explain the importance of these issues for individuals and the whole of society. Answer: The World Health Organization (WHO) defines health as a state of complete physical, mental, and social well-being. Health involves not only the absence of disease, but also a positive sense of wellness. Health is a multidimensional phenomenon: it includes physical, social, and psychological factors. Illness refers to an interference with health; like health, illness is socially defined and may change over time and between cultures. Disease is an objective reality: it is a particular destructive process in the body, with specific causes and characteristic symptoms. There are specific medical criteria for identifying a disease. Healing involves both personal and institutional responses to perceived illness and disease. One aspect of institutional healing is health care and the health care delivery system in a society. Health care is any activity intended to improve health. When people experience illness, they often seek medical attention in hopes of having their health restored. A vital part of health care is medicine—an institutional system for the scientific diagnosis, treatment, and prevention of illness. 2. Compare health (between high-income and low-income nations) from a global perspective. Answer: Disparities in health are glaringly apparent between high-income and low-income nations when factors such as the prevalence of life-threatening diseases, rates of life expectancy, rates of infant mortality, and access to health services are examined. In regard to global health, the number of people infected with HIV/AIDS more than doubled between 1990 and 2000 (from fewer than 15 million to more than 34 million). Life expectancy refers to an estimate of the average lifetime of people born in a specific year. Most deaths in low-income and middle-income nations are linked to infectious and parasitic diseases that are now rare in high-income, industrialized nations. Among these diseases are tuberculosis, polio, measles, diphtheria, meningitis, hepatitis, malaria, and leprosy. It is estimated that only 13 percent of U.S. citizens and 9 percent of Canadians will die prior to age 60. By contrast, in low-income nations such as Zambia, 80 percent of the people are not expected to see their sixtieth birthday. The infant mortality rate is the number of deaths of infants under 1 year of age per 1,000 live births in a given year. The infant mortality rate in some low-income nations is staggering (261 infants under 1 year of age die per 1,000 live births in Angola). In fact, almost 14 percent of all children born in low-income nations die before they reach their first birthday. A child born in Latin America or Asia can expect to live between 7 and 13 fewer years, on average, than one born in North America or Western Europe. There are many reasons for these differences in life expectancy and infant mortality. Many people in low-income countries have insufficient or contaminated food; lack access to pure, safe water, and do not have adequate sewage and refuse disposal. Added to these hazards is a lack of information about how to maintain good health. Many of these nations also lack qualified physicians and health care facilities with up-to-date equipment and medical procedures. Nevertheless, tremendous progress has been made in saving the lives of children and adults over the past 15 years. Life expectancy at birth has risen to more than 70 years in 84 countries, up from only 55 countries in 1990. Life expectancy in low-income nations increased on average from 53 to 62 years, and mortality of children under 5 years of age dropped from 149 to 85 per 1,000 live births. An especially important advance has been the development of a safe water supply. The percentage of the world’s population with access to safe water nearly doubled between 1990 and 2000. 3. Discuss health in the United States, focusing on social epidemiology areas such as age, sex, race/ethnicity, and social class. Answer: Social epidemiology is the study of causes and distribution of health, disease, and impairment throughout a population. Typically, the target of the investigation is disease agents, the environment, and the human host. Disease agents include biological agents such as insects, bacteria, and viruses that carry or cause disease; nutrient agents such as fats and carbohydrates; chemical agents such as gases and pollutants in the air; and physical agents such as temperature, humidity, and radiation. The environment includes the physical (geography and climate), biological (presence or absence of known disease agents), and social (socioeconomic status, occupation, and location of home) environments. The human host takes into account demographic factors (age, sex, and race/ethnicity), physical condition, habits and customs, and lifestyle. Age—rates of illness and death are highest among the old and the young. Chronic diseases are illnesses that are long-term or lifelong and that develop gradually or are present from birth; in contrast, acute diseases are illnesses that strike suddenly and cause dramatic incapacitation and sometimes death. Two of the most common sources of chronic disease and premature death are tobacco use, which increases mortality among both smokers and people who breathe the tobacco smoke of others, and alcohol abuse. Sex—prior to the 2oth century, women had lower life expectancies than men because of high mortality rates during pregnancy and childbirth. Preventive measures have greatly reduced this cause of female mortality, and women now live longer than men. Gender roles and gender socialization also contribute to the differences in life expectancy. Men are more likely to work in dangerous occupations. As a result of gender roles, males may be more likely than females to engage in risky behavior such as drinking alcohol, smoking cigarettes, using drugs, driving dangerously, and engaging in fights. Women are more likely to use the health care system with the result that health problems are identified and treated earlier, whereas many men are more reluctant to consult doctors. Race/ethnicity and social class—recent research trends suggest that income and factors such as the neighbourhood in which a person lives may be more significant than race or ethnicity with respect to these issues. According to a study by the Stanford Centre for Research in Disease Prevention, people have a higher survival rate if they live in better-educated or wealthier neighbourhoods. Among the reasons researchers believe that neighbourhoods make a difference are the availability (or lack of) of safe areas to exercise, grocery stores with nutritious foods, and access to transportation, education, and good jobs. People of colour are more likely to have incomes below the poverty line, and the poorest people typically receive less preventive care and less optimal management of chronic diseases than do other people. 4. Discuss what sympathetic and intuitive framing are in the context of drug ads. Answer: Drug advertising is a large business—nearly $5 billion is spent each year on trying to get consumers to want to take a particular drug. Drug ads use sympathetic framing and intuitive framing to help TV viewers, newspaper and magazine readers, and Internet users to believe that they are not alone if they have a particular illness or disability. In sympathetic framing a “real person” gives a testimonial about how a particular drug has helped him or her cope with the problem. The goal is to convey a sympathetic message to the audience because he or she has also experienced that particular problem. Then, a narrator or voice-over makes several statements indicating that the consumer may not want to discuss the problem with others, but they can help. The solution: buy the pill or ask the doctor for a prescription. 5. Explain how drug use and abuse lifestyle factors affect health. Answer: A drug is any substance other than food and water that, when taken into the body, alters its functioning in some ways. Drugs are used for either therapeutic or recreational purposes. Therapeutic use occurs when a person takes a drug for a specific purpose such as reducing a fever or controlling a cough. In contrast, recreational use occurs when a person takes a drug for no purpose other than achieving a pleasurable feeling or psychological state. Alcohol and tobacco are example of drugs that are primarily used for recreational purposes. Alcohol—the use of alcohol is considered an accepted part of the dominant culture in the United States. Chronic heavy drinking or alcoholism can cause permanent damage to the brain or other parts of the body. For alcoholics, the long-term negative health effects include nutritional deficiencies resulting from poor eating habits; cardiovascular problems such as inflammation and enlargement of the heart muscle, high blood pressure, and stroke; and eventually to alcoholic cirrhosis—a progressive development of scar tissue that chokes off blood vessels in the liver and destroys liver cells by interfering with their use of oxygen. Nicotine (tobacco)—the nicotine in tobacco is a toxic, dependency producing psychoactive drug that is more addictive than heroin. It is classified as a stimulant because it stimulates central nervous system receptors and activates them to release adrenaline, which raises blood pressure, speeds up the heartbeat, and gives the user a temporary sense of alertness. Tobacco is still responsible for about one in every five deaths in this country. Even people who never light up a cigarette are harmed by environmental tobacco smoke—the smoke in the air inhaled by nonsmokers as a result of other people’s tobacco smoking. Illegal drugs—marijuana is the most extensively used illegal drug in the United States. About one-third of all people over age twelve have tried marijuana at least once. High doses of marijuana smoked during pregnancy can disrupt the development of a fetus and result in congenital abnormalities and neurological disturbances. Another widely used illegal drug is cocaine. People who use cocaine over extended periods of time have higher rates of infection, heart problems, internal bleeding, hypertension, stroke, and other neurological and cardiovascular disorders than do nonusers. Intravenous cocaine users who share contaminated needles are also at risk for contracting AIDS. 6. Discuss how lifestyle factors related to sexually transmitted diseases affect health. Answer: Prior to 1960, the incidence of sexually transmitted diseases (STDs) in this country had been reduced sharply by barrier type contraceptives (condoms) and the use of penicillin as a cure. However, in the 1960s and 1970s the number of cases of STDs increased rapidly with the introduction of the birth control pill, which led to women having more sexual partners and couples being less likely to use barrier contraceptives. Gonorrhea and syphilis—until the 1960s, gonorrhea (today the second most common STD) and syphilis were the principle STDs in this country. Today, however, they constitute less than 15 percent of all cases of STDs reported in U.S. clinics. Untreated gonorrhea may spread from the sexual organs to other parts of the body, among other things negatively affecting fertility; it can also spread to the brain or heart and cause death. Untreated syphilis can, over time, cause cardiovascular problems, brain damage, or even death. Penicillin can cure most cases of either gonorrhea or syphilis as long as the disease has not spread. Genital herpes—this sexually transmitted disease produces a painful rash on the genitals. It can not be cured: once the virus enters the body, it stays there for the rest of a person’s life, regardless of treatment. AIDS (acquired immunodeficiency syndrome) which is caused by HIV (human immunodeficiency virus) is among the most significant health problems that this nation and the world faced today. Although AIDS almost inevitably ends in death, reduces the body’s ability to fight diseases, making a person vulnerable to many diseases, such as pneumonia that result in death. Worldwide, however, the number of people with HIV or AIDS is increasing at an alarming rate. The United Nations Joint Programme on HIV/AIDS estimates that in 2005, more than 40 million people had HIV/AIDS. More than two-thirds of the people with HIV/AIDS live in sub-Saharan Africa. HIV is transmitted through unprotected (or inadequately protected) sexual intercourse with an infected partner (either male or female), by sharing a contaminated hypodermic needle with someone who is infected, by exposure to blood or blood products (usually from a transfusion), and by an infected woman who passes the virus on to her child during pregnancy, childbirth, or breast feeding. 7. Summarize the rise of scientific medicine, professionalism and medicine today, in the United States. Answer: To make medicine in the United States more scientific and more profitable, the Carnegie Foundation (at the request of the American Medical Association and the forerunner of the Association of American Medical Colleges) commissioned an official study of medical education. The “Flexner report” that resulted from this study has been described as the catalyst of modern medical education. To conduct his study, Abraham Flexner met with the leading faculty at the Johns Hopkins University School of Medicine to develop a model of how medical education should take place; he next visited each of the155 medical schools then in existence, comparing them with the model. As a result of the Flexner report, all but two of the African American medical schools then in existence were closed, and only one of the medical schools for women survived. As a result, white women and people of color were largely excluded from medical education for the first half of the twentieth century. The Flexner report did help professionalize medicine. We find that it meets those characteristics: (1) abstract, specialized knowledge, (2) autonomy, (3) self-regulation, (4) authority, and (5) altruism. Throughout its history in the United States, medical care has been on a fee-for-service basis. Patients are billed individually for each service they receive, including treatment by doctors, laboratory work, hospital visits, prescriptions, and other health-related expenses. There are both good and bad sides to the fee-for-service approach. The good side is that in the “true spirit” of capitalism, coupled with the hard work and scholarship of many people, this approach has resulted in remarkable advances in medicine. Among recent medical innovations are the following: bloodless surgery and robotdoc. The bad side of fee-for–service medicine is its inequality of distribution. In effect, the United States has a two-tier system of medical care. Those who can afford it are able to get top-notch medical treatment. 8. Explain the four methods of paying for health care and controlling health care costs in the United States. Answer: The United States and the Union of South Africa are the only developed nations without some form of universal health coverage for all citizens. Private health insurance—part of the reason that the cost of fee-for-service health care in the United States escalated rapidly beginning in the 1960s was the expansion of medical insurance programs at that time. Third-party providers began picking up large portions of doctor and hospital bills for insured patients. With third-party fee-for-service payment, patients pay premiums into a fund that in turn pays doctors and hospitals for each treatment the patient receives. According to medical sociologist Paul Starr, third-party fee-for-service is the main reason for medical inflation because it gives doctors and hospitals an incentive to increase medical services. In other words, the more services they provide, the more fees they charge, and the more money they make. Patients have no incentive to limit their visits to doctors or hospitals because they have already paid their premiums and feel entitled to medical care, regardless of the cost. Likewise, man patients simply depend on the advice of their physicians to determine what treatment to have; they do not independently decide on what medical care they need. Public health insurance—the United States has two nationwide public health insurance programs, Medicare and Medicaid. Medicare is a program for persons age 65 or older who are covered by Social Security or who eligible and “buy into” the program by paying a monthly premium. Medicare pays part of the health care costs of these people. Medicaid, a jointly funded federal-state-local program, was established to make health care more available to the poor. However, both the Medicaid program and the Medicare program are in financial difficulty. Health maintenance organizations (HMOs)—were created in an effort to provide workers with health coverage, by keeping costs down. Health maintenance organizations (HMOs) provide, for a set monthly fee, total care with an emphasis on prevention to avoid costly treatment later. The doctors do not work on a fee-for-service basis, and patients are encouraged to get regular checkups and to practice good health practices (exercise and eat right). As long as patients use only the doctors and hospitals that are affiliated with their HMO, they pay no fees, or only small co-payments, beyond their insurance premiums. Managed care—is another approach to controlling health care costs in the United States. Managed care is any system of cost containment that closely monitors and controls health care providers’ decisions about medical procedures, diagnostic tests, and other services that should be provided to patients. Patients choose a primary-care physician from a list of participating doctors. When patients need medical services, they must first contact the primary-care physician; if a specialist is needed for treatment, the primary-care physician refers the patient to a specialist who participates in the program. Doctors must get approval before they perform certain procedures or admit a patient to a hospital; if they fail to obtain such advance approval, the insurance company has the right to refuse to pay for the treatment or hospital stay. 9. Describe how other nations (Canada, Great Britain, and China) pay for medical care. Answer: Canada—prior to the 1960s, their health care system was similar to that of the United States today. However, in 1962 the government of the province of Saskatchewan implemented a health insurance plan despite opposition from doctors, who went on strike to protest the program. The Saskatchewan program proved itself viable in the years following the strike, and by 1972 all Canadian provinces and territories had coverage for medical and hospital service. Canada has a universal health care system—a health care system in which all citizens receive medical services paid for by tax revenues. In Canada, these revenues are supplemented by insurance premiums paid by all taxpaying citizens. One major advantage of the Canadian system over that in the United States is a significant reduction in administrative costs. Whereas more than 20 percent of the U.S. health care dollar represents administrative costs, in Canada the corresponding figure is 10 percent. Canadians are allowed unlimited trips to the doctor, and doctors can increase their income by ordering extensive tests and repeat visits. The Canadian health care system does not constitute what is referred to as socialized medicine—a health care system in which the government owns the medical care facilities and employs the physicians. Canada has maintained the private nature of the medical profession. Great Britain—in 1946 passed the National Health Service Act, which provided for all health care services to be available at no charge to the entire population. The government sets health care policies, raises funds and controls the medical care budget, owns health care facilities, and directly employs physicians and other health care personnel. The health care system in Great Britain does constitute socialized medicine. Physicians receive capitation payments from the government: a fixed annual fee for each patient in their practice regardless of how many times they see the patient or how many procedures they perform. They also receive supplemental payments for each low-income or elderly patient in their practice, to compensate for the extra time such patients may require. China – after a lengthy civil war in 1949 the Communist Party won control of the mainland. Malnutrition was prevalent, life expectancies were short, and infant and maternal mortality rates were high. With a lack of both financial resources and trained health care personnel, China needed to adopt innovative strategies in order to improve the health of its populace. One policy was to develop a large number of physician extenders and sending them into the cities and rural areas to educate the public regarding health and health care and to treat illness and disease. Doctors who work in hospitals receive a salary; all other doctors now work on a fee-for-service basis. The cost of health care generally remains low, but the cost of hospital care has risen; accordingly, many Chinese, if they can afford it, purchase health care insurance to cover the cost of hospitalization. As a low-income country, China spends only 5 percent of its gross domestic product on health care, but the health of its citizens is only slightly below that of most industrialized nations. 10. List and discuss three major social implications of advanced medical technology. Answer: Advances in medical technology are occurring at a speed that is almost unbelievable; however, sociologists have identified specific social implications of some of the new technologies. (1) the new technologies create options for people and for society, but options that alter human relationships. An example is the ability of medical personnel to sustain a life that in earlier times would have ended as the result of disease or an accident. Although this can be beneficial, technologically advanced equipment that can sustain life after consciousness is lost and there is no likelihood that the person will recover can create a difficult decision for the family of that person if he or she has not left a living will—a document stating the person’s wishes regarding the medical circumstances under which his or her life should be terminated. Federal law requires all hospitals and other medical facilities to honor the terms of a living will. (2) the new technologies increase the cost of medical care. For example, the computerized axial tomography (CAT) scanner—which combines a computer with X-rays that are passed through the body at different angles, produces clear images of the interior of the body that are invaluable in investigating disease. However, the cost of such a scanner is around $1 million. Magnetic resonance imaging (MRI) equipment that allows pictures to be taken of internal organs ranges in cost from $1 million to $2.5 million. (3) the new technologies raise provocative questions about the very nature of life. During 1997, Dr. Ian Williams and his associates in Scotland cloned a lamb (that they named Dolly) from the DNA of an adult sheep. Subsequently, scientists have cloned other animals in the same manner, raising a number of profound questions. 11. Compare and contrast holistic medicine and alternative medicine with traditional or orthodox medical treatment. Answer: When examining the subject of medicine, it is easy to think only in terms of conventional (or mainstream) medical treatment. By contrast, holistic medicine is 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 part of or parts in which symptoms occur. Under this approach, it is important that people not look solely to medicine and doctors for their health, but rather that people engage in health-promoting behavior. Likewise, medical professionals must not only treat illness and disease but also work with the patient to promote a healthy lifestyle and self-image. Many practitioners of alternative medicine—healing practices inconsistent with dominant medical practice, take a holistic approach, and today many people are turning to alternative medicine either in addition to or in lieu of traditional medicine. In understanding the medical establishment’s reactions to alternative medicine, it is important to keep in mind the philosophy of scientific medicine—that medicine is a science, not an art. Undoubtedly, self-interest is also involved in mainstream medicine’s reaction to alternative medicine. If the public can be persuaded that scientific medicine is the only legitimate healing practice, fewer health care dollars will be spent of a form of medical treatment that is (at least to some extent) in competition with the medical establishment. But if all forms of alternative medicine (including chiropractic, massage, and spiritual) are taken into account, people spend more money on unconventional therapies than they do for all hospitalizations. 12. In relation to health and medicine, explain how the functionalist perspective views the sick role. Answer: According to the functionalist approach, if society is to function at as a stable system, it is important for people to be healthy and to contribute to their society. Consequently, sickness is viewed as a form of deviant behavior that must be controlled by society. This view was initially set forth by sociologist Talcott Parsons in his concept of the sick role—the set of patterned expectations that defines the norms and values appropriate for individuals who are sick and for those who interact with them. According to Parsons, the sick role has four primary characteristics: (1) people who are sick are not responsible for their condition. It is assumed that being sick is not a deliberate and knowing choice of the sick person. (2) people who assume the sick role are temporarily exempt from their normal roles and obligations. For example, people with illnesses are typically not expected to go to school or work. (3) people who sick must want to get well. The sick role is considered to be a temporary role that people must relinquish as soon as their condition improves sufficiently. Those who do not return to their regular activities in a timely fashion may be labeled as hypochondriacs or malingerers. (4) people who are sick must seek competent help from a medical professional to hasten their recovery. Parsons believed that illness is dysfunctional for both individuals and the larger society. Those who assume the sick role are unable to fulfill their necessary social roles, such as being parents or employees. Similarly, people who are ill lose days from their productive roles in society, thus weakening the ability of groups and organizations to fulfill their functions. According to Parsons, it is important for the society to maintain social control over people who enter the sick role. Physicians are empowered to determine who may enter this role and when patients are ready to exit it. Because physicians spend many years in training and have specialized knowledge about illness and its treatment, they are certified by the society to be “gatekeepers” of the sick role. When patients seek the advice of a physician, they enter into the patient-physician relationship, which does not contain equal power for both parties. The patient is expected to follow the “doctor’s orders” by adhering to a treatment regime, recovering from the malady, and returning to a normal routine as soon as possible. 13. In regards to health and medicine, discuss how the conflict perspective views inequalities in health and health care. Answer: Conflict theory emphasizes the political, economic, and social forces that affect health and the health care delivery systems. Among the issues of concern to conflict theorists are the ability of all people to obtain health care; how race, class, and gender inequalities affect health and health care; power relationships between doctors and other health care workers; the dominance of the medical model of health care; and the role of profit in the health care system. According to many conflict theorists, problems in U.S. health care delivery are rooted in the capitalist economy, which views medicine as a commodity that is produced and sold by the medical-industrial complex. The medical-industrial complex encompasses both local physicians and hospitals as well as global health-related industries such as insurance companies and pharmaceutical and medical supply companies. Access to high-quality medical care is linked to people’s ability to pay and to their position within the class structure. Those who are affluent or have good medical insurance may receive high-quality, state-of-the-art care in the medical-industrial complex because of its elaborate technologies and treatment. However, people below the poverty level and those just above it have greater difficulty gaining access to medical care. Referred to as the medically indigent, these individuals do not earn enough money to afford private medical care but earn just enough money to keep them from qualifying for Medicaid. According to conflict theorists, physicians, who hold a legal monopoly over medicine, benefit from the existing structure because they can charge inflated fees. Similarly, clinics, pharmacies, laboratories, hospitals, supply manufacturers, insurance companies, and many other corporations derive excessive profits from the existing system of payment in medicine. In recent years, large drug companies and profit-making hospital corporations have come to occupy a larger and larger part of health care delivery. As a result, medical costs have risen rapidly, and the federal government and many insurance companies have place pressure for cost containment on other players in the medical-industrial complex. Conflict theorists increase our awareness of inequalities of race, class, and gender as these statuses influence people’s access to health care. They also inform us about the problems associated with health care becoming “big business.” 14. In relation to health and medicine, summarize how the symbolic interactionist perspective views the social construction of illness. Answer: In studying health, symbolic interactionists focus on the meanings that social actors give their illness or disease and how these affect people’s self-concept and relationships with others. We socially construct “health” and “illness” and how both should be treated. For example, some people explain disease by blaming it on those who are ill. If we attribute cancer to the acts of a person, we can assume that we will be immune to that disease if we do not engage in the same behavior. For example, nonsmokers who learn that a lung cancer victim had a two-pack-a-day habit feel comforted that they are unlikely to suffer the same fate. Although biological characteristics provide objective criteria for determining medical conditions such as heart disease, tuberculosis, or cancer, there is also a subjective component to how illness is defined. This subjective component is very important when we look at conditions such as childhood hyperactivity, mental illness, alcoholism, drug abuse, cigarette smoking and overeating, all of which have been medicalized. The term medicalization refers to the process whereby nonmedical problems become defined and treated as illnesses or disorders. Medicalization may occur on three levels: (1) the conceptual level (the use of medical terminology to define the problem), (2) the institutional level (physicians are supervisors of treatment and gatekeepers to applying for benefits, and (3) the interactional level (when physicians treat patients’ conditions as medical problems. Sociologists often refer to habitual gambling as the medicalization of deviance because it gives physicians and other medical professionals greater authority to determine what should be considered “normal” and “acceptable” behavior and to establish the appropriate mechanisms for controlling “deviant behaviors.” Medicalization is a two-way process: just as conditions can be medicalized, so can they be demedicalized. Demedicalization refers to the process whereby a problem ceases to be defined as an illness or a disorder. Examples include the removal of certain behaviors (such as homosexuality) from the list of mental disorders compiled by the American Psychiatric Association and the deinstitutionalization of mental health patients. Symbolic interactionists examine how doctors and patients interact in health care settings. Some physicians may hesitate to communicate certain kinds of medical information to patients, such as why they are prescribing certain medications or what side-effects or drug interactions may occur. 15. In relation to health and medicine, summarize how the postmodern perspective views the clinical gaze. Answer: Postmodern theorist Michel Foucault questioned existing assumptions about medical knowledge and the power that doctors have gained over other medical personnel and everyday people. Foucault asserted that truth in medicine—like all other areas of life—is a social construction, in this instance one that doctors have created. Foucault believed that doctors gain power through the clinical (or “observing”) gaze, which they use to gather information. Doctors develop the clinical gaze through their observation of patients; as the doctors begin to diagnose and treat medical conditions, they also start to speak “wisely” about everything. As a result, other people start to believe that doctors can “penetrate illusion and see the hidden truth.” According to Foucault, the prestige of the medical establishment was further enhanced when it became possible to categorize all illnesses within a definitive network of disease classification under which physicians can claim that they know why patients are sick. Moreover, the invention of new tests made it necessary for physicians to gaze upon the naked body, to listen to the human heart with an instrument, and to run tests on the patient’s body fluids. Patients who objected were criticized by the doctors for their “false modesty” and “excessive restraint.” As the new rules allowed for the patient to be touched and prodded, the myth of the doctor’s diagnostic wisdom was further enhanced, and “medical gestures, words, gazes took on a philosophical density that had formerly belonged only to mathematical thought.” For Foucault, the formation of clinical medicine was merely one of the more visible ways in which the fundamental structures of human experience have changed throughout history. ESSAY SECTION 1. Describe health in global perspective. Answer: Health in a global perspective varies widely due to socioeconomic factors, healthcare access, and cultural practices: • Global Health Inequalities: Disparities exist between high-income countries with advanced healthcare systems and low-income countries with limited access to basic healthcare services. • Public Health Challenges: Issues such as infectious diseases (e.g., malaria, HIV/AIDS), maternal and child health, malnutrition, and lack of sanitation contribute to global health burdens. • Global Health Initiatives: International organizations, NGOs, and governments collaborate on initiatives to improve healthcare infrastructure, disease prevention, and health education globally. 2. Summarize health in the United States. Answer: Health in the United States is shaped by several factors: • Healthcare System: Predominantly private healthcare system with a mix of public programs (e.g., Medicare, Medicaid) and employer-sponsored insurance. • Health Outcomes: Overall, Americans have access to advanced medical treatments and technologies, resulting in longer life expectancy but significant disparities based on income, race, and geographic location. • Public Health Challenges: Obesity, chronic diseases (e.g., diabetes, cardiovascular diseases), mental health issues, and disparities in healthcare access remain significant challenges. 3. Discuss the framing of drug ads. Answer: Framing of Drug Ads influences consumer perceptions and behavior: • Marketing Strategies: Pharmaceutical companies use advertisements to promote prescription drugs directly to consumers, emphasizing benefits while downplaying risks. • Consumer Influence: Ads shape public demand for specific medications, potentially leading to overprescription and increased healthcare costs. • Regulation: The FDA regulates drug ads to ensure accuracy, balance in presenting risks and benefits, and compliance with legal standards. 4. Discuss health care in the United States. Answer: Healthcare in the United States is characterized by complexity and challenges: • System Overview: Fragmented system with a mix of public and private insurers, providers, and varying levels of coverage and access. • Affordability: Rising healthcare costs impact affordability for individuals and families, leading to financial burdens and barriers to accessing necessary care. • Reform Efforts: Policy debates focus on expanding coverage, controlling costs, improving quality of care, and addressing disparities through reforms like the Affordable Care Act (ACA). 5. Summarize paying for medical care in the United States. Answer: Paying for Medical Care involves various financial arrangements: • Insurance Coverage: Most Americans rely on private health insurance through employers or government programs (Medicare, Medicaid) to cover medical expenses. • Out-of-Pocket Costs: Patients may incur copayments, deductibles, and coinsurance for healthcare services not covered by insurance. • Financial Burdens: High healthcare costs can lead to medical debt, bankruptcy, and disparities in healthcare access based on socioeconomic status. 6. Compare paying for medical care in other nations (Canada, Great Britain, and China). Answer: • Healthcare System: Universal healthcare system funded through taxation, providing publicly funded essential medical services to residents. • Paying for Care: Covered by government funding; patients may incur minimal out-of-pocket costs for prescription drugs, dental care, and some specialized services. Great Britain (United Kingdom): • Healthcare System: National Health Service (NHS) provides comprehensive healthcare services funded through taxation. • Paying for Care: Mostly free at the point of use; patients may pay for prescription medications, dental care, and some elective procedures. China: • Healthcare System: Combination of public and private healthcare services; public hospitals provide basic healthcare funded by government subsidies. • Paying for Care: Out-of-pocket payments common, particularly for advanced treatments and medications not covered by public insurance; private insurance options emerging. 7. Explain the social implications of advanced medical technology. Answer: Advanced Medical Technology impacts society in several ways: • Improved Health Outcomes: Enhances diagnosis, treatment, and management of diseases, improving life expectancy and quality of life. • Cost and Access: Raises concerns about affordability, disparities in access to advanced treatments, and healthcare inequalities. • Ethical Considerations: Raises ethical dilemmas such as patient autonomy, privacy concerns with data sharing, and potential misuse of technology. • Social Change: Alters healthcare delivery, workforce dynamics, and patient-provider relationships, influencing societal attitudes toward health and wellness. 8. Discuss the four sociological perspectives in terms of their views on health care in the U.S. Answer: Functionalist Perspective: • Views healthcare as essential for maintaining social stability and productivity. • Emphasizes healthcare's role in promoting public health, preventing disease, and supporting economic growth. • Criticizes for overlooking healthcare disparities and systemic issues in access and quality. Conflict Perspective: • Critiques healthcare as reinforcing social inequalities based on race, class, and socioeconomic status. • Highlights profit motives of healthcare industries and unequal distribution of resources. • Advocates for healthcare reforms to address disparities and ensure equitable access. Symbolic Interactionist Perspective: • Focuses on healthcare interactions between patients, healthcare providers, and healthcare institutions. • Examines how social meanings, symbols, and interactions shape health behavior, patient experiences, and healthcare outcomes. Feminist Perspective: • Critiques healthcare for gender biases in medical research, treatment, and access to reproductive health services. • Advocates for reproductive rights, gender-sensitive healthcare policies, and addressing healthcare needs of marginalized communities. 9. Explain how the functionalist perspective views the sick role. Answer: Functionalist Perspective on the Sick Role: • Views illness as a form of social deviance disrupting normal social roles and responsibilities. • Assigns a temporary, socially accepted role to sick individuals with expectations of seeking medical help, cooperating with treatment, and striving to recover. • Justifies sick leave and social support to enable recovery and reintegration into society. 10. Explain how the conflict perspective views inequalities in health and health care. Answer: Conflict Perspective on Health Inequalities: • Attributes health inequalities to social structures, economic disparities, and unequal distribution of resources. • Critiques healthcare as serving the interests of powerful elites and reinforcing social hierarchies. • Advocates for addressing root causes of health inequalities through equitable healthcare policies, social reforms, and community empowerment. Test Bank for Sociology in Our Times: The Essentials Diana Kendall 9781337109659, 9781111305505, 9781305094154