Health and Illness: Chapters 6-9

Question 1

Conflict theory in sociology

Answer 1

emphasizes social class, hierarchy - that society has lots of conflict in it

Question 2

Illness behavior

Answer 2

the activity undertaken by a person who feels ill for the purpose of defining that illness and seeking relief from it

Question 3

Health behavior

Answer 3

the activity undertaken by individuals for the purpose of maintaining or enhancing their health, preventing health problems, or achieving a positive body image

Question 4

Health lifestyles

Answer 4

collective patterns of health-related behavior based on choices from options available to people according to their life chances; include contact with medical professionals for checkups and preventive care, but the majority of activities take place outside the

Question 5

Life chances

Answer 5

largely determined by class position that either enables or constrains health lifestyle choices; influences the potential for realizing life conduct choices

Question 6

Engineering methods

Answer 6

the building of safe water supplies and sewers and the production of cheap food for urban areas through the use of mechanized agriculture; engineering issues deal with sanitation, medical vaccines, etc

Question 7

Medical era

Answer 7

dominant approach to health was mass vaccination and the extensive use of antibiotics to combat infections

Question 8

Postmedical era

Answer 8

physical well-being is largely undermined by social and environmental factors, such as smoking, loneliness, poverty, pollution

Question 9

Social capital

Answer 9

what kind of social networks a person participates in

Question 10

Status group

Answer 10

aka social class, people who share similar material circumstances, prestige, education, and political influence; members of the same status group share similar lifestyles; ones lifestyle is a reflection of the types and amounts of goods and services one uses or consumes

Question 11

Life conduct

Answer 11

the choices that people have in the lifestyles they wish to adopt

Question 12

Constrained choices

Answer 12

the choices we make operate within certain limits, the limits of what resources available and the limits of where you grew up

Question 13

Cultural capital

Answer 13

culture - habits, tastes, and styles; different positions in society; within different groups, people tend to have certain habits, tastes, and styles

Question 14

Weber’s concept of lifestyles

Answer 14

led to the development of SES as the most accurate reflection of a person’s social class position - influenced by income, education, occupational status; lifestyle is a reflection of a person’s status in society - based on what people consume; lifestyles are based upon choices, which are dependent upon the individual’s potential for realizing them; some lifestyles spread across class boundaries and gain influence in the wider society

Question 15

Habitus (Bourdieu)

Answer 15

class related set of durable dispositions to act in particular ways; these dispositions produce lifestyle practices for individuals that are similar to those of other people in their social classes and different from people in other classes

Question 16

Four categories of social structural variables

Answer 16

class circumstances - lifestyles of upper classes are the healthiest and those of the lower class the least healthy;
age, gender, and race/ethnicity - people take better care of their health as they grow older, women eat better and visit doctors more and smoke less and have overall healthier lifestyle, racial disparities in health are largely determined by class position; 
collectivities - collections of actors linked together through particular relationships such as kinship, work, religion, politics - their shared norms, values, ideals reflect a particular collective viewpoint capable of influencing health lifestyle; 
living conditions - differences in the quality of housing and access to basic utilities, neighborhood facilities, and personal safety

Question 17

Theory of health lifestyles

Answer 17

social structural variables influence your life chances (structure), which interplay with your life choices (agency); life choices are influenced by socialization and experience;
dispositions to act (habitus) caused by the interplay leads to various practices (actions) which make up a health lifestyle

Question 18

Preventive care

Answer 18

routine physical examinations, immunizations, prenatal care, dental checkups, screening for health disease and cancer, and other services intended to ensure good health and prevent disease - or minimize the effects of illness if it occurs

Question 19

Health belief model

Answer 19

based on the theory that people exist in a life space composed of regions with both positive and negative valences (values) - a person’s behavior might be viewed as the result of seeking regions that offer the most attractive values

Question 20

Health belief model - human behavior

Answer 20

human behavior is seen as being dependent on the value placed by a person upon a particular outcome, and the person’s belief that a given action will result in that outcome

Question 21

Likelihood of action (triggers)

Answer 21

involves weighing of the perceived benefits to action contrasted to the perceived barriers; what people believe may depend on what goes on around you - a stimulus in the form of an action cue may be required to trigger an appropriate behavior

Question 22

BRFSS

Answer 22

Behavioral Risk Factor Surveillance System; a population approach to studying health behavior, collects data on general health behaviors - largest phone survey; a household survey by the CDC on how people report their behavior and status relative to health risks such as smoking, diet, exercise

Question 23

Upstream vs. downstream

Answer 23

upstream interventions - focus on aspects of our social and physical environments that are either conducive or not to good health and well‐being - structural, larger scale incentives/restrictions
downstream interventions - focus on what we generally think of as medical care, outpatient or inpatient care, doctor’s office, diagnosis and treatment - individual, personal behaviors

Question 24

Illness behavior

Answer 24

the varying ways individuals respond to bodily indications, how they monitor internal states, define and interpret symptoms, make attributions, take remedial actions and utilize various sources of informal and formal care

Question 25

Self-care

Answer 25

taking preventive measures, self treatment of symptoms, and managing chronic conditions; may involve consultation with health care providers and use of their services; consists of both health and illness behavior

Question 26

Factors that promote self-care

Answer 26

the shift in disease patterns from acute to chronic illnesses and the accompanying need to care for symptoms that cannot be cured; dissatisfaction with professional medical care that is depersonalized; recognition of the limits of modern medicine; the increasing awareness of alternative healing practice; heightened consciousness of the effects of lifestyles on health; a desire to be in control of one's own health when feasible

Question 27

Women's self-care movement

Answer 27

part of the second wave on feminism in the 1970s; many women objected to what they perceived as inadequate or inappropriate treatment from doctors; women sought more info and familiarity into their bodies and body processes and practiced self-examination and non-medical remedies

Question 28

Age and gender

Answer 28

use of health services is greater for females than for males and is greatest for the elderly, women have higher morbidity rate, but also know more about health matters than men and take better care of themselves; elderly people visit doctors more than younger people and are hospitalized more, increase in physician visits typically exists after age of 45- women increase at a faster rate than men

Question 29

Cosmopolitan vs parochial perspectives (Suchman)

Answer 29

cosmopolitan - low ethnic exclusivity, less limited friendship systems, fewer authoritarian family relationships, more likely to know about disease, trust health professionals, less dependent on other while sick parochial (unsophisticated) - close and exclusive relationships with family, friends, members of their ethnic group and to display limited knowledge of disease, skepticism of medical care, high dependency in illness, more likely to depend on lay-referral system

Question 30

Lay-referral system

Answer 30

consists of nonprofessionals - family members, friends, or neighbors - who assist individuals in interpreting their symptoms and recommending a course of action

Question 31

Role of social networks

Answer 31

close, ethnically exclusive social relationships tend to channel help-seeking behavior toward the group rather than professional health care delivery systems; people in ethnically exclusive groups are more likely to respond to a health problem by seeking medical care if it is consistent with their cultural beliefs and practices, or less likely to seek medical care if their beliefs support skepticism and distrust of professional medicine

Question 32

Social network

Answer 32

the social relationships a person has during day-to-day interaction, which serve as the normal avenue for the exchange of opinion, information, and affection; role of social networks is to suggest, advise, influence, or coerce an individual into taking or not taking particular courses of action

Question 33

SES

Answer 33

lower-class persons tended to underutilize health services because of the financial cost and/or culture of poverty

Question 34

Culture of poverty

Answer 34

phenomenon in which poverty, over time, influences the development of certain social and psychological traits among those immersed within it - these traits include dependence, fatalism, inability to delay gratification, and a lower value placed on health - reinforces the poor person's disadvantaged social position

Question 35

Locus of control

Answer 35

people with a strong internal locus of control (belief that one can master, control or effectively alter the environment) knew more about illnesses and take a more active role in coping with disease; people with external locus of control (belief that one is more or less at the mercy of the environment, fate-fatalism, or other more powerful people) tend to be of the lowest socioeconomic group

Question 36

5 Different response stages to illness (Suchman)

Answer 36

1. the symptom experience - indiv confronted with decision about whether something is wrong; 2. the assumption of the sick role - accept symptoms and and relinquish normal social roles; 3. medical care contact - seeking professional assistance, legitimizes the sick role status and negotiate treatment procedures, illness experience may be confirmed or denied by physician; 4. the dependent-patient role - patient and doctor agree that treatment is necessary and undergoes treatment, but still has option to terminate treatment; 5. recovery and rehabilitation - acute illness patients may recover, but chronic may not be able to relinquish the sick role

Question 37

Secondary gain

Answer 37

sometimes patients settle for the secondary gain of enjoying the privileges accorded to a sick person, such as taking time off work

Question 38

Consumer role in health

Answer 38

more of a consumer orientation toward health among socially advantaged people; health consumers typically have more freedom to choose their source and mode of health care in a free-market health situation

Question 39

Socially constructed

Answer 39

decision to seek care is socially constructed there are factors that affect one's decision to seek care, more likely to seek care when there's disruption in everyday activities; availability of treatment (systems barrier) is a big factor that affects whether someone seeks care, culture of poverty and financial coverage affects it a little

Question 40

Opportunity costs, pride, stigma

Answer 40

opportunity cost - if you're doing one thing, then it detracts from other things, takes time and resources pride - if you think you're the type of person who doesn't get sick, may be reluctant to seek treatment stigma - cultural or social stigma surrounding the disease, people may think differently of you; bad treatment of discrimination because of where you're from

Question 41

EMTALA

Answer 41

Emergency medical treatment and labor act; an act passed in the 80s, guarantees emergency medical care at participating hospitals regardless of citizenship, legal status, or ability to pay; cant get turned away, have to treat you until you’re stable

Question 42

Insurance coverage

Answer 42

affects people’s willingness to go to the doctor; about 15% of the population in the U.S. doesn’t have public or private insurance

Question 43

Functionalist explanation of illness

Answer 43

illness is a form of deviance; being ill is a deviation from the idea of how human beings are supposed to function; deviance from a biological norm of health and feelings of well-being

Question 44

Illness

Answer 44

a state or condition of suffering as the result of a disease or sickness; a subjective state, pertaining to an individual's psychological awareness of having a disease and usually causing that person to modify his or her behavior

Question 45

Disease

Answer 45

an adverse physical state, consisting of a physiological dysfunction within an individual

Question 46

Sickness

Answer 46

a social state, signifying an impaired social role for those who are ill; according to functionalists, sickness is dysfunctional because it also threatens to interfere with the stability of the social system; if people think you're sick or you think other people think you're sick, it affects our behavior

Question 47

Sick role (Parsons)

Answer 47

based on the assumption that being sick is not a deliberate and knowing choice of the sick person, though illness may occur as a result of motivated exposure to infection or injury

Question 48

Four categories of the sick role

Answer 48

1. The sick person is exempt from the normal social roles; the exemption is relative to the nature and severity of the illness 2. The sick person is not responsible for his or her condition; an individual's illness is thought to be beyond his or her own control 3. The sick person should try to get well; exemption from social roles is temporary and conditional upon the desire to regain normal health 4. The sick person should seek technically competent help and cooperate with the physician; expected to work with the physician to get well

Question 49

Doctors as gatekeepers

Answer 49

they can decide who is able to work and who can’t, who opens the gate and who closes the gate, society trusts them to make that decision, to have principles and values and a service-oriented mind set

Question 50

Physician-patient role relationship

Answer 50

doctor holds a position of dominance; exercises leverage through 3 basic techniques: professional prestige - rests upon technical qualifications and the certification by society as a healer situational authority - the physicians having what the patient wants and needs situational dependency of the patient - patient is dependent because he/she lacks the expertise required to treat the health disorder

Question 51

Medicalization

Answer 51

the process by which medical definitions and practices are applied to behaviors, psychological phenomena, and somatic experiences not previously within the conceptual or therapeutic scope of medicine; there's not a fixed list of things under the authority of physicians or medicine, it's negotiable and changes over time

Question 52

Managed care

Answer 52

has become the dominant form of health care delivery in the US; makes insurance companies as third-party payers important in bolstering medicalization through its coverage of particular services and a constraint in placing limitations on those services

Question 53

Biomedicalization

Answer 53

consists of the capability of computer information and new technologies to extend medical surveillance and treatment interventions well beyond past boundaries, by the use of genetics, bioengineering, chemoprevention, drugs, patient records, etc.

Question 54

Medicine as social control

Answer 54

medicine has taken responsibility for an ever greater proportion of deviant behaviors and bodily conditions; acts that may have been defined as crime and controlled by the law and increasingly regarded as illnesses to be controlled through treatment

Question 55

Criticism of the sick role

Answer 55

behavioral variation, type of disease, stigma, patient-physician role relationship, middle-class orientation

Question 56

Behavioral variation

Answer 56

variation according to ethnic differences among patients; sick role more applicable to Jews and they saw themselves as being sick more, white Protestants more compliant with their doctors, Italian americans more focused on alleviating pain; people's responses to illness are contingent upon how you are raised, how you were socialized with respect to medicine - based on upbringing, which depends on ethnicity, religion, SES, etc

Question 57

Type of disease

Answer 57

parsons's sick role seemed to only apply to acute illnesses, which are temporary, recognizable by laypersons, and overcome with physician's help; patients with chronic disorders perceive the sick role differently; the sick role applied to mentally ill people implies that you should seek professional care - that may bring a stigma

Question 58

Patient-physician role relationship

Answer 58

the sick role is based on a traditional one-to-one interaction between a patient and a physician; other patterns of interaction may emerge in the hospital where perhaps a team of physicians and other members are involved; the interaction changes if a client targets preventive techniques rather than therapeutic treatments

Question 59

Middle-class orientation

Answer 59

the sick role model is based off middle-class behaviors; fails to take into account an environment of poverty, low SES

Question 60

Stigma

Answer 60

a number of illness have some negative association; people may think badly about you, the reason or way you get a certain illness may be looked down upon; people may make assumptions about you and not be interested in explanations about how you got the illness 3 main forms of stigma: abominations of the body; blemishes of individual character; and tribal stigmas of race, religion, and nationality

Question 61

Disability

Answer 61

a physical or mental impairment, may be a source of limitation for many people – the label of being disabled often has more serious repercussions than the actual impairment itself; contingent on a mismatch in interactions between the environment and the impairment

Question 62

Labeling theory

Answer 62

based on the concept that what is regarded as deviant behavior by one person or social group may not be so regarded by other persons or social groups

Question 63

Typology of illness and legitimacy (Freidson)

Answer 63

in illness states, there are 3 types of legitimacy, which involve either a minor or serious deviation; conditional legitimacy, unconditional legitimacy, illegitimacy

Question 64

Conditional legitimacy

Answer 64

the deviants are temporarily exempted from normal obligations and gain some extra privileges on the proviso that they seek help in order to rid themselves of their deviance; ex. a cold or pneumonia

Question 65

Unconditional legitimacy

Answer 65

the deviants are exempted permanently from normal obligations and are granted additional privileges in view of the hopeless nature of their deviance, ex. terminal cancer

Question 66

Illegitimacy

Answer 66

the deviants are exempted from some normal obligations by virtue of their deviance, for which they are technically not responsible, but gain few if any privileges and take on handicaps such as stigma; ex. a stammer or epilepsy

Question 67

Criticisms of labeling theory

Answer 67

does not address what causes deviance, other than the reaction of other people to it; doesn't examine common characteristics between deviant acts and actors; does not explain why certain people commit deviant acts and others in the same circumstances do not

Question 68

People with disabilities

Answer 68

face additional problems of altered mobility, a negative body image, and stigma; problems they face are not just medical, but also social, attitudinal, economic, and other adjustments

Question 69

Problems disabled people face in health

Answer 69

most disabled people have a thinner margin of health – more at risk of developing other diseases; people with disabilities have fewer opportunities for health behavior ex. exercise may be limited, the kinds of food you eat; many people who have impairments are at greater risk for certain kinds of chronic problems that may or may not be related to their first illness/disability; social barriers – a lot of healthcare professionals are nervous treating people with disabilities, accompanied with stigma – doctor may not feel they have enough knowledge to treat you; transportation is an issue, particularly if you have a vision disability or a mobility disability

Question 70

Doctor-patient interaction

Answer 70

the relationship is one that is orientated toward the doctor helping the patient deal effectively with a health problem (Parsons); physicians tend to have a bias in favor of finding illness in their patients

Question 71

Medical decision rule

Answer 71

the guiding principle behind everyday medical practice; the notion that since the work of the physician is for the good of the patient, physicians tend to impute illness to their patients rather than to deny it and risk overlooking or missing it; if given a choice, doctors are more likely to treat than not treat

Question 72

3 possible models of the doctor-patient interaction

Answer 72

depending on the severity of symptoms, the interaction falls into one of the three: activity-passivity, guidance-cooperation, and mutual participation

Question 73

Activity-passivity model

Answer 73

applies when the patient is seriously ill or being treated on an emergency basis in a state of relative helplessness, due to a severe injury or lack of consciousness

Question 74

Guidance-cooperation model

Answer 74

arises most often when the patient has an acute, often infectious illness, such as the flu or measles; patient knows what's going on and can cooperate with the physician by following his or her guidance in the matter - the physician makes the decisions

Question 75

Mutual participation model

Answer 75

applies to the management of chronic illness in which the patient works with the doctor as a full participant in controlling the affliction

Question 76

Clash of perspectives

Answer 76

the difference and often conflict between the perspective of medicine and medical providers, which focuses on biomedical issues in disease, and the perspective of patients, which focuses on how illness affects their daily lives

Question 77

Barriers to communication

Answer 77

barriers lie in the differences between physicians and their patients with respect to status, education, professional training, and authority; physicians state that an inability to understand and the negative effect or threatening info are the 2 most reasons for not communicating fully with their patients

Question 78

Hayes-Bautista model for doctor-patient interaction

Answer 78

view of the interaction as a process of negotiation, rather than the physician simply giving orders and the patient following them in an automatic, unquestioning manner; the model is limited to situations in which the patient is not satisfied with treatment and wants to persuade the doctor to change it

Question 79

(Cassell) Information as a therapeutic tool

Answer 79

information can be an important therapeutic tool in medical situations if it meets three tests: reduces uncertainty, provides a basis for action, and strengthens the physician-patient relationship

Question 80

Social class

Answer 80

social class differences were the most important factors in physician-patient communication; doctors from upper-middle class backgrounds tended to communicate more info to their patients than doctors from lower class backgrounds; patients from higher class position usually received more information; SES emerged as a determining factor in both providing and receiving medical info

Question 81

Social distance

Answer 81

patients who are similar to physicians in social class (less social distance) are more likely to share their communication style and communicate effectively with them, and vice versa

Question 82

Gender factors in interaction

Answer 82

female doctors were more attentive to patient's comments and medical histories, especially those of women, more empathic and egalitarian in their relationships with patients, more respectful, more responsive; male doctors were not sensitive to women patients; attitudes about women are changing, but women still have trouble being recognized as equals by male colleagues and as real doctors by male patients

Question 83

Culture

Answer 83

physican-patient interaction can also be influenced by cultural differences in communication; Italians overstated their symptoms while Irish patients understated them; language misunderstandings can take place

Question 84

Patient compliance (adherance)

Answer 84

compliance requires comprehension by the patient, and communication is key for avoiding noncompliance; motivation to be healthy, a perceived vulnerability to an illness, the potential for negative consequences, effectiveness of the treatment, sense of personal control, and effective communication are the strongest influences on compliance

Question 85

Technology

Answer 85

patients are much less dependent on their physicians, the internet is a good tool, self-diagnosing going on; Shift from biographical medicine (taking patient history, understanding symptoms, and diagnosing by doctor) to techno-medicine (get information through internet, using technology for testing, diagnosis, treatment, patients are self-monitoring or self-examining) – patients become much more independent or are put in a position to go negotiate with their doctors

Question 86

Effects of consumerism

Answer 86

consumer (patients) want to make informed choices about the services available and not be treated as inferior; patients have more status in the doctor-patient relationship

Question 87

Managed care

Answer 87

traditional doctor-patient relationship has been intruded on by third party payers - government such as medicare and medicaid, private health insurance companies, and managed care programs; they monitor and restrict physicians in their treatment of patients