Study Guide Questions

Sociology 315 with Keith at Texas A&M University

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By: Nadia Ewing
Created: 2011-11-04
Size: 58 flashcards
Views: 15

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Name the various dimensions of health as defined by whom?

Physical functioning

Mental health

Social well-being

Role functioning

General health perceptions

Symptoms

Physical functioning

physical limitations regarding ability to take care of self, being mobile, and participating in physical activities; number of days confine to bed

Mental health

feelings of anxiety and depression, psychological we-being, and control of emotions and behaviors.

Social well-being

speaking with family and on number of close friends and acquaintances.

Role functioning

freedom of limitations discharging usual role activities such as work or school

Role functioning

freedom of limitations discharging usual role activities such as work or school

Symptoms

a focus on reports of physical and psychophysiologic symptoms

What is the difference between activities aimed at prevention, protection, and disease detection? Can you recognize each if given an example?

Prevention - minimizing the risk of disease, injury, and disability. These "health-protective behaviors" include exercise, favorable weight and healthy diet, not smoking, and getting immunizations

Detection - getting a check up before symptoms occur (screenings for specific diseases)

Protection - efforts to make the environment as healthy as possible (monitoring all types of environmental conditions)

What health protective behaviors are most and least practiced?

Behaviors with Serious Risk (greatest to least):

Smoking
Diet and lack of exercise (obesity and overweight)
Excessive alcohol consumption

How does health behavior differ from illness and sick role behavior?

Health behaviors are individual actions taken to protect, promote, or maintain health so as to avoid illness altogether.

Illness and sick role behavior has to do with...

What does McKinlay mean by refocusing upstream? Be familiar with examples of up and down stream."

He stresses the fact that legislators and physicians (as opposed to individuals) should focus more on the factors that cause sickness and preventing it, rather than just treating the sickness once it occurs. (page 126)

example of a downstream participant: individual smokers

example of an upstream participant: tobacco industry (laws against them is more effective than efforts to persuade people to quit smoking)

What is McKinlay's criticism of the movement?

Using policy and the force of laws to regulate individual behavior is viewed by some as contradicting the cultural value of individualism.

What is the health belief model? Why was its originally developed?

provides a paradigm for understanding why some individuals engage in HPBs, while other behaving in knowingly unhealthy ways.

Development was sparked by the concern of many public health researcher in the 50s/60s that few people were changing their behavior despite public health warnings

What are the health belief model's major components? How can it be used to encourage healthy behavior? Be able to apply it in a concrete example.

It claims that people will take preventive health action only when the following 4 conditions exist at the same time:

feels vulnerable to disease
knows the disease would have serious consequences
thinks that taking action would prevent or reduce the symptoms of disease
has one or more triggers for action (friend, physician, illness of someone else)

(Page 134 - review model)

Why does McKinlay believe that it is difficult to change health habits?

Because of the mostly-negative resources available to the individual:

the availability of harmful consumer products (cigarettes, tobacco)

media and cultural messages (advertisements for alcohol - drinking is cool)

THE MACRO LEVEL FACTORS

health promotion movement. What is its philosophy? What are its advantages and limitations? Why is it popular?

READ ARTICLE BY BECK

Emphasis on personal control

Holds promise of extending life expectancy

What did Fuchs find regarding mortality in Utah and Nevada? What was the major point of his findings?

Focused on primary prevention

Prescriptive (diet, seat belt, exercise)

Prescriptive (avoid smoking, excessive drinking)

READ FUCHS!

Who was John Knowles? What does he mean by the manufacturers of illness?

Believed maintaining a healthy lifestyle is an individual responsibility - MICRO APPROACH

Modern medicine limited in addressing chronic disease

Good health habits linked to health and mortality

Americans justify bad behavior by claiming individual freedom

Noted the limited funding for prevention

Good evidence that behavior can be changed

What do Morland and Evenson mean when they talk about the food environment? What did their study reveal about the relationship between the food environment and obesity? How do their findings related to McKinlay’s discussion?

READ "obesity... local food environment"

Let me guess... our food environment is bad.

What is illness behavior? How does the “social” view of illness differ from the biomedical view of illness?

"the way in which symptoms are perceived, evaluated, and acted upon by a person who recognizes some pain, discomfort or other signs of organic malfunction"

People are influenced by cultural factors and pressures rather than the facts of risks and illness.

Biomedical view sees illness as an objective state consisting of signs and symptoms.

more... page 143

What is the sick role? What are the rights and obligations of the sick?

introduced by Talcott Partsons

A person takes on a new role which replaced their normal one. The sick role is a deviant behavior, violating normal role expectations.

Rights: The sick person is temporary excused from normal social roles, and not held responsible for the illness.

Obligations: The person must want to get well and is expected to seek medical advice and cooperate with medical experts.

Why did Parsons believe that sickness was dysfunctional for society?

Because when one member is sick, other members are required to pick up the slack, and may become overburdened in so doing.

What are criticisms of the sickrole?

1. it does not account for variability in behavior among sick people

2. it not accurate in describing people with chronic illness and may not get well no matter how much they want to (only relevant for acute illnesses)

3. does not adequately account for variety of setting physicians and patients interact (only office interaction)

4. more applicable to middle class patients than lower class groups

What is the major point made by Suchman’s research regarding symptom experiences?

Illness and reactions to illness are not entirely objective: there is a subjective element

Ideas about normality and deviations from normality differ across social groups

Illness definitions and reactions to illness are influenced by: norms; socialization experiences; modeling; perceptions

Illness and reactions to illness are socially constructed.

Suchman's Model: Define parochial vs. cosmopolitan.

Parochial group structure or orientation

More traditional
More skeptical of medicine
Longer time to proceed through stages

Cosmopolitan group structure or orientation

More scientific orientation
Less skeptical of medicine
Proceed through stages faster

What was Friedson’s critique of the sick role? What kinds of medical conditions represent the three kinds of legitimacy that Friedson outlined?

He agrees that society responds negatively to people who are sick (when they could have taken measures to prevent it) just as they would respond to someone who broke the law. But he does, though, account for variations among the degrees of deviation. He divided illnesses into either a minor deviation or a serious deviation, and of those, the sickness can be: Illegitimate-Stigmatized (some exemption), Conditionally Legitimate (temp. exemption), or Unconditionally Legitimate (permanent exempt)

What is medicalization?

The process by which health or behavior conditions come to be defined and treated as medical issues and thus come under the purview of doctors and other health professionals to engage with, study, and treat.

Who are the sources of medicalization?

Physicians

Supported PMS but resisted domestic violence

Lay constituencies/public

Through social movements demanded treatment for PTSD

Pharmaceutical companies

Viagra

According to McCann and Conrad what are the conceptual, institutional, and interactional levels of medicalization?

Conceptual— medical vocabulary used but no medical treatment (Alcoholics Anonymous)
Institutional-- medical model predominates but physicians not directly involved (treatment center for eating disorders)
Interactional– physicians directly involved through provision of treatment (patient prescribed psychoactive drugs without firm diagnosis)

What are some of the positive and negative consequences of medicalization?

Positive Consequences

less stigma (less blame)
insurance coverage
validation of troubles

Negative Consequences

medical excuse for deviance
expands social control of medicine—use of powerful drugs or surgical procedures (Medicated Child)
increases national health care bill

Medical expertise privileged over other knowledge

TODAY the stimulus for medicalization is coming from what three agents?

pharmaceutical industry lobbying for medical definitions to conditions (erectile dysfunction)

consumers seeking to have treatment paid for by insurance that is not necessarily a "needed" treatment (cosmetics: plastic surgery)

managed care [acting either as an incentive for certain medical procedures (such as its willingness to pay for psychiatric medicine)

Demedicalizatin

a countermovement of medicalization in which there was concern that the medical profession's powers of social control were becoming too extensive (removal of homosexuality from the American Psychiatric Association's list of mental disorders)

What is the social organization strategy?

it emphasizes the importance of social interaction and social networks as the "the mechanism through which individuals learn handle difficulties"

emphasizes that responding to illness is a process

ccording to Lee and Mysyk, what factors are driving the medicalization of compulsive buying? Why is it happening at this time (explanations)? Why do Lee and Mysyk believe that treating overspending/compulsive buying as a medical condition is a problem?

Because it's connected to psychological problems like low self-esteem; depression

What are some treatments that might be used as alternatives to Selective Serotonin Reuptake Inhibitors?

Consumer education if social causation is at work

Focus on enhancing self-concept

Group therapy using behavior modification

(SSRIs treat depression, anxiety, premature ejaculation)

What are criticism sof the AMA?

it acts in its own interest not the public interest

it became too powerful

the "service" aspect was declining as agreed to in the Great Trade

What is consumerism/deprofessionalization?

Patients are now "consumers" (more knowledge on what to buy in place of screenings/treatment)

there's been a reduction in patient trust in physicians

And in increase in use of complementary and alternative medicine (CAM)

What are some of the positive and negative consequences of physician dominance?

Positives:
Highly trained physicians
Technologically, the most advanced health care system in the world
Negatives:
Fostered narrow approach to illness

Failed to take a holistic perspective

Rigid stratification system–perhaps too much control over other medical occupations
Peer regulation became problematic

Marsha Millman’s study of mortality review

Excesses: unnecessary tests, procedures; hospitalizations

What factors contribute to physicians’ dissatisfaction?

Bureaucratic and institutional controls

Paperwork

Declining incomes

What is malpractice and why did it increase?

Malpractice: preventable harm which results from the action or inaction of health care personnel (a form of external control)

It increased due to the following factors:

Consumer health movement
Increasing distance between patient and physician
Trial lawyers specializing in malpractice
Medical technology
Poor disability compensation

Review the Harvard Medical Practice Study in your text. What are some of the consequences of the malpractice “crisis”? What approaches are being used to stem the malpractice crisis?

Most legitimate cases are not filed

Large % of cases filed are not justified

Consequences of malpractice:

Defensive medicine—rising costs
Premium costs passed on to patients—rising out-of-pocket costs
Strains in physician-patient relationships
Physicians changing specialization or services offered (example: obstetrical services)

According to Goode, what are the characteristics of a true profession?

Autonomy - licensed, dominant

pertaining to rigorous standards - difficult education process to obtain status

pertaining to prestige and identification - occupation gain income, it is a good form of work, members are strongly affiliated with profession

What is professional dominance and autonomy as defined by Friedson?

the extensive control held by the medical profession over the organization, law, clinical practice, and financing of medical care and its ability to promote its own autonomy, prestige, and income.

What factors present increasing challenges to physician dominance?

The medical profession (physicians) have less autonomy and are less dominant now than in the 1950s—considered the height of dominance

Physician do not have as much freedom in making treatment decisions and they are subject to more oversight than in the past.

There are several explanations for these changes---each explanation emphasizing a different aspect.

What is the theory of countervailing powers?

the tendency for other players to put effort into balancing that power (when a professions gains extraordinary dominance

What is proletarisnization?

corporatization has led to proletarianization of medicine - that physicians eventually have their autonomy and self-control stripped and replaced with control by corporate owners and managers.

What is corporatization?

an increasing amount of corporate control of medicine

occurred in the 1980s and was characterized by the use of and payment for services by managed care companies

About this deck

By: Nadia Ewing
Created: 2011-11-04
Size: 58 flashcards
Views: 15

About StudyBlue

“Simply amazing. The flash cards are smooth, there are many different types of studying tools, and there is a great search engine. I praise you on the awesomeness.”
Dennis