1
Q
According to Crawford, why has the pursuit of health become such a highly valued activity today?
A
- Crawford argues that health is now seen as a personal responsibility and moral obligation. The pursuit of health reflects broader social values like individualism, self-control, and productivity, especially in a neoliberal context where people are expected to manage risks themselves
2
Q
To Crawford, a commitment to health is a way that people accumulate symbolic capital. What is this symbolic capital used for, according to the author?
A
- Symbolic capital refers to non-material social assets (e.g., prestige, honor) that confer status - Crawford suggests that a commitment to health serves as symbolic capital—healthy behavior signals responsibility, discipline, and moral virtue, elevating one’s social standing
3
Q
According to Crawford, what does the pursuit of health have to do with identity in our society?
A
- Health becomes central to how individuals construct and express their identities
- Being seen as “healthy” aligns with being seen as a “good” or “successful” person
4
Q
Why was there a growing attention to health in the 1970s, according to Crawford?
A
- Due to rising awareness of chronic diseases and government promotion of preventative health, the public began focusing more on individual responsibility for health outcomes
5
Q
How does Crawford characterize health-consciousness today?
A
- He describes it as a moral and political project - It involves self-surveillance, personal responsibility, and aligns with neoliberal ideologies that shift responsibility from institutions to individuals
6
Q
Crawford says “the political question about danger (health risks) is which ones will be identified as requiring public action and which will be relegated to the private sphere.” What does he mean?
A
- Crawford is pointing out that health risks are politically constructed—some are deemed public concerns warranting government action, while others are framed as private, personal responsibilities
7
Q
What does Crawford mean by the “new health consciousness”?
A
- This refers to a shift toward individual responsibility for managing health risks
- People are expected to be informed, proactive, and self-regulating, aligning with neoliberal values.
8
Q
According to Crawford, what’s the relationship between the new health consciousness and political tenets of “neoliberalism”?
A
- Neoliberalism emphasizes deregulation, privatization, and personal responsibility
- The new health consciousness mirrors this by shifting health accountability onto individuals rather than public institutions
9
Q
What are the principal characteristics of and differences between the medical and sociological models of illness?
A
- The medical model is more objective than the sociological model
- the medical model has no political or social meaning and does not include bias or prejudice
- The sociological model affects how we view illness and bias
10
Q
What is medicalization? What is demedicalization? Can you think of any examples?
A
- medicalization is treating non-medical issues as medical problems (alcoholism, sexual performance)
- demedicalization is when a medicalized problem is treated again as a non-medical issue (aging)
11
Q
What are some of the unintended consequences of medicalization, according to Weitz and lecture?
A
- overreliance on pharmaceutical treatments
- loss of social or political explanations for problems
- increased surveillance and control over individuals
- creation of new stigmas or dependencies
12
Q
What is meant by the “sick role” and what are its component expectations?
A
- the sick person is exempt from normal social expectations
- they are expected to follow medical advice and get better
13
Q
According to Spence and her colleagues, what role does narrative play in how people experience illness (i.e. long Covid)?
A
- Narrative allows individuals to make sense of their illness, validate their experiences, and seek social recognition
- For long COVID sufferers, it helps articulate symptoms that lack medical acknowledgment
14
Q
How did long covid affect sufferers’ identities, according to Spence, et. al.?
A
- Long COVID disrupted their sense of self, careers, and social roles
- Many experienced biographical disruption, feeling that their identities were fundamentally changed
15
Q
What does Spence and her colleagues’ study suggest about the role of medical amounts of illness on the expereince of people suffering from illness?
A
- Medical accounts heavily influence whether patients feel validated
- Lack of recognition from medical institutions can lead to feelings of isolation and delegitimization
16
Q
According to lecture, were the subjects in Spence’s fulfill the sick role?
A
- Not fully, many struggled to have their illness recognized and thus couldn’t receive the social legitimacy that would allow them to adopt the sick role
17
Q
According to Spence, et. al., what factors prevented long haulers from having their illness experiences validated?
A
- Lack of biomedical testing, uncertain or invisible symptoms, and inconsistent recognition by health professionals prevented validation
18
Q
What role did online communities play in the illness experiences of long haulers interviewed in Spence’s study?
A
- Online communities provided social support, a sense of legitimacy, and shared narratives that validated sufferers’ experiences
19
Q
What is the medical model of disability and what is the sociological model of disability? How do they differ?
A
- medical model sees disability as a defect or illness within the individual, needing treatment or cure
- sociological model views disability as a product of social and physical barriers in the environment
20
Q
What are the implications of the medical sociological models of disability?
A
- Medical model can pathologize individuals and focus on cure
- Sociological model emphasizes accessibility, social justice, and structural change
21
Q
Why have the proportion of the U.S. population living with disabilities grown over time?
A
- Due to aging populations, better diagnosis, broader definitions, and greater recognition of chronic and mental health conditions
22
Q
What did the American Coalition of Citizens with Disabilities, featured in the film Crip Camp, want to achieve?
A
They advocated for civil rights, inclusion, and accessibility for people with disabilities, ultimately contributing to legislation like the Americans with Disabilities Act
23
Q
How do the medical and sociological models of mental illness differ?
A
- Medical model views mental illness as a disease rooted in biology, treatable through medication or therapy
- Sociological model sees mental illness as shaped by social context, labeling, and stigma
24
Q
What did the Rosenhan experiment claim to demonstrate about psychiatry?
A
- That psychiatric diagnoses can be unreliable and shaped by context
- Healthy individuals feigned symptoms and were admitted, raising concerns about labeling and institutional power
25
How were people with mental illness treated in the pre-scientific era?
- They were often subjected to moral judgment, imprisonment, or exorcism
- Care was often inhumane or nonexistent
26
How could mental illness be treated, according to advocates of “moral treatment”?
- With kindness, structured routines, and therapeutic environments
- It emphasized humane and compassionate care
27
What led to the decline of asylums and moral treatment?
- Overcrowding, underfunding, and a shift toward biomedical explanations led to deteriorating conditions and loss of support
28
What did the “mental hygiene” movement in psychiatric care seek to achieve, according to the lecture?
- It aimed to prevent mental illness and promote mental wellness through education, early intervention, and improved care systems
29
What contributed to the development of community mental health of psychiatric care, according to the lecture?
- Critiques of institutional care, advancements in medication, and the push for deinstitutionalization encouraged outpatient services and community-based models
30
What “evolving public views” did Pescosolido, Manago, and Monahan’s research attempt to understand?
- Changes in how the public perceives the causes of mental illness and their willingness to interact with individuals with mental illness
31
What did the results of Pescosolido, Manago, and Monahan’s research suggest about the way the public views mental illness?
- Despite increased awareness, stigma persists—especially the association of mental illness with violence
32
What are the implications of medicalizing violence (associating violence with mental illness), according to Pescosolido, Manago, and Monaham?
- It reinforces stigma, misrepresents most people with mental illness as dangerous, and can lead to misguided policies and social exclusion
33
What was the original purpose of Blue Cross and Blue Shield, according to Weitz?
To provide affordable hospital care by pooling resources through non-profit insurance plans
34
Why were commercial insurers able to offer lower premiums than Blue Cross/Blue Shield, according to Weitz?
- They used actuarial risk rating to insure only low-risk individuals, avoiding higher costs associated with high-risk patients
35
How do managed care organizations control costs, according to Weitz?
- By limiting services, requiring pre-approvals, emphasizing preventative care, and negotiating lower fees with providers
36
Do managed care organizations seek to control costs solely to improve services for its members, according to Weitz?
- No, while cost control may improve efficiency, it often serves profit motives and may reduce quality or access to care
37
How does Medicare and Medicaid benefit private and non-private insurers and health providers?
- They guarantee payment, cover high-risk patients, and indirectly subsidize the health care industry
38
What contributes to high costs of health care in the U.S., according to Weitz and lecture?
- Administrative complexity, pharmaceutical prices, advanced technologies, and profit motives in a fragmented system
39
What are the popular myths about U.S. health care, according to Weitz?
- That it is the best in the world and that high costs equate to high quality care
40
How does investment in advanced technologies contribute to high health care costs, according to lecture and as illustrated in the film The Healthcare Divide?
- It increases spending, often without improving outcomes, and drives demand for expensive diagnostic procedures
41
What does it mean to be “underinsured”, according to Weitz?
- Having insurance that does not adequately cover medical costs, leading to high out-of-pocket expenses
42
What are the common reasons why people in the U.S. lose their health insurance, according to Weitz?
- Job loss, changing employment, aging out of parental plans, and affordability
43
What changes were introduced by the 2010 Patient Protection and Affordable Care Act?
- Expanded Medicaid, prevented denial for preexisting conditions, created insurance exchanges, and required coverage
44
What are the characteristics of the German “Bismarck” model of health care?
- Based on mandatory insurance through 'sickness funds'; providers and insurers are private but heavily regulated
45
How is the German model able to control costs?
- Through price negotiations, government regulation, and non-profit sickness funds
46
What are the characteristics of the Canadian national health insurance model of health care?
- A single-payer system funded by taxes that covers all citizens; private providers bill the government
47
How is the Canadian health care system able to control costs?
- By eliminating profit motives in insurance, reducing administrative overhead, and negotiating prices
48
What are the characteristics of the British “Beveridge” model of health care? How does it differ from the Canadian model?
- The government provides and funds care directly
- Unlike Canada’s single-payer model with private providers, the UK system is publicly owned and operated
49
How is the British health care service able to control costs?
- Central budgeting, salaried providers, and prioritization of cost-effective care
50
What was the chief difference between the two competing medical sects, regular, allopathic doctors and homeopathic doctors?
- Allopathic doctors used aggressive treatments like bloodletting, while homeopaths used minimal doses and emphasized natural healing
51
What contributed to an increase in respect for regular, allopathic doctors by the late 19th century, according to lecture/Weitz?
- Scientific advances, professional organization, and public health successes improved their legitimacy
52
What factors contributed to the rise of medical dominance, according to Weitz?
- Control over licensing, education, and hospitals, plus support from the state and public trust
53
What role did the American Medical Association play in establishing the professional dominance of medicine, according to Weitz?
- It standardized education, lobbied for licensing laws, and marginalized competitors
54
What was the Flexner Report and what impact did it have on the field of medicine, according to Weitz?
- A 1910 report that led to stricter standards for medical education, closing substandard schools and elevating professional medicine
55
What are the characteristics of a profession, as defined by Freidson and summarized in lecture?
- Expertise, autonomy, authority over clients and peers, and self-regulation
56
What factors have contributed to the decline of medical dominance, according to lecture/Weitz?
- Government regulation, corporatization, rise of non-physician clinicians, and consumer movements
57
In what ways has the corporatization posed a threat to medicine as a profession, according to Weitz/lecture?
- It reduces physician autonomy, prioritizes profit over care, and turns medicine into a business
58
Erlanger, featured in The Healthcare Divide, is a “safety net hospital”. What does that mean?
- A hospital that provides care regardless of patients’ ability to pay, often serving uninsured or underinsured populations
59
Why did Erlanger, featured in The Healthcare Divide, struggle financially?
- It had a high percentage of uninsured patients and received insufficient reimbursement for care provided
60
What did Erlanger do to improve its financial viability?
- Partnered with insurers, restructured management, and reduced uncompensated care
61
What has contributed to the decline in public support of medicine, according to Weitz/lecture?
- Growing awareness of profit motives, unequal care, and physician errors
62
What factors have contributed to changes in the doctor-patient relationship, according to lecture?
- Greater patient access to information, emphasis on shared decision-making, and time constraints
63
What has lead to the decline in the American Medical Association’s power, according to Weitz/lecture?
- Rising pluralism in medical governance and declining physician membership
64
Role
set of rights, duties, obligations, expectations, norms, and behaviors assumed by individuals who occupy a given position/status
65
Social control
- medicine is seen as a legitimate and trusted power in society
- patients expect truth from doctors
- medicine creates power over people's power
66
Medicalization
attributing non-medical issues to medical problems so there can be a solution presented
67
Demedicalization
the process of redefining a condition as no longer medical
68
Contested illness
conditions that are not universally recognized by medical professionals, often because of ambiguous symptoms or lack of biomedical explanation (ex. chronic Lyme disease)
69
Biographical disruption
A fundamental shift in a person's self-concept and life trajectory due to chronic illness or disability
70
Narrative reconstruction
- the process by which individuals reshape their life stories to make sense of and integrate the experience of illness or disability into their identity and future
71
The sick role
- sick person is expected to recognize their sickness as undesirable and work to get well
72
Reliability
- The consistency of a measure or diagnosis
- In psychiatry, a lack of reliability undermines diagnostic credibility
73
Validity
Whether a diagnosis accurately reflects the condition it intends to label
74
Deinstitutionalization
The movement away from institutional care toward community-based treatment
75
Stigma
A social process that discredits individuals and groups based on a perceived trait, such as mental illness
76
Community rating
Insurance pricing strategy where everyone pays the same premium regardless of individual health risks
77
Actuarial risk rating
Insurance pricing based on an individual’s health risk, often leading to higher premiums for those with preexisting conditions
78
Fee-for-service insurance
A health care model where providers are paid for each service rendered, encouraging high volume but not necessarily better care
79
Managed care
A system that manages cost, utilization, and quality by requiring members to use a network of providers and often needing preapprovals
80
Diagnostic related groups (DRGs)
A classification system that determines Medicare reimbursement rates based on diagnosis and procedure type
81
Medicaid
A public health insurance program in the U.S. for low-income individuals and families, jointly funded by federal and state governments
82
Medicare
A federal health insurance program primarily for people aged 65 and older and some younger individuals with disabilities
83
Social insurance
A system where health insurance is funded by contributions from employers and employees, common in countries like Germany
84
Sickness funds (Germany)
Non-profit insurance organizations in Germany that collect premiums and pay for care
85
National health insurance
A system (e.g., Canada) where a single public insurer pays for care provided by private doctors and hospitals
86
Single-payer system
A system in which one public agency handles health financing for all residents, simplifying access and costs
87
Capitation
A payment arrangement where providers are paid a fixed amount per patient, regardless of the number of services provided
88
Regular doctors
Historically, those trained in allopathic (biomedical) medicine, which became the dominant medical practice
89
Irregular practitioners
Medical providers outside the dominant biomedical model, such as homeopaths, herbalists, or midwives
90
Allopathic medicine
Conventional Western medicine that treats illness through drugs, surgery, and scientifically validated methods
91
Homeopathic medicine
An alternative approach based on the idea that “like cures like,” using very small doses of natural substances
92
Heroic medicine
A historical practice of using aggressive treatments like bloodletting, purging, and strong drugs
93
Diagnosis related groups
- shift focus from individualized care to standardized treatment and economic management, affecting how doctors practice medicine and how patients experience hospital care
- It introduces tension between professional autonomy and bureaucratic control
94
Resource-based relative value scale
A payment system that assigns value to medical services based on the resources required to perform them
95
Corporatization
The transformation of health care delivery from physician-centered practices to systems dominated by large, often for-profit, organizations
96
Non-physician clinician
Health care professionals such as nurse practitioners or physician assistants who provide many services traditionally offered by doctors
Medical Sociology
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