Caring in the Medical Care System
Medical Sociology: Caring in the Medical Care System
UCLA
Spring 2020
Sociology Department SOC 170
Professor: Stefan Timmermans
Office Hours: Monday 2-3 pm or by zoom appointment
Office: 216 Haines Hall
E-mail: Stefan@soc.ucla.edu
The best way to get in touch with me is via e-mail.
T.A.s: Parnoor Khinda
Lexie Askins
Apurva Barve
Andrew Chalfoun
Course Description
This course takes a critical examination of the organization and operation of the medical care system. It links the institutional aspects of medical care with the experience of being a professional caregiver and a patient in the U.S.
Important Dates
Midterm handed out: Friday April 24
Book reaction paper Abraham due: Wednesday April 29
Midterm due: Friday May 1
Book reaction paper Fadiman due: Friday May 22
Final exam handed out: Friday May 29
Final exam due: Frida June 5
Reaction Papers: When we read books, I expect a written one-page reaction paper to the questions: What was interesting in the book? Do you agree or disagree with the argument the author sets forth? These short papers will not be returned but they count towards your class-participation grade. Please hand those reaction papers at the beginning of lecture on the day the reading is due. You will write two reaction papers.
The midterm and final exam will consist of essay questions (general and comparative). You have a week to finish the exam. Extensions are only allowed if you had a documented university-accepted absence for the entire exam period. Late submissions for any other reason will result in a full grade loss for the assignment for each late day. Please, turn the midterm and final as 1 file into "turnitin" and bring a hard copy of each question to class on the due date. Do not put your name on the exam but only your student ID number. Unless otherwise indicated, all work is due at the beginning of class and will be considered late ten minutes after the due time.
If you think you should have received a higher grade, please put your request with an explanation in writing within a week of the return of the essays. Your TA will respond to your request. If you are dissatisfied with the response, you can appeal to me in writing, again within a week of receiving your reply. Keep in mind that a request for a higher grade may result in a higher, unchanged, or lower grade.
You are expected to be honest in all of your academic work. Plagiarism is a serious offense. It is the presentation of another author’s words or ideas as if they were your own. University regulations require that any case of plagiarism be sent to the Dean of Students for review. If you have any questions about documentation, quotations, and related matters, please do not hesitate to ask me or the TAs before submitting your work.
Attendance and participation will be considered in borderline cases, although in my experience students who actively participate in class discussions also tend to perform better on assignments and exams. Getting engaged in this material really does enhance learning! When missing class is unavoidable, it is your responsibility to find out what material was covered and what announcements were made. Missing class is never an acceptable excuse for missing deadlines or not completing coursework. Attendance at all discussion sections is a requirement of this course. It contributes to 10% of your final grade. Missing more than one section and/or failing to participate in more than one section will lead to a reduction of 2% of your final grade (lowest score is 0%, meaning that you need to attend and participate at least 6 times to get 2%).
Online notice
This program uses video recording or other personal information capture for the purpose of facilitating the course and/or course environment. Persuant to the terms of the terms of the agreement with UCLA. The data is used solely for this purpose and any vendor is prohibited from redisclosing this information. UCLA also does not use the data for any other purpose.
Grade distribution:
Midterm: 40%
Final: 40%
Class and section participation:
-two book reactions: 10% total
-class attendance and section participation: 10%
Besides that, we work on having fun.
Reading
Abraham, Kaye Laurie, 1993,
Mama Might Be Better Off Dead: The Failure of Health Care in Urban America
Chicago: The University of Chicago Press.
Fadiman, Anne, 1997,
The Spirit Catches You and You Fall Down
New York: Noonday Press.
Starr, Paul, 1982,
The Social Transformation of Medicine,
New York: Basic Books
All articles will be available on the class website.
Schedule
Week 1
Wednesday April 1
-Welcome and introduction: The best and worst of health care in the U.S.
* COVID-19
* Roseto Effect (no reading but google it)
Part I. History of the social organization of U.S. health care
Friday April 3
-How much does the health care system matter for population health?
* Mckinlay, John and Sonja Mckinlay Medical measures and the decline of mortality, The Milbank Quarterly, Vol 55 (3), pp. 405-428.
* Cutler, David M. 2004. Your Money or Your Life: Strong Medicine for America's Health Care System. Oxford: Oxford University Press, pp. 1-10, 22-32, 47-75.
Week 2
Wednesday April 8
-Power of the medical profession
* Starr, Paul, 1982, The Social Transformation of Medicine, New York: Basic Books, chapter 3, pp. 79-145
Part II. Major health policy issues
Friday April 10
-Paying for health care
* Atul Gawande, Cost Conundrum
* Almeling, Rene, Selling Genes, Selling Gender: Egg Agencies, Sperm Banks, and the Medical Market in Genetic Material, American Sociological Review, Vol 72 (3), pp. 319-340
Week 3
Wednesday April 15
Covid-19
-Social distancing vs. Social Isolation
* Umberson, Debra, and Jenifer Montez, 2010, Social Relationships and Health: A Flashpoint for Health Policy, Journal of Health and Social Behavior, Vol 51, S54-S66.
* Hatchett, Richard, Carter Mecher, Marc Lipsitch, 2007, Public Health Interventions and Epidemic Intensity during the 1918 Influenza Epidemic, PNAS, Vol 104 (18), pp. 7582-7587.
Friday April 17
-Access to health care
* Movie “Sick around America”
* Marrow, Helen B, 2012, Deserving to a point: Unauthorized immigrants in San Francisco's universal access healthcare model, Social Science & Medicine[pic]74. 6[pic]: 846-85
* Kaiser Family Foundation: fact sheet on the uninsured and difference health insurance makes
Week 4
Wednesday April 22
-Covid-19
* Klinenberg, Eric, 1999, Denaturalizing Disaster: A Social Autopsy of the 1995 Heat Wave, Theory and Society, Vol. 28, pp. 239-295.
* Markel, Howard, Alexandra Minn Stern, 2002, The Foreignness of Germs: The Persistent Association of Immigrants and Disease in American Society, The Milbank Quarterly, Vol 80 (4), pp. 757-788.
Friday April 24
-Fatalism, personal responsibility, and rationing
* Abraham pp. 1-133
* Midterm handed out
Week 5
Wednesday April 29
* Abraham pp 133-end
Recommended: Jennifer Reich, 2020, Vaccine Refusal and Pharmaceutical Acquiescence: Parental Control and Ambivalence in Managing Children’s Health, American Sociological Review, Vol. 85 (1), pp. 106-127
* reaction paper due
Friday May 1
-Fundamental causes of disease and the role of SES
* Link, Bruce G., and Jo C. Phelan. 1995. "Social Conditions as Fundamental Causes of Disease." J Health Soc Behav extra issue:80-94.
* Marmot. 2004. The Status Syndrome: How Social Standing Affects Our Health and Longevity. (pp. 1-12, 43-5, 78-81, 160-3, 188-9, 240-1)
* Midterm due
Week 6
Wednesday May 6
-Race, Gender, and Intersectionality
* W.E.B. Du Bois. 1899. The Philadelphia Negro: A Social Study. (pp. 147-63)
* Williams David and Selina A. Mohammed. 2013. “Racism and Health I: Pathways and Scientific Evidence.” American Behavioral Scientist, Vol 57(8): pp. 1-19
* Homan, Patricia. 2019. “Structural Sexism and Health in the United States: A New Perspective on Health Inequality and the Gender System.” American Sociological Review, Vol 84(3), pp. 486-516
* López, Nancy and Vivian L. Gadsden. 2016. “Health Inequities, Social Determinants, and Intersectionality.” National Academy of Medicine, pp 1-14.
Friday May 8
-Health care reform in the U.S.
* Mechanic, David and Donna Alpine, 2010, Sociology of Health Care Reform: Building on Research and Analysis to Improve Health Care, Journal of Health and Social Behavior Vol 51 (S), S147-S159.
Week 7
Wednesday May 13
-Health care abroad: UK, Canada, and Germany
* Light, Donald W, 2011, Comparative Models of Health Care Systems, Social Science and Medicine, Vol 72 (2), pp. 129-132.
* Deber, Raisa Berlin, 2003, Health Care Reform, lessons from Canada, American Journal of Public Health , Vol. 93(1), pp. 20-24.
Part III Working, living, and dying in the U.S. health care system
Friday May 15
-Becoming a Doctor: Socialization in medical school
*In class movie
* Renee C. Fox [1988], “Training for uncertainty” in Essays in Medical Sociology: Journeys into the Field. New Brunswick: Transaction Press, pp.19-50
* Howard S. Becker and Blanche Geer, 1958 "The Fate of Idealism in Medical School" American Sociological Review, vol 28, pp. 50-56.
* Bosk, Charles, 1979, Forgive and Remember, Chicago: University of Chicago Press, chapter 2.
Week 8
Wednesday May 20
-Patient-Doctor Interaction: The sick role, paternalism, and patient-centered care
* Fadiman, Chapter 1-8
Friday May 22
-From cultural competency, cultural health capital, to structural competency, CAM
* Fadiman, Chapter 9-18
* Reaction paper due
Week 9
Wednesday May 27
-Medical technology
* Timmermans, Stefan, and Mara Buchbinder. 2010. "Patients-in-Waiting: Living Between Sickness and Health in the Genomics Era." J Health Soc Behav 51(4):408-23.
* Timmermans, Stefan and Rebecca Kaufman. 2020. “Medical Technologies and Health Inequities, Annual Review of Sociology
Friday May 29
-The engaged patient and health social movements
* Brown, Phil, et al., 2004, Embodied Health Movements: New Approaches to Social Movements in Health, Sociology of Health and Illness, Vol 2 (1), pp. 50-80.
* Barker, Kristin, 2008, Electronic Support Groups, Patient-Consumers, and Medicalization: The Case of Contested Illness, Journal of Health and Social Behavior, Vol 49, pp. 20-36.
* Best, Rachel, 2012, Disease Politics and Medical Research Funding: Three Ways Advocacy Shapes Policy, American Sociological Review, Vol 77 (5), pp. 780-803.
* Final exam handed out
Week 10
Wednesday June 3
-Disability: the social and the medical model
* Mauldin, Laura, 2012. "Parents of deaf children with cochlear implants: a study of technology and community." Sociol Health Illn 34(4):529-43.
* Sparrow, Robert. 2010. "Implants and Ethnocide: Learning from the Cochlear Implant Controversy." Disability & Society 25(4):455-66.
Friday June 5
-Conclusion
* Final Exam due
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