Sociology of Medicine Final

Question 1

What social effect does segregation have?

Answer 1

Limits social connections- people may become displaced due to gentrification and lose social networks

Question 2

What economic effect does segregation have?

Answer 2

Segregation reinforces inequality and concentrates poverty.

Question 3

What effect does segregation have on the physical environment?

Answer 3

-built environments: man-made settings constructed and operated for the purpose of human activity
-examples: dampness, overcrowding, lead, housing insecurity

Question 4

What effect does segregation have on health behaviors and health outcomes?

Answer 4

-constrains the ability to engage in healthy behaviors (increased marking of tobacco, alcohol, fast food, less ability to exercise)
-leads to a concentration of infectious disease patterns
-constrains access to social networks that facilitate social mobility
-public disinvestment of city services creates harmful conditions

Question 5

What effect does segregation have on access to care?

Answer 5

-lowers access to care (less access to transportation, long waiting times to be seen, little access to most advanced medical terminology, little time with providers due to provider time constraints, and urban clinics are more likely to be shut down)

Question 6

What effect does segregation have on social networks?

Answer 6

-Segregation leads to a concentration of infectious disease patterns in the population
-segregation determines access to social network ties and resources that can facilitate social mobility, but networks don’t have equal access to resources

Question 7

Gentrification

Answer 7

the process whereby the character of a poor urban area is changed by wealthier people moving in, improving housing, and attracting new businesses, typically displacing current inhabitants in the process.

Question 8

Place stratification theory

Answer 8

-majority group preferences and discrimination constrain social and spatial mobility of minority group members
-political leaders more likely to disinvest in poor communities of color
-many commercial enterprises avoid this area (why food deserts exist)

Question 9

Redlining

Answer 9

discriminatory practice in which financial services are withheld from neighborhoods that have significant numbers of racial and ethnic minorities

Question 10

What is environmental racism?

Answer 10

subjection to disproportionate exposure to pollutants, the denial of access to ecological benefits, or both

Question 11

Rural vs Urban Health

Answer 11

-rural communities have higher rates of morbidity (including chronic illness) and mortality (due to geographic isolation, and less access to healthcare providers)

Question 12

how does network structure/position affect health?

Answer 12

-an individual’s health may be affected by connectivity to or isolation from others and their network position: (degree, closeness, betweenness, and centrality)
-network bridges: individuals that serve to connect previously unconnected groups (can be positive or negative (spread of disease or knowledge))

Question 13

How does network size affect health?

Answer 13

-Smaller network sizes = increased isolation (loneliness leads to increased rates of morbidity and mortality)
-Network homophily (“birds of a feather flock together”)
-Network transitivity (“my friend’s friend is also my friend”)

Question 14

How do social networks influence health?

Answer 14

-Positively or negatively affecting health behaviors
-Facilitating/regulating behaviors, setting norms, physical spread of pathogens or harmful/healthy substances (person-to-person or within group boundaries), spread of misinformation
-Furnishing tangible assistance (money, care, transport)

Question 15

What social position is best at introducing groups to each other?

Answer 15

Betweenness

Question 16

What is instrumental support?

Answer 16

Helping with tasks (running errands, helping with transportation, etc)

Question 17

What is informational support?

Answer 17

Advice (what you would do in that situation)

Question 18

What is affective support?

Answer 18

-Emotional support
-Those with strong social support care with stress better, and experience more positive health outcomes
-artificially created support networks (support groups) have been shown to benefit mental and physical health (Support groups offer informational, instrumental, and affective support)

Question 19

What is social capital?

Answer 19

Resources that accrue to individuals through social connections (reciprocity)
-characteristics of social networks from which individuals drae materials (goods, services)
-Bonding (within group) vs bridging (between groups)

Question 20

Strength of weak ties

Answer 20

-weak ties are more common than strong ties
-brings networks into contact with each other (encourages information sharing between groups) (ex. social media connections)

Question 21

Neoliberalism and health

Answer 21

-emphasis on a free market, individualism, etc…
-the goal is to reduce public expenditure and increase efficiency
-introduction of market mechanisms as a counterbalance to public sector growth
-other countries have constructed a tighter regulatory framework to constrain free markets

Question 22

Social policies and health outcomes

Answer 22

-policies designed to affect the distribution and impact of unequal resources
-work on health directly limiting or broadening social/economic supports
-policy regimes fall under 3 categories (liberal (provides limited social welfare programs), conservative (provides social insurance funds that reward work performance/status), social democratic (guarantees universal benefits))

Question 23

Hegemony

Answer 23

The processes by which dominant culture maintains its dominant position: The US and Europe are examples

Question 24

Hybridization

Answer 24

In which existing local social/regional practices and values fuse with global ones

Question 25

Global governance

Answer 25

Informal and diffuse- includes actors other than the formal government: promotes riles and establishes cooperative agreements… largely lacks authority to reinforce
-Actors in global governance are States (create intergovernmental org IGOs), IGOs are created and maintained by states, NGOs are voluntary organizations like the Red Cross, epistemic communities (emerge from national governments, research institutions, private industry, and academia), multinational corporations (race to the bottom))

Question 26

Structural Adjustment Programs

Question 27

Globalization and COVID-19

Question 28

Examples of globalization

Question 29

global labor force- “race to the bottom”

Question 30

Migration and Health

Question 31

Reasons for high pharmaceutical spending:

Question 32

Pharmaceutical patents

Answer 32

-as long as a drug is under patent, only the company with the patent can sell the drug
-“Evergreening” is expanding patents by creating new formulations that only differ slightly from the original
-“pay for delay” pharmaceutical company with a brand name drug pays generic manufacturers to not enter the market
-New Molecular Entity (a patentable drug innovation

Question 33

Interactions between pharmaceutical companies and researchers/physicians/FDA

Answer 33

-Some physicians can be paid by pharmaceutical companies to promote their drug
-FDA oversees the safety of pharmaceuticals in the US (but they make decisions on reported data and drug companies don’t have to report all data…)

Question 34

Causes of the Opioid Epidemic in the US: Porter and Jick letter, “deaths of despair”

Answer 34

-Said that addiction was rare in patients treated with narcotics

Question 35

Medicalization/ Pharmaceuticalization

Answer 35

Process by which deviant behavior, life behavior, problems of everyday living, and bodily/cognitive enhancement are reframed as medical concerns (pharmaceuticalization frames these as targets for pharmaceutical intervention)

Question 36

Occupational segregation

Answer 36

-Vertical segregation: clustering of men at the top of occupational hierarchies and women at the bottom
-horizontal segregation: at the same occupation level men and women have different jobs
-women are 70% of global health workforce but only hold 25% of senior roles
-In medicine: women tend to pick different specialities that are “suitable” for family planning

Question 37

Lack of diversity in medicine- causes and consequences

Answer 37

-Lack of women in certain specialties because they “don’t” allow time for families
-trans medical professionals are discriminated against
-Lack of POC doctors

Question 38

Medical profession and expert authority:

Answer 38

-generally status and power of providers and patients are not equal
-providers act as authority to decide who is sick and who is well
-patients dependent on the expertise of providers
-providers act as gatekeepers to the sick role
-providers objectify and dehumanize the body

Question 39

Drivers of high health care spending

Question 40

Uninsured

Answer 40

-31.6 million of US residents were uninsured in 2020
-most uninsured people are low-income families and have at least one worker in the family
-people may lack insurance due to high costs, no access to coverage through a job, and poor adults in states that did not expand Medicaid

Question 41

Underinsured

Answer 41

-individuals with insurance who still can’t pay medical bills
-20% of all insured individuals under 65, cant pay premiums or deductibles or copays, which occurs when insurers cap payments for or don’t cover certain procedures, can occur due to poverty
-receive less preventative care, diagnosed later, receive less therapeutic care, hospitalized for more avoidable conditions, less likely to have primary care

Question 42

Types of health insurance

Answer 42

-Medicaid: covers all needy persons receiving cash assistance, including children under 6 and pregnant women with income under the poverty line.
CHIP: A Branch of Medicaid that covers children and teenagers whose families fall 200% under the poverty line
-Medicare: for individuals 65 or older or disabled people under 65 who receive SS. !Does not include prescription coverage!
-Private Insurance: Paid for by employer and/or individual

Question 43

Affordable Care Act

Answer 43

-AKA Obama Care
-enacted in 2010 after years of attempting to pass healthcare reforms
-reflects a compromise between liberals and conservatives
-expanded health coverage, primarily expanding Medicaid
-minimum level of benefits set by the government must be included in all plans
-All employers with more than 50 employees must provide coverage or pay a penalty

Question 44

Public health investment

Answer 44

There is little public health investment because public health typically focuses on prevention, improves statistical lives, achieves over the long term, and focuses on upstream causes.

Question 45

Health literacy (insurance-specific)

Question 46

Individual resilience

Question 47

Community resilience

Question 48

Equity

Question 49

Equality

Question 50

Gerrymandering

Question 51

Disenfranchisement

Question 52

Activism

Question 53

Social Empathy