This course explores some basic theoretical issues regarding health and health care in present day society. The course offers a sociological orientation to the study of the meaning of health, the medical profession, and the system in which health care is delivered. Throughout the semester we will explore values and assumptions underlying the medical definition of health. Readings are taken from the medical sociology literature and the course will focus on the following topic areas:

As this is an upper level undergraduate course, it’s designed is based on the premise of ‘active learning’: student participation through assignments and oral presentations of readings. Class discussions, handouts, and assignments are designed to encourage you to think like a medical sociologist by applying various theories and concepts to health and health care.

Texts and coursepak:

Two readers and a small coursepak are required for this class. The coursepak can be purchased at Copytron and the readers can be purchased at the University Bookstore:

Readings in Medical Sociology. Cockerham, Glasser, and Heuser (eds.) Prentice Hall (referred to on syllabus as CGH)

Health, Illness and the Social Body. Freund and McGuire, 3^rd ed. Prentice Hall (referred to on syllabus as FM)

In an effort to offset the cost of the coursepak, six required readings can be found at the Undergraduate Library Reserve Desk. These are listed under the course ID (Soci. 169) by author.

My office hours for this semester are on Wednesday afternoons from 3:30 – 5:30. I schedule 15 minutes per student meeting and there will be a sign-up sheet posted on my door at the beginning of every week. If a student requires a longer meeting students are permitted 30 minutes per meeting. (No more). Short, simple questions are best answered via email. I check my email twice a day, once in the morning and once again at 6:00 pm, and I try to respond within 24 hours. My email address is haritos@email.unc.edu. The class will also make use of a listserver so messages can be posted to all students. Please check your emails daily for listserver announcements, in case of class cancellation, changes in readings or assignments. In addition there is a class web page, http:// www.unc.edu/~haritos, where you can easily retrieve the syllabus, handouts, assignments, and other important class information.

Student summaries: Class format of this class is a combination of lecture and student participation. As this is an upper level course, students will be required to provide a weekly summary of readings and will also be called upon to lead discussions. These summaries are meant to get students think critically about issues and to include their own thoughts and opinions on what they have read. (I will provide you will further details during the second week of class) Students sometimes have difficulty in getting the gist of writing summaries, so stick with it. I will provide you with comments and may suggest that students come to see me during office hours to discuss progress or problems. Readings and presentations constitute 30% of your final grade.

Group assignments: To help you apply concepts and theories you will be asked to write up four (4) short written assignments. Early in the semester the class will be separated into groups and students will work in these groups for all four assignments. Assignments are structured around a specific issue. Each assignment will be discussed in class and details will be provided one week before the assignment is due. All assignments must be typed, double-spaced. No exceptions and no late assignments will be accepted. The dates are firm and failure to comply will result in a grade of zero for that assignment. Assignments constitute 20% of your final grade.

Exams: There will be a midterm and a final for this course. Both are take home exams and require careful thought and integration of class lectures and readings. Each exam is worth 25% of a student’s grade. The dates for exams are firm: October 11 for midterm and December 11 for final. Make up examinations will be provided only upon my approval. (A cold or being admitted to health services will not automatically excuse you from an exam) Please note that make-up examinations are oral.

Your final grade is based on your overall performance in this course. This means that I consider a student’s overall improvement in the course. Please note that I do not grade on a curve and the class grading scale is as follows-

A = 100-97                    C+ = 80-77

A- = 96-93                     C = 76-73

B+ = 92-89                    C- = 72-69

B = 88-85                      D = 68-65

B- = 84-81                     F < 65

The university honor code holds for all assignments and examinations. Read the provisions carefully and make certain that you fully understand and adhere to them. You are to sign the honor pledge on all assignments, group projects, and examinations.

Readings preceded by an asterisk ‘*’ are found in the coursepak

August 23–25:

FM: A sociological perspective, 1-9; Mind Body and Society, 74-98; The social construction of medical knowledge, 188-97.

CGH: Health, Illness, and Healing in an Uncertain Era, 3-20

Fisher: Chapter 2: Situated knowledge (reserve)

August 30:

Movie – in class viewing of Lorenzo’s Oil

September 1:

Discussion of Lorenzo’s Oil- follow handout

September 6: No class –Labor Day

September 8-13:

FM: Ideas and Ideologies on the construction of medical knowledge, 198-206 (top); Illness experience, 138-163

Kleinman: Chapter 1: The meaning of symptoms and disorders (reserve)

Kleinman: Chapter 2: The personal and social meanings of illness (reserve)

September 15:

FM: The social meanings of sickness, 117-36

*Brown: Naming and Framing: The social construction of diagnosis and illness

*Rosenhan: On being sane in insane places

*Szasz: The myth of mental illness

September 20: Assignment on health and everyday life: An interview

September 22-27:

CGH: Health behavior, 163-204; Healing options, 257-272

FM: Alternative healing systems, 177-186

Handout: Practice and Culture, 38-42

September 29, October 4, October 6:

FM: Modern biomedicine, knowledge and practice, 217-241

CGH: A critical theory of medical discourse, 273-97; Emotional expression during medical encounters, 298-314

*Zola: Structural constraints in the doctor-patient relationship: The case of noncompliance

*Conrad: The meaning of medications: Another look at compliance

October 6: Midterm examination distributed. Due in on Monday, October 11

October 11: In class assignment: Playing the sick role

October 13: No class, winter break

October 18-20:

FM: Seeking health and help, 165-176

CGH: Beyond rational choice, 205-223; Stress, coping and social support processes, 109-139

October 25-27:

*Gallagher: Chapter 21: Content and Context in health professional education

*Light: Chapter 22: Social control and the American health care system

October 27: Assignment: To Tell the Truth – The Ideal Physician

November 1-3:

CGH: Toward a new sociology of medical education, 315-334; Learning to doctor, 335-345; Gender and medical socialization, 346-358

Rosser: Chapter 9: More than add women and stir (reserve)

Rosser: Chapter 10: A chilly climate for women in medicine (reserve)

November 8, 10, 15:

Freidson: How dominant are the professions?

Wolinsky: The professional dominance, deprofessionalization, proletarianization and corporatization perspectives: An overview and synthesis.

CGH: Physicians in a changing society, 359-404

*Light: Countervailing power: The changing character of the medical profession in the US

November 17:

FM: Economic interests and power in health care, 278-320

CGH: Why congress did not enact health reform, 471-475; Whatever happened to the health insurance crisis in the US? , 476-484

November 22: Assignment on health care decisions

November 24: No class, Thanksgiving break

November 29, December 1

CGH: Women in a women’s job, 405-420

FM: Stratification and power in health care systems, 248-276

*Fisher: Chapter 7: Institutional patterns of interpretation

December 6: Review

December 11: Final examination, 4 pm.