Current Podcasts

2015 Health & the Public: Medicine and Disease in Social Context

Here we provide links to lecture videos of the most recent year of Sociology 126 (as they become available); videos from last year are available here.  The lectures for 2015 are keyed to the syllabus for 2015.

 

Lecture 1: Course Introduction

We will briefly review the burden of illness and death in the USA, touching on the costs, family effects, and implications for people’s well-being.  We will also review the leading causes of death and how they vary by certain socio-demographic attributes.  We will note geographic variation in illness and mortality and also the relevance of circumstances of birth (including diverse in utero exposures, birthweight, birth order, parental occupation, etc.) to lifelong health.  In short, we will introduce the basic biosocial facts to be explored in the course.  And we will introduce the tension between individualistic and collective perspectives on medical care.  We will in particular consider the case of suicide and the extent to which it reflects individual decision-making or collective constraints.

Lecture 2: The Health Transition

What are the benefits of medical care? How much do doctors actually help people? What are the relative roles of curative and preventative maneuvers in the health of the public? On the population level, what have been the benefits of “big medicine”? We will consider how the nature of illness and death has changed over the last century in the U.S., as part of the “health transition.” And we will introduce some ways of defining and measuring health other than mortality, including morbidity, physical functioning, quality of life, and “utility.” We will also begin to consider the major determinants of health at the population level.

Lecture 3: The Role of Medical Care

Lectures 4 & 5: We will examine how disease and survival are distributed by basic socioeconomic variables.  What is the role of sex, race, ethnicity, education, income, marital status, and other social variables in patient preferences, patient risks, patient care, and health outcomes?  What are the methodological challenges of demonstrating and interpreting differences and inequalities in health outcomes and care?  How do we distinguish the problem of unequal outcomes from that of unequal treatment, and what is the ethical implication of this difference?

Lecture 4: Socioeconomic Status and Health

Lecture 5: Unequal Treatment or Unequal Outcomes with Respect to Race and Ethnicity

Lecture 6: The Social Construction of Illness and Medicine

How are the seemingly objective, natural or scientific concepts of “body,” “illness,” or “treatment” influenced and determined by social phenomena and the medical system itself? How does the way people come to view the world have concrete and measurable effects on their health? How do people cognitively construct medically relevant concepts, such as diagnostic categories, and how do these constructions in turn influence medical care and human experience? We will consider diverse examples, ranging from childbirth to plastic surgery to mental illness to cardiac care.

Lecture 7: Cancelled due to snow

Lecture 8: Latrogenesis and Medical Error

How common and serious are medical errors? What is the difference between harm, error, and maloccurrence? What is a “therapeutic misadventure”? How do physicians cope with the inevitability of mistakes and harm? In what ways is “iatrogenesis” (doctor-caused injury) a widespread socio-medical phenomenon? Why does harm occur and what, if anything, can be done about it? What ethical and policy issues are raised by medical mistakes?  

Lecture 9: Religion and Health

What do baboons in the Serengeti, civil servants in London, and actors in Hollywood have in common? How does relative position, and not just absolute position, matter to health? How can social structure be stressful? How can it be salubrious? What are the health consequences of stress and how might an individual’s social support buffer the adverse effect of stress on health?  

Lecture 10: Midterm #1

Lectures 11 & 12: Health Behaviors

How do individuals’ choices and behaviors affect individuals’ health risks and health status? We will consider a range of health-related behaviors that are socially patterned and that can have substantial effects on both individual and population health. We will also explore the role of broader social policies and environmental effects on individual outcomes.

Lecture 11: Obesity and Exercise

Lecture 12: Tobacco, Alcohol, and Firearms

Lectures 13, 14 and 15: Inequality, Social Hierarchy, Stress, And Social Support

What do baboons in the Serengeti, civil servants in London, and actors in Hollywood have in common? How does relative position, and not just absolute position, matter to health? How can social structure be stressful? How can it be salubrious? What are the health consequences of stress and how might an individual’s social support buffer the adverse effect of stress on health?

Lecture 13: Social Inequality and Individual Health

Lecture 14: Stress, Status, and Social Hierarchy

Lecture 15: Social Support and the Health Benefits of Relationships

Lecture 16: Neighborhood Effects on Health

We will consider how neighborhoods, as a particular form of collective social structure, may influence individual health. We will examine how local social capital and collective efficacy play a role in health. And we will examine how local physical infrastructure and medical resources affect health. In the process, we will examine geographic variation in a large variety of seemingly objective medical procedures, including the striking differences in care at the end of life and the widely varying patterns of elective surgery across the U.S.. And we will consider the phenomenon of “physician-induced demand” for medical care. 

Lecture 17: Health and Social Networks

Can there be a non-biological transmission of disease? How does the health care delivered to one person affect the health of others? Does treating depression in parents prevent asthma in their children? Does weight gain or seatbelt use or drinking by those close to you directly affect your health? We will examine the difference between social support (measured at the individual level) and social networks (construed at the group level); and we will consider how illness and health-related phenomena (ranging from sexual practices to smoking to obesity to emotions) might spread within a social network and result in positive and negative “externalities.” We will explore the evolutionary significance and biological basis for social network structure and function. We will consider very new work involving interventions in online and offline networks to improve health, including a variety of experiments in this area. We will also evaluate some of the ethical implications of using network methods to target interventions. And we will introduce the idea of computational social science and of big data. Lecture 18: Social Network Structure

Lecture 19: Social Network Intervention

Lecture 20: Social Capital
  Lecture 21: Midterm #2 Lectures 22 and 23: Behavior Genetics, Gene-Environment Interactions, and Social Epigenetics  We will consider the cutting-edge field of biosocial science, and in particular focus on the ways in which our genes are in conversation with our social environment. To what extent does our genetic makeup influence our behaviors? To what extent do our genes increase or decrease our risk for illness given particular environmental exposures? What are the biological bases of resilience? And how does the social environment come to regulate our genome? How do social exposures “get under our skin”? How are they literally embodied?  Lecture 22: How the Biological Becomes Social and Behavior Genetics

Lecture 23: How the Social Becomes Biological, Gene-Culture Co-Evolution, and Social Epigenetics

Lectures 24, 25 and 26: Public Policy and Health Care
We will examine some macro and micro public policies that can affect individual and public health. As a powerful illustration, we will examine how society might respond to the emergence of new bio-technologies that promise to provide “super-human” enhancements to the human body, and we will consider moral aspects of these developments as well as how society might regulate them. We will also consider the implications of lack of insurance for the health of over 46,000,000 Americans, a number slated to substantially decrease with the implementation of recent health reform legislation. We will close with a consideration of some illustrative individual, local, and national efforts to improve the health of the public, and with a recapitulation of the fundamental tension between individual and collective perspectives on health and health care. And we will discuss what a new era of “big data” can offer public policy as it relates to health and health care.

 

 

Lecture 24: Social Control of Individual Use of New Biotechnologies

Lecture 25: A Selection of Policy Interventions

Lecture 26: Public Health and Individual Experience