Professor Deborah Carr
Wednesday March 31, 2010
I. What is the Sociology of Health, or Medical Sociology?
A. Medical sociology often takes one of two quite different approaches;
1. One strand of research and theory emphasizes health care as a social institution.
Here, sociologists are interested in how health care services are delivered, the organization of
medical care, and differences in how subgroups are treated by the medical establishment.
2. A second strand of research in the sociology of health is often referred to as
“social epidemiology.” Social epidemiology is the study of the effects of social, cultural,
temporal and regional factors on health and illness. Among the most important factors that affect
individuals’ physical and mental health are race/ethnicity, social class, gender, and age.
a. Understanding subgroup differences in physical and mental health
offers important insights into a society’s values and practices. Health is considered one of
the single best indicators of “quality of life” in a society, and thus it is one of the most
telling indicators of inequalities in society.
A. Life expectancies for women and men today are ages 79 and 73, respectively. This
gender gap is a relatively new
phenomenon however. In the past, men and women had similar
life expectancies. How can we explain this historical change? [Note: life expectancy is the
average number of years one can expect to live. We have life expectancies at different ages: age
birth, at age 15, etc. Countries with very high infant mortality rates tend to have quite low life
expectancies at birth, because of the many “age 0” deaths. However, life expectancies are much
higher at age 30, for example, because it includes those persons who managed to survive the
dangers of infancy and adolescence.]
1. Causes of death have changed. Whereas the leading causes of death in the past
affected men and women at similar rates, the leading causes of death in the late 20
century disproportionately strike men. This pattern is due, in part, to a phenomenon
called the epidemiologic transition.
a. The concept of epidemiologic transition reveals that in pre-modern eras
(prior to the 18
century), pestilence, famine and “crisis” mortality accounted for
the majority of deaths. In this era, life expectancy at birth wavered from 20-40.
b. Age of receding pandemics (18
to early 20
century). Here the leading
causes of death were infectious diseases which are “egalitarian” diseases,
meaning that they struck both genders and were fostered by malnutrition and poor
sanitary conditions. Children were at particularly high risk. In NYC at the turn of
the century, only one in four babies survived until age 5, and this high risk of
death affected babies born to poor and wealthy families alike.
i. Main causes of death at the turn of the century were: