Sociology of Medicine: Sociology 322, Spring, 2004
(CRN 53967), WF
Prof. Carl Milofsky Office: Coleman 204, ph: 73468, Office Hours MW 11-12; email: milofsky@bucknell.edu; ERES Password=health
class website:
http://www.facstaff.bucknell.edu/milofsky/
Course Project Space: You can find the folder on Netspace/Projects. It is called: health-research
The web address (if a page is created) will be: http://www.students.bucknell.edu/projects/health-research
This course will give an overview of the sociology of medicine with the objective of giving upper level sociology students some understanding of how the discipline structures this sub-field. The course is not only more advanced than SOCI 130 but also is less meant as a general information course than a course for serious social science students. To that end, in addition to reading and discussing academic texts the class will engage in some collective research projects.
This class has an unusual structure because everything we do will be done in concert with ECON 312, Health Economics, taught by Prof. Amy Wolaver. We have synchronized our syllabi so that important topics in the social science approach to health and medicine will be covered each week from a sociological perspective in our class and from an economics perspective in Wolaver’s class. We have some students registered in both classes but students from both sides are encouraged to audit class sessions from the other discipline as your time allows. The instructors will attend both class sessions and we are confident that students from both disciplines will be able to handle material in both courses.
One way the courses will coordinate work is by having a common class on Wednesdays during which time we will discuss research issues. Our plan is for students in the two classes to work together on projects and these Wednesday sessions will be a time when some necessary coordination will happen. We have the general idea that economics students will concentrate more on quantitative aspects of the research while sociology students will concentrate more on ethnographic, field observation research and organizational studies.
However, students in both disciplines need to learn and understand the range of skills from qualitative to quantitative. We hope all students will participate in community survey days that will be organized at various times during the semester. The whole class will also work together in developing issues or problems we hope to explore through research, in identifying issues we want to learn about and formulating questions, in developing interview outlines and questionnaires, in administering those research instruments, and in analyzing results. We also hope to access various kinds of statistical data on communities we plan to study and we expect that sociology students will want to know how these data are organized, how to access this kind of information, and how to assess whether the quantitative data fit the qualitative situations we are seeing on the ground.
Grading will be based on the following:
Two exams (takehome midterm and final), 20% each 40%
Three short research reports 20%
One final research report, 30%
Participation 10%
Two publications will be in the bookstore although both publications may be delayed in showing up there:
Renée Fox, The Sociology of Medicine. A Participant Observer’s View (Engelwood Cliffs, NJ: Prentice-Hall 1989)
Carl Milofsky and Jo Anne Schneider, The Field Notes Manual. Doing Ethnography in Sociology and
Anthropology (
This course will be organized on Blackboard and there
will be ERES readings. I also use my personal
website for the course for many class purposes so be sure you know how to
access that web page and if you cannot find things you expect to find on
Blackboard look on the website.
The following is a detailed schedule of assignments for the semester. This
schedule is likely to be changed as we go along. The correct and updated
version of the syllabus will be maintained on Blackboard and on the course
website. The schedule will tell you the
specific reading requirements you must do, the order in which they will occur,
and what the writing assignment and examination schedule is.
Jan 21 Introduction and Overview. Introduce research component and discuss community studies and the variety of projects students can choose.
**Read** On ERES Field Notes Manual, “Introduction”, pp 1-12.
Jan 23 The
social and cultural construction of health
**Read** On ERES Consumer Reports, “Cut the Fat”, Jan. 2004:
12-16; Mim Udovich, “A
Secret Society of the Starving”, New York Times Magazine, September 8,
2002: 18, 20, 22, 66, 68; Fox, Chapter 1, “The Social and Cultural Significance
of Health and Illness,”
pp 1-37.
Jan 28 Access, risk, and the protection of human subjects.
**Read** Field
Notes Manual, Chs.
3 and 7.
Brandt, A.M., “Racism and Research: The Case of the Tuskgegee
Syphilis Experiment,” pp 392-405 in J.L. Leavitt and R.L. Numbers (eds.), Sickness
and Health in
Jan 30 Sickness as deviance; youth and risky
behavior.
**Read** On ERES Howard Becker,
"Becoming a Marijuana Smoker", Ch 3,
pp 41-58 in Outsiders. Studies in the Sociology of Deviance (New
York: Free Press 1973); Kristin Luker, "Why Do They Do It?", Ch 6, pp 134-174 in Dubious Conceptions: The Politics of Teenage
Pregnancy (
Feb 4 Qualitative Research Versus Quantitative Research (or the
little picture: sampling and question development)
**Read** Field Notes Manual, Chs 5. E. Babbie, “Survey Research”, pp 238-278 in The
Basics of Social Research 2nd ed. (Wadsworth 2002).
We
will meet in the computer lab and spend some time familiarizing ourselves with
SPSS.
**Writing** First research assignment
due for sociology students.
Feb 6 Health as a social experience versus medical treatment.
**Read** A. Kleinman, “Conflicting
Explanatory Models in the Care of the Chronically Ill: The Voice of Medicine and the Voice of the Lifeworld”, pp 95-103 in H.D. Schwartz (ed.), Dominant Issues in Medical Sociology 3rd
ed. (NY: McGraw Hill 1994). R.C.R. Taylor, “The Politics of Prevention”, pp 368-388 in P.
Brown, Perspectives in Medical Sociology
(Prospect Heights, IL: Waveland Press 1989).
Feb 11 Statistical analysis of data
**Read** Trochim, 2000, Research Knowledge Data Base---Types of data, unit of analysis, two research fallacies, deduction and induction, descriptive statistics.
Feb 13 The theory of professions: moral community vs. cartel.
**Read**
Feb 14 Community survey in
Feb 18 Qualitative observation and writing field notes
**Read** Field Notes Manual, Ch 8
**Writing** Second research assignment due for sociology students.
Feb 20 Medical errors and the social control of physicians.
**Read**
Feb 21 Snow date for Antrim community survey.
Feb 25 The art of medicine and variability in medical community practices
**Read**
A.S. Elstein, L.S. Shulman,
and
**Writing** Take home exam distributed.
Feb 27 Secondary Data Analysis
**Read** Field Notes Manual, Ch 11
Mar 3 Ecological analysis.
**Read** Eric Klinenberg, Chs
1 and 2 in Heat Wave. A Social
Autopsy of Disaster in
Mar 5 The social class gradient of disease; job stress and health; health as a causal factor in socioeconomic status.
**Read** Leonard Syme and Lisa F. Berkman, "Social Class, Susceptibility, and Sickness," pp 28-34, and Michael Marmot and Tores Theorell, "Social Class and Cardiovascular Disease: The Contribution of Work," pp. 95-107, both in Peter Conrad and Rochelle Kern (eds.), The Sociology of Health and Illness. Critical Perspectives. 3rd Ed. (NY: St. Martin's Press 1990.)
**Writing** Take home midterm exam due.
Mar 10 Due: SPSS assignment.Topic: Endogeneity bias (health <-> economic status) (more SPSS training?),
**Read** S. Averett and
Mar 12 Race and
health differences; racial stress and health; access to health care and
untreated conditions.
**Read** W. Michael Byrd and
Linda A. Clayton, “Introduction”, pp 1-31 in An American Health Dilemma,
Volume 2 (New York: Routledge 2002) and Helen
Epstein, “Enough to Make You Sick?”, pp 74-81, 98, 102, 104, 105, & 106 in New York Times Magazine, Oct 12, 2003
and David Williams, “Race, SES, and Health:
The Added Effects of Racism and Discrimination,” pp 21-39 in Phil Brown
(ed.), Perspectives in Medical Sociology
(Prospect Heights, IL: Waveland Press 2000).
Mar 15-19 Spring Break
Mar 24 Topic: Quantitative measures; Correlation, regression analysis- more SPSS Practice
**Read** Trochim, 2000, Research Methods Data Base, --- “inferential statistics” – “The t test”, “general linear model”
Mar 26 The Hospital
**Read** Fox, Ch 5, “The Hospital: A Social and
Cultural Microcosm,” pp 142-180. On ERES, Brad Gray, "The
Evolution of Investor-Owned Hospital Companies", pp 470-483 in Phil Brown
(ed.), Phil Brown (ed.), Perspectives in Medical Sociology, 3rd Edition
(
Mar 31 More SPSS
Apr 2 Institutional context of ethical choices about how to care for and how to give care, transplantations, indigent care
**Read** D.W. Light, "Excluding More, Covering Less: The Health Insurance Industry in the U.S.," pp 464-477 in Phil Brown (ed.), Perspectives in Medical Sociology, 2nd Edition (Prospect Heights, IL: Waveland Press 1996) and Consumer Reports, two part series: “The Unraveling of Health Insurance”, pp 48-53 (July, 2002), and “The Perils of Buying Your Own Policy”, pp 35-41 (September 2002).
Apr 7 Pulling it together. Writing a paper. Preparing and honors
proposal.
**Read** TBA
**Writing** Your third writing assignment will be a written report of the presentation you give on the remaining Wednesdays of the class which may be a summary of the project you are doing this semester or a written statement of an idea for a project you might do next year, like an honors project.
Apr 9 Institutional context of ethical choices about how to care for and how to give care, transplantations, indigent care
**Read** Carol Heimer, "Your Baby's Fine, Just Fine: Certification Procedures, Meetings, and the Supply of Information in Neonatal Intensive Care Organizations, Uncertainties, and Risk (Boulder: Westview Press 1992) and Carol. Heimer, "Life in Two Neonatal Intensive Care Units", pp 37-76 in C.A. Heimer and L.R. Steffan, For the Sake of the Children. The Social Organization of Responsibility in the Hospital and the Home (Chicago: University of Chicago Press 1998).
Apr 14 Student presentations of Research
Apr 16 Health Charities- what gets attention, how charities behave as organizations, accountability
**Read** M. Sun, "A New Arthritis Institute Nears Approval",
Science 217: 610-612 (1982) and R. Massie and S Massie, Journey,
Chapter 18, pp 260-291 (New York: Knopf 1975)(This is an excerpt from an older
book by a couple whose son was borne with hemophilia and who describe their
experience of living with the disease. This section talks about their experiences
with the Red Cross. Conditions are radically different today since a freeze-dried
version of factor VIII is now available. Unfortunately, most of the hemophiliac
population died of AIDS thanks to the blood concentration process described
in this chapter.)
Apr 21 Guest speaker: David Zanis on rural teen drug use.
Apr 23 Medicare, Medicaid, and Social Security
**Read** T. Marmor and J. Oberlander, "Rethinking
Medicare Reform", Health Affairs 17(1): 52-68 (1998) and H.J.
Aaron and R.D. Reischauer, "'Rethinking Medicare Reform' Needs Rethinking".
Health Affairs 17(1): 69-71 (1998). Also,.
Light, D.W., “The Origins and Rise of Managed Care”, pp 484-503 in P. Brown
(ed.), Perspectives in Medical Sociology
3rd ed. (
Apr 28 Student presentations of Research
Apr 30 National Health Insurance
**Read**
Starr, P. “Breaking the Job Linkage”, pp 55-69 in P. Starr, The Logic of Health Care Reform (NY:
Penguin 1994); Skocpol, T., “Mobilization against
Government,” pp. 133-172 in T. Skocpol, Boomerang.
May 7 Papers due,
May 11