Overview:

This graduate course explores some basic conceptual and theoretical aspects in medical sociology. The primary focus of the course is on understanding varying constructions and contexts of health and illness. Research in this subfield of medical sociology is vast and continues to grow by leaps and bounds and as a result, the readings in this course are meant to introduce students to a select number of topics. In addition, one class session will be devoted to the study of methods. I have provided students with a tentative list of methods materials. (see week of November 10) This list is subject to change depending upon participant’s intellectual curiosity and research interests.

The course will take the form of class discussion around weekly readings. Starting on September 15^th, each student will select a section of his/her choice and serve as the organizer and lead discussant for that section. For each section the organizer -may be one or more students depending upon class size- will provide a brief summary of the reading (approximately 5 typed pages) and propose a set of issues for discussion. Some questions organizers might want to consider when writing their summaries are:

Requirements:

Class participation and presentation: 30%. Students are expected to read required materials prior to class, prepare for leading discussion and presentation, and actively participate in all class discussions.

A critique paper: 20%. Students are to choose an original research article and offer a critique of the work- on either a theoretical or methodological level. Students may choose a work from the ‘further reading’ list or suggest a work that is relevant to their area of study. (Instructor must approve selection)

Paper: 50%. This paper is meant to help students enter the field or further their own research interests. Students have the following options: a) choose an area in the field of medical sociology and provide a systematic literature review, tracing main lines of research and theoretical/empirical issues; identify what they believe to be ‘cutting edge’ research issues for future work; b) choose a subfield of interest and identify one or two research issues, theoretical OR methodological, being debated in the literature and propose a research design to address the unsolved problem. (For example: MA departmental proposal or grant to funding agency) Due date: December 13, 1999.

Office hours are by appointment. Students will make appointments with the instructor regularly during the semester to discuss progress on their final paper, and their interests regarding methodology. (And of course, any other issues they may care to discuss) Students should plan to meet with the instructor a minimum of three times this semester.

Required Texts: Available at the University Bookstore:

Eliot Freidson, Profession of Medicine: A Study of the Sociology of Applied Knowledge. Chicago, 1988

Judith Lorber, Gender and the Social Construction of Illness. Sage, 1997

Robert Zussman, Intensive Care: Medical Ethics and the Medical Profession. Chicago, 1992

Andrew Abbott, The System of Professions: An Essay on the Division of Expert Labor. Chicago, 1988 (recommended)

Hafferty and McKinlay (eds.) The Changing Medical Profession: An International Perspective. Oxford, 1993.

A copy of each of these books will also be available at the Reserve Desk at the Undergraduate Library. In addition, journal readings are available at the reserve desk at the Undergraduate Library. (Again, may be subject to change depending on class composition) There are three copies of each reading at the reserve desk. The journals themselves are available at either Davis Library or Health Sciences Library.

There is a class web page which can be found at: http://www.unc.edu/~haritos. This should be up and running by September 8^th. Please be sure to look at this list from time to time during the semester, especially as I will be adding class session summaries, outlines, and making reading additions depending on student interests.

Handbook of Medical Sociology (4^th edition) Freeman, Levine (eds.), 1989

The Social Medicine Reader. Henderson, Strauss, Estroff, Churchill (eds.), Duke, 1997.

Applications of Social Science to Clinical Medicine and Health Policy. Aiken, Mechanic (eds.), Rutgers, 1986.

Perspectives in Medical Sociology. Phil Brown, Wadsworth, 1986.

Medical Men and their Work. Freidson, Lorber, (eds.), Aldine, 1972.

The Sociology of Health and Illness: Critical Perspectives. Conrad, Kern, (eds.), St. Mattings, 1990

The Changing Medical Profession: An International Perspective. Hafferty, McKinlay (eds.) Oxford University Press, 1993.

For those students who have asked for references regarding qualitative methodology and insights for their work in this field:

The Focused Interview: A Manual of Problems and Procedures. (2^nd edition) Merton, Fiske, Kendall. (eds.) Free Press, 1990.

Research Interviewing: Context and Narrative. Elliot G. Mishler. Harvard University Press, 1991.

The Focus Group. D. Morgan and R. Krueger. (eds.) Sage, 1998.

The Research Interview: Uses and Approaches. Brenner, Brown, Canter. (eds.) Academic Press, 1985

Issues in Participant Observation: A Text and Reader. McCall, Simmons. (eds.) Addison-Wesley, 1969.

Contemporary Field Research: A Collection of Readings. Emerson. (ed.) Little Brown, 1983.

Analyzing Social Settings. (3^rd edition) Lofland, Lofland. (eds.) Wadsworth, 1995.

Robert K. Merton, "On Sociological Theories of the Middle Range," in Merton Social Theory and Social Structure. Free Press, 1968. ]

Class Schedule and Readings:

August 18^th- Brief class. Books should be available at the University Bookstore by end of this week. Amazon is another source- cheaper and sometimes quicker.

August 25: Social Constructions I: Illness as a biological and social state (NB – This will be the only class where I will lecture, for the most part. Class will be ‘model’ upon which future student presentations are given. Handout guide for reading will be available on the web page on August 23.)

Freidson, Profession of Medicine, Chapters 10, 11, 13: "Illness as Social Deviance", "Sociological Types of Illness"; "The Lay Construction of Illness".

P. Brown, "Naming and Framing: The Social Construction of Diagnosis and Illness," Journal of Health and Social Behavior (JHSB) 1995, 40^th Anniversary Issue, 34-52. Reserve UL.

Link and Phelan, "Social Conditions as Fundamental Causes of Disease," JHSB 1995, 40^th Anniversary Issue, 80-94. Reserve UL.

A. Segall, N. Chappell "Making sense out of sickness: Lay explanations of chronic illness among older adults," Advances in Medical Sociology, (AMS) Vol. 2, pp. 115-133, 1991. Reserve UL.

Uta Gerhardt, Ideas about Illness: An Intellectual and Political History of Medical Sociology. New York: NYU Press, 1989

Rose, The Strategy of Preventive Medicine. Oxford University Press, 1992.

Dubos, Mirage of Health. Allen & Unwin, 1960.

Meredith Tursshen, The Politics of Public Health. New Brunswick: Rutgers University Press, 1989.

Landrigan, Selikoff (eds.), Occupational Health in 1990s: Developing a Platform for Disease Prevention. Annals of the New York Academy of Sciences, Vol. 572, 1989.

J. Lorber, Gender and the Social Construction of Illness. Entire book.

C. Horton, "Women have headaches, Men have backaches," pp. 143-155 in Henderson, Strauss, Estroff, Churchill, (eds.), The Social Medicine Reader. Durham: Duke University Press, 1997.

R. Saltonstall, "Healthy Bodies, Social Bodies: Men and Women’s Concepts and Practices of Health in Everyday Life," Social Science and Medicine (SSM) Vol. 36, No. 1, pp. 7-14, 1993. Reserve UL.

S. MacIntyre, "Gender Differences in the Perceptions of Common Cold Symptoms". SSM Vol. 36, No. 1, pp. 15-20, 1993.

Barbara Katz Rothman, Recreating Motherhood: Ideology and Technology in Patriarchal Society. Norton, 1989.

Chapter 5, "Patriarchy and the Professions," in K. Macdonald, The Sociology of the Professions. Thousand Oaks, CA: Sage Publications, 1995.

Rushing, "The Functional Importance of Sex Roles and Sex Related Behavior in Societal Reactions to Residual Deviants," JHSB Vol. 20 Sept. 208-217.

Rosenfield, "Sex Differences in Depression: Do Women always have Higher Rates?" JHSB 1980, Vol. 21 March 33-42.

Rosenfield, "Sex Roles and Societal Reactions to Mental Illness: The Labeling of ‘Deviant’ Deviance," JHSB 1982, Vol. 23 March 18-24

Ripa, Women and Madness: The Incarceration of Women in 19th Century France. University of Minnesota, 1990.

Readings will be made available on Friday, September 10^th.

D. Light, "Toward a New Sociology of Medical Education," JHSB Vol. 29, pp. 307-322, 1988. Reserve UL.

P. Conrad, "Learning to Doctor: Reflections on Recent Accounts of the Medical School Years," JHSB Vol. 29, 323-332, 1988. Reserve UL.

S. Bloom, "Structure and Ideology in Medical Education: An Analysis of Resistance to Change," JHSB Vol. 29, 294-306, 1988. Reserve UL.

R.K. Merton, "Some Preliminaries to a Sociology of Medical Education," pp. 3-79, in Merton, Reeder, and Kendall, (eds.), The Student Physician. Cambridge: Harvard University Press, 1969 [1957]

E. Freidson, Profession of Medicine, Chapters 1-4: "The Emergence of Medicine as a consulting profession", "Political Organization and Professional Autonomy", "The Medical Division of Labor", "The Formal Characteristics of a Profession".

R. Fox, "Training for Uncertainty," pp. 207-241, in Merton et al., The Student Physician.

A. Abbott, The System of Professions: pp. 33-113.

Talcott Parsons, The Social System. Glencoe, Ill.: Free Press, 1951. Chapter 10: "Social Structure and Dynamic Process: The Case of Modern Medical Practice," pp. 428-479. Reserve at UL.

E. Freidson, Profession of Medicine, Chapter 5-9: "Everyday work settings of the professional", "Patterns of practice in the hospital", "The Test of Autonomy", "The Clinical Mentality", "Profession as Organization".

A. Abbott, The System of Professions, Chapter 5, "Internal Differentiation and the Problem of Power," pp. 117-142.

Rosemary Stevens, "The Changing Hospital" in Aiken and Mechanic (eds.), Applications of Social Science to Clinical Medicine and Health Policy. Rutgers, 1986.

Rosemary Stevens, In Sickness and in Wealth: American Hospitals in the 20^th Century. Basic, 1989

Freidson, Doctoring Together: A Study of Professional Control. Elsevier, 1975.

Rosenberg, Care of Strangers: Rise of America’s Hospital System. Basic 1987

Rothman, Conscience and Convenience. Little Brown, 1971

Rothman, The Discovery of the Asylum. Little Brown, 1980

D. Mechanic, "Sources of Countervailing Power in Medicine" Journal of Health Policy, Politics, and Law (JHPPL) Vol. 16, No. 3, Fall 1991, pp. 485-497.

D. Light, "Professionalism as a Countervailing Power," (Commentary) JHPPL Vol. 16, No. 3, Fall 1991, pp. 499-507

F. Hafferty, D. Light, "Professional Dynamics and the Changing Nature of Medical Work," JHSB 40^th Anniversary Issue, 1995, pp. 132-153.

J. McKinlay, J.D. Stoeckle, "Corporatization and the Social Transformation of Doctoring," Reserve UL.

Irving K. Zola, "Bringing our Bodies and Ourselves Back In: Reflections on a Past, Present, and Future ‘Medical Sociology’," JHSB Vol. 32, 1991, pp. 1-16.

R, Fox, "The Medicalization and Demedicalization of American Society," pp. 390-394, in Conrad and Kern, (eds.), The Sociology of Health and Illness.

E. Freidson, "The Medical Profession in Transition", in Aiken and Mechanic (eds.), Applications of Social Science to Clinical Medicine and Health Policy. Rutgers, 1986

"Professional Dominance, Deprofessionalization, Proletarianization and Corporatization Perspectives: An Overview and Synthesis," in Hafferty and McKinlay, The Changing Medical Profession.

The Milbank Memorial Quarterly, Special Issue #4, 1988. Changes in the Medical Profession.

Readings to be arranged from The Changing Medical Profession: An International Perspective.

The Milbank Memorial Quarterly

JAMA and the NEJM

D. Mechanic, "Medical Sociology: Some Tensions among Theory, Method, and Substance," JHSB Vol. 30, 1989, pp. 147-160. Reserve UL.

C. Kadushin, "The Friends and Supporters of Psychotherapy: On Social Circles in Urban Life" ASR Vol. 31, No. 6, 1966, pp. 786-802. Reserve UL.

J. Coleman et al., "The Diffusion of an Innovation among Physicians," Sociometry pp. 253-270. Reserve UL.

H. Menzel, E. Katz, "Social Relations and Innovation in the Medical Profession: The Epidemiology of a New Drug," Public Opinion Quarterly Winter 1955-56, pp. 337-352. Reserve UL.

Schneider and Conrad, Having Epilepsy: Chapter 1 and Appendix.

Erving Goffman, Asylums. Garden City, NY: Anchor Books, 1961. Selected readings

Srole, Fischer, Mental Health in the Metropolis: The Midtown Manhattan Study. New York: Harper, 1962.

M. Hardesty, P. Geist, "Physicians’ self-referent communication as management of uncertainty along the illness trajectory," in AMS, Vol. 1, 1990, pp. 27-55. Reserve UL.

E. Idler, R. Angel, "Age, Chronic Pain, and Subjective Assessments of Health," AMS Vol. 1, 1990, pp. 131-152.

B. Pescosolido, "Illness Careers and Network Ties: A Conceptual Model of Utilization and Compliance," in AMS Vol. 2, 1991, pp. 161-185.

Freidson, Patients’ Views of Medical Practice: A Study of Subscribers to a Prepaid Medical Plan in the Bronx. Russell Sage Foundation, 1961.

Research Methods in Health Care: A Selection of Articles from the Milbank Memorial Fund Quarterly. McKinlay, ed., 1973.

November 17: TBA

Readings for this class will be arranged according to students’ interests.