Chapter 2 Power Point

Chapter 2: Physical and Mental Health and
Health Care
“In health there is freedom. Health is the first of all liberties”
Henri Amiel
Philospher
Mooney/Clever/Van Willigen, Understanding Social Problems, 11th Edition. © 2022 Cengage. All Rights Reserved. May not be
scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 1
Chapter Objectives (1 of 2)
By the end of this chapter, you should be able to:

1. Identify factors which contributed to the differential impact of the COVID-19 pandemic
in the United States.
2. Compare life expectancy and mortality in low-, middle-, and high-income countries.
3. Identify ways in which globalization affects health and health care.
4. Explain how conflict theory, structural-functionalism, and symbolic interactionism help
us understand illness and health care.
5. Describe the prevalence, impact, and causes of mental illness.
6. Give examples of how socioeconomic status, gender, and race and ethnicity affect
health.
Chapter Objectives (2 of 2)
By the end of this chapter, you should be able to:

7. Describe the various types of private insurance plans and public health care
insurance programs in the United States.
8. Identify factors that contribute to the high costs of health care in the United States.
9. Describe efforts to improve health in low- and middle-income countries, improve
mental health care, increase access to affordable health care, and prepare for future
pandemics in the United States.
10. Discuss the complexity of factors that affect health and that must be addressed in
order to improve the health of a society.
The Global Context: The COVID-19 Pandemic
• World Health Organization (WHO) and social problems

• Health is a state of complete physical, mental, and social well-being.
• Study of social problems is the study of health.
• COVID-19 is a pandemic or a world disease outbreak.

• Death rate is number of people per 100,000 in a population that die in a
specific period.
• Contact tracing focuses on identifying contacting people exposed to others
with positive test results.
• Positivity rate is the percentage of positive results for every 100 tests.
An Overview of Global Health
• Life expectancy is the average number of years that individuals born during a
specific year can expect to live.
• Japan (84 years) versus Central African Republic (53 years)
• Mortality or deaths
• Noninfectious versus infectious disease
• Infant mortality rates are the number of deaths of infants under 1 year of age
per 1,000 live births.
• Averages 4 to 48 deaths/1,000 live births around the globe
• Maternal mortality are deaths from complications associated with pregnancy,
childbirth, and unsafe abortion.
• More than 94% of maternal deaths occur in low-income countries.
Maternal Mortality
TABLE 2.3 Lifetime Risk of Maternal Mortality by

Country Income
Lifetime Risk of Maternal Mortality
Low income 1 in 45
Lower-middle income 1 in 140
Upper-middle income 1 in 1,200
High income 1 in 5,400
The United States 1 in 3,000
SOURCE: World Health Organization 2019b.
Globalization and Health (1 of 2)
• Globalization
• International organizations monitor and report outbreaks of disease,

disseminate guidelines for controlling and treating disease, and share
medical knowledge and research findings.
• Global travel is the primary means by which illnesses are transmitted
between countries.
• Global economic trade agreements influence health.
• Access to range of goods including tobacco and processed foods
• Globesity is a consequence of growing middle-class in poor countries.
Globalization and Health (2 of 2)
It is estimated that more than 1.4 million
Americans seek health care in another
country each year. Medical tourism is a
growing multi-billion-dollar global industry
that involves travel across international
borders to obtain medical care primarily
(1) to obtain medical treatment that is not
available in their home country, (2) to
avoid waiting periods for treatment, and/or
(3) to save money on the cost of medical
treatment.
Copyright Oscar Avila/Chicago Tribune/MCT

via Getty Images
Sociological Theories (1 of 4)
• Structural-Functionalist Perspective
• Health care is a social institution that functions to maintain the well-being of

individuals and the society.
• Failures in the health care system are dysfunctions that impact large
numbers of people and other social institutions such as the economy.
• Social change impacts health, and health concerns impact social change.
• Latent dysfunctions are unintended or unrecognized consequences.
• Use of antibiotics in agriculture and the connection to antimicrobial
resistance among humans
• Conflict Perspective
• Socioeconomic status or social class, power, and profit motive have an

impact on illness and health care.
• Health care industrial complex
• Powerful groups and wealthy corporations influence health-related
policies and laws.
• 600 million was spent by health industry in 2019 lobbying Congress.
• Pharma corporations decide which drugs and products to develop.
• Symbolic Interactionist Perspective
• Meanings, definitions, and labels influence health, illness, and health care.
• Meanings are learned through interaction with others and through media
messages and portrayals.
• Society or groups come to decide and agree what social conditions are
defined as illness or disease.
• Medicalization
• Labeling behaviors and conditions as medical problems
• Individual experiences of distress into shared experiences of illness
• Childbirth, menopause, and death, etc.
“As twisted as it sounds, I was so happy

that I had received a diagnosis.”
–BETHANY STAHL, AUTHOR OF

THE BOOK ENDOMETRIOSIS: IT’S
NOT IN YOUR HEAD
Health Disparities in the United States (1 of 5)
• Health disparities
• Preventable differences in exposure to disease or injury or in opportunities to
achieve optimal health across social groups
• Social stratification
• Systems of social inequality by which a society divides people into groups
with unequal access to wealth, material and social resources, and power
• Socioeconomic status or social class
• Gender
• Race and ethnicity
• Socioeconomic status (SES) or social class

• Educational attainment, occupation, and household income
• Low socioeconomic status and poor communities linked to:
• Lower life expectancy and leading causal factor of poor health
• Greater stress and fewest resources to cope
• Hospitals more likely to be understaffed and lack life-saving equipment
• COVID-19 deaths in U.S. are higher in low-income counties
• Food deserts are areas that lack access to grocery stores.
• Health also affects socioeconomic status and ability to pursue education,

pursue employment training, and find or keep employment.
• Gender
• Males have more access to social power, privileges, resources, and
opportunities but lower life expectancy.
• Greater exposure to occupational hazards
• Social norms encourage risk-taking behaviors.
• Less likely to seek health care and disclose symptoms
• Less likely to take COVID-19 seriously and take precautions
• Higher rates of antisocial personality disorder, and alcohol abuse
• Women’s health is impacted by gender inequalities.
• Economic, political, and spousal inequalities
• Higher rates of depression and anxiety
• Race and ethnicity

• Income, education, housing, toxins, and access to healthcare
• Black Americans, Native Americans, and Alaska Natives have lower than
average health outcomes.
• COVID-19 disproportionately impacts underserved groups.
• Overcrowded and collective-living arrangements
• Employed in essential jobs
• Higher rates of chronic conditions
• Hispanic Paradox
• Hispanic cultural values promote family and community closeness, and
traditional healthy diets which control for risk factors.
TABLE 2.4 Life Expectancy at Birth by Race/Hispanic

Origin and Sex:
United States, 2018
Non-Hispanic White Black Hispanic
Female 81.1 78.0 84.3
Male 76.2 71.3 79.1
SOURCE: National Center for Health Statistics 2019.
Problems in U.S. Health Care (1 of 7)
• Health Insurance Options
• Universal health care system

• System of health care, typically financed by the government, that ensures
health care coverage for all members
• The United States is the only developed country without universal health
care.
• Private insurance coverage exists mainly through employers and
employee contributions.
• Private insurance is also purchased by individuals through Affordable
Care Act exchanges.
• Medicare
• Federally funded program provides health insurance benefits to elderly,
disabled, and those with advanced kidney disease.
• Medicare recipients pay monthly premiums, copays, and partial or full costs
for long-term care, vision, dental, and prescriptions.
• Over seven million seniors cannot afford prescriptions.
• Medicaid
• Public health insurance funded by federal and state governments and covers
individuals who meet low-income eligibility criteria.
• Physicians less likely to accept Medicaid over private insurance because
government reimbursement for fees are lower and slower.
• Children Health Insurance Program (CHIP)

• Military Health System (MHS) and TRICARE
• Veterans Health Administration (VHA)
• Recent changes impact more co-payments especially for family members
and conditions not related to military service.
• Indian Health Service
• Funding appropriated annually by Congress
• Lower coverage than Medicare, Medicaid, and VHA leaving many
American Indians and Alaska Natives without access and care.
• Uninsured
• In 2019, 8% or 29.3 million people did not have health insurance for the
entire year.
• People of color, nonelderly adults, and children are less likely to be
insured.
• 73% of noninsured families had one or more full-time employed member.
• Companies do not offer insurance, employees might not be eligible
due to part-time status or waiting periods, and some employees
cannot afford the premiums.
• High Health Care Costs

• The United States spends more on health care per person than any other
country in the world.
• Health care costs average $10,966 per person.
• Health care is 17% of the national GDP (Gross Domestic Product).
• Two-thirds of all bankruptcies are related to health care debt.
• One-fourth of U.S. adults report that they or a family member postponed
treatment for a serious medical condition due to cost.
• Compared to other industrialized countries, the U.S. has lower life
expectancies and higher maternal and infant mortality rates.
• High Health Care Costs Factors

• High cost of administration
• U.S. spends three times more on health administrative costs.
• Higher-cost services and prescription drugs
• In the U.S. people spend more on medical procedures.
• In 2019, nearly one-third of U.S. adults reported not taking prescription
medications at some point in the previous year due to cost.
• One estimate suggests there are 125K deaths annually associated with
skipping medications.
• Lack of competition and transparency

• Patients often experience surprise billing especially common for
emergency services.
• Medical practitioners often charge patients with private insurance higher
fees than are allowed for Medicare patients.
• Higher utilization of hospitals and specialists

• A third of all health care expenditures in the U.S. are for hospitals.
• In communities where uninsured people lack access to health clinics,
they are more likely to utilize emergency services.
Mental Illness: The Hidden Epidemic (1 of 4)
• Mental health is psychological, emotional, and social well-being.

• Mental illness refers collectively to all mental disorders characterized by
sustained patterns of abnormal thinking, mood, or behaviors that are
accompanied by significant distress and/or impairment in daily functioning.
• Stigma surrounding mental illness is partly due to misconceptions about
their causes, such as that mental illness is caused by personal weakness, or
results from engaging in immoral behavior.
• Media reinforce violence stereotypes through selective news reports and
stereotypical portrayals in fictional crime shows and dramas.
• Extent and impact of mental illness

• In 2019, nearly 1 in 5 adults had a mental illness in the past year.
• The highest prevalence was among 18–25-year-olds.
• About 65% received treatment.
• Almost half of adolescents (13-18) had been diagnosed with a mental
disorder in their lifetime.
• Depression and anxiety are the most common in U.S. and around globe.
• Untreated mental illness has many social consequences.
• Suicide is the 10th leading cause of death in the U.S. and second leading
cause of death among 10–34-year-olds.
• Mental illness among college students
• In 2019, 1 in 3 college students had been diagnosed or treated for a mental

health condition in the past year.
• 24% had been diagnosed for depression.
• 22% had been diagnosed for anxiety.
• 12% had been diagnosed for panic attacks.
• More than 1 in 4 college students reported that anxiety affected their
academic performance; 1 in 5 reported that depression affected their
academic performance.
• Treatment of mental illness
• Deinstitutionalization refers to the shift during the 1960s from in-patient

care to community-based mental health centers and drug therapies.
• Legislation passed prohibiting committing people to psychiatric hospitals
against their will unless they posed a danger to themselves.
• Community-based mental health centers have not adequately met mental
health care needs as millions of Americans go without care.
• The criminalization of mental illness refers to the view that correctional

facilities have replaced the mental health asylums of the past.
Strategies for Action (1 of 3)
• Improving health in middle- and low-income countries

• Access to adequate nutrition, clean water, and sanitation
• Increase immunizations and distribute mosquito nets to prevent malaria.
• Provide access to quality reproductive care and family planning services.
• Provide women education and income-producing opportunities.
• Expanding U.S. health coverage
• The Affordable Care Act (ACA) expanded health coverage and mandated
pre-existing medical conditions.
• Supporters for a single-payer health care system in which a single tax-
financed public insurance program replaces private insurance, argue that the
$400 billion in potential savings would cover every U.S. resident.
• Improving mental health care

• Eliminate the stigma of mental illness.
• Improve access to mental health services.
• Recruit more mental health professionals.
• Improve health insurance coverage.
• Expand mental health screening.
• Make mental health screenings a standard practice reimbursed by
insurance companies.
• Support the mental health needs of college students.
The COVID-19 pandemic has
taken a toll on the mental health
of frontline health care workers,
many of whom suffer increased
stress, anxiety, exhaustion and
burnout, depression, and worry
over being infected by the virus or
exposing their loved ones to the
disease (Cabarkapa et al. 2020).
Copyright Steve Pfost/Newsday

LLC/Getty Images
Understanding Problems of Illness and
Health Care
• Sociological view of illness and health care examines both social causes and
social consequences of health problems.
• Families, communities, and society are impacted when individuals cannot

support themselves due to physical or mental illness.
• COVID-19 showed how illness can affect all aspects of social life.
• A comprehensive approach to improving the health of a society requires a
society-wide commitment to addressing diverse societal issues.

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Chapter 2: Physical and Mental Health and

“In health there is freedom. Health is the first of all liberties”

By the end of this chapter, you should be able to:

By the end of this chapter, you should be able to:

• World Health Organization (WHO) and social problems

• COVID-19 is a pandemic or a world disease outbreak.

TABLE 2.3 Lifetime Risk of Maternal Mortality by

• International organizations monitor and report outbreaks of disease,

Copyright Oscar Avila/Chicago Tribune/MCT

• Health care is a social institution that functions to maintain the well-being of

• Socioeconomic status or social class, power, and profit motive have an

• Symbolic Interactionist Perspective

“As twisted as it sounds, I was so happy

–BETHANY STAHL, AUTHOR OF

• Socioeconomic status (SES) or social class

• Health also affects socioeconomic status and ability to pursue education,

• Race and ethnicity

TABLE 2.4 Life Expectancy at Birth by Race/Hispanic

• Universal health care system

• Children Health Insurance Program (CHIP)

• High Health Care Costs

• High Health Care Costs Factors

• Lack of competition and transparency

• Higher utilization of hospitals and specialists

• Mental health is psychological, emotional, and social well-being.

• Extent and impact of mental illness

• Mental illness among college students

• In 2019, 1 in 3 college students had been diagnosed or treated for a mental

• Treatment of mental illness

• Deinstitutionalization refers to the shift during the 1960s from in-patient

• The criminalization of mental illness refers to the view that correctional

• Improving health in middle- and low-income countries

• Improving mental health care

Copyright Steve Pfost/Newsday

• Families, communities, and society are impacted when individuals cannot

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