soc101 - health & medicine
TRANSCRIPT
Introduction to Sociology | Hunter CollegeJessie Daniels, PhD
Sociology of Health & Medicine
Today
• Key Questions: – Why are some people healthy & others not?
– How is diagnosis a form of social control?
– How are health & morality linked?
• Key Concepts: – Structural Determinants of Health
– Structural Violence
– Medicalization
– Healthism
<why are some healthy & others
not?>
is it because some ‘lead good lives’ &
others do not?
is it because some ‘lead good lives’ &
others do not?
what is the single best predictor of
someone’s overall health?
zip code
10028 or 10035
Health of those living in 10028
• Life expectancy: 80 yrs
• Low rates of childhood asthma
• Low mortality for heart disease and cancer
Health of those living in 10035
• Life expectancy: 70 yrs
• High rates of childhood asthma
• Higher rates of mortality from cancer and heart disease
Boston: % of adults with diabetes by T stop
how do we explain this?
Health is (mostly) structural
Zip Code is a proxy measure for structure
Poorer neighborhoods, more exposure
Structural factors that damage health
Structural factors that damage health
Structural Determinants of Health
why are the same groups damaged?
Structural violence: systematic ways
in which social structures harm or
otherwise disadvantage individuals.
“Structural violence is one way of describing
social arrangements that put individuals and
populations in harm’s way… The
arrangements are structural because they are
embedded in the political and economic
organization of our social world; they are
violent because they cause injury to people …
neither culture nor pure individual will is at
fault; rather, historically given (and often
economically driven) processes and forces
conspire to constrain individual agency.” ~ Dr. Paul Farmer
Sample question: The people of
Flint, Michigan have not had clean
water for over three years. High
levels of lead in the water are
correlated with high rates of school
suspension. How is this a form of
structural violence?
Possible answer: The water crisis
in Flint, Michigan is a form of
structural violence because the
causes are embedded in the political
and economic organization of our
social world. It is violent because it is
causing injury to people.
<how is diagnosis a form of social control?>
medicalization
medicalization: a process by which
normal human conditions and
problems become defined and
treated
as medical conditions
a few historical examples
“drapetomania”
“drapetomania”: a mental illness
that cause enslaved people to have
an uncontrollable desire to run away
from captivity (1851)
“hysteria”
“nervous exhaustion and
extreme excitability”
“the rest cure”
medicalization is a type of labeling
Labeling Theory
• Everyone labels
• Those with power are able to label someone and make others accept that label
• Labeling can lead to self-fulfilling prophecy
• If the label is especially damaging, it can become a ‘master status’
medicalization is a form of
social control
medicalization is most effective on
those with little social power
does medicalization still
happen?
yes
Four Agents of Medicalization
• Medical professionals (diagnosis, prescriptions)
• Patients (response to ads, requests for diagnosis and prescriptions)
• Corporations(advertising, marketing to MDs)
• Social norms(support for ‘the sick role,’ sanctions for resisting diagnosis)
During 1960s, sharp increase in
diagnosis of African Americans –
particularly men – as schizophrenic
after DSM-11 added “hostility” and
“aggression” as symptoms
diagnosis exerts social control through labeling
medicalization permeates our culture
it’s not just corporations
we actively engage in
medicalization
women’s bodies are “policed” &
we “police” ourselves through
medicalization
Sample question: There are some
who suggest that small breasts are a
medical condition that require
surgery to fix. How is this a form of
medicalization?
Possible answer: Labeling
someone who has small breasts as
“unwell” or “having a condition” is a
form of medicalization because it
takes a normal human conditions
and defines it as a medical condition
in need of treatment.
<how are health & morality linked?>
Healthism: a preoccupation with
personal health as the primary focus
or goal, which is to be attained
primarily through the modification of
individual life styles
they argue as “better health”
is one of those ruling ideas
Healthism: a key strategy of neoliberalism
(recall neoliberalism is a form of capitalism
that says the ‘marketplace’ is the best way
to distribute social goods)
if we are busy policing our bodies and
modifying our individual behavior,
then we have no time for addressing the real,
structural factors that are actually damaging to
health, like poverty or housing or clean water.
the fact is investment structural factors is the
most important intervention for improving
health
Sample question: Recently,
Congressman Brooks (R-AL) said
that “people who live good lives don’t
have pre-existing conditions.” How
are they an example of ‘healthism’?
How are his comments an example
of ‘the ruling ideas’?
Possible answers: Rep. Brooks’
comments are an example of healthism
because they suggest that health is entirely
the result of individual choices. His
comments are also an example of the idea
that ‘the ruling ideas,’ in this case ‘better
health,’ serve the interests of those in
power. In this instance, a wealthy member
of Congress is trying to deny access to
health care for everyone else, and his ideas
serve to justify that action.
What should you do before next class?
1. Be sure you’ve read Ch. 19, “Health & Medicine” in your text.
2. Print out your Video Worksheet for the film on Thursday.3. Brush up on current events for final exam. Check #SOC101
hashtag on Twitter.