What is medical sociologySociology: is the study of social groups and the individuals within themDifferentiation and inequalities between groups (Race, Gender, Age)Achieved and ascribed statuses (master status)Medical sociology: is the study of the social causes and consequences of health and illnessWe look at:Social patterns of disease (epidemiology)Behavior of practitioners and patientsHealth organizations and institutionsHealth care systems at a social level-Refocusing upstream, seeing what causes the problem (disease)Medical sociology’s beginnings-Rudolf Virchow (1840s)living conditionsfounding father of pathology, studied the spread of typhoid, looks in the spread of disease in poor, unhealthy areas, “germ theory”early 1900s- “Social Medicine”-1930s/1940sGrowth in sociologyStudy of medical practice “as a scientific endeavor”Epidemiology-1950s/1960sLegitimation of medical sociology, American sociological association took over the journal of health and social behavior (top medical journal)-Talcott parsons- published The Social System in 1951- First major social theorist to deal with health, illness, and the role of medicine-Structural-functionalist perspective- Introduced concept of the sick roleA patterned set of expectations defining the norms and values appropriate to being sick (preventing spread of disease by not going into the public)Sociology of medicine (sociology)The medical environment; norms, roles, and behaviors within every aspect of health and illness including the medical profession and policySociology in medicine (Public health; epidemiology)The social determinants of health; health disparities across groups – age, gender, race, class, etc.Conceptions of Health-Body as a machine, human body breaks down from time to time, medicine counteracts that and fixes the broken parts-Foucault (1970s)- Medicine of the speciespatient and disease as object- Medicine of social spacespublic health and health behaviorHealthWhat is health? What does it mean to be healthy?-Biological?, Functional?, Emotional?, Social?-World Health Organization (WHO) definitionA state of complete physical, mental and social well-being, and not merely the absence of disease or injury.- Most people tend to view health as the capacity to carry out their daily activitieshealth as the ability to function-Prehistory up to the present-beliefprayer/karma/placebotrephinationshamanism (holistic healers/medicine-Hippocratesdisease is naturalhomeostasisethics (a code of ethics in western thought)-Middle Ages (500-1500 A.D)Church vs. Medicine in Europe (disease is a sign of punishment, witchcraft, possessions of demons)Arabic resurgence of Greek medicine (code of medicine, physicians)-Renaissance (1500s and up until about 1900)AnatomySpecialization (apothecaries, surgeons)Scientific revolution (1600s, Bacon, Decartes, Harvey)-Mid-1800scells (Virchow)Germ Theory (Pasteur) and vaccines-1900s - Antibiotics (Fleming)-Mid-1900s - Social aspect of health like the state of housing, sanitation and diet- Because of vaccines and antibiotics health has changed drastically since the 1900s- Shifts in early to mid 20th centuryinfluenza and tuberculosis (spread of pathogens, people started to raise awareness in order to prevent disease )prevention and public healthpsychiatry (psychophysiology)OrganizationCurrent Health (20th-21st century)Whole person health care, not just trying to treat a disease but have to manage disease and lifestyleTransition from infectious to chronic diseasesSocial environment and lifestyleEpidemiological transitions-Three epidemiological transitions in human history that influence health-First around 8000 B.C, Agriculture, Emergence of novel infectious and nutritional diseasesagriculture—if disease spreads throughout food that is produced-Second -1800s to 1950sInfectious disease replaced largely by chronic disease (paying attention to social situations-Third—beginning nowResurgence of infectious diseases previously thought to be under control (antibiotic resistant bacteria)West Nile virus first appeared in new york city in the summer of 1999, initially puzzled medical personnel and public health officials, eventually spread throughout the U.sEbola up to 90% fatality, Began in 1976 in two simultaneous outbreaksGlobalization of trade and travelOther lifestyle/behavioral changesChangesWhat else has changed drastically over the past few decadesSexually transmitted disease/infectionBirth control pillSexual liberationMigrant employmentAvailability of multiple sexual partnersWhat else might we worry more about infectious disease more than we used to?Relatively new threat of infectious diseases-epidemiological shifts: infectious disease and treating diseaseEpidemiological shifts:-Infectious disease and treating disease- Chronic/degenerative disease and treating peopleTreating: lifestyle, diet, habits, sexualityStudying: income/wealth, education, employment, family structureHow have we dealt with change in medical practice and research?Bioethics- Focused on ethical decisions and practices with respect to medical care, research and rights- Medical decisions can have profound social implications- Men do not go to doctors as much as women do- Spurring development of regulationsNazi experimentsTuskegee syphilis study- Institutional review boards (IRBs) responsible for oversight of researchFully informed voluntary patient consentRisk-benefit ratiosPatient anonymity and confidentiality- Health insurance Portability and Accountability Act (HIPAA) of 1996regulates the handling of patient data and privacy- Funding of research by pharmaceutical companies- Stem cell research- Use of human genetic material- Abortion- Euthanasia- Reproductive technologyEpidemiology-Studies the origin and distribution of illness- Case: An episode of a disorder, illness, or injury involving a person (one instance)- Prevalence: The total number of cases of a health disorder that exist at any given timepoint prevalence (the number of cases at a certain point in time, usually a particular day or week)Period prevalence (the total number of cases during a specified period of time, usually a month or year)Lifetime prevalence (the number of people who have had the health problem at least once during their lifetime)- Incidence: the number of new cases of a specific health disorder occurring (within a given population during a stated period of time)- Crude rate: The number of people (cases) who have the characteristic being