Sociology of health and illness

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The sociology of health and illness, alternatively the sociology of health and wellness (or simply health sociology), examines the interaction between society and health. The objective of this topic is to see how social life affects morbidity and mortality rate, and vice versa. [1] This aspect of sociology differs from medical sociology in that this branch of sociology discusses health and illness in relation to social institutions such as family, employment, and school. The sociology of medicine limits its concern to the patient-practitioner relationship and the role of health professionals in society. [2] The sociology of health and illness covers sociological pathology (causes of disease and illness), reasons for seeking particular types of medical aid, and patient compliance or noncompliance with medical regimes. [2]

Society group of people related to each other through persistent relations, or a large social grouping sharing the same territory, subject to the same authority and culture

A society is a group of individuals involved in persistent social interaction, or a large social group sharing the same geographical or social territory, typically subject to the same political authority and dominant cultural expectations. Societies are characterized by patterns of relationships between individuals who share a distinctive culture and institutions; a given society may be described as the sum total of such relationships among its constituent of members. In the social sciences, a larger society often exhibits stratification or dominance patterns in subgroups.

Health, as defined by the World Health Organization (WHO), is "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." This definition has been subject to controversy, as it may have limited value for implementation. Health may be defined as the ability to adapt and manage physical, mental and social challenges throughout life.

Mortality rate measure of the number of deaths in a population

Mortality rate, or death rate, is a measure of the number of deaths in a particular population, scaled to the size of that population, per unit of time. Mortality rate is typically expressed in units of deaths per 1,000 individuals per year; thus, a mortality rate of 9.5 in a population of 1,000 would mean 9.5 deaths per year in that entire population, or 0.95% out of the total. It is distinct from "morbidity", which is either the prevalence or incidence of a disease, and also from the incidence rate.

Contents

Health, or lack of health, was once merely attributed to biological or natural conditions. Sociologists have demonstrated that the spread of diseases is heavily influenced by the socioeconomic status of individuals, ethnic traditions or beliefs, and other cultural factors. [3] Where medical research might gather statistics on a disease, a sociological perspective on an illness would provide insight on what external factors caused the demographics who contracted the disease to become ill. [3]

This topic requires a global approach of analysis because the influence of societal factors varies throughout the world. This will be demonstrated through discussion of the major diseases of each continent. These diseases are sociologically examined and compared based on the traditional medicine, economics, religion, and culture that is specific to each region. HIV/AIDS serves as a common basis of comparison among regions. While it is extremely problematic in certain areas, in others it has affected a relatively small percentage of the population. [4] Sociological factors can help to explain why these discrepancies exist.

Traditional medicine medicine based on traditional beliefs

Traditional medicine comprises medical aspects of traditional knowledge that developed over generations within various societies before the era of modern medicine. The World Health Organization (WHO) defines traditional medicine as "the sum total of the knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness". Traditional medicine is contrasted with scientific medicine.

Economics social science that analyzes the production, distribution, and consumption of goods and services

Economics is the social science that studies the production, distribution, and consumption of goods and services.

Religion may be defined as a cultural system of designated behaviors and practices, morals, worldviews, texts, sanctified places, prophecies, ethics, or organizations, that relates humanity to supernatural, transcendental, or spiritual elements. However, there is no scholarly consensus over what precisely constitutes a religion.

There are obvious differences in patterns of health and illness across societies, over time, and within particular society types. There has historically been a long-term decline in mortality within industrialized societies, and on average, life-expectancies are considerably higher in developed, rather than developing or undeveloped, societies. [5] Patterns of global change in health care systems make it more imperative than ever to research and comprehend the sociology of health and illness. Continuous changes in economy, therapy, technology and insurance can affect the way individual communities view and respond to the medical care available. These rapid fluctuations cause the issue of health and illness within social life to be very dynamic in definition. Advancing information is vital because as patterns evolve, the study of the sociology of health and illness constantly needs to be updated. [2]

Research formal work undertaken systematically to increase the stock of knowledge

Research comprises "creative and systematic work undertaken to increase the stock of knowledge, including knowledge of humans, culture and society, and the use of this stock of knowledge to devise new applications." It is used to establish or confirm facts, reaffirm the results of previous work, solve new or existing problems, support theorems, or develop new theories. A research project may also be an expansion on past work in the field. Research projects can be used to develop further knowledge on a topic, or in the example of a school research project, they can be used to further a student's research prowess to prepare them for future jobs or reports. To test the validity of instruments, procedures, or experiments, research may replicate elements of prior projects or the project as a whole. The primary purposes of basic research are documentation, discovery, interpretation, or the research and development (R&D) of methods and systems for the advancement of human knowledge. Approaches to research depend on epistemologies, which vary considerably both within and between humanities and sciences. There are several forms of research: scientific, humanities, artistic, economic, social, business, marketing, practitioner research, life, technological, etc.

Therapy medical treatment

Therapy is the attempted remediation of a health problem, usually following a diagnosis. In the medical field, it is usually synonymous with treatment. Among psychologists and other mental health professionals, including psychiatrists, psychiatric nurse practitioners, counselors, and clinical social workers, the term may refer specifically to psychotherapy. The English word therapy comes via Latin therapīa from Greek: θεραπεία and literally means "curing" or "healing".

Technology making, modification, usage, and knowledge of tools, machines, techniques, crafts, systems, and methods of organization

Technology is the collection of techniques, skills, methods, and processes used in the production of goods or services or in the accomplishment of objectives, such as scientific investigation. Technology can be the knowledge of techniques, processes, and the like, or it can be embedded in machines to allow for operation without detailed knowledge of their workings. Systems applying technology by taking an input, changing it according to the system's use, and then producing an outcome are referred to as technology systems or technological systems.

Historical background

Wall painting found in the tomb of an Egyptian official known as the physicians tomb Akmanthor.jpg
Wall painting found in the tomb of an Egyptian official known as the physicians tomb

Humans have long sought advice from those with knowledge or skill in healing. Paleopathology and other historical records, allow an examination of how ancient societies dealt with illness and outbreak. Rulers in Ancient Egypt sponsored physicians that were specialists in specific diseases. [6] Imhotep was the first medical doctor known by name. An Egyptian who lived around 2650 B.C., he was an adviser to King Zoser at a time when Egyptians were making progress in medicine. Among his contributions to medicine was a textbook on the treatment of wounds, broken bones, and even tumors. [7]

Healing is the process of the restoration of health from an unbalanced, diseased or damaged organism. The result of healing can be a cure to a health challenge, but one can heal without being cured.

Paleopathology Archaeological sub-discipline

Paleopathology, also spelled palaeopathology, is the study of ancient diseases. Studying pathologies, these abnormalities in biologic individuals and systems, may be intrinsic to the system itself or caused by an extrinsic factor. Any living organism can have pathology. Studies have historically focused on humans, but there is no evidence that humans are more prone to pathologies than any other animal.

In epidemiology, an outbreak is a sudden increase in occurrences of a disease in a particular time and place. It may affect a small and localized group or impact upon thousands of people across an entire continent. Two linked cases of a rare infectious disease may be sufficient to constitute an outbreak. Outbreaks include epidemics, which term is normally only used for infectious diseases, as well as diseases with an environmental origin, such as a water or foodborne disease. They may affect a region in a country or a group of countries. Pandemics are near-global disease outbreaks.

Stopping the spread of infectious disease was of utmost importance for maintaining a healthy society. [6] The outbreak of disease during the Peloponnesian War was recorded by Thucydides who survived the epidemic. From his account it is shown how factors outside the disease itself can affect society. The Athenians were under siege and concentrated within the city. Major city centers were the hardest hit. [8] This made the outbreak even more deadly and with probable food shortages the fate of Athens was inevitable. [8] Approximately 25% of the population died of the disease. [8] Thucydides stated that the epidemic "carried away all alike". The disease attacked people of different ages, sexes and nationalities. [8]

Disease abnormal condition negatively affecting organisms

A disease is a particular abnormal condition that negatively affects the structure or function of part or all of an organism, and that is not due to any external injury. Diseases are often construed as medical conditions that are associated with specific symptoms and signs. A disease may be caused by external factors such as pathogens or by internal dysfunctions. For example, internal dysfunctions of the immune system can produce a variety of different diseases, including various forms of immunodeficiency, hypersensitivity, allergies and autoimmune disorders.

Peloponnesian War ancient Greek war fought by Athens and its empire against the Peloponnesian League led by Sparta

The Peloponnesian War was an ancient Greek war fought by the Delian League led by Athens against the Peloponnesian League led by Sparta. Historians have traditionally divided the war into three phases. In the first phase, the Archidamian War, Sparta launched repeated invasions of Attica, while Athens took advantage of its naval supremacy to raid the coast of the Peloponnese and attempt to suppress signs of unrest in its empire. This period of the war was concluded in 421 BC, with the signing of the Peace of Nicias. That treaty, however, was soon undermined by renewed fighting in the Peloponnese. In 415 BC, Athens dispatched a massive expeditionary force to attack Syracuse, Sicily; the attack failed disastrously, with the destruction of the entire force in 413 BC. This ushered in the final phase of the war, generally referred to either as the Decelean War, or the Ionian War. In this phase, Sparta, now receiving support from the Achaemenid Empire, supported rebellions in Athens's subject states in the Aegean Sea and Ionia, undermining Athens's empire, and, eventually, depriving the city of naval supremacy. The destruction of Athens's fleet in the Battle of Aegospotami effectively ended the war, and Athens surrendered in the following year. Corinth and Thebes demanded that Athens should be destroyed and all its citizens should be enslaved, but Sparta refused.

Thucydides Greek historian and Athenian general

Thucydides was an Athenian historian and general. His History of the Peloponnesian War recounts the fifth-century BC war between Sparta and Athens until the year 411 BC. Thucydides has been dubbed the father of "scientific history" by those who accept his claims to have applied strict standards of impartiality and evidence-gathering and analysis of cause and effect, without reference to intervention by the deities, as outlined in his introduction to his work.

Physician in Ancient Greece treating a patient 480-470 BC Medicine aryballos Louvre CA1989-2183.jpg
Physician in Ancient Greece treating a patient 480–470 BC

Ancient medical systems stressed the importance of reducing illness through divination and ritual. [6] Other codes of behavior and dietary protocols were widespread in the ancient world. [6] During the Zhou Dynasty in China, doctors suggested exercise, meditation and temperance to preserve one's health. [6] The Chinese closely link health with spiritual well-being. Health regimes in ancient India focused on oral health as the best method for a healthy life. [6] The Talmudic code created rules for health which stressed ritual cleanliness, connected disease with certain animals and created diets. [6] Other examples include the Mosaic Code and Roman baths and aqueducts. [6]

Those that were most concerned with health, sanitation and illness in the ancient world were those in the elite class. [6] Good health was thought to reduce the risk of spiritual defilement and therefore enhanced the social status of the ruling class who saw themselves as the beacon of civilization. [6] During the late Roman Period, sanitation for the lower classes was a concern for the leisured class. [6] Those that had the means would donate to charities that focused on the health of non-elites. [6] After the decline of the Roman Empire, physicians and concern with public health disappeared except in the largest cities. [6] Health and public doctors remained in the Byzantine Empire. [6] Focusing on preventing the spread of diseases such as small pox lead to a smaller mortality rate in much of the western world. [6] Other factors that allowed the modern rise in population include: better nutrition and environmental reforms (such as getting clean water supplies). [6]

The present day sense of health being a public concern for the state began in the Middle Ages. [9] A few state interventions include maintaining clean towns, enforcing quarantines during epidemics and supervising sewer systems. [9] Private corporations also played a role in public health. The funding for research and the institutions for them to work were funded by governments and private firms. [9] Epidemics were the cause of most government interventions. The early goal of public health was reactionary whereas the modern goal is to prevent disease before it becomes a problem. [9] Despite the overall improvement of world health, there still has not been any decrease in the health gap between the affluent and the impoverished. [10] Today, society is more likely to blame health issues on the individual rather than society as a whole. This was the prevailing view in the late 20th century. [10] In the 1980s the Black Report, published in the United Kingdom, went against this view and argued that the true root of the problem was material deprivation. [10] This report proposed a comprehensive anti-poverty strategy to address these issues. [10] Since this did not parallel the views of the Conservative government, it did not go into action immediately. [10] The Conservative government was criticized by the Labour Party for not implementing the suggestions that the Black Report listed. [10] This criticism gave the Black Report the exposure it needed and its arguments were considered a valid explanation for health inequality. [10] There is also a debate over whether poverty causes ill-health or if ill-health causes poverty. [10] Arguments by the National Health Service gave considerable emphasis to poverty and lack of access to health care. It has also been found that heredity has more of a bearing on health than social environment, but research has also proved that there is indeed a positive correlation between socioeconomic inequalities and illness. [10]

More recently, sociological studies following a life course perspective in health emphasised the limitations of the view linking health outcomes on individual agency only [11] .

Methodology

The Sociology of Health and Illness looks at three areas: the conceptualization, the study of measurement and social distribution, and the justification of patterns in health and illness. By looking at these things researchers can look at different diseases through a sociological lens. The prevalence and response to different diseases varies by culture. [5] By looking at bad health, researchers can see if health affects different social regulations or controls. When measuring the distribution of health and illness, it is useful to look at official statistics and community surveys. Official statistics make it possible to look at people who have been treated. It shows that they are both willing and able to use health services. It also sheds light on the infected person's view of their illness. On the other hand, community surveys look at people's rating of their health. Then looking at the relation of clinically defined illness and self reports and find that there is often a discrepancy.

A great deal of the time, mortality statistics take the place of the morbidity statistics because in many developed societies where people typically die from degenerative conditions, the age in which they die sheds more light on their life-time health. This produces many limitations when looking at the pattern of sickness, but sociologists try to look at various data to analyze the distribution better. Normally, developing societies have lower life expectancies in comparison to developed countries. They have also found correlations between mortality and sex and age. Very young and old people are more susceptible to sickness and death. On average women typically live longer than men, although women are more likely to have bad health. [5]

>80
77.5-80
75-77.5
72.5-75
70-72.5
67.5-70
65-67.5
60-65
55-60
50-55
Life expectancy by region in 2015 Expectancy of life.svg
  >80
  77.5–80
  75–77.5
  72.5–75
  70–72.5
  67.5–70
  65–67.5
  60–65
  55–60
  50–55
Life expectancy by region in 2015

Disparities in health were also found between people in different social classes and ethnicities within the same society, even though in the medical profession they put more importance in “health related behaviors” such as alcohol consumption, smoking, diet, and exercise. There is a great deal of data supporting the conclusion that these behaviors affect health more significantly than other factors. [5] Sociologists think that it is more helpful to look at health and illness through a broad lens. Sociologists agree that alcohol consumption, smoking, diet, and exercise are important issues, but they also see the importance of analyzing the cultural factors that affect these patterns. Sociologists also look at the effects that the productive process has on health and illness. While also looking at things such as industrial pollution, environmental pollution, accidents at work, and stress-related diseases. [5]

Social factors play a significant role in developing health and illness. Studies of epidemiology show that autonomy and control in the workplace are vital factors in the etiology of heart disease. One cause is an effort-reward imbalance. Decreasing career advancement opportunities and major imbalances in control over work have been coupled with various negative health costs. Various studies have shown that pension rights may shed light on mortality differences between retired men and women of different socioeconomic statuses. These studies show that there are outside factors that influence health and illness. [5]

International perspective

Africa

Estimation of the number of adults in Africa who are infected with HIV or AIDS. Note that levels of infection are much higher in sub-Saharan Africa. Map-of-HIV-Prevalance-in-Africa.png
Estimation of the number of adults in Africa who are infected with HIV or AIDS. Note that levels of infection are much higher in sub-Saharan Africa.

HIV/AIDS is the leading epidemic that affects the social welfare of Africa. [12] Human Immunodeficiency virus (HIV) can cause AIDS which is an acronym for Acquired Immunodeficiency Syndrome (AIDS), a condition in humans in which the immune system begins to fail, leading to life-threatening infections. Two-thirds of the worlds HIV population is located in Sub-Saharan Africa. Since the epidemic started more than 15 million Africans have died by complications with HIV/AIDS. [12]

People apart of religious sub-groups of Sub-Saharan Africa and those who actively and frequently participate in religious activities are more likely to be at a lower risk of contracting HIV/AIDS. On the opposite end, there are many beliefs that an infected male can be cured of the infection by having sex with a virgin. These beliefs increase the number of people with the virus and also increase the number of rapes against women. [13]

Herbal treatment is one of the primary medicines used to treat HIV in Africa. It is used more than standard treatment because it is more affordable. [12] Herbal treatment is more affordable but is not researched and is poorly regulated . This lack of research on whether the herbal medicines work and what the medicines consist of is a major flaw in the healing cycle of HIV in Africa. [13]

Economically, HIV has a significant negative effect. The labor force in Africa is slowly diminishing, due to HIV-related deaths and illness. In response, government income declines and so does tax revenue. The government has to spend more money than it is making, in order to care for those affected with HIV/AIDS. [12]

AIDS orphans in Malawi Aid Orphans in Malawi 2.jpeg
AIDS orphans in Malawi

A major social problem in Africa in regards to HIV is the orphan epidemic. The orphan epidemic in Africa is a regional problem. In most cases, both of the parents are affected with HIV. Due to this, the children are usually raised by their grandmothers and in extreme cases they are raised by themselves. In order to care for the sick parents, the children have to take on more responsibility by working to produce an income. Not only do the children lose their parents but they also lose their childhood as well. Having to provide care for their parents, the children also miss out on an education which increases the risk of teen pregnancy and people affected with HIV. The most efficient way to diminish the orphan epidemic is prevention: preventing children from acquiring HIV from their mothers at birth, as well as educating them on the disease as they grow older. Also, educating adults about HIV and caring for the infected people adequately will lower the orphan population. [14]

The HIV/AIDS epidemic is reducing the average life expectancy of people in Africa by twenty years. The age range with the highest death rates, due to HIV, are those between the ages of 20 and 49 years. The fact that this age range is when adults acquire most of their income they cannot afford to send their children to school, due to the high medication costs. It also removes the people who could help aid in responding to the epidemic. [12]

Asia

Asian countries have wide variations of population, wealth, technology and health care, causing attitudes towards health and illness to differ. Japan, for example, has the third highest life expectancy (82 years old), while Afghanistan has the 11th worst (44 years old). [15] Key issues in Asian health include childbirth and maternal health, HIV and AIDS, mental health, and aging and the elderly. These problems are influenced by the sociological factors of religion or belief systems, attempts to reconcile traditional medicinal practices with modern professionalism, and the economic status of the inhabitants of Asia.

People living with HIV/AIDS People living with HIV AIDS world map.PNG
People living with HIV/AIDS

Like the rest of the world, Asia is threatened by a possible pandemic of HIV and AIDS. Vietnam is a good example of how society is shaping Asian HIV/AIDS awareness and attitudes towards this disease. Vietnam is a country with feudal, traditional roots, which, due to invasion, wars, technology and travel is becoming increasingly globalized. Globalization has altered traditional viewpoints and values. It is also responsible for the spread of HIV and AIDS in Vietnam. Even early globalization has added to this problem – Chinese influence made Vietnam a Confucian society, in which women are of less importance than men. Men in their superiority have no need to be sexually responsible, and women, generally not well educated, are often unaware of the risk, perpetuating the spread of HIV and AIDS as well as other STIs. [16]

Confucianism has had a strong influence on the belief system in Asia for centuries, particularly in China, Japan, and Korea, and its influence can be seen in the way people chose to seek, or not seek, medical care. [17] An important issue in Asia is societal effect on the ability of disabled individuals to adjust to a disability. Cultural beliefs shape attitudes towards physical and mental disabilities. China exemplifies this problem. According to Chinese Confucian tradition (which is also applicable in other countries where Confucianism has been spread), people should always pursue good health in their lives, with an emphasis on health promotion and disease prevention. [18] To the Chinese, having a disability signifies that one has not led a proper lifestyle and therefore there is a lack of opportunities for disabled individuals to explore better ways to accept or adapt to their disability. [18]

Indigenous healing practices are extremely diverse throughout Asia but often follow certain patterns and are still prevalent today. Many traditional healing practices include shamanism and herbal medicines, and may have been passed down orally in small groups or even institutionalized and professionalized. [19] In many developing countries the only health care available until a few decades ago were those based on traditional medicine and spiritual healing. Now governments must be careful to create health policies that strike a balance between modernity and tradition. Organizations, like the World Health Organization, try to create policies that respect tradition without trying to replace it with modern science, instead regulating it to ensure safety but keeping it accessible. [20] India in particular tries to make traditional medicines safe but still available to as many people as possible, adapting tradition to match modernization while still considering the economic positions and culture of its citizens. [20]

Flag of World Health Organization Flag of WHO.svg
Flag of World Health Organization

Mental health issues are gaining an increasing amount of attention in the Asian countries.[ citation needed ] Many of these countries have a preoccupation with modernizing and developing their economies, resulting in cultural changes. In order to reconcile modern techniques with traditional practices, social psychologists in India are in the process of “indigenizing psychology”. Indigenous psychology is that which is derived from the laws, theories, principals, and ideas of a culture and unique to each society. [18]

In many Asian countries, childbirth is still treated by traditional means and is thought of with regional attitudes. For example, in Pakistan, decisions concerning pregnancy and antenatal care (ANC) are usually made by older women, often the pregnant woman's mother-in-law, while the mother and father to be are distanced from the process. They may or may not receive professional ANC depending on their education, class, and financial situation. [21] Generally in Asia, childbirth is still a woman's area and male obstetricians are rare. Female midwives and healers are still the norm in most places. Western methods are overtaking the traditional in an attempt to improve maternal health and increase the number of live births. [22]

Asian countries, which are mostly developing nations, are aging rapidly even as they are attempting to build their economies. Even wealthy Asian nations, such as Japan, Singapore, and Taiwan, also have very elderly populations and thus have to try to sustain their economies and society with small younger generations while caring for their elderly citizens. [23] The elderly have been traditionally well respected and well cared for in most Asian cultures; experts predict that younger generations in the future are less likely to be concerned and involved in the health care of their older relatives due to various factors such as women joining the workforce more, the separation of families because of urbanization or migration, and the proliferation of Western ideals such as individualism. [24]

Australia

The health patterns found on the continent of Australia which includes the Pacific Islands, have been very much influenced by European colonization. While indigenous medicinal beliefs are not significantly prevalent in Australia, traditional ideas are still influential in the health care problems in many of the islands of the Pacific. [25] The rapid urbanization of Australia led to epidemics of typhoid fever and the Bubonic plague. Because of this, public health was professionalized beginning in the late 1870s in an effort to control these and other diseases. Since then Australia's health system has evolved similarly to Western countries and the main cultural influence affecting health care are the political ideologies of the parties in control of the government. [25]

Old heroin bottle Bayer Heroin bottle.jpg
Old heroin bottle

Australia has had treatment facilities for 'problem drinkers' since the 1870s. In the 1960s and 1970s it was recognized that Australia had several hundred thousand alcoholics and prevention became a priority over cures, as there was a societal consensus that treatments are generally ineffective. [25] The government began passing laws attempting to curb alcohol consumption but consistently met opposition from the wine-making regions of southern Australia. The government has also waged a war on illegal drugs, particularly heroin, which in the 1950s became widely used as a pain reliever. [25]

Experts believe that many of the health problems in the Pacific Islands can be traced back to European colonization and the subsequent globalization and modernization of island communities. [26] (See History of the Pacific Islands.) European colonization and late independence meant modernization but also slow economic growth, which had an enormous effect on health care, particularly on nutrition in the Pacific Islands. The end of colonization meant a loss of medical resources, and the fledgling independent governments could not afford to continue the health policies put in place by the colonial governments. [26] Nutrition was changed radically, contributing to various other health problems. While more prosperous, urban areas could afford food, they chose poor diets, causing 'overnourishment', and leading to extremely high levels of obesity, type 2 diabetes, and cardiovascular diseases. Poorer rural communities, on the other hand, continue to suffer from malnutrition and malaria. [26]

Traditional diets in the Pacific are very low in fat, but since World War II there has been a significant increase in fat and protein in Pacific diets. Native attitudes towards weight contribute to the obesity problem. Tongan natives see obesity as a positive thing, especially in men. They also believe that women should do as little physical work as possible while the men provide for them, meaning they get very little exercise. [26]

Europe

The largest endeavors to improve health across Europe is the World Health Organization European Region. [27] The goal is to improve the health of poor and disadvantaged populations by promoting healthy lifestyles including environmental, economic, social and providing health care. [27] Overall health in Europe is very high compared to the rest of the world. [27] The average life expectancy is around 78 in EU countries but there is a wide gap between Western and Eastern Europe. It is as low as 67 in Russia and 73 in the Balkan states. [27] Europe is seeing an increase in the spread of HIV/AIDS in Eastern Europe because of a worsening socioeconomic situation. [27] Cardiovascular disease, cancer and diabetes mellitus are more prevalent is Eastern Europe. [27] The WHO claims that poverty is the most important factor bringing on ill health across Europe. [27] Those at low socioeconomic status levels and many young people are also at risk because of their increased tobacco, alcohol and drug abuse. [27] Health and illness prevention in Europe is largely funded by the governmental services including: regulating health care, insurance and social programs. [27] The role of religion and traditional medicine, however, is often left unexamined in such reports.

The study of hypertension within the United Kingdom has turned to examining the role that beliefs play in its diagnosis and treatment. Hypertension is an essential topic for study since it is linked to increased risk of stroke and coronary heart disease. The most common treatment for hypertension is medication but compliance for this treatment plan is low. [28] A study conducted in the UK examined the differences between 'white' patients and first generation immigrants from the West Indies. There were differing reasons for non-compliance that involve the patients' perception and beliefs about the diagnosis. Patients commonly believe that high levels of anxiety when first diagnosed are the major cause and think that when stress levels decline so too will their hypertension. Other respondents in this UK based study had varying beliefs concerning the necessity of medication while others still argued that it was the side effects of medication that made them end their prescribed regimen. [28] West Indian respondents whose lay culture teaches them to reject long-term drug therapy opted instead for folk remedies in higher numbers than the 'white' respondents. What can be seen here is that some people will choose to ignore a doctor's expert advice and will employ 'lay consultation' instead. [28]

Regions of the WHO World Health Organisation regional offices.svg
Regions of the WHO

Before people seek medical help they try to interpret the symptoms themselves and often consult people in their lives or use 'self-help' measures. [29] A study of 'everyday illness' in Finland including: influenza, infections and musculo-skeletal problems focused on reasons for consulting medical experts and explanations of illness. These common illness were examined not because of their seriousness but because of their frequency. The researchers explain five possible triggers that people seek medical aid: 1- the occurrence of an interpersonal crisis 2- perceived interference with social and personal relations 3- perceived interference with vocational & physical activity 4- sanctioning by other people 5- sufferers ideas about how long certain complaints should last. These kind of explanatory models are part of the process that people use to construct medical culture. [29] They give meaning to illness and health, answer questions about personal responsibility about health and most importantly are part of the dialogue between patients' and professionals' illness explanations. It can help explore why some patients will follow a doctors instructions to the letter and others ignore them completely. A patient's explanation or understanding of their illness can be much broader than a physician's and this dynamic has become a major criticism of modern medical practice since it normally excludes the "social, psychological and experiential dimensions of illness." [29]

The Finnish study examined 127 patients and the results have been different from findings in other countries where there is more 'lay consultation'. Half of the respondents did not have any lay consultation before coming to the doctors office. One-third did not try any self-treatment and three-quarters of the sample consulted the doctor within three days of symptoms developing. [29] Possible explanations are that in Finland there is an aspect "over-protectiveness" within their health care system. Many[ who? ] might conclude that the Finnish people are dependent and helpless but the researchers of this study found that people chose to consult professionals because they trusted them over some lay explanation. These results echo similar studies in Ireland that explain this phenomenon as being based in a strong work ethic. Illness in these countries will affect their work and Finnish people will quickly get treatment so they can return to work. This research out of Finland also describes that this relationship between patient and doctor is based on:

  1. national and municipal administrative bureaucracies that demand more output and more satisfied patients
  2. the public demanding better care
  3. nurses criticizing physicians for not taking a holistic view of patients
  4. hospital specialists wanting better/earlier screening for serious illnesses (e.g. cancer). [29]

The conflict between medical and lay worlds is prominent. On one hand many patients believe they are the expert of their own body and view the Doctor-patient relationship as authoritarian. These people will often use knowledge outside the medical field to deal with health and illness. Others see the doctor as the expert and are shy about describing their symptoms and therefore rely on the doctor for diagnosis and treatment. [29]

In Europe, sociology of health and illness is represented by the European Society for Health and Medical Sociology (ESHMS).

North America

Compares figures in the population of OECD countries and the percentage of total population (aged 15 and above) with a body mass index greater than 30. Data was collected between 1996 and 2003. Obesity country comparison - path.svg
Compares figures in the population of OECD countries and the percentage of total population (aged 15 and above) with a body mass index greater than 30. Data was collected between 1996 and 2003.

North America is a fairly recent settled continent, made up of the United States, Canada, Mexico, Central America, and the Caribbean. It was built by an amalgamation of wealth, ideas, culture, and practices. North America is highly advanced intellectually, technologically, and traditionally. This advantageous character of North American nations has caused a high average life expectancy of 75 years for males and 80 years for females. This leads to the conclusion that North America has cultivated a comparatively healthy society. As North America contains several core nations, the growing economies in those nations are able to maintain and develop medical institutions. This subsequently provides more access to health care for American citizens but health care is not universal. North America is known for being a leading nation in regards to industrialization and modernization, but the United States lacks federal laws regarding health care as a basic human right. This lag of health care security causes subsequent issues with pharmaceutical competition, lack of care for the elderly, and little attention to alternative medicine. [2] Health care and education are plentiful at a price and illness still persists for many reasons. [30] A main reason is that a lower- and middle-class population still exists in plentiful numbers, maintaining a group that is highly vulnerable to physical ailment.

World map showing alcohol consumption around the world Alcohol by country.svg
World map showing alcohol consumption around the world

North America's primary risk factors for illness are currently[ when? ] alcohol abuse, malnutrition, obesity, tobacco use, and water sanitation. [30] Obesity is a recent epidemic in North America. The 1990s brought a rise in the average Body Mass Index, or BMI. From the beginning and to the end of the decade, the median percent of adults who were obese rose from 12% to 20%. [30] Alcoholism is the addiction of over-consumption of alcohol and is highly prevalent in the US. There are high incidence rates in many other world regions. Roughly 61% of American adults drank in 2007, and 21% of current drinkers consumed five or more drinks at one point in the last year. There have also been 22,073 alcohol induced deaths in the United States in the past year, about 13,000 of which were related to liver disease. [31] Alcoholism has many risk factors ingrained in North American culture, such as heredity, stress from competition or availability.

The Swine Flu (also known as (H1N1) epidemic is a recent disease emerging in the early 21st century. In April 2009, during the early days of the outbreak, a molecular biologist named Dr. Henry Miller wrote in the Wall Street Journal about New York City high-school students. These students apparently brought the virus back from Mexico and infected their classmates. [32] All six cases so far reported in Canada were connected directly or indirectly with travel to Mexico as well. Flu viruses can be directly transmitted (via droplets from sneezing or coughing) from pigs to people, and vice versa. These cross-species infections occur most commonly when people are close to large numbers of pigs, such as in barns, livestock exhibits at fairs, and slaughterhouses. The flu is transmissible from human to human, either directly or via contaminated surfaces." [32]

South America

There are many diseases that affect South America, but two major conditions are malaria and Hepatitis D. Malaria affects every country in South America except Uruguay, Chile, and The Falkland Islands. Elevation is a major factor in the areas where malaria is found. The disease is spread from person to person via mosquito bites. People are typically bitten by mosquitoes at dusk and dawn. Symptoms of this disorder are: high fever, chills, sweating, headaches, body aches, weakness, vomiting and diarrhea. If left untreated, new symptoms can occur; people that are infected may experience seizures, delirium and coma. Severe cases may end in death. Malaria can be cured, but the symptoms may not become noticeable until months later. There are three forms of medication that can cure Malaria. An infected person's accessibility to these drugs is dependent upon their access to medical care and their financial situation. Literature about Malaria treatment typically is focused toward people who are tourists. Most sources are not written with the native in mind. [33]

Malaria Malaria map.PNG
Malaria

The first sign of Hepatitis D was detected in 1978 when a strange and unrecognizable internuclear antigen was discovered during a liver biopsy of several Italians who suffered HBV infection. Scientists initially thought that it was an antigenic specificity of HBV, but they soon found that it was a protein from another disease altogether. They called it "Hepatitis Delta Virus" (HDV). This new virus was found to be defective. HDV needed HBV to act as a helper function in order for it to be detected. Normally Hepatitis B is transmitted through blood or any type of blood product. In South America Hepatitis D was found to be fatal. Scientists are still unsure in what way this disease was being transmitted throughout certain South American countries. Sexual contact and drug use are the most common means of transmission. HDV is still considered an unusual form of hepatitis. Agents of this virus resemble that of plant viroids. It is still hard to tell how many stereotypes exist because HDV is under the umbrella of HBV. HDV causes very high titers in the blood of people who are infected. Incubation of Hepatitis D typically lasts for thirty five days. Most often Hepatitis D is a co-infection with Hepatitis B or a super-infection with chronic hepatitis. In terms of super infections there are high mortality rates, ranging seventy to eighty percent; in contrast with co-infections which have a one to three percent mortality rate. There is little information with the ecology of Hepatitis D. Epidemics have been found in Venezuela, Peru, Columbia, and Brazil. People who are treated for Hepatitis B have been able to control Hepatitis D. People who have chronic HDB will continue to get HDV. [34]

Another disease that affects South America is HIV and AIDS. In 2008 roughly two million people had HIV and AIDS. By the end of 2008 one hundred and seventy thousand people were infected with AIDS and HIV. Seventy seven thousand people died from this disease by the end of that year. Brazil has the most people that are affected with AIDS and HIV in South America. Forty-three percent of people in Brazil have HIV.[ citation needed ] In Brazil sixty percent of the inhabitants use drugs, are HIV positive, and are HIV positive because of their drug use. Usually this disease is transmitted by either drug use involving needles or unprotected sex. Sharing needles and being infected with HIV and AIDS is most common in Paraguay and Uruguay. South America is trying to get treatment to the thousands of people infected by this disease. Brazil is offering generic AIDS prescriptions that are much less expensive than the name brand drugs. One hundred and eighty-one thousand inhabitants in Brazil who were infected are being treated. That accounts for eighty percent of those who needed immediate help. This aid from the government has had positive results. Statistics show that there was a fifty percent decrease in mortality rates, approximately sixty to eighty percent decrease in morbidity rates and a seventy percent decrease in hospitalization of infected people. [35]

In very remote areas of South America, traditional healers are the only forms of health care people have. [36] In north Aymara and south Mapuche, where the indigenous groups have the strongest voices, they still heavily use traditional medicine. The government in Chile has implemented an Indigenous Health System to help strengthen the health care system. Even with Chile's indigenous groups, Chile still has the best public health services in South America.[ citation needed ] They also have the lowest mortality rates in the area. Their health care policies are centered around family and community wellbeing by focusing on the strategies for prevention health strategies. Reports have shown an increase in mental health issues, diabetes, and cardiovascular diseases. [37]

South America's economy is developing rapidly and has a great deal of industries.[ citation needed ] The major industry in South America are agriculture. Other industries are fishing, handicrafts, and natural resources. Its trade and import-export market is continually thriving. In the past South American countries moved slowly in regards to economic development. South America began to build its economy ever since World War II. South America's largest economies are Brazil, Chile, Argentina, and Columbia. Venezuela, Peru, and Argentina's economy are growing very rapidly. [38]

See also

Related Research Articles

Tropical medicine medical specialty

Tropical medicine is an interdisciplinary branch of medicine that deals with health issues that occur uniquely, are more widespread, or are more difficult to control in tropical and subtropical regions.

A syndemic or synergistic epidemic is the aggregation of two or more concurrent or sequential epidemics or disease clusters in a population with biological interactions, which exacerbate the prognosis and burden of disease. The term was developed by Merrill Singer in the mid-1990s. Syndemics develop under health disparity, caused by poverty, stress, or structural violence and are studied by epidemiologists and medical anthropologists concerned with public health, community health and the effects of social conditions on health.

A chronic condition is a human health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time. The term chronic is often applied when the course of the disease lasts for more than three months. Common chronic diseases include arthritis, asthma, cancer, chronic obstructive pulmonary disease, diabetes and some viral diseases such as hepatitis C and acquired immunodeficiency syndrome. An illness which is lifelong because it ends in death is a terminal illness.

Diseases of poverty is the term used to describe diseases that are more prevalent in the low-income population. It includes infectious diseases as well as diseases related to malnutrition and poor health behaviors. Poverty is one of the social determinants of health. The World Health Report, 2002 states that diseases of poverty account for 45% of the disease burden in the countries with high poverty rate which are preventable or treatable with exciting interventions. Diseases of poverty are often co-morbid and ubiquitous with malnutrition.

HIV/AIDS Spectrum of conditions caused by HIV infection

Human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV). Following initial infection, a person may not notice any symptoms or may experience a brief period of influenza-like illness. Typically, this is followed by a prolonged period with no symptoms. As the infection progresses, it interferes more with the immune system, increasing the risk of developing common infections such as tuberculosis, as well as other opportunistic infections, and tumors that rarely affect people who have working immune systems. These late symptoms of infection are referred to as acquired immunodeficiency syndrome (AIDS). This stage is often also associated with unintended weight loss.

Globalization, the flow of information, goods, capital, and people across political and geographic boundaries, allows infectious diseases to rapidly spread around the world, while also allowing the alleviation of factors such as hunger and poverty, which are key determinants of global health. The spread of diseases across wide geographic scales has increased through history. Early diseases that spread from Asia to Europe were bubonic plague, influenza of various types, and similar infectious diseases.

Unitaid organization

Unitaid is a global health initiative that is working with partners to end the world's tuberculosis, HIV/AIDS, malaria and hepatitis C epidemics. Founded in 2006, the organization funds the final stages of research and development of new drugs, diagnostics and disease-prevention tools, helps produce data supporting guidelines for their use, and works to allow more affordable generic medicines to enter the marketplace in low- and middle-income countries. Hosted by the World Health Organization (WHO) in Geneva, Unitaid was established by the governments of Brazil, Chile, France, Norway and the United Kingdom.

Health in Venezuela

From 1992 to 1993, there was a cholera epidemic in the Orinoco Delta and Venezuela's political leaders were accused of racial profiling of their own indigenous people to deflect blame from the country's institutions, thereby aggravating the epidemic. During the 1990s, the mortality rate was 318 per 100,000 population for diseases of the [cardiac system], 156 for cancers, 634 for external causes (including drowning, self-harm, violence, falls, road accidents etc, 1126 for communicable diseases such as chest infections, syphilis, meningitis, and 654 for certain conditions originating before birth.

Pakistan as a developing country is struggling in many fields in which the health system has suffered a lot, resulting in a 122 rank out of 190 countries in a World Health Organization performance report. Pakistan per capita income is 5,041 and the total expenditure on health per capita is 129, which is only 2.6% of GDP (2014). The gender inequality in Pakistan is 0.536 and ranks the country 147 out of 188 countries (2004). The total adult literacy rate in Pakistan is 55% (2014) and primary school enrolment is 73%. Life expectancy at birth is 66 years, which is the lowest in comparison to south Asian countries. The proportion of population which has access to improved drinking water and sanitation is 91% (2015) and 64% (15) respectively.

Economic impact of HIV/AIDS

HIV and AIDS affects economic growth by reducing the availability of human capital. Without proper prevention, nutrition, health care and medicine that is available in developing countries, large numbers of people are falling victim to AIDS.

Since HIV/AIDS was first reported in Thailand in 1984, 1,115,415 adults had been infected as of 2008, with 585,830 having died since 1984. 532,522 Thais were living with HIV/AIDS in 2008. In 2009 the adult prevalence of HIV was 1.3%. As of 2016, Thailand had the highest prevalence of HIV in Southeast Asia at 1.1 percent, the 40th highest prevalence of 109 nations.

HIV/AIDS in Bolivia has a less than 1 percent prevalence of Bolivia's adult population estimated to be HIV-positive and therefore the country has one of the lowest HIV prevalence rates in the Latin America and Caribbean region.

With less than 1 percent of the population estimated to be HIV-positive, Egypt is a low-HIV-prevalence country. However, between the years 2006 and 2011, HIV prevalence rates in Egypt increased tenfold. Until 2011, the average number of new cases of HIV in Egypt was 400 per year. But, in 2012 and 2013 it increased to about 600 new cases and in 2014 it reached 880 new cases per year. According to UNAIDS 2016 statistics, there are about 11,000 people currently living with HIV in Egypt. However, unsafe behaviors among most-at-risk populations and limited condom usage among the general population place Egypt at risk of a broader epidemic.

Health in South Africa

Ecuador contains three distinct climatic regions: Tropical, Highland or Sierra and Amazon rain forest. The health conditions of this country vary according to these regions. In the sierras, in cities such as Quito or Cuenca where most Ecuadorians live, health conditions most commonly associated with the tropics do not exist. For example, the types of mosquitoes which carry malaria and dengue fever cannot live at altitudes above 2300 meters as is the case in virtually all of the sierras. While there does not seem to be general agreement in the medical community about the prevalence of altitude-related conditions, some visitors to the highlands may experience symptoms. The lower atmospheric pressure of the sierras affects some individuals profoundly with difficulty in breathing, nausea and dizziness but these conditions are typically not of long duration and require a period of reduced activity and conservative eating and drinking for acclimatization. Ecuadorians living most of their lives in the sierras commonly require a brief period of re-adjustment after living at sea level for prolonged periods of time. In the low-lying coastal regions and in the Amazonian region the predictable diseases of those climates exist. Malaria, for example, is according to UN sources no longer epidemic in Ecuador. Nor is Dengue Fever. According to WHO data on confirmed cases of malaria, Ecuador had 8464 cases per 100,000 population in 2007 and 544 cases in 2012. Changes in living conditions and health care appear to have had a significant effect on this condition. The potential for these diseases does exist but mostly in isolated, economically-depressed areas of the Amazon and seacoast. Many do not realize that dengue-infected mosquitoes exist in the states of the southeastern US but do not infect inhabitants on a widespread basis. Life expectancy is approximately that of the US.

Health in North Korea

North Korea has a life expectancy of 71.69 years as of 2016. While North Korea is classified as a low-income country, the structure of North Korea's causes of death (2013) is unlike that of other low-income countries. Instead, it is closer to the worldwide averages, with non-communicable diseases – such as cardiovascular disease – accounting for two-thirds of the total deaths.

Research on race and health in the United States shows many health disparities between the different racial/ethnic groups. The possible causes, such as genetics, socioeconomic factors, and racism, continue to be debated. Different health problems, in both mental and physical health, are present in all races but are not always equally treated. Health care professionals show "implicit bias" in the way that they treat patients. In America, racism consists of stereotypes mainly that are political and economic. While this article focuses mainly on racism towards African Americans in the health field, it covers various other backgrounds including racism towards Native Americans, Asian Americans, and others while drawing comparisons between various incomes and ages. Race and health in the United States is a topic that has been researched many times over the years. There are various specific diseases that are more present among various races as well as different means for life expectancy.

Discrimination against people with HIV/AIDS or serophobia is the prejudice, fear, rejection and discrimination against people living with HIV/AIDS (PLHIV). Discrimination is one manifestation of stigma, and stigmatizing attitudes and behaviors may fall under the rubric of discrimination depending on the legislation of a particular country. HIV stands for human immunodeficiency virus. If left untreated, HIV can lead to the disease AIDS. HIV/AIDS is a sexually transmitted disease and cannot be cured, but with proper treatment, the individual can live just as long as without the disease.

Malawi ranks 170th out of 174 in the World Health Organization lifespan tables; 88% of the population live on less than £2.40 per day; and 50% are below the poverty line.

The United States intelligence community (IC) has a long history of producing assessments on infectious diseases. Most of these papers are distributed to government administrators and inform the choices of policymakers. Three of these assessments stand out as analytical products that have had important impact on the awareness, funding and treatment of infectious diseases around the world. The first paper is the National Intelligence Estimate on the Global Infectious Disease Threat, the second paper is the assessment on the Next Wave of HIV/AIDS, and the third paper was the assessment on SARS. This page summarizes the findings of these three papers and provides information about their impact.

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Further reading