Aging & Health

1. Aging & Health The Graying of Society

2. Health Defined • According to the World Health Organization, health is “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”

3. Social Epidemiology • Social epidemiology is the study of the distribution of diseases and health throughout a society’s population. • Social epidemiologists want to find a link between health and the social environment.

4. Age & Health • In the United States, unlike other areas of the world, death among the young is rare. • For the most part, children and young adults are generally healthy. • With this in mind, more people as they age, experience more and more serious health problems.

5. Gender & Health • In the United States, women are expected to live an average of 80.4 years, while men live only 75.2 years. • Sociologists attribute many factors to this trend. • For example, men have higher testosterone levels than women, which may make men more likely to abuse alcohol and tobacco, driving aggressively, and engage in other life-threatening behaviors.

6. Men and women differ in their desire for health care. • Women are twice as likely to get preventative care and have regular checkups, while men are less likely to discuss health issues with their doctors.

7. Social Class & Health • Sociologists believe that one’s social class has a direct effect on his or her health, particularly in the United States. • Studies show that a higher socioeconomic status leads to longer, healthier and happier lives. • Sociologist Jason Schnittker agues that income improves health because more money means that affordable health care and basic needs are met.

8. Neighborhoods • Neighborhoods can also have an effect on health. • Neighborhoods that house poor, poorly educated, unemployed, and single mothers with little government assistance adversely affect the health of the people living there.

9. Similarly, people living in neighborhoods with high crime and drug use also report poor health. • These threatening environments can lead to stress, which can in turn lead to more serious health problems.

10. In 2005, the life expectancy of whites was 78.3 years, while African Americans were expected to live only to 73.2 years. Social class plays a role in explaining why whites are living longer. Race & Health

11. In the United States, 24.9% of African Americans and 21.8% of Hispanics live below the poverty level, while only 8.3% of whites are impoverished.

12. Minorities also have higher rates of infant mortality. • In a study by Bhagat Singh Thind, et. Al, non-whites living in Newark, NJ were found to have more babies with low birth weight, which increases the risk of infant mortality, than white women.

13. Possible factors contributing to this included drug and alcohol abuse, smoking, and not receiving pre-natal care. • In an effort to help the women in these poorer communities, the government created programs like Healthy Start. • Infant mortality rates are down, but the mothers still live in communities that put their children at risk.

14. The Medicalization of American Society • One way to consider the sociology of health is to look at how health and health care influence people’s lives. • Talcott Parsons believed that sickness can become a sick role. • A sick role is the expected behaviors and responsibilities appropriate for someone who is ill.

15. For example, part of an ill person’s role is to go to the doctor in an attempt to get rid of the illness. • Physicians have a primary position in society, allowing them to label sickness and health, which gives them great power over those whom they come in contact.

16. This has led to what many consider the medicalization of American society, or the idea that the medical community is the center of m any aspects of American society. • Americans tend to believe that we can find the right pill for anything. • Our society believes that if you take a pill, all will be okay.

17. The Myth of Mental Illness • Dr. Thomas Szasz wrote The Myth of Mental Illness which suggests that mental illness is not really a disease at all. • In fact, the diagnosis of mental illness is often used as a means of social control.

18. Paula Caplan argues that the Diagnostic and Statistical Manual of the American Psychiatric Association, used for the diagnosis of all mental illness, relies on personal ideology and political maneuvering. • America has many issues associated with the medicalization of our society. • Keeping this in mind, let’s look at obesity.

19. Health in the United States:Living off the Fat of the Land • With employment, health care and food often only a phone call or a key stroke away, the United States should be a country of healthy citizens. • However, all affluent nations face a host of health concerns, including obesity, an unhealthy accumulation of body fat.

20. Although it is a relatively new phenomenon, the United States is in the grips of what some are calling an obesity epidemic.

21. Food options in the United States run the gamut from healthy (organic arugula) to unhealthy (bacon cheddar cheeseburgers). • Many U.S. consumers prefer the latter. • Shopping for healthier food takes more time, effort and money. • Fast food is convenient and inexpensive, making it hugely popular, despite being unhealthy.

22. Childhood Obesity • A 2006 study determined that the increase in childhood obesity was a direct result of the availability of energy-dense foods and drinks combined with a lack of energy expenditure. • That is children are getting bigger because they are taking in more calories than they are burning.

23. Challenges facing Children: • Kids today face many challenges in keeping their weight down: • School lunches are higher in calories • Dual-income or single parent families create a need for pre-packaged meals that are unhealthy • Television, computers, and video games keeps children entertained, and sedentary.

24. Stigmatization of the Obese • Another consequence of childhood obesity is that overweight children are often targets of scorn and ridicule among their peers (bullying). • Numerous studies have shown that people hold prejudicial attitudes towards obese people. • This perception can cause discrimination against an obese person. • This loss of status can have harmful psychological, economic and physical consequences.

25. Obesity and Race • Research has shown that African Americans have a substantially higher rate of obesity than whites. • Poverty also plays a role in obesity.

26. Why are the poor more likely to be obese? • Michael Pollan points to the high cost of healthier food options. • Unhealthy, inexpensive foods are often necessary for those who cannot afford healthier food options. • A lack of education about nutrition can lead people to make uninformed choices about what they eat. • Add that to floundering health care system, and you have a recipe for an obesity problem.

27. Health Care • There are many other issues in the sociology of health other than obesity. • One important issue to consider is health care. • It seems that during every election cycle, health care– care, services, or supplies related to a person’s health—is always one of the major issues.

28. The Uninsured • In 2005, nearly 45 million people in the United States were uninsured. • Of the 45 million people, more than 34 million were under the age of 44. • Many of these people either didn’t make enough income to pay for insurance or had parents who didn’t make enough. • In the United States, the uninsured “are sicker, receive inferior care, and are more likely to die prematurely.

29. Cost of Services • The U.S. government has historically rejected plans for universal health care unless they apply to senior citizens. • Why the constant rejection? According to sociologist Jill Quadagno, three reasons explain this practice.

30. Quadagno’s Rationale for Rejected Universal Health Care: • The Constitution states that power of the state must be limited. Providing national health care is viewed as a form of welfare, which threatens our freedom. • The working class and labor unions fail to support legislation that would provide universal health care. • Private health care companies strongly oppose the idea of national health care.

31. Although many of the U.S. health care companies are private firms that are provided through a person’s employer or medical union, there are some public forms of health care. • Medicare and Medicaid provide the elderly, veterans, poor and disabled with insurance.

32. Health Care- An International Comparison • In 2000, the World Health Organization (WHO) released a report that identified five characteristics that a good and fair health system should have.

33. WHO Good & Fair Health System Criteria: • Overall good health (low infant mortality rates and high life expectancy) • A fair distribution of good health (low infant mortality and high life expectancy across the entire population) • A high level of overall responsiveness • A fair distribution of responsiveness • A fair distribution of financing health care (the health care costs are evenly distributed based on a person’s ability to pay)

34. A Global Look at Health Care Systems in 2005

35. Health Care and the Elderly--Medicare • Most of the U.S. elderly population has access to Medicare-a government-run social insurance program that provides health coverage for people 65 and older. • People ages 65 or over qualify for coverage if they are U.S. citizens or have been legal residents for five continuous years.

36. The program covers hospital stays, skilled nursing facilities, doctor visits and outpatient hospital services or allows people the option of receiving their benefits through private insurance plans. • There is also assistance to pay for prescription drugs, which helps seniors on tight budgets get the health care they need.

37. Health Care and the Elderly--Medicare • Those who have never worked and are poor are eligible for Medicaid, a form of government health insurance designed for the poor and disabled.

38. Aging: The Graying of the United States • The population of the United States has experienced a long trend of “graying” from 1900 to the present. • Persons aged 65 or older comprised about 4% of the population in the year 1900; in 2002 it was over 12%.

39. Baby Boomers • As baby boomers go into retirement, these numbers are going to skyrocket. • The Census Bureau estimates that by 2050, persons over the age of 65 will make up more than 20% of the total population.

40. Aging and Demographic Change in the United States • Concerns about the increasing percentage of elderly people in society have drawn the attention of psychologists, medical professionals and sociologists. • The study of aging and the elderly is officially known as gerontology.

41. The elderly have been broken down into two major cohorts: “young old” and the “old old”. • The “young old” consist of people between the ages of 65 and 75. • The “old old” refers to those over the age of 75.

42. Life Expectancy • Medical advances and higher standards of living dramatically increase life expectancy. • At the beginning of the 20th century, the average life expectancy was 47.3 years. • In 2007, life expectancy for men reached 75.2 while women’s life expectancy was 80.4 years.

43. The development of vaccines for many infectious diseases, such as measles, diphtheria and smallpox, virtually eliminate these diseases, allowing many more people to live longer, healthier lives.

44. The “Sandwiched” Generation • The baby boomer generation (people born between 1946-1964) is unique in that it is the first “sandwiched” generation—it takes care of its children and its elderly parents.

45. Most future generations will probably also be sandwiched between their children and their parents because of longer lives and delays in childbearing. • This can keep families close together.

46. The elderly can help their adult children in times of crisis by watching their grandchildren, providing temporary housing, giving loans, and offering advice to their adult children. • This allows the elderly to stay involved in family life and increases overall life satisfaction.

47. Gender and Aging: Where are the men? • According to sociologists John Knodel and Mary Beth Ofstedal, concerns about gender inequality have taken too much precedence, and the situation of elderly men is not being considered. • The Second World Assembly on Aging produced a report that is almost solely concerned with the situation of aging women called the “Madrid International Plan of Action”.

48. Knodel and Ofstedal were taken aback by the asssembly’s “willingness to acknowledge that the relationship between gender and aging varies across settings and over time.” • Although it is a noble goal to promote gender equality and empowerment of women, a one-sided view of the situation fails to actually promote gender equality.

49. Knodel and Ofstedal suggest that research should also examine the “experiences of older men and women within the context in which they live.”

50. Concerns about Aging • Biological changes • Ageism prejudice and discrimination based solely on age