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Economics Science

On Social Epidemiology, Healthcare Disparities, and Privitized Medicine

Social epidemiology is the study of causes and distribution of disease. Social epidemiology can show how social problems are connected to the health of different populations. These studies show that health problems of high-income nations differ greatly compared to those of low-income nations. Some diseases are universal, but others, like obesity, heart disease, and diabetes, are much more common in high-income countries and are a direct result of a sedentary lifestyle and poor diet.

Some theorists differentiate among three types of countries: core nations, semi-peripheral nations, and peripheral nations. Core nations are those that we think of as highly industrialized, semi-peripheral nations are those that are often called developing nations, and peripheral nations are those that are relatively underdeveloped.  While the biggest issue in the U.S. healthcare system is affordable access to healthcare services, other core countries have different issues, and semi-peripheral and peripheral nations face a host of additional concerns.

Health disparities based on gender include how women are affected adversely both by unequal access to, and institutionalized sexism in, the healthcare industry. Women experienced a decline in their ability to see needed specialists between 2001 and 2008, according to the Kaiser Family Foundation. Feminist sociologist Patricia Hill Collins developed intersection theory, which suggests that we cannot separate the effects of race, class, gender, sexual orientation, and other attributes. Further information derived from the Kaiser study found that women categorized as low income were more likely to express concerns about healthcare quality.

Many critics point to the medicalization (the process by which previously normal aspects of life are redefined as deviant and needing medical attention to remedy) of women’s issues as an example of institutionalized sexism. Historically and contemporarily, many aspects of women’s lives have been medicalized, including menstruation, PMS, pregnancy, childbirth, and menopause.

The concepts of socioeconomic status and health overlap in discussions of health with race and ethnicity, since the two are intertwined in the United States. Marilyn Winkleby and her research associates stated that “one of the strongest and most consistent predictors of a person’s morbidity (the incidence of disease) and mortality experience is that person’s socioeconomic status.” This finding persists across all diseases with few exceptions, continues throughout their lifespan, and extends across numerous risk factors of disease.

Research suggests that education also plays an important role in the socioeconomic status picture, not just economics. Some experts note that many behavior-influenced diseases like lung cancer, coronary artery disease, and AIDS initially were widespread across socioeconomic groups, however, once information linking habits to diseases was disseminated, these diseases decreased in high socioeconomic groups and increased in low socioeconomic groups, This shows the importance of education initiatives regarding disease, as well as possible inequalities in how these initiatives effectively reach different socioeconomic groups.

When looking at the social epidemiology of the United States, it’s hard to miss the disparities among races and ethnicities. In 2008, the average life expectancy for white males was approximately five years longer than for black males. An even stronger disparity was found in 2007: in infant mortality, which is the number of deaths in a given time or place, the rate for black people was nearly twice that of white people. Black Americans also have a higher incidence of several other diseases and causes of mortality.

Scoial Epidemiology of Mental Health

The treatment received by those defined as mentally ill or disabled varies greatly from country to country. People with mental disorders (a condition that makes it more difficult to cope with everyday life) and people with mental illness (a severe, lasting mental disorder that requires long-term treatment) experience a wide range of effects. According to the National Institute on Mental Health, the most common mental disorders in the United States are anxiety disorders. The second most common mental disorders are mood disorders; major mood disorders are depression, bipolar disorder, and dysthymic disorder. Another fairly commonly diagnosed mental disorder is Attention-Deficit Hyperactivity Disorder (ADHD), which statistics suggest affects 9 percent of children and 8 percent of adults on a lifetime basis.

Autism Spectrum Disorders (ASD) have gained a lot of attention in recent years. The term ASD encompasses a group of developmental brain disorders that are characterized by “deficits in social interaction, verbal and nonverbal communication, and engagement in repetitive behaviors or interests.” The National Institute of Mental Health distinguishes between serious mental illness and other disorders. The key feature of serious mental illness is that it results in “serious functional impairment, which substantially interferes with or limits one or more major life activities. Thus, the characterization of “serious” refers to the effect of the illness (functional impairment), not the illness itself.

Disability refers to a reduction in one’s ability to perform everyday tasks. The World Health Organization makes a distinction between the various terms used to describe handicaps that’s important to the sociological perspective. They use the term impairment to describe the physical limitations, while reserving the term disability to refer to the social limitation. Before the passage of the Americans with Disabilities Act in 1990, people in the United States with disabilities were often excluded from opportunities and social institutions many of us take for granted. This occurred through employment and other kinds of discrimination but also through casual acceptance by most people in a world designed for the convenience of the able-bodied. Ramps on sidewalks, Braille instructions, and more accessible door levers are all accommodations to help people with disabilities. According to the Bureau of Labor Statistics, people with a disability had a higher rate of unemployment than people without a disability in 2010.

Healthcare Systems and Access to Care

U.S. healthcare coverage can broadly be divided into two main categories: public healthcare (government-funded) and private healthcare (privately funded). The two main publicly funded healthcare programs are Medicare, which provides health services to people over sixty-five years old as well as people who meet other standards for disability, and Medicaid, which provides services to people with very low incomes who meet other eligibility requirements. The United States already has a significant problem with lack of healthcare coverage for many individuals. The U.S. Census Current Population Survey of 2013 showed that 18 percent of people in the United States had no health insurance at all. Skyrocketing healthcare costs are part of the issue. Many people cannot afford private health insurance, but their income level is not low enough to meet eligibility standards for government supported insurance. Furthermore, even for those who are eligible for Medicaid, the program is less than perfect. Many physicians refuse to accept Medicaid patients, citing low payments and extensive paperwork.

Many people in the United States are fond of saying that this country has the best healthcare in the world, and while it is true that the United States has a higher quality of care available than many peripheral or semi-peripheral nations, it is not necessarily the “best in the world.” Most peripheral or semi-peripheral and majority of developed countries rely on socialized medicine. Under a socialized medicine system, the government owns and runs the system. It employs the doctors, nurses, and other staff, and it owns and runs the hospitals. Germany, Singapore, and Canada all have universal healthcare. Universal healthcare is simply a system that guarantees healthcare coverage for everybody, as opposed to socialized medicine. People often look to Canada’s universal healthcare system, Medicare, as a model for the system. In Canada, healthcare is publicly funded and is administered by the separate provincial and territorial governments. However, the care itself comes from private providers. This is the main difference between universal healthcare and socialized medicine. Perhaps with recent progressive advances in establishing a Medicare For All program in the United States would aid in minimizing disparities in our healthcare systems. As of now, our current system has failed us, as many Americans lose their lives every year to preventable illness or disease simply due to lack of access to healthcare resources.

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Economics Philosophy & Politics Science

Piaget, Vygotsky, and Political Economy

Piaget and Vygotskys’ theories of cognitive development are somewhat contrasting, and can be compared to one-another endlessly using anecdotal evidence from our lives. Piaget’s model implies that cognitive development occurs parallel to neurobiological development and the child’s interaction with their environment. It’s relatively individualistic by nature of its focus on how the individual’s sensory processing of information from their environment effectively leads to formulation of ideas, and furthers cognitive development (subconsciously attempting to master their environment). The concepts proposed by Vygotsky differ from Piaget conversely; he proposes that through the zone of proximal development and by use of scaffolding, the individual develops cognitively through social interaction. Vygotsky concludes that social interaction is crucial to the process of learning and cognitive development; I’d make the comparison between the two theories that one seems to be individualistic (Pieget), while the other, relativistic (Vygotsky) in nature.

After making this mental connection, I decided to do some digging. I found that Piaget was born in the turn of the 20th century in capitalist Switzerland, while Vygotsky was a Soviet psychologist, educated at the Imperial Moscow University. It’s fascinating to me that two psychologists who likely harbor some sentiment for ideologically opposing political-economic theories (Communism, which is culturally relativistic, and Capitalism, which is culturally individualistic) would propose two conversed theories of cognitive development. Not to discount the validity of the theories- but I truly wonder if this is evidence of human nature being contingent on the material conditions of our reality, rather than some inherited, implicit biases towards thoughts or behaviors. What do you think? Did the fact that the material conditions of Piaget and Vygotskys’ environments differed influenced their psychology? If so, doesn’t that necessarily imply that Piaget was right? Would this information discount Vygotsky’s theory?