In this class, we learned various aspects of the sociology of healthcare, but the topic that I found most interesting was about socioeconomic status in the second portion of the course. We learned that socioeconomic status is the biggest factor that influence health outcomes in the United States—even bigger than gender or race. According to the fundamental cause theory, there is an association between socioeconomic status and health disparities. Despite advances in health technology and knowledge, disparities still exist because those in lower socioeconomic status do not have the resources to protect or improve their health. This does not solely mean that the poor have worse health than those well-off; this association is true across all hierarchical gradients. We also learned about the constrained choice theory, which states that although people may know about health conditions and disparities, they are unable to do anything about it because of social constraints, their community, biological factors, and family ties. Continue reading “Smoking & Disparities”
In the Timmerman’s article “Social Death as Self-Fulfilling Prophesy,” he discusses, among other aspects of resuscitation efforts, advance directives: “advance directives, living wills, durable powers of attorney, and do-not-resuscitate orders” are all various legal methods to give a patient a say in what medical treatment they receive in the event of sudden death. If a patient does not wish to be resuscitated, they can make this clear through these advance directives, as they will be unable to do so if and when they do end up in this situation. Continue reading “Why even have advance directives?”
In Timmermans’ text about Social Death, he cites many sources including past researchers, physicians and nurses in order to piece together the idea of social value as a determinate of received care. Throughout his segment, sources are cited claiming that a person’s social worth has and should determine the care they receive which in turn leads the outcome of their situation. For example, there seems to be a trend that old people are determined as less important and less urgent to deal with as opposed to younger people or people of high social status.
Is this idea of social status as a limiting factor in determination of care a real component of our medical system today? If so, is this fair it certain patients receive a lower degree of care due to their social situation even if they have to pay the same amount of money?
According to a recent study, the number of African American students applying to medical school has been decreasing within the last 40 years. This has become a concern for not only the African American community, but also the health care field. Why is it important that medical schools stress diversity of all races? What could be an explanation for the decline of African American students who apply to medical school? How could medical schools encourage more African American students to apply to medical school?
In Smith’s and Kleinman’s article, “Managing Emotions in Medical School: Students’ Contacts with the Living and the Dead”, they analyze doctor-patient relationship and how medical schools try to desensitize medical students in the effort to control emotions that medical situations provoke. Medical schools want to emphasize the importance of keeping a professional relationship with their patients and not let their emotions get involved as it may cloud their clinical judgements and medical decisions.
I have shadowed many doctors before and what they thought me was to “treat the patient first, then treat the illness”. They also emphasized the point where relationship with patients is the key to gain their trust and it makes it easier to provide better care for them. This makes me question this article as to why medical schools would want to desensitize medical student’s emotions while dealing with patients. I understand that there still needs to be a professional relationship with your patient, but to what extend does that need to be fulfilled as to what the article was explaining? If one were to desensitize their emotions, I feel that in any given circumstance, the doctor will do whatever in their power to provide the best outcomes and quality service to their patient. My question is that do you think that keeping it “strictly professional” provides better health outcomes? Because of this, will medical professionals lose their sensitivity towards the people they serve? If it does provide better health outcomes, is it better to have better health outcomes or decrease the quality of service to their patients? When it comes to one’s health, does a professional relationship outweigh the interpersonal doctor-patient relationship?
In the article, “Tall Girls: The Social Shaping of a Medical Therapy” by Joyce M. Lee, MD, MPH; Joel D. Howell, MD, PhD, the authors discuss how Estrogen therapy came about. Prior to reading this article I had never heard of Estrogen therapy being used to stunt the growth of a girl who was expected to be taller then what a medical professional deemed normal. This was very surprising to me because this seems like a very cosmetic procedure, and there was a lot of time and research put into it. In the article it states that this was such a pressing issue at the time because, “Some girls feel so embarrassed with boys shorter than themselves that they believe that their choice of male companions, both in the immediate future and as adults, will be seriously jeopardized.” Because the 1950s and 60s were a time when women worked mostly as stay at home moms, it was necessary for them to be attractive to find a male companion. I believe that part of the issue of women feeling unattractive because of their “abnormal” height is because of the social norm that was set in stone by medical professionals. Once someone with as high of ranking as a medical professional or scientist declares that being too tall is an issue then society will agree. My question is, did the medical professionals responsible for the use of Estrogen therapy to stunt growth, create the social norm of tall women being less attractive?
Conrad et al. in “Construction of Illness: Key Insights and Policy Implications” I find it interesting that the concept of social constructionism addresses the fact that the same disease can affect people is different ways, depending on their culture and social systems.
I remember reading another article a few months back that compared the rate of breast cancer recovery in members of families from different cultures. The study found that members of Hispanic families who suffered from breast cancer had a higher chance of recovering and overcoming this disease that patients who belonged to other cultures. This made me think about the concept of the Hispanic paradox that we have been talking about in class. I honestly do not know how reliable this study is, because I think many other variables should have been taken into account. However, I think it is an interesting example of how cultural factors (in this case, family support) can affect the disease of a person.
This week’s article also mentioned how in some cultures there is a stigma to some diseases, such as HIV/AIDS. Talking from my personal background, I grew up in a Latin-American country where I believe this disease is still a “taboo” subject to talk about. I agree with the article when it says that it is more difficult in these scenarios for patients to get access to treatment; there is shame and embarrassment associated with the disease, so the patients are less likely to tell others and/or seek for help. I wonder about if, in the case of HIV, patients are even more immunocompromised because of the stress generated by living in countries/societies where this disease is more stigmatized.
In The Social Construction of Illness: Key Insights and Policy Implications, Peter Conrad and Kristin K. Barker explore the origins of the belief that illness is a socially constructed phenomenon. Near the end of this publication, they discuss policy implications related to this phenomenon and future directions it may take us in. Something I found extremely interesting in this section was the mention of the Internet and how it has radically changed the social construct of illness.
Women have been fighting for gender equality since the beginning of time, and indeed we’ve come a long way – but the battle is surely not over yet. We still see inequality with regards to income, job positions, household positions, etc, and for the latter part of the 20th century, we saw gender inequality in the form of estrogen therapy. In the article “Tall Girls: The Social Shaping of a Medical Therapy” by Lee et al., they explore the popularity of estrogen therapy for tall girls, and explain how social norms perpetuated this idea that tall girls were, basically, too tall. In a study described in the article, these conclusions were stated: “men are almost always taller than women among lovers and married couples by the fact that “most men do not feel attracted to taller women. In this study, desirable women were almost never described as tall and attractive men were almost never described as short. (Lee et al., par.13). So because of this general idea that tall women were inadequate for men, estrogen therapy was highly utilized in the latter part of the 20th century.
Although it is true that this stereotype has declined, along with estrogen therapy in general, it still exists and tall women find themselves in this perpetuating stereotype – men just can’t be with tall women. And to replace the once popular estrogen therapy, short men now find themselves increasingly utilizing growth hormones in order to combat the stigma placed among short men. Is the popularity of estrogen therapy and GH therapy perpetuating the negative connotations associated with tall women and short men, and encouraging gender inequality and discrimination? Is getting rid of these synthetic therapies the next big step we need to take in order to achieve gender equality?
In Peter Conrad and Kristin Barker’s article, they explain the concept of social constructionism and say that “the emphasis is on how meanings of phenomena do not necessarily inhere in the phenomena themselves but develop through interaction in a social context.” In other words, the disease itself may have an entirely different meaning than the illness, based on social context, cultural differences, lack of knowledge, and different perceptions. They also claim that a “stigmatized illness can make an illness much more difficult to treat and manage” and then go into the example about HIV/AIDS and how people are less likely to seek help for their condition. Because technology heavily influences social behavior and experiences today, do you think this has anything to do with how we view illnesses and diseases? Technology, especially the Internet, allows information to be public, available, and accessible as well, so is it bad that all this excess information is available since the public is able to interpret it however they want to? Should we be focusing on educating and reducing the stigma in society instead of giving out all this information to the public?