bluuebunny/crossref_metadata_2025 huggingface dataset:
Health Care Delivery System: Italy
Authors: Maturo Antonio
Published: February 2014

The health care delivery system may be defined as the organized set of functions and activities delivered by the state and its subsystems in order to meet the health needs of the population, respecting the dignity of the individual. In Italy, until 1978, care was based on a system of social insurance connected to the workplace, as in France. In 1978, a reform was enacted and the National Health Care Service was established. Nowadays, the regions have the responsibility for the delivery of health care and patients can freely choose among the public or the accredited private providers. The idea is to promote competition between the providers, making the health care sector more flexible and less bureaucratic. Yet, the competition should not be considered a pure market competition, but as a coordinated competition among structures which have to respect many standards and guidelines (managed competition). In Italy, total health care costs were 9.5 percent of the gross domestic product in 2009: lower than in France and in the United Kingdom and significantly lower than in the United States.
Migration, Stress, and Health
Authors: Xi Juan
Published: February 2014

Migration is defined as any permanent change in residence. It has long been seen as a stressful life event because it entails tremendous social and economic costs with uncertain benefits. Depending on situations in both the place of origin and place of destination, the migration experiences vary across individuals. The initial high mental distress and the gradual decline of physical health, however, is a common pattern.
Mental and Physical Gendered Health Links
Authors: Needham Belinda L. , Hill Terrence D.
Published: February 2014

Mental health research clearly shows that women have higher rates of internalizing disorders, including mood and anxiety disorders, while men have higher rates of externalizing disorders, including impulse control and substance use disorders. Physical health research demonstrates that while women are more likely to have chronic debilitating conditions, such as arthritis and migraines, men are more likely to have life threatening conditions, such as cardiovascular disease and cerebrovascular disease. In this entry, we discuss the evidence that gender differences in mental health contribute to gender differences in physical health.
Professional Deviance
Authors: Banja John
Published: February 2014

This entry discusses various facets of “professional deviance.” Beginning with a characterization of the term, the author will proceed to explain deviating or non‐conforming work behavior as essentially compensatory, meaning that system operators will usually violate rules, protocols, standards, regulations, etc., because they understand the deviation to be necessitated by various pressures exerted by their work reality. The entry concludes with recommendations that might diminish professional deviance, but also notes that such behaviors will predictably occur as byproducts of the human penchant for experimenting and accommodating their work organization's productivity expectations.
Stress Proliferation
Authors: Ward Brian W.
Published: February 2014

Stress proliferation is defined as the development or expansion of a stressor or set of stressors within and beyond a situation, resulting in additional stressors that were not originally present. In other words, it is the phenomenon of how an initial stressor can produce further stressors. Not only is understanding the function of stress proliferation important in itself, but knowledge of this phenomenon can also help bring better understanding to various physical and mental health outcomes experienced by an individual, and the pathways (whether direct or indirect) that lead to these outcomes.
Parenthood and Health
Authors: Cross Jennifer Moren
Published: February 2014

Parenthood is a ubiquitous social role around the world. It represents a paramount role transition and serves as a principal organizing framework for one's life. Given how pervasive parenthood is, there is a surprising paucity of social scientific research on the interplay of parenthood and physical health. Existing evidence largely falls under three domains – socioeconomic, social ties, and health behaviors – and is summarized here.
Substance Abuse and Social Policy
Authors: Freudenberg Nicholas , Heller Daliah
Published: February 2014

Substance use policy regulates psychoactive drug use in society. Since the early twentieth century, national governments and international bodies have enacted legislation, policies, and programs to reduce psychoactive drug use and its related harms. This history reflects an ongoing effort to balance public health and public safety related to substance use, with the emphasis shifting in response to sociopolitical trends. Several sectors, including health care, law enforcement, the military, and national governments play a role in creating substance use policies. Policies can have unintended as well as intended consequences at the local, national, and global levels. By focusing on desired outcomes such as reduced direct and indirect harm associated with drug use, policymakers can increase the likelihood of success.
Impact of Business and Corporate Practices on Health
Authors: Freudenberg Nicholas
Published: February 2014

Business and corporate practices play an increasingly important role in shaping population health. They influence every aspect of human experience, from diet, air pollution, work, and health care to personal identity, lifestyle, sexuality, and governance. Businesses influence health through various pathways, including the impact of their production practices on the health of workers and the larger environment, their products on the health and lifestyle of consumers, and their political practices on governance and the ability of the state and civil society to protect public health. Businesses have both positive and negative influences on health; the goal of public health is to propose and implement policies and programs that maximize the former while minimizing the latter. In response to the growing power of corporations to shape health, a variety of countervailing forces have emerged. These include global alliances of governments and civil society groups that set standards for corporate behaviors that influence health, non‐governmental organizations that take action to promote corporate social responsibility for health, government regulation, and social movements and advocacy campaigns to modify harmful business practices.
Social Psychology and the Stress Process
Authors: McLeod Jane D. , Caputo Jennifer L. , Erving Christy L.
Published: February 2014

The stress process model has deep roots in the symbolic interactionist and social structure and personality traditions within sociological social psychology. Symbolic interactionism emphasizes the centrality of meaning in social life, an emphasis that informs a key tenet of stress research that the effects of stressors on outcomes depend on their meanings to the person. The social structure and personality tradition emphasizes the macro‐structural origins of proximate life experiences, an emphasis that is evident in research on the role of stress in health inequality. The greatest potential contributions of social psychology to research on the stress process combine these emphases in analyses of the macro‐structural and interactional origins of the meanings of stressors.
Stress and Migration
Authors: Shuval Judith T.
Published: February 2014

Stress occurs when an individual confronts a salient situation in which her/his usual modes of behavior are inadequate and the consequences of not adapting are sufficiently disturbing to result in a disruption in homeostasis. Situations are not objectively stressful but are constructed as such by individuals in terms of social and cultural norms. Stress may be viewed as both a cause and a consequence of migration. On the causative level, stress in any given location may act as a motivator of migration – when people believe that they can reduce stress and improve their overall situation by migrating to a different setting. In order for stress to serve as an effective motivator, two conditions are required: (a) a level of stress which is perceived as sufficiently powerful and salient to justify uprooting oneself and one's family from a familiar setting; (b) knowledge about the destination and a belief that conditions there will provide less stress and a more satisfactory setting.
Euthanasia
Authors: Castra Michel
Published: February 2014

While the notion of euthanasia has been used to depict quite different, and even contradictory, practices, the emergence of this issue is indicative both of a transformation in the way medicine approaches the end of life, and of a new relationship between medicine and society. This is demonstrated in the range of legal and political claims that are made in different countries as assertions of a right to die. These claims articulate a new individualization of death through their characterization of the last days of life.
Pollution and Purity
Authors: van der Geest Sjaak
Published: February 2014

“Pollution” and “purity” form a classic conceptual pair in cultural anthropology, mostly applied to ritual status. The solemn and somewhat archaic tone of the two terms betrays their religious pedigree, but pollution and purity are basically about very mundane matters: being dirty and being clean. These everyday experiences lend themselves eminently as metaphors to express positive or negative valuation of nearly everything in human lives. Their efficacy as metaphors lies in the intense visceral emotions of aversion and attraction concerning what is physically dirty or clean. “Dirt” and “cleanliness” may therefore be better terms for an anthropological discourse on everyday experience and the emotions of disgust and desire.
ICT inHealth Care
Authors: Winthereik Brit Ross
Published: February 2014

The digitalization of health care work began gaining momentum in the 1990s in Europe and the United States. Since then social studies of information and communication technology (ICT) have taken a substantial interest in health care organizations as sites of investigation. Often based on detailed ethnographies of technology usage and clinical work, sociological and anthropological studies of ICT point to the local and contingent nature of standardized technologies and procedures in health care institutions. One of the conclusions is that to understand technological and procedural standardization – or attempts to standardize – it is crucial to be attentive to dynamic and complex interplays between ICT and its social environment.
Traditional Health Services Utilization among Cancer Patients in Western Countries
Authors: Broom Alex , Kirby Emma
Published: February 2014

Traditional health services – including traditional, complementary, and alternative medicines – are playing an increasingly prominent role in Western cancer care, with up to 80 percent of patients utilizing some form of non‐conventional care. The resurgence in public interest in and use of traditional health services reflects a contemporary waning in deference to, and singular reliance on, conventional cancer care. Moreover, it reflects shifting sociocultural values regarding the body, illness, and disease including those related to subjectivity, individualization, agency, and holistic care. While the limits of conventional cancer care have received significant attention, the limits and cultural impacts of traditional health services have received relatively little attention, and warrant exploration to unpack their interplay with recent movements to devolve responsibility to individuals and citizens for their health and well‐being.
Medical School Socialization
Authors: Hafferty Frederic , Cruess Richard L. , Cruess Sylvia R.
Published: February 2014

Issues of socialization and the occupational formation of future physicians form an essential foundation for how educators understand and then improve the training of medical students. In this entry, we link early sociological studies of medical school training to the broader conceptual framework of how occupational groups such as medicine ensure that its future practitioners acquire the knowledge, skills, and values that underscore the work of that group. We then explore important conceptual distinctions between occupational and organizational socialization and examine how the structure of training and differences among learning environments help to shape professional identity. We conclude with an overview of current research on medical student socialization and the challenges raised by major initiatives such as longitudinal training, reforming the hidden curriculum, and interprofessional education.
Vaccination
Authors: Moulin Anne Marie
Published: February 2014

The principle of vaccination was discovered more than three centuries ago. The many vaccines that have been introduced at distinct times as an official tool for public health have had a considerable impact on societies. Once the instrument of nation‐states, their use is increasingly scrutinized by citizens privileging individual choices. The demand for scientific information has created a permanent forum where ancient and novel strategies and vaccines are discussed – a good model within the social sciences for the study of decision‐making.
HIV/AIDS and Gender
Authors: Mwaria Mercy
Published: February 2014

As HIV/AIDS moves on to its third decade since the initial reported cases, the epidemic continues to wreak havoc on many population groups in the world. Gender is a socially defined construct, which suggests that society assigns and defines roles for men and women and expects them to behave in certain ways. Gender is an important factor in understanding how various sections of the population experience HIV/AIDS and the kinds of risks they face. It is imperative that HIV/AIDS prevention agencies and programs consider how gender intersects with the particular risk factors that they seek to reduce or eliminate among the populations that they serve. A careful consideration of the influence of gender roles in HIV/AIDS care and prevention will ensure that these service providers optimize benefits and address risk determinants among the specific populations that they serve.
Animal Health
Authors: Spencer Adam
Published: February 2014

For as long as humans have lived, our fates have been intimately bound up with the lives of the other animals with which we share the planet. In the earliest days ofhomo sapiensanimals posed both a threat to human life and also a valuable source of food. The development of farming provided a means to utilize the food value of particular animals without the inconvenience and uncertainty of the hunt. As well as food animals, humans have domesticated some species of animals as pets. Today the relationship between animal and human health remains very close, and deserving of the attentions of social scientists.
Professional Trust
Authors: Cruess Richard L. , Cruess Sylvia R.
Published: February 2014

Sociologists state that professions exist as a means of organizing the delivery of the complex services required by society, including health care. In granting professional status to medicine and other healthcare disciplines, society establishes a social contract based on professionalism. As a part of this contract, medicine and other health care professions are granted a monopoly over the use of their knowledge base (licensure), considerable autonomy in practice, the privilege of self or profession led regulation, prestige and financial rewards. In return, the members of the professions and their institutions are expected to be altruistic, abide by codes of ethics, assure the competence of practitioners, and address issues of societal concern within their domains. Essential to the success of this “bargain” is professional trust.
Clinical Trials
Authors: Will Catherine M.
Published: February 2014

The rise of randomized controlled trials, and their current hegemony, in much of medicine is an important topic in social science. Safety and efficacy trials in both healthy volunteers and patients have been required in many countries for approval of drugs since the 1960s, and are also carried out to further the marketing of new drugs as well as investigate their “effectiveness” in general use. According to theorists of “regulatory objectivity,” trials may be seen as serving organizations who wish to regulate professional work, thus appearing to replace or displace clinical judgment. Sociologists have been concerned to explore the practical workings of these medical experiments and the experience of participants. Here debates among physicians, scientists, and patients about appropriate designs have been of particular interest, most prominently around the case of AIDS activism in the 1990s, informing wider debates about lay involvement or expertise in medicine and science.
Childbearing, International Practices
Authors: Goode Keisha , Rothman Barbara Katz , Chen Kuan‐Yi , Stone Nancy
Published: February 2014

Childbirth, like other social practices, is influenced and affected by the society in which it occurs. In this entry is a snapshot of nine countries (Ghana, South Africa, China, Philippines, Germany, France, the Netherlands, Brazil, and Peru), representative of four continents throughout the world. Though there are certainly many world regional patterns of childbirth, a detailed account of select countries offers a rich insight into the interconnectedness of childbirth with the social, political and economic system(s) of a given society. They vary widely, but in many cases are similar, in primary providership, model of care, and rates of mortality, morbidity, and cesarean section, among other vital statistics.
Biology and Life Sciences
Authors: Crowe Nathan
Published: February 2014

The fields that constitute the life sciences experienced dramatic changes during the twentieth century. From 1901 to 2000, the life sciences splintered into hundreds of specializations: older disciplines fractured into more specific subjects and new disciplines arose from advances in knowledge and technology. Moreover, at the beginning of the century the public had little exposure to the life sciences, reflecting not only the subject's popularity, but also its perceived utility. By 2000, however, discoveries about new genes, drugs, and diseases could be found everywhere, and the life sciences generated immense excitement for both scientists and the general public.
Street Children and Gendered Health Consequences
Authors: Shephard Daniel D.
Published: February 2014

Millions of children spend a majority of their time working and living on the streets without adequate adult supervision. These street children are exposed to many health risks due to poverty, hazardous work, lack of service access, and abuse. This exposure is also highly gendered within the street child population. Boys make up the vast majority of street children and therefore are more exposed to many of these risks. Girls are less likely to enter into street life, but once they are there, they are at elevated risk for poor physical and mental health. While research on street children's exposure to health risks has advanced in recent decades, there is a lack of gender‐disaggregated data. The little data that exist suggest that boys are more likely to be addicted to drugs while girls suffer from more mental illness, sexual health problems, and general physical ailments.
Complexity and Health
Authors: Gatrell Anthony C.
Published: February 2014

It is very common to read that health issues, whether relating to behaviors, outcomes, or service configurations, are “complex,” and complexity theory (or complexity science) has been invoked by some researchers in order to illuminate the workings of such systems. This entry clarifies the characteristics of a complex system and illustrates this with particular reference to health inequalities. An implication of complexity thinking for public health (as very broadly conceived) demands transdisciplinary thinking. Carefully invoked, concepts from complexity science can be productive in health research.
Aging and Health Geography
Authors: Wiles Janine L.
Published: February 2014

This entry delineates three themes of spatial, relational, and critical geographies of aging and health. Spatial approaches to aging and health geography focus on measuring and understanding the implications of the changing distribution of aging from global to national, regional, and urban levels. Relational approaches to aging and health geographies seek to understand older people's interactions with social and physical environments for example through place attachment and “insideness,” while critical approaches to aging and health geographies challenge normalizing and often negative discourses around aging, for example around the concept of aging in place.
Mental Health Public Policies in the United States
Authors: Chandler Susan Meyers
Published: February 2014

Almost every choice that a person makes about his or her treatment or type of care provided in the system of mental health services in the United States is strongly influenced by federal, state, and county laws, policies, administrative rules, procedures, and regulations. This influence may affect who can be licensed to provide what type of treatment; where that treatment can take place; who is eligible to obtain a service; who will pay; what is covered by private insurance; how different states regulate the insurance companies; what is the individual state's design of Medicaid coverage; even how persons eligible for Medicare can access and receive services. This entry reviews the history and impact of mental health policies on the system of mental health care in America.
Care, Quality of
Authors: Robelet Magali
Published: February 2014

Since the 1990s, new definitions, new institutions, and new quality evaluation tools have appeared in most Western nations. Two emblematic tools in this new focus on quality are medical recommendations and initiatives for management within health care organizations. This article aims not to justify and compare the effectiveness of these tools in the actual improvement of quality of care but rather to discuss the appearance of these tools and their effects on the content of medical work and on power relations between doctors, government, and the public. The attention focused on quality of care has caused a resurgence in debates over the autonomy and power of health care professionals, physicians in particular. Quality of care has become an indicator of changes in the regulation of medical professionals, passing from self‐regulation to a more hybrid form, leaving more power to government, to health care insurers, and to the public. The evaluation and improvement of quality of care does increase the role of government and payers, but it does not necessarily lead – at least not at the present time – to the reinforcement of constraints and controls on the content of medical work.
Geographies of Disability and Impairment
Authors: Hall Edward
Published: February 2014

Geographies of disability and impairment examine the interrelationships between bodily and mental impairments and social, cultural, political, and physical environments, and how these shape the experiences of disabled people and, more broadly, the understanding and valuing of “disability” in society. Geographies of disability and impairment have described and mapped the incidence of disability, and studied the exclusions and everyday lives of disabled people, developing a distinctive socio‐spatial theoretical understanding of disability within what is now a discernible field in human geography. Geographical study of disability and impairment has reflected wider changes in the social and cultural conceptualization of disability and the social position and valuing of disabled people, from an individual medically defined condition to a socially constructed phenomenon, and more recently a material embodied experience.
Mental Health and Marital Status
Authors: Spiker Russell L.
Published: February 2014

Marriage is a social institution and its effects on mental health vary across societies. In societies which emphasize marriage, being married is related to lower depression, lower anxiety, lower suicide risk, and lower substance abuse, on average. Two models explain the relationship between mental health and marital status: causation and selection. Selection models propose that healthy and socially desirable people are more likely to become and stay married. In causation models, marriage confers benefits directly to participants. Divorce and remarriage result in short‐term decreases in mental well‐being. Remarriage positively affects mental health, but less than first marriage. Never‐married and cohabiting people are emerging groups of interest, with research suggesting that effects vary by social norms and selection factors. Social support is the mechanism through which relationships affect mental health. Some caveats and potential avenues of research are also outlined.
Experts and Expertise
Authors: Gilbert Claude , Henry Emmanuel
Published: February 2014

Expertise – and scientific expertise more specifically – is seen as crucial to public health decision‐making. The idea that, in order to deal with increasingly complex problems in this regard, decision‐makers must rely on experts and the knowledge they mobilize is no longer questioned. Yet the articulation of expertise and public decision‐making is not self‐evident. Both expertise and the place experts should have in decision‐making processes are a core issue in many debates.
Health and Climate Change
Authors: Lake Iain R.
Published: February 2014

There are several mechanisms through which climate change may affect health ranging from direct (e.g., heat wave deaths) to indirect effects (e.g., famine from crop failures). The Intergovernmental Panel on Climate Change have examined the likely impacts on health and suggested that extreme weather (e.g., cyclones) is projected to increase leading to elevated deaths, disease and injuries. More illnesses associated with poor air quality and malnutrition are also projected. Climate change may affect the distribution of disease causing vectors (e.g., mosquitoes transmitting dengue fever) with negative health consequences. However, in the case of malaria some countries will see more and others less disease with overall neutral consequences. Elevated temperatures are projected globally which may reduce cold weather mortality in high latitudes. Diarrheal diseases are caused by a variety of organisms and increasing incidence is indicated. Climate change is unlikely to lead to new diseases although new strains of microbes may possibly emerge. It may, however, affect the range, incidence, and seasonality of existing diseases. Existing public health and health care systems provide countries with the capacity to adapt to the consequences. Many of the most severe impacts are projected to fall disproportionally on lower income countries that have relatively few resources to adapt.
Mental Health, Men's
Authors: Smith Dena T. , Mouzon Dawne M.
Published: February 2014

Very little research examines men's mental health specifically, though there is extensive research on gender differences in mental health. Most studies find that men and women have similar rates of disorder but experience different types of mental illnesses. Women have higher rates of internalizing disorders (e.g., depression, anxiety) while men typically display externalizing symptoms (e.g., violence, substance abuse). It is unclear whether these trends reflect true gender differences or measurement bias instead, because scholars have less adequately tapped men's experiences. In this entry we review literature that helps explain men's mental health, including research on gender roles, help‐seeking, coping, and social support. We then outline literature assessing the potential role of measurement bias. Future research should move beyond gender comparisons and focus specifically on men's lived experiences (including heterogeneity among men), in addition to testing the possibility that men's depression and anxiety may be masked by substance abuse and violence.
Homelessness and Physical Health in the United States
Authors: Kantayya Vivek S. , Hawkins Alesia O. , Koon Adam D.
Published: February 2014

Homelessness is a serious public health concern. A significant number of physical health problems are associated with homelessness including both acute and chronic medical conditions. Homeless people experiencing mental health issues, substance abuse, and victimization contribute to poorer health outcomes. Experiencing homelessness imposes several barriers to effective patient care requiring tailored health services to meet the challenges faced by this population. Health care providers may meet the needs of the homeless by taking an integrated team approach to patient care that incorporates different delivery systems of care, continuity, and sensitive case management.
Health and Illness, Cultural Perspectives on
Authors: Benard Akeia A. F.
Published: February 2014

Health and illness in every society are socially constructed concepts discussed using key cultural symbols and metaphors. Different medical systems, including biomedicine, humoral medicine, and spirit healing should be understood in their cultural context. Doctors and patients can gain cultural competency when each knows the other's perspective on health and illness. We should not, however conflate culture and poverty when discussing differences in health outcomes.
Health, Identities, and Stress
Authors: Shank Daniel B.
Published: February 2014

In many ways identities can alter stress processes leading to differential health outcomes; and, less studied, identities also develop as the outcome of stress and health behavior. Stressors and the meaning of those stressors are often affiliated with specific identities. Therefore, identities also provide social support and buffering resources to reduce the stress processes on health outcomes.
Socioeconomic Status, Measurement
Authors: Bateman Lori Brand
Published: February 2014

Socioeconomic status (SES) is utilized in a broad range of sociological research and refers to the relative placement of individuals within the hierarchical social structure of a given society. An individual's SES is correlated with behavior and lifestyle, and SES has been one of the most robust and consistent variables in explicating variations among social groups in health status. SES is a multidimensional construct and has traditionally been measured by occupational prestige, educational attainment, and/or income. More recently, researchers have used area‐ based measures, such as neighborhood SES, and some have proposed that utilizing a life course perspective is crucial to more accurately understanding the relation between SES and health. Critics claim that researchers should seek to account for as many of the socioeconomic variables as possible while considering how differences in social groups may play a role in the interpretation of findings.
Stress Management: International Variations
Authors: Huey Wesley S.
Published: February 2014

A great deal of research on occupational stress and its effects on health is done outside the United States. With roots in epidemiology, the predominant model for occupational stress – the job demand–control model – provides a simple and unifying framework for interdisciplinary research across cultures and occupation types. This entry reviews the literature on occupational stress in general, then spotlights the contributions made by researchers outside the United States. The growing importance of occupational stress as a sociological object is addressed.
Mental Health Policies, International
Authors: Szaflarski Magdalena
Published: February 2014

A mental health policy is an official statement by a government or health authority that provides the overall direction for improving mental health of people by defining a vision, values, principles, and objectives, and by establishing a broad model for action to achieve that vision. A policy is distinguished from a plan, or a strategy for implementing actions to achieve objectives of a policy. International health authorities, such as the World Health Organization, develop and establish guidelines for the development of mental health policy, strategic plans, and health care services at the country level. The key recommendations for developing mental health policy currently are to deinstitutionalize mental health care, to integrate mental health into general health care, and to develop community mental health services. There are similarities and differences among countries in mental health policies and systems. Similarities include shared international principles and guidelines. Differences are visible in the scope/type of services, financing, workforce development, and approaches to prevention, intervention, and ongoing care. Notably, low‐ and middle‐income countries are less likely to have policies although they carry a disproportionate burden of mental health conditions. Inequity in mental health care is also present within countries and linked to policies and system type.
Systems Theory
Authors: Boiko Olga V.
Published: February 2014

This entry addresses the application of Luhmann's theory of self‐referential social systems to understanding the functional differentiation of the medical system. System/environment distinction has been illuminated in this theory to show the complexity and contingency of interactions within and between systems. The key propositions of the theory imply that social systems solve different problems and are also capable of self‐referential reproduction and, simultaneously, change. The medicine's integrity is explained by the primordial focus on illness; lately, however, health communication emerges from obscurity to prompt the evolutionary developments that give rise to the system of health care. Functional systems aside, the entry highlights the approaches of systems theory to the analysis of other social systems: interactional and organizational. The systems theory attests that health care presents not random context but a system with meaningful boundaries that guides health communication of professionals and lay people.
Professional Work, Managing
Authors: Waring Justin
Published: February 2014

The management of health care work remains a prominent topic of inquiry within medical sociology, and more broadly the sociology of the professions, organizational studies, management science, and public policy. This interdisciplinary field shows a significant shift in the organization of expert work since the 1970s, where the logic of professionalism has been replaced by the logics of the market and bureaucracy. The managerialization of health care work has been one of the most significant global trends in health policy since this time, with managers acquiring an increasingly influential role in the organization of professional work, especially the allocation of resources, formulation and implementation of strategy, work planning and coordination, and performance management. For many health professions, it has opened up new career pathways, arenas for decision‐making, and opportunities for service improvement. At the same time, management is often interpreted as fundamentally changing the social organizational of care work. In most cases, the medical profession has been the primary unit of analysis, but other health care professions, especially nursing, are often more subject to the influence of management, revealing important variations in how health professions experience management change.
Medical Education and Professionalism
Authors: Michalec Barret , Hafferty Frederic W.
Published: February 2014

In this entry we explore the sociocultural history of the current push for “professionalism” within organized medicine. We argue that the contemporary discourse of professionalism within organized medicine is, in actuality, a debate about medicine's status as a profession and its efforts to maintain and promote cultural authority, organizational autonomy, and a positive occupational identity. The entry also examines the drive to define, assess, and institutionalize professionalism within medical education circles, and the related pushback from medical students. We conclude by showcasing relatively new areas of activity within medical education that may enhance understanding of the development of professionalism principles such as the construction and implementation of interprofessional education (IPE) programs, and the role of certification and licensing organizations in the maintenance and institutionalization of professionalism.
Stress and Work/Family
Authors: Ballard Sarah
Published: February 2014

Work–family research studies how individuals manage the competing demands of multiple roles. Two prominent frameworks – role strain and person–environment fit – both emphasize how this is often a stressful experience. The influence of gender roles and ideology means that men and women tend to experience work–family stress for different reasons. Similarly, the characteristics of work and family (e.g., work hours, autonomy, number of children, and spousal support) also play a big role in who experiences work–family stress and how much.
Food Insecurity
Authors: Hadley Craig
Published: February 2014

Food insecurity occurs whenever people lack predictable access to foods that are safe and nutritious and support an active and healthy lifestyle. Given that food plays important social, cultural, and biological roles, social scientists have been very interested in understanding the causes and consequences of insecure access to food. Research to date has focused heavily on understanding how best to measure food insecurity, to understand who is at risk of food insecurity (and why), and the consequences of food insecurity for mental and physical well‐being.
Health Locus of Control
Authors: Hinote Brian P.
Published: February 2014

One fundamental question facing patients, practitioners, and researchers in social science and other health fields involves exactly who or what is responsible for an individual's health. Many look to the outside world or the various social contexts surrounding the individual in locating the origins of health or disease; some focus on the personal decisions made by individuals on a day‐to‐day basis, and still others look to the interplay of structural considerations (i.e., life chances) and individual choices for clues relating to the various mechanisms of pathogenesis.
Socioeconomic Status and Stress
Authors: Shea Brent M.
Published: February 2014

Stress is studied in sociology as a variable that contributes to explanations for why socioeconomic status (SES), which includes some combination of indicators of education, income, and occupational status, is related to mental and physical health, illness, and health behaviors. These social patterns are identified by categorizing individuals or families by SES. The dominant causal direction is from SES to health rather than from health to SES, but the relationship is reciprocal. The monotonic relationship between SES and stress is generally inverse. This corresponds to the inverse relationship between SES of individuals and physical and mental health. Community or neighborhood SES also is related to health but not as strongly as individual or family SES. The differential exposure to stress, especially when combined with inadequate coping resources in families, communities, and nations, is part of the explanation for persistent inequities in both mental and physical health.
Occupational Health and Safety
Authors: Howard Penny McCall
Published: February 2014

At least 2.34 million people died from work‐related incidents or diseases in 2008, and the number is growing. Workplace hazards range from physical to chemical and organizational, and change continually. Since the 1970s, many countries (as well as EU and ILO standards) have shifted to “regulated self‐regulation” for the control of occupational health and safety (OHS) in systems which involve workers and management in regulating safety at a workplace level, while reducing technical standards. At the same time, corporate downsizing, outsourcing, casualization of work, and work intensification have had a negative impact on OHS which must be addressed in order to reduce work‐related harm.
Sex Work
Authors: Oxlund Bjarke
Published: February 2014

The term “sex work,” coined by sex worker Carol Leigh in 1973, was introduced as an alternative to the denigrating term “prostitution,” with all its connotations of shame and wrong‐doing. Instead, the term “sex work” promotes an understanding of empowerment and liberation and the leveling out of sex work with other kinds of work. Radical feminists have therefore been very critical of the use of the term, because they see prostitution and sex work as the quintessential oppression of women through coercion, abuse, and harassment. Social scientific understandings of sex work and prostitution have changed over time. From a rather exclusive focus on individual pathology and the victimization of sex workers there is now an appreciation that the positive and negative effects of sex work largely depend on the conditions of specific sex workers. There is also a growing appreciation that sex workers may be female, male, or transgender, and that a singular focus on women as providers and men as customers is not adequate.
Health Professions, Sociology of
Authors: Stevens Fred C. J.
Published: February 2014

This entry highlights health professions from the three perspectives that have dominated sociological theory and inquiry since the 1950s – the functional approach (professions have social functions), the traits approach (professions have certain attributes in common), and the power approach (professions have a power position) – and from a fourth perspective centered on the viewpoints of interacting professions. These perspectives serve as a means for understanding some of the current and prospective problems that health care and the health care professions are facing: bureaucracy versus professionalization, the frictions in health care between work and non‐work, the need for and limits to internal and external control of professionals, and the specialization of professionals versus the increasing need of health care generalists.
Syndemics
Authors: Singer Merrill
Published: February 2014

The syndemic perspective seeks to understand disease not as an isolated condition as seen in the laboratory, but as found in the natural world, a comorbid with other diseases and threats to health. Specifically, the term “syndemic” refers to the adverse interaction of diseases of all types (e.g., infections, chronic non‐communicable diseases, mental health problems, behavioral conditions, toxic exposure, and malnutrition) commonly as a result of social conditions that directly and indirectly promote disease clustering. Syndemic interactions enhance the total health burden faced by a population and often play an important role in hard‐hitting epidemics.
Health Care, Commercialism in
Authors: Guseva Alya
Published: February 2014

Commercialism in health care is an application of operating and managing principles typically found in business and commerce (financial incentivizing, profit‐making, competition, marketing/advertising, and focus on the bottom line) to health care delivery. The US health care system ranks the highest on commercialism among Western industrialized democracies. Commercialism poses a threat to medical professionalism, patient care, and even the integrity of science, which is a foundation of our trust in medicine and medical professionalism. The downsides of commercialism are not confined to the for‐profit health sector, as private not‐for‐profit and public institutions are forced to compete with for‐profit health care providers and to emulate their strategies. Commercialism in health care may also increase health care costs. While it encourages profit‐making among health care providers and insurers, the nature of health care service is such that patients are limited in their ability to exercise their power as consumers, which leads to overuse of services, high costs, and variable quality.
Health Belief Model
Authors: Green Edward C. , Murphy Elaine
Published: February 2014

The health belief model became one of the most widely recognized conceptual frameworks of health behavior, focusing on behavioral change at the individual level. The model suggests that decision‐makers make a mental calculus about whether the benefits of a promoted behavior change outweigh its practical and psychological costs or obstacles. That is, individuals conduct an internal assessment of the net benefits of changing their behavior, and decide whether or not to act. The model identifies four aspects of this assessment: perceived susceptibility to ill‐health (risk perception), perceived severity of ill‐health, perceived benefits of behavior change, and perceived barriers to taking action. The concept of self‐efficacy, or the perceived ability to actually take a recommended action, was later recognized as an important component or factor.
Home Care Workers
Authors: Denton Margaret , Barken Rachel
Published: February 2014

Home care workers are a key component of the formal home health and social care workforce. They work under the supervision of a health care professional or under the direction of a client. The location of their work may vary from a client's home to a supportive housing environment. They provide a range of services including personal care, light housekeeping, clinical care services, and delegated acts. The majority of workers are women and middle‐aged, and many are migrant workers. They tend to work part‐time, with low pay and few benefits. Recruitment and retention of home care workers is an issue. Their jobs expose them to many occupational health and safety hazards. However, many home care workers gain satisfaction in their work and the caring relationships they have with their clients.
Physician Assistant Profession
Authors: Van Vught Anneke J. A. H. , Van Den Brink Geert T. W. J. , Harbert K. , Ballweg R.
Published: February 2014

Physician assistants (PAs) are health care professionals who, in some countries, are authorized to practice medicine as part of a team that includes physicians. PAs deliver a broad range of medical and surgical services that are typically performed by physicians. PAs work in hospitals, clinics, and a variety of other health facilities, and exercise autonomy in medical decision‐making as directed by their supervising physician. A period of intense classroom and clinical training precedes the granting of a license to practice as a PA. The profession was created to improve and expand health care. The concept gained acceptance and backing in the United States, as early as the 1970s, as a creative solution to physician shortages. Since then PAs have been increasingly employed and are now found worldwide. Understanding how PAs are utilized is important to international health policy. Several studies in the United States and the Netherlands are currently investigating the efficiency and effectiveness of employing PAs.
Health Care Delivery System: Canada
Authors: Bourgeault Ivy Lynn
Published: February 2014

Canada's health care delivery system is a set of loosely coordinated provincial and territorial systems of hospital and medical care insurance. The means by which the provincial and territorial health care systems are coordinated is through a series of joint financing initiatives with the federal government. The principles of health care in Canada include universality, accessibility, comprehensiveness, portability, and public administration. Structurally, health care in Canada includes coverage of the costs of the most expensive form of care – hospitals and physicians’ services. It is little surprise, therefore, that cost controls have become an issue. The accommodations made to establish public health care in Canada also serve to institutionalize the status quo of medical dominance with doctors as the gatekeepers to access many aspects of the system.