Medicine & Society Test 1

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life expectancy: average number of years individuals born in a certain year can expect to live
Relationship of disability to income: Poorer persons are more likely to report disability
epidemiological transition: The shift from a society characterized by infectious and parasitic diseases and low life expectancy to one characterized by degenerative and chronic diseases and high life expectancy. Seems to occur around the world once a nation's mean per capita income reaches a threshold level in 2005 dollars of about $7,365.
"Women are sicker, men are deader.": Men have a lower life expectancy than women, but women have a greater morbidity rate throughout their lifetimes. Men are more likely to smoke and drink, leading to car accidents, and they're more likely to work in dangerous industries. They also have poorer social networks and are more biologically susceptible to CVD/sudden death from heart attack in their 40s & 50s.
social construction: Illness is socially constructed because each cultural group, at each point in time, assigns the label "illness" to whatever it considers both biological and problematic. More broadly speaking, a social construction or social construct is any phenomenon "invented" or "constructed" by participants in a particular culture or society, existing because people agree to behave as if it exists or follow certain conventional rules.
Medicaid: free health care in the U.S. for the poorest individuals
Munchausen Syndrome: mental illness where sufferers want attention from being sick, surgery, and treatment and so they seek out medical care.
Disabled people—a minority group?: Once we start thinking of disability as primarily based on social attitudes and built environments rather than on individual deficiencies, strong parallels emerge between people with disabilities and members of minority groups. A minority group is defined as any group that, because of its cultural of physical characteristics, is considered inferior and subjected to differential and unequal treatment and that therefore develops a sense of itself as the object of collective discrimination. People with disabilities do experience prejudice and discrimination. To fit the definition of a minority group, a group must not only experience prejudice and discrimination but also consider themselves objects of collective discrimination.
Human Genome Project: Internationally funded project with the goal to map the locations of all human genes and to determine the role each gene plays in health and illness. The potential for medicine to act as a form of social control may soon grow through the work of this project.
retrospective study: In medicine, a study that looks backward in time, usually using medical records and interviews with patients who already known to have a disease.
opportunistic infections: When our immune system is working, it controls these germs. But when the immune system is weakened by HIV disease or by some medications, these germs can get out of control and cause health problems. Infections that take advantage of weakness in the immune defenses are called "opportunistic".
neonatal infant mortality: deaths occurring during the first 27 days after birth
demedicalization: The process through which a condition or behavior becomes defined as a natural condition or process rather than an illness. Countermovement fostered by the dangers of medicalization. Begins with lobbying by consumer groups.
acute vs. chronic diseases: Acute conditions are severe and sudden in onset. This could describe anything from a broken bone to an asthma attack. A chronic condition, by contrast is a long-developing syndrome, such as osteoporosis or asthma.
case-control study: A study which compares a group of people with an illness or other factor of interest to a control group.
social drift hypothesis: theory to explain the link between poverty and illness stating that as people become disabled or ill, their abilities to earn a living or attract an employed spouse decline, and they fall to a lower social status than that of their parents; cohort studies have found that this theory explains only a small proportion of the poor ill population. far more often, poverty causes illness.
relative income differential: Theory states that increases in average income above $7,365 only bring modest increases in life expectancy. Instead, further increases in life expectancy appear to occur not when absolute incomes increase but only when the relative income differential within a country narrows. As
Americans with Disabilities Act, effective 1992: Federal law passed in 1990 that outlaws discrimination against those w/ disabilities in employment, public services (incl. transit), and public accomodations (such as restaurants, hotels, and stores). It requires that existing public transit systems and public accommodations be made accessible, along with all new public buildings and major renovations of existing buildings.
standardized mortality ratio: The Standardized Mortality Ratio uses the indirect method of adjustment to compare the mortality experience of a given area with a standard or to evaluate the mortality experience due to several causes of death within a given area against a common standard. Calculated as SMR = (Observed Deaths / Expected Deaths)
medicalization—four main interest groups: the process through which a condition or behavior becomes defined as a medical problem requiring a medical solution. For this to occur, one or more organized social groups must have both a vested interest in it and sufficient power to convince others (including doctors, the public and insurance companies) to accept their new definition of the situation. Four main interest groups in this process: 1)Doctors 2)Consumers and consumer groups 3)Pharmaceutical industry 4)Managed care organizations
Avoidance vs. vigilance: Avoidance = actively working to remain ignorant in order to maintain one's emotional balance and images of the future. Vigilance = Seeking knowledge so that one can feel able to respond appropriately and therefore feel more in control. Both strategies reduce uncertainty and give individuals ways of understanding and thus responding to their health problems. Particularly relevant to the uncertainty associated with chronic disease.
racism as a health issue: African Americans have a relatively high rate of infant mortality, even after controlling for income. This may reflect a constellation of factors stemming from racism, which remains embedded in American culture. May result from psychosocial stresses, poor living conditions and pollution. Infant mortality rates are highest among those living in the most segregated cities.
prevalence: total number of cases within a specified population at a specified time (both those newly diagnosed and those diagnosed in previous years but still living with the condition under study)
medical model of illness: what doctors typically mean when they say something is an illness; illness as an objective label, a concrete, unchanging reality, nonmoral, apolitical, and each one has specific features so diagnosis is consistent and is caused by unique biological forces.
DTC advertisements: Advertising of pharmaceuticals directly to consumers, even when requiring a prescription; may damage doctor-patient relationship.
prevention: attempts made at various levels to ward off causes of premature death
rate: proportion of a specified population that experiences a given circumstance
etiology: the unique cause for each illness that is assumed to exist by the medical model. The doctrine of unique etiology discourages medical researchers from asking why individuals respond in such different ways to the same health risks and encourages researchers to search for magic bullets.
Gender differences in the effects of disability: More disabled persons are women than men, largely because women live longer than men.
Alternative and complementary therapies—reasons for growing popularity: Treatments not widely integrated into medical training or practice in the US. Growing in popularity for prevention and treatment because conventional treatments don't help or they are supplementing with them and they believe/hope in efficacy while doubting the potential for harm from a "natural" product. Some theorize it has to do with a new social movement focused on human relationships.
Interruption, intrusion, immersion: For chronically ill people, illness can be experienced as an interruption, an intrusion, or something in which an inidividual is immersed. Interruption = the illness remains only a small and temporary part of a person's life, an acute problem. Intrusion = illness demands time, accommodation, and attention and requires that a person lives "day-to-day." Immersion = When disease progresses farther and people suffering from it must structure their lives around the demands of their bodies rather than structuring the demands of their bodies around their lives. Social relationships wither, and people often withdraw into themselves.
Indian Health Service: the federally funded program charged with providing health care to Native Americans; offers direct and contract care and has increasingly moved toward local control; is underfunded and this promotes tribal conflict and pursuance of casino gambling to raise funds
Health belief model: Model predicting that individuals will follow medical advice when they 1) believe they are susceptible to a particular health problem, 2)believe the health problem they risk is a serious one, 3)believe compliance will significantly reduce their risk, and 4) do not perceive any significant barriers to compliance.
technological imperative: the American medical system's propensity to embrace expensive treatments without considering their long-term social or medical impact; drives doctors to use all available technology (cited with respect to the drive to identify and treat prostate cancer among older men)
refocusing upstream: activities of a small fraction of doctors, usually in public health, to work for primary prevention; that is, working to keep people from becoming ill or disabled rather than minimizing physical deterioration and complications among those already ill
health organizations that collect data: WHO, CDC, and National Center for Health Statistics (NCHS)
calculate rate: (number of events in a given period/specified population during that period) x 10^n
manufacturers of illness: Term coined by McKinlay; those groups that promote illness-causing behaviors and social conditions. These groups include alcohol distributors, auto manufacturers that fight against vehicle safety standards, and politicians who vote to subsidize tobacco production.
blaming the victim: INdividuals are blamed for causing the problems from which they suffer. Exemplified by individualizing disability.
postneonatal infant mortality: deaths occurring between 28 days and 11 months after birth; almost 3x higher in Native Americans than whites, although their rates of neonatal infant mortality are about the same, due to pneumonia and gastritis (caused by poverty, malnutrition, and poor living conditions and normally controlled through prompt medical attention)
epidemiology: The study of distribution of disease within a population. Social version = the distribution of disease within a population according to social factors (such as social class or use of tobacco) rather than biological factors (such as blood pressure of genetics).
Munchausen by Proxy Syndrome: n individual — usually a mother — deliberately makes a nother person (most often his or her own preschool child) sick or convinces others that the person is sick. The parent or caregiver misleads others into thinking that the child has medical problems by lying and reporting fictitious episodes. He or she may exaggerate, fabricate, or induce symptoms. As a result, doctors usually order tests, try different types of medications, and may even hospitalize the child or perform surgery to determine the cause. Typically, the perpetrator feels satisfied by gaining the attention and sympathy of doctors, nurses, and others who come into contact with him or her and the child. Some experts believe that it isn't just the attention that's gained from the "illness" of the child that drives this behavior, but also the satisfaction in being able to deceive individuals that they consider to be more important and powerful than themselves.
adjusted rates: Can be for age or sex, for example, age-adjusted rates are calculated using standard statistical procedures that eliminate the effect of age differences among populations.
David Mechanic's predictors of help-seeking behavior: 1) Symptoms appear frequently or persistently; 2) Symptoms are very visible; 3)Symptoms are sever enough to disrupt normal activities; 4)Illness is only likely explanation for physical problems; 5)They have ready access to health care; 6)They have a positive attitude to health care providers.
naturalistic theories: one of two (and the less common) traditional, prescientific theories of illness causation around the world: hold that illness occurs when heat, cold, wind, damp, or other natural forces upset the body's equilibrium
disability: Acc. to WHO: "any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being." Includes some but not all people with chronic illnesses, as well as people who are born deaf, become paralyzed, or experience chronic pain that limits their ability to function.
Reasons for increased incidence of disability (3): 1)Injuries that previous would have resulted in death can lead to lives with serious disabilities 2)Average survival times for various common chronic conditions like cvd have increased 3) as the proportion of the population over 65 has increased, so has the proportion of people living with disabilities
morbidity: symptoms, illnesses, and impairments
battering as a health problem: Although neither health care workers nor the general public typically thinks of this as a health problem, woman battering is a major cause of injury, disability, and death among American women and women worldwide. It continues to exist because it reflects basic cultural and political forces in our society and around the world. Most often occurs among men who believe that their power within the family is threatened. Recognition of it as a health risk has led various health-related organizations to enter the fight against woman battering.
intersex: the name for the up to 2 percent of babies that are born with genitalia that appear neither clearly male nor clearly female
effects of globalization: Promotes spread of infectious diseases; erodes cultural traditions; leads to environmental changes that encourage disease primarily from Western-based industries; increases number of people traveling across regions and thus globalized disease.
genetic paradigm: A way of looking at the world that emphasizes genetic causes. Adopted by the media, according to conclusions of Conrad. The news media has a tendency to play up genetic links with disease while downplaying uncertainties or refutations of findings of earlier links.
epidemic: any significant increase in the numbers affected by a disease or to the first appearance of a new disease.
incidence: the number of new occurrences of an event (disease, births, deaths, etc.) within a specified population during a specified period
Positive effects of chronic illness and disability: Can bring improved self esteem and quality of life. Individuals may learn to devalue physical appearances, derive self-esteem from other sources, and focus on the present rather than on an intangible future. May learn to set priorities so taht they can accomplish their most important goals more often rather than wasting energy on trivial concerns. They may come to define their condition simply as part of who they are, with good points and bad points, and to recognize that much of their personalities and accomplishments exist not despite their physical conditions, but because of it.
medicine as a form of social control: Because illness is labeled as a form of deviance, it results in negative social sanctions and these are enforced by social control agents (the medical establishment). Medicalization creates an illness and significantly expands the range of life experiences under medical control. Once a condition is medicalized, medical treatment may become the only logical response to it. Allows for definition as a medical rather than political problem.
prospective study: A study in which the subjects are identified and then followed forward in time. Expensive, must determine variables to examine at the outset, but is strong for determining relationships.
sociological model of illness: summarizes critical sociologists' retort to the medical model of illness; reflects sociologists view of how the world currently operates, not how it ideally should operate. Illness is a subjective category, a moral term indicating deviance, a political label reflecting groups with power, a social construction, and not specific or universally recognized and is caused by a combination of social, psychological, and biological causes.
experimental study: Looks at impact of one variable and controls for all others to determine a cause-effect relationship; often lab/animal studies.
mortality: deaths
tertiary: strategies designed to minimize physical deterioration and complications among those already ill
calculate prevalence: (number of persons living with the condition this year/population of the country or region this year) x 100,000
environmental racism/environmental justice: chemical, air, and noise pollution all occur more often in poor (and minority) neighborhoods than in wealthier neighborhoods both because the cheap rents in neighborhoods blighted by pollution attract poor people and because poor people lack the money, votes, and social influence needed to keep polluting industries, waste dumps, and freeways out of their neighborhoods. pollution fosters cancer, leukemia, high blood pressure, and other health problems, as well as emotional stress.
sick role: Refers to social expectations of how society should view sick people and how sick people should behavior. According to it, a sick person is 1)excused from normal roles, 2)not blamed for illness, 3)expected to want to get better, and 4)expected to seek and follow medical advice. Critiqued for a number of reasons, including the poorness of fit with chronic conditions. Critiqued by those who adopt the conflict rather than functional perspectives in sociology.
Americans with Disabilities Act: Outlaws employment discrimination based on illness, disability, or genetic characteristics, but it is legally unclear whether the ADA applies to discrimination in other areas of life. Most states have outlawed genetic discrimination in health insurance and in the workplace, and federal legislators are debating similar national legislation, but such laws can help only those who know about them, have evidence of discrimination, and can afford legal assistance.
Strategies for managing stigma: 1) Pass=hide illnesses or disabilities from others 2)Covering=Not hiding the condition but trying to deflect attention from it, 3)Disclosing=Telling others about their disability to elicit sympathy or aid, particularly if it's invisible, 4)Deviance disavowal=Convincing others that they are the same as "normal people" and their illness doesn't make them different from others, aka "supercrips" in special Olympics, or 5) more radical step of Challenging=individuals reject the social norms that denigrate them and refuse to adopt the accoodative strategies of passing, covering or disavowing deviance. They argue their illness shouldn't limit their civil rights or social status.
similarities of personalistic & naturalistic prescientific theories of illness: Both blame ill persons for causing their illness, whether by displeasing supernatural beings or by exposing themselves to harmful elements. And both define ill persons as less morally worthy than others, whether as sinners or as fools.
moral status of illness: An ill person is one whose actions, ability, or appearance do not meet social norms. Such a person will typically be considered less whole and less socially worthy than those deemed healthy. Illness is therefore a moral status, a social condition that we believe indicates the goodness or badness, worthiness or unworthiness, of a person. Related to labeling of ill behaviors as deviant.
secondary: strategies designed to reduce the prevalence of disease through early detection and prompt intervention
primary: strategies designed to keep people from becoming ill or disabled, such as discouraging drunk driving, lobbying for stricter highway safety regulations, and promoting vaccination
personalistic theories: the more common of the two traditional, prescientific theories of illness causation around the world: hold that illness occurs when a god, witch , spirit, or other supernatural power lashes out at an individual, either deservedly or maliciously
Malingerer: a medical and psychological term that refers to an individual fabricating or exaggerating the symptoms of mental or physical disorders for a variety of motives, including getting financial compensation (often tied to fraud), avoiding work, obtaining drugs, getting lighter criminal sentences, trying to get out of going to school, or simply to attract attention or sympathy.
endemic: disease that has established itself within a population such that it maintains a fairly stable prevalence
Illness as a form of deviance from social norms: According to the sociological model, conditions and behaviors are labeled illness when they are considered bad (deviant). Labeling something deviant means not that it is necessarily immoral, but refers to behaviors or conditions that socially powerful persons within a given culture perceive, whether accurately or inaccurately.
Disability Rights Movement: The disability rights movement aims to improve the quality of life of people with disabilities. For people with physical disabilities accessibility and safety are primary issues that this movement works to reform.
Medicare: U.S. governmental health insurance provided to individuals who are 65 or older or meet other special criteria. Comes with significant out-of-pocket costs.
infant mortality: proportion of infants who die during or soon after childbirth (one year of age or younger)
feminization of aging: the steady rise in the proportion of the population who are female in each older age group, so that women comprise a larger proportion of the elderly than of the young and middle-aged. Because elderly women more often than elderly men are poor and lack a spouse who can/will care for them, and because women in general experrience more illness than men do, the feminization of aging will increase the costs of providing health and social services to the elderly.
calculate incidence: (number of new cases diagnosed this year/population of country or region this year) x 100,000
Placebos: May explain growing success of alternative therapies. Drug known to have no biological effect but consumer's belief in the therapy helps the body heal itself or feel better in 30 percent of the persons receiving the "treatment."
the unintended negative consequences of applying the medical model: 1)When a situation becomes medicalized, doctors become the only experts considered appropriate for diagnosing the problem and for defining appropriate responses to it, 2)Medicalization significantly expands the range of life experiences under medical control & the condition that is medicalized now only has medical treatment as a logical response, 3)When doctors define situations in medical terms, they reduce the chances that these situations will be understood in political terms, 4)Can justify not only voluntary but also involuntary treatment
stereotypes, discrimination: Stereotypes is how prejudice (unwarranted suspicion, dislike of, disdain towards individuals because they belong to a particular group). Are oversimplistic ideas about members of a given group. Nondisabled see disabled as menacing/untrustworthy or childlike & objects to be pitied. Discrimination = Unequal treatment grounded in prejudice.
Illness behavior: The process of responding to symptoms and deciding whether to seek diagnosis and treatment.

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