1. Which is NOT a major area of investigation in medical sociology?a. Social facets of health and disease.b. Social behavior of health care personnel and their patients.c. Social functions of health organizations and institutions. d. The relationship of health care delivery systems to other systems.e. All of the above answers are major areas of investigation in medical sociology.
Answer: E Page: 1
2. Medical sociology is an important area of study because:a. It promotes the role biology plays in social life.b. It represents a departure from the theory-heavy discipline of general sociology.c. It recognizes the role that social factors play in determining or influencing health.d. It is the result of a merger between medicine and sociology.e. None of the above.
Answer: C Page: 1-2
3. Medical sociology, as a subdiscipline, began gaining strength:a. It was always part of sociology as a major focus of classical sociologists.b. After World War II with the infusion of large amounts of federal funding for
research.c. Only in the last two decades when major worldwide health crises highlighted the
need for it.d. It never has been a major part of sociology and exists only as a small part of the
medical field.
Answer: B Page: 2
4. Which circumstance(s) particularly affected the development of medical sociology in its early stages?
a. Pressure to produce work that could be applied to medical practice and health policy.
b. Rich development of theories unique to medical sociology by academic sociologists.
c. Lack of attention on the role of medicine and health from classical theorists. d. A and Be. A and C
5. The scholar who first provided a major theoretical approach for medical sociology was:a. Durkheim.b. Parsons.c. Weber.d. Mead.e. Goffman.
Answer: B Page: 4
6. What important event occurred in 1951 that began to reorient American medical sociology toward the use of theory?
a. The Vietnam War.b. The publication of Parsons’s The Social System.c. The increase in chronic diseases.d. The growth of universities. e. The political swing towards a more conservative era.
Answer: B Page: 4
7. Talcott Parsons’s book The Social System contained which concept important for medical sociology?
a. Micro theory.b. Medicalization.c. Patient power.d. Culture.e. Sick role.
Answer: E Page: 4
8. In the case of the sick role, illness is seen as __________, and its undesirable nature reinforces the motivation to be healthy.
a. Deviance.b. Normal.c. Biological.d. Social.e. A stimulus.
Answer: A Page: 4
9. In developing his concept of the sick role, Parsons linked his ideas to which two classical theorists?
a. Marx and Goffman.b. Weber and Marx.c. Marx and Engels.d. Durkheim and Weber.
10. What is NOT a task of a sociologist in medicine?a. Analyze the social etiology or causes of health disorders b. Study the differences in social attitudes as they relate to healthc. Understand the way in which the incidence and prevalence of a specific health
disorder is related to social variables.d. Develop theory that assists in understanding social issues related to health.e. All of these are tasks of a sociologist in medicine.
Answer: D Page: 5
11. Most sociologists of medicine are employed as:a. Biostatisticians.b. Hospital workers.c. Professors at universities.d. Researchers in governmental agencies.e. Independent contractors.
Answer: C Page: 5
12. What trend(s) reduced tensions between sociologists in medicine and sociologists of medicine?
a. Most government funding is awarded to research with practical application.b. Medical sociology itself is converging with general sociology.c. Sociology of medicine became the more dominant side of medical sociology.d. A and Be. B and C
Answer: D Page: 5-6
13. The World Health Organization defines health as:a. Normality.b. The absence of disease.c. Ability to function.d. A state of complete physical, mental, and social well-beinge. All of the above.
Answer: D Page: 7
14. One of the earliest attempts in the Western world to formulate principles of health care, based upon rational thought and the rejection of supernatural phenomena, is found in the work of the Greek physician:
15. The Hippocratic Oath requires the physician to swear that he or she will:a. Help the sick.b. Refrain from intentional wrongdoing or harm.c. Keep confidential all matters pertaining to the doctor–patient relationship.d. All of the above.e. None of the above.
Answer: D Page: 8
16. The so-called “clinical gaze” is best associated with which of the following perspectives?a. Medicine of social spaces.b. Medicine of the species.c. Public health paradigm.d. “Whole person” medical care.e. None of the above.
Answer: B Page: 9
17. The medicine of social spaces is concerned with:a. Curing disease.b. Preventing disease.c. Understanding disease.d. Cataloging disease.e. All of the above.
Answer: B Page: 9
18. Decline in deaths from infectious diseases in the second half of the nineteenth century was mainly due to:
a. Improvements in diet, housing, and public sanitation.b. Better training of physicians.c. The discovery of penicillin.d. Epidemiological transitions.e. All of the above.
Answer: A Page: 10
19. The germ theory of disease is a perspective which asserts:
a. Diseases are caused by a biological agent.b. Medicine is the only true way to treat disease.c. Illness can be caused by lifestyle choices.d. Germs are conscious agents that intentionally harm their hosts.e. None of the above.
Answer: A Page: 10-11
20. Unlike infectious diseases, chronic diseases typically are _____________ and ______________.
a. Short term; incurable.b. Short term; curable.c. Long term; incurable.d. Long term; curable.e. There is no difference.
Answer: C Page: 11
21. With the transition to a greater prevalence of chronic diseases, physicians have increasingly had to take which approach to medical care?
a. The clinical gaze.b. Use of “magic bullets.”c. “Whole person” care.d. The re-mystification of disease.e. Assembly-line care.
Answer: C Page 11
22. Which of the following are TRUE about health lifestyles?a. They include behaviors like smoking, drinking, and alcohol consumption.b. They influence whether and how severely one becomes ill.c. They can be positive or negative. d. They are influenced by one’s social environment.e. All of the above.
Answer: E Page: 12
23. Which of the following have been significant factors in the most recent epidemiologic transition, which has seen a reemergence of infectious diseases?
a. Decreased attention to public sanitation.b. Globalization of trade and travel.c. Global warming and climate change.d. A and B.e. B and C.
24. The appearance of the West Nile virus in New York city reflects:a. An example of bioterrorism.b. The role of globalization in the spread of infectious diseases.c. Evidence of the declining prevalence of infectious diseases.d. The transition of infectious diseases into chronic ones.e. None of the above.
Answer: B Page: 15-17
25. One of the greatest threats from infectious diseases worldwide comes from:a. Ebola and the avian bird flu.b. Sexually transmitted diseases.c. Food contaminated with E. coli.d. Cancer and heart disease.e. All of the above.
Answer: B Page: 17
26. What caused the prevalence of STDs to soar around the globe?a. The birth control pill.b. A worldwide ideology of sexual liberation and permissiveness. c. A new pattern of employment in developing nations. d. Greater availability of multiple sexual partners.e. All of the above.
Answer: E Page: 17
27. There are two categories of bioterrorism:a. Overt and covert.b. Latent and manifest.c. Balanced and skewed.d. International and domestic.e. Medical and behavioral.
Answer: A Page: 18
28. A disgruntled coworker infects a box of pastries with dysentery, causing several staff to become ill. This is an example of:
a. Bioterrorism.b. Bioethics.c. Epidemiological transitions.d. Social causes of disease.e. None of the above.
29. In which study were syphilis patients intentionally not treated and allowed to die?a. Nazi experiments.b. Tuskegee.c. STD1976.d. Belmont.e. Zimbardo prison.
Answer: B Page: 20
30. Which is not a major bioethical issue?a. Embryonic stem cell use.b. Abortion.c. Euthanasia.d. Use of adult stem cells.e. Cloning.
Answer: D Page: 20-21
True False Questions
1. Medical sociology focuses on the social causes and consequences of health and illness.
Answer: TRUE Page: 1
2. Medical sociology is important because it focuses on the critical role social factors play in determining or influencing the health of individuals, groups, and the larger society.
Answer: TRUE Page: 1
3. Health includes a number of components which are not just biological, but also social, cultural, political, and economic.
Answer: TRUE Page: 2
4. Medical sociology is a relatively new field in sociology.
Answer: TRUE Page: 3
5. Unlike law, religion, politics, economics, and other social institutions, medicine was ignored by sociology’s founders in the late nineteenth century because it did not appear to shape the structure and nature of society.
6. The tremendous growth of medical sociology would have been possible even without financial support for applied studies provided by the government.
Answer: FALSE Page: 3
7. Talcott Parsons provided a theoretical approach for medical sociology in the 1950s that was important in the subdiscipline's early development.
Answer: TRUE Page: 4
8. The sick role presents an ideal representation of how people act when sick.
Answer: TRUE Page: 4
9. Working within an atheoretical, applied approach, Parsons was the first to demonstrate how medicine functions to exert social control within the larger social system.
Answer: FALSE Page: 4
10. The sociologist in medicine is one who collaborates directly with the physician and other health personnel in studying the social factors that are relevant to a particular health problem.
Answer: TRUE Page: 5
11. The sociology of medicine deals with such factors as the organization, role relationships, norms, values, and beliefs of medical practice as a form of human behavior.
Answer: TRUE Page: 5
12. There is a growing divergence between medical sociology and the general discipline of sociology.
Answer: FALSE Page: 6
13. At present, medical sociologists constitute the largest and one of the most active groups of people doing sociological work in the United States and Europe.
Answer: TRUE Page: 6
14. According to Michel Foucault, the development of modern medicine transformed perceptions of disease from something beyond the boundaries of knowledge to something to be scientifically studied and controlled.
15. The practice of medicine in the twentieth century was based on the premise that every disease had a specific pathogenic cause and was best addressed within a biomedical framework.
Answer: TRUE Page: 11
16. The poor have the highest rates of disease and disability of an socioeconomic group, demonstrating their greater biological disposition toward illness.
Answer: FALSE Page: 13
17. The number of sex partners an individual has is the most important risk factor in exposure to sexually transmitted diseases.
Answer: TRUE Page: 17
18. Bioterrorism represents a relatively old threat of infectious diseases.
Answer: FALSE Page: 18
19. Drug companies are typically non-profit agencies and do not benefit when academics publish articles about the effectiveness of their drugs.
Answer: FALSE Page: 20
20. The development of institutional review boards and the Health Insurance Portability and Accountability Act have eliminated ethical concerns about issues such as clinical care, informed consent, and drug testing.
Answer: FALSE Page: 20
Essay Questions
1. What factors have been important in the development of medical sociology?
2. Explain the differences between sociology in medicine and the sociology of medicine.
3. Has there been a re-emergence of infectious disease? Explain your answer?
4. What was the Tuskegee Study and why is it an important reminder of the need for ethical oversight in research?
5. Although there is no standard definition of health, there are many concepts. Provide your own definition of health. How does it relate to the World Health Organization’s definition of health?
1. The primary focus of the epidemiologist is on:a. Catastrophic disease outbreaks.b. Societal demographics.c. Health and wellness of children.d. Individual’s diseases.e. Health problems of social aggregates.
Answer: E Page: 23
2. A scientist who studies the origin and distribution of all types of diseases is best described as a(n):
a. Biochemist.b. Social worker.c. Epidemiologist.d. Demographer.e. Sociologist.
Answer: C Page: 23
3. In epidemiology, a “case” refers to:a. An investigation into an outbreak of disease or illness.b. The classification of a disorder, illness, or injury.c. A collection of a single type of disorder, illness, or injury.d. A single episode of a disorder, illness, or injury involving an individual.e. There is no such epidemiological term.
Answer: D Page: 24
4. A researcher is interested in reporting how many people in a community were diagnosed with HIV during the past month. He/she would measure the:
a. Incidence.b. Prevalence.c. Crude rate.d. Cases.e. Age-specific rate.
Answer: A Page: 24
5. Which of the following is TRUE about incidence and prevalence?a. Prevalence is used to analyze the rate at which new cases occur.b. Incidence and prevalence are interchangeable terms.c. Incidence is reported in raw numbers while prevalence is expressed as a ratio.
d. The incidence for a given disease can be low at the same time that its prevalence is high.
e. None of the above
Answer: D Page: 24
6. A ratio, such as the crude mortality rate, is expressed as:a. Total number of cases divided by prevalence.b. Total number of cases divided by incidence.c. Total number of cases divided by total population.d. Total number of cases times total population.e. Total number of cases times incidence.
Answer: C Page: 24-25
7. _________________ has special significance for a society because it is traditionally used as an approximate indicator of a society’s standard of living and quality of health care delivery.
a. Prevalence of chronic diseases.b. Life expectancy.c. Infant mortality rate.d. Crude birth rate.e. Age adjusted fertility rate.
Answer: C Page: 25
8. What is NOT a factor in the increasing emergence of epidemics?a. Increase in international transportation channels.b. Migration from rural areas into urban cities.c. Increase in public sanitation. d. All of the above.e. None of the above.
Answer: C Page: 26
9. Whose investigations into cholera outbreaks established the foundation of modern epidemiology?
a. Louis Pasteur.b. John Snow.c. Karl Marx.d. Ralph Paffenbarger.e. All these men helped lay the foundation of epidemiology.
12. As a nation shifts from primarily rural-agricultural to urban-industrial, what changes are seen in the health profile of the nation?
a. Leading causes of death change from mostly chronic diseases to infectious diseases.
b. Leading causes of death change from mostly infectious diseases to chronic diseases.
c. Infectious diseases are eliminated entirelyd. Both infectious and chronic diseases are reduced to a minimum.e. There is no difference
Answer: B Page: 29
13. What is the leading cause of death in the United States, accounting for more than one-third of all deaths?
a. Diabetes.b. HIV/AIDS.c. Stroke.d. Heart disease.e. Cancer.
Answer: D Page: 30
14. The _____________ study was important for showing that arteriosclerosis does not strike people at random as they age, but that highly susceptible individuals can be identified in advance.
15. What do studies on diet, exercise, and obesity suggest with respect to heart disease?a. Diet and physical activity have little effect on an individual’s likelihood of
developing heart disease.b. Changing one’s eating habits toward a diet low in saturated fat can reduce the risk
of developing heart disease.c. Obesity is the result of individual choices and relates little to the development of
heart disease.d. Only lengthy, vigorous physical activity has been shown to provide some
protection against heart disease.e. None of the above.
Answer: B Page: 31-35
16. At the end of 2007, the majority of AIDS cases in the U.S. were found in:a. Homosexual and bisexual men.b. Homosexual and bisexual women.c. Intravenous drug users.d. Blood transfusion patients.e. Children of a parent with AIDS.
Answer: A Page: 38
17. The lowest AIDS mortality rates for American males are found in:a. Native Americans.b. Non-Hispanic whites.c. Hispanics.d. Non-Hispanic African Americans. e. Asians.
Answer: E Page: 39
18. Since 2000, the number of AIDS cases has sharply increased in what region of the U.S.?a. Northwest.b. West.c. Midwest.d. Northeast.e. South.
19. AIDS is transmitted in Africa and some parts of Asia primarily by:a. Heterosexual contact.b. Homosexual contact.c. Intravenous drug use.d. Blood transfusions.e. Infected mother to child.
Answer: A Page: 40-41
20. Which of the following plays a particularly important role in the transmission of AIDS in Sub-Saharan Africa?
a. Government.b. Health delivery system.c. Migrant labor force.d. Homosexuals.e. Drug users.
Answer: C Page: 41
21. AIDS now affects _____________ in Africa more than ________________.a. Whites, natives.b. Children, adults.c. Homosexuals, heterosexuals.d. Men, women.e. Women, men.
Answer: E Page: 41
22. ___________ appears to be a major channel for AIDS transmission in India.a. Marijuana use.b. Mother to child transmission.c. Prostitution.d. Improper sanitation.e. Overcrowding.
Answer: C Page: 42
23. The HIV outbreak in China initially occurred among ____________ in Yunnan Province.a. Bisexuals.b. Homosexuals.c. Intravenous drug users.d. Blood transfusions recipients.e. Infected mothers to children.
24. People who become infected with HIV may be subjected to discrimination, which can isolate them socially. This social outcome is:
a. Stigma.b. Stagflation.c. Disintegration.d. Disentanglement.e. All of the above.
Answer: A Page: 42
25. _______________ activity by Latin American men is believed to be important in the infection of a large proportion of females.
a. Bisexual.b. Heterosexual.c. Intravenous drug use.d. Homosexual.e. Illegal.
Answer: A Page: 42
26. Which of the following demonstrates the sociological implications of the HIV/AIDS epidemic?
a. Its influence on modifying social norms, values, and lifestyles.b. How certain social behaviors lead to the transmission of the disease and result in a
pandemic.c. The social rejection of AIDS patients.d. Moral and religious debates over the meaning of the disease and treatment
options.e. All of the above.
Answer: E Page: 43
27. Which term describes an individual’s most important position in society and typically comes from one’s occupation?
a. Default status.b. Ordinary status.c. Master status.d. Primary status.e. Main status.
28. Since AIDS results from a private act that has extreme social consequences, serious moral and legal questions also arise about the rights of ____________ versus the welfare of _______________.
29. The current public policy approach to dealing with AIDS is:a. Through banning high-risk behaviors.b. Through mandatory universal testing.c. Through quarantine of infected individuals.d. Through safe-sex education.e. None of the above.
Answer: D Page: 43
30. Which of the following best describes influenza pandemics?a. They occur frequently but the threat to worldwide health is minimal.b. They have been mostly eliminated due to the development of vaccines such as
Tamiflu.c. They are easily contained to the region of outbreak.d. They are unpredictable and occur at irregular intervals.e. None of the above.
Answer: D Page: 44
True False Questions
1. Many sociologists working in the field of medicine are epidemiologists.
Answer: TRUE Page: 23
2. Present-day epidemiologists primarily study epidemic diseases and give little attention to other diseases such as chronic ailments or unhealthy behaviors.
Answer: FALSE Page: 23
3. Prevalence rates, when expressed as point prevalence, period prevalence, or lifetime prevalence, vary based on the disease being measured.
4. The simplest ratio computed by the epidemiologist is called the crude rate.
Answer: TRUE Page: 24
5. Crude death and birth rates are too gross a measure to be meaningful for most sociological purposes
Answer: TRUE Page: 25
6. The living conditions of early nomadic humans, with close proximity to others and exploration of new environments, was favorable to widespread and frequent epidemics.
Answer: FALSE Page: 26
7. The bubonic plague was ended in 1750 with the development of penicillin.
Answer: FALSE Page: 27
8. What a person does, who a person is, and where a person lives can specify what health hazards are most likely to exist in that individual’s life.
Answer: TRUE Page: 28
9. The social environment, referring not only to living conditions but also norms and values, can cause sickness.
Answer: TRUE Page: 28
10. Developing nations are typically characterized by a high birth rate and a high death rate, with a relatively young population.
Answer: TRUE Page: 29
11. About twice as many males die from heart disease as females, and men are more likely than women to have a worse prognosis if they survive the first serious heart attack.
Answer: FALSE Page: 30
12. Smoking is the leading cause of sudden cardiac death in the United States and quitting smoking nearly eliminates this risk after a year or two.
Answer: TRUE Page: 31
13. Pandemics are regional or local outbreaks of a disease and rarely happen.
14. HIV/AIDS first appeared in intravenous drug users in New York and San Francisco.
Answer: FALSE Page: 37
15. AIDS potentially entered the U.S. through Haiti.
Answer: TRUE Page: 38
16. Much of the fear about AIDS arises from the fact that many people who carry the virus are not aware of it.
Answer: TRUE Page: 38
17. People most at risk for developing AIDS are those who have had multiple sex partners and know little about their partners’ past sexual behavior.
Answer: TRUE Page: 38
18. In states like Mississippi and North Carolina, more black women than white men have contracted HIV.
Answer: TRUE Page: 40
19. Estimating the number of individual flu cases in an outbreak is an easy task, since almost everyone who becomes sick with the flu requires medical care.
Answer: FALSE Page: 44
Essay Questions
1. Define incidence and prevalence. Explain the relationship between the two, and identify which issues with each pertain when examining chronic and acute illnesses.
2. Recognition that germs were causal agents of disease served as a precursor to scientific findings that people come into contact with a variety of causal agents. Define all five agents, and provide examples of each type.
3. Describe the four eras of epidemiology.
4. Modification in what four lifestyle areas significantly reduce the risk of heart disease? Discuss how and why these modifications affect the risk of developing heart disease.
5. Developing and developed nations have a different pattern of disease and illness. List the most prevalent diseases in both nation types, and discuss why these differences exist.
Chapter 3 The Social Demography of Health: Social Class
Multiple Choice Questions
1. Historically, many urban clinics providing treatment for the poor were established primarily as:
a. A way to use tax dollars.b. Religious facilities.c. Medical research facilities.d. Safe houses.e. Teaching facilities.
Answer: E Page: 48
2. Several studies find that the strongest and most consistent predictor of a person’s health and life expectancy is
a. Psychological profileb. Neighborhood.c. Gender.d. Social class.e. Income.
Answer: D Page: 49
3. Susan is a white, middle-aged doctor who lives in an affluent neighborhood. Max is a young, African American lawyer living in a trendy loft district. What social variable are they most likely to share in common?
a. Ethnicity.b. Social class.c. Number of doctor visits.d. Life expectancy.e. Good self-rated health.
Answer: B Page: 49
4. A social class is a category or group of people who:a. Are in the same age range.b. Share similar ethnicity and culture.c. Live in the same neighborhood.d. Share similar levels of wealth, status, and power.e. None of the above.Answer: D Page: 49
5. Which is NOT one of the five classes proposed by Weber?
a. Upper class.b. Upper-lower class.c. Working class.d. Upper-middle class.e. All of these are correct.
Answer: B Page: 51
6. The lower class would include:a. Affluent well-educated professionals and high-level managers.b. Semi-skilled and unskilled workers, the chronically unemployed.c. Office and sales workers, small business owners, teachers, managers.d. Skilled and semi-skilled workers, lower-level clerical workers.e. All of the above.
Answer: B Page: 51
7. The National Statistics Socio-Economic Classification (NS-SEC) is a measure of class position, which is based on differences in:
a. Age and gender.b. Neighborhood.c. Income.d. Work/employment.e. Education.
Answer: D Page: 51
8. The National Statistics Socio-Economic Classification (NS-SEC) is typically used by:a. CDC.b. Americans.c. British.d. Chinese.e. Unions.
Answer: C Page: 51
9. Social status is a(n) ___________ dimension in “social class” consisting of how much esteem the person is accorded by other people.
a. Objective.b. Subjective.c. Quantifiable.d. Hidden.e. None of the above.
10. According to Weber, _________ is the ability to realize one’s will even against the resistance of others.
a. Power.b. Prestige.c. Presence.d. Principle.e. None of the above.
Answer: A Page: 52
11. In quantitative studies, what variables are used to measure socioeconomic status?a. Social and human capital.b. Income, occupational prestige, and education.c. Income and wealth.d. Status, wealth, and power.e. Neighborhood characteristics.
Answer: B Page: 52
12. Which component of social class is consistently the strongest single predictor of good health?
a. Income.b. Education.c. Wealth.d. Occupation.e. Neighborhood.
Answer: B Page: 52
13. New research is showing that the relationship between occupation, income, education, and health changes over the life course, with __________ becoming more important for health as a person moves toward older age.
a. Occupation.b. Education.c. Income.d. All of the above.e. None of the above.
Answer: C Page: 53
14. People living in poverty have the greatest exposure to risk factors producing ill health. Which of the following is a risk factor that is influenced by socioeconomic circumstances?
15. In the United States, heart disease has ______________ over the past 30 years.a. Increased.b. Decreased.c. Stayed the same.d. Been eradicated.e. Mildly increased.
Answer: B Page: 55
16. Changes in lifestyle patterns over the past decades has meant that coronary heart disease is now concentrated more among which group?
a. Upper class.b. Upper-middle class.c. Middle class.d. Working class.e. Poor/lower class.
Answer: E Page: 55
17. The type of lifestyle that promotes a healthy existence is typical in which class?a. Upper class.b. Middle class.c. Working class.d. Both A and B.e. Both B and C.
Answer: D Page: 55
18. Which of the following are more prevalent among the upper and middle classes?a. Schizophrenia.b. Anxiety and mood disorders.c. Substance-related disorders.d. All of the abovee. None of the above.
Answer: B Page: 55
19. According to Richard Wilkinson, which is the most important variable influencing a county’s overall level of health?
a. Degree of modernization.b. Access to quality health care.
c. Income inequality within a country.d. Overall wealth of the country.e. Cultural lifestyles that promote health.
Answer: C Page: 56
20. Several studies in Britain, with its universal health care, have shown that the equalization of health care alone has _____________ the disparity in health between social classes.
a. Reduced.b. Not reduced.c. Eliminated.d. Reversed.e. Exaggerated.
Answer: B Page: 56
21. Compared to other social classes, lower class individuals visit physicians _________.a. The same amount.b. Less often.c. More often.d. Not at all.e. None of the above.
Answer: C Page: 57
22. What 1980 report in Great Britain dispelled the notion that social class differences were becoming less important because of the growth of state welfare services?
a. Health in Britain.b. Disparities Report.c. Black Report.d. Whitehall Report.e. None of the above.
Answer: C Page: 57
23. The Whitehall studies conducted in Britain demonstrated that regardless of cause of death, which group had the lowest rates of mortality?
a. Senior administrators.b. Professional/executives.c. Clerical.d. Other low status jobs.e. No relation to rank.
24. The finding that even the upper middle class lives shorter than the uppermost class, and that every class lives longer than the one directly below it is evidence of what?
a. Educational differences.b. Influence of deprivation.c. Social gradient in mortality.d. Social patterning of disease.e. None of the above.
Answer: C Page: 59
25. The cause(s) of the social gradient is most likely related to differences between socioeconomic groups and classes in:
a. Self-esteem and stress levels.b. The effects of income inequality.c. Deprivation through the life course.d. Health lifestyles and social support.e. Some combination of all of the above.
Answer: E Page: 60
26. What group uses preventative services the least?a. Upper class.b. Middle class.c. Working class.d. Lower class.e. None of the above.
Answer: D Page: 60
27. Neighborhood disadvantage focuses on:a. Poor neighborhoods.b. Unhealthy urban living conditions.c. Southern states with high rates of poverty.d. Minority-populated neighborhoods.e. None of the above.
Answer: B Page: 62
28. Which of the following is NOT one of the features of neighborhoods that can influence health?
a. Physical environment.b. Support services.c. Sociocultural aspects.d. Reputation of an area.e. Racial makeup of the neighborhood.
29. ______________ neighborhoods are clean and safe, houses and buildings are well-maintained, and residents are respectful of each other and each other’s property.
a. Orderly.b. Disorderly.c. Suburban.d. Urban.e. Government.
Answer: A Page: 62
30. In order for a social variable to qualify as a cause of sickness and mortality it must meet which criteria?
a. Influence multiple diseases.b. Affect diseases through multiple pathways of risks.c. Be reproduced over time.d. Involve access to resources that can be used to avoid risks.e. All of the above.
Answer: E Page: 64
True False Questions
1. To be poor is by definition to have less of the good things in life, including health and longevity
Answer: TRUE Page: 48
2. Improved access to health services is the primary solution for advancing health.
Answer: FALSE Page: 49
3. Socioeconomic status or social class is the strongest predictor of a person’s life expectancy.
Answer: TRUE Page: 49
4. Whereas Americans focus on a person’s occupation in determining that individual’s location in a class hierarchy, British sociologists use a broader measure.
Answer: FALSE Page: 51
5. The concept of SES is derived from ideas about social stratification put forward by Weber.
6. Status indicates a person’s level of social prestige, which typically corresponds to wealth.
Answer: FALSE Page: 51
7. People with similar class standing generally have similar lifestyles.
Answer: TRUE Page: 52
8. The well-educated are more likely to smoke and less likely to exercise than their less-educated counterparts.
Answer: FALSE Page: 52
9. The relative influence of income and education on health changes over the life course.
Answer: TRUE Page: 53
10. Income is significant with respect to differences in the onset of chronic disease and physical limitations, but education is more strongly associated with the manner in which the health problems progressed over time.
Answer: FALSE Page: 53
11. Heart disease has been decreasing in Japan due to the spread of Western medicine.
Answer: FALSE Page: 54-55
12. The lower class is disadvantaged with respect to physical, but not mental health.
Answer: FALSE Page: 55
13. Wilkinson’s theory of the relationship of inequality to population health has received strong support from numerous other studies and is currently the leading explanation of health disparities.
Answer: FALSE Page: 56
14. The social gradient in mortality links chance of death to differences in hierarchy rather than deprivation.
Answer: TRUE Page: 59
15. The Black Report provided strong evidence that the lower a person is on the social scale, the less healthy that person is likely to be.
16. Recent evidence has found that unemployment itself does not cause deterioration in mental health.
Answer: FALSE Page: 60
17. Poor housing quality is a problem in less-developed countries, but not in industrialized nations.
Answer: FALSE Page: 61
18. Neighborhoods contain resources needed to produce good or poor health for its residents.
Answer: TRUE Page: 62
19. The “fundamental social cause” thesis suggests that social class contributes to poor health and mortality, but is not a direct cause.
Answer: FALSE Page: 64
20. White-collar jobs tend to be more dangerous and stressful than blue-collar jobs and to carry inferior health benefits.
Answer: FALSE Page: 65
Essay Questions
1. Social class is made of multiple components. Identify these components, and comment on their contribution to the overall idea of “social class.”
2. The poor fall victim to different diseases at different rates compared to more affluent classes. Identify some “diseases of the lower class,” and discuss why these are more prevalent.
3. What is “neighborhood disadvantage?” Discuss how it is related to health.
4. In order for a social variable to qualify as a cause of mortality, Link and Phelan hypothesize that it must meet four criteria. List those criteria. Does “social class” meet these criteria? How so, or why not?
5. Discuss the Whitehall studies conducted by Marmot. What were the main findings in terms of social class and health?
The Social Demography of Health: Gender, Age, and Race
Multiple Choice Questions
1. In 2008, a nationwide study of mortality in the United States revealed that life expectancy for part of the nation’s women had ___________ significantly between 1983 and 1999.
a. Stagnated.b. Fluctuated.c. Remained the same.d. Increased.e. Decreased.
Answer: E Page: 69
2. What has been the general pattern in life expectancy during the 20th century with respect to men and women?
a. Women outlive men only in a handful of countries.b. Both men and women gained approximately the same amount.c. Men gained more than women in the first half of the century, but dramatic social
change in recent decades has meant that women are catching up to men.d. Women gained more than men in the first half of the century but since then men
have made greater gains and the gap is narrowing.e. None of the above
Answer: D Page: 70
3. Today, women outlive men by how many years?a. 1 b. 3 c. 5 d. 7 e. 10
Answer: C Page: 71
4. ________________ is the leading cause of death for women after age 66a. Osteoporosis.b. Cancer.c. Heart disease.d. Injuries.e. Suicide.
5. Compared to women, men usually have substantial health inferiority in terms of life expectancy because of the combination of two major effects: biological and ___________ effects.
a. Physical exertion.b. Developmental.c. Social-psychological d. Environmental.e. Marital.
Answer: C Page: 72
6. _____________babies die more often than _________________ babies.a. Healthy, sick.b. Female, male.c. Male, female.d. Younger, older.e. Older, younger.
Answer: C Page: 72
7. The most dangerous job in the United States is that of a:a. Fisherman.b. Fireman.c. Police officer.d. Doctor.e. Landscaper.
Answer: A Page: 73
8. Morbidity is:a. Sadness.b. The cause of illness.c. The amount of sickness.d. The rate of death.e. All of the above.
Answer: C Page: 73
9. About _____________ Americans die each year from smoking-related diseases.a. 250,000b. 450,000c. 800,000d. 1,000,000e. 1,250,000
10. ________________ has been found to make women particularly vulnerable to psychological distress.
a. Lack of control.b. Astrological patterns.c. Climate change.d. All of the above.e. None of the above.
Answer: A Page: 79
11. In 2006, the average infant in the U.S. could expect to live for ______ years.a. 68b. 72c. 78d. 85e. 88
Answer: C Page: 80
12. What is the “fertility rate”?a. The age until a female remains fertile.b. The number of births per women of childbearing age.c. The rate of fertile women in a given country, region, etc.d. The number of pregnancies a woman has.e. None of the above.
Answer: B Page: 80
13. By 2050 it is projected that _______ of all Americans will be 65 or older.a. 10%b. 15%c. 20%d. 25%e. 30%
Answer: C Page: 80
14. What federal program provides health insurance to those 65 years and older?a. Pensions.b. Social Security.c. Medicare.d. Medicaid.e. Medihealth.
15. Which of the following trends is most likely to strain health care delivery systems and public health insurance in future years?
a. Increasing proportion of elderly in the population.b. Increasing size of the Hispanic population.c. Medical tourism.d. Reemergence of infectious diseases.e. All of the above.
Answer: A Page: 81
16. Many elderly rate their health as good despite the health problems that often accompany aging. What does this phenomenon suggest about the usefulness of self-rated heath as a tool to measure health?
a. It is not accurate and probably should not be used.b. Self-assessments are relative, since people compare themselves to others similar
in age and sex.c. As people become older they revise their definition of “healthy” to fit their
circumstances.d. Both A and B.e. Both B and C.
Answer: E Page: 82
17. What is most prevalent health problem of persons over the age of 65?a. Heart disease.b. Stroke.c. Cancer.d. Hypertension.e. Arthritis.
Answer: E Page: 83
18. Which racial group in the United States is especially disadvantaged in regard to health?a. Non-Hispanic whites.b. Non-Hispanic blacks.c. Hispanics.d. Asians/Pacific Islanders.e. American Indians/Alaskan Natives.
Answer: B Page: 83
19. The _____________ hypothesis asserts that blacks are more prone to diseases such as pyelonephritis and syphilis that may result in secondary hypertension.
c. Psychological stress.d. Physical exertion.e. Diet.
Answer: A Page: 84
20. Some research suggests that the _____________ hypothesis and the psychological stress hypothesis contribute the most to providing an answer for the higher prevalence of hypertension in blacks, since blacks in general have higher rates of hypertension than whites.
a. Associated disorder. b. Genetic.c. Psychological stress.d. Physical exertion.e. Diet.
Answer: B Page: 84
21. For all causes of death, _____________ have the highest death rates.a. Whites.b. Non-Hispanic blacks.c. Hispanics.d. Asians/Pacific Islanders.e. American Indians/Alaskan Natives.
Answer: B Page: 85
22. For all causes of death, _____________ have the lowest death rates.a. Non-Hispanic whites.b. Non-Hispanic blacks.c. Hispanics.d. Asians/Pacific Islanders.e. American Indians/Alaskan Natives.
Answer: D Page: 86
23. A major factor causing the infant mortality difference between blacks and whites is:a. Sanitation.b. Health care.c. Poverty.d. Education.e. Insurance.
24. __________ represents the convergence of biological factors with geographic origins, and cultural, economic, political, and legal factors.
a. Race.b. Age.c. Ethnicity.d. Gender.e. None of the above.
Answer: A Pages: 86
25. Although obesity affects people of all races, low-income _____________, have the highest concentration of obesity in American society.
a. Non-Hispanic whites.b. Non-Hispanic blacks.c. Hispanics.d. Asians/Pacific Islanders.e. American Indians/Alaskan Natives.
Answer: B Page: 87
26. What is the “intra-racial network effect?”a. It says that there is no difference in STDs across different racial groups.b. It discusses how health is improved by cross-cultural alliances and relationships.c. The IRNE is a theory, which says that Hispanics are more likely to have an STD
due to their residence in enclaves.d. It asserts that because of cross-cultural sex partners, STDs are spreading.e. It suggests that segregation contributes to the high rate of STDs in the black
population.
Answer: E Page: 88
27. _______________ are the largest minority group in American society.a. Non-Hispanic whites.b. Non-Hispanic blacks.c. Hispanics.d. Asians/Pacific Islanders.e. American Indians/Alaskan Natives.
Answer: C Page: 90
28. In 2050, nearly _______ of Americans will be Hispanic.a. 15%b. 20%c. 25%d. 30%e. 35%
29. What minority group is most likely to use hospital emergency rooms as their primary source of medical services?
a. Non-Hispanic whites.b. Non-Hispanic blacks.c. Hispanics.d. Asians/Pacific Islanders.e. American Indians/Alaskan Natives.
Answer: C Page: 91
30. Suicide is a major health concern for which minority group?a. Non-Hispanic whites.b. Non-Hispanic blacks.c. Hispanics.d. Asians/Pacific Islanders.e. American Indians/Alaskan Natives.
Answer: E Page: 92
True False Questions
1. A 2008 study found a decline in female life expectancy. The decline was most common in urban, low-income female populations.
Answer: FALSE Page: 69
2. The downturn in female life expectancy was due to a rise in mortality from chronic diseases related to smoking, obesity, and high blood pressure.
Answer: TRUE Page: 69
3. A decline in female life expectancy is expected in the wealthiest countries, with the highest spending on health care.
Answer: FALSE Page: 69
4. The lives of men and women used to be more predictable in that men typically behaved in certain distinct ways and women in others.
Answer: TRUE Page: 70
5. Patterns are emerging that show Americans moving toward greater inequality in mortality between the sexes.
6. Women tend to suffer from more frequent illnesses and disability, but their usual health disorders are not as serious or as life threatening as those encountered by men
Answer: TRUE Page: 72
7. Although white females live longer than white males, black males live longer than black females.
Answer: FALSE Page: 72
8. Accidents cause more deaths among females than males.
Answer: FALSE Page: 72
9. There is an inverse relationship between mortality and morbidity when gender differences are considered.
Answer: TRUE Page: 74
10. Studies of self-rated health typically show women rating their own health less positively than men do.
Answer: TRUE Page: 75
11. The current trend in the United States is toward a decrease in smoking for females, but an increase for males.
Answer: FALSE Page: 76
12. Prior to 1979, Hispanics were counted as either white or black and not as a separate racial category by the National Center for Health Statistics.
Answer: FALSE Page: 77
13. It appears that Hispanics have lower rates of smoking than either non-Hispanic whites or blacks.
Answer: TRUE Page: 77
14. Projections for 2010 put the number of elderly at around 40 million.
15. Typically, older people rate their health in a negative fashion
Answer: FALSE Page: 82
16. The adverse health situation of black Americans identifies a pattern that is generally produced by biological, not socioeconomic factors.
Answer: FALSE Page: 86
17. Perceptions of racism and racial harassment are associated with poor health.
Answer: TRUE Page: 86
18. Obesity adversely affects physical and psychological well-being.
Answer: TRUE Page: 88
19. Hispanic immigrants are generally in poor health when they arrive in the United States.
Answer: FALSE Page: 90
20. American Indians have an exceptionally high prevalence of alcoholism.
Answer: TRUE Page: 92
Essay Questions
1. Discuss the relationship between gender and overall health.
2. Various hypotheses have been suggested to explain the rates of hypertension in African Americans. Six are discussed in this chapter. Identify these hypotheses and discuss their validity.
3. What is the “Hispanic paradox?” Provide a thorough explanation, examples of this phenomenon, and discuss what makes it less of a paradox.
4. Discuss patterns of morbidity and mortality between blacks, whites, Hispanics, and Asians.
5. What health care changes should be expected resulting from our aging population?
1. Stress can be defined as:a. A heightened mind-body reaction to stimuli inducing fear or anxiety.b. A physiological change due to an environmental agent.c. A disruption in daily life caused by primarily negative events.d. All of the above.e. None of the above.
Answer: A Page: 97
2. What is an example of a stressful situation?a. Death.b. Divorce.c. Marriage.d. A and B only.e. All of the above.
Answer: E Page: 97
3. The work of ______________ reflects the symbolic interactionist approach to human behavior.
a. Durkheim.b. Thomas.c. Marx.d. Brenner.e. None of the above.
Answer: B Pages: 98
4. Symbolic interactionism is based upon the work of ________________ (founder).a. Drentea.b. Bourdieu.c. Cooley.d. Mead.e. Durkheim.
Answer: D Page: 98
5. The theory of the _______________ maintains that our self-concepts are the result of social interaction in which we see ourselves reflected in other people.
a. Looking mirror.b. Glass selfish sense.c. Looking-glass self.d. Mirror in mirror.e. None of the above.
6. Which is NOT a component of Coley’s theory?a. We see in our imagination the other person’s judgment of ourselves.b. We have a core sense of individuality, unique to each of us.c. We see ourselves in our imagination as we think we appear to the other person.d. As a result of what we see in our imagination about how we are viewed by the
other person, we experience some sort of self-feelings.e. All of these are components.
Answer: B Page: 98
7. Goffman believed that in order for social interaction to be possible, people need information about the others in a joint act. Such information is communicated through:
a. A person’s appearance.b. A person’s experience with other similar individuals.c. The social setting.d. The information communicated about her/himself through words and actions.e. All of the above.
Answer: E Page: 99
8. The positive social value that individuals claim for themselves by the line that others assume they have taken during a particular encounter is termed a _____________.
a. Veil.b. Form.c. Face.d. Shield.e. Self.
Answer: C Page: 99
9. The _____________ is more important than anything else to us, because it represents who we are and is always with us.
a. Veil.b. Form.c. Face.d. Shield.e. Self.
Answer: E Page: 100
10. The symbolic interactionist perspective, as outlined by Cooley, Thomas, and Goffman asserts that:
a. Certain situations are inherently stressful.b. Stress is caused by societal pressure to conform.c. Stress can result from an individual's perception of the meaning of a situation.
d. Stress is constant.e. All four answers are features.
Answer: C Page: 100
11. As members of society, individuals are constrained in their behavior by laws and customs. These constraints are ______________.
a. Imagined.b. Realities.c. Social nuances.d. Social facts.e. Norms.
Answer: D Page: 100
12. Durkheim suggests that society has an existence __________ the individual.a. Outside.b. Inside.c. Beside.d. Within.e. None of the above.
Answer: A Page: 100
13. Which suicide type was not fully developed by Durkheim?a. Egoistic.b. Fatalistic.c. Altruistic.d. Anomic.e. None of the above.
Answer: B Page: 101
14. ______________ suicide occurs when people become detached from society and, suddenly on their own, are overwhelmed by the resulting stress.
a. Egoistic.b. Fatalistic.c. Altruistic.d. Anomic.e. None of the above.
Answer: A Page: 101
15. __________________ suicide occurs when people suffer a sudden dislocation of normative systems where their norms and values are no longer relevant, so that controls of society no longer restrain them from taking their lives.
a. Egoistic.b. Fatalistic.c. Altruistic.d. Anomic.e. None of the above.
Answer: D Page: 101
16. ______________ suicide occurs when people feel themselves so strongly integrated into a demanding society that their only escape seems to be suicide.
a. Egoistic.b. Fatalistic.c. Altruistic.d. Anomic.e. None of the above.
Answer: C Page: 101
17. The importance of Emile Durkheim's work for understanding stress lies in his:a. Typology of three specific types of suicide.b. Denial of biological influences on human behavior.c. Insight into the link between the state of the economy and certain types of illness.d. Notion of the capability of society to create situations where people are
constrained to respond with certain behavior.e. None of the above.
Answer: D Pages: 101-102
18. Brenner’s thesis is that there are few areas of our lives not intimately affected by the state of the _________________.
a. Economy.b. Family.c. Political system.d. Environment.e. Self.
Answer: A Page: 102
19. Brenner offers two hypotheses to explain the relationship between the economy and mental health. What are they?
a. Provocation and complacency.b. Inflation and uncovering.c. Inflation and stagflation.d. Provocation and reduction.e. Provocation and uncovering.
20. What is homeostasis?a. Changing constantly.b. Physiological adaptation.c. Not moving or adapting.d. Physically growing.e. None of the above.
Answer: B Page: 103
21. The ______________ system controls heart rate, blood pressure, and gastrointestinal functions: processes that are not under the control of the central nervous system.
a. Limbic.b. Respiratory.c. Endocrine.d. Autonomic.e. None of the above.
Answer: D Page: 104
22. Who developed the theory known as the general adaptation syndrome?a. Brenner.b. Siegrist.c. Selye.d. Goffman.e. Pearlin.
Answer: C Page: 105
23. Who suggests two major types of stressors: life events and chronic strains?a. Brenner.b. Siegrist.c. Selye.d. Goffman.e. Pearlin.
Answer: E Page: 106
24. The extent of physiological damage or change within an individual depends on:a. The stimulus situation.b. An individual’s capacity to deal with the stimulus situation.c. The individual’s preparation by society to meet problems.d. The influence of society’s approved modes of behavior.e. All of the above.
25. What is defined by Turner as “the social investments of individuals in society in terms of their membership in formal and informal groups, networks, and institutions”?
a. Social facts.b. Social networks.c. Social capital.d. Social circumstances.e. None of the above.
Answer: C Page: 108
26. Putnam defines ____________ as a community-level resource reflected in social relationships involving networks, but also norms, and levels of trust.
a. Social facts.b. Social networks.c. Social capital.d. Social circumstances.e. None of the above.
Answer: C Page: 109
27. Hurricane Katrina is an example of a(n):a. Natural disaster.b. Life event.c. Chronic stressor.d. Extreme situation.e. All of the above.
Answer: E Page: 110
28. Antonovsky argues that ______________ is a personal orientation that allows an individual to view the world with feelings of confidence, faith in the predictability of events, and a notion that things will most likely work out reasonably well.
a. Confidence.b. Coherence.c. Delusion.d. Optimism.e. None of the above.
Answer: B Page: 112
29. Which situations are more stressful in the long term?a. Extreme situations.b. Non-extreme situations.c. Extraordinary life events.
30. Besides the type of change and the speed with which it occurs, the extent to which change affects a person’s life may also be important. Libby Ruch (1977) investigated this over 30 years ago and suggested that life change actually has three dimensions. Which is NOT a dimension?
a. Degree of change evoked.b. Undesirability of change.c. Depth of change expected.d. Aspect of one’s life that is affected.e. None are dimensions.
Answer: C Page: 115
True False Questions
1. Social situations can cause severe stress that, in turn, affects health and longevity.
Answer: TRUE Page: 97
2. Stress typically starts with a situation that people find non-threatening.
Answer: FALSE Page: 97
3. Mead compares the reflection of our self in others to our reflections in a looking glass.
Answer: FALSE Page: 98
4. Symbolic interaction theory emphasizes interpersonal forms of interaction.
Answer: TRUE Page: 100
5. Functionalist theory focuses on the influence of individuals on the larger society.
Answer: FALSE Page: 100
6. Functionalist theory is derived from the initial work of Emile Durkheim.
Answer: TRUE Page: 100
7. Brenner formulated the concept of the “fight or flight” pattern of physiological change to illustrate how the body copes with stress resulting from a social situation.
8. When a person experiences fear or anxiety, the body undergoes psychological changes that prepare it for vigorous effort and the effect of possible injury.
Answer: TRUE Page: 104
9. Most threats in modern society are symbolic, not physical, and they do not usually require a physical response.
Answer: TRUE Page: 105
10. A number of studies have shown that the human organism’s inability to manage the social, psychological, and emotional aspects of life can lead to health problems.
Answer: TRUE Page: 105
11. The outcome or effect of a crisis depends on how well a person comes to terms with the situation.
Answer: TRUE Page: 106
12. Mechanic believes that in social situations people use the same skills and abilities in coping with problems.
Answer: FALSE Page: 106
13. Most people have an equal degree of control in managing emotional defenses or similar motivation and personal involvement in a given situation.
Answer: FALSE Pages: 106-7
14. People’s perceptions of an event may be influenced by their intelligence.
Answer: TRUE Page: 107
15. Conformity to group-approved attitudes and definitions has been hypothesized to reduce anxiety.
Answer: TRUE Page: 108
16. Social capital is a property of individuals, not a characteristic of networks.
Answer: FALSE Page: 109
17. Social connectedness, in Putnam’s view, is one of the weakest determinants of health.
18. The lower class is characterized as having the fewest resources to cope with stress.
Answer: TRUE Page: 109
19. The upper class and the upper middle class have about the same longevity, which is greater than the lower class.
Answer: FALSE Page: 110
20. People typically flee in panic from the site of a potential disaster (natural/unnatural) area.
Answer: FALSE Page: 110
Essay Questions
1. Define social stressors, life events, and life changes. How do these concepts relate to stress?
2. How does functionalist theory explain stress? How does symbolic interaction theory explain stress? How do the two viewpoints differ?
3. Describe Patricia Drentea’s (2000) research on stress, age, and credit card debt.
4. What are the features of life events that cause stress in individuals?
5. Describe the three types of suicide outlined by Durkheim. How do they relate to stress?Chapter 6
Health Behavior and Lifestyles
Multiple Choice Questions
1. Medical sociologists divide health-oriented behavior into two general categories: ________ behavior and _________ behavior.
a. Preventative; disease causing.b. Health; illness.c. Health lifestyles; sickness.d. Health seeking; spreading.e. None of the above.
Answer: B Page: 120
2. What is defined as activity undertaken by individuals for the purpose of maintaining or enhancing their health, preventing health problems, or achieving a positive body image?
a. Health lifestyles.b. Illness behavior.c. Health behavior.d. Health promotion.e. Premedical.
Answer: C Page: 120
3. What are collective patterns of health-related behavior based on choices from options available to people according to their life chances?
a. Health lifestyles.b. Illness behavior.c. Health behavior.d. Health promotion.e. Premedical.
Answer: A Page: 121
4. According to the World Health Organization, significant improvements in health in the 19th century were brought about by what might be called ____________ methods.
a. Engineering.b. Medical.c. Preventative.d. Health lifestyles.e. Health behavior.
Answer: A Page: 121
5. According to the World Health Organization, we are currently living in the _____________ era.
a. Engineering.b. Medical.c. Postmedical.d. Hypermedical.e. Premedical.
Answer: C Page: 121
6. Crawford points out, there has been a growing recognition of positive health behaviors, facilitated by:
a. Mass media.b. Word of mouth.c. The spread of disease.d. Education.e. Technology.
7. What disease is, typically, NOT caused by particular styles of living?a. Alcoholism.b. AIDS.c. Lung cancer.d. Heart disease.e. All of these are caused by individual behaviors.
Answer: E Page: 122
8. ___________ suggested that a person’s social class position is determined exclusively by his or her degree of access to a society’s means of production.
a. Weber.b. Durkheim.c. Marx.d. Wickrama.e. Bourdieu.
Answer: C Page: 122
9. According to the sociologist Max Weber, lifestyles are based upon a person’s relationship to the means of:
a. Consumption.b. Needs.c. Wants.d. Production.e. All of the above.
Answer: A Page: 123
10. Lebensführung means ____________, and Lebenschancen means ________________.a. Life conduct; lifestyle.b. Life chances; lifestyle.c. Life conduct; life chances.d. Life chances; life conduct.e. Lifestyle; life conduct.
Answer: C Page: 123
11. ____________ refers to the choices that people have in the lifestyles they wish to adopt.a. Life chances.b. Life conduct.c. Life behaviors.d. Agency.e. None of the above.
12. Weber maintains that life __________ influence life conduct/life choices.a. Realities.b. Chances.c. Modes.d. Demands.e. None of the above.
Answer: B Page: 123
13. Health lifestyles are common to which social class?a. Upper classes.b. Upper and middle classes.c. Middle classes.d. Lower classes.e. All of the above.
Answer: E Page: 124
14. Health lifestyles emphasizing exercise, sports, a healthy diet, avoidance of unhealthy practices such as smoking, and so on originated in the:
a. Working class.b. Lower class.c. Lower middle class.d. Upper middle class.e. Upper class.
Answer: D Page: 124
15. What is a class-based set of durable dispositions to act in particular ways that shape particular facets of health lifestyles?
a. Life chances.b. Norms.c. Habitus.d. Lifestyles.e. Life conduct.
Answer: C Page: 125
16. _______________ is the notion that the more distant a person is from economic necessity, the more freedom and time that person has to develop and refine personal tastes in line with a more privileged class status.
c. Distance from mean (average).d. Distance from poverty.e. None of the above.
Answer: E Page: 126
17. What is NOT a category of social structural variables that have the potential to shape health lifestyles?
a. Class circumstances.b. Age, gender, and race/ethnicity.c. Collectivities.d. Languages/linguistics.e. Living conditions.
Answer: D Pages: 126
18. What is the likely the most powerful influence on lifestyle forms?a. Class circumstances.b. Age, gender, and race/ethnicity.c. Collectivities.d. Languages/linguistics.e. Living conditions.
Answer: A Pages: 126
19. What are collections of actors linked together through particular relationships, such as kinship, work, religion, and politics?
a. Guilds.b. Collectivities.c. Knitting circles.d. Social groups.e. None of the above.
Answer: B Page: 129
20. The interaction between life choices and life chances produces ___________ toward particular forms of action. These constitute a “habitus,” according to Bourdieu.
a. Expectations.b. Practices.c. Lifestyles.d. Dispositions.e. None of the above.
21. _____________ may be either positive or negative, but nonetheless comprise a person’s overall pattern of health lifestyles.
a. Expectations.b. Practices.c. Lifestyles.d. Dispositions.e. None of the above.
Answer: B Page: 129-30
22. ____________ consumption of red wine is beneficial for preventing heart disease.a. Abstinence from.b. Mild.c. Moderate.d. Heavy.e. Sporadic.
Answer: C Page: 135
23. The French norm of “duty to be healthy” was strongest in the _______________.a. Working class.b. Lower class.c. Middle class.d. Upper class.e. All classes.
Answer: C Page: 135
24. In 2008, the average life expectancy for a Russian male was _______ years.a. 56.b. 62.c. 66.d. 69.e. 73.
Answer: B Page: 136
25. Health lifestyles activities typically take place __________ the health care delivery system.
a. Inside.b. Outside.c. Beyond.d. In conjunction with.e. Near.
26. What refers to routine physical examinations, immunizations, prenatal care, dental checkups, screening for heart disease and cancer, and other services intended to ensure good health and to minimize the effects of illness if it occurs?
a. Routine checkups.b. Health behavior.c. Preventive care.d. Health lifestyles.e. None of the above.
Answer: C Page: 137
27. What is the reason many low-income persons do not have a source of medical care?a. Health facilities may not be near.b. Costs may not be covered by health insurance.c. They may lack health insurance.d. B and C only.e. All of the above.
Answer: E Page: 137
28. ______________ of preventive care among the poor is common.a. Underutilization.b. Overutilization.c. Utilization.d. There is extensive utilization diversity even in the poor.e. None of the above.
Answer: A Page: 137
29. One influential social-psychological approach designed to account for the ways in which healthy people seek to avoid illness is:
a. The health lifestyles model.b. Maslow’s hierarchy of care.c. The health belief model.d. The illness behavior model.e. The health-seeking behavior system.
Answer: C Page: 138
30. In Rosenstock’s model, what would NOT be an example of an external trigger? a. Personal knowledge of someone affected by the health problem.b. Mass media communication.c. Interpersonal interaction.d. Perception of bodily states.e. All of these are examples of external triggers.
1. Health-oriented behavior pertains just to those activities concerned with recovering from disease or injury.
Answer: FALSE Page: 120
2. Health behavior is the activity undertaken by sick people to regain their health.
Answer: FALSE Page: 120
3. The focus in medical sociology is on the health behavior of the individual.
Answer: FALSE Page: 121
4. A person’s life chances are largely determined by his or her class position.
Answer: TRUE Page: 121
5. The first 60 years of the 20th century was the “premedical era.”
Answer: FALSE Page: 121
6. Members of the same status group share similar lifestyles.
Answer: TRUE Page: 122
7. One’s lifestyle is a reflection of the types and amounts of goods and services one produces and desires.
Answer: FALSE Page: 123
8. One’s life chances are rarely shaped by one’s socioeconomic circumstances.
Answer: FALSE Page: 124
9. There is evidence to show that health lifestyles emphasizing exercise, healthy diet, and avoidance of unhealthy habits such as drugs, alcohol, and smoking are spreading across class boundaries in Western society.
Answer: TRUE Page: 124
10. The wealthy show the highest proportion of cigar and cigarette smokers.
11. Most studies on race address differences in sickness and mortality rather than health lifestyle practices.
Answer: TRUE Page: 126
12. Some studies suggest that religious attitudes and behaviors can have a negative effect on numerous health-related activities.
Answer: FALSE Page: 129
13. There has been extensive research performed linking living conditions to health lifestyles.
Answer: FALSE Page: 129
14. Agency is a term referring to the process by which people critically evaluate and choose their course of action.
Answer: TRUE Page: 129
15. The healthiest state in 2009 was Vermont, followed by Louisiana.
Answer: FALSE Page: 131
16. Germany has an extensive system of national health insurance that covers over 90 percent of the total population.
Answer: TRUE Page: 132
17. The more paternalistic German system of health insurance coverage appears to undermine personal incentives to stay fit in comparison to the American system, where individuals are more responsible for their own health.
Answer: FALSE Page: 132
18. It appears that health lifestyles are spreading in British society, and distinct differences between the social classes no longer remain.
Answer: FALSE Page: 133
19. The case cannot be made that healthy lifestyles have spread completely throughout Western society on the basis of the existing studies.
20. An important facet of health behavior includes contact by healthy people with physicians and other health personnel for preventive care.
Answer: TRUE Page: 137
Essay Questions
1. What are the major components of Weber's concept of lifestyles and how do these components influence each other?
2. Why are health lifestyles gaining in significance as the 21st century approaches? Explain your answer.
3. How do agency and structure influence health lifestyles?
4. Explain Rosenstock’s health belief model.
5. An extensive ten-year survey of the health lifestyles of nearly 7,000 adults in Alameda County, California, identified seven good health practices. What are these practices, and how to they relate to health and longevity?
Chapter 7
Illness Behavior
Multiple Choice Questions
1. The most common response to symptoms of illness by people throughout the world is:a. Health behavior.b. Illness behavior.c. Self care.d. Doctor visits.e. None of the above.
Answer: C Page: 143
2. Visits to physicians are higher for:a. Males.b. Females.c. Adults.
d. No difference in the response options.e. None of the above.
Answer: B Page: 144
3. The data in the Dutton (1978) study on health care utilization among the poor favored the _______________ hypothesis.
a. Systems barrier.b. Financial coverage.c. Culture of poverty.d. Disparities.e. None of the above.
Answer: A Page: 153
4. Which group has the highest percentage of persons without health insurance?a. Non-Hispanic white.b. Non-Hispanic black.c. Hispanic, Mexican.d. Asians.e. European migrants.
Answer: C Page: 149
5. Which social class visits doctors the least?a. Upper classes.b. Upper and middle classes.c. Middle classes.d. Lower classes.e. All of the above.
Answer: A Page: 152
6. The process of seeking medical help involving a group of potential consultants, beginning in the family and extending outward to more select individuals until professionals are consulted, is known as the:
a. Medical referral system.b. Lay-referral system.c. Professional referral system.d. Health networking process.e. None of the above.
Answer: B Page: 145
7. Persons with a strong internal locus-of-control tend to have:a. More self-initiated preventive care.
b. Less self-initiated preventive care.c. More optimism about the effectiveness of care.d. Less pessimissim about the effectiveness of care.e. None of the above.
Answer: A Page: 157
8. Which stage of Suchman's concept of the illness experience requires decision-making by the sick person?
a. The symptom experience.b. Medical care contact.c. Assumption of the sick role.d. Dependent-patient role.e. All of the above.
Answer: E Page: 161
9. According to Suchman, persons in a cosmopolitan group were found to:a. Demonstrate high ethnic exclusivity.b. Distrust health professionals.c. Be very dependent on others while sick.d. All of the above.e. None of the above.
Answer: E Page: 145
10. ________________ interpretations of feeling states are medically significant, because sometimes physical changes are not obvious.
a. Objective.b. Subjective.c. Professional.d. Thoughtful.e. None of the above.
Answer: B Page: 142
11. Which is NOT a component of self-care?a. Taking preventive measures.b. Self-treatment of symptoms.c. Managing chronic conditions.d. Consultation with health care providers.e. All of the above are components of self-care.
12. A number of factors have promoted self-care on the part of laypersons. Which is NOT a factor?
a. The shift in disease patterns from acute to chronic illnesses.b. Dissatisfaction with professional medical care that is depersonalized.c. Recognition of the limits of modern medicine.d. The increasing awareness of alternative healing practices.e. All of the above are factors promoting self-care.
Answer: E Page: 143
13. People have been doing self-care for ______________ and it is made easier today by access to the Internet with its abundance of medical information.
a. A couple years.b. Decades.c. Centuries.d. Self-care is relatively new, and we don’t know how long it has been occurring.e. None of the above.
Answer: C Page: 143
14. People engage in self-care in a manner ____________ with medical norms, values, and information.
a. Consistent.b. Inconsistent.c. At odds with.d. In tandem.e. None of the above.
Answer: A Page: 143
15. Studies of the utilization of medical services by the aged indicate that such use is determined more by ___________ need than any other single factor.
a. Actual.b. Perceived.c. Medically directed.d. Economic.e. None of the above.
Answer: A Page: 144
16. Which point in the life course is NOT a peak period for when women visit doctors the most?
a. Childhood.b. Childbearing years.c. After 35.d. After 45.
e. All of these are peaks in the visitation pattern for females.
Answer: C Page: 144
17. Woman’s reproductive role accounts for less than _________ of all doctor visits.a. 10%.b. 20%.c. 30%.d. 40%.e. 50%.
Answer: B Page: 144
18. Who is NOT part of the lay-referral system?a. Family.b. Friends.c. Neighbors.d. All are part of the lay-referral system.e. None are part of the lay-referral system.
Answer: D Page: 145
19. The process by which a family provides a child with a specific social identity is:a. Classification.b. Socialization.c. Enculturation.d. Brain washing.e. None of the above.
Answer: B Page: 146
20. Which refers to the social relationships a person has during day-to-day interaction, which serves as the normal avenue for the exchange of opinion, information, and affection?
a. Intrapersonal affect.b. Lay-referral system.c. Family.d. Social network.e. None of the above.
Answer: D Page: 146
21. Which is NOT an example of an alternative medical practitioner?a. Faith healers.b. Folk healers.c. Osteopaths.d. Acupuncturists.
22. Which is NOT an example of a modern medical practitioner?a. Podiatrists.b. Chiropractors.c. Druggists.d. Optometrists.e. Orderlies.
Answer: B Page: 147-148
23. The higher an individual’s socioeconomic position, the __________ ethnic the person often becomes.
a. Less.b. More.c. Balanced.d. Really.e. None of the above.
Answer: A Page: 148
24. Approximately _________ of Americans have private health insurance.a. 55%.b. 58%.c. 65%.d. 67%.e. 75%.
Answer: D Page: 149
25. Which group has a higher rate of those covered by private insurance than the national average?
a. Blacks.b. Hispanics.c. Asians.d. Native Americans.e. None of the above.
Answer: C Page: 149
26. Koos’s study helped establish the premise that _______________ persons are less likely than others to recognize various symptoms as requiring medical treatment and that these beliefs contribute to differences in the actual use of services.
b. Middle-class.c. Upper-class.d. Middle- and upper-class.e. Lower- and middle-class.
Answer: A Page: 152
27. Dutton tested different explanations concerning why the poor would show lower use rates in relation to actual need than the non-poor. Which was NOT a tested explanation?
a. Financial coverage.b. Level of education.c. Culture of poverty.d. Systems barrier.e. All of these were tested.
Answer: B Page: 153
28. Consumerism in medicine means that people:a. Make informed choices about the services available to them.b. Spend money on health care.c. Buy and sell health services to one another.d. Sell their personal advice within the lay referral system.e. All of the above.
Answer: A Pages: 156
29. Consumerism is more likely a feature characteristic of the:a. Lower class.b. Middle class.c. Upper class.d. Middle and upper class.e. Lower and middle class.
Answer: D Page: 156
30. _______________ does not promote equality among laypersons when direct physician–patient interaction is required, nor does it provide a context within which such an orientation can grow within the medical environment.
a. Health care philosophy.b. The lay-referral system.c. The culture of medicine.d. Consumerism.e. None of the above.
1. Christakis and Fowler found that obese persons were highly likely to have social networks of family and friends who were similarly obese people with shared outlooks.
Answer: TRUE Page: 146-147
2. Puerto Rican Americans are among those most likely to report that they could not afford health insurance as the main reason they did not have coverage.
Answer: FALSE Page: 150
3. Given that the poor are visiting doctors in greater numbers, it is generally accepted that they use the same sources of medical treatment as those of higher income groups.
Answer: FALSE Page: 152
4. On average, females tend to visit physicians more often than males in the U.S.
Answer: TRUE Page: 144
5. A person's opinion of their own health is a critical variable in whether they will seek formal health care.
Answer: TRUE Page: 163
6. Self-care consists of both health and illness behavior.
Answer: TRUE Page: 143
7. About 12 percent of the American population does not have health insurance.
Answer: FALSE Page: 149
8. Self-care is an action that is independent of the medical profession.
Answer: FALSE Page: 143
9. It appears that men generally know more about health matters than women, but women take better care of themselves.
Answer: FALSE Page: 144
10. The family represents a social experience that influences how a particular person perceives his or her health situation.
11. The strategies that people employ for seeking health care are socially organized around the opportunities they have for interacting with people in a position to help.
Answer: TRUE Page: 148
12. Ethnicity’s influence on physician utilization appears wide-sweeping and goes beyond its role in providing a cultural context for decision making within social networks.
Answer: FALSE Page: 148
13. Surprisingly, socioeconomic status does not confound the effects of ethnicity on help seeking.
Answer: FALSE Page: 148
14. The culture of poverty includes traits of dependence, fatalism, inability to delay gratification, and a lower value placed on health.
Answer: TRUE Page: 151
15. Only some 10 percent of all American physicians are of Hispanic origin.
Answer: FALSE Page: 151
16. When actual need for health services is taken into account, low-income persons appear to use fewer services relative to their needs.
Answer: TRUE Page: 153
17. Dutton found the culture of poverty explanation to have little to no validity when combined with measures of income.
Answer: FALSE Page: 153
18. Beliefs can have an impact on the use of physician services that is independent of financial constraints and the structural organization of services.
Answer: TRUE Page: 156
19. Blacks and less educated individuals have gained less equitable access to the health care system with the advent of Medicare and Medicaid.
20. There is more of a consumer orientation toward health among socially advantaged persons.
Answer: TRUE Page: 156
Essay Questions
1. Describe the relationship between socioeconomic status and illness behavior. Explain the basis for your answer.
2. Define Mechanic’s ten determinants. Discuss this model. How does it relate to illness?
3. Compare and contrast the systems barrier and culture of poverty theories. How are they similar? How are they different?
4. Define Medicare and Medicaid. How have Medicare and Medicaid affected health care access and utilization across various groups?
5. What are some patterns and trends we see amongst various racial/ethnic groups in illness behavior? Blacks, Hispanics, Native Americans, and Asians?
Chapter 8 The Sick Role
Multiple Choice Questions
1. Which theorist’s work was not included as part of Parsons’s concept of the sick role?a. Emile Durkheim.b. Max Weber.c. Sigmund Freud.d. Erving Goffman.e. All of the above are theorists whose work was included.
Answer: D Page: 171
2. “A state or condition of suffering as the result of a disease or sickness” defines:a. The sick role.b. Illness.c. Disability.d. Disease.e. None of the Above.
Answer: B Page: 166
3. The traditional identifying criteria for disease do NOT include:
a. The patient’s experience of subjective feelings of sickness.b. The finding by the physician through examination and/or laboratory tests or other
indicators that the patient has a disordered function of the body.c. The patient’s symptoms conforming to a recognizable clinical pattern.d. The patient’s significant other’s identification of a “sick pattern.”e. All of the above.
Answer: D Page: 166
4. The sick role is oriented toward which group?a. Upper class.b. Upper and middle class.c. Middle class.d. Lower class.e. All of the above.
Answer: C Page: 182
5. The term ___________ has been characterized as an adverse physical state, consisting of a physiological dysfunction within an individual.
a. The sick role.b. Illness.c. Disability.d. Disease.e. None of the Above.
Answer: D Page: 167
6. The physician exercises leverage over the patient through three basic techniques. Which is NOT one?
a. Professional prestige.b. Situational authority.c. Situational dependency of the patient.d. Objective authority.e. All of the above are techniques used to exercise leverage.
Answer: D Page: 173
7. Medicalization is:a. The process where an individual falls sick, goes to the doctor, and seeks out a
cure or guidance.b. A process where previously non-medical problems are defined and treated as
medical problems.c. A concept which is not health care/medical related, but rather refers to the
sociological process of identifying stakeholders in a given situation.
d. Purely about the shift in expectation from birthing at home to delivering at a hospital.
e. None of the above.
Answer: B Page: 176
8. Which is NOT a criticism of Parsons’s sick-role theory?a. Behavioral variation.b. Types of diseases.c. Behavioral modification.d. The patient–physician relationship.e. All of the above are criticisms.
Answer: C Page: 178
9. _______________ is where the deviants are temporarily exempted from normal obligations and gain some extra privileges, provided that they seek help in order to rid themselves of their deviance.
a. Conditional legitimacy.b. Unconditional legitimacy.c. Illegitimacy.d. Forgiveness.e. None of the above.
Answer: A Page: 184
10. ________________ is where the deviants are exempted from some normal obligations by virtue of their deviance, for which they are technically not responsible, but gain few if any privileges.
a. Conditional legitimacy.b. Unconditional legitimacy.c. Illegitimacy.d. Forgiveness.e. None of the above.
Answer: C Page: 185
11. ________________ is where deviants are exempted permanently from normal obligations and are granted additional privileges in view of the hopeless nature of their deviance.
a. Conditional legitimacy.b. Unconditional legitimacy.c. Illegitimacy.d. Forgiveness.e. None of the above.
12. People who are physically handicapped typically fall into which category of stigma?a. Abominations of the body.b. Blemishes of individual character.c. Disability of the form and mind.d. Feeling of lack of control.e. All of the above.
Answer: A Page: 189
13. A pronouncement of deviant behavior involves making a _____________ about what is right and proper behavior according to a social norm.
a. Psycho-social stand.b. Stigmatized assertion.c. Lasting proclamationd. Wide-sweeping statement.e. Social judgment.
Answer: E Page: 167
14. The functionalist perspective on deviance:a. Is based on the concept that what is regarded as deviant behavior by one person or
social group may not be so regarded by other persons or social groups.b. Relies on the ideas of what is good and what is bad to define illness, but also
incorporates biological components.c. Stresses societal-level processes, systems, equilibrium, and interrelationships,
representing a homeostatic approach to deviance.d. Purely focuses on health and well-being and disregards other forms of deviance,
such as criminality.e. None of the above.
Answer: C Page: 169
15. The symbolic interactionalist perspective on deviance:a. Is based on the concept that what is regarded as deviant behavior by one person or
social group may not be so regarded by other persons or social groups.b. Relies on the ideas of what is good and what is bad to define illness, but also
incorporates biological components.c. Stresses societal-level processes, systems, equilibrium, and interrelationships,
representing a homeostatic approach to deviance.d. Purely focuses on health and wellbeing and disregards other forms of deviance,
16. Who was one of the leading proponents of labeling theory?a. Emile Durkheim.b. Max Weber.c. Sigmund Freud.d. Howard Becker.e. All of these were proponents.
Answer: D Page: 183
17. As Goffman points out, stigma represents a rupture between an individual’s __________ and ___________ social identity that is regarded in some way as failing.
a. Perceived; real.b. Virtual; actual.c. Imagined; socially assigned.d. Pre-illness; post-illness.e. None of the above.
Answer: B Page: 190
18. Processes such as crime and mental illness which disrupt the social order are:a. Functional.b. Dysfunctional.c. Unnecessary.d. Rare.e. None of the above.
Answer: B Page: 169
19. Which is NOT used as a form of sanction?a. Jails.b. Prisons.c. Mental hospitals.d. Juvenile detention.e. All of the above are examples of sanctions.
Answer: E Page: 169
20. Parsons’s concept of the sick role is based on the assumption that:a. Illness is normal and routine.b. Being sick is not a deliberate and knowing choice of the sick person.c. There are different types of illnesses resulting in different reactions.d. Illness always subsides and is replaced by well-being.e. None of the above.
21. A person may desire to retain the sick role more or less permanently because of what Parsons calls a _______________, which is the exemption from normal obligations and the gaining of other privileges commonly accorded to the sick.
a. Primary reward.b. Secondary gain.c. Tertiary exemptions.d. Primary reaction.e. None of the above.
Answer: B Page: 171
22. Whose views on religious values are utilized by Parsons in describing the role of the physician?
a. Emile Durkheim.b. Max Weber.c. Sigmund Freud.d. Howard Becker.e. All of the above are theorists whose work was included.
Answer: B Page: 172
23. Parsons was the first to demonstrate the function of medicine as a form of:a. Social control.b. Deviance.c. Medicalization.d. Stigmatization.e. None of the above.
Answer: A Page: 172
24. The patient-physician relationship involves mutuality in the form of behavioral expectations, and the status and power of the parties are ______________.
a. Balanced.b. Equal.c. Unequal.d. Unknown.e. None of the above.
Answer: C Page: 173
25. The American Psychiatric Association releases a guide to identifying disease called:a. The Manual to Diagnosing Disease and Illness.b. The Guide to Illness and Health.c. Health U.S.d. The Diagnostic and Statistical Manual of Mental Disorders.
26. __________________ has become the dominant form of health care delivery in the U.S., which makes insurance companies as third-party payers important in both bolstering medicalization through its coverage of particular services and a constraint in placing limitations on those services.
a. Managed care.b. Fee-for-service.c. Medicare/Medicaid.d. All of the above.e. None of the above.
Answer: A Page: 177
27. Twaddle found that the sick role, as defined by Parsons, was much more applicable to which religious group?
a. Catholics.b. Muslims.c. Protestants.d. Jews.e. Hindus.
Answer: D Page: 178
28. Which ethnic group was more susceptible to pain in the Zborowski study? a. Italians.b. British.c. Americans.d. Chinese.e. Mexicans.
Answer: A Page: 179
29. Parsons’s concept of the sick role seems to typically apply only to _________ diseases.a. Chronic.b. Acute.c. Infectious.d. Catastrophic.e. None of the above.
Answer: B Page: 181
30. Many people in the ______________ may tend to deny the sick role.a. Upper class.
b. Upper and middle class.c. Middle class.d. Lower class.e. All of the above.
Answer: D Page: 182
True False Questions
1. Functionalist theorists conceptualize social systems as composed of various connected parts. They argue that changes, decisions, and definitions made in one part of the system affects the other parts of the system.
Answer: TRUE Page: 169
2. Parson's concept of the sick role applies to chronic illnesses as well as to acute illnesses.
Answer: FALSE Page: 181
3. Parson's concept of the sick role adequately accounts for variations in the way people perceive illness and illness behavior.
Answer: FALSE Page: 180
4. In medical sociology, a sickness is a social state, signifying an impaired social role for those who are ill.
Answer: TRUE Page: 167
5. Deviant behavior always produces undesirable consequences for society.
Answer: FALSE Page: 168
6. Parsons insists that sickness is functional because it provides the basis for social control of the ill.
Answer: FALSE Page: 171
7. Labeling theory does not explain the cause of deviance other than by the reaction of other people to it.
Answer: TRUE Page: 185
8. Sociologists have typically viewed sickness as a form of deviant behavior.
9. Conformity to prevailing norms is generally punished for lack of ingenuity.
Answer: FALSE Page: 167
10. The biological view of deviance has been generally accepted by contemporary sociologists.
Answer: FALSE Page: 169
11. A major expectation concerning the sick is that they are able to take care of themselves.
Answer: FALSE Page: 171
12. Deviance in a social system is reduced through the application of social sanctions against the offender.
Answer: TRUE Page: 169
13. Psychoanalytic theories of the structure of personality and the unconscious played little role in Parson’s development of his notion of individual motivation.
Answer: FALSE Page: 171
14. Ideas on the function of moral authority and views on religious values are utilized by Parsons in describing the role of the patient.
Answer: FALSE Page: 172
15. The physician’s role is, as Parsons tells us, to return the sick person to his or her normal state of functioning.
Answer: TRUE Page: 172
16. The role of the patient depends on the conception that the patient holds of the his/her role.
Answer: FALSE Page: 172
17. The role of the physician is based upon an imbalance of power and technical expertise favorable exclusively to the physician.
Answer: TRUE Page: 173
18. The patient–physician relationship is not intended by society to be therapeutic in nature.
19. Parsons’s concept of the sick role helps us understand medicine’s role in promoting social stability.
Answer: TRUE Page: 176
20. Some criticisms of Parson’s sick role are based upon a misunderstanding of Parsons.
Answer: TRUE Page: 183
Essay Questions
1. What are the major criticisms of Parsons' concept of the sick role? Should the concept be abandoned? Explain.
2. What are the strengths and weaknesses of the labeling theory view of sickness?
3. What are the four basic categories of Parson’s sick role? Describe thoroughly.
4. Describe Rier’s story/experience. Why was this a unique experience? Were any conclusions made?
5. What is stigma? Define Goffman’s types of stigma. How does stigma relate to the sick role and illness in general?
Chapter 9 Doctor–Patient Interaction
Multiple Choice Questions
1. _________________ is the notion that, since the work of the physician is for the good of the patient, physicians tend to impute illness to their patients rather than to deny it and risk overlooking or missing it.
a. Choice v. health theory.b. Health care paternalism.c. The medicalization belief.d. The medical decision rule.e. None of the above.
Answer: D Page: 193
2. Distress may not be only physical; purely ____________ needs can trigger a visit to a doctor as well.
b. Psychological.c. Metaphysical.d. All of the above.e. None of the above.
Answer: B Page: 193
3. ____________________ take(s) the position that the seriousness of the patient’s symptoms is the determining factor in doctor–patient interaction.
a. Haug and Lavin.b. Parsons.c. Hayes-Bautista.d. Szasz and Hollender.e. All of the above.
Answer: D Page: 194
4. ___________________ argue that physician–patient interaction falls into one of three possible models.
a. Haug and Lavin.b. Parsons.c. Hayes-Bautista.d. Szasz and Hollender.e. All of the above.
Answer: D Page: 194
5. The ___________________ model applies when the patient is seriously ill or being treated on an emergency basis in a state of relative helplessness, due to a severe injury or lack of consciousness.
a. Activity-passivity.b. Guidance-cooperation.c. React-revise.d. Mutual participation.e. None of the above.
Answer: A Page: 194
6. The ___________________ model arises most often when the patient has an acute, often infectious illness, like the flu or measles.
a. Activity-passivity.b. Guidance-cooperation.c. React-revise.d. Mutual participation.e. None of the above.
7. The ___________________ model applies to the management of chronic illness in which the patient works with the doctor as a full participant in controlling the disease.
a. Activity-passivity.b. Guidance-cooperation.c. React-revise.d. Mutual participation.e. None of the above.
Answer: D Page: 194
8. The ___________________ model applies to the management of hypochondriacs who falsely develop symptoms.
a. Activity-passivity.b. Guidance-cooperation.c. React-revise.d. Mutual participation.e. None of the above.
Answer: E Page: 194
9. Physicians have to take on a variety of roles to induce patient adherence to their treatment regimens. Which is NOT a role?
a. Educator.b. Salesperson.c. Cheerleader.d. Detective.e. None of the above.
Answer: E Page: 195
10. The relevance of the ______________ model for understanding doctor–patient relations is the view of the interaction as a process of negotiation, rather than the physician simply giving orders and the patient following them in an automatic, unquestioning manner.
a. Hayes-Bautista.b. Szasz and Hollender.c. Activity-passivity.d. Guidance-cooperation.e. React-revise.
Answer: A Page: 195
11. People with middle and upper socioeconomic status tend to be more ________________ and active participants in the physician–patient encounter.
b. Consumer-oriented.c. Focused on getting well.d. Disease-focused.e. None of the above.
Answer: B Page: 195
12. Which model of interaction is the norm in most doctor–patient interactions?a. Activity-passivity.b. Guidance-cooperation.c. React-revise.d. Mutual participation.e. None of the above.
Answer: D Page: 195
13. A major barrier to effective communication lies in the differences between physicians and their patients with respect to:
a. Status.b. Education.c. Training.d. Authority.e. All of the above.
Answer: E Page: 198
14. Cassell explains that information can be an important therapeutic tool in medical situations if it meets which test(s)?
a. Reduces uncertainty.b. Provides a basis for action.c. Strengthens the physician–patient relationship.d. All of the above.e. None of the above.
Answer: D Page: 198
15. Mary Boulton and her colleagues explain that the influence of social class on the doctor–patient relationship is best understood in terms of:
a. Social distance.b. Social space.c. Power and space.d. All of the above.e. None of the above.
16. As part of the women’s health movement, feminist health organizations have evolved that advocate:
a. Equal pay.b. Abortion rights.c. Ms. over Mrs.d. All of the above.e. None of the above.
Answer: B Pages: 201
17. Male physicians tend to misdiagnose ______________ in female patients.a. Heart attack.b. Stroke.c. Anxiety.d. Cancer.e. None of the above.
Answer: A Page: 202
18. _______________ is thought to protect women against heart attacks until menopause, when levels drop.
a. Testosterone.b. Progesterone.c. Estrogen.d. All of the above.e. None of the above.
Answer: C Page: 202
19. Women have been historically underrepresented in medical school classes owing to which of the following?
a. Differences in the academic performance of boys and girls.b. Perceptions that women are unfit for medical work.c. Differences in the socialization experiences of boys and girls.d. Different career choices of boys and girls due to innate differences between them.e. None of the above.
Answer: C Page: 204
20. It was not until the 1970s that women accounted for at least ________ of all first-year medical students.
21. In 2009-10, about ____________ of all students entering medical schools were women.a. 30%.b. 35%.c. 40%.d. 45%.e. 50%.
Answer: E Page: 204
22. Which medical specialty have women been more likely to go into?a. Surgery.b. General practice.c. Urology.d. Orthopedics.e. All of the above.
Answer: B Page: 205
23. Which is NOT a barrier to communication between doctors and patients?a. Age.b. Gender.c. Culture.d. Socioeconomic status.e. None of the above.
Answer: E Page: 217
24. Physicians prescribe medications, diets, and the like and expect patients to follow them faithfully. This is called:
a. Compliance.b. Doctor-patient expectation.c. The contract.d. Acceptance.e. None of the above.
Answer: A Page: 208
25. Doctor–patient relationships in the U.S. have seriously _______________ in recent years.a. Improved.b. Eroded.c. Stagnated.d. Morphed.e. None of the above.
26. Dissatisfaction with the doctor-patient relationship is heavily dependent on one’s:a. Gender.b. Culture.c. Race.d. Social class.e. None of the above.
Answer: D Page: 209
27. The shift toward consumerism in health care means patients have more status in the doctor–patient relationship. However, this relationship is significantly affected by an external influence:
a. Third-party payers.b. Social class.c. The state.d. Religious groups.e. All of the above.
Answer: A Page: 209-210
28. Which is a relevant factor driving consumerism? a. Shift in the state’s role from protecting the medical profession to protecting
corporate health care interests in order to reduce costs.b. Proliferation of commercial products for the body that the patient can use
independent of the physician.c. Rise of chronic disease.d. All of the above.e. None of the above.
Answer: D Page: 210
29. Expanding reliance on new technologies has promoted a shift away from ____________, with its focus on the patient’s oral account of his or her medical history.
a. Folk medicine.b. Biographical medicine.c. Hereditary medicine.d. Verbal medicine.e. None of the above.
30. Which involves the extensive use of advanced technology for testing, diagnosis, and the scientific determination of treatment in a more differentiated world of health care delivery?
a. Techno-medicine.b. Electronic medical records.c. eMedicine.d. WebMD.e. None of the above.
Answer: A Page: 211
True False Questions
1. Talcott Parsons’s concept of the sick role provides some basic guidelines for understanding doctor–patient interaction.
Answer: TRUE Page: 193
2. Parsons explains that the relationship between a physician and patient is one that is oriented toward the patient helping himself/herself deal effectively with a health problem.
Answer: FALSE Page: 193
3. When people visit doctors for treatment and medical advice, doctors rarely take some type of action to satisfy the patient’s expectations.
Answer: FALSE Page: 193
4. Szasz and Hollender focused on the manner in which patients try to modify treatment prescribed by a physician.
Answer: FALSE Page: 194
5. Better educated and younger adults tend to be more skeptical of physician motives in providing treatment.
Answer: TRUE Page: 195
6. When a patient is extremely ill or there is an emergency, doctors still cannot make life-saving decisions about patients without consulting them.
Answer: FALSE Page: 196
7. A major barrier to effective communication lies in the differences between physicians and their patients.
8. Well educated persons are the most likely to have their questions treated impersonally.
Answer: FALSE Page: 200
9. Doctors from upper-middle-class backgrounds tended to communicate less information to their patients generally than doctors with lower-middle- or working-class origins.
Answer: FALSE Page: 200-1
10. The lack of male sensitivity to women patients was a major factor in the formation of the women’s health movement to combat sexual discrimination in medicine.
Answer: TRUE Page: 201
11. One example of male physician misperceptions about female patients is a tendency to misdiagnose heart attacks as anxiety problems.
Answer: TRUE Page: 202
12. Some patients may perceive women physicians as less of an authority figure than male physicians.
Answer: TRUE Page: 203
13. Surprisingly, the number of women physicians is decreasing.
Answer: FALSE Page: 204
14. Zola found that Italian patients tended to understate their symptoms, while Irish patients tended to overstate them.
Answer: FALSE Page: 207
15. Some male doctors feel reduced in status by being referred to as health care “providers” instead of physicians.
Answer: TRUE Page: 206
16. Modern-day medical practice is provided within the context of middle-class norms.
Answer: TRUE Page: 208
17. Communication is the key for avoiding noncompliance.
18. The belief among laypersons that the “doctor knows best” is still very accepted.
Answer: FALSE Page: 209
19. The Internet has become a major source of medical information for many lay people.
Answer: TRUE Page: 211
20. Treatments normally available only in hospitals, like chemotherapy, may be reconfigured into pills and taken at home now.
Answer: TRUE Page: 213
Essay Questions
1. Depending on the severity of symptoms, Szasz and Hollender argue that physician–patient interaction falls into one of three possible models. Describe each model.
2. What is the relationship between communication and class? Discuss.
3. Do cultural differences in communication exist? Explain your answer.
4. Will medicine remain a masculine-dominated profession?
5. What does the future hold for doctor-patient relations?
Chapter 10 Healing Options
Multiple Choice Questions
1. For many years, ________________was viewed by the medical profession as a form of quackery. But gradually, professional respectability was achieved by moving away from an exclusive focus on spinal manipulation techniques to treat general health problems.
a. Shamanism.b. Acupuncture.c. Chiropractic medicine.d. Osteopathy.e. None of the above.
Answer: D Page: 219
2. Today, _______________ are part of mainstream medicine and they work as physicians.a. Osteopaths.
b. Chiropractors.c. Podiatrists.d. Accupuncturalists.e. None of the above.
Answer: A Page: 219
3. By the mid-20th century, osteopaths were receiving scientific medical training in such areas as _______________ and ___________________.
a. Spinal alignment; neurology.b. Surgery; pharmacology.c. Obstetrics; spinal alignment.d. Acupuncture; surgery.e. None of the above.
Answer: B Page: 219
4. Osteopaths earn which degree?a. MD.b. MBBS.c. D.O.d. MD.O.e. All of the above.
Answer: C Pages: 219-220
5. Which occupation does not require an internship and residency?a. Osteopath.b. Chiropractor.c. Family practice.d. Gastroenterologist.e. None of the above.
Answer: B Page: 222
6. Which is NOT an osteopathic specialty?a. Anesthesiology.b. Psychiatry.c. Pediatrics.d. Radiology.e. None of the above.
Answer: E Page: 220
7. Which is NOT a form of CAM?a. Visits to chiropractors.
b. Treatment by faith healers.c. Care by homeopaths.d. Work by acupuncturists.e. None of the above.
Answer: E Page: 220
8. _______________ is based on the idea that disease arises from blockages in a person’s life force in the body.
a. Naturopathy.b. Homeopathy.c. Acupuncture.d. Osteopathy.e. None of the above.
Answer: A Page: 220
9. Which is a centuries-old Indian technique of using oils and massage to treat insomnia, hypertension, and digestive problems?
a. Aromatherapy.b. Ayurveda.c. Shiatsu.d. Biofeedback.e. Crystal healing.
Answer: B Page: 220
10. Which uses machines to train people to control involuntary bodily functions?a. Aromatherapy.b. Ayurveda.c. Shiatsu.d. Biofeedback.e. Crystal healing.
Answer: D Page: 220
11. The ___________________ industry alone has sales of over one billion dollars annually.a. Dietary supplement.b. Acupuncture.c. Massage.d. Chiropractic.e. None of the above.
Answer: A Page: 222
12. It appears that many persons who use some form of alternative or “new age” medicine
have ____________________ social background(s).a. Middle-class.b. Working- or lower-class.c. Upper- or middle-class.d. Middle- or working-class.e. None of the above.
Answer: D Page: 222
13. It appears that many persons who use some form of alternative or “new age” medicine are:
a. Younger.b. Older.c. Middle age or younger.d. Middle age or older.e. None of the above.
Answer: C Page: 222
14. People use CAM techniques because they are:a. Dissatisfied with physician care.b. Dislike haggling with insurance providers.c. Want to be in control of their own health.d. All of the above.e. None of the above.
Answer: D Page: 222
15. Those who use faith and folk healers typically come from a _____________ background.a. Upper-class.b. Middle-class.c. Working-class.d. Lower-class.e. All of the above.
Answer: D Page: 222
16. Like osteopathy, the ______________ approach to healing also involves manipulation of bones in the spinal column.
a. Ayurveda.b. Acupuncture.c. Chiropractic.d. Homeopathic.e. All of the above.
17. _________________ today are restricted solely to nonmedical techniques.a. Osteopaths.b. Chiropractors.c. Podiatrists.d. Neonatologists.e. All of the above.
Answer: B Page: 222
18. Chiropractors may be favored by some patients because they have a reputation for:a. Charging less.b. Being friendly.c. Giving more time to patients.d. All of the above.e. None of the above.
Answer: D Page: 223
19. ______________ are the second largest category of primary health care practitioners in the United States.
a. Osteopaths.b. Chiropractors.c. Podiatrists.d. Massage therapists.e. None of the above.
Answer: B Page: 223
20. Those belonging to __________________ used divine healing as a central aspect of dogma; it did not prohibit members from seeking professional medical care.
a. Hinduism.b. The Pentecostal church.c. Islam.d. The Church of Snakes.e. All of the above.
Answer: B Page: 224
21. Research suggests that faith healing accomplishes for patients:a. Alleviation of symptoms.b. Relief from psychological distress.c. Acceptance of one’s health or life situation.d. Adoption of another perspective about one’s situation.e. All of the above.
22. The most prominent group in American society advocating a preference for religious healing is the:
a. Christian Science Church.b. Islamic Coalition.c. Church of Latter Day Saints.d. Greek Orthodox Church.e. None of the above.
Answer: A Page: 225
23. Persons with the highest levels of religious involvement showed the lowest rates of:a. Knowledge.b. Disability.c. Income.d. Education.e. None of the above.
Answer: B Page: 227
24. Few _______________ go to folk healers.a. Blacks.b. Whites.c. Asians.d. Hispanics.e. Native Americans.
Answer: B Page: 228
25. Some elderly persons living in poverty and rural areas may be prone to use ___________ in treating ailments.
a. Folk healers.b. Folk remedies.c. Faith healers.d. Only prayer.e. None of the above.
Answer: B Page: 228-229
26. Practicing _____________ are most likely to be found among African Americans, Hispanics, and American Indians.
a. Folk healers.b. Faith healers.c. Shamans.d. Accupuncturalists.
27. “All life events, including illness, are viewed in relation to the total environment as natural or unnatural, good or evil… Thus, life is generally good or bad, and the cure for one problem might cure all problems.” These healers typically charge for their services. This view is of __________ folk healers.
a. Native American.b. Hispanic.c. Non-Hispanic black.d. Asian.e. Non-Hispanic white.
Answer: C Page: 229
28. “The most dreaded form of disorder, either physical or mental, is that caused by witchcraft. Witches are evil persons who supposedly have made pacts with the devil and use supernatural powers in the form of curses, magic, herbs, or ghosts to harm other people.” This view is of __________ folk healers.
a. Native American.b. Hispanic.c. Non-Hispanic Black.d. Asian.e. Non-Hispanic White.
Answer: B Page: 234
29. Black folk healers claim to have received their ability to heal:a. As a result of learning.b. During an altered state of consciousness.c. At birth.d. All of the above.e. None of the above.
Answer: D Page: 230
30. The _________________ healer views helping the patient accept suffering as a major task. In this context, suffering is explained as being part of the patient’s burden for the world’s sin and ignorance and a necessary role in God’s plan for the universe.
a. Native American.b. Hispanic.c. Non-Hispanic black.d. Asian.e. Non-Hispanic white.
1. The majority of persons in developed societies turn to medical doctors for help when they are sick or injured.
Answer: TRUE Page: 219
2. Osteopathy is not a part of mainstream medicine; rather osteopaths are alternative practitioners.
Answer: FALSE Page: 219
3. Ayruveda is an ancient technique of inserting fine needles into specific points in the body to ease pain and stimulate bodily functions.
Answer: FALSE Page: 220
4. Allopathic medicine is the use of microdoses of natural substances to bolster immunity.
Answer: FALSE Page: 220
5. Homeopathy is based on the idea that disease arises from blockages in a person’s life force in the body and treatments such as acupuncture and homeopathy are needed to restore the energy flow.
Answer: FALSE Page: 220
6. CAM rarely includes the use of dietary supplements.
Answer: FALSE Pages: 220
7. Some procedures like acupuncture appear effective and show some possibility of being considered by mainstream medicine.
Answer: TRUE Pages: 220-1
8. Some CAM practitioners are allowed to provide their services in hospitals and clinics.
Answer: TRUE Page: 222
9. Rather than attempt to absorb the chiropractor into medicine, some physicians have preferred to eliminate the field altogether.
20. Folk diagnosis of a health problem emphasizes the cause of the problem, not the symptoms.
Answer: TRUE Page: 229
Essay Questions
1. Compare and contrast three different types of folk healers.
2. Compare and contrast: complementary and alternative medicine (CAM), chiropractors, faith healers, and folk healers.
3. Discuss the professionalization of chiropractors.
4. Denton offers five general categories of faith healing. Describe each one.
5. What is the “storefront church” about?
Chapter 11 Physicians
Multiple Choice Questions
1. Which is a sociologically relevant characteristic noted by Goode in explaining professionalism?
a. Professional titles and prestige.b. Prolonged training in a body of specialized knowledge.c. Entrance screening to only admit the most qualified.d. Being male dominated.e. All of the above.
Answer: B Page: 238
2. Once a professional group becomes established, Goode indicates that it begins to further consolidate its power by:
a. Formalizing social relationships.b. Encouraging a service orientation.c. Developing associations that limit membership.d. Expanding practice scope.e. All of the above.
3. Recognition on the part of clients, outside agencies, and the wider society of the profession’s claim to _____________________ is necessary if professional decisions are not to be reviewed by outside authorities.
a. Professionalism.b. Dominance.c. Competence.d. Being service-oriented.e. None of the Above.
Answer: C Pages: 238-239
4. Which is NOT a feature of professionalism?a. The profession determines its own standards of education and training.b. The student professional goes through a more stringent socialization experience
than the learner in other occupations.c. Professional practice is often legally recognized by some form of licensure.d. Licensing and admission boards are staffed by members of the profession.e. All of the above are features.
Answer: E Page: 239
5. Which is NOT a feature of professionalism?a. Most legislation concerned with the profession is shaped by that profession.b. As the occupation gains income, power, and prestige, it can demand high-caliber
students.c. The practitioner is relatively free of lay evaluation and control.d. Members are strongly identified by their profession.e. All of the above are features.
Answer: E Page: 239
6. Who defined the guidelines for analyzing the development of the medical profession in American society?
a. Goode.b. Koch.c. Durkheim.d. Brown.e. Grant.
Answer: A Page: 239
7. Physicians in the United States used to lack:a. A service orientation.b. Lengthy training in specialized knowledge.c. Male dominance.d. The desire to help patients.
8. Most American medical practitioners in the period before the American Revolution were:a. Ship’s surgeons.b. Apothecaries.c. Clergy.d. Trained in Europe.e. All of the above.
Answer: E Page: 239
9. The ____________ was founded in Philadelphia in 1847.a. American Medical Association.b. American College of Physicians.c. Health Care Workers, USA Chapter.d. Alliance of Physicians.e. All of the above.
Answer: A Page: 241
10. Who was responsible for significant advancements in the germ theory of disease?a. Koch.b. Goode.c. Pasteur.d. Virchow.e. Grant.
Answer: C Page: 239
11. Who unveiled a general concept of disease based on cellular pathology?a. Koch.b. Goode.c. Pasteur.d. Virchow.e. Grant.
Answer: D Page: 240
12. With the founding of the American Medical Association (AMA) in Philadelphia, _____________ could mark the beginning of a new era in medicine.
a. Nurses.b. Physicians.c. The government.d. Hospitals.
13. In 2007, what percentage of all eligible physicians were members of the AMA?a. Less than 30%.b. 40%.c. 50%.d. 60%.e. Over 70%.
Answer: A Page: 242
14. AMA local societies have the power to enforce conformity at their level because they determine:
a. Dues.b. Membership qualifications.c. Participation in events.d. Membership size (maximum size of the AMA).e. None of the above.
Answer: B Page: 241
15. One of the most significant guiding principles of the AMA has been its view of the physician as a(an) ___________________________.
a. Academic force for change.b. Articulate, charismatic healer.c. Societal leader.d. Independent practitioner.e. All of the above.
Answer: D Page: 242
16. President Bill Clinton referred to the AMA as just another ___________________.a. Special interest group.b. Lobbyist organization.c. Powerful force trying to shape American policy.d. Civil society group.e. None of the above.
Answer: A Page: 243
17. American medical schools in the 1800s were known to have:a. Low standards.b. Poor facilities.c. Incentive programs (e.g., trips to Europe).
d. Financially strong students.e. All of the above.
Answer: E Page: 243
18. In the developing American West, anyone who had ___________ could obtain a medical degree and practice medicine.
a. Ambition.b. Money.c. Enthusiasm.d. Noble blood/heritage.e. All of the Above.
Answer: B Page: 243
19. The Flexner Report was sponsored by the:a. American government.b. European government.c. Carnegie Foundation.d. National Institutes of Health.e. All of the above.
Answer: C Page: 244
20. The Flexner Report reviewed the state of:a. Medical education.b. The AMA.c. The professionalization of physicians.d. Infectious disease.e. None of the above.
Answer: A Page: 244
21. Oswald Hall pointed out that the decision to study medicine is largely ___________ in character:
a. Biological.b. Humanitarian.c. Psychological.d. Social.e. None of the above.
Answer: D Page: 246
22. Physicians from a lower-class social origin were more likely than upper-class doctors to emphasize success values as reasons for going into medicine. Those physicians who were
initially success-oriented became less so after commencing their practices, while the reverse occurred with those who were less success-oriented. This change occurs through:
a. Socialization.b. Professionalization.c. Medicalization.d. Hazing.e. All of the above.
Answer: A Page: 247
23. Renée Fox found that medical students at Cornell Medical School acquired two basic traits as a result of their medical training: the ability to be emotionally detached from the patient and to ___________________.
a. Understand the limitations of medicine.b. Convey “bad news.”c. Tolerate uncertainty.d. All of the above.e. None of the above.
Answer: C Pages: 247-248
24. Medical schools have begun to employ which method to help decrease doubt and improve the application of medical knowledge?
a. Clinical rotations.b. Koch’s postulates.c. Evidence-based medicine.d. Grand rounds.e. None of the above.
Answer: C Page: 248
25. Medical students shift from __________ to _____________ as part of a functional learning process fitted to the physician’s role of maintaining an objective perspective of health and disease.
a. Excitement; dejection.b. Defeatism; hopefulness.c. Optimism; to pessimism.d. Idealism; cynicism.e. None of the above.
Answer: D Page: 250
26. What is a purpose of medical slang?a. Creating a sense of belonging.b. Establishing a unique identity.c. Providing a private means of communication.
d. Creating opportunities for humor and wit.e. All of the above.
Answer: E Page: 251
27. Medical education is adjusting to new realities in medical practice. Changes include the transition in American health care delivery from:
a. A system run by doctors to one shaped by the purchasers of care and the competition for profits.
b. A decline in the public’s trust in doctors to greater questioning and even distrust.c. A change in emphasis on specialization and subspecialization to primary care and
prevention.d. Less hospital care to more outpatient care in homes and doctors’ offices.e. All of the above.
Answer: E Page: 253
28. Which is NOT an important factor in establishing prestige within the medical profession?a. Hospital affiliation.b. Race of the practitioner.c. Clientele.d. The inner fraternity.e. All are important factors.
Answer: B Page: 254
29. The “inner core” of physicians is divided into two major groups. Which of the following is one of these groups?
a. Student elite.b. Practitioner elite.c. Administrative elite.d. Surgeon elite.e. None of the above.
Answer: C Page: 256
30. Which group exercises influence over medical work through its research productivity rather than focusing on individual diagnosis and treatment?
a. Knowledge elite.b. Research elite.c. Policy elite.d. Management elite.e. None of the above.
1. In 2005, there were about 200,000 doctors actively practicing medicine in the United States.
Answer: FALSE Page: 238
2. Administrators generally control clinical work and the efforts of most other people who provide health care directly to patients.
Answer: FALSE Page: 238
3. The status and prestige accorded to the physician is recognition of the physician’s expertise concerning one of society’s most essential functions—the definition and treatment of health problems.
Answer: TRUE Page: 238
4. The social importance of medical practice and the limited number of people with the requisite training are not the only criteria explaining the professional status of physicians.
Answer: TRUE Page: 238
5. After 1935, the number of American medical schools began to increase rapidly.
Answer: FALSE Page: 239
6. About two-thirds of all women doctors belong to the AMA.
Answer: FALSE Page: 242
7. There is no forum for effective dissent within the AMA.
Answer: TRUE Page: 242
8. Many influential appointments to AMA councils and committees are voted upon by either the general membership or the House of Delegates.
Answer: FALSE Page: 242
9. The AMA supported the implementation of Medicare.
Answer: FALSE Page: 243
10. A larger percentage of physicians are AMA members today than were in years past.
11. The AMA no longer yields influence in health legislation.
Answer: FALSE Page: 243
12. The professionalization of medicine would not have been possible without control over the standards for medical education.
Answer: TRUE Pages: 243
13. Past studies on the social origins of American medical students show that most are from upper- and upper-middle-class families.
Answer: TRUE Page: 246
14. Family influence is an especially important variable in encouraging and reinforcing the ambitions of the future recruit to the medical profession.
Answer: TRUE Page: 246
15. The primary reason given by many medical students for choosing a career in medicine has been that of wanting “to have a higher income.”
Answer: FALSE Page: 247
16. Becker and his associates noted that most entering medical students assumed they would be well paid. Hence, making money was apparently secondary to helping patients.
Answer: TRUE Page: 247
17. Evidence-based medicine utilizes clinical practice guidelines, providing highly detailed step-by-step instructions on medical care that the students can refer to in clinical situations.
Answer: TRUE Page: 248
18. While evidence-based medicine is a major improvement in reducing uncertainty, uncertainty is still attached to many aspects of medical practice.
Answer: TRUE Page: 248
19. One aspect of medical training that appears in several studies of medical students is the finding that the experience tends to promote emotional attachment to patients.
20. Some physicians do not need to spend a lot of time with patients in order to make diagnoses.
Answer: TRUE Page: 250
Essay Questions
1. According to Robert Coombs et al., what purpose does medical slang serve? Provide examples of medical slang.
2. Medical education is having to adjust to new realities in medical practice. What are these realities?
3. What are three factors important in establishing prestige within the medical profession? Discuss.
4. Describe the history of the American Medical Association. What is this body? How does it contribute or hurt the professionalization of medicine?
5. What is the Flexner Report, and how did it affect medical education? Chapter 12
Physicians in a Changing Society
Multiple Choice Questions
1. Public dissatisfaction with the medical profession in the United States is generally viewed as having ______________ and ________________ origins.
a. Educational; economicb. Educational; socialc. Economic; sociald. Economic; ethnic.e. None of the above.
Answer: C Page: 259
2. The decline in the status and autonomy of physicians is largely due to greater:a. Government regulationb. Corporations in the health care marketc. Changes in the physician-patient relationshipd. All of the abovee. None of the above
3. __________________ considerations have become a primary motivation among physicians, hospitals, and private health insurance companies.
a. Economic.b. Social.c. Governmental.d. Insurance.e. All of the above.
Answer: A Page: 259
4. Which group may hold doctorates in their field?a. Nurses.b. Physical therapists.c. Pharmacists.d. Nutritionists.e. All of the above.
Answer: E Page: 260
5. What is medicalization?a. Path by which a student becomes a medical professional.b. Process of turning commonly regarded normal human conditions into medical
ailments.c. Process where a traditionally non-medical professional/occupational sphere
becomes labeled as medical (e.g. insurance companies).d. None of the above.e. All of the above.
Answer: B Page: 260
6. Medicalization is a form of ______________ action.a. Socioeconomic.b. Individual.c. Collective.d. Physician-driven.e. None of the above.
Answer: C Page: 260
7. Which is NOT an important feature of a positive relationship for patients with their physician?
a. High levels of trust.b. General satisfaction.c. Participation in decision-making.d. Gender matching.e. None of the above.
8. What restricted the evaluation of work and discouraged the expression of criticism within physician circles?
a. Rules of etiquette.b. Laws.c. Formal sanctions.d. Hospital guidelines.e. None of the above.
Answer: A Page: 261
9. Etiquette was a more important _______________ than accountability in undermining attempts at critical evaluation of physicians by physicians.
a. Value.b. Belief.c. Norm.d. Opinion.e. All of the above.
Answer: C Page: 261
10. Millman contended that a “gentlemen’s agreement” existed among the hospital physicians. What did this agreement allow for?
a. Overlooking each other’s mistakes.b. Not to discuss personal issues with physician’s partners.c. Assisting in negotiating the highest pay possible for physicians.d. Doctors to be unreliable.e. Irresponsibility to patients.
Answer: A Page: 262
11. Millman contended that ________________ errors could be forgiven and often had the result of motivating the offending physician to work harder, spend more time with patients, double-check procedures, and learn from the mistake.
a. Moral.b. Technical.c. Accidental.d. Real.e. Personal.
Answer: B Page: 262
12. Millman contended that _______________ errors resulted in unfavorable letters of recommendation for those seeking jobs and social isolation from other physicians in the
14. Freidson argues that it can be ___________ that physicians are dedicated to their patients.a. Guessed.b. Believed.c. Denied.d. Assumed.e. None of the above.
Answer: D Page: 264
15. ______________were established in 1970 in conjunction with Medicaid and Medicare, to review and evaluate the medical care given to patients eligible to use these services.
a. PSROs.b. DRGs.c. HMOs.d. PPOs.e. AMAs.
Answer: A Page: 264
16. _______________ are composed of licensed physicians and osteopaths who determine if the services rendered are medically necessary, meet professional standards of quality, and are provided as efficiently and effectively as possible.
17. Mistakes and errors in medical practice, through neglect or ignorance, can sometimes be defended as:
a. Cultural latitude.b. A difference of opinion.c. Accidental.d. Unintentional.e. None of the above.
Answer: B Page: 265
18. A major defect in the professional autonomy argument arises from the fact that the autonomy granted to the medical profession is granted _____________, on the assumption that it will resolve significant issues in favor of the public interest.
a. Partially.b. Completely.c. Conditionally.d. Unconditionally.e. None of the above.
Answer: C Page: 265
19. What situation has reduced public confidence in medicine more than any other single issue?
a. Refusal to be regulated by an external body.b. Resistance to cost controls.c. Acceptance of HMOs and PPOs.d. Adoption of medical technology which does the doctor’s work “for them.”e. None of the above.
Answer: B Page: 265
20. The “golden age” of doctoring was marked by:a. Escalating prices and overcharging to a degree previously unknown.b. Provider-structured insurance that paid for almost any mistakes.c. A proliferation of unnecessary tests, hospitalizations, prescriptions, and surgical
operations.d. All of the above.e. None of the above.
Answer: D Page: 265
21. At the beginning of the 21st century we are witnessing that the dominance of medical profession is:
a. Declining.b. Expanding.c. Increasing.d. Stagnating.e. None of the above.
Answer: A Page: 266
22. Support through planning grants and loan guarantees was provided to encourage the development of _______________; a form of prepaid group practice emphasizing preventive care.
a. PSROs.b. DRGs.c. HMOs.d. SCHIPs.e. AMAs.
Answer: C Page: 267
23. _____________ are schedules of fees placing a ceiling on how much the government will pay for specific services rendered to Medicare patients by hospitals and doctors.
a. PSROs.b. DRGs.c. HMOs.d. PPOs.e. AMAs.
Answer: B Page: 267
24. ____________ refers to health care organizations that control the cost of health care by monitoring how doctors treat specific illnesses, limit referrals to specialists, and require authorization prior to hospitalization, among other measures.
a. Health savings companies.b. Medicare and Medicaid.c. Health insurance.d. Managed care.e. None of the above.
Answer: D Page: 267
25. What is a double agent?a. Physicians who look out for the interests of the patient and the interests of a
managed care organization.b. Insurance agents who seem to be offering a great financial package, but are
actually creating more profits for insurance companies.c. A physician who is also a patient.
d. A nurse who reports on the mistakes of a physician who he/she works for.e. None of the above.
Answer: A Page: 268
26. What is a gatekeeper?a. Typically, the government.b. A primary care physician who screens patients prior to referring them to a
specialist.c. A physician who blocks the review of another physician in an attempt to protect
him/her.d. None of the above.e. All of the above.
Answer: B Page: 268
27. ______________ are forced to spend time as “patient advocates,” convincing various bureaucrats that more specialized and expensive care is warranted.
a. Specialists.b. Physicians’ assistants.c. Nurses.d. Primary care physicians.e. All of the above.
Answer: D Page: 268
28. What attracted corporations to health care delivery is the potential for:a. Improving health care.b. Helping people.c. Financial profit.d. All of the above.e. None of the above.
Answer: C Page: 269
29. Which is NOT a term used to describe free-standing emergency centers?a. Docs-in-a-Box.b. 7-Eleven Medicine.c. Quick-fix facilities.d. None of the above are correct terms.e. All of the above are correct terms.
Answer: C Page: 270
30. Which is NOT a feature of a free-standing emergency center?a. Open around 18-24 hours a day, 7 days a week.
b. Attend to their patients with a minimum of waiting time.c. Treat cuts, broken bones, bruises, and minor ailments.d. Sometimes these are located in shopping centers or other convenient locations.e. All of the above are features.
Answer: E Page: 270
True False Questions
1. Public attitudes toward the medical profession have shifted away from the unquestioning acceptance of physician authority to a more critical view of doctors today.
Answer: TRUE Page: 259
2. Americans still have high regard for medicine as a social institution.
Answer: TRUE Page: 259
3. The movement of public opinion has been toward less confidence in physician authority.
Answer: TRUE Page: 259
4. The profit motive has bred resentment among consumers and demands that the professional power of doctors be increased.
Answer: FALSE Page: 259
5. The social control of medical practice has been beneficial for American society.
Answer: FALSE Page: 261
6. Physicians are rarely judged by their patients. Typically, only health care professionals judge the performance of doctors.
Answer: FALSE Page: 261
7. Millman contended that a technical error was making the mistake of being unreliable, uncooperative, lacking in responsibility to patients, and failing to acknowledge subordination to superiors.
Answer: FALSE Page: 262
8. Rates for malpractice insurance have declined as states have set limits on the amount of money awarded in malpractice lawsuits and physicians have become more careful in dealing with patients.
9. Instances of Medicare/Medicaid fraud are common.
Answer: FALSE Page: 264
10. Physicians cannot be arrested and/or sentenced to prison for misrepresenting care they claimed they gave to Medicare and Medicaid patients, because of the “veil.”
Answer: FALSE Page: 264
11. Medical standards and practices continue to be regulated by the practitioners themselves.
Answer: TRUE Page: 265
12. It is generally difficult to find a physician who will be openly critical of another physician or who will publicly testify against a colleague.
Answer: TRUE Page: 265
13. The problem with a professional dominance thesis is that it does not allow for decline.
Answer: TRUE Page: 266
14. The rise of the profit orientation in medicine signifies a trend in medical practice away from formal rationality toward greater substantive rationality.
Answer: FALSE Page: 273
15. The medical profession has been strengthened through an oversupply of doctors.
Answer: FALSE Page: 266
16. Rising costs of health care resulted in physician demands for government intervention.
Answer: FALSE Page: 266
17. The AMA was a major proponent supporting the creation of Medicare.
Answer: FALSE Page: 266
18. Free-standing emergency centers were established in the 1940s.
19. One of the most extensive changes in health care delivery, reducing the authority of physicians, has been the introduction of managed care.
Answer: TRUE Page: 267
20. About 15 percent of all U.S. hospitals are owned by profit-making organizations.
Answer: TRUE Page: 269
Essay Questions
1. What does the term “countervailing power” mean? What are the sources of this notion? Discuss.
2. What is managed care? What is its role in health care delivery? What effect does it have on the work of physicians?
3. Is there a deprofessionalization of physicians occurring? Why? Why not?
4. “The social control of medical practice has traditionally presented special problems for American society.” How so? What kind of problems?
5. There is a changing relationship between physicians and their patients. Identify and discuss trends contributing to this change.
Chapter 13 Nurses, Physician Assistants, Pharmacists, and Midwives
Multiple Choice Questions
1. Other than a few consulting professions such as ________________, the occupations performing tasks of patient care are organized around the work of the physician, and are usually under the physician’s direct control.
a. Clinical psychology.b. Physical therapy.c. Pharmacy.d. Nursing.e. All of the above.
Answer: A Page: 277
2. Technical knowledge employed in health occupations (other than “medicine”) needs to be approved by:
a. Occupational organizations (e.g., the AMA).b. The government.c. Patients.
3. Among the various occupational roles in the health field, _____________ have the greatest prestige.
a. Midwives.b. Physicians.c. Pharmacists.d. Administrators.e. None of the above.
Answer: B Page: 277
4. About 75 percent of licensed registered and practical nurses in the United States work in:a. Doctors’ offices.b. Public health agencies.c. Schools and industrial plants.d. Hospitals and nursing homes.e. None of the above.
Answer: D Page: 278
5. In many European languages, the word ____________ not only refers to nuns but also generically identifies the nurse.
a. Sister.b. Mother.c. Priestess.d. Angel.e. None of the above.
Answer: A Page: 278
6. The role of nursing in Western society was changed in the middle of the 19th century, through the insight and effort of:
a. Louie Pasteur.b. Florence Nightingale.c. The Nursing Coalition of America.d. Universities.e. None of the above.
Answer: B Page: 279
7. The early approach to nursing training emphasized a code of behavior that idealized nurses as being:
a. Responsible.b. Clean.c. Courageous.d. Obedient to the physician.e. All of the above.
Answer: E Page: 280
8. Nightingale incorporated the best attributes of the _____________ and the _________________ into her ideal nurse.
a. Physician; nanny.b. Maid; physician.c. Sister; wife.d. Mother; housekeeper.e. None of the above.
Answer: D Page: 281
9. During the late 19th and early 20th centuries, increasing numbers of women entered the labor market as a result of:
a. Immigration.b. The women’s rights movement.c. The depression.d. Boredom.e. All of the above.
Answer: A Page: 281
10. Which nursing program may qualify the student as a registered nurse (RN)? a. Hospital-based diploma schools.b. Two-year associate degree programs.c. University baccalaureate programs.d. All of the above.e. None of the above.
Answer: D Page: 281
11. Which registered nurse (RN) program is intended to provide training not only in nursing skills and theory, but also to provide the background for becoming a nursing educator or leader?
a. Associate degree programs.b. Hospital-based diploma schools.c. University baccalaureate programs.d. Post-baccalaureate advanced programs.e. Military nursing programs.
12. Which type of program produces the fewest registered nurses today?a. Associate degree programs.b. Hospital-based diploma schools.c. University baccalaureate programs.d. Post-baccalaureate advanced programs.e. Military nursing programs.
Answer: B Page: 282
13. The _________________ are relatively inexpensive, require only two years of training, and yet place their graduates on the same career track as graduates of other programs.
a. Associate degree programs.b. Hospital-based diploma schools.c. University baccalaureate programs.d. Post-baccalaureate advanced programs.e. Military nursing programs.
Answer: A Page: 282
14. Nursing is ranked by sociologists as a distinctly ____________ class occupation.a. Working.b. Lower.c. Middle.d. Upper.e. None of the above.
Answer: C Page: 283
15. This stage of socialization in the nursing student’s education consisted of nursing students wanting to do things for patients within a secularized Christian-humanitarian ethic of care and kindness, consistent with the lay image of nursing:
a. Initial innocence.b. Labeled recognition of incongruity.c. Psyching out.d. Role simulation.e. Provisional internalization.
Answer: A Page: 283
16. What socialization stage was characterized by students performing so as to elicit favorable responses from the instructors?
a. Initial innocence.b. Labeled recognition of incongruity.c. Psyching out.
d. Role simulation.e. Provisional internalization.
Answer: D Page: 283
17. Nursing students begin to collectively articulate their disappointment and openly question their choice of becoming a nurse at what stage?
a. Initial innocence.b. Labeled recognition of incongruity.c. Psyching out.d. Role simulation.e. Provisional internalization.
Answer: B Page: 283
18. The central rule of the doctor-nurse game is to avoid:a. Administrator intervention in day-to-day activities.b. A shift in the balance of power.c. Medical errors.d. Open disagreement between the players.e. None of the above.
Answer: D Page: 286
19. Researchers find that many nurses are no longer willing to be treated as mere subordinates by physicians. Several reasons are offered for this change. What is NOT a reason for this change?
a. Declining public esteem for doctors.b. Increased number of women doctors.c. The nursing shortage.d. Most nurses today are educated in academic settings.e. Increase in nursing salaries.
Answer: E Page: 287
20. Although this was not always the case, nursing students today tend to view their occupation as:
a. Secondary to life goals of marriage and family.b. A career to be followed throughout their working lives.c. The pathway to better jobs in hospital administration.d. A second choice because they couldn’t get into medical school.e. None of the above.
21. Registered nurses, especially those with baccalaureate degrees, have expanded their range of services to include:
a. Hospital administration.b. Primary-care healing.c. Nurse anesthetists.d. Cardiovascular nurse specialists.e. All of the above.
Answer: E Page: 288
22. _______________ allows nurses to develop, demonstrate, and communicate to physicians their superiority in certain important spheres of patient care.
a. Medicalization.b. Nurse specialization.c. Nurse socialization.d. Nursing education.e. None of the above.
Answer: B Page: 289
23. From the perspective of hospital administrators, _____________ can be used more economically in managerial and supervisory positions.
a. Registered nurses.b. Licensed practical nurses.c. Nurses’ aids.d. Orderlies.e. All of the above.
Answer: A Page: 289
24. Students of what program will be taught advanced clinical skills, collaboration with other health professionals to solve complex clinical problems, leadership, and other topics?
a. Registered nurse.b. Nurse practitioner.c. Certified nurse’s aide.d. Doctor of nursing practice.e. Licensed practical nurse.
Answer: D Pages: 290
25. ______________ typically have a bachelor’s degree, experience in health care as a nurse or paramedic, and become qualified after completing a training program of approximately 26 months.
a. Registered nurses.b. Physician assistants.c. Pharmacists.
26. Who are the key sources of medication information for the general public?a. Doctors/Physicians.b. Nurses.c. Pharmacists.d. Physician’s Assistants.e. Midwives.
Answer: C Page: 291
27. The word “drug” is of _____________ origin.a. American.b. Arab.c. French.d. British.e. Chinese.
Answer: B Page: 292
28. What was one of the earliest forms of care available to women?a. Midwifery.b. Hospitalization.c. Home health care.d. Clinic care.e. None of the above.
Answer: A Page: 292
29. Lay midwives have remained in existence because they:a. Use special sterilization techniques.b. Act as emotional coaches for pregnant women.c. Deliver babies in the home.d. Move in with the patient during her third trimester.e. None of the above.
Answer: C Page: 293
30. While opposition to midwifery by the medical profession continues, approximately how many states today license or register lay midwives?
1. Modern medical treatment has come to involve a great variety of health professionals.
Answer: TRUE Page: 277
2. More than ten million people in the U.S. are employed in non-physician health care tasks.
Answer: FALSE Page: 277
3. Nursing represents the largest single group of health workers in the United States.
Answer: TRUE Page: 278
4. Florence Nightingale’s ideas formed the basis for establishing the first accredited schools of medicine in the United States.
Answer: FALSE Page: 281
5. The most prestigious of the nursing education programs is the hospital-based program.
Answer: FALSE Page: 282
6. A major source of nurses in the United States has traditionally been the two-year associate degree programs.
Answer: FALSE Page: 282
7. Nursing faculties have tended to insist on students viewing their patients objectively, and this tendency has operated to de-emphasize an intimate nurse–patient relationship.
Answer: TRUE Page: 283
8. There are signs that gender inequality is gaining greater power in nurse–doctor relationships.
Answer: FALSE Page: 285
9. Nursing has attracted larger numbers of males in recent years with increasing pay.
10. Male physicians tend to regard male nurses as more competent than female nurses.
Answer: TRUE Page: 287
11. Female physicians were more likely to play the doctor–nurse game with both male and female nurses.
Answer: FALSE Page: 287
12. Female physicians are more likely than male physicians to have their actions questioned by nurses.
Answer: TRUE Page: 287
13. Competent nurses cannot be rewarded by promotion to the higher rungs of the medical profession.
Answer: TRUE Page: 289
14. The nurse practitioner is intended to occupy a work position similar to that of the physician assistant role.
Answer: TRUE Page: 289
15. A formal role for nurses who practice medicine as well as nursing, as nurse practitioners, is developing within the context of patient care.
Answer: TRUE Page: 290
16. Only half of the United States allows nurse practitioners to prescribe medications and only 6 states allow them to prescribe controlled substances.
Answer: FALSE Page: 290
17. A general job description of the physician assistant would be to provide a level of primary patient care similar to or lower than that of nurse practitioners.
Answer: FALSE Page: 290
18. It appears that the use of nurse practitioners and physician assistants will increase, as long as they extend the medical functions of physicians without competing for or challenging their authority and autonomy.
19. Pharmacists are the least accessible of all health care personnel, especially in hospitals.
Answer: FALSE Page: 291
20. Arabs founded the first pharmacies.
Answer: TRUE Page: 292
Essay Questions
1. Compare and contrast the occupational roles of nurses, physician assistants, pharmacists, and midwives.
2. Describe the history and current state of nursing.
3. What is the doctor-nurse game? Describe.
4. What are the future trends in nursing? Explain the basis of your answer.
5. Who was Florence Nightingale? What role did she have in the development of nursing?
Chapter 14 The Hospital in Society
Multiple Choice Questions
1. The ______________, as a major social institution for the delivery of health care in the modern world, offers considerable advantages to both patient and society.
a. Government.b. Nonprofit sector.c. Institution of medicine.d. Hospital.e. All of the above.
Answer: D Page: 297
2. _______________ beliefs emphasized that human beings were duty bound to provide assistance to the sick and needy.
a. Christian.b. Humanitarian.c. Governmental.d. Religious.e. None of the above.
3. Which is NOT an example of a secular benefactor?a. Kings.b. Churches.c. Merchants.d. Guilds.e. None of the above.
Answer: B Page: 298
4. These hospitals were community centers for the care of the lower-class sick:a. Nonprofit hospitals.b. For-profit hospitals.c. Medieval hospitals.d. Renaissance hospitals.e. None of the above.
Answer: C Page: 298
5. During the Renaissance and the Reformation, an increasing numbers of hospitals were placed under the jurisdiction of _______________ authorities.
a. Religious.b. Secular.c. Governmental.d. Community.e. None of the above.
Answer: B Page: 298
6. Which is NOT a basic feature of the modern hospital derived from the influence of the Church?
a. Concept of a service oriented toward helping others.b. Having a “universalistic” approach.c. The custodial nature of hospital care.d. A fee-for-service philosophy where penance equals payment.e. None of the above.
Answer: D Page: 298
7. The secular control of hospitals marked a period of ____________ for the development of Europe’s hospital system.
a. Improvement.b. Decline.c. Fluctuation.d. Stagnation.e. None of the above.
8. People with chronic health problems requiring long-term hospitalization tend to be sent to ______________ institutions.
a. Public.b. Private.c. For-profit.d. Nonprofit.e. None of the above.
Answer: A Page: 299
9. ___________ hospitals tend to accept patients with acute disorders.a. Public.b. Private.c. For-profit.d. Nonprofit.e. None of the above.
Answer: B Page: 299
10. About 70 percent of all resident patients in psychiatric facilities enter ______________.a. Due to a criminal act.b. Involuntarily.c. Voluntarily.d. Through family commitment.e. None of the above.
Answer: C Page: 317
11. Involuntary commitment proceedings are of two types: ____________ and ___________.a. Criminal; civil.b. Forcible; uncontested.c. Violent; non-violent.d. Chronic; acute.e. None of the above.
Answer: A Page: 317
12. Physicians began to associate themselves with hospitals in the 14th century. Initially they had little influence because they provided their services on a _____________ basis.
a. Part-time.b. Hourly.c. Consultant.d. Voluntary.
13. Since the end of the _________ century, a new image of hospitals evolved as institutions where patients of all social classes could generally expect to find the highest quality medical care and could reasonably expect to be cured of their disorders.
a. 17th .b. 18th .c. 19th .d. 20th .e. None of the above.
Answer: C Page: 300
14. Hospitals eventually became places where physicians also referred their _________and _________ class patients, since the most advanced medical technology was located there.
a. Lower; working.b. Middle; lower.c. Middle; upper.d. Upper; working.e. None of the above.
Answer: C Page: 300-301
15. No single change has transformed the day-to-day work in a hospital more than trained ___________.
a. Doctors.b. Nurses.c. Administrators.d. Technicians.e. None of the above.
Answer: B Page: 301
16. ________________ hospitals tend to lack prestige in comparison to other hospitals.a. Community.b. Nonprofit.c. Private.d. Government.e. None of the above.
Answer: D Page: 303
17. America’s hospital system remains a _____________ class system of medical care.a. Single.
18. What is NOT a part of the organization of a nonprofit community hospital?a. Satellite outpatient clinics.b. Affiliated group practices.c. Management organizations providing administrative services to physicians.d. Employing primary care doctors as part of their physician network.e. None of the above.
Answer: E Page: 303-305
19. Who described bureaucracy as a rational and impersonal division of labor characterized by the principles of office hierarchy and levels of graded authority, and by fixed and official areas of jurisdiction governed by laws or administrative regulations?
a. Weber.b. Perrow.c. Hillier.d. Durkheim.e. None of the above.
Answer: A Page: 305
20. Which is NOT a reason that trustee domination succumbed to medical domination in the 1930s?
a. The emphasis on free care declined significantly as hospital services became oriented toward patients who could pay.
b. The facilities to support a complex system of medical technology were developed, and the quality of care provided patients was improved.
c. The hospital sought prestige through medical research in terms defined by physicians.
d. The hospitals differentiated and offered specialized care to certain segments such as cancer patients.
e. None of the above.
Answer: D Page: 306
21. In the 1940s and 1950s, the role of the hospital ______________ gained in importance.a. Physician.b. Nurse.c. Administrator.d. Social worker.
22. The occupational groups in the hospital most affected by its system of dual authority are the ______________ who perform health care tasks on the hospital’s wards.
a. Physicians.b. Nurses.c. Pharmacists.d. Social workers.e. None of the above.
Answer: B Page: 307
23. To make the hospital organization function effectively, it has been necessary to construct a _______________ system of authority organized around a central objective of service to the patient.
a. Decentralized.b. Loose.c. Dual.d. Hierarchical.e. None of the above.
Answer: A Page: 309
24. The process of ________________ is not just a result of the manner in which large numbers of patients are managed or the work conditions, but is also related to the patient’s subjective experience of feeling sick.
a. Depersonalization.b. Demoralization.c. Standardization.d. Assembly line medicine.e. None of the above.
Answer: A Page: 311
25. When patients present themselves for treatment in a hospital, they bring with them a particular social identity, what Goffman refers to as a:
a. Self.b. Face.c. Front.d. Persona.e. None of the above.
26. ___________ occurs when the hospital systematically divests the person of these past representations of self.
a. Stripping.b. Removal.c. Fading.d. Standardization.e. None of the above.
Answer: A Page: 312
27. The ________________ and ________________ educated the patient, the less likely the patient was to express highly conforming attitudes.
a. Older; better.b. Older; worse.c. Younger; better.d. Younger; worse.e. None of the above.
Answer: C Page: 313
28. About _______ of all expenses for hospital services are now paid by third-party sources.a. 60%.b. 70%.c. 80%.d. 90%.e. None of the above.
Answer: D Page: 314
29. About _____________ of all the money spent on health in the United States in 2007 was spent on hospital services.
a. 30-35%.b. 36-39%.c. 40-45%.d. 46-50%.e. None of the above.
Answer: A Page: 314
30. The most expensive hospitals in the United States are located in New England and the:a. South.b. Pacific Coast.c. Rocky Mountain states.d. Midwest.e. None of the above.
1. The Romans were the first to establish separate medical facilities that have been described as hospitals.
Answer: TRUE Page: 298
2. The origin of the institution we know today as the hospital has usually been associated with the rise of Judaism.
Answer: FALSE Page: 298
3. Hospitals have passed through four distinct phases of development.
Answer: TRUE Page: 298
4. During the period of the Crusades, many hospitals were established along the routes to the Iran followed by the Christian armies.
Answer: FALSE Page: 298
5. Secular benefactors rarely founded hospitals. This was primarily the role of the Church.
Answer: FALSE Page: 298
6. By the end of the 15th century, an extensive network of hospitals existed throughout Eastern Europe.
Answer: FALSE Page: 298
7. A legacy of the hospitals as poorhouses is that of mental hospitals.
Answer: TRUE Page: 317
8. Mental hospital admissions are involuntary.
Answer: FALSE Page: 317
9. In criminal cases, the claim of mental disorder is used as an excusing condition that relieves the individual of criminal responsibility for his or her crime.
Answer: TRUE Page: 317
10. The first hospitals were founded in the United States more than 250 years ago.
11. Early hospitals were largely based on voluntary initiative by private citizens who wanted medical care available on a nonprofit basis. They were generally intended to provide treatment for patients who had incurable disorders.
Answer: FALSE Page: 301
12. Federal government participation in health care began in the late 1800s.
Answer: FALSE Page: 301
13. Federal government participation in health care began with the U.S. Public Health Service hospital program for merchant seamen.
Answer: TRUE Page: 301
14. State governments entered into health care delivery in the 1700s.
Answer: FALSE Page: 301
15. State government early involvement in health care delivery was largely confined to the establishment of mental institutions.
Answer: TRUE Page: 301
16. The most common type of hospital in the United States is the nonfederal and nonprofit community hospital.
Answer: TRUE Page: 302
17. Controlled by a board of trustees, government hospitals are exempt from federal income taxes and many other forms of state and local taxes.
Answer: FALSE Page: 302
18. Large nonprofit hospitals are less dependent than smaller hospitals on local physicians, because of more extensive facilities and higher ratio of staff positions for doctors.
Answer: TRUE Page: 302
19. The total number of hospitals in the United States has increased from 1975 to 2007.
20. For-profit hospitals have decreased from 1975 to 2007, and nonprofit hospitals have increased due to a focus on civil society.
Answer: FALSE Page: 302
Essay Questions
1. Patients are alienated from their usual lives and reduced to a largely impersonal status in the hospital through three basic mechanisms. Name and explain each one.
2. What are multipurpose health institutions? List five health-related functions they provide.
3. Historically, hospitals have passed through four distinct phases of development. Name and describe each phase.
4. Why is Max Weber’s concept of bureaucracy not totally compatible with the norms of hospital authority?
5. Describe what mental hospitals are, as well as the admissions/commitment processes.
Chapter 15 Health Care Reform and Social Policy in the United States
Multiple Choice Questions
1. In 2008, an average of ____________ per person was spent on health care in the United States, which was the highest in the world at that time.
a. $1,072.b. $5,568.c. $7,681.d. $9,307.e. None of the above.
Answer: C Page: 320
2. Estimates for 2019 indicate that health costs may average _________for every man, woman, and child.
a. $5,568.b. $7,026.c. $10,008.d. $13,387.e. None of the above.
Answer: D Page: 320
3. Which is NOT a contributor to the increase in health care expenditures?
a. Aging of the population.b. Increases in hospital expenses.c. Higher costs for health insurance.d. Increase in the number of prescriptions written.e. All of the above are contributors.
Answer: E Pages: 321
4. What are the primary issues in debates about health care delivery in the U.S.?a. Rising costs of servicesb. Equity in the provision and distribution of care.c. Which country to model reforms on.d. Both A and B.e. Both B and C.
Answer: D Page: 319
5. Which of the following is NOT one of the provisions included in the 2010 U.S. health care reforms?
a. Persons with preexisting conditions can no longer be denied coverage.b. A minimum level of benefits set by the government must be provided in all health
insurance plans.c. Businesses with three or more employees are required to provide health insurance
for both full-time and part-time employees.d. Low-income persons will be covered by an expanded Medicaid program.e. Children may remain on their parent’s health insurance plan until age 26.
Answer: C Pages: 331-332
6. What does DRG stand for?a. Diagnostic related groups.b. Drug review guide.c. DR (doctor) G (guild).d. Dermatology rheumatology groups.e. None of the above.
Answer: A Page: 323
7. In the public sector, the federal government instituted cost controls for services to _______________ patients by establishing set fees for DRGs.
a. Welfare.b. SCHIP.c. Medicare.d. Medicaid.e. None of the above.
8. DRGs:a. List what the government would pay for medical procedures.b. Help physicians diagnose the proper illness to classify a patient with.c. Create a monthly payment schedule for physicians, depending on the number of
patients they see.d. Are organizations of physicians that regulate expenditures in clinics throughout
the United States.e. None of the above.
Answer: A Page: 323
9. In 2006, about ___________ of all Americans with health insurance were enrolled in managed care programs:
a. 35%.b. 48%.c. 53%.d. 61%.e. None of the above.
Answer: C Page: 326
10. What is the role of a managed care organization?a. Control the cost of health care.b. Monitor the work of doctors and hospitals.c. Limit visits to specialists.d. Require prior authorization for hospitalization.e. All of the above.
Answer: E Page: 326
11. The ______________ represents the bill payer and certifies that the care to be rendered is both effective and the least costly alternative.
a. Case manager.b. Social worker.c. HMO.d. Hospital administrator.e. All of the above.
Answer: A Page: 326-327
12. _________________ financing is a fixed monthly sum paid by the subscriber and his or her employer that guarantees care, with little or no additional cost.
c. Partial.d. Health insurance.e. None of the above.
Answer: B Page: 327
13. What is the main health care problem in rural areas with respect to equity?a. Quality.b. Cost.c. Access.d. Pharmaceuticals.e. All of the above.
Answer: C Page: 333
14. The more financially rewarding medical practices are those in __________ sized cities.a. Small.b. Rural.c. Medium.d. Large.e. None of the above.
Answer: D Page: 334
15. One out of every _______ counties in the United States does not have a single doctor.a. 10.b. 20.c. 30.d. 40.e. None of the above.
Answer: B Page: 334
16. Medical specialties like ____________ became increasingly popular in recent years.a. Dermatology.b. Anesthesiology.c. Radiology.d. Emergency-room medicine.e. All of the above.
Answer: E Page: 334
17. ________________ are public organizations supported by tax funds, which are intended to support and conduct research, develop educational materials, protect the nation’s health, and provide services designed to minimize public health problems.
b. Voluntary agencies.c. Health maintenance organizations.d. Preferred provider organizations.e. Allied health enterprises.
Answer: A Page: 336
18. ________________ are the manufacturers of pharmaceuticals and medical supplies and equipment, which play a major role in research, development, and distribution of medical goods.
a. Official agencies.b. Voluntary agencies.c. Health maintenance organizations.d. Preferred provider organizations.e. Allied health enterprises.
Answer: E Page: 337
19. ___________________ are a relatively new form of managed care health organization, in which employers who purchase group health insurance agree to send their employees to particular hospitals or doctors in return for discounts.
a. Official agencies.b. Individual practice associations.c. Health maintenance organizations.d. Preferred provider organizations.e. Allied health enterprises.
Answer: D Page: 336-337
20. _________________ solicit funds from the general public and use them to support medical research and provide services for disease victims.
a. Official agencies.b. Voluntary agencies.c. Health maintenance organizations.d. Preferred provider organizations.e. Allied health enterprises.
Answer: B Page: 336
21. _________________ are managed care prepaid group practices, in which a person pays a monthly premium for comprehensive health care services.
a. Official agencies.b. Individual practice associations.c. Health maintenance organizations.d. Preferred provider organizations.e. Allied health enterprises.
22. _________________ are solo practitioners or small groups of physicians who contract independently with HMOs to provide care to patients enrolled in their plans.
a. Official agencies.b. Individual practice associations.c. Health maintenance organizations.d. Preferred provider organizations.e. Allied health enterprises.
Answer: B Page: 336
23. This method of payment is consistent with the principle of the open market, in which the consumers of health care, like the consumers of other products, are free to choose which health care providers offer the best services at prices they can afford:
a. Fee-for-service.b. Capitation.c. Managed care.d. Credit cards.e. All of the above.
Answer: A Page: 338
24. The medical profession in the United States has had a consistent record of ____________ to social legislation.
a. Compliance.b. Resistance.c. Deference.d. Defiance.e. None of the above.
Answer: B Page: 323
25. Which is one reason medical students tend to specialize rather than go into general practice?
a. Specialties usually represent a more manageable body of knowledge.b. Specialties may be less demanding of personal time.c. Specialties usually have greater prestige and better income.d. All of the above.e. A and C only.
Answer: D Page: 334
26. In the U.S., health care tends to be viewed as:a. A privilege based on ability to pay for a commodity.
b. A privilege based on citizenship.c. A right granted regardless of living conditions or financial status.d. A right based on participation in capitalist markets.e. None of the above.
Answer: A Page: 340
27. The Medicare program is under the overall direction of the:a. Centers for Disease Control and Prevention.b. Secretary of Health and Human Services.c. American Association of Retired Persons.d. Health and Elderly Organization.e. None of the above.
Answer: B Page: 324
28. This organization provides for the federal government’s sharing in the payments made by state welfare agencies to health care providers for services rendered to the poor:
a. Medicare.b. Medicaid.c. DRGs.d. HMOs and PPOs.e. None of the above.
Answer: B Page: 325
29. The establishment of the welfare state is the latest phase in the evolution of citizens’ rights in the West. Which was the first group of rights granted to citizens in the 18th century?
a. Basic.b. Political.c. Civil.d. Social.e. All of the above.
Answer: C Page: 341
30. ___________ theory takes the position that social inequality leads to clash, which leads to change.
a. Structural functionalism.b. Conflict.c. Symbolic interaction.d. Health lifestyles.e. None of the above.
1. Despite initial resistance to rationing services by the middle class, the managed care model has continued to control escalating costs for health care.
Answer: FALSE Page: 329
2. A number of states have sued the federal government over the recent health care reforms on the basis that it is unconstitutional and unprecedented to require people to buy any commercial good or service as a condition of lawful residence in the U.S.
Answer: TRUE Page: 332
3. Not having health insurance drastically undermines the ability of people to obtain health care, since they cannot pay for it and may therefore be denied it.
Answer: TRUE Page: 319
4. Sometimes not having health insurance can contribute to the death of a patient.
Answer: TRUE Page: 320
5. The idea that advertising drives up drug costs is a myth.
Answer: FALSE Page: 321
6. Almost all drugs can reduce health spending by lowering the need for hospital care.
Answer: FALSE Page: 321
7. The greatest single increase since 1982–84 has been in the cost of prescription drugs. This category is followed by increases in hospital costs.
Answer: FALSE Page: 322
8. Since the early 1980s, physician costs have remained fairly stable, neither rising nor falling.
Answer: FALSE Page: 322
9. In the early to mid-1990s, private health care in the United States experienced a dramatic reorganization into managed care plans.
10. Managed care does not alter the patient-physician relationship; it exists above and beyond it.
Answer: FALSE Page: 326
11. A feature of managed care is its reliance upon capitation financing.
Answer: TRUE Page: 327
12. The urban poor have historically been dependent on public hospitals and clinics rather than private hospitals and practitioners for providing patient care.
Answer: TRUE Page: 333
13. The rural poor are less likely to be treated by foreign medical school graduates.
Answer: FALSE Pages: 333
14. The laws of a competitive marketplace do not apply well to medicine, because physicians define what patients need and provide their services at prices they, their employers, or the federal government set.
Answer: TRUE Page: 338
15. Primary care or family practitioners are over-represented among physicians.
Answer: FALSE Page: 333
16. Physicians generally prefer to practice medicine in urbanized settings.
Answer: TRUE Page: 333
17. There are more than 50 specialty boards affiliated with the American Medical Association that certify physicians to practice in as many as 115 medical specialties.
Answer: FALSE Page: 335
18. Medical specialization has produced very few positive benefits.
Answer: FALSE Page: 335
19. The people who tend to utilize emergency rooms for primary care are the underprivileged.
20. HMOs are oriented toward preventive and ambulatory services intended to reduce hospitalization.
Answer: TRUE Page: 336
Essay Questions
1. Identify and discuss the three major issues in the public debate about health care delivery in the United States.
2. Present arguments for and against health reform.
3. “The problem of equity with respect to health services is and remains a serious problem in American society.” Why is this a problem, and how does it relate to policy?
4. Provide an overview of the health care delivery system in the United States.
5. Describe the Medicare and Medicaid programs in depth, with an evaluation for each in the context of health policy.
Chapter 16 Global Health Care
Multiple Choice Questions
1. What country does NOT have a centralized national health program? a. Japan.b. Russia.c. Germany.d. Mexico.e. None of the above.
Answer: B Page: 344
2. In what way(s) do decentralized national health programs differ from socialized medicine?
a. There are both publicly and privately owned facilities.b. Public access to care is guaranteed.c. Private care plays only a limited role.d. Government regulation is indirect.e. All of the above.
3. In some European countries, providing national health insurance was a means to reduce the chance that the working class would:
a. Die.b. Revolt.c. Get sick and be out of work.d. Unionize.e. None of the above.
Answer: B Page: 345
4. What country established the first national health insurance program?a. U.K.b. Germany.c. Japan.d. Canada.e. Austria.
Answer: B Page: 345
5. ________________ are aimed at providing people with welfare and health benefits, regardless of their position in society.
a. Pensions.b. Employer sponsored health care plans.c. Benefits.d. Entitlements.e. None of the above.
Answer: D Page: 345
6. Many Europeans receive:a. Comprehensive health insurance.b. Protection of lost income due to illness, injury, or unemployment.c. Allowances to supplement family expenses for the maintenance of children, such
as clothing and school lunches.d. A and B only.e. All of the above.
Answer: E Page: 345
7. Except for the __________, participation in the welfare system is not considered normative in the United States.
a. Poor.b. Elderly.c. Unwed.d. Young.e. None of the above.
8. What country had the lowest infant mortality rate in the world in 2005?a. Cuba.b. United States.c. Japan.d. Sweden.e. Germany.
Answer: C Page: 346, 348
9. What country had the highest life expectancy for males in the world in 2005? For females?
a. United States; United States.b. Switzerland; Japan.c. Japan; Japan.d. Israel; Switzerland.e. Australia; Spain.
Answer: B Page: 347, 349
10. The _____________ system of health care delivery is of particular interest to Americans, because it is the system most often discussed as a future model for the United States.
a. British.b. Canadian.c. German.d. Swedish.e. None of the above.
Answer: B Page: 350
11. What is NOT covered by the Canadian insurance system?a. Prescription drugs for persons under age 65.b. Dental.c. Ambulance service.d. Eyeglasses.e. All of the above.
Answer: E Page: 351
12. The major problem facing Canada with respect to health care delivery is:a. Rising costs.b. Physicians’ dissatisfaction with reimbursement.c. Patient dissatisfaction with wait-times for procedures.d. Program administration.
13. What country established the first health care system in any Western society to offer free medical care to the entire population?
a. Britain.b. United States.c. Canada.d. Sweden.e. Germany.
Answer: A Page: 353
14. The Chinese health care system is best characterized as:a. A state-run socialist program.b. A system financed largely by fees by patients and private payers.c. A decentralized national health program.d. A comprehensive socialized program with traditional and Western elements.e. None of the above.
Answer: B Pages: 373
15. The first line of medical care in Great Britain is the:a. Nurse practitioner/physician’s assistant.b. General practitioner.c. Hospital, specifically the emergency room.d. Gatekeeper, a nurse who assigns physicians based upon need.e. None of the above.
Answer: B Page: 354
16. In Britain, _______________ are responsible for paying for health care in their area, managing the provision of that care, and planning in accordance with regional and national guidelines.
a. executive councils.b. local health authority services.c. district health authorities.d. hospital and specialist services.e. None of the above.
Answer: C Page: 355
17. Taxes in ______________ have been the highest in the world.a. Britain.b. United States.
22. The largest health plan in Mexico covers workers in the private sector and is administered by the:
a. Mexican Social Insurance Institute.b. National Health Service.c. Federal Ministry of Labor and Social Affairs.d. Secretariat of Health and Welfare.e. None of the above.
Answer: A Page: 366
23. The _____________ is responsible for Mexico’s overall health policy and provides health care directly to the urban poor through its own hospitals and clinics.
a. Mexican Social Insurance Institute.b. National Health Service.c. Federal Ministry of Labor and Social Affairs.d. Secretariat of Health and Welfare.e. None of the above.
Answer: D Page: 366
24. About _________ of the Mexican population has health insurance.a. 50%.b. 60%.c. 70%.d. 80%.e. 90%.
Answer: A Page: 366
25. Which of the following is one of the general trends affecting health policy worldwide?a. Attention to the cost of health care and implementation of cost control measures.b. Increasing emphasis on preventive medical services.c. Improving efficiency in the administration of large health care systems.d. Demands that governments increase efforts to provide a health care system that
meets national needs.e. All of the above.
Answer: E Page: 376-377
26. ____________ has more doctors per capita than any major nation.a. Mexico.b. Russia.c. China.d. Australia.e. Untied States.
27. What country has the highest per capita consumption of alcohol in the world?a. Ireland.b. Germany.c. Russia.d. United States.e. Mexico.
Answer: C Page: 372
28. What was the effort in China in which 1.8 million paramedical personnel were trained in rudimentary medicine and sent to rural areas to provide basic medical treatment and assist in efforts at preventive medicine and public health called?
a. Barefoot doctors movement.b. Rural outreach.c. People-to-people in health care.d. Grassroots medicine.e. None of the above.
Answer: A Page: 374
29. Some __________ of China’s adult male population smoke.a. 20%.b. 35%.c. 55%.d. 70%.e. None of the above.
Answer: D Page: 375
True False Questions
1. All nations of the world are faced with the pressure of public demands for quality health care and faced with rising costs of providing that care.
Answer: TRUE Page: 344
2. The value of studying the health care delivery systems of different countries is the insight provided into the norms, values, culture, and national outlook of those societies, as well as the lessons learned from their experiences.
3. A nation’s approach to health care is based upon its historical experience, culture, economy, political ideology, social organization, level of education and standard of living, economic resources, and attitudes toward welfare and the role of the state.
Answer: TRUE Page: 344
4. In Europe, the provision of health services became an important component of government policy in the last half of the eighteenth century.
Answer: FALSE Page: 344
5. The social welfare systems of the U.S. are more advanced than in Europe.
Answer: FALSE Page: 345
6. Europeans have historically been less committed to government welfare programs and more in favor of private enterprise in dealing with economic and social problems.
Answer: FALSE Page: 345
7. Americans who receive welfare tend to be stigmatized and have low social status.
Answer: TRUE Page: 345
8. The German health service organization represents a form of corporatism in which a set of institutions situated between the government and its citizens have the authority to manage health care.
Answer: TRUE Page: 364
9. The Japan health care delivery system is by far the most expensive in the world.
Answer: FALSE Page: 346
10. The United States has the lowest infant mortality rate of any nation.
Answer: FALSE Page: 346
11. The United States has the highest rate of longevity of any nation.
Answer: FALSE Page: 347
12. There are three different forms of socialized medicine.
13. Canada has a single, national health care delivery system.
Answer: FALSE Page: 350
14. Canada was late in adopting its version of socialized medicine.
Answer: TRUE Page: 351
15. Canadians had a lower rate of infant mortality than Americans.
Answer: TRUE Page: 351
16. The U.K. was the first country to enact national health insurance.
Answer: FALSE Page: 353
17. Whereas higher SES groups in the U.S. have healthier lifestyles, the well-educated and higher-income in China tended to have worse health than the lower classes.
Answer: TRUE Pages: 375
18. The Swedish National Health Service is financed through taxation.
Answer: TRUE Page: 357
19. A major characteristic of the National Health Service in Sweden is that general hospitals are not owned by the government.
Answer: FALSE Page: 358
20. The Japanese national health insurance plan covers all Japanese citizens.
Answer: FALSE Page: 361
Essay Questions
1. What are the four general trends appearing in developed societies, which are likely to have an effect on health care policy in the future? Discuss.
2. What is socialized medicine? Discuss the systems in three countries that have socialized medicine.
3. Discuss in detail the health care system in Germany.
4. What is a decentralized national health program? Use the case of Mexico to illustrate this type of healthcare system.
5. Compare and contrast fee-for-service, socialized medicine, decentralized national health, and social medicine systems in terms of regulation, provider payments, facility ownership, public access, and private care.
