The Sociology of Health, Healing, and Illness / Edition 8

by Gregory L. Weiss, Lynne E. Lonnquist

Overview

Designed to reflect important changes in health care and significant advancements in medical sociology, this reader-friendly book provides a readable, interesting, and in-depth overview of the field. It offers solid coverage of traditional topics with a keen focus on the current issues and public policy debates affecting this dynamic area of study. The volume offers perspectives on the sociology of health, healing, and illness, the influence of the social environment on health and illness, health and illness behavior, health care practitioners and their relationships with patients and a look at the social implications of health care technology and comparative health care systems. For individuals looking for an appreciation for how the sociological perspective and social theory contribute to health, healing and illness.

Product Details

ISBN-13:	9780133803877
Publisher:	Taylor & Francis
Publication date:	06/23/2014
Edition description:	Older Edition
Pages:	464
Product dimensions:	7.00(w) x 9.00(h) x 0.70(d)

About the Author

Gregory L. Weiss earned his PhD from Purdue University and is now Professor Emeritus of Sociology at Roanoke College. During his career, he has been an honored teacher (winning numerous college, statewide, regional (SSS), and national (ASA’s Section on Teaching and Learning)) awards, a dedicated researcher and writer (author of Grass Roots Medicine and co-author of Experiencing Social Research and the ASA publication on Creating an Effective Sociology Assessment Program as well as dozens of scholarly articles), and active in the community in a variety of health- and animal-related organizations.

Denise A. Copelton, PhD, is Associate Professor of Sociology at The State University of New York (SUNY), College at Brockport. One of the first social scientists to study celiac disease and gluten-free eating, her work has been published in Social Science & Medicine, Sociology of Health & Illness, Advances in Gender Research, and Deviant Behavior, among others outlets. She is co-author (with Amy Guptill and Betsy Lucal) of Food & Society: Principles and Paradoxes, now in its second edition. She regularly teaches courses on introductory sociology, sociology of health and illness, sociology of families, and deviance. Her college-wide leadership was recognized in 2019 with the prestigious SUNY Chancellor’s Award for Faculty Service.

Table of Contents

Preface     ix
Perspectives on the Sociology of Health, Healing, and Illness
A Brief Introduction to the Sociology of Health, Healing, and Illness     1
Definition of Medical Sociology     1
Historical Development of Medical Sociology     2
Sociology's Contribution to Understanding Health, Healing, and Illness     6
The Role of the Medical Sociologist in the Twenty-First Century     9
Summary     10
Health on the Internet     10
Key Concepts and Terms     10
Discussion Question     10
References     11
The Development of Scientific Medicine     12
A Brief History of Medicine     13
Early Humans     13
The Egyptian Civilization     14
Greek and Roman Societies     14
The Medieval Era     18
Medicine in the Renaissance     19
Medicine from 1600 to 1900     20
The Ascendancy of Medical Authority in America     23
Perspectives on the Ascendancy of Medical Authority     29
Summary     31
Health on the Internet     31
Key Concepts and Terms     32
Discussion Question     32
References     32
The Influence of the Social Environment on Health and Illness
Social Epidemiology     34
The Work of the Epidemiologist     34
The Epidemiological Transition     36
Life Expectancy and Mortality     40
Infant Mortality     46
Maternal Mortality     50
Morbidity     50
Disability     55
Summary     56
Health on the Internet     56
Key Concepts and Terms     56
Discussion Case     57
References     57
Society, Disease, and Illness     60
The Interrelationship of Fundamental Causes and Proximate Risk Factors: The Case of Developing Countries     62
The Influence of Genetic Transmission on Disease and Illness     63
Cardiovascular Diseases     65
Cancer     70
HIV/AIDS     74
Alzheimer's Disease     79
Mental Illness     81
Summary     84
Health on the Internet     85
Key Concepts and Terms     85
Discussion Case     85
References     86
Social Stress     89
Definition of Stress     89
Historical Development of the Stress Concept     90
A Model of Social Stress     91
Stressors     91
Appraisal of Stressors     97
Mediators of Stress: Coping and Social Support     97
Stress Outcomes     101
The Role of Social Class, Race, and Gender in Social Stress     102
Summary     107
Health on the Internet     108
Key Concepts and Terms     108
Discussion Case     108
References     109
Health and Illness behavior
Health Behavior     112
The Concept of Health     112
Health Behavior     114
Describing Individual Health Behaviors     114
Explaining Health Behavior     120
Summary     127
Health on the Internet     127
Key Concepts and Terms     128
Discussion Cases     128
References     129
Experiencing Illness and Disability     132
Stages of Illness Experience     132
Symptom Experience     132
Assumption of the Sick Role; Illness as Deviance     135
Medical Care Contact/Self-Care     140
Dependent-Patient Role     148
Recovery and Rehabilitation     149
Experiencing Chronic Illness, Impairment, and Disability     149
Summary     153
Health on the Internet     154
Key Concepts and Terms     154
Discussion Question     154
References     155
Health Care Practitioners and Their Relationship with Patients
Physicians and the Profession of Medicine     157
The Profession of Medicine     157
The Social Control of Medicine     163
The Number, Composition, and Distribution of Physicians in the United States     169
Female Physicians     171
Physician Satisfaction and Dissatisfaction     174
Physician Impairment: Stresses and Strains of the Physician Role     176
Summary     177
Health on the Internet     178
Key Concepts and Terms     178
Discussion Case     178
References     179
Medical Education and the Socialization of Physicians     182
The History of Medical Education     182
Modern Medical Education     184
The Medical School Experience: Attitude and Value Acquisition     192
The Medical School Experience: Stress     195
The Medical School Experience: Career Choices     197
Future Directions in U.S. Medical Education     198
Summary     199
Health on the Internet     199
Key Concepts and Terms     199
Discussion Case     200
References     200
Nurses, Mid-Level Health Care Practitioners, and Allied Health Workers     203
Evolution of Nonphysician Health Care Practitioners     203
Nurses and the Field of Nursing     206
Mid-Level Health Care Practitioners     214
Allied Health Workers     217
The Health Care Team     218
Relationships among Health Care Workers     219
The Changing Environment among Health Care Workers     222
Summary     222
Health on the Internet     223
Key Concepts and Terms     223
Discussion Question     223
References     224
Complementary and Alternative Medicine     226
The Meaning of Complementary and Alternative Medicine (CAM)     226
Scientific Medicine and Alternative Healing     227
Complementary and Alternative Healers     228
Chiropractic     232
Acupuncture     236
Spiritual Healing and Christian Science     239
Ethnic Folk Healing     244
Summary     248
Health on the Internet     248
Key Concepts and Terms     249
Discussion Case     249
References     249
The Physician-Patient Relationship: Background and Models     252
Models of the Physician-Patient Relationship     252
Key Dimensions of the Physician-Patient Relationship     254
The Influence of Social Class, Race, and Symptomology on the Physician-Patient Relationship     263
The Influence of Gender on the Physician-Patient Relationship     264
Patient Satisfaction with Physicians     268
Patient Compliance with Medical Regimens     270
Summary     272
Health on the Internet     273
Key Concepts and Terms     273
Discussion Case     273
References     274
Professional and Ethical Obligations of Physicians in the Physician-Patient Relationship     277
Truth-telling as an Issue     277
Confidentiality as an Issue     281
Obligation to Treat AIDS Patients     286
Summary     290
Health on the Internet     291
Key Concepts and Terms      291
Discussion Cases     291
References     292
The Health Care System
The Health Care System of the United States     295
Rating the United States Health Care System     295
The United States Health Care System     296
Health Care Expenditures     297
Explanations for Rapidly Increasing Health Care Costs     304
America's Uninsured Population     307
Cost Containment: Limited Prospective Budgeting, Rationing, and Managed Care     309
The Politics of Health Care Reform     314
Summary     319
Health on the Internet     319
Key Concepts and Terms     320
Discussion Cases     320
References     320
Health Care Delivery     323
The Emergence of Freestanding Ambulatory Care Sites     323
The Flourishing of Managed Care Systems: HMOs and PPOs     327
Emergence of the Modern Hospital     332
Home Health Care     343
Summary     344
Health Care on the Internet     344
Key Concepts and Terms     344
Discussion Case     345
References     345
The Social Implications of Advanced Health Care Technology     347
Health Care Technology     348
The Right to Refuse or Demand Advanced Health Care Technology     353
Organ Donation and Transplantation     361
Assisted Procreation     365
Summary     370
Health on the Internet     370
Key Concepts and Terms     370
Discussion Case     371
References     371
Comparative Health Care Systems     373
Major Influences on Health Care Systems     373
Health Care Services in Developing and Industrialized Countries     375
Types of Health Care Systems     375
China     377
Russia     380
Canada     383
Great Britain     388
Common Challenges to Health Care Systems Around the World     390
Summary     391
Health on the Internet     391
Key Concepts and Terms     391
Discussion Questions     392
References     392
Photo Credits     394
Name Index     395
Subject Index     401

Introduction

We are living through a time of dynamic changes regarding disease and illness, health- and illness related behaviors, the health care professions, and the health care systems in the United States and other countries. The fourth edition of this text has been written to update our description and analysis of these dynamic processes and the work of medical sociologists that help us to understand them.

In preparing this fourth edition we have sought to retain and strengthen the emphases and features of the earlier editions; to thoroughly update patterns, trends, and statistics; and to present new material that reflects important changes in health care in society and important advancements in medical sociology.

KEY EMPHASES WITHIN THE TEXT

This edition of the text maintains the same five emphases as the earlier editions. First, we provide broad coverage of the traditional subject matter of medical sociology and include both new perspectives and new research findings on this material. The core areas of medical sociology (the influence of the social environment on health and illness, health and illness behavior, health care practitioners and their relationships to patients, and the health care system) all receive significant attention within the text. Naturally, statistics throughout the text have been updated to provide timely analysis of patterns and trends. Recent research findings and thought have been incorporated in every chapter. Attention devoted to relatively new areas in the field has not reduced coverage of traditional areas such as social stress, illness behavior, and the physician-patient relationship.

Second, we have continued toemphasize emerging areas of analysis in medical sociology and recent work within the field. Recent health care reform efforts in both the public and private domains continue to have dramatic effects on almost every aspect of health care. We describe these effects on the profession of medicine (Chapter 8); medical education (Chapter 9); the status of nurses, mid-level health care practitioners, and alternative healers (Chapters 10 and 11); the physician-patient relationship (Chapter 12); the way that we pay for care (Chapter 14); and the sites at which we receive health care (Chapter 15).

We also continue to incorporate key medical ethics issues throughout the text. These issues represent some of the most important health related debates occurring in the United States today, and many medical sociologists have acknowledged the importance of understanding these policy debates and setting them within a sociological context. We have attempted to provide balanced and comprehensive coverage of several of these issues (especially in Chapters 13 and 16 and in the Discussion Questions and Cases at the ends of chapters).

This fourth edition also provides extended analysis of a wide range of topics including:

• Expanded focus on global perspective. Material on both developing and industrialized countries has been added to the text in several chapters. In addition, each chapter includes a new feature, "In Comparative Focus," that offers an informative comparison between the United States and one or more other countries on a selected topic. For example, infant mortality in developing countries (with a focus on Pakistan) is examined in Chapter 3; the provision of prenatal care in Western Europe is examined in Chapter 4; the status of female physicians in Mexico is examined in Chapter 8; the extent of truth-telling in the physician-patient relationship in Japan is examined in Chapter 13; and the exportation of managed care to Latin America is examined in Chapter 15.
• Extended coverage of health issues of children and adolescents.
• A reworking (and retitling) of Chapter 4 to extend coverage on experiencing chronic illness and disability.
• Extended coverage of the effects of the Human Genome Project.
• Added specificity to the manner in which macro-level factors affect health behavior.
• Added coverage of medical errors.
• Added analysis of declining enrollments in medical schools and of changes in the medical school curriculum.
• Added coverage of increasing political activism among nurses.
• Added description of the key elements underlying complementary and alternative medicine.
• Added coverage of the health care systems in developing countries.

Third, our extensive coverage of gender, race, and class issues as they relate to health, healing, and illness has been maintained. Throughout the textbook, we examine issues in light of race, class, and gender. We want students to constantly be exposed to the important influence of these factors on matters related to health and illness. The chapters on social epidemiology, social stress, health and illness behaviors, the profession of medicine and medical education, and the physician-patient relationship all give special emphasis to these matters.

Fourth, we continue to emphasize key social policy questions. Timely questions and issues addressed in the earlier edition are continued and updated here—for example, the provision of clean needles to people using injectable drugs (Chapter 4), the reconfiguration of traditional responsibilities of hospital nurses (Chapter 10), the social acceptance and legitimation of complementary and alternative healers (Chapter 11), the legal status of medical marijuana (Chapter 11), the influence of managed care on physicians and patients (several chapters), the effects of trends toward consolidation and merger among American hospitals and the pressures placed on the viability of public hospitals (Chapter 15), and the use and possible abuse of advanced health care technologies (Chapter 16).

Fifth, we have attempted to prepare a text that is informative, readable, and interesting. We want readers to become aware of many of the understandings of health, healing, and illness that we have because of medical sociology. We want readers to become intrigued by the provocative issues and debates that exist in medical sociology and in the health care field. We want readers to find this book readable and interesting.

Both of us enjoy structuring our classrooms to enable as much reflection and critical thinking and student participation as possible. We have found that there is simply not time for some of the classroom activities that we most enjoy (e.g., reading and then discussing a provocative paperback, watching a good documentary and critically analyzing it together, or using student panels to introduce issues) if we feel obligated to lecture on all of the material in each chapter. On the other hand, we do want students to become familiar with the important contributions of the field. When we use this book, we do spend some time lecturing on parts of it, adding to certain discussions and presenting some of the material in an alternative manner. But, our students are able to grasp much of the book on their own, enabling us to supplement and to create additional types of learning experiences.

What are the key pedagogical features of this text?

• Clear organization within chapters and a clear writing style
• Interesting boxed inserts ( "In the Field") that provide illustrations of key points made in the chapters
• Interesting boxed inserts ( "In Comparative Focus") that examine a selected health topic or issue in another country or countries
• Meaningful tables and charts with the most recent data available at the time the book is being written
• Illustrative photographs, most of which were taken specifically, for use in this book
• Chapter summaries
• End-of-chapter "Health on the Internet" references and questions
• End-of-chapter "Key Concepts and Terms" sections
• End-of-chapter "Discussion Cases"
• References conveniently provided at the end of each chapter

Three additional facets of the book are important to us and help to describe its place within the field. First, we consider a strength of the book to be the large number of research studies cited to illustrate key points. We do this to constantly demonstrate to students the empirical basis of sociology, the origin of sociological knowledge, and the fascinating types of research conducted in medical sociology. We hope it inspires students to consider interesting research projects.

We have worked hard to identify theoretically meaningful and methodologically sound studies that contribute important knowledge to our understanding of health, healing, and illness. While making heavy use of research conducted by medical sociologists, we also include appropriate material from the other social sciences, from the government, and from the medical professional literature. We believe that this is helpful in forming the most comprehensive understanding of the topics covered in the book.

A second facet of our book that is important to us is that we provide balanced coverage on key issues. That does not mean that our book lacks critical perspective or analysis. In fact, readers will find no shortage of critical questions being asked. But we do not equate critical analysis vkith one-sided analysis. We believe students learn more when they are exposed to arguments on both sides of issues and are challenged to consider the soundness of reasoning and quality of evidence that are offered.

Finally, we hope that this text reflects a genuine understanding of some very important and complex issues. Both of us have had many opportunities to experience various dimensions of the health care system. Between the two of us, we have been able to apply and extend our medical sociological training through work in a free health clinic, a family planning clinic, in family counseling, in hospital bioethics groups, on the human rights committee of a state psychiatric hospital, on the Navajo reservation, and in voluntary health agencies. While we have not substituted our personal experiences for more general understandings developed through sound theory and research, we believe that our experiences have helped us to develop a better understanding of certain issues and have assisted us in being able to illustrate important concepts and patterns.

Ultimately, our hopes for student-readers remain the same as with the earlier editions—that they gain an appreciation for how the sociological perspective and social theory contribute to an understanding of health, healing, and illness and for the manner in which social research is used to study these processes. In addition we hope that readers perceive some of the many wonderfully exciting issues that are studied by medical sociologists.

Editorial Reviews

Presenting an overview of the field of medical sociology, this text aims to include new perspectives and research findings; cover gender, race, and class issues as they relate to health, healing, and illness; and provide insight into significant social policy questions. Pedagogical features include chapter summaries, list of terms, discussion cases, and new end-of-chapter Internet resource information. Annotation c. Book News, Inc., Portland, OR (booknews.com)

Booknews

This medical sociology textbook demonstrates the influence of cultural, social-structural, and institutional forces on health, healing, and illness. Weiss (Roanoke College) and Lonnquist (Mary Baldwin College) examine health- and illness-related behaviors, the health care system, and health care practitioners. The fourth edition updates the status of social policy issues. Annotation c. Book News, Inc., Portland, OR