CHAPTER 14 Health Care and Illness: Physical and Mental Nature of the Problem: Health Care and Illness (pp. 472-485) Life expectancy in this century has increased from about 47 to over 76 years
by 2000, partly as a result of improved living conditions, advanced technology,
and application of medical knowledge. Larger numbers of people now fall victim
to chronic debilitating illness with profound effects on the quality of life--these
diseases are the major cause of death in the United States. There is concern
about a resurgence of infectious diseases. The health problems we face vary
by gender and age. AIDS is a disease that is receiving considerable public attention
because of its mode of transmission and its deadly outcome. Mental illness is
linked with stress and social change but is found in all societies. Mental disorders
are classified in terms of etiology and as either organic or functional. The
extent of mental illness is difficult to assess, but studies of hospitalization
rates and estimates of "true" prevalence support the notion that mental illness
and its symptoms are becoming increasingly more serious in our society. Health Care, Illness, and the Quality of Life (pp. 486-493) In our health-oriented society, physical and mental illnesses cause disruptions
in everyday life as well as fears for the future of those directly involved.
The obvious impact of illness on the quality of life is the stress and suffering
that illness imposes on people. Poor interpersonal relationships and ill health
can become a vicious circle, while good relationships tend to promote good health.
Inadequate medical care is related to the fact that medicine is still an inexact
science, facilities are often inadequate and personnel incompetent, cost is
high, and sources of care are distributed poorly among the population. Individual
privacy and medical advances are in conflict, as in screening for control of
genetic disease. Costs of health care to individuals and to families have been
rising steadily to oppressive levels; costs to society in lost productivity
are rising to substantial levels. The inadequate care of the mentally ill has
been compounded by the deinstitutionalization movement that began in the 1960s.
The history of medicine is marked by ongoing conflict between the advocates
of medical advance and those who defend the freedom of the individual. An increasing
amount of the nation's economic resources is channeled into the effort to combat
illness and promote good health. Contributing Factors (pp. 493-504) Sociocultural factors are involved in both the etiology of disease and the
problems of inadequate care and access to care. Certain roles in society have
been identified as particularly stress-inducing and therefore possible precursors
to physical and mental disease. The role of a married woman is implicated in
prevalence rates for all kinds of illness in women, while high stress levels
of certain occupations predispose men to coronary heart disease. The rapid rate
of social change-future shock-is, for many, a stressor. Elements of the industrial
economy expose workers and neighborhoods to carcinogens, noise, and substance
pollutants, but seem unresponsive to efforts at protection. A politics of illness
exists, as evidenced by the stratification of illness patterns and the maldistribution
of medical resources. What Is to Be Done? (pp. 504-507) Long-standing attitudes, values, and the ideology of free enterprise perpetuate
problems of treatment and inhibit efforts toward positive change. As in the
case of drug and alcohol abuse, more money and effort have been expended on
treatment of ill health than on prevention. Some treatment of mental disorders,
however, has been of doubtful value. Continuing research is aimed at making
prevention, diagnosis, and treatment of both physical and mental illnesses more
effective. Innovative programs are needed to further ensure the more equitable
delivery of all health-care services. |