Instructor’s Manual for Sullivan, Introduction to Social Problems, 10/e

Solution Manual for Introduction to Social Problems 10th

Edition Sullivan 0205896464 9780205896462
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Chapter 4
Health and Illness

Chapter Outline

Perspectives on Health Care

The Functionalist Perspective
Myths and Facts: About Health and Health Care
The Conflict Perspective
The Interactionist Perspective
Politics, Stigma, and the AIDS Epidemic

Health, Illness, and Society

Health and Societal Development
Applied Research: Combating the Spread of AIDS
Social Factors in Health and Illness
Socioeconomic Status
Gender
Race
Economic Stress and Other Lifestyle Factors

Mental Illness
The Nature of Mental Illness
The Medical Model
Mental Illness as Deviance
Mental Illness as Problems of Living
The Treatment of Mental Disorders
Problems with Diagnosis
Community Treatment

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 Chapter 4: Health and Illness

Problems in Health Care

Rising Health-Care Costs
Access to Medical Services
Quality of Medical Services
Gender Inequality in Health Care
The Corporatization of Health Care

Bioethics: Technology and Health

The Prolongation of Life
Whom Shall We Treat?

Future Prospects
Publicly Funded Health Insurance
Medicare and Medicaid
National Health Insurance
Mandated Health Insurance
International Perspectives: Paying For Health Care in Other Societies
HMOs and Managed Care
Policy Issues: Should Health Care Be For Profit?
New Health-Care Practitioners
Self-Care and Changing Lifestyles

Chapter 4 At-A-Glance

Detailed Instructor Print Media Professor

Outline Resources Supplements Supplements Notes
Perspectives Learning Obj.: Test Bank for PPT for
on Health 1 Chapter 4 Chapter 4
Care Teach. Sugg.:
1, 10
Health, Illness, Changes: 1 Test Bank for PPT for
and Society Learning Obj.: Chapter 4 Chapter 4
2
Teach. Sugg.:
5, 9,
10
Mental Illness Learning Obj.: Test Bank for PPT for
3 Chapter 4 Chapter 4
Teach. Sugg.:
3, 6,
8, 9
Problems of Learning Obj.: Test Bank for PPT for

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Instructor’s Manual for Sullivan, Introduction to Social Problems, 10/e

Health Care 4 Chapter 4 Chapter 4

Teach. Sugg.:
4, 5,
8
Bioethics: Test Bank for PPT for
Technology Chapter 4 Chapter 4
and
Health
Future Changes: 2 Test Bank for PPT for
Prospects Learning Obj.: Chapter 4 Chapter 4
6
Teach. Sugg.:
2, 7

Changes in the Tenth Edition

1. In the International Perspectives insert, more details have been added on how
the Canadian system of national health insurance operates and differs from the
U.S. health-care system.

Learning Objectives

1. Analyze health, illness, and heath care institutions from the three sociological
perspectives and describe how social and political factors influence what
conditions are defined as illness.
2. Characterize how levels of societal development and a person’s social position
shape the illnesses that person is likely to get.
3. Compare and contrast the three positions on the nature of mental illness, and
summarize the issues that arise in regard to the treatment of mental disorders.
4. Summarize and evaluate the issues of rising health care costs, access to
medical services, quality of medical services, gender inequality in health care,
and the corporatization of health care.
5. Define bioethics and identify how it plays a part in issues of the prolongation of
life and the decision of whom to treat for illness.
6. Analyze the various social policy alternatives that have been considered or
implemented to deal with issues of access to and financing health care in the
United States, and compare that with what is done in other nations.

Suggestions for Teaching and Discussion

1. Most students are unaware of the cultural and historical context of health care
systems. They tend to assume that the existent health care system works.
People choose and accept it on the basis of some kind of rational calculation of
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 Chapter 4: Health and Illness

its utility. It would be useful to lecture on the long cultural development that
preceded modern medicine and on the role of political and social processes in
determining how modern medicine evolved. The lecture could include an
analysis of the many forms of medicine that existed in the United States in 19th
century, the emergence of the American Medical Association in 1847 and the
rise to medical hegemony by its members, and the importance of the Flexner
Report of 1910 and its aftermath. Some excellent sources for this lecture are
Paul Starr, The Social Transformation of American Medicine (New York: Basic
Books, 1982); Andrew C. Twaddle and Richard M. Hessler, A Sociology of
Health, 2d ed. (New York: Macmillan, 1987); and Rose Weitz, The Sociology of
Health, Illness, and Health Care, 5th ed. (Belmont, Calif.: Wadsworth/Cengage
Learning, 2010).

2. It is important for students to recognize that there are alternatives—and viable

ones—to conventional medicine. By understanding alternatives, students gain a
better grasp of the fact that conventional medicine follows one paradigm of
health and medicine and that there are other paradigms. Some excellent sources
for material on this are books by J. Warren Salmon, Alternative Medicines, (New
York: Tavistock, 1984) and M. S. Micozzi, Fundamentals of Complementary and
Alternative Medicine, 4th ed (St. Louis: Saunders Elsevier, 2011). These books
cover homeopathy, chiropractic, Chinese medicine, holistic medicine, psychic
healing, and others as they are practiced in the United States today. They
describe the healing systems and review the research on their effectiveness. If
instructors can locate a practitioner of any of these alternative healing systems in
their community, students may find it interesting to hear them lecture on the
topic.

3. A topic that is addressed only sporadically in the text is mental illness. Coverage
of this topic could be expanded on during the lecture. The topics that might be
covered include the biological versus sociological nature of mental illness, social
factors that produce mental illness, the social construction of mental illness, and
the treatment of mental illness. While there are many sources of information on
these topics, three good ones are a textbook by William C. Cockerham,
Sociology of Mental Disorder, 8th ed (Upper Saddle River, NJ: Pearson, 2011); a
book edited by Teresa L. Scheid and Tony N. Brown, A Handbook for the Study
of Mental Health: Social Contexts, Theories, and Systems, 2d ed. (New York:
Cambridge University Press, 2010); and a highly critical book by journalist and
science writer Robert Whitaker, Mad in America: Bad Science, Bad Medicine,
and the Enduring Mistreatment of the Mentally Ill (Cambridge, Mass.: Perseus
Publishing, 2002).

4. When lecturing on the issue of the high cost of health care, use some
hypothetical cases—or real ones if instructors can find someone to volunteer
their records—of particular health care episodes. For example: Older woman
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Instructor’s Manual for Sullivan, Introduction to Social Problems, 10/e

with a broken wrist has it set with pins and spends two nights in the hospital;
middle aged man has surgery for cancer of the bowel. If instructors can get an
actual printout of the costs for episodes such as this, it will illustrate the many
factors that contribute to high health care costs.

5. Lecture can build on the textbook material by elaborating on the social factors
and social processes that produce illness and influence the likelihood of seeking
care and getting better. This includes topics of stress, social support, and the
like. Excellent material for these lectures can be found in articles by Howard
Kaplan (“Health, Disease, and Social Structure”) and by Ronald Kessler and
Camille Wortman (“Social and Psychological Factors in Health and Illness”) in
Howard E. Freeman and Sol Levine, Handbook of Medical Sociology, 4th ed.
(Englewood Cliffs, N. J.: Prentice Hall, 1989). The September 2004 issue (vol.
45) of Journal of Health and Social Behavior has a series of articles that report
the most recent research and theory on the topic of socioeconomic status, social
inequality, and health status. The Centers for Disease Control and Prevention
just published a report titled “CDC Health Disparities and Inequalities Report—
United States 2011”, Morbidity and Mortality Weekly Report, Supplement
Volume 60, January 14, 2011. It is an extensive summary of the data on racial,
ethnic, gender, and other disparities in health status and outcomes. There is
much material here to present in class that goes beyond the data presented in
the text. Another possibility is presented in an excellent article by Pamela Herd,
Brian Goesling, and James House that explores the relative impact of education
versus income on people’s health status: “Socioeconomic Position and Health:
The Differential Effects of Education Versus Income on the Onset Versus
Progression of Health Problems,” Journal of Health and Social Behavior, 48
(September 2007: 223-238). Their research will provide depth to a lecture on this
topic because they show that level of education has a bigger impact on who
becomes sick with a variety of ailments while income seems to influence the
progression of the illness. A recent review of research explores how social
relationships at different stages in the life course influence people’s health
behavior. Read Debra Umberson, Robert Crosnoe, and Corrine Reczek’s,
“Social Relationships and Health Behavior Across the Life Course,” in Karen S.
Cook and Douglas S. Massey, eds., Annual Review of Sociology, vol. 36 (Palo
Alto, CA: Annual Reviews, 2010). This can be a way to encourage students to
talk about their own health and unhealthy behaviors and how they might be
linked with various social influences in their lives.

6. Invite a judge or lawyer who handles cases involving institutionalizing the

mentally ill into class to discuss their experiences and opinions. This is an
excellent way to draw students into a discussion of their opinions about the
ethical, legal, and constitutional issues involved here.

7. To grasp some of the changes that have occurred in the U.S. health care system
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 Chapter 4: Health and Illness

in the past 30 years, organize a discussion of the role of new health care
providers, particularly nurse practitioners and physician’s assistants. Bring one of
each into class and have them describe what they do and how they differ from
one another. Bring in one or two physicians to present their views on these
developments. This is an excellent way to engage the students in a discussion of
conflict and competition among health care providers.

8. Have students read Ken Kesey’s novel One Flew Over the Cuckoo’s Nest (or
screen the movie in class). Discuss whether McMurphy belonged in a mental
institution. What was the dynamic that led to more vigorous efforts to “cure” him?
Does something like this really happen in mental health (or other institutional)
settings today? Is there a broader principle that can be applied to other settings?

9. Students find it interesting to hear about how marital transitions (getting married,
getting divorced, and so on) impact on one’s physical and mental health. Two
good articles that present theory and research on this topic are Terrance J.
Wade and David J. Pevalin, “Marital Transitions and Mental Health,”Journal of
Health and Social Behavior, 45 (June 2004: 155-170); and Kristi Williams and
DebraUmberson, “Marital Status, Marital Transitions, and Health: A Gendered
Life Course Perspective,”Journal of Health and Social Behavior, 45 (March 2004:
81-98).

10. This chapter does not consider issues of discrimination and social inequality in
the context of disabilities, but this would certainly be an excellent topic to expand
the focus of this chapter and Chapter 9. Two good sources for lecture material
on the sociology of disability are Julie Smart, Disability, Society, and the
Individual (Gaithersburg, MD: Aspen, 2001); and Kathy Livingston, “When
Architecture Disables: Teaching Undergraduates to Perceive Ableism in the Built
Environment,” Teaching Sociology, 28 (July 2000: 182-191). The Livingston
article describes an exercise that can help students understand the nuances of
discrimination.

Suggested Films

Alternative Medicine (2002, 52m, Insight Media): This video presents some
approaches to healing that are outside the confines of conventional western
medicine, such as acupuncture, homeopathy, therapeutic touch, etc.

Big Bucks, Big Pharma: Marketing Disease & Pushing Drugs (2006, 46m, Media
Education Foundation): This video explores some of the practices used by the
pharmaceutical industry to market drugs and convince people to buy them—whether
they need them or not.

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Instructor’s Manual for Sullivan, Introduction to Social Problems, 10/e

Canada’s Single Payer Health System: A Model for Reform (1994, 16m, Off Center
Video): This film provides a brief description of the Canadian health care system as
described in this chapter.

Changing Patterns of Disease (2000, 30m, Insight Media): This video explores such
issues as life expectancy, aging, and chronic diseases in an effort to describe the
patterns of disease that afflict human beings.

Last Rights: Facing End-of-Life Choices (2009, 57m, Filmakers Library): This video
explores some of the choices and dilemmas that people confront when facing death
and deciding how it will go.

Health for Sale (2007, 53m, California Newsreel): This video explores the workings
of the global pharmaceutical industry, addressing the many benefits it provides as
well as the ways in which it may create obstacles to people’s search for health.

Money-Driven Medicine (2009, 4 versions from 18m to 86m, California Newsreel):

This video provides what is essential to understanding the health-care system of the
U. S.: the extent to which money and profitmaking drives the system.

The Split Horn: Life of a Hmong Shaman in America (2001, 57m, Filmakers Library):
This film shows how a traditional healer from Laos adapts to life in Wisconsin and to
changes in his family and authority. It shows how a variety of healing practices exist
side-by-side with scientific medicine.

Unnatural Causes: Is Inequality Making Us Sick? (2008, 26-56m, California

Newsreel): This seven-part series explores the many ways in which social and
economic environments contribute to the illnesses and injuries we suffer from as well
as to our longevity and general well-being.

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