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What If We Thought of Societies As Patients?

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What If We Thought of Societies As Patients? Spring 2021 • Volume 49 • Number 2 In This Issue What If We Thought of Societies as Patients? In this issue on health and health care, sociologists discuss how a careful consideration of relationships among individuals, medical and political systems, and social environments can create healthier societies. 2 Why Sociologists Are Good for Our Health Margaret Weigers Vitullo, Deputy Public Health Infrastructure and Bernice Pescosolido and Christine Bachrach Director, American Sociological Implications for Marginalized Byungkyu Lee (“COVID-19 and Association Populations”) brings a similar the Sociology’s Mental Health Structural Racism and he baby was born healthy. analytic lens to the pandemic, Moment”) consider the possibility 4 Inequalities in Health The woman who had a stroke explaining that it is only through that widely experienced social Taylor W. Hargrove T had a long history of high blood consideration of the interactions isolation during the pandemic, and the concomitant increases “All in This Together?”: pressure. The man suffered from between individuals and their in depression, anxiety, and other 6 Inequalities and Hesitancy depression. Statements like these environments that we can Surrounding the COVID-19 reflect the fact that in the U.S., understand why Black individ- mental health problems, may lead Vaccine health is generally thought of as an uals comprise 14.7 percent of all to a broader understanding of the individual characteristic. Likewise, relationship between environment Jennifer A. Reich COVID-19 deaths while only medicine and medical treatment 4.6 percent of vaccines have gone and mental health and perhaps even 8 How the Vaccine are usually framed in individual to Black people. Christine Bachrach a reduction in social stigma around Rollout Reveals Another terms. The field of public health is (“Why Sociologists Are Good For mental illness and its treatment. Failure of U.S. Public the domain that generally studies Our Health”) points out that even However, the articles in this issue population-level health, considering Health Infrastructure when environmental factors, like do not just reveal the fault lines and the factors that impact communities and Implications for neighborhood violence or poverty, failings that have led to systemic and societies. Interventions in Marginalized Populations are taken into inequality in public health usually occur at the Tiffany D. Joseph account, they health out- policy level and may include things are generally In the articles that follow, comes across The Rise of U.S. States and such as regulations and programs individuals and 9 conceptualized authors use the methods the Fall of U.S. Health and the administration of services. communities. as “exposures” Jennifer Karas Montez The distinction between medicine and insights of sociology to They also pro- suffered by and public health has long provided demonstrate the tightly bound vide guidance Understanding the individuals, a convenient delineation of areas on how we can 10 Pandemic’s Impact on Black instead of relationships between individual of expertise. Clinical professionals, move toward Americans’ Health from a taking the health and social conditions including doctors and nurses, focus solutions. Life Course Perspective entire inter- on treating individuals. Public across multiple outcomes, and call Producing Latrica E. Best health researchers focus on com- active system for a far more nuanced, multi-level healthier munities and promoting conditions into account. and interactive consideration of societies will COVID-19 and Sociology’s that will improve the health of the Jennifer Reich 12 Mental Health Moment require careful individuals within them. (“All in this the factors behind health and consideration Bernice A. Pescosolido and This issue of Footnotes challenges Together?”) well-being. Byungkyu Lee of the on-going this distinction. The authors here demonstrates and structured use the methods and insights of ASA News the ways those relationships 14 sociology to demonstrate the tightly interactive feedback loops produce between individuals, medical Announcements bound relationships between indi- 19 vaccine hesitancy and serve to and political systems, and social vidual health and social conditions perpetuate it. across multiple outcomes, including environments. It will require us to Taylor Hargove (“Structural COVID-19 deaths and vaccination think and work in interdisciplinary Racism and Inequalities in Health”) rates. They call for a far more ways that draw on the expertise and Latrica Best (“Understanding nuanced, multi-level and interactive of sociologists, public health the Pandemic’s Impact on Black consideration of the factors behind professionals, and state- and Americans’ Health from a Life health and well-being. national-level policy makers, as Jennifer Karas Montez (“The Course Perspective”) help us well as the expertise of medical Rise of U.S. States and the Fall of understand that it is not enough to practitioners. In short, it may help U.S. Health”) demonstrates the examine the point-in-time relation- if we begin to think of societies impact of state policies regarding ships between people and places and communities as “patients” labor, the environment, tobacco when considering health. Rather, and not just the individuals within taxes, civil rights, and immigration we need nuanced and intersectional them. “Treatment” then takes on a on health and longevity. Tiffany analyses that consider how those far broader meaning and, as these Joseph (“How the Vaccine Rollout factors will interact and accumulate articles demonstrate, may result in Reveals Another Failure of U.S. across the life course. far better health outcomes. n footnotes 1 American Sociological Association footnotes.asanet.org Feature Why Sociologists Are Good for Our Health Christine Bachrach, Research Professor, health and health equity, but the effects of their “exposures,” but does and health care, making the social Sociology, Maryland Population imperative to advocate for integrat- nothing to address the root causes determinants of health invisible. Research Center ing sociological knowl- of the exposures themselves—rac- Health policy, and our discourse • Contact with the edge into our country’s ism, stratification systems, and around it, is still strongly focused criminal justice system health agenda. institutional policies and practices. on health care and access to health impairs mental health. Sociologists understand that insurance. Even the World Health Why Sociology Is So social systems are complex and his- Organization, which champions • Welfare programs Important to Health improve health for all; torically contingent, and that there social determinants of health, defines For decades now, is often more than one path to an health policy as the “decisions, plans, anti-discrimination health scientists have policies reduce outcome. For example, Bruce Link and actions that are undertaken to pointed to the multiple achieve specific health care goals health inequalities. Christine Bachrach and Jo Phelan’s seminal fundamen- layers of causal factors tal causes theory underscores how within a society.” • Women affected by involved in the pro- important this is to understanding Reflecting U.S. cultural values structural sexism are less healthy. duction of health, ranging from health disparities. Those higher of individualism and personal • Wealth improves health, but genetics and physiological systems, up the social ladder will always responsibility, health behaviors liquid assets and homeownership to individual behavior and cogni- have better health because they are the other major component improve it in different ways. tion, and to the social, physical, and have more resources with which to of our cultural understanding of chemical environments in which secure it; but how they secure their health. Even the ASA titles its health • Organizations can improve people’s lives unfold. health advantage will change over journal Health and Social Behavior. mental health by giving employ- Elements of the social envi- time in response to new technolo- I conducted a search for “health” ees more control. ronment that research has firmly gies, new policies, or other changes on the website This I Believe, which These findings, all published in linked to health and health dispar- in the social environment. features contributed essays on the ASA journals during the last five ities include the full range of what values people hold. Of the 78 essays years, highlight what many are sociologists study. The World Health Why Have Social Determinants that characterized health in some now saying are the primary drivers Organization’s 2008 Closing the Gap Received Less Attention? substantive way, the majority of health and health equity across in a Generation report highlights Parsing out the relative focused on personal behavior, about different populations—the ways in families, preschool programs and importance of medical care, health a third on medical treatment, and a which human societies are struc- services, urban and rural develop- behaviors, and the conditions of fifth on the need to be strong to deal tured. The distribution of wealth ment, housing, employment, living people’s lives in contributing to poor with health problems. and power, institutional policies, wages, working conditions, social health and premature mortality is Only four connected some aspect and associated cultural beliefs protection systems—and health fraught with difficulty, but efforts
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