08 26 2014 What is medical sociology Sociology is the study of social groups and the individuals within them Differentiation 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 illness We look at Social patterns of disease epidemiology Behavior of practitioners and patients Health organizations and institutions Health care systems at a social level Refocusing upstream seeing what causes the problem disease Medical sociology s beginnings Rudolf Virchow 1840s living conditions founding 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 1940s Growth in sociology Study of medical practice as a scientific endeavor Epidemiology 1950s 1960s Legitimation 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 role A 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 policy Sociology 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 species patient and disease as object Medicine of social spaces public health and health behavior Health What is health What does it mean to be healthy Biological Functional Emotional Social World Health Organization WHO definition A 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 activities health as the ability to function Prehistory up to the present belief prayer karma placebo trephination shamanism holistic healers medicine Hippocrates disease is natural homeostasis ethics 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 Anatomy Specialization apothecaries surgeons Scientific revolution 1600s Bacon Decartes Harvey Mid 1800s cells 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 century influenza and tuberculosis spread of pathogens people started to raise awareness in order to prevent disease prevention and public health psychiatry psychophysiology Organization Current Health 20th 21st century Whole person health care not just trying to treat a disease but have to manage disease and lifestyle Transition from infectious to chronic diseases Social environment and lifestyle Epidemiological transitions Three epidemiological transitions in human history that influence health First around 8000 B C Agriculture Emergence of novel infectious and nutritional diseases agriculture if disease spreads throughout food that is produced Second 1800s to 1950s Infectious disease replaced largely by chronic disease paying attention to social situations Third beginning now Resurgence of infectious diseases previously thought to be under control antibiotic resistant bacteria o 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 s o Ebola up to 90 fatality Began in 1976 in two simultaneous outbreaks Globalization of trade and travel Other lifestyle behavioral changes Changes What else has changed drastically over the past few decades Sexually transmitted disease infection o Birth control pill o Sexual liberation o Migrant employment o Availability of multiple sexual partners What 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 disease 08 26 2014 Epidemiological shifts Infectious disease and treating disease Chronic degenerative disease and treating people Treating lifestyle diet habits sexuality Studying income wealth education employment family structure How 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 regulations Nazi experiments Tuskegee syphilis study Institutional review boards IRBs responsible for oversight of research Fully informed voluntary patient consent Risk benefit ratios Patient anonymity and confidentiality Health insurance Portability and Accountability Act HIPAA of 1996 regulates the handling of patient data and privacy Funding of research by pharmaceutical companies Stem cell research Use of human genetic material Abortion Euthanasia Reproductive technology Epidemiology 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 time point 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 measure during a specific unit of time examples birth rates and mortality rates Age