Medical Sociology

SOC 3214

Winter, 2008, Wed (9:30-11:15)
HYS LG04
Instructor: Jin Lei
Office: Sino Bldg R419
Email: ljin@cuhk.edu.hk
Phone: 2696-1185
Teaching Assistant: Mong Hong
Email: menghonghk@gmail.com
Course Website: http://webct.cuhk.edu.hk/webct/
 
Summary:
This course offers a broad introduction to the study of illness, health and medicine from sociological perspectives. It surveys the social meanings of health and illness, the social distribution and social causes of health and illness, and the social structuring of the medical encounter. It also examines systems of healthcare from a comparative perspective to understand the social and political factors related to the quality, cost and accessibility of healthcare. An emphasis will be placed on the evolution of health care provision in China.
 
Learning Objectives:
1)      Learn to critically assess biomedicine from sociological perspectives.
2)      Understand the social factors that contribute to health and illness.
3)      Gain insight into the constituent components of the healthcare system and the social and political factors related to the quality, cost and accessibility of healthcare.
4)      Learn to draw links between students’ daily experience and observation, and conceptual issues
 
Course requirements:
1)      Class Participation (5%): Class participation will be checked by several random quizzes.
2)      Short Essays (30%): Write one short essay for each of the first two parts of the class.  The first essay is due on 2/20 and the second essay is due on 3/19. Each essay should discuss an aspect of the readings for a week and summarize the arguments/issues and evidence supporting the arguments. You should then present your comments and raise questions.  Each essay should not exceed 1,000 words.
3)      Tutorial Attendance and Research Project Presentation (30%): There will be five tutorials. During these tutorials you are expected develop a project on a topic related to health, health care and the society. Some topics will be suggested but they are optional. The end product of the project is a presentation of your research project. More description of the research project is attached in the end of the syllabus. The grading is based on tutorial attendance and participation (10%) and the presentation (20%).
4)      Final Exam (35%): The final exam will consist of multiple-choice, true/false, and short essay questions.  Students will have a choice in short-essay questions.  It will be based on topics and concepts covered in the class and in required readings.  I will hand out an outline of the topics and concepts before the exam.  The final exam will be open-book. It will be scheduled during the exam week.
 
Readings:
Required text:
Cockerham, William C. 2007. Medical Sociology. Upper Saddler River, NJ: Prentice Hall. Available for purchase at the University Bookstore

WebCT
It is best to exchange e-mail with the instructor via WebCT.  Course syllabus and readings are available on WebCT.   You should check WebCT on a regular basis.
 
Academic Honesty
Attention is drawn to University policy and regulations on honesty in academic work, and to the disciplinary guidelines and procedures applicable to breaches of such policy and regulations. Details may be found at http://www.cuhk.edu.hk/policy/academichonesty/ . With each assignment, students will be required to submit a statement that they are aware of these policies, regulations, guidelines and procedures.

Course schedule:
 
The Convergence of Sociology and Medicine  

Week 1: Introduction: Sociological Theorizing about Health and Illness (1/9)
 
Week 2: Models of Illness and the Role of Medicine in Fostering Health (1/16)
Chapter 1: Medical Sociology pp 1-13
Chapter 2: Epidemiology pp 21-32
 
Week 3: The Social Construction of Illness and the DNA age (1/23)
Chapter 7: The Sick Role pp143-169
Harmon, Amy. "The DNA Age: Cancer Free at Age 33, but Weighing a Mastectomy." in The New York Times. New York. September 16, 2007
Watch excerpts from “Cracking the Code of Life”, a documentary on genetic discoveries and their implication for the modern society (in class)
 
Week 4: Health Behavior, the Social Context and Public Policy (1/30)
Chapter 5: Health Behavior and Lifestyles pp100-119
Mello MM, et al.  Obesity -- The New Frontier of Public Health Law.  New England Journal of Medicine  2006; 354: 2601-2610.
Watch excerpts from “Supersize Me”, a documentary of a young man who embarked on a 30-day experiment of eating exclusively food from McDonald’s (in class)
 
Week 6: Illness Behavior (2/13)
Chapter 6: Illness Behavior pp121-142
 
The Social Distribution and Social Causes of Health and Illness
 
Week 7: The Social Distribution of Illness (2/20)
Chapter 3: The Social Demography of Health pp 42-52 62-74
Farmer, P. (1999). Infections and inequalities: the modern plagues. Berkeley, University of California Press: 37-58; notes on 288-91.
Watch “The Great Leveler”, a BBC documentary on social status, social hierarchy and health (in class)
 
Week 8: Social Hierarchy, Social Status and Health (2/27)
Chapter 4: Social Stress and Health pp 75-97
 
Week 9: Social Support, Family and Health (3/5)
House JS, Landis KR, and Umberson D. Social Relationships and Health. Science 1988; 241: 540-45.
Cowley, Geoffrey. "Family Matters." Pp. 31-41 in Newsweek. May 16, 2005
Week 10: Social Network, Social Capital and Health (3/12)
Berkman LF, and Kawachi, I.  Social Epidemiology.  Oxford: Oxford University Press, 2000, Chapter 8 “Social Cohesion, Social Capital, and Health” (pp. 174-190).
Christakis NA. Social Networks and Collateral Health Effects. British Medical Journal 2004; 329: 184-185.
Christakis, N. A. and J. H. Fowler (2007). "The Spread of Obesity in a Large Social Network over 32 Years." New England Journal of Medicine 357(4): 370-379.
 
The Social Organization of Medicine
 
Week 11: Health and Health Care in China I (3/19)
Blumenthal, David and William Hsiao. 2005. "Privatization and its discontents — the evolving Chinese health care system." New England Journal of Medicine 353:1165-70.
"Operation Where Everyone Gets a Cut." in South China Morning Post. Hong Kong. September 11, 2007
 
Week 12: Health and Health Care in China II (3/26)
Liu, Y., William C.L. Hsiao, Karen Eggleston. 1999. "Equity in health and health care: the Chinese experience." Social Science & Medicine 49:1349-56.
Zamiska, Nicholas. 2007. "In China, Farmers Become Health-Care Monitors: Test Program Targets Nation's Broken System; Fining the Local Doctor." Pp. A1-A5 in The Wall Street Journal.
"Who Should Foot the Bill for Medical Reform?" in South China Morning Post. Hong Kong. September 10, 2007: A7-A8
 
Week 13: The Organization of Health Care in Developed Countries (4/2)
Chapter 15: Health care in Developed Countries pp 321-350
Watch excerpts from “Sicko”, a documentary on health care systems in the US and other industrialized countries (in class)
 
Week 14: The Patient-Doctor Relationship (4/9)
Chapter 10: Doctor-Patient Interaction pp211-232
Taylor, K. M. (1988). Physicians and the Disclosure of Undesirable Information. Biomedicine Examined. M. Lock, and Deborah R. Gordon. Dordrecht, Kluwer,: 441-463.
 
Week 15: Complementary and Alternative Medicine & Review (4/16)
Chapter 7: Healing Options pp 170-187
Lee, R, Stephen W.K. Chiu, and Lisanne S.F. Ko. 2005. "Decolonization and the Movement for Institutionalization of Chinese Medicine in Hong Kong: A Political Process Perspective." Social Science and Medicine 27:249-274.

Research Project
I. Topics
The following is a list of topics suggested for the research project. You can also come up with your own topics, as long as they are related to the social context of health and health care. Your topics need to be approved by the TA.
1.      Socioeconomic status and health in Hong Kong
2.      Social inequality and health in Hong Kong
3.      Neighborhoods and health in Hong Kong – are there healthier neighborhoods? Why?
4.      Family and health in Hong Kong. For example, are married people healthier?
5.      What are the problems of the health care system in Hong Kong? Are there any reform proposals? What do you think should be done to remedy the problems?
6.      Why do people seek medical help? Interview 15 individuals about the last time they felt unwell and figure out why they did or did not seek medical help.
7.      Why do people smoke? Interview 15 smokers about their history of smoking and why they keep on smoking.
8.      What kind of practices of complementary and alternative medicine (CAM) do people use in Hong Kong? Interview 15 individuals and find out if and what kind of CAM practices people use. Also find out why they chose to use CAM instead of conventional medicine.

II. Data Sources (in addition to interviews)
1.      Online databases such as MEDLINE (a database of peer-reviewed medical journals) or prominent journals in social science research in health and medicine including but not limited to Social Science & Medicine, Sociology of Health and Illness, Journal of Health and Social Behavior, Health Services Research;
2.      News reports;
3.      Official governmental documentation.
Whatever your sources are, you need to clearly specify how you obtain the information.
III. Presentation (see tutorial guidelines)


Tutorial Guidelines
There are five tutorial classes to help you finish the research project. This project is group-based and two students will form a group.
Students must attend all tutorials.
The tutorials will be conducted in English.
Students are encouraged to email the TA with questions regarding the research projects and presentations, as well as the class.
Tutorial 1: Orientation
Tutorial introduction: introduce the objectives and guidelines of the following tutorials.
Group formation: help students to form groups.
Research topic selection: each students group set up their research topic.
Presentation date confirmation: use luck draw to help decide the presentation date.
 
Tutorial 2: Discussion of research design
Students are supposed to finish the preliminary design of their group project and orally report in the class. The report should include the following:
How to specify the research topic?
How to conduct the research? (Research method)
How to structure the presentation?
Class discussion will follow each group’s report and students are encouraged to actively participate the discussion.
 
Tutorials 3 & 4: Presentation
Each group should finish a handout of the presentation and send it by e-mail to the tutor two days before their presentation date. The presentation should be limited to 20 minute and cover the following: the motivation, the objectives, existing literature and theories, the significance, the data collection process and the findings. A short discussion will follow each presentation.
 
Tutorial 5: Watch “The Doctor”, a feature film about a successful doctor who became a patient and took on new perspectives about medicine (in class)
 
Time arrangement:
week of Jan. 21; week of Feb. 18; week of Mar. 24; week of Mar. 31; week of April 7