# Study Guide: Chapter 13 — Health And Health Care > Organized by textbook section. Review the objectives, study topics, key takeaways, and questions for each section. ## 13.1: Sociological Perspectives on Health and Health Care ### Study Topics - Learning Objective - Table 13.1 Theory Snapshot - The Functionalist Approach - The Conflict Approach - The Symbolic Interactionist Approach - The Symbolic Interactionist Approach ### Key Terms - **conflict theory** — The view that society is composed of groups with different interests arising from their placement in the social structure. - **Discrimination** — With regard to racial and ethnic inequality, the arbitrary denial of rights, privileges, and opportunities to members of subordinate racial and ethnic groups. - **drug** — Any substance other than food that, when taken into the body, affects the structure and/or functioning of the body. - **economy** — The social institution that organizes the production, distribution, and consumption of a society’s goods and services. - **family** — A group of two or more people who are related by blood, marriage, adoption, or a mutual commitment and who care for one another. - **Functionalism** — The view that social institutions are important for their contributions to social stability. - **health care** — The provision of medical services to prevent, diagnose, and treat health problems. - **race** — A category of people who share certain inherited physical characteristics, such as skin color, facial features, and stature. - **sick role** — Expectations of how people are supposed to think and act when they are ill. - **social construction** — A concept that has no objective reality but rather is what people decide it is. - **Socialization** — The process whereby individuals learn the culture of their society. ### Key Takeaways - A sociological understanding emphasizes the influence of people’s social backgrounds on the quality of their health and health care. A society’s culture and social structure also affect health and health care. - The functionalist approach emphasizes that good health and effective health care are essential for a society’s ability to function, and it views the physician-patient relationship as hierarchical. - The conflict approach emphasizes inequality in the quality of health and in the quality of health care. - The interactionist approach emphasizes that health and illness are social constructions; physical and mental conditions have little or no objective reality but instead are considered healthy or ill conditions only if they are defined as such by a society and its members. ### Review Questions 1. Which approach—functionalist, conflict, or symbolic interactionist—do you most favor regarding how you understand health and health care? Explain your answer. 2. Think of the last time you visited a physician or another health-care professional. In what ways did this person come across as an authority figure possessing medical knowledge? In formulating your answer, think about the person’s clothing, body position and body language, and other aspects of nonverbal communication. ## 13.2: Global Aspects of Health and Health Care ### Study Topics - International Disparities in Health and Illness - Figure 13.2 Percentage of Population with Access to Adequate Sanitation Facilities, 2008 - Health Care in Industrial Nations - Lessons from Other Societies ### Key Terms - **health care** — The provision of medical services to prevent, diagnose, and treat health problems. - **life expectancy** — The average age to which people can be expected to live. - **national health insurance** — A system of medicine in which the government pays all or most of the costs of health care, prescriptions, and other items for the entire population. ### Learning Objectives 1. Describe how the nations of the world differ in important indicators of health and illness. 2. Explain the health-care model found in industrial nations other than the United States. ### Key Takeaways - The world’s nations differ dramatically in the quality of their health and health care. People in poor nations suffer from many health problems, and poor nations have very high rates of infant mortality and maternal mortality. - Except for the United States, industrial nations have national health-care systems and national health insurance. Their health- care models help their citizens to have relatively good health at affordable levels. ### Review Questions 1. What do you think should be done to help improve the health of poor nations? What role should the United States play in any efforts in this regard? 2. Do you think the United States should move toward the national health insurance model found in other Western nations? Why or why not? ## 13.3: Problems of Health in the United States ### Study Topics - The Poor Status of American Health - Health Disparities: Physical Health - Social Class - Children and Our Future - Race and Ethnicity - Table 13.2 US Life Expectancy at Birth for People Born in 2007 - Health Disparities: Mental Health - Social Class - Race and Ethnicity ### Key Terms - **Discrimination** — With regard to racial and ethnic inequality, the arbitrary denial of rights, privileges, and opportunities to members of subordinate racial and ethnic groups. - **educational attainment** — How far one gets in school, which has been shown to depend heavily on family income and race/ethnicity. - **family** — A group of two or more people who are related by blood, marriage, adoption, or a mutual commitment and who care for one another. - **gerontology** — The study of aging. - **health care** — The provision of medical services to prevent, diagnose, and treat health problems. - **health disparities** — Differences in health and illness according to social class, race and ethnicity, and gender. - **life expectancy** — The average age to which people can be expected to live. - **poverty line** — The government’s measure of official poverty, based on the cost of a minimal diet for a family that is then multiplied by three. - **race** — A category of people who share certain inherited physical characteristics, such as skin color, facial features, and stature. - **sexism** — The belief that women are inferior to men. - **social construction** — A concept that has no objective reality but rather is what people decide it is. - **Socialization** — The process whereby individuals learn the culture of their society. ### Learning Objectives 1. Describe how and why social class, race and ethnicity, and gender affect physical health and health care in the United States. 2. Summarize the differences that social class, race and ethnicity, and gender make for mental health. ### Key Takeaways - Social class, race and ethnicity, and gender all influence the quality of health in the United States. Health problems are more common among people from low-income backgrounds and among people of color. Women are more likely than men to have health problems that are not life threatening. - Although debate continues over whether mental illness is a social construction, many people do suffer mental health problems. The social epidemiology for mental health and illness resembles that for physical health and illness, with social class, race/ethnicity, and gender disparities existing. - The private insurance model in the United States incurs huge administrative costs and results in more than 50 million people lacking health insurance. ### Review Questions 1. In thinking about the health problems of individuals from low-income backgrounds, some people blame lack of access to adequate health care for these problems, while other people blame unhealthy lifestyles practiced by low-income individuals. Where do you stand on this debate? Explain your answer. 2. Write a brief essay in which you present a sociological explanation of the higher rate of depression found among women than among men. ## 13.4: Problems of Health Care in the United States ### Study Topics - Private Health Insurance and the Lack of Insurance - Figure 13.6 US Health-Care Expenditure, 1980–2010 (in Billions of Dollars) - Table 13.4 Health Insurance Coverage in the United States, 2010 - Applying Social Research - The High Cost of Health Care - Figure 13.8 Average Cost of Selected Medical Procedures and Services - Managed Care and HMOs - Figure 13.9 Growth of Health Maintenance Organizations (HMOs), 1980–2007 (Millions of Enrollees) - Racial and Gender Bias in Health Care - Other Problems in the Quality of Care - Medical Ethics and Medical Fraud ### Key Terms - **direct-fee system** — A system of medicine in which patients pay for health care, prescriptions, and other medical costs themselves. - **drug** — Any substance other than food that, when taken into the body, affects the structure and/or functioning of the body. - **economy** — The social institution that organizes the production, distribution, and consumption of a society’s goods and services. - **family** — A group of two or more people who are related by blood, marriage, adoption, or a mutual commitment and who care for one another. - **health care** — The provision of medical services to prevent, diagnose, and treat health problems. - **health maintenance organizations** — Prepaid health plans with designated providers that typically enroll their subscribers through their workplaces. - **race** — A category of people who share certain inherited physical characteristics, such as skin color, facial features, and stature. ### Learning Objectives 1. Summarize the problems associated with the model of private insurance that characterizes the US health system. 2. Explain how and why mistakes and infections occur in hospitals. 3. Describe any two other problems in US health care other than the lack of health insurance. ### Key Takeaways - The US health-care model relies on a direct-fee system and private health insurance. This model has been criticized for contributing to high health-care costs, high rates of uninsured individuals, and high rates of health problems in comparison to the situation in other Western nations. - Other problems in US health care include the restrictive practices associated with managed care, racial/ethnic and gender bias in health-care delivery, hospital errors, and medical fraud. ### Review Questions 1. Do you know anyone, including yourself or anyone in your family, who lacks health insurance? If so, do you think the lack of health insurance has contributed to any health problems? Write a brief essay in which you discuss the evidence for your conclusion. 2. Critics of managed care say that it overly restricts important tests and procedures that patients need to have, while proponents of managed care say that these restrictions are necessary to keep health-care costs in check. What is your view of managed care? ## 13.5: Improving Health and Health Care ### Study Topics - People Making a Difference ### Key Terms - **corporation** — An organization that has a legal existence apart from that of its members. - **Discrimination** — With regard to racial and ethnic inequality, the arbitrary denial of rights, privileges, and opportunities to members of subordinate racial and ethnic groups. - **health care** — The provision of medical services to prevent, diagnose, and treat health problems. - **national health insurance** — A system of medicine in which the government pays all or most of the costs of health care, prescriptions, and other items for the entire population. - **race** — A category of people who share certain inherited physical characteristics, such as skin color, facial features, and stature. - **single-payer system** — A program of health insurance for all citizens that is funded and operated by the federal government. ### Learning Objectives 1. Explain how the United States could improve the quality of health and health care. 2. List strategies that will improve global health. ### Key Takeaways - Effective health care reform must address social class, racial and ethnic, and gender inequalities in health and health care. - National health insurance involving a single-payer system would improve many aspects of health and health care in the United States. - In the absence of national health insurance, several types of changes could still help to reduce health care costs. ### Review Questions 1. Do you favor or oppose national health insurance for the United States? Explain your answer. 2. Why do you think the United States remains the only industrial nation without national health insurance? ## 13.6: End-of-Chapter Material ### Key Terms - **Discrimination** — With regard to racial and ethnic inequality, the arbitrary denial of rights, privileges, and opportunities to members of subordinate racial and ethnic groups. - **health care** — The provision of medical services to prevent, diagnose, and treat health problems. - **life expectancy** — The average age to which people can be expected to live. - **national health insurance** — A system of medicine in which the government pays all or most of the costs of health care, prescriptions, and other items for the entire population. - **race** — A category of people who share certain inherited physical characteristics, such as skin color, facial features, and stature. ### Chapter Summary 1. A sociological approach emphasizes the relationship between health, medicine, and society. In particular, our social backgrounds influence our health and access to health care. 2. Sociological perspectives on health and illness fall into the functional, conflict, and interactionist approaches encountered in previous chapters. The functional view emphasizes the importance of health for a society’s stability and the roles that people play when they are sick. The conflict view stresses inequality in the quality of health and health-care delivery and efforts by physicians to monopolize the practice of medicine to increase their profits. According to the interactionist view, health and illness are social constructions subject to people’s and society’s interpretations. The interactionist view also studies how medical professionals and patients interact and the way professionals manage understandings of such interaction. 3. Health and the quality of health care differ widely around the world and reflect global inequality. The earth’s poorest nations have extremely high rates of infant mortality and life-threatening diseases such as AIDS and very low life expectancy. 4. The United States lags behind most other industrial nations in important health indicators such as infant mortality and life expectancy. Moreover, serious disparities exist within the United States in the social distribution of health, as evidenced by the study of social epidemiology. 5. Social class, race and ethnicity, and gender all affect the quality of health. The health of poor people is worse than that of the nonpoor. African Americans, Hispanics, and Native Americans all fare worse than whites on many health indicators, in large part because of their poverty and history of discrimination. Women fare worse than men on several heath indicators, but men have lower life expectancies because of their higher rates of certain life-threatening illnesses. 6. Health care in the United States today faces several problems. The United States is alone among the world’s industrial nations in not offering universal national health insurance; its absence is thought to help account for the country’s low ranking in the industrial world on major health indicators. Managed care has also come under criticism for restricting coverage of important medical procedures and prescription medicines. Racial and gender bias in health care is another problem that has adverse effects on the nation’s health. Other quality-of-care problems include tired physicians, a lack of emergency room physicians, and numerous mistakes made in hospitals. ### Application You have been working for two months as a volunteer in a hospital in or near your hometown. Your duties include bringing food to patients, talking with them, and otherwise helping them to feel comfortable. However, you have noticed that many of the physicians and nurses you have seen coming into patients’ rooms do not wash their hands, and you doubt that they washed their hands immediately before entering the rooms. What, if anything, do you do? Explain your answer. ### Action Ideas To help deal with the health and health-care problems discussed in this chapter, you may wish to do any of the following: 1. Volunteer at a local hospital or health clinic. 2. Start a group on your campus to advocate for national health insurance, or join an existing group in the nearby community. 3. Volunteer for a local agency that tries to address the health-care needs of low-income children and their families.