Beloit College Spring 2004 Prof.
Marion Field Fass
Teaching Assistant: Marika
Marland marikamarland@yahoo.com
Both disease
and medical care are related to the structure of society. The social organization of society
influences to a significant degree the type and distribution of disease. It also shapes the organized response
to disease and illness- the medical care system.
Health
care in the US and around the world has changed dramatically in the last two
decades. We will try to understand
these changes.
TEXTS:
Abraham, Laurie Kaye, Mama
might be better off dead,
University of Chicago Press,
Chicago, 1993. (Mama)
Freund, Peter E.S., McGuire,
Meredith B., Podhurst, Linda S., Health, Illness and the Social Body: A
Critical Sociology, Prentice Hall Publishers, Saddle River, NJ, 2003
Gawande, Atul, Complications:
A SurgeonÕs Notes on an Imperfect Science, Picador, New York, 2002.
Videos from the series
"Medicine at the Crossroads" after the book by Melvin Konner,
MD. Penguin Books, 1994.
Whitman, Steven, Williams,
Cynthia, and Shah, Ami M. Improving Community Health Survey: Catalyzing
Public Policy to Improve Community Health , Sinai Health System, Chicago,
2004. Download from the web at
http://www.sinai.org/urban/originalresearch/rwj/index.asp
Requirements:
Attendance
is required. After 3 absences your
grade will fall.
First
response: 5% Due Monday January 27 View Travis and write about how it reflects
both the best and worst in American health care.
Paper
1, Monday, February 16 15% Use the readings and MAMA to write a
paper about health inequalities.
Please focus upon a specific health problem.
Paper
2, Wednesday, March 3 15% Cora Jackson Memorial Fund Grant application
Paper
3 Friday, March 26 15% paper on Gawande stories and the
experience of ÒdoctoringÓ
Paper
4 10% Health
insurance: personal perspectives
Project
and presentation: 15%
Final
takehome exam: 15 %
Class
participation: 10% and
other random activities
Academic
Honesty
All
work that you submit should be your own.
If you work with others on an assignment, place the names of all of the
participants on the assignment.
When you use written, video, World Wide Web, or other sources of
information, please cite these sources in your work. Please use a consistent and accepted reference style. Plagiarism, the use of ideas,
information, and text from other people without giving them appropriate credit,
is a serious breach of ethics in the academic world. When academic writers use the ideas of others, they
generally paraphrase these ideas rather than quoting them verbatim. Paraphrased text must be attributed to
the original author, usually with a parenthetical citation followed by a
complete bibliographic citation in a list of literature cited at the end of the
document. I expect that to follow
this convention in all of your writing, including proposals, reports, and
exams. Oral presentations should
also provide information on the sources of the ideas that they contain. It is never appropriate to cut and
paste information directly from web pages without crediting the source of the
information. It is always better
to put information in your own words.
Please see the Beloit College Academic Dishonesty Policy (http://www.beloit.edu/~stuaff/acadplcy.html#acts)
for information on our expectations of Beloit College students. (This statement was developed by
Professor Yaffa Grossman and modified by Marion Fass, 1/19/04.)
Tuesday, January 20
Intro to the course- How do
Health and Health care differ? How
are they related?
How does the health care
system contribute to health or ill-health? How does the community contribute to health and ill health?
Discuss data from Margellos,
Helen, Silva, Abigail, and Whitman, Steven (2004) ÒComparison of Health Status Indicators in Chicago:
Are Black-White Disparities Worsening? AJPH 94(1): 116-121.
For Wednesday, January 21
Read MAMA, Intro and Chapter
1
Read Mc Cord and Freeman,
Excess Mortality in Harlem, NEJMed, 1990, 322:173-3 RESERVE
Wednesday, January 21
Race, inequality and health
Reading for Monday,
January 26 MAMA, Chapters 2 and
3 For Monday, please
turn in response to Travis video Travis is the story of a
little boy with HIV, but it is also a story of how we think about health
and medical care in the United States. The number of children born with HIV in the US is now
very low, but the perspective on health and medical care persists. Travis reflects the best and worst
of health care system in America.
In 2 pages, please identify what you see as the best and worst of
health care in America as reflected in the movie. Remember to think of
health care broadly- and think about what problems money is spent on and
what problems are ignored. MAMA, Chapters 4 and
5
Reading for Wednesday, January 28
Friday, January 23
Video: Travis
Discuss MAMA 2 and 3 and Mc Cord and Freeman article
and Travis
Marion will
lecture on an overview of the US health care system
Read Kawachi, Ichiro, Bruce P Kennedy,
Kimberly Lochner, and Deborah Prothrow-Stith, ÒSocial Capital, Income
Inequality and Mortality,Ó AJPH
87(9): 1491-1497, 1997.
And Marmot M. Inequalities in Health N
Engl J Med 2001; 345:134-136, Jul 12, 2001.
RESERVE
Wednesday,
January 28
Discuss
Chapters 4 and 5 and Social Capital
Mama's health: What factors are contributing to the
health problems of Mama's family?
What solutions can you propose?
For Friday,
January 30, Read HISB, Chapters 1 and 2
Friday,
January 30
Who becomes
sick, injured or dies?
For Monday, February 2
Diez-Roux, A.V. et al, "Prevalence and Social Correlates of Cardiovascular
Disease Risk Factors in Harlem," AJPH 89(3): 302-7, 1999. RESERVE
Diez-
Roux A. V., Merkin S. S., Arnett D., Chambless L., Massing M., Nieto F. J.,
Sorlie P., Szklo M., Tyroler H. A., Watson R. L.Neighborhood of Residence
and Incidence of Coronary Heart Disease N Engl J Med 2001; 345:99-106, Jul 12,
2001. RESERVE
Monday February
2
Tuesday, February 3, VIDEO, Temple of Science or Code of Silence
HISB, Chapter 6 The
Social Meanings of Sickness
Wednesday, February 4
Discuss Sick Role and the
Social construction of Illness
MamaÕs sick role and the
limitations of sociological models
Reflect on the impact of
Economic factors on MamaÕs experience.
For Friday, February 6
Read Freund and McGuire,
Chapter 7, The Illness Experience
and MAMA, Chapter 8 Who is Responsible for Tommy MarkhamÕs
health
The illness experience;
patienthood
For Monday, February 9
Think about- Is MAMA still valid. Given all the money you need, how would
you determine if the picture of health and health care persists?
Write a brief plan.
Monday, Discuss strategies
for assessment.
For Tuesday, Read Improving Community Health, Executive Summary
through page 12 on the web at http://www.sinai.org/urban/originalresearch/rwj/index.asp
Discuss the art and science
of survey research
Read for
Wednesday, February 11
And
read MAMA Chapter 6 and Chapter 10 in Mama about Empty Promises
Wednesday
February 11
ERs, poverty
and judgments
Read Iglehart J. K.The Dilemma of Medicaid N Engl J Med
2003; 348:2140-2148, May 22, 2003.
And Improving Community Health , Chapter on Access
For
Friday, February 13
The
dilemma of child health
Read for Monday February
15, Read Improving Community Health,
Diabetes and Smoking
For Friday, February 20, Whitman et al Improving
Community Health, Community health, p 18-33, through discussion of asthma
For Monday, Feb 23 Read Whitman et al Improving Community
Health, Community health, Depression and Obesity, HIV/AIDS and Health Related
Quality of Life Reread Chapter in MAMA on Depression
Discuss depression and health
For Tuesday, Feb 24 discuss HIV in US. Reference list
for 2nd paper due
For Wednesday Feb 25 Read Mama, Chapters 9 and 11, 12
and Read Fox, Renee and Judith P. Swazey, "Transplantation and the
Medical Commons" from Spare Parts: Organ Replacement in American
Society, pp 73-86, 1992 OR Delmonico F. L., Arnold R., Scheper-Hughes N., Siminoff
L. A., Kahn J., Youngner S. J.(2002),Ethical Incentives - Not Payment - For
Organ Donation,
N Engl J Med 2002; 346:2002-2005. on reserve
Discuss care of the ill and the commodification of organs, the commodification
of health
Friday, Feb 27 Finish MAMA
Monday, March 1, Video on End of Life issues
For Tuesday, March 2, read Albom, Tuesdays with Morrie and
Goodwin, James, Geriatrics and the Limits of Modern Medicine"
Tuesday March 2 and Wednesday, March 3 more on end of
life issues
Call home and interview your parents about your family's health care coverage
and their satisfaction with it over the last 10 years.
Friday, March 5, NO CLASS
For Monday, March 15
Read Gawande, A Queasy
feeling, Crimson Tide and The Man Who couldnÕt Stop Eating.
Monday
Discuss Medicalization
For Wednesday, Read
Gawande
The Computer and the
Hernia Factory, Whose Body is it anyway? And The Pain Perplex. And ABELSON, Reed and MELODY PETERSEN
An Operation to Ease Back Pain Bolsters the Bottom Line, Too New York Times, (on line edition ) December 31,
2003
Wednesday,
March 17
Discuss
surgery
Read HISB, Chapter 10 Modern
Biomedicine: Knowledge and Practice
Friday, March 19
Doctors, Patients and
Professional Dominance
Read: Emanuel, Ezekiel and Dubler, Nancy
Neveloff, Preserving the Physician Patient Relationship in the Era of Managed
Care, JAMA 273(4): 323-329, 1995 RESERVE
Levinson, Wendy et al,
Physician-Patient Communication:
The Relationship with Malpractice Claims among Primary Care Physicians
and Surgeons, JAMA, 277(7):553-558, 1997. RESERVE
Monday March 22
Doctors and patients and
professional dominance
More on doctor-patient
relationships and health insurance
Read HISB, Chapter 9, The
Social Construction of Medical Knowledge
Wednesday March 24
The social construction of
medical knowledge
Reflections on Mama and
Gawande
Menopause, medicines and
medical knowledge
POLITICS, POWER, and THE
HEALTH CARE SYSTEM
Monday, March 29-end
Visits: Nurse, doctor, pharmacist,
pharmaceutical rep, hospital administrator