Thursday, October 14, 2010

Nicholas A. Christakis | Podcasts 2009 | Sociology 190: Life and Death in the U.S.A. - Harvard

This course examines the social causes and context of illness, death, longevity, and health care in the U.S. today. Who stays healthy and who falls ill? Who has a long life and who has a short one? What are the circumstances of death for most Americans, and how do these vary? What is a good death and why do so few Americans achieve it? What is good medical care, who gets it, and why? What role do physicians play in producing health in our society? To what extent do factors outside individuals' control (factors such as geography, social networks, parental traits, or hospital quality) influence health and health care? Does socioeconomic inequality in society harm individual health? Do certain kinds of social networks or neighborhoods improve health? What are the collective constraints on individuals' life prospects? What is the difference between an individualistic and a public health perspective on illness? And what issues of ethics and justice are raised by such questions? Would a different organization of society, different public expenditures, or different public policies matter? What policy levers are available to improve the health of the public?

While exploring these questions, we will also consider how social scientists, epidemiologists, public health experts, and doctors address them -- how they use theory to understand them and how they make "causal inferences" based on observational or experimental data. However, students are not expected to have in-depth knowledge of social science methods or statistics. The readings span the medical, public health, and social science literatures, and they reflect both qualitative and quantitative approaches. In many ways, this course serves as an introduction to the field of public health.

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We will briefly review the burden of illness and death in the U.S., touching on the costs, family effects, and implications for people's well-being and suffering. We will also review the leading causes of death and how they vary by certain socio-demographic attributes. We will note geographic variation in illness and mortality and also the relevance of circumstances of birth, (including in utero exposures, birthweight, birth order, parental occupation, etc.) to life-long health. In short, we will introduce the basic bio-social facts to be explored in the course. And we will introduce the tension between individualistic and collective perspectives on medical care. We will in particular consider the case of suicide and the extent to which it reflects individual decision-making or collective constraints.

http://christakis.med.harvard.edu/pages/teaching/subnav/podcasts_current.html