Carina Tenaglia Post Exam 3 Reading Notes Chapter 10 Medical Care Physical and Mental Illness Social Component to Health Industrial revolution heart disease 1 killer eat richer foods exercise less more stress o Unprotected sex STDs STIs smoking drinking drugs related illnesses Iatrogenesis illness caused by medical care 6th leading cause of death if ranked Examples of pregnancy and coal miners black lung problems as medical condition or not How Incompetent Can a Doctor Be Surgeon accidentally left steel retractor in patient while distracted during surgery Many cases of wrong way surgeries or procedures done on the wrong person body part Social Organization of Medicine The nation s medical bills have exploded o Reasons More elderly people in population Development of new more expensive technology View that medical care is a commodity that should be sold for profit Two tier system of medical care o Those who can afford good insurance o Those who can t afford good insurance Cesarean Section C Section expensive baby delivery through abdominal surgery o Extra profits motivate doctors to perform these o Carries greater health risks for mother bleeding sterility death o They are convenient allow doctors to control times of delivery o Technology use of fetal monitors increases of C section deliveries o Preference some women ask for it because they fear labor pains of vaginal child birth o SOCIAL ISSUE FEMINISTS C sections take power of childbirth away from women some see C sections as empowering women though Solving Medical Mysteries Cholera stopped by Snow when he traced cholera to wells in London Destruction of environment can increase disease o Fruit bats spreading more malaria closer to villages o Asthma triggered exacerbated by diesel fuels o Lyme disease increased b c global warming provides better environment for ticks Scope of the Problem Analyzing life expectancy helps evaluate health of society o Life expectancy has increased mainly b c infant mortality has declined o Infant mortality of babies that die before 1st birthday per 1 000 live births Poverty plays a role so does lifestyle o Lifestyle is the major cause of illness and death Heroic medicine complex technical and expensive best care In store clinics now compete w emergency rooms Uneven distribution of doctors urban v rural areas Mental illness tough to measure increase or decrease b c only recently recognized Deinstitutionalization discharges of mentally ill patients where most are left to fend for themselves oftentimes on the streets Suicide Suicide more than an individual act related to social conditions o Men more likely to commit suicide than women but women attempt it more often o Men more likely to use guns women more likely to beautify themselves before death and take pills usually allows time for discovery cries for help possibly Looking at the Problem Theoretically SYMBOLIC INTERACTIONISM We use cultural and subcultural symbols to determine what our symptoms mean Homosexuality used to be considered a mental illness o Conversion therapy psychiatrists would attempt to change a person s sexual orientation Drunkenness disease of alcoholism Lay referral network family friends neighbors and coworkers with whom the patient talks over medical problems helps decide whether or not to see a doctor Professional referral network made up of physicians and medical professionals prescribe appropriate treatment Depersonalization being treated as an inanimate object Defensive medicine doctors order lab tests and consultations that may not be needed in order to leave a paper trail that shows they did everything reasonable in case a patient sues them FUNCTIONALISM Doctors and patients benefit doctors can make more money patients can shop around and choose which doctor to see and which services to purchase o Increase in life expectancy and decrease in infant mortality rates They argue that this system is self correcting Vaccines and medicines reduced deaths on a global scale but also dysfunctional because they set the conditions for the global population explosion that worries many CONFLICT FEMINIST THEORY groups They view patterns of illness and health care in US as outcome of clashes between interest Medicaid result of conflict AMA American Medical Association Medical Union worked against Medicaid to preserve the fee for service system Physicians commonly fail to explain their procedures and diagnoses send patients on their way Women s reproductive organs o Surgeons recommend total hysterectomy even when no cancer is present o War on the womb Research Findings Decline in infectious diseases only 6 of the top 10 leading causes of death have remained the same since 1900 o Pneumonia tuberculosis diarrhea polio whooping cough measles smallpox diphtheria all used to be huge killers o Life expectancy 47 to 70 1st of 20th century Vaccinations helped but mostly declined due to Cleaner public water supplies better living conditions Resurgence of infectious diseases new strains of diseases resistant to drugs vaccines o XXDR TB cost 500 000 but saved others b c disease is airborne HIV AIDS and Other STDs HIV AIDS global epidemic 3 million people year o Lack of sex education unprotected sex prostitution children born to AIDS infected mothers o Antiretroviral drugs ARVs can halt the HIV infection preventing full blown AIDS from appearing for up to 20 years Extremely expensive doesn t prevent spread of HIV Epidemic can surge again w new strains of HIV Superbugs in the Global Village Baby died of staph infection o The more antibiotics are used misused Looking for new antibiotics to fight next generation of microbes Definition of sex can lead to how people interpret how they can can t transmit or receive What is Sex and So What STDs STIs Social Inequalities in Physical Illness In general the poorer people are the sicker they are The working class is more likely to be exposed to harmful environmental chemicals contaminants than executives working and company headquarters Patient Protection Affordable Care Act Obamacare those who cannot afford health care will be provided it by raising taxes on those who have higher incomes Some social classes have more emotional problems than others increases w lower social class o Drift hypothesis people w emotional difficulties tend to be less successful in life so they drift from higher income families down into the lower classes o Socialization hypothesis children who are reared by disturbed parents are