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|Ch. 1||A brief introduction to the sociology of health, healing, and illness||1|
|Ch. 2||The development of scientific medicine||12|
|Ch. 3||Social epidemiology||34|
|Ch. 4||Society, disease, and illness||58|
|Ch. 5||Social stress||85|
|Ch. 6||Health behavior||107|
|Ch. 7||Experiencing illness and disability||126|
|Ch. 8||Physicians and the profession of medicine||150|
|Ch. 9||Medical education and the socialization of physicians||175|
|Ch. 10||Nurses, mid-level health care practitioners, and allied health workers||196|
|Ch. 11||Complementary and alternative medicine||219|
|Ch. 12||The physician-patient relationship : background and models||245|
|Ch. 13||Professional and ethical obligations of physicians in the physician-patient relationship||270|
|Ch. 14||The health care system of the United States||289|
|Ch. 15||Health care delivery||314|
|Ch. 16||The social implications of advanced health care technology||336|
|Ch. 17||Comparative health care systems||363|
We are living through a time of dynamic changes regarding disease and illness, health- and illness related behaviors, the health care professions, and the health care systems in the United States and other countries. The fourth edition of this text has been written to update our description and analysis of these dynamic processes and the work of medical sociologists that help us to understand them.
In preparing this fourth edition we have sought to retain and strengthen the emphases and features of the earlier editions; to thoroughly update patterns, trends, and statistics; and to present new material that reflects important changes in health care in society and important advancements in medical sociology.
This edition of the text maintains the same five emphases as the earlier editions. First, we provide broad coverage of the traditional subject matter of medical sociology and include both new perspectives and new research findings on this material. The core areas of medical sociology (the influence of the social environment on health and illness, health and illness behavior, health care practitioners and their relationships to patients, and the health care system) all receive significant attention within the text. Naturally, statistics throughout the text have been updated to provide timely analysis of patterns and trends. Recent research findings and thought have been incorporated in every chapter. Attention devoted to relatively new areas in the field has not reduced coverage of traditional areas such as social stress, illness behavior, and the physician-patient relationship.
Second, we have continued toemphasize emerging areas of analysis in medical sociology and recent work within the field. Recent health care reform efforts in both the public and private domains continue to have dramatic effects on almost every aspect of health care. We describe these effects on the profession of medicine (Chapter 8); medical education (Chapter 9); the status of nurses, mid-level health care practitioners, and alternative healers (Chapters 10 and 11); the physician-patient relationship (Chapter 12); the way that we pay for care (Chapter 14); and the sites at which we receive health care (Chapter 15).
We also continue to incorporate key medical ethics issues throughout the text. These issues represent some of the most important health related debates occurring in the United States today, and many medical sociologists have acknowledged the importance of understanding these policy debates and setting them within a sociological context. We have attempted to provide balanced and comprehensive coverage of several of these issues (especially in Chapters 13 and 16 and in the Discussion Questions and Cases at the ends of chapters).
This fourth edition also provides extended analysis of a wide range of topics including:
Third, our extensive coverage of gender, race, and class issues as they relate to health, healing, and illness has been maintained. Throughout the textbook, we examine issues in light of race, class, and gender. We want students to constantly be exposed to the important influence of these factors on matters related to health and illness. The chapters on social epidemiology, social stress, health and illness behaviors, the profession of medicine and medical education, and the physician-patient relationship all give special emphasis to these matters.
Fourth, we continue to emphasize key social policy questions. Timely questions and issues addressed in the earlier edition are continued and updated here—for example, the provision of clean needles to people using injectable drugs (Chapter 4), the reconfiguration of traditional responsibilities of hospital nurses (Chapter 10), the social acceptance and legitimation of complementary and alternative healers (Chapter 11), the legal status of medical marijuana (Chapter 11), the influence of managed care on physicians and patients (several chapters), the effects of trends toward consolidation and merger among American hospitals and the pressures placed on the viability of public hospitals (Chapter 15), and the use and possible abuse of advanced health care technologies (Chapter 16).
Fifth, we have attempted to prepare a text that is informative, readable, and interesting. We want readers to become aware of many of the understandings of health, healing, and illness that we have because of medical sociology. We want readers to become intrigued by the provocative issues and debates that exist in medical sociology and in the health care field. We want readers to find this book readable and interesting.
Both of us enjoy structuring our classrooms to enable as much reflection and critical thinking and student participation as possible. We have found that there is simply not time for some of the classroom activities that we most enjoy (e.g., reading and then discussing a provocative paperback, watching a good documentary and critically analyzing it together, or using student panels to introduce issues) if we feel obligated to lecture on all of the material in each chapter. On the other hand, we do want students to become familiar with the important contributions of the field. When we use this book, we do spend some time lecturing on parts of it, adding to certain discussions and presenting some of the material in an alternative manner. But, our students are able to grasp much of the book on their own, enabling us to supplement and to create additional types of learning experiences.
What are the key pedagogical features of this text?
Three additional facets of the book are important to us and help to describe its place within the field. First, we consider a strength of the book to be the large number of research studies cited to illustrate key points. We do this to constantly demonstrate to students the empirical basis of sociology, the origin of sociological knowledge, and the fascinating types of research conducted in medical sociology. We hope it inspires students to consider interesting research projects.
We have worked hard to identify theoretically meaningful and methodologically sound studies that contribute important knowledge to our understanding of health, healing, and illness. While making heavy use of research conducted by medical sociologists, we also include appropriate material from the other social sciences, from the government, and from the medical professional literature. We believe that this is helpful in forming the most comprehensive understanding of the topics covered in the book.
A second facet of our book that is important to us is that we provide balanced coverage on key issues. That does not mean that our book lacks critical perspective or analysis. In fact, readers will find no shortage of critical questions being asked. But we do not equate critical analysis vkith one-sided analysis. We believe students learn more when they are exposed to arguments on both sides of issues and are challenged to consider the soundness of reasoning and quality of evidence that are offered.
Finally, we hope that this text reflects a genuine understanding of some very important and complex issues. Both of us have had many opportunities to experience various dimensions of the health care system. Between the two of us, we have been able to apply and extend our medical sociological training through work in a free health clinic, a family planning clinic, in family counseling, in hospital bioethics groups, on the human rights committee of a state psychiatric hospital, on the Navajo reservation, and in voluntary health agencies. While we have not substituted our personal experiences for more general understandings developed through sound theory and research, we believe that our experiences have helped us to develop a better understanding of certain issues and have assisted us in being able to illustrate important concepts and patterns.
Ultimately, our hopes for student-readers remain the same as with the earlier editions—that they gain an appreciation for how the sociological perspective and social theory contribute to an understanding of health, healing, and illness and for the manner in which social research is used to study these processes. In addition we hope that readers perceive some of the many wonderfully exciting issues that are studied by medical sociologists.