Medicine and Society Exam 1 Study Notes

• Study notes for Medicine and Society Exam 1

Medical Measures and the Decline of Mortality

• Doctors support institutions like hospitals, universities, pharmaceutical companies, and insurance firms.
• Modern medical treatments and healthcare services are not the primary reason for the decline in death rates.
• Mortality decline could stem from prophylactic or chemotherapeutic measures.
• Data on mortality statistics can often be lacking.
• Studies might be disregarded due to awareness of limitations or inaccuracies.
• Declines in infectious diseases do not always coincide with treatment dates.
• Medical measures appear to have contributed little to the overall decline in mortality since 1900.
• Social change warrants prioritization and acknowledgment over medical interventions when considering declining mortality.

Social Conditions as Fundamental Causes of Health Inequalities

• People with lower socioeconomic status (SES) have worse health and die younger.
• Socioeconomic inequalities in health have persisted despite efforts to eradicate them.
• SES is a fundamental cause of health inequalities.
• SES consistently predicts health outcomes due to access to new health-improving resources like cancer screening.
• A fundamental social cause of health inequalities influences multiple disease outcomes, affects disease factors, and is reproduced over time.
• Flexible resources that can be used in different situations allow for healthier lifestyles.

Policy Implications for Reducing Health Inequalities

• Address root causes by reducing income and education disparities instead of focusing on individual risk factors like smoking.
• Equalize access to health resources by making new technologies and treatments widely available.
• Improve social conditions through better housing, a higher minimum wage, and public education.

Conclusions on Health Inequalities

• The persistence of health inequalities relates to systemic social advantages, not just specific diseases.
• Tackling SES disparities is key to improving health outcomes.

Social Class, Susceptibility, and Sickness

• Social class is a determinant of health, affecting both the likelihood of developing illnesses and the ability to recover.
• Lower socioeconomic status links to increased illness, death, and disability rates.
• Social and environmental rather than healthcare access explains why lower-class individuals are more susceptible to disease.
• As social class decreases, the likelihood of developing disease increases.
• This connection applies to heart disease, respiratory infections, and mental health disorders.
• Chronic stress from financial instability, job insecurity, and unsafe living conditions weakens the immune system.
• High-risk environments are more common in lower-class populations and contribute to disease susceptibility.
• Lower-class individuals have a general susceptibility to many illnesses.
• Poor nutrition, chronic stress, inadequate healthcare, and harmful environmental exposures contribute to this general susceptibility.
• Healthcare access is important but doesn't fully explain health disparities.
• Even with universal healthcare, health inequalities by social class still exist.
• Preventative social policies are needed.
• Policy interventions must address broader determinants of health beyond medical treatment alone.
• Prioritizing education, improved working conditions, economic stability, and access to healthy food and housing helps in reducing class-based health disparities.
• Health follows a gradient of social class and lower SES equates to higher mortality rates.
• Lenord S. Syem is the father of epidemiology.
• There are social class gradients of mortality and morbidity.
• This applies from infectious to non-infectious diseases, and to almost every disease.

Factors Affecting General Susceptibility to Disease

• Life change.
• Stress.
• Less access to medical care and resources.
• Living in more toxic environments.
• Deficient coping mechanisms.
• Lower classes experience more instability.

Social Position

• Status: resources
• Stress: susceptibility

Racism and Health: Pathways and Scientific Evidence

• Racism is a key driver of health disparities in the U.S. and other societies.
• Health inequalities continue due to institutional, cultural, and interpersonal racism, which includes education, employment, housing, and healthcare access.
• Racial minorities experience higher rates of illness and earlier deaths.
• Racism is a fundamental cause of health disparities through structural, cultural, and interpersonal interactions.
• Housing discrimination and job inequality create long-term disparities, limiting health opportunities.
• Chronic racial discrimination causes stress-related illnesses.
• The "weathering" effect accelerates aging and the risk of heart disease, hypertension, and mental illness.
• Racially segregated neighborhoods result in poorer healthcare, fewer grocery stores, and excess pollution.
• Cultural racism reinforces stereotypes and mental stress.
• Negative media portrayals and discrimination affect mental and physical health.
• Decreasing housing segregation, improving economic mobility, and healthcare access can help address these disparities.
• Racial discrimination, unconscious bias, institutional racism, internalized racism, and stereotype threat contribute to racism
• 200 black people die every day due to health inequities.

Sex, Gender, and Vulnerability

• Sex refers to biological attributes (chromosomes, hormones, anatomy).
• Gender is a social construct rooted in cultural expectations and behaviors.
• Many health studies confuse both terms.
• Some health conditions have biological causes and others shaped by gender norms.
• A subset of existing conditions remains ambiguous.
• Some health conditions have inherent biological causes, like respiratory distress in male newborns with slower lung maturation.
• Heath is shaped by gender norms like, men are more likely to be involved in road traffic accidents due to risk-taking behaviors
• The prevalence of depression vs. gout in men depends on the subsets of existing conditions.
• Gender stereotypes endanger the healthy lives of both women and men”
• Potential impact of interventions that offer alternative gender images for both males and females

Mutability of Gender

• Gender can change via stereotyping and expectations.
• Gender is a health problem and investing resources to prevent harmful stereotypes rather than waiting for people to get sick
• Author drew a line between sex and gender and looked at how each independently impacts health outcomes

Health

• Defined by Disability-Adjusted Life Years Lost (DALYs Lost) or years of life lost due to premature mortality and disease/disability
• Mortality + Morbidity
• Gender is susceptible to change and redefining gender could cause better health
• Social Determinants are defined by Sex: biological (ex chromosomes, genetics) and Gender social difference.

Social Relationships and Health

• Individuals with strong social relationships have lower mortality rates.
• Lack of social integration raises disease and early death risk, comparable to smoking and obesity.
• Social support can shield one from stress and reduce the likelihood of mental and physical illness.
• Community networks with friends and family help with with well-being and immune function.
• Psychological mechanisms: Social ties offer feelings of belonging.
• Behavioral mechanisms: Strong social networks link to health-promoting behaviors like regular exercise.
• Physiological mechanisms: Social connections affect hormone levels, stress, and immune function.
• Traditional social structures have declined with modern day, negatively impacting public health.
• Health policies require social integration for disease prevention and health promotion.
• Public health initiatives would require focus on social isolations, especially for vulnerable populations.

Dying Alone: The Social Production of Urban Isolation

• Chicago Heat Wave of 1995 highlighted social isolation and urban neglect when over 700 people, mostly elderly individuals living alone, died due to extreme heat in city.
• Aging populations, fear of crime, urban degradation, and erosion of social support led to the isolation.
• Isolation raises risks of untreated medical conditions, premature death, and mental illness.
• Socially isolated individuals are more likely to suffer from stress-related illnesses and lacking emergency support.
• The rise in people living alone is a health concern as interventions are required.
• Strengthening social programs, civic engagement, and prioritizing spaces are needed to help elderly and low-income individuals.
• Lacking connection is as dangerous as smoking, drinking, and physical inactivity.

6 Pillars To Advance Social Connection

• Strengthen social infrastructure.
• Enact pro-connection public policies.
• Mobilize the health sector.
• Reform digital environments.
• Deepen our knowledge.
• Build a culture of connection.

News Media Constructions of Overweight and Eating Disorders

• Media framing typically portrays anorexia and bulimia as illnesses beyond one's control, with sufferers depicted as young, white, middle-class women.
• Media frames obesity as being a moral failure involving blaming, with emphasis being on ignoring structural factors like SES.
• The media frames portray obesity as common among racial minorities and low income populations.
• Comparative studies: A white girl with anorexia is depicted with sympathy and a recovery as heroic in nature, but a black single mother with obesity struggles to manage son's weight is criticized harshly with a focus on person accountability and not systematic barriers.

Managing Chronic Pain In The Urban Safety Net

• The CDC gave new guidelines restricting the use of opioids and patients receiving them.
• The Structural Inequalities involved, show women, those w/ low SES, and POC were less likely to receive management.
• Doctors and patients are part of political and social influenced parties.
• High cultural capital is involved in healthcare.

The Shifting Engines of Medicalization

• Medicalization = needing a condition
• Doctors/Pharmaceuticals expanding categories of medical need or treatment can now drive medicalization, as well as narratives.