Académique Documents
Professionnel Documents
Culture Documents
Medical Sociology
Multiple Choice Questions
1. Which is NOT a major area of investigation in
msdfgdfgaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaddddd
dddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddd
dedical sociology?
a. Social facets of health and disease.
b. Social behavior of health care personnel and their patients.
c. Social functions of health organizations and institutions.
d. The relationship of health care delivery systems to other systems.
e. All of the above answers are major areas of investigation in medical sociology.
Answer: E
Page: 1
Page: 1-2
Page: 2
e. A and C
Answer: E
Page: 3
5. The scholar who first provided a major theoretical approach for medical sociology was:
a. Durkheim.
b. Parsons.
c. Weber.
d. Mead.
e. Goffman.
Answer: B
Page: 4
6. What important event occurred in 1951 that began to reorient American medical
sociology toward the use of theory?
a. The Vietnam War.
b. The publication of Parsonss The Social System.
c. The increase in chronic diseases.
d. The growth of universities.
e. The political swing towards a more conservative era.
Answer: B
Page: 4
7. Talcott Parsonss book The Social System contained which concept important for medical
sociology?
a. Micro theory.
b. Medicalization.
c. Patient power.
d. Culture.
e. Sick role.
Answer: E
Page: 4
8. In the case of the sick role, illness is seen as __________, and its undesirable nature
reinforces the motivation to be healthy.
a. Deviance.
b. Normal.
c. Biological.
d. Social.
e. A stimulus.
Answer: A
Page: 4
9. In developing his concept of the sick role, Parsons linked his ideas to which two classical
theorists?
a. Marx and Goffman.
2
b.
c.
d.
e.
Answer: D
Page: 4
Page: 5
Page: 5
12. What trend(s) reduced tensions between sociologists in medicine and sociologists of
medicine?
a. Most government funding is awarded to research with practical application.
b. Medical sociology itself is converging with general sociology.
c. Sociology of medicine became the more dominant side of medical sociology.
d. A and B
e. B and C
Answer: D
Page: 5-6
Page: 7
14. One of the earliest attempts in the Western world to formulate principles of health care,
based upon rational thought and the rejection of supernatural phenomena, is found in the
work of the Greek physician:
a. Hippocrates.
b. Socrates.
c. House.
d. Aristotle.
e. Dioceses.
Answer: A
Page: 8
15. The Hippocratic Oath requires the physician to swear that he or she will:
a. Help the sick.
b. Refrain from intentional wrongdoing or harm.
c. Keep confidential all matters pertaining to the doctorpatient relationship.
d. All of the above.
e. None of the above.
Answer: D
Page: 8
16. The so-called clinical gaze is best associated with which of the following perspectives?
a. Medicine of social spaces.
b. Medicine of the species.
c. Public health paradigm.
d. Whole person medical care.
e. None of the above.
Answer: B
Page: 9
Page: 9
18. Decline in deaths from infectious diseases in the second half of the nineteenth century
was mainly due to:
a. Improvements in diet, housing, and public sanitation.
b. Better training of physicians.
c. The discovery of penicillin.
d. Epidemiological transitions.
e. All of the above.
4
Answer: A
Page: 10
Page: 10-11
20. Unlike infectious diseases, chronic diseases typically are _____________ and
______________.
a. Short term; incurable.
b. Short term; curable.
c. Long term; incurable.
d. Long term; curable.
e. There is no difference.
Answer: C
Page: 11
21. With the transition to a greater prevalence of chronic diseases, physicians have
increasingly had to take which approach to medical care?
a. The clinical gaze.
b. Use of magic bullets.
c. Whole person care.
d. The re-mystification of disease.
e. Assembly-line care.
Answer: C
Page 11
Page: 12
23. Which of the following have been significant factors in the most recent epidemiologic
transition, which has seen a reemergence of infectious diseases?
a. Decreased attention to public sanitation.
b. Globalization of trade and travel.
c. Global warming and climate change.
5
d. A and B.
e. B and C.
Answer: E
Page: 13
24. The appearance of the West Nile virus in New York city reflects:
a. An example of bioterrorism.
b. The role of globalization in the spread of infectious diseases.
c. Evidence of the declining prevalence of infectious diseases.
d. The transition of infectious diseases into chronic ones.
e. None of the above.
Answer: B
Page: 15-17
25. One of the greatest threats from infectious diseases worldwide comes from:
a. Ebola and the avian bird flu.
b. Sexually transmitted diseases.
c. Food contaminated with E. coli.
d. Cancer and heart disease.
e. All of the above.
Answer: B
Page: 17
26. What caused the prevalence of STDs to soar around the globe?
a. The birth control pill.
b. A worldwide ideology of sexual liberation and permissiveness.
c. A new pattern of employment in developing nations.
d. Greater availability of multiple sexual partners.
e. All of the above.
Answer: E
Page: 17
Page: 18
28. A disgruntled coworker infects a box of pastries with dysentery, causing several staff to
become ill. This is an example of:
a. Bioterrorism.
b. Bioethics.
c. Epidemiological transitions.
6
Page: 18
29. In which study were syphilis patients intentionally not treated and allowed to die?
a. Nazi experiments.
b. Tuskegee.
c. STD1976.
d. Belmont.
e. Zimbardo prison.
Answer: B
Page: 20
Page: 20-21
Page: 1
2. Medical sociology is important because it focuses on the critical role social factors play
in determining or influencing the health of individuals, groups, and the larger society.
Answer: TRUE
Page: 1
3. Health includes a number of components which are not just biological, but also social,
cultural, political, and economic.
Answer: TRUE
Page: 2
Page: 3
5. Unlike law, religion, politics, economics, and other social institutions, medicine was
ignored by sociologys founders in the late nineteenth century because it did not appear to
shape the structure and nature of society.
7
Answer: TRUE
Page: 3
6. The tremendous growth of medical sociology would have been possible even without
financial support for applied studies provided by the government.
Answer: FALSE
Page: 3
7. Talcott Parsons provided a theoretical approach for medical sociology in the 1950s that
was important in the subdiscipline's early development.
Answer: TRUE
Page: 4
8. The sick role presents an ideal representation of how people act when sick.
Answer: TRUE
Page: 4
9. Working within an atheoretical, applied approach, Parsons was the first to demonstrate
how medicine functions to exert social control within the larger social system.
Answer: FALSE
Page: 4
10. The sociologist in medicine is one who collaborates directly with the physician and other
health personnel in studying the social factors that are relevant to a particular health
problem.
Answer: TRUE
Page: 5
11. The sociology of medicine deals with such factors as the organization, role relationships,
norms, values, and beliefs of medical practice as a form of human behavior.
Answer: TRUE
Page: 5
12. There is a growing divergence between medical sociology and the general discipline of
sociology.
Answer: FALSE
Page: 6
13. At present, medical sociologists constitute the largest and one of the most active groups
of people doing sociological work in the United States and Europe.
Answer: TRUE
Page: 6
Answer: TRUE
Page: 9
15. The practice of medicine in the twentieth century was based on the premise that every
disease had a specific pathogenic cause and was best addressed within a biomedical
framework.
Answer: TRUE
Page: 11
16. The poor have the highest rates of disease and disability of an socioeconomic group,
demonstrating their greater biological disposition toward illness.
Answer: FALSE
Page: 13
17. The number of sex partners an individual has is the most important risk factor in
exposure to sexually transmitted diseases.
Answer: TRUE
Page: 17
Page: 18
19. Drug companies are typically non-profit agencies and do not benefit when academics
publish articles about the effectiveness of their drugs.
Answer: FALSE
Page: 20
20. The development of institutional review boards and the Health Insurance Portability and
Accountability Act have eliminated ethical concerns about issues such as clinical care,
informed consent, and drug testing.
Answer: FALSE
Page: 20
Essay Questions
1. What factors have been important in the development of medical sociology?
2. Explain the differences between sociology in medicine and the sociology of medicine.
3. Has there been a re-emergence of infectious disease? Explain your answer?
4. What was the Tuskegee Study and why is it an important reminder of the need for ethical
oversight in research?
5. Although there is no standard definition of health, there are many concepts. Provide your
own definition of health. How does it relate to the World Health Organizations definition
of health?
Chapter 2
Epidemiology
Multiple Choice Questions
1. The primary focus of the epidemiologist is on:
a. Catastrophic disease outbreaks.
b. Societal demographics.
c. Health and wellness of children.
d. Individuals diseases.
e. Health problems of social aggregates.
Answer: E
Page: 23
2. A scientist who studies the origin and distribution of all types of diseases is best
described as a(n):
a. Biochemist.
b. Social worker.
c. Epidemiologist.
d. Demographer.
e. Sociologist.
Answer: C
Page: 23
Page: 24
Page: 24
10
Page: 24
Page: 24-25
Page: 25
Page: 26
Answer: B
Page: 27
10. Germ theory provided a framework for understanding the causal agents of disease. What
are the five agents recognized today?
a. Biological, social, psychological, toxic, and environmental.
b. Biological, physical, social, mental, and metaphysical.
c. Biological, physical, social, mental, and psychological.
d. Biological, nutritional, chemical, mental, and psychological.
e. Biological, nutritional, chemical, physical, and social.
Answer: E
Page: 28
11. The science of epidemiology has passed through three eras and is entering a fourth. In
what order did it pass through the first three eras?
a. Sanitary, Infectious, Chronic.
b. Sanitary, Chronic, Infectious.
c. Chronic, Sanitary, Infectious.
d. Chronic, Infectious, Sanitary.
e. Infectious, Sanitary, Chronic.
Answer: A
Page: 28
12. As a nation shifts from primarily rural-agricultural to urban-industrial, what changes are
seen in the health profile of the nation?
a. Leading causes of death change from mostly chronic diseases to infectious
diseases.
b. Leading causes of death change from mostly infectious diseases to chronic
diseases.
c. Infectious diseases are eliminated entirely
d. Both infectious and chronic diseases are reduced to a minimum.
e. There is no difference
Answer: B
Page: 29
13. What is the leading cause of death in the United States, accounting for more than onethird of all deaths?
a. Diabetes.
b. HIV/AIDS.
c. Stroke.
d. Heart disease.
e. Cancer.
Answer: D
Page: 30
12
14. The _____________ study was important for showing that arteriosclerosis does not strike
people at random as they age, but that highly susceptible individuals can be identified in
advance.
a. CVD1960.
b. Framingham.
c. Tuskegee.
d. Whitehall.
e. Engels.
Answer: B
Page: 30
15. What do studies on diet, exercise, and obesity suggest with respect to heart disease?
a. Diet and physical activity have little effect on an individuals likelihood of
developing heart disease.
b. Changing ones eating habits toward a diet low in saturated fat can reduce the risk
of developing heart disease.
c. Obesity is the result of individual choices and relates little to the development of
heart disease.
d. Only lengthy, vigorous physical activity has been shown to provide some
protection against heart disease.
e. None of the above.
Answer: B
Page: 31-35
16. At the end of 2007, the majority of AIDS cases in the U.S. were found in:
a. Homosexual and bisexual men.
b. Homosexual and bisexual women.
c. Intravenous drug users.
d. Blood transfusion patients.
e. Children of a parent with AIDS.
Answer: A
Page: 38
17. The lowest AIDS mortality rates for American males are found in:
a. Native Americans.
b. Non-Hispanic whites.
c. Hispanics.
d. Non-Hispanic African Americans.
e. Asians.
Answer: E
Page: 39
18. Since 2000, the number of AIDS cases has sharply increased in what region of the U.S.?
a. Northwest.
b. West.
c. Midwest.
13
d. Northeast.
e. South.
Answer: E
Page: 40
19. AIDS is transmitted in Africa and some parts of Asia primarily by:
a. Heterosexual contact.
b. Homosexual contact.
c. Intravenous drug use.
d. Blood transfusions.
e. Infected mother to child.
Answer: A
Page: 40-41
20. Which of the following plays a particularly important role in the transmission of AIDS in
Sub-Saharan Africa?
a. Government.
b. Health delivery system.
c. Migrant labor force.
d. Homosexuals.
e. Drug users.
Answer: C
Page: 41
Page: 41
Page: 42
23. The HIV outbreak in China initially occurred among ____________ in Yunnan Province.
a. Bisexuals.
b. Homosexuals.
14
Page: 42
24. People who become infected with HIV may be subjected to discrimination, which can
isolate them socially. This social outcome is:
a. Stigma.
b. Stagflation.
c. Disintegration.
d. Disentanglement.
e. All of the above.
Answer: A
Page: 42
Page: 42
26. Which of the following demonstrates the sociological implications of the HIV/AIDS
epidemic?
a. Its influence on modifying social norms, values, and lifestyles.
b. How certain social behaviors lead to the transmission of the disease and result in a
pandemic.
c. The social rejection of AIDS patients.
d. Moral and religious debates over the meaning of the disease and treatment
options.
e. All of the above.
Answer: E
Page: 43
27. Which term describes an individuals most important position in society and typically
comes from ones occupation?
a. Default status.
b. Ordinary status.
c. Master status.
d. Primary status.
e. Main status.
15
Answer: C
Page: 43
28. Since AIDS results from a private act that has extreme social consequences, serious moral
and legal questions also arise about the rights of ____________ versus the welfare of
_______________.
a. Individuals, government.
b. Individuals, society.
c. Hospitals, individuals.
d. Hospitals, society.
e. Government, society.
Answer: B
Page: 43
29. The current public policy approach to dealing with AIDS is:
a. Through banning high-risk behaviors.
b. Through mandatory universal testing.
c. Through quarantine of infected individuals.
d. Through safe-sex education.
e. None of the above.
Answer: D
Page: 43
Page: 44
Page: 23
2. Present-day epidemiologists primarily study epidemic diseases and give little attention to
other diseases such as chronic ailments or unhealthy behaviors.
Answer: FALSE
Page: 23
Answer: FALSE
Page: 24
4. The simplest ratio computed by the epidemiologist is called the <ITAL>crude rate.
Answer: TRUE
Page: 24
5. Crude death and birth rates are too gross a measure to be meaningful for most
sociological purposes
Answer: TRUE
Page: 25
6. The living conditions of early nomadic humans, with close proximity to others and
exploration of new environments, was favorable to widespread and frequent epidemics.
Answer: FALSE
Page: 26
7. The bubonic plague was ended in 1750 with the development of penicillin.
Answer: FALSE
Page: 27
8. What a person does, who a person is, and where a person lives can specify what health
hazards are most likely to exist in that individuals life.
Answer: TRUE
Page: 28
9. The social environment, referring not only to living conditions but also norms and values,
can cause sickness.
Answer: TRUE
Page: 28
10. Developing nations are typically characterized by a high birth rate and a high death rate,
with a relatively young population.
Answer: TRUE
Page: 29
11. About twice as many males die from heart disease as females, and men are more likely
than women to have a worse prognosis if they survive the first serious heart attack.
Answer: FALSE
Page: 30
12. Smoking is the leading cause of sudden cardiac death in the United States and quitting
smoking nearly eliminates this risk after a year or two.
Answer: TRUE
Page: 31
17
13. Pandemics are regional or local outbreaks of a disease and rarely happen.
Answer: FALSE
Page: 36
14. HIV/AIDS first appeared in intravenous drug users in New York and San Francisco.
Answer: FALSE
Page: 37
Page: 38
16. Much of the fear about AIDS arises from the fact that many people who carry the virus
are not aware of it.
Answer: TRUE
Page: 38
17. People most at risk for developing AIDS are those who have had multiple sex partners
and know little about their partners past sexual behavior.
Answer: TRUE
Page: 38
18. In states like Mississippi and North Carolina, more black women than white men have
contracted HIV.
Answer: TRUE
Page: 40
19. Estimating the number of individual flu cases in an outbreak is an easy task, since almost
everyone who becomes sick with the flu requires medical care.
Answer: FALSE
Page: 44
Essay Questions
1. Define incidence and prevalence. Explain the relationship between the two, and identify
which issues with each pertain when examining chronic and acute illnesses.
2. Recognition that germs were causal agents of disease served as a precursor to scientific
findings that people come into contact with a variety of causal agents. Define all five
agents, and provide examples of each type.
3. Describe the four eras of epidemiology.
4. Modification in what four lifestyle areas significantly reduce the risk of heart disease?
Discuss how and why these modifications affect the risk of developing heart disease.
18
5. Developing and developed nations have a different pattern of disease and illness. List the
most prevalent diseases in both nation types, and discuss why these differences exist.
Chapter 3
The Social Demography of Health: Social Class
Multiple Choice Questions
1. Historically, many urban clinics providing treatment for the poor were established
primarily as:
a. A way to use tax dollars.
b. Religious facilities.
c. Medical research facilities.
d. Safe houses.
e. Teaching facilities.
Answer: E
Page: 48
2. Several studies find that the strongest and most consistent predictor of a persons health
and life expectancy is
a. Psychological profile
b. Neighborhood.
c. Gender.
d. Social class.
e. Income.
Answer: D
Page: 49
Page: 49
Answer: D
Page: 49
Page: 51
Page: 51
Page: 51
Page: 51
9. Social status is a(n) ___________ dimension in social class consisting of how much
esteem the person is accorded by other people.
a. Objective.
b. Subjective.
c. Quantifiable.
d. Hidden.
e. None of the above.
20
Answer: B
Page: 51
10. According to Weber, _________ is the ability to realize ones will even against the
resistance of others.
a. Power.
b. Prestige.
c. Presence.
d. Principle.
e. None of the above.
Answer: A
Page: 52
11. In quantitative studies, what variables are used to measure socioeconomic status?
a. Social and human capital.
b. Income, occupational prestige, and education.
c. Income and wealth.
d. Status, wealth, and power.
e. Neighborhood characteristics.
Answer: B
Page: 52
12. Which component of social class is consistently the strongest single predictor of good
health?
a. Income.
b. Education.
c. Wealth.
d. Occupation.
e. Neighborhood.
Answer: B
Page: 52
13. New research is showing that the relationship between occupation, income, education,
and health changes over the life course, with __________ becoming more important for
health as a person moves toward older age.
a. Occupation.
b. Education.
c. Income.
d. All of the above.
e. None of the above.
Answer: C
Page: 53
14. People living in poverty have the greatest exposure to risk factors producing ill health.
Which of the following is a risk factor that is influenced by socioeconomic
circumstances?
21
a.
b.
c.
d.
e.
Physical.
Biological.
Psychological.
Lifestyle.
All of the above.
Answer: E
Page: 54
15. In the United States, heart disease has ______________ over the past 30 years.
a. Increased.
b. Decreased.
c. Stayed the same.
d. Been eradicated.
e. Mildly increased.
Answer: B
Page: 55
16. Changes in lifestyle patterns over the past decades has meant that coronary heart disease
is now concentrated more among which group?
a. Upper class.
b. Upper-middle class.
c. Middle class.
d. Working class.
e. Poor/lower class.
Answer: E
Page: 55
17. The type of lifestyle that promotes a healthy existence is typical in which class?
a. Upper class.
b. Middle class.
c. Working class.
d. Both A and B.
e. Both B and C.
Answer: D
Page: 55
18. Which of the following are more prevalent among the upper and middle classes?
a. Schizophrenia.
b. Anxiety and mood disorders.
c. Substance-related disorders.
d. All of the above
e. None of the above.
Answer: B
Page: 55
22
19. According to Richard Wilkinson, which is the most important variable influencing a
countys overall level of health?
a. Degree of modernization.
b. Access to quality health care.
c. Income inequality within a country.
d. Overall wealth of the country.
e. Cultural lifestyles that promote health.
Answer: C
Page: 56
20. Several studies in Britain, with its universal health care, have shown that the equalization
of health care alone has _____________ the disparity in health between social classes.
a. Reduced.
b. Not reduced.
c. Eliminated.
d. Reversed.
e. Exaggerated.
Answer: B
Page: 56
21. Compared to other social classes, lower class individuals visit physicians _________.
a. The same amount.
b. Less often.
c. More often.
d. Not at all.
e. None of the above.
Answer: C
Page: 57
22. What 1980 report in Great Britain dispelled the notion that social class differences were
becoming less important because of the growth of state welfare services?
a. Health in Britain.
b. Disparities Report.
c. Black Report.
d. Whitehall Report.
e. None of the above.
Answer: C
Page: 57
23. The Whitehall studies conducted in Britain demonstrated that regardless of cause of
death, which group had the lowest rates of mortality?
a. Senior administrators.
b. Professional/executives.
c. Clerical.
d. Other low status jobs.
e. No relation to rank.
23
Answer: A
Page: 57
24. The finding that even the upper middle class lives shorter than the uppermost class, and
that every class lives longer than the one directly below it is evidence of what?
a. Educational differences.
b. Influence of deprivation.
c. Social gradient in mortality.
d. Social patterning of disease.
e. None of the above.
Answer: C
Page: 59
25. The cause(s) of the social gradient is most likely related to differences between
socioeconomic groups and classes in:
a. Self-esteem and stress levels.
b. The effects of income inequality.
c. Deprivation through the life course.
d. Health lifestyles and social support.
e. Some combination of all of the above.
Answer: E
Page: 60
Page: 60
Page: 62
28. Which of the following is NOT one of the features of neighborhoods that can influence
health?
a. Physical environment.
b. Support services.
c. Sociocultural aspects.
24
d. Reputation of an area.
e. Racial makeup of the neighborhood.
Answer: E
Page: 62
29. ______________ neighborhoods are clean and safe, houses and buildings are wellmaintained, and residents are respectful of each other and each others property.
a. Orderly.
b. Disorderly.
c. Suburban.
d. Urban.
e. Government.
Answer: A
Page: 62
30. In order for a social variable to qualify as a cause of sickness and mortality it must meet
which criteria?
a. Influence multiple diseases.
b. Affect diseases through multiple pathways of risks.
c. Be reproduced over time.
d. Involve access to resources that can be used to avoid risks.
e. All of the above.
Answer: E
Page: 64
Page: 48
2. Improved access to health services is the primary solution for advancing health.
Answer: FALSE
Page: 49
Page: 49
Page: 51
25
5. The concept of SES is derived from ideas about social stratification put forward by
Weber.
Answer: TRUE
Page: 51
6. Status indicates a persons level of social prestige, which typically corresponds to wealth.
Answer: FALSE
Page: 51
Page: 52
8. The well-educated are more likely to smoke and less likely to exercise than their lesseducated counterparts.
Answer: FALSE
Page: 52
9. The relative influence of income and education on health changes over the life course.
Answer: TRUE
Page: 53
10. Income is significant with respect to differences in the onset of chronic disease and
physical limitations, but education is more strongly associated with the manner in which
the health problems progressed over time.
Answer: FALSE
Page: 53
11. Heart disease has been decreasing in Japan due to the spread of Western medicine. </P>
Answer: FALSE
Page: 54-55
12. The lower class is disadvantaged with respect to physical, but not mental health.
Answer: FALSE
Page: 55
13. Wilkinsons theory of the relationship of inequality to population health has received
strong support from numerous other studies and is currently the leading explanation of
health disparities.
Answer: FALSE
Page: 56
14. The social gradient in mortality links chance of death to differences in hierarchy rather
than deprivation.
Answer: TRUE
Page: 59
26
15. The Black Report provided strong evidence that the lower a person is on the social scale,
the less healthy that person is likely to be.
Answer: TRUE
Page: 60
16. Recent evidence has found that unemployment itself does not cause deterioration in
mental health.
Answer: FALSE
Page: 60
17. Poor housing quality is a problem in less-developed countries, but not in industrialized
nations.
Answer: FALSE
Page: 61
18. Neighborhoods contain resources needed to produce good or poor health for its residents.
Answer: TRUE
Page: 62
19. The fundamental social cause thesis suggests that social class contributes to poor health
and mortality, but is not a direct cause.
Answer: FALSE
Page: 64
20. White-collar jobs tend to be more dangerous and stressful than blue-collar jobs and to
carry inferior health benefits.
Answer: FALSE
Page: 65
Essay Questions
1. Social class is made of multiple components. Identify these components, and comment on
their contribution to the overall idea of social class.
2. The poor fall victim to different diseases at different rates compared to more affluent
classes. Identify some diseases of the lower class, and discuss why these are more
prevalent.
3. What is neighborhood disadvantage? Discuss how it is related to health.
4. In order for a social variable to qualify as a cause of mortality, Link and Phelan
hypothesize that it must meet four criteria. List those criteria. Does social class meet
these criteria? How so, or why not?
27
5. Discuss the Whitehall studies conducted by Marmot. What were the main findings in
terms of social class and health?
Chapter 4
The Social Demography of Health: Gender, Age, and Race
Multiple Choice Questions
1. In 2008, a nationwide study of mortality in the United States revealed that life expectancy
for part of the nations women had ___________ significantly between 1983 and 1999.
a. Stagnated.
b. Fluctuated.
c. Remained the same.
d. Increased.
e. Decreased.
Answer: E
Page: 69
2. What has been the general pattern in life expectancy during the 20th century with respect
to men and women?
a. Women outlive men only in a handful of countries.
b. Both men and women gained approximately the same amount.
c. Men gained more than women in the first half of the century, but dramatic social
change in recent decades has meant that women are catching up to men.
d. Women gained more than men in the first half of the century but since then men
have made greater gains and the gap is narrowing.
e. None of the above
Answer: D
Page: 70
Page: 71
28
Answer: C
Page: 72
5. Compared to women, men usually have substantial health inferiority in terms of life
expectancy because of the combination of two major effects: biological and ___________
effects.
a. Physical exertion.
b. Developmental.
c. Social-psychological
d. Environmental.
e. Marital.
Answer: C
Page: 72
Page: 72
Page: 73
8. Morbidity is:
a. Sadness.
b. The cause of illness.
c. The amount of sickness.
d. The rate of death.
e. All of the above.
Answer: C
Page: 73
Answer: B
Page: 75
Page: 79
11. In 2006, the average infant in the U.S. could expect to live for ______ years.
a. 68
b. 72
c. 78
d. 85
e. 88
Answer: C
Page: 80
Page: 80
Page: 80
14. What federal program provides health insurance to those 65 years and older?
a. Pensions.
b. Social Security.
c. Medicare.
d. Medicaid.
e. Medihealth.
30
Answer: C
Page: 81
15. Which of the following trends is most likely to strain health care delivery systems and
public health insurance in future years?
a. Increasing proportion of elderly in the population.
b. Increasing size of the Hispanic population.
c. Medical tourism.
d. Reemergence of infectious diseases.
e. All of the above.
Answer: A
Page: 81
16. Many elderly rate their health as good despite the health problems that often accompany
aging. What does this phenomenon suggest about the usefulness of self-rated heath as a
tool to measure health?
a. It is not accurate and probably should not be used.
b. Self-assessments are relative, since people compare themselves to others similar
in age and sex.
c. As people become older they revise their definition of healthy to fit their
circumstances.
d. Both A and B.
e. Both B and C.
Answer: E
Page: 82
17. What is most prevalent health problem of persons over the age of 65?
a. Heart disease.
b. Stroke.
c. Cancer.
d. Hypertension.
e. Arthritis.
Answer: E
Page: 83
18. Which racial group in the United States is especially disadvantaged in regard to health?
a. Non-Hispanic whites.
b. Non-Hispanic blacks.
c. Hispanics.
d. Asians/Pacific Islanders.
e. American Indians/Alaskan Natives.
Answer: B
Page: 83
19. The _____________ hypothesis asserts that blacks are more prone to diseases such as
pyelonephritis and syphilis that may result in secondary hypertension.
31
a.
b.
c.
d.
e.
Associated disorder.
Genetic.
Psychological stress.
Physical exertion.
Diet.
Answer: A
Page: 84
20. Some research suggests that the _____________ hypothesis and the psychological stress
hypothesis contribute the most to providing an answer for the higher prevalence of
hypertension in blacks, since blacks in general have higher rates of hypertension than
whites.
a. Associated disorder.
b. Genetic.
c. Psychological stress.
d. Physical exertion.
e. Diet.
Answer: B
Page: 84
21. For all causes of death, _____________ have the highest death rates.
a. Whites.
b. Non-Hispanic blacks.
c. Hispanics.
d. Asians/Pacific Islanders.
e. American Indians/Alaskan Natives.
Answer: B
Page: 85
22. For all causes of death, _____________ have the lowest death rates.
a. Non-Hispanic whites.
b. Non-Hispanic blacks.
c. Hispanics.
d. Asians/Pacific Islanders.
e. American Indians/Alaskan Natives.
Answer: D
Page: 86
23. A major factor causing the infant mortality difference between blacks and whites is:
a. Sanitation.
b. Health care.
c. Poverty.
d. Education.
e. Insurance.
Answer: C
Page: 86
32
24. __________ represents the convergence of biological factors with geographic origins,
and cultural, economic, political, and legal factors.
a. Race.
b. Age.
c. Ethnicity.
d. Gender.
e. None of the above.
Answer: A
Pages: 86
25. Although obesity affects people of all races, low-income _____________, have the
highest concentration of obesity in American society.
a. Non-Hispanic whites.
b. Non-Hispanic blacks.
c. Hispanics.
d. Asians/Pacific Islanders.
e. American Indians/Alaskan Natives.
Answer: B
Page: 87
Page: 88
Page: 90
e. 35%
Answer: C
Page: 90
29. What minority group is most likely to use hospital emergency rooms as their primary
source of medical services?
a. Non-Hispanic whites.
b. Non-Hispanic blacks.
c. Hispanics.
d. Asians/Pacific Islanders.
e. American Indians/Alaskan Natives.
Answer: C
Page: 91
Page: 92
Page: 69
2. The downturn in female life expectancy was due to a rise in mortality from chronic
diseases related to smoking, obesity, and high blood pressure.
Answer: TRUE
Page: 69
3. A decline in female life expectancy is expected in the wealthiest countries, with the
highest spending on health care.
Answer: FALSE
Page: 69
4. The lives of men and women used to be more predictable in that men typically behaved
in certain distinct ways and women in others.
Answer: TRUE
Page: 70
34
5. Patterns are emerging that show Americans moving toward greater inequality in mortality
between the sexes.
Answer: FALSE
Page: 70
6. Women tend to suffer from more frequent illnesses and disability, but their usual health
disorders are not as serious or as life threatening as those encountered by men
Answer: TRUE
Page: 72
7. Although white females live longer than white males, black males live longer than black
females.
Answer: FALSE
Page: 72
Page: 72
9. There is an inverse relationship between mortality and morbidity when gender differences
are considered.
Answer: TRUE
Page: 74
10. Studies of self-rated health typically show women rating their own health less positively
than men do.
Answer: TRUE
Page: 75
11. The current trend in the United States is toward a decrease in smoking for females, but an
increase for males.
Answer: FALSE
Page: 76
12. Prior to 1979, Hispanics were counted as either white or black and not as a separate racial
category by the National Center for Health Statistics.
Answer: FALSE
Page: 77
13. It appears that Hispanics have lower rates of smoking than either non-Hispanic whites or
blacks.
Answer: TRUE
Page: 77
14. Projections for 2010 put the number of elderly at around 40 million.</P>
35
Answer: TRUE
Page: 80
Page: 82
16. The adverse health situation of black Americans identifies a pattern that is generally
produced by biological, not socioeconomic factors.
Answer: FALSE
Page: 86
17. Perceptions of racism and racial harassment are associated with poor health.
Answer: TRUE
Page: 86
Page: 88
19. Hispanic immigrants are generally in poor health when they arrive in the United States.
Answer: FALSE
Page: 90
Page: 92
Essay Questions
1. Discuss the relationship between gender and overall health.
2. Various hypotheses have been suggested to explain the rates of hypertension in African
Americans. Six are discussed in this chapter. Identify these hypotheses and discuss their
validity.
3. What is the Hispanic paradox? Provide a thorough explanation, examples of this
phenomenon, and discuss what makes it less of a paradox.
4. Discuss patterns of morbidity and mortality between blacks, whites, Hispanics, and
Asians.
5. What health care changes should be expected resulting from our aging population?
Chapter 5
Social Stress and Health
36
Page: 97
Page: 97
Pages: 98
Page: 98
5. The theory of the _______________ maintains that our self-concepts are the result of
social interaction in which we see ourselves reflected in other people.
a. Looking mirror.
b. Glass selfish sense.
c. Looking-glass self.
d. Mirror in mirror.
e. None of the above.
37
Answer: C
Page: 98
Page: 98
7. Goffman believed that in order for social interaction to be possible, people need
information about the others in a joint act. Such information is communicated through:
a. A persons appearance.
b. A persons experience with other similar individuals.
c. The social setting.
d. The information communicated about her/himself through words and actions.
e. All of the above.
Answer: E
Page: 99
8. The positive social value that individuals claim for themselves by the line that others
assume they have taken during a particular encounter is termed a _____________.
a. Veil.
b. Form.
c. Face.
d. Shield.
e. Self.
Answer: C
Page: 99
9. The _____________ is more important than anything else to us, because it represents
who we are and is always with us.
a. Veil.
b. Form.
c. Face.
d. Shield.
e. Self.
Answer: E
Page: 100
10. The symbolic interactionist perspective, as outlined by Cooley, Thomas, and Goffman
asserts that:
a. Certain situations are inherently stressful.
38
b.
c.
d.
e.
Answer: C
Page: 100
11. As members of society, individuals are constrained in their behavior by laws and
customs. These constraints are ______________.
a. Imagined.
b. Realities.
c. Social nuances.
d. Social facts.
e. Norms.
Answer: D
Page: 100
12. Durkheim suggests that society has an existence __________ the individual.
a. Outside.
b. Inside.
c. Beside.
d. Within.
e. None of the above.
Answer: A
Page: 100
Page: 101
14. ______________ suicide occurs when people become detached from society and,
suddenly on their own, are overwhelmed by the resulting stress.
a. Egoistic.
b. Fatalistic.
c. Altruistic.
d. Anomic.
e. None of the above.
Answer: A
Page: 101
39
Page: 101
16. ______________ suicide occurs when people feel themselves so strongly integrated into
a demanding society that their only escape seems to be suicide.
a. Egoistic.
b. Fatalistic.
c. Altruistic.
d. Anomic.
e. None of the above.
Answer: C
Page: 101
17. The importance of Emile Durkheim's work for understanding stress lies in his:
a. Typology of three specific types of suicide.
b. Denial of biological influences on human behavior.
c. Insight into the link between the state of the economy and certain types of illness.
d. Notion of the capability of society to create situations where people are
constrained to respond with certain behavior.
e. None of the above.
Answer: D
Pages: 101-102
18. Brenners thesis is that there are few areas of our lives not intimately affected by the state
of the _________________.
a. Economy.
b. Family.
c. Political system.
d. Environment.
e. Self.
Answer: A
Page: 102
19. Brenner offers two hypotheses to explain the relationship between the economy and
mental health. What are they?
a. Provocation and complacency.
b. Inflation and uncovering.
c. Inflation and stagflation.
40
Page: 102-103
Page: 103
21. The ______________ system controls heart rate, blood pressure, and gastrointestinal
functions: processes that are not under the control of the central nervous system.
a. Limbic.
b. Respiratory.
c. Endocrine.
d. Autonomic.
e. None of the above.
Answer: D
Page: 104
22. Who developed the theory known as the <ITAL>general adaptation syndrome?
a. Brenner.
b. Siegrist.
c. Selye.
d. Goffman.
e. Pearlin.
Answer: C
Page: 105
23. Who suggests two major types of stressors: life events and chronic strains?
a. Brenner.
b. Siegrist.
c. Selye.
d. Goffman.
e. Pearlin.
Answer: E
Page: 106
24. The extent of physiological damage or change within an individual depends on:
a. The stimulus situation.
b. An individuals capacity to deal with the stimulus situation.
c. The individuals preparation by society to meet problems.
41
Page: 107
25. What is defined by Turner as the social investments of individuals in society in terms of
their membership in formal and informal groups, networks, and institutions?
a. Social facts.
b. Social networks.
c. Social capital.
d. Social circumstances.
e. None of the above.
Answer: C
Page: 108
Page: 109
Page: 110
Page: 112
a.
b.
c.
d.
e.
Extreme situations.
Non-extreme situations.
Extraordinary life events.
Ordinary life events.
All of the above.
Answer: D
Page: 113-114
30. Besides the type of change and the speed with which it occurs, the extent to which
change affects a persons life may also be important. Libby Ruch (1977) investigated this
over 30 years ago and suggested that life change actually has three dimensions. Which is
NOT a dimension?
a. Degree of change evoked.
b. Undesirability of change.
c. Depth of change expected.
d. Aspect of ones life that is affected.
e. None are dimensions.
Answer: C
Page: 115
Page: 97
Page: 97
3. Mead compares the reflection of our self in others to our reflections in a looking glass.
Answer: FALSE
Page: 98
Page: 100
Page: 100
Page: 100
43
7. Brenner formulated the concept of the fight or flight pattern of physiological change to
illustrate how the body copes with stress resulting from a social situation.
Answer: FALSE
Page: 104
8. When a person experiences fear or anxiety, the body undergoes psychological changes
that prepare it for vigorous effort and the effect of possible injury.
Answer: TRUE
Page: 104
9. Most threats in modern society are symbolic, not physical, and they do not usually
require a physical response.
Answer: TRUE
Page: 105
10. A number of studies have shown that the human organisms inability to manage the
social, psychological, and emotional aspects of life can lead to health problems.
Answer: TRUE
Page: 105
11. The outcome or effect of a crisis depends on how well a person comes to terms with the
situation. </P>
Answer: TRUE
Page: 106
12. Mechanic believes that in social situations people use the same skills and abilities in
coping with problems.
Answer: FALSE
Page: 106
13. Most people have an equal degree of control in managing emotional defenses or similar
motivation and personal involvement in a given situation.
Answer: FALSE
Pages: 106-7
Page: 107
15. Conformity to group-approved attitudes and definitions has been hypothesized to reduce
anxiety. </P>
Answer: TRUE
Page: 108
44
Answer: FALSE
Page: 109
17. Social connectedness, in Putnams view, is one of the weakest determinants of health.
Answer: FALSE
Page: 109
18. The lower class is characterized as having the fewest resources to cope with stress.
Answer: TRUE
Page: 109
19. The upper class and the upper middle class have about the same longevity, which is
greater than the lower class.
Answer: FALSE
Page: 110
20. People typically flee in panic from the site of a potential disaster (natural/unnatural) area.
Answer: FALSE
Page: 110
Essay Questions
1. Define social stressors, life events, and life changes. How do these concepts relate to
stress?
2. How does functionalist theory explain stress? How does symbolic interaction theory
explain stress? How do the two viewpoints differ?
3. Describe Patricia Drenteas (2000) research on stress, age, and credit card debt.
4. What are the features of life events that cause stress in individuals?
5. Describe the three types of suicide outlined by Durkheim. How do they relate to stress?
Chapter 6
Health Behavior and Lifestyles
Multiple Choice Questions
1. Medical sociologists divide health-oriented behavior into two general categories:
________ behavior and _________ behavior.
a. Preventative; disease causing.
b. Health; illness.
c. Health lifestyles; sickness.
d. Health seeking; spreading.
e. None of the above.
Answer: B
Page: 120
45
Page: 120
3. What are collective patterns of health-related behavior based on choices from options
available to people according to their life chances?
a. Health lifestyles.
b. Illness behavior.
c. Health behavior.
d. Health promotion.
e. Premedical.
Answer: A
Page: 121
Page: 121
Page: 121
6. Crawford points out, there has been a growing recognition of positive health behaviors,
facilitated by:
a. Mass media.
b. Word of mouth.
c. The spread of disease.
46
d. Education.
e. Technology.
Answer: A
Page: 122
Page: 122
Page: 122
9. According to the sociologist Max Weber, lifestyles are based upon a persons relationship
to the means of:
a. Consumption.
b. Needs.
c. Wants.
d. Production.
e. All of the above.
Answer: A
Page: 123
Page: 123
11. ____________ refers to the choices that people have in the <DOCPAGE
NUM="103"></DOCPAGE>lifestyles they wish to adopt.
a. Life chances.
47
b.
c.
d.
e.
Life conduct.
Life behaviors.
Agency.
None of the above.
Answer: B
Page: 123
12. Weber maintains that life __________ influence life conduct/life choices.
a. Realities.
b. Chances.
c. Modes.
d. Demands.
e. None of the above.
Answer: B
Page: 123
Page: 124
14. Health lifestyles emphasizing exercise, sports, a healthy diet, avoidance of unhealthy
practices such as smoking, and so on originated in the:
a. Working class.
b. Lower class.
c. Lower middle class.
d. Upper middle class.
e. Upper class.
Answer: D
Page: 124
15. What is a class-based set of durable dispositions to act in particular ways that shape
particular facets of health lifestyles?
a. Life chances.
b. Norms.
c. Habitus.
d. Lifestyles.
e. Life conduct.
Answer: C
Page: 125
48
16. _______________ is the notion that the more distant a person is from economic
necessity, the more freedom and time that <DOCPAGE
NUM="105"></DOCPAGE>person has to develop and refine personal tastes in line with
a more privileged class status.
a. Distance from norm.
b. Distance from normality.
c. Distance from mean (average).
d. Distance from poverty.
e. None of the above.
Answer: E
Page: 126
17. What is NOT a category of social structural variables that have the potential to shape
health lifestyles?
a. Class circumstances.
b. Age, gender, and race/ethnicity.
c. Collectivities.
d. Languages/linguistics.
e. Living conditions.
Answer: D
Pages: 126
18. What is the likely the most powerful influence on lifestyle forms?
a. Class circumstances.
b. Age, gender, and race/ethnicity.
c. Collectivities.
d. Languages/linguistics.
e. Living conditions.
Answer: A
Pages: 126
19. What are collections of actors linked together through particular relationships, such as
kinship, work, religion, and politics?
a. Guilds.
b. Collectivities.
c. Knitting circles.
d. Social groups.
e. None of the above.
Answer: B
Page: 129
20. The interaction between life choices and life chances produces ___________ toward
particular forms of action. These constitute a habitus, according to Bourdieu.
a. Expectations.
b. Practices.
c. Lifestyles.
49
d. Dispositions.
e. None of the above.
Answer: D
Page: 129
21. _____________ may be either positive or negative, but nonetheless comprise a persons
overall pattern of health lifestyles.
a. Expectations.
b. Practices.
c. Lifestyles.
d. Dispositions.
e. None of the above.
Answer: B
Page: 129-30
22. ____________ consumption of red wine is beneficial for preventing heart disease.
a. Abstinence from.
b. Mild.
c. Moderate.
d. Heavy.
e. Sporadic.
Answer: C
Page: 135
23. The French norm of duty to be healthy was strongest in the _______________.
a. Working class.
b. Lower class.
c. Middle class.
d. Upper class.
e. All classes.
Answer: C
Page: 135
24. In 2008, the average life expectancy for a Russian male was _______ years.
a. 56.
b. 62.
c. 66.
d. 69.
e. 73.
Answer: B
Page: 136
25. Health lifestyles activities typically take place __________ the health care delivery
system.
a. Inside.
b. Outside.
50
c. Beyond.
d. In conjunction with.
e. Near.
Answer: B
Page: 137
26. What refers to routine physical examinations, immunizations, prenatal care, dental
checkups, screening for heart disease and cancer, and other services intended to ensure
good health and to minimize the effects of illness if it occurs?
a. Routine checkups.
b. Health behavior.
c. Preventive care.
d. Health lifestyles.
e. None of the above.
Answer: C
Page: 137
27. What is the reason many low-income persons do not have a source of medical care?
a. Health facilities may not be near.
b. Costs may not be covered by health insurance.
c. They may lack health insurance.
d. B and C only.
e. All of the above.
Answer: E
Page: 137
Page: 137
29. One influential social-psychological approach designed to account for the ways in which
healthy people seek to avoid illness is:
a. The health lifestyles model.
b. Maslows hierarchy of care.
c. The health belief model.
d. The illness behavior model.
e. The health-seeking behavior system.
Answer: C
Page: 138
a.
b.
c.
d.
e.
Answer: D
Page: 138
Page: 120
2. Health behavior is the activity undertaken by sick people to regain their health.
Answer: FALSE
Page: 120
Page: 121
4. A persons life chances are largely determined by his or her class position.
Answer: TRUE
Page: 121
5. The first 60 years of the 20th century was the premedical era.
Answer: FALSE
Page: 121
Page: 122
7. Ones lifestyle is a reflection of the types and amounts of goods and services one
produces and desires.
Answer: FALSE
Page: 123
Page: 124
52
9. There is evidence to show that health lifestyles emphasizing exercise, healthy diet, and
avoidance of unhealthy habits such as drugs, alcohol, and smoking are spreading across
class boundaries in Western society.
Answer: TRUE
Page: 124
10. The wealthy show the highest proportion of cigar and cigarette smokers.
Answer: FALSE
Page: 125
11. Most studies on race address differences in sickness and mortality rather than health
lifestyle practices.
Answer: TRUE
Page: 126
12. Some studies suggest that religious attitudes and behaviors can have a negative effect on
numerous health-related activities. </P>
Answer: FALSE
Page: 129
13. There has been extensive research performed linking living conditions to health lifestyles.
Answer: FALSE
Page: 129
14. Agency is a term referring to the process by which people critically evaluate and choose
their course of action.
Answer: TRUE
Page: 129
Page: 131
16. Germany has an extensive system of national health insurance that covers over 90 percent
of the total population. </P>
Answer: TRUE
Page: 132
17. The more paternalistic German system of health insurance coverage appears to
undermine personal incentives to stay fit in comparison to the American system, where
individuals are more responsible for their own health.
Answer: FALSE
Page: 132
18. It appears that health lifestyles are spreading in British society, and distinct differences
between the social classes no longer remain.
53
Answer: FALSE
Page: 133
19. The case cannot be made that healthy lifestyles have spread completely throughout
Western society on the basis of the existing studies.
Answer: TRUE
Page: 135
20. An important facet of health behavior includes contact by healthy people with physicians
and other health personnel for preventive care.
Answer: TRUE
Page: 137
Essay Questions
1. What are the major components of Weber's concept of lifestyles and how do these
components influence each other?
2. Why are health lifestyles gaining in significance as the 21st century approaches? Explain
your answer.
3. How do agency and structure influence health lifestyles?
4. Explain Rosenstocks health belief model.
5. An extensive ten-year survey of the health lifestyles of nearly 7,000 adults in Alameda
County, California, identified seven good health practices. What are these practices, and
how to they relate to health and longevity?
Chapter 7
Illness Behavior
Multiple Choice Questions
1. The most common response to symptoms of illness by people throughout the world is:
a. Health behavior.
b. Illness behavior.
c. Self care.
d. Doctor visits.
e. None of the above.
54
Answer: C
Page: 143
Page: 144
3. The data in the Dutton (1978) study on health care utilization among the poor favored the
_______________ hypothesis.
a. Systems barrier.
b. Financial coverage.
c. Culture of poverty.
d. Disparities.
e. None of the above.
Answer: A
Page: 153
4. Which group has the highest percentage of persons without health insurance?
a. Non-Hispanic white.
b. Non-Hispanic black.
c. Hispanic, Mexican.
d. Asians.
e. European migrants.
Answer: C
Page: 149
Page: 152
Page: 145
Page: 157
Page: 161
Page: 145
Page: 142
Page: 143
12. A number of factors have promoted self-care on the part of laypersons. Which is NOT a
factor?
a. The shift in disease patterns from acute to chronic illnesses.
b. Dissatisfaction with professional medical care that is depersonalized.
c. Recognition of the limits of modern medicine.
d. The increasing awareness of alternative healing practices.
e. All of the above are factors promoting self-care.
Answer: E
Page: 143
13. People have been doing self-care for ______________ and it is made easier today by
access to the Internet with its abundance of medical information.
a. A couple years.
b. Decades.
c. Centuries.
d. Self-care is relatively new, and we dont know how long it has been occurring.
e. None of the above.
Answer: C
Page: 143
14. People engage in self-care in a manner ____________ with medical norms, values, and
information.
a. Consistent.
b. Inconsistent.
c. At odds with.
d. In tandem.
e. None of the above.
Answer: A
Page: 143
15. Studies of the utilization of medical services by the aged indicate that such use is
determined more by ___________ need than any other single factor.
a. Actual.
b. Perceived.
c. Medically directed.
d. Economic.
e. None of the above.
Answer: A
Page: 144
57
16. Which point in the life course is NOT a peak period for when women visit doctors the
most?
a. Childhood.
b. Childbearing years.
c. After 35.
d. After 45.
e. All of these are peaks in the visitation pattern for females.
Answer: C
Page: 144
17. Womans reproductive role accounts for less than _________ of all doctor visits.
a. 10%.
b. 20%.
c. 30%.
d. 40%.
e. 50%.
Answer: B
Page: 144
Page: 145
19. The process by which a family provides a child with a specific social identity is:
a. Classification.
b. Socialization.
c. Enculturation.
d. Brain washing.
e. None of the above.
Answer: B
Page: 146
20. Which refers to the social relationships a person has during day-to-day interaction, which
serves as the normal avenue for the exchange of opinion, information, and affection?
a. Intrapersonal affect.
b. Lay-referral system.
c. Family.
d. Social network.
e. None of the above.
Answer: D
Page: 146
58
Page: 147-148
Page: 147-148
23. The higher an individuals socioeconomic position, the __________ ethnic the person
often becomes.
a. Less.
b. More.
c. Balanced.
d. Really.
e. None of the above.
Answer: A
Page: 148
Page: 149
25. Which group has a higher rate of those covered by private insurance than the national
average?
a. Blacks.
b. Hispanics.
c. Asians.
d. Native Americans.
e. None of the above.
59
Answer: C
Page: 149
26. Kooss study helped establish the premise that _______________ persons are less likely
than others to recognize various symptoms as requiring medical treatment and that these
beliefs contribute to differences in the actual use of services.
a. Lower-class.
b. Middle-class.
c. Upper-class.
d. Middle- and upper-class.
e. Lower- and middle-class.
Answer: A
Page: 152
27. Dutton tested different explanations concerning why the poor would show lower use rates
in relation to actual need than the non-poor. Which was NOT a tested explanation?
a. Financial coverage.
b. Level of education.
c. Culture of poverty.
d. Systems barrier.
e. All of these were tested.
Answer: B
Page: 153
Pages: 156
Page: 156
30. _______________ does not promote equality among laypersons when direct physician
patient interaction is required, nor does it provide a context within which such an
orientation can grow within the medical environment.
a. Health care philosophy.
b. The lay-referral system.
60
Page: 158
Page: 146-147
2. Puerto Rican Americans are among those most likely to report that they could not afford
health insurance as the main reason they did not have coverage.
Answer: FALSE
Page: 150
3. Given that the poor are visiting doctors in greater numbers, it is generally accepted that
they use the same sources of medical treatment as those of higher income groups.
Answer: FALSE
Page: 152
4. On average, females tend to visit physicians more often than males in the U.S.
Answer: TRUE
Page: 144
5. A person's opinion of their own health is a critical variable in whether they will seek
formal health care.
Answer: TRUE
Page: 163
Page: 143
7. About 12 percent of the American population does not have health insurance.
Answer: FALSE
Page: 149
Page: 143
9. It appears that men generally know more about health matters than women, but women
take better care of themselves.
61
Answer: FALSE
Page: 144
10. The family represents a social experience that influences how a particular person
perceives his or her health situation.
Answer: TRUE
Page: 146
11. The strategies that people employ for seeking health care are socially organized around
the opportunities they have for interacting with people in a position to help.
Answer: TRUE
Page: 148
12. Ethnicitys influence on physician utilization appears wide-sweeping and goes beyond its
role in providing a cultural context for decision making within social networks. </P>
Answer: FALSE
Page: 148
13. Surprisingly, socioeconomic status does not confound the effects of ethnicity on help
seeking.
Answer: FALSE
Page: 148
14. The culture of poverty includes traits of dependence, fatalism, inability to delay
gratification, and a lower value placed on health.
Answer: TRUE
Page: 151
15. Only some 10 percent of all American physicians are of Hispanic origin. </P>
Answer: FALSE
Page: 151
16. When actual need for health services is taken into account, low-income persons appear to
use fewer services relative to their needs.
Answer: TRUE
Page: 153
17. Dutton found the culture of poverty explanation to have little to no validity when
combined with measures of income.
Answer: FALSE
Page: 153
18. Beliefs can have an impact on the use of physician services that is independent of
financial constraints and the structural organization of services.
Answer: TRUE
Page: 156
62
19. Blacks and less educated individuals have gained less equitable access to the health care
system with the advent of Medicare and Medicaid.
Answer: FALSE
Page: 156
20. There is more of a consumer orientation toward health among socially advantaged
persons.
Answer: TRUE
Page: 156
Essay Questions
1. Describe the relationship between socioeconomic status and illness behavior. Explain the
basis for your answer.
2. Define Mechanics ten determinants. Discuss this model. How does it relate to illness?
3. Compare and contrast the systems barrier and culture of poverty theories. How are they
similar? How are they different?
4. Define Medicare and Medicaid. How have Medicare and Medicaid affected health care
access and utilization across various groups?
5. What are some patterns and trends we see amongst various racial/ethnic groups in illness
behavior? Blacks, Hispanics, Native Americans, and Asians?
Chapter 8
The Sick Role
Multiple Choice Questions
1. Which theorists work was not included as part of Parsonss concept of the sick role?
a. Emile Durkheim.
b. Max Weber.
c. Sigmund Freud.
d. Erving Goffman.
e. All of the above are theorists whose work was included.
Answer: D
Page: 171
d. Disease.
e. None of the Above.
Answer: B
Page: 166
Page: 166
Page: 182
Page: 167
6. The physician exercises leverage over the patient through three basic techniques. Which
is NOT one?
a. Professional prestige.
b. Situational authority.
c. Situational dependency of the patient.
d. Objective authority.
e. All of the above are techniques used to exercise leverage.
Answer: D
Page: 173
7. Medicalization is:
64
a. The process where an individual falls sick, goes to the doctor, and seeks out a cure
or guidance.
b. A process where previously non-medical problems are defined and treated as
medical problems.
c. A concept which is not health care/medical related, but rather refers to the
sociological process of identifying stakeholders in a given situation.
d. Purely about the shift in expectation from birthing at home to delivering at a
hospital.
e. None of the above.
Answer: B
Page: 176
Page: 178
Page: 184
10. ________________ is where the deviants are exempted from some normal obligations by
virtue of their deviance, for which they are technically not responsible, but gain few if
any privileges.
a. Conditional legitimacy.
b. Unconditional legitimacy.
c. Illegitimacy.
d. Forgiveness.
e. None of the above.
Answer: C
Page: 185
a.
b.
c.
d.
e.
Conditional legitimacy.
Unconditional legitimacy.
Illegitimacy.
Forgiveness.
None of the above.
Answer: B
Page: 184-185
12. People who are physically handicapped typically fall into which category of stigma?
a. Abominations of the body.
b. Blemishes of individual character.
c. Disability of the form and mind.
d. Feeling of lack of control.
e. All of the above.
Answer: A
Page: 189
Page: 167
Page: 169
66
Page: 184
Page: 183
Page: 190
18. Processes such as crime and mental illness which disrupt the social order are:
a. Functional.
b. Dysfunctional.
c. Unnecessary.
d. Rare.
e. None of the above.
Answer: B
Page: 169
Page: 169
67
20. Parsonss concept of the sick role is based on the assumption that:
a. Illness is normal and routine.
b. Being sick is not a deliberate and knowing choice of the sick person.
c. There are different types of illnesses resulting in different reactions.
d. Illness always subsides and is replaced by well-being.
e. None of the above.
Answer: B
Page: 170
21. A person may desire to retain the sick role more or less permanently because of what
Parsons calls a _______________, which is the exemption from normal obligations and
the gaining of other privileges commonly accorded to the sick.
a. Primary reward.
b. Secondary gain.
c. Tertiary exemptions.
d. Primary reaction.
e. None of the above.
Answer: B
Page: 171
22. Whose views on religious values are utilized by Parsons in describing the role of the
physician?
a. Emile Durkheim.
b. Max Weber.
c. Sigmund Freud.
d. Howard Becker.
e. All of the above are theorists whose work was included.
Answer: B
Page: 172
23. Parsons was the first to demonstrate the function of medicine as a form of:
a. Social control.
b. Deviance.
c. Medicalization.
d. Stigmatization.
e. None of the above.
Answer: A
Page: 172
Answer: C
Page: 173
25. The American Psychiatric Association releases a guide to identifying disease called:
a. The Manual to Diagnosing Disease and Illness.
b. The Guide to Illness and Health.
c. Health U.S.
d. The Diagnostic and Statistical Manual of Mental Disorders.
e. None of the above.
Answer: D
Page: 176
26. __________________ has become the dominant form of health care delivery in the U.S.,
which makes insurance companies as third-party payers important in both bolstering
medicalization through its coverage of particular services and a constraint in placing
limitations on those services.
a. Managed care.
b. Fee-for-service.
c. Medicare/Medicaid.
d. All of the above.
e. None of the above.
Answer: A
Page: 177
27. Twaddle found that the sick role, as defined by Parsons, was much more applicable to
which religious group?
a. Catholics.
b. Muslims.
c. Protestants.
d. Jews.
e. Hindus.
Answer: D
Page: 178
28. Which ethnic group was more susceptible to pain in the Zborowski study?
a. Italians.
b. British.
c. Americans.
d. Chinese.
e. Mexicans.
Answer: A
Page: 179
29. Parsonss concept of the sick role seems to typically apply only to _________ diseases.
a. Chronic.
b. Acute.
69
c. Infectious.
d. Catastrophic.
e. None of the above.
Answer: B
Page: 181
30. Many people in the ______________ may tend to deny the sick role.
a. Upper class.
b. Upper and middle class.
c. Middle class.
d. Lower class.
e. All of the above.
Answer: D
Page: 182
Page: 169
2. Parson's concept of the sick role applies to chronic illnesses as well as to acute illnesses.
Answer: FALSE
Page: 181
3. Parson's concept of the sick role adequately accounts for variations in the way people
perceive illness and illness behavior.
Answer: FALSE
Page: 180
4. In medical sociology, a sickness is a social state, signifying an impaired social role for
those who are ill.
Answer: TRUE
Page: 167
Page: 168
6. Parsons insists that sickness is functional because it provides the basis for social control
of the ill.
Answer: FALSE
Page: 171
70
7. Labeling theory does not explain the cause of deviance other than by the reaction of other
people to it.
Answer: TRUE
Page: 185
Page: 167
Page: 167
10. The biological view of deviance has been generally accepted by contemporary
sociologists.
Answer: FALSE
Page: 169
11. A major expectation concerning the sick is that they are able to take care of themselves.
</P>
Answer: FALSE
Page: 171
12. Deviance in a social system is reduced through the application of social <DOCPAGE
NUM="147"></DOCPAGE>sanctions against the offender.
Answer: TRUE
Page: 169
13. Psychoanalytic theories of the structure of personality and the unconscious played little
role in Parsons development of his notion of individual motivation.
Answer: FALSE
Page: 171
14. Ideas on the function of moral authority and views on religious values are utilized by
Parsons in describing the role of the patient.
Answer: FALSE
Page: 172
15. The physicians role is, as Parsons tells us, to return the sick person to his or her normal
state of functioning. </P>
Answer: TRUE
Page: 172
16. The role of the patient depends on the conception that the patient holds of the his/her role.
Answer: FALSE
Page: 172
71
17. The role of the physician is based upon an imbalance of power and technical expertise
favorable exclusively to the physician.
Answer: TRUE
Page: 173
Page: 172
19. Parsonss concept of the sick role helps us understand medicines role in promoting social
stability.
Answer: TRUE
Page: 176
20. Some criticisms of Parsons sick role are based upon a misunderstanding of Parsons.
Answer: TRUE
Page: 183
Essay Questions
1. What are the major criticisms of Parsons' concept of the sick role? Should the concept be
abandoned? Explain.
2. What are the strengths and weaknesses of the labeling theory view of sickness?
3. What are the four basic categories of Parsons sick role? Describe thoroughly.
4. Describe Riers story/experience. Why was this a unique experience? Were any
conclusions made?
5. What is stigma? Define Goffmans types of stigma. How does stigma relate to the sick
role and illness in general?
Chapter 9
DoctorPatient Interaction
Multiple Choice Questions
1. _________________ is the notion that, <DOCPAGE NUM="212"></DOCPAGE>since
the work of the physician is for the good of the patient, physicians tend to impute illness
to their patients rather than to deny it and risk overlooking or missing it.
a. Choice v. health theory.
b. Health care paternalism.
72
Page: 193
2. Distress may not be only physical; purely ____________ needs can trigger a visit to a
doctor as well.
a. Sociological.
b. Psychological.
c. Metaphysical.
d. All of the above.
e. None of the above.
Answer: B
Page: 193
Page: 194
Page: 194
Page: 194
73
6. The <ITAL>___________________ model arises most often when the patient has an
acute, often infectious illness, like the flu or measles.
a. Activity-passivity.
b. Guidance-cooperation.
c. React-revise.
d. Mutual participation.
e. None of the above.
Answer: B
Page: 194
Page: 194
Page: 194
9. Physicians have to take on a variety of roles to induce patient adherence to their treatment
regimens. Which is NOT a role?
a. Educator.
b. Salesperson.
c. Cheerleader.
d. Detective.
e. None of the above.
Answer: E
Page: 195
10. The relevance of the ______________ model for understanding doctorpatient relations
is the view of the interaction as a process of negotiation, rather than the physician simply
giving orders and the patient following them in an automatic, unquestioning manner.
a. Hayes-Bautista.
b. Szasz and Hollender.
74
c. Activity-passivity.
d. Guidance-cooperation.
e. React-revise.
Answer: A
Page: 195
11. People with middle and upper socioeconomic status tend to be more ________________
and active participants in the physicianpatient encounter.
a. Aggressive.
b. Consumer-oriented.
c. Focused on getting well.
d. Disease-focused.
e. None of the above.
Answer: B
Page: 195
Page: 195
13. A major barrier to effective communication lies in the differences between physicians and
their patients with respect to:
a. Status.
b. Education.
c. Training.
d. Authority.
e. All of the above.
Answer: E
Page: 198
14. Cassell explains that information can be an important therapeutic tool in medical
situations if it meets which test(s)?
a. Reduces uncertainty.
b. Provides a basis for action.
c. Strengthens the physicianpatient relationship.
d. All of the above.
e. None of the above.
Answer: D
Page: 198
75
15. Mary Boulton and her colleagues explain that the influence of social class on the doctor
patient relationship is best understood in <DOCPAGE NUM="219"></DOCPAGE>terms
of:
a. Social distance.
b. Social space.
c. Power and space.
d. All of the above.
e. None of the above.
Answer: A
Page: 201
16. As part of the womens health movement, feminist health organizations have evolved that
advocate:
a. Equal pay.
b. Abortion rights.
c. Ms. over Mrs.
d. All of the above.
e. None of the above.
Answer: B
Pages: 201
Page: 202
18. _______________ is thought to protect women against heart attacks until menopause,
when levels drop.
a. Testosterone.
b. Progesterone.
c. Estrogen.
d. All of the above.
e. None of the above.
Answer: C
Page: 202
19. Women have been historically underrepresented in medical school classes owing to
which of the following?
a. Differences in the academic performance of boys and girls.
b. Perceptions that women are unfit for medical work.
c. Differences in the socialization experiences of boys and girls.
d. Different career choices of boys and girls due to innate differences between them.
76
Page: 204
20. It was not until the 1970s that women accounted for at least ________ of all first-year
medical students.
a. 5%.
b. 10%.
c. 15%.
d. 20%.
e. 25%.
Answer: B
Page: 204
21. In 2009-10, about ____________ of all students entering medical schools were women.
a. 30%.
b. 35%.
c. 40%.
d. 45%.
e. 50%.
Answer: E
Page: 204
22. Which medical specialty have women been more likely to go into?
a. Surgery.
b. General practice.
c. Urology.
d. Orthopedics.
e. All of the above.
Answer: B
Page: 205
Page: 217
24. Physicians prescribe medications, diets, and the like and expect patients to follow them
faithfully. This is called:
a. Compliance.
b. Doctor-patient expectation.
c. The contract.
77
d. Acceptance.
e. None of the above.
Answer: A
Page: 208
25. Doctorpatient relationships in the U.S. have seriously _______________ in recent years.
a. Improved.
b. Eroded.
c. Stagnated.
d. Morphed.
e. None of the above.
Answer: B
Page: 209
Page: 209
27. The shift toward consumerism in health care means patients have more status in the
doctorpatient relationship. However, this relationship is significantly affected by an
external influence:
a. Third-party payers.
b. Social class.
c. The state.
d. Religious groups.
e. All of the above.
Answer: A
Page: 209-210
Page: 210
78
29. Expanding reliance on new technologies has promoted a shift away from ____________,
with its focus on the patients oral account of his or her medical history.
a. Folk medicine.
b. Biographical medicine.
c. Hereditary medicine.
d. Verbal medicine.
e. None of the above.
Answer: B
Page: 211
30. Which involves the extensive use of advanced technology for testing, diagnosis, and the
scientific determination of treatment in a more differentiated world of health care
delivery?
a. Techno-medicine.
b. Electronic medical records.
c. eMedicine.
d. WebMD.
e. None of the above.
Answer: A
Page: 211
Page: 193
2. Parsons explains that the relationship between a physician and patient is one that is
oriented toward the patient helping himself/herself deal effectively with a health problem.
Answer: FALSE
Page: 193
3. When people visit doctors for treatment and medical advice, doctors rarely take some
type of action to satisfy the patients expectations.
Answer: FALSE
Page: 193
4. Szasz and Hollender focused on the manner in which patients try to modify treatment
prescribed by a physician.
Answer: FALSE
Page: 194
5. Better educated and younger adults tend to be more skeptical of physician motives in
providing treatment.
79
Answer: TRUE
Page: 195
6. When a patient is extremely ill or there is an emergency, doctors still cannot make lifesaving decisions about patients without consulting them.
Answer: FALSE
Page: 196
7. A major barrier to effective communication lies in the differences between physicians and
their patients.
Answer: TRUE
Page: 198
8. Well educated persons are the most likely to have their questions treated impersonally.
Answer: FALSE
Page: 200
Page: 200-1
10. The lack of male sensitivity to women patients was a major factor in the formation of the
womens health movement to combat sexual discrimination in medicine.
Answer: TRUE
Page: 201
11. One example of male physician misperceptions about female patients is a tendency to
misdiagnose heart attacks as anxiety problems.
Answer: TRUE
Page: 202
12. Some patients may perceive women physicians as less of an authority figure than male
physicians.
Answer: TRUE
Page: 203
Page: 204
14. Zola found that Italian patients tended to understate their symptoms, while Irish patients
tended to overstate them. </P>
Answer: FALSE
Page: 207
80
15. Some male doctors feel reduced in status by being referred to as health care providers
instead of physicians.
Answer: TRUE
Page: 206
16. Modern-day medical practice is provided within the context of middle-class norms.
Answer: TRUE
Page: 208
Page: 208
18. The belief among laypersons that the doctor knows best is still very accepted.
Answer: FALSE
Page: 209
19. The Internet has become a major source of medical information for many lay people.
Answer: TRUE
Page: 211
20. Treatments normally available only in hospitals, like chemotherapy, may be reconfigured
into pills and taken at home now.
Answer: TRUE
Page: 213
Essay Questions
1. Depending on the severity of symptoms, Szasz and Hollender argue that physician
patient interaction falls into one of three possible models. Describe each model.
2. What is the relationship between communication and class? Discuss.
3. Do cultural differences in communication exist? Explain your answer.
4. Will medicine remain a masculine-dominated profession?
5. What does the future hold for doctor-patient relations?
Chapter 10
Healing Options
Multiple Choice Questions
81
Page: 219
2. Today, _______________ are part of mainstream medicine and they work as physicians.
a. Osteopaths.
b. Chiropractors.
c. Podiatrists.
d. Accupuncturalists.
e. None of the above.
Answer: A
Page: 219
3. By the mid-20th century, osteopaths were receiving scientific medical training in such
areas as _______________ and ___________________.
a. Spinal alignment; neurology.
b. Surgery; pharmacology.
c. Obstetrics; spinal alignment.
d. Acupuncture; surgery.
e. None of the above.
Answer: B
Page: 219
Pages: 219-220
82
Answer: B
Page: 222
Page: 220
Page: 220
8. _______________ is based on the idea that disease arises from blockages in a persons
life force in the body.
a. Naturopathy.
b. Homeopathy.
c. Acupuncture.
d. Osteopathy.
e. None of the above.
Answer: A
Page: 220
9. Which is a centuries-old Indian technique of using oils and massage to treat insomnia,
hypertension, and digestive problems?
a. Aromatherapy.
b. Ayurveda.
c. Shiatsu.
d. Biofeedback.
e. Crystal healing.
Answer: B
Page: 220
10. Which uses machines to train people to control involuntary bodily functions?
a. Aromatherapy.
b. Ayurveda.
c. Shiatsu.
d. Biofeedback.
e. Crystal healing.
83
Answer: D
Page: 220
11. The ___________________ industry alone has sales of over one billion dollars annually.
a. Dietary supplement.
b. Acupuncture.
c. Massage.
d. Chiropractic.
e. None of the above.
Answer: A
Page: 222
12. It appears that many persons who use some form of alternative or new age medicine
have ____________________ social background(s).
a. Middle-class.
b. Working- or lower-class.
c. Upper- or middle-class.
d. Middle- or working-class.
e. None of the above.
Answer: D
Page: 222
13. It appears that many persons who use some form of alternative or new age medicine
are:
a. Younger.
b. Older.
c. Middle age or younger.
d. Middle age or older.
e. None of the above.
Answer: C
Page: 222
Page: 222
15. Those who use faith and folk healers typically come from a _____________ background.
a. Upper-class.
b. Middle-class.
c. Working-class.
d. Lower-class.
84
Page: 222
16. Like osteopathy, the ______________ approach to healing also involves manipulation of
bones in the spinal column.
a. Ayurveda.
b. Acupuncture.
c. Chiropractic.
d. Homeopathic.
e. All of the above.
Answer: C
Page: 222
Page: 222
18. Chiropractors may be favored by some patients because they have a reputation for:
a. Charging less.
b. Being friendly.
c. Giving more time to patients.
d. All of the above.
e. None of the above.
Answer: D
Page: 223
19. ______________ are the second largest category of primary health care practitioners in
the United States.
a. Osteopaths.
b. Chiropractors.
c. Podiatrists.
d. Massage therapists.
e. None of the above.
Answer: B
Page: 223
c. Islam.
d. The Church of Snakes.
e. All of the above.
Answer: B
Page: 224
Page: 225
22. The most prominent group in American society advocating a preference for religious
healing is the:
a. Christian Science Church.
b. Islamic Coalition.
c. Church of Latter Day Saints.
d. Greek Orthodox Church.
e. None of the above.
Answer: A
Page: 225
23. Persons with the highest levels of religious involvement showed the lowest rates of:
a. Knowledge.
b. Disability.
c. Income.
d. Education.
e. None of the above.
Answer: B
Page: 227
Page: 228
25. Some elderly persons living in poverty and rural areas may be prone to use ___________
in treating ailments.
86
a.
b.
c.
d.
e.
Folk healers.
Folk remedies.
Faith healers.
Only prayer.
None of the above.
Answer: B
Page: 228-229
26. Practicing _____________ are most likely to be found among African Americans,
Hispanics, and American Indians.
a. Folk healers.
b. Faith healers.
c. Shamans.
d. Accupuncturalists.
e. None of the above.
Answer: A
Page: 229
27. All life events, including illness, are viewed in relation to the total environment as
natural or unnatural, good or evil Thus, life is <ITAL>generally</ITAL> good or bad,
and the cure for <ITAL>one</ITAL> problem might cure <ITAL>all</ITAL> problems.
These healers typically charge for their services. This view is of __________ folk healers.
a. Native American.
b. Hispanic.
c. Non-Hispanic black.
d. Asian.
e. Non-Hispanic white.
Answer: C
Page: 229
28. The most dreaded form of disorder, either physical or mental, is that caused by
witchcraft. Witches are evil persons who supposedly have made pacts with the devil and
use supernatural powers in the form of curses, magic, herbs, or ghosts to harm other
people. This view is of __________ folk healers.
a. Native American.
b. Hispanic.
c. Non-Hispanic Black.
d. Asian.
e. Non-Hispanic White.
Answer: B
Page: 234
29. Black folk healers claim to have received their ability to heal<NL><ITEM><P><INST>:
a. As a result of learning.
b. During an altered state of consciousness.
c. At birth.
87
Page: 230
30. The _________________ healer views helping the patient accept suffering as a major
task. In this context, suffering is explained as being part of the patients burden for the
worlds sin and ignorance and a necessary role in Gods plan for the universe.
a. Native American.
b. Hispanic.
c. Non-Hispanic black.
d. Asian.
e. Non-Hispanic white.
Answer: B
Page: 233
Page: 219
Page: 219
3. Ayruveda is an ancient technique of inserting fine needles into specific points in the body
to ease pain and stimulate bodily functions.
Answer: FALSE
Page: 220
Page: 220
5. Homeopathy is based on the idea that disease arises from blockages in a persons life
force in the body and treatments such as acupuncture and homeopathy are needed to
restore the energy flow.
Answer: FALSE
Page: 220
Pages: 220
88
7. Some procedures like acupuncture appear effective and show some possibility of being
considered by mainstream medicine.
Answer: TRUE
Pages: 220-1
8. Some CAM practitioners are allowed to provide their services in hospitals and clinics.
Answer: TRUE
Page: 222
9. Rather than attempt to absorb the chiropractor into medicine, some physicians have
preferred to eliminate the field altogether.
Answer: TRUE
Page: 223
Page: 223
Page: 223
Page: 223
13. In the United States, some faith healers hold services in a church or in their homes. </P>
Answer: TRUE
Page: 225
14. The doctrines of a few religious groups prohibit their members from seeking modern
medical treatment.
Answer: TRUE
Page: 225
15. The medical profession does not hold faith healing in high esteem, but large segments of
the general public do.
Answer: FALSE
Page: 226
Page: 227
89
17. Folk healers are widely used in the United States. </P>
Answer: FALSE
Page: 228
18. Folk medicine is often regarded as a residue of health measures left over from prescientific historical periods.
Answer: TRUE
Page: 229
Page: 229
20. Folk diagnosis of a health problem emphasizes the cause of the problem, not the
symptoms.
Answer: TRUE
Page: 229
Essay Questions
1. Compare and contrast three different types of folk healers.
2. Compare and contrast: complementary and alternative medicine (CAM), chiropractors,
faith healers, and folk healers.
3. Discuss the professionalization of chiropractors.
4. Denton offers five general categories of faith healing. Describe each one.
5. What is the storefront church about?
Chapter 11
Physicians
Multiple Choice Questions
1. Which is a sociologically relevant characteristic noted by Goode in explaining
professionalism?
a. Professional titles and prestige.
b. Prolonged training in a body of specialized knowledge.
c. Entrance screening to only admit the most qualified.
d. Being male dominated.
e. All of the above.
Answer: B
Page: 238
90
2. Once a professional group becomes established, Goode indicates that it begins to further
consolidate its power by:
a. Formalizing social relationships.
b. Encouraging a service orientation.
c. Developing associations that limit membership.
d. Expanding practice scope.
e. All of the above.
Answer: A
Page: 238
3. Recognition on the part of clients, outside agencies, and the wider society of the
professions claim to _____________________ is necessary if professional decisions are
not to be reviewed by outside authorities.
a. Professionalism.
b. Dominance.
c. Competence.
d. Being service-oriented.
e. None of the Above.
Answer: C
Pages: 238-239
Page: 239
Page: 239
6. Who defined the guidelines for analyzing the development of the medical profession in
American society?
a. Goode.
b. Koch.
91
c. Durkheim.
d. Brown.
e. Grant.
Answer: A
Page: 239
Page: 239
8. Most American medical practitioners in the period before the American Revolution were:
a. Ships surgeons.
b. Apothecaries.
c. Clergy.
d. Trained in Europe.
e. All of the above.
Answer: E
Page: 239
Page: 241
10. Who was responsible for significant advancements in the germ theory of disease?
a. Koch.
b. Goode.
c. Pasteur.
d. Virchow.
e. Grant.
Answer: C
Page: 239
d. Virchow.
e. Grant.
Answer: D
Page: 240
12. With the founding of the American Medical Association (AMA) in Philadelphia,
_____________ could mark the beginning of a new era in medicine.
a. Nurses.
b. Physicians.
c. The government.
d. Hospitals.
e. None of the above.
Answer: B
Page: 241
13. In 2007, what percentage of all eligible physicians were members of the AMA?
a. Less than 30%.
b. 40%.
c. 50%.
d. 60%.
e. Over 70%.
Answer: A
Page: 242
14. AMA local societies have the power to enforce conformity at their level because they
determine:
a. Dues.
b. Membership qualifications.
c. Participation in events.
d. Membership size (maximum size of the AMA).
e. None of the above.
Answer: B
Page: 241
15. One of the most significant guiding principles of the AMA has been its view of the
physician as a(an) ___________________________.
a. Academic force for change.
b. Articulate, charismatic healer.
c. Societal leader.
d. Independent practitioner.
e. All of the above.
Answer: D
Page: 242
16. President Bill Clinton referred to the AMA as just another ___________________.
a. Special interest group.
93
b.
c.
d.
e.
Lobbyist organization.
Powerful force trying to shape American policy.
Civil society group.
None of the above.
Answer: A
Page: 243
Page: 243
18. In the developing American West, anyone who had ___________ could obtain a medical
degree and practice medicine.
a. Ambition.
b. Money.
c. Enthusiasm.
d. Noble blood/heritage.
e. All of the Above.
Answer: B
Page: 243
Page: 244
Page: 244
21. Oswald Hall pointed out that the decision to study medicine is largely ___________ in
character:
94
a.
b.
c.
d.
e.
Biological.
Humanitarian.
Psychological.
Social.
None of the above.
Answer: D
Page: 246
22. Physicians from a lower-class social origin were more likely than upper-class doctors to
emphasize success values as reasons for going into medicine. Those physicians who were
initially success-oriented became less so after commencing their practices, while the
reverse occurred with those who were less success-oriented. This change occurs through:
a. Socialization.
b. Professionalization.
c. Medicalization.
d. Hazing.
e. All of the above.
Answer: A
Page: 247
23. Rene Fox found that medical students at Cornell Medical School acquired two basic
traits as a result of their medical training: the ability to be emotionally detached from the
patient and to ___________________.
a. Understand the limitations of medicine.
b. Convey bad news.
c. Tolerate uncertainty.
d. All of the above.
e. None of the above.
Answer: C
Pages: 247-248
24. Medical schools have begun to employ which method to help decrease doubt and
improve the application of medical knowledge?
a. Clinical rotations.
b. Kochs postulates.
c. Evidence-based medicine.
d. Grand rounds.
e. None of the above.
Answer: C
Page: 248
c. Optimism; to pessimism.
d. Idealism; cynicism.
e. None of the above.
Answer: D
Page: 250
Page: 251
27. Medical education is adjusting to new realities in medical practice. Changes include the
transition in American health care delivery from:
a. A system run by doctors to one shaped by the purchasers of care and the
competition for profits.
b. A decline in the publics trust in doctors to greater questioning and even distrust.
c. A change in emphasis on specialization and subspecialization to primary care and
prevention.
d. Less hospital care to more outpatient care in homes and doctors offices.
e. All of the above.
Answer: E
Page: 253
28. Which is NOT an important factor in establishing prestige within the medical profession?
a. Hospital affiliation.
b. Race of the practitioner.
c. Clientele.
d. The inner fraternity.
e. All are important factors.
Answer: B
Page: 254
29. The inner core of physicians is divided into two major groups
<NL><ITEM><P><INST>. Which of the following is one of these groups?
a. Student elite.
b. Practitioner elite.
c. Administrative elite.
d. Surgeon elite.
e. None of the above.
Answer: C
Page: 256
96
30. Which group exercises influence over medical work through its research productivity
rather than focusing on individual diagnosis and treatment?
a. Knowledge elite.
b. Research elite.
c. Policy elite.
d. Management elite.
e. None of the above.
Answer: A
Page: 256
Page: 238
2. Administrators generally control clinical work and the efforts of most other people who
provide health care directly to patients.
Answer: FALSE
Page: 238
3. The status and prestige accorded to the physician is recognition of the physicians
expertise concerning one of societys most essential functionsthe definition and
treatment of health problems.
Answer: TRUE
Page: 238
4. The social importance of medical practice and the limited number of people with the
requisite training are not the only criteria explaining the professional status of physicians.
Answer: TRUE
Page: 238
5. After 1935, the number of American medical schools began to increase rapidly.
Answer: FALSE
Page: 239
Page: 242
Page: 242
97
8. Many influential appointments to AMA councils and committees are voted upon by either
the general membership or the House of Delegates.
Answer: FALSE
Page: 242
Page: 243
10. A larger percentage of physicians are AMA members today than were in years past.
Answer: FALSE
Page: 242
Page: 243
12. The professionalization of medicine would not have been possible without control over
the standards for medical education.
Answer: TRUE
Pages: 243
13. Past studies on the social origins of American medical students show that most are from
upper- and upper-middle-class families.
Answer: TRUE
Page: 246
14. Family influence is an especially important variable in encouraging and reinforcing the
ambitions of the future recruit to the medical profession.
Answer: TRUE
Page: 246
15. The primary reason given by many medical students for choosing a career in medicine
has been that of wanting to have a higher income. </P>
Answer: FALSE
Page: 247
16. Becker and his associates noted that most entering medical students
<ITAL>assumed</ITAL> they would be well paid. Hence, making money was
apparently secondary to helping patients.
Answer: TRUE
Page: 247
17. Evidence-based medicine utilizes clinical practice guidelines, providing highly detailed
step-by-step instructions on medical care that the students can refer to in clinical
situations.
98
Answer: TRUE
Page: 248
Page: 248
19. One aspect of medical training that appears in several studies of medical students is the
finding that the experience tends to promote emotional attachment to patients.
Answer: FALSE
Page: 249
20. Some physicians do not need to spend a lot of time with patients in order to make
diagnoses.
Answer: TRUE
Page: 250
Essay Questions
1. According to Robert Coombs et al., what purpose does medical slang serve? Provide
examples of medical slang.
2. Medical education is having to adjust to new realities in medical practice. What are these
realities?
3. What are three factors important in establishing prestige within the medical profession?
Discuss.
4. Describe the history of the American Medical Association. What is this body? How does
it contribute or hurt the professionalization of medicine?
5. What is the Flexner Report, and how did it affect medical education?
Chapter 12
Physicians in a Changing Society
Multiple Choice Questions
1. Public dissatisfaction with the medical profession in the United States is generally viewed
as having ______________ and ________________ origins.
a. Educational; economic
b. Educational; social
c. Economic; social
d. Economic; ethnic.
e. None of the above.
99
Answer: C
Page: 259
2. The decline in the status and autonomy of physicians is largely due to greater:
a. Government regulation
b. Corporations in the health care market
c. Changes in the physician-patient relationship
d. All of the above
e. None of the above
Answer: D
Page: 266
Page: 259
Page: 260
5. What is medicalization?
a. Path by which a student becomes a medical professional.
b. Process of turning commonly regarded normal human conditions into medical
ailments.
c. Process where a traditionally non-medical professional/occupational sphere
becomes labeled as medical (e.g. insurance companies).
d. None of the above.
e. All of the above.
Answer: B
Page: 260
d. Physician-driven.
e. None of the above.
Answer: C
Page: 260
7. Which is NOT an important feature of a positive relationship for patients with their
physician?
a. High levels of trust.
b. General satisfaction.
c. Participation in decision-making.
d. Gender matching.
e. None of the above.
Answer: D
Page: 261
8. What restricted the evaluation of work and discouraged the expression of criticism within
physician circles?
a. Rules of etiquette.
b. Laws.
c. Formal sanctions.
d. Hospital guidelines.
e. None of the above.
Answer: A
Page: 261
Page: 261
10. Millman contended that a gentlemens agreement existed among the hospital
physicians. What did this agreement allow for?
a. Overlooking each others mistakes.
b. Not to discuss personal issues with physicians partners.
c. Assisting in negotiating the highest pay possible for physicians.
d. Doctors to be unreliable.
e. Irresponsibility to patients.
Answer: A
Page: 262
101
11. Millman contended that ________________ errors could be forgiven and often had the
result of motivating the offending physician to work harder, spend more time with
patients, double-check procedures, and learn from the mistake.
a. Moral.
b. Technical.
c. Accidental.
d. Real.
e. Personal.
Answer: B
Page: 262
Page: 262
13. Millman contended that _______ errors, if they were made in good faith, were less
serious than _______ <DOCPAGE NUM="238"></DOCPAGE>errors.
a. Technical; moral.
b. Moral; technical.
c. Accidental; real.
d. Real; accidental.
e. Accidental; personal.
Answer: A
Page: 262
14. Freidson argues that it can be ___________ that physicians are dedicated to their patients.
a. Guessed.
b. Believed.
c. Denied.
d. Assumed.
e. None of the above.
Answer: D
Page: 264
d. PPOs.
e. AMAs.
Answer: A
Page: 264
16. _______________ are composed of licensed physicians and osteopaths who determine if
the services rendered are medically necessary, meet professional standards of quality, and
are provided as efficiently and effectively as possible.
a. PSROs.
b. DRGs.
c. HMOs.
d. PPOs.
e. AMAs.
Answer: A
Page: 264
17. Mistakes and errors in medical practice, through neglect or ignorance, can sometimes be
defended as:
a. Cultural latitude.
b. A difference of opinion.
c. Accidental.
d. Unintentional.
e. None of the above.
Answer: B
Page: 265
18. A major defect in the professional autonomy argument arises from the fact that the
autonomy granted to the medical profession is granted <ITAL>_____________,</ITAL>
on the assumption that it will resolve significant issues in favor of the public interest.
a. Partially.
b. Completely.
c. Conditionally.
d. Unconditionally.
e. None of the above.
Answer: C
Page: 265
19. What situation has reduced public confidence in medicine more than any other single
issue?
a. Refusal to be regulated by an external body.
b. Resistance to cost controls.
c. Acceptance of HMOs and PPOs.
d. Adoption of medical technology which does the doctors work for them.
e. None of the above.
Answer: B
Page: 265
103
Page: 265
21. At the beginning of the 21st century we are witnessing that the dominance of medical
profession is:
a. Declining.
b. Expanding.
c. Increasing.
d. Stagnating.
e. None of the above.
Answer: A
Page: 266
22. Support through planning grants and loan guarantees was provided to encourage the
development of _______________; a form of prepaid group practice emphasizing
preventive care.
a. PSROs.
b. DRGs.
c. HMOs.
d. SCHIPs.
e. AMAs.
Answer: C
Page: 267
23. _____________ are schedules of fees placing a ceiling on how much the government will
pay for specific services <DOCPAGE NUM="242"></DOCPAGE>rendered to Medicare
patients by hospitals and doctors.
a. PSROs.
b. DRGs.
c. HMOs.
d. PPOs.
e. AMAs.
Answer: B
Page: 267
24. ____________ refers to health care organizations that control the cost of health care by
monitoring how doctors treat specific illnesses, limit referrals to specialists, and require
authorization prior to hospitalization, among other measures.
104
a.
b.
c.
d.
e.
Answer: D
Page: 267
Page: 268
Page: 268
27. ______________ are forced to spend time as patient advocates, convincing various
bureaucrats that more specialized and expensive care is warranted.
a. Specialists.
b. Physicians assistants.
c. Nurses.
d. Primary care physicians.
e. All of the above.
Answer: D
Page: 268
28. What attracted corporations to health care delivery is the potential for:
a. Improving health care.
b. Helping people.
c. Financial profit.
d. All of the above.
e. None of the above.
105
Answer: C
Page: 269
Page: 270
Page: 270
Page: 259
Page: 259
3. The movement of public opinion has been toward less confidence in physician authority.
Answer: TRUE
Page: 259
4. The profit motive has bred resentment among consumers and demands that the
professional power of doctors be increased.
Answer: FALSE
Page: 259
5. The social control of medical practice has been beneficial for American society.
Answer: FALSE
Page: 261
106
6. Physicians are rarely judged by their patients. Typically, only health care professionals
judge the performance of doctors.
Answer: FALSE
Page: 261
7. Millman contended that a technical error was making the mistake of being unreliable,
uncooperative, lacking in responsibility to patients, and failing to acknowledge
subordination to superiors.
Answer: FALSE
Page: 262
8. Rates for malpractice insurance have declined as states have set limits on the amount of
money awarded in malpractice lawsuits and physicians have become more careful in
dealing with patients.
Answer: TRUE
Page: 263
Page: 264
10. Physicians cannot be arrested and/or sentenced to prison for misrepresenting care they
claimed they gave to Medicare and Medicaid patients, because of the veil.
Answer: FALSE
Page: 264
11. Medical standards and practices continue to be regulated by the practitioners themselves.
Answer: TRUE
Page: 265
12. It is generally difficult to find a physician who will be openly critical of another physician
or who will publicly testify against a colleague.
Answer: TRUE
Page: 265
13. The problem with a professional dominance thesis is that it does not allow for decline.
</P>
Answer: TRUE
Page: 266
14. The rise of the profit orientation in medicine signifies a trend in medical practice away
from formal rationality toward greater substantive rationality.
Answer: FALSE
Page: 273
15. The medical profession has been strengthened through an oversupply of doctors.
107
Answer: FALSE
Page: 266
16. Rising costs of health care resulted in physician demands for government intervention.
Answer: FALSE
Page: 266
17. The AMA was a major proponent supporting the creation of Medicare. </P>
Answer: FALSE
Page: 266
Page: 270
19. One of the most extensive changes in health care delivery, reducing the authority of
physicians, has been the introduction of managed care.
Answer: TRUE
Page: 267
20. About 15 percent of all U.S. hospitals are owned by profit-making organizations.
Answer: TRUE
Page: 269
Essay Questions
1. What does the term countervailing power mean? What are the sources of this notion?
Discuss.
2. What is managed care? What is its role in health care delivery? What effect does it have
on the work of physicians?
3. Is there a deprofessionalization of physicians occurring? Why? Why not?
4. The social control of medical practice has traditionally presented special problems for
American society. How so? What kind of problems?
5. There is a changing relationship between physicians and their patients. Identify and
discuss trends contributing to this change.
Chapter 13
Nurses, Physician Assistants, Pharmacists, and Midwives
Multiple Choice Questions
108
Page: 277
Page: 277
3. Among the various occupational roles in the health field, _____________ have the
greatest prestige.
a. Midwives.
b. Physicians.
c. Pharmacists.
d. Administrators.
e. None of the above.
Answer: B
Page: 277
4. About 75 percent of licensed registered and practical nurses in the United States work in:
a. Doctors offices.
b. Public health agencies.
c. Schools and industrial plants.
d. Hospitals and nursing homes.
e. None of the above.
Answer: D
Page: 278
5. In many European languages, the word <ITAL>____________ not only refers to nuns
but also generically identifies the nurse.
a. Sister.
b. Mother.
c. Priestess.
d. Angel.
109
Page: 278
6. The role of nursing in Western society was changed in the middle of the 19th century,
through the insight and effort of:
a. Louie Pasteur.
b. Florence Nightingale.
c. The Nursing Coalition of America.
d. Universities.
e. None of the above.
Answer: B
Page: 279
7. The early approach to nursing training emphasized a code of behavior that idealized
nurses as being:
a. Responsible.
b. Clean.
c. Courageous.
d. Obedient to the physician.
e. All of the above.
Answer: E
Page: 280
Page: 281
9. During the late 19th and early 20th centuries, increasing numbers of women entered the
labor market as a result of:
a. Immigration.
b. The womens rights movement.
c. The depression.
d. Boredom.
e. All of the above.
Answer: A
Page: 281
10. Which nursing program may qualify the student as a registered nurse (RN)?
a. Hospital-based diploma schools.
110
b.
c.
d.
e.
Answer: D
Page: 281
11. Which registered nurse (RN) program is intended to provide training not only in nursing
skills and theory, but also to provide the background for becoming a nursing educator or
leader?
a. Associate degree programs.
b. Hospital-based diploma schools.
c. University baccalaureate programs.
d. Post-baccalaureate advanced programs.
e. Military nursing programs.
Answer: C
Page: 282
12. Which type of program produces the fewest registered nurses today?
a. Associate degree programs.
b. Hospital-based diploma schools.
c. University baccalaureate programs.
d. Post-baccalaureate advanced programs.
e. Military nursing programs.
Answer: B
Page: 282
13. The _________________ are relatively inexpensive, require only two years of training,
and yet place their graduates on the same career track as graduates of other programs.
a. Associate degree programs.
b. Hospital-based diploma schools.
c. University baccalaureate programs.
d. Post-baccalaureate advanced programs.
e. Military nursing programs.
Answer: A
Page: 282
Page: 283
111
Page: 283
Page: 283
17. Nursing students begin to collectively articulate their disappointment and openly question
their choice of becoming a nurse at what stage?
a. Initial innocence.
b. Labeled recognition of incongruity.
c. Psyching out.
d. Role simulation.
e. Provisional internalization.
Answer: B
Page: 283
Page: 286
19. Researchers find that many nurses are no longer willing to be treated as mere
subordinates by physicians. Several reasons are offered for this change. What is NOT a
reason for this change?
a. Declining public esteem for doctors.
b. Increased number of women doctors.
c. The nursing shortage.
112
Page: 287
20. Although this was not always the case, nursing students today tend to view their
occupation as:
a. Secondary to life goals of marriage and family.
b. A career to be followed throughout their working lives.
c. The pathway to better jobs in hospital administration.
d. A second choice because they couldnt get into medical school.
e. None of the above.
Answer: B
Page: 284
21. Registered nurses, especially those with baccalaureate degrees, have expanded their range
of services to include:
a. Hospital administration.
b. Primary-care healing.
c. Nurse anesthetists.
d. Cardiovascular nurse specialists.
e. All of the above.
Answer: E
Page: 288
Page: 289
23. From the perspective of hospital administrators, _____________ can be used more
economically in managerial and supervisory positions.
a. Registered nurses.
b. Licensed practical nurses.
c. Nurses aids.
d. Orderlies.
e. All of the above.
Answer: A
Page: 289
113
24. Students of what program will be taught advanced clinical skills, collaboration with other
health professionals to solve complex clinical problems, leadership, and other topics?
a. Registered nurse.
b. Nurse practitioner.
c. Certified nurses aide.
d. Doctor of nursing practice.
e. Licensed practical nurse.
Answer: D
Pages: 290
25. ______________ typically have a bachelors degree, experience in health care as a nurse
or paramedic, and become qualified after completing a training program of approximately
26 months.
a. Registered nurses.
b. Physician assistants.
c. Pharmacists.
d. Midwives.
e. None of the above.
Answer: B
Page: 290
26. Who are the key sources of medication information for the general public?
a. Doctors/Physicians.
b. Nurses.
c. Pharmacists.
d. Physicians Assistants.
e. Midwives.
Answer: C
Page: 291
Page: 292
28. What was one of the earliest forms of care available to women?
a. Midwifery.
b. Hospitalization.
c. Home health care.
d. Clinic care.
e. None of the above.
114
Answer: A
Page: 292
Page: 293
Page: 293
Page: 277
2. More than ten million people in the U.S. are employed in non-physician health care tasks.
Answer: FALSE
Page: 277
3. Nursing represents the largest single group of health workers in the United States.
Answer: TRUE
Page: 278
4. Florence Nightingales ideas formed the basis for establishing the first accredited schools
of medicine in the United States.
Answer: FALSE
Page: 281
5. The most prestigious of the nursing education programs is the hospital-based program.
Answer: FALSE
Page: 282
115
6. A major source of nurses in the United States has traditionally been the two-year
associate degree programs.
Answer: FALSE
Page: 282
7. Nursing faculties have tended to insist on students viewing their patients objectively, and
this tendency has operated to de-emphasize an intimate nursepatient relationship.
Answer: TRUE
Page: 283
8. There are signs that gender inequality is gaining greater power in nursedoctor
relationships.
Answer: FALSE
Page: 285
9. Nursing has attracted larger numbers of males in recent years with increasing pay.
Answer: TRUE
Page: 287
10. Male physicians tend to regard male nurses as more competent than female nurses.
Answer: TRUE
Page: 287
11. Female physicians were more likely to play the doctornurse game with both male and
female nurses.
Answer: FALSE
Page: 287
12. Female physicians are more likely than male physicians to have their actions questioned
by nurses.
Answer: TRUE
Page: 287
13. Competent nurses cannot be rewarded by promotion to the higher rungs of the medical
profession. </P>
Answer: TRUE
Page: 289
14. The nurse practitioner is intended to occupy a work position similar to that of the
physician assistant role.
Answer: TRUE
Page: 289
15. A formal role for nurses who practice medicine as well as nursing, as nurse practitioners,
is developing within the context of patient care.
116
Answer: TRUE
Page: 290
16. Only half of the United States allows nurse pr<DOCPAGE NUM="265"><<FNIND
NUMBER="1"/>actitioners to prescribe medications and only 6 states allow them to
prescribe controlled substances.
Answer: FALSE
Page: 290
17. A general job description of the physician assistant would be to provide a level of
primary patient care similar to or lower than that of nurse practitioners. </P>
Answer: FALSE
Page: 290
18. It appears that the use of nurse practitioners and physician assistants will increase, as long
as they extend the medical functions of physicians without competing for or challenging
their authority and autonomy.
Answer: TRUE
Page: 291
19. Pharmacists are the least accessible of all health care personnel, especially in hospitals.
Answer: FALSE
Page: 291
Page: 292
Essay Questions
1. Compare and contrast the occupational roles of nurses, physician assistants, pharmacists,
and midwives.
2. Describe the history and current state of nursing.
3. What is the doctor-nurse game? Describe.
4. What are the future trends in nursing? Explain the basis of your answer.
5. Who was Florence Nightingale? What role did she have in the development of nursing?
Chapter 14
The Hospital in Society
Multiple Choice Questions
117
1. The ______________, as a major social institution for the delivery of health care in the
modern world, offers considerable advantages to both patient and society.
a. Government.
b. Nonprofit sector.
c. Institution of medicine.
d. Hospital.
e. All of the above.
Answer: D
Page: 297
2. _______________ beliefs emphasized that human beings were duty bound to provide
assistance to the sick and needy.
a. Christian.
b. Humanitarian.
c. Governmental.
d. Religious.
e. None of the above.
Answer: A
Page: 298
Page: 298
4. These hospitals were community centers for the care of the lower-class sick:
a. Nonprofit hospitals.
b. For-profit hospitals.
c. Medieval hospitals.
d. Renaissance hospitals.
e. None of the above.
Answer: C
Page: 298
5. During the Renaissance and the Reformation, an increasing numbers of hospitals were
placed under the jurisdiction of _______________ authorities.
a. Religious.
b. Secular.
c. Governmental.
d. Community.
e. None of the above.
118
Answer: B
Page: 298
6. Which is NOT a basic feature of the modern hospital derived from the influence of the
Church?
a. Concept of a service oriented toward helping others.
b. Having a universalistic <DOCPAGE NUM="273"></DOCPAGE>approach.
c. The custodial nature of hospital care.
d. A fee-for-service philosophy where penance equals payment.
e. None of the above.
Answer: D
Page: 298
7. The secular control of hospitals marked a period of ____________ for the development
of Europes hospital system.
a. Improvement.
b. Decline.
c. Fluctuation.
d. Stagnation.
e. None of the above.
Answer: B
Page: 298
8. People with chronic health problems requiring long-term hospitalization tend to be sent to
______________ institutions.
a. Public.
b. Private.
c. For-profit.
d. Nonprofit.
e. None of the above.
Answer: A
Page: 299
Page: 299
10. About 70 percent of all resident patients in psychiatric facilities enter ______________.
a. Due to a criminal act.
b. Involuntarily.
c. Voluntarily.
d. Through family commitment.
119
Page: 317
11. Involuntary commitment proceedings are of two types: ____________ and ___________.
a. Criminal; civil.
b. Forcible; uncontested.
c. Violent; non-violent.
d. Chronic; acute.
e. None of the above.
Answer: A
Page: 317
12. Physicians began to associate themselves with hospitals in the 14th century. Initially they
had little influence because they provided their services on a _____________ basis.
a. Part-time.
b. Hourly.
c. Consultant.
d. Voluntary.
e. None of the above.
Answer: D
Page: 300
13. Since the end of the _________ century, a new image of hospitals evolved as institutions
where patients of all social classes could generally expect to find the highest quality
medical care and could reasonably expect to be cured of their disorders.
a. 17th.
b. 18th.
c. 19th.
d. 20th.
e. None of the above.
Answer: C
Page: 300
14. Hospitals eventually became places where physicians also referred their <DOCPAGE
NUM="276"></DOCPAGE>_________and _________ class patients, since the most
advanced medical technology was located there.
a. Lower; working.
b. Middle; lower.
c. Middle; upper.
d. Upper; working.
e. None of the above.
Answer: C
Page: 300-301
120
15. No single change has transformed the day-to-day work in a hospital more than trained
___________.
a. Doctors.
b. Nurses.
c. Administrators.
d. Technicians.
e. None of the above.
Answer: B
Page: 301
Page: 303
17. Americas hospital system remains a _____________ class system of medical care.
a. Single.
b. Two.
c. Three.
d. Four.
e. None of the above.
Answer: B
Page: 303
Page: 303-305
19. Who described bureaucracy as a rational and impersonal division of labor characterized
by the principles of <ITAL>office hierarchy</ITAL> and levels of graded authority, and
by <ITAL>fixed and official areas of jurisdiction</ITAL> governed by laws or
administrative regulations?
a. Weber.
b. Perrow.
c. Hillier.
d. Durkheim.
e. None of the above.
121
Answer: A
Page: 305
20. Which is NOT a reason that trustee domination succumbed to medical domination in the
1930s?
a. The emphasis on free care declined significantly as hospital services became
oriented toward patients who could pay.
b. The facilities to support a complex system of medical technology were developed,
and the quality of care provided patients was improved.
c. The hospital sought prestige through medical research in terms defined by
physicians.
d. The hospitals differentiated and offered specialized care to certain segments such
as cancer patients.
e. None of the above.
Answer: D
Page: 306
21. In the 1940s and 1950s, the role of the hospital ______________ gained in importance.
a. Physician.
b. Nurse.
c. Administrator.
d. Social worker.
e. All of the above.
Answer: C
Page: 306
22. The occupational groups in the hospital most affected by its system of dual authority are
the ______________ who perform health care tasks on the hospitals wards.
a. Physicians.
b. Nurses.
c. Pharmacists.
d. Social workers.
e. None of the above.
Answer: B
Page: 307
23. To make the hospital organization function effectively, it has been necessary to construct
a _______________ system of authority organized around a central objective of service
to the patient.
a. Decentralized.
b. Loose.
c. Dual.
d. Hierarchical.
e. None of the above.
Answer: A
Page: 309
122
24. The process of ________________ is not just a result of the manner in which large
numbers of patients are managed or the work conditions, but is also related to the
patients subjective experience of feeling sick.
a. Depersonalization.
b. Demoralization.
c. Standardization.
d. Assembly line medicine.
e. None of the above.
Answer: A
Page: 311
25. When patients present themselves for treatment in a hospital, they bring with them a
particular social identity, what Goffman refers to as a:
a. Self.
b. Face.
c. Front.
d. Persona.
e. None of the above.
Answer: B
Page: 312
26. ___________ occurs when the hospital systematically divests the person of these past
representations of self.
a. Stripping.
b. Removal.
c. Fading.
d. Standardization.
e. None of the above.
Answer: A
Page: 312
27. The ________________ and ________________ educated the patient, the less likely the
patient was to express highly conforming attitudes.
a. Older; better.
b. Older; worse.
c. Younger; better.
d. Younger; worse.
e. None of the above.
Answer: C
Page: 313
28. About _______ of all expenses for hospital services are now paid by third-party sources.
a. 60%.
b. 70%.
c. 80%.
123
d. 90%.
e. None of the above.
Answer: D
Page: 314
29. About _____________ of all the money spent on health in the United States in 2007 was
spent on hospital services.
a. 30-35%.
b. 36-39%.
c. 40-45%.
d. 46-50%.
e. None of the above.
Answer: A
Page: 314
30. The most expensive hospitals in the United States are located in New England and the:
a. South.
b. Pacific Coast.
c. Rocky Mountain states.
d. Midwest.
e. None of the above.
Answer: B
Page: 315
Page: 298
2. The origin of the institution we know today as the hospital has usually been associated
with the rise of Judaism.
Answer: FALSE
Page: 298
Page: 298
4. During the period of the Crusades, many hospitals were established along the routes to
the Iran followed by the Christian armies.
Answer: FALSE
Page: 298
5. Secular benefactors rarely founded hospitals. This was primarily the role of the Church.
124
Answer: FALSE
Page: 298
6. By the end of the 15th century, an extensive network of hospitals existed throughout
Eastern Europe.
Answer: FALSE
Page: 298
Page: 317
Page: 317
9. In criminal cases, the claim of mental disorder is used as an excusing condition that
relieves the individual of criminal responsibility for his or her crime.
Answer: TRUE
Page: 317
10. The first hospitals were founded in the United States more than 250 years ago.
Answer: TRUE
Page: 301
11. Early hospitals were largely based on voluntary initiative by private citizens who wanted
medical care available on a nonprofit basis. They were generally intended to provide
treatment for patients who had incurable disorders.
Answer: FALSE
Page: 301
12. Federal government participation in health care began in the late 1800s.
Answer: FALSE
Page: 301
13. Federal government participation in health care began with the U.S. Public Health
Service hospital program for merchant seamen. </P>
Answer: TRUE
Page: 301
14. State governments entered into health care delivery in the 1700s.
Answer: FALSE
Page: 301
15. State government early involvement in health care delivery was largely confined to the
establishment of mental institutions.
125
Answer: TRUE
Page: 301
16. The most common type of hospital in the United States is the nonfederal and nonprofit
community hospital.
Answer: TRUE
Page: 302
17. Controlled by a board of trustees, government hospitals are exempt from federal income
taxes and many other forms of state and local taxes. </P>
Answer: FALSE
Page: 302
18. Large nonprofit hospitals are less dependent than smaller hospitals on local physicians,
because of more extensive facilities and higher ratio of staff positions for doctors.
Answer: TRUE
Page: 302
19. The total number of hospitals in the United States has increased from 1975 to 2007.
Answer: FALSE
Page: 302
20. For-profit hospitals have decreased from 1975 to 2007, and nonprofit hospitals have
increased due to a focus on civil society.
Answer: FALSE
Page: 302
Essay Questions
1. Patients are alienated from their usual lives and reduced to a largely impersonal status in
the hospital through three basic mechanisms. Name and explain each one.
2. What are multipurpose health institutions? List five health-related functions they provide.
3. Historically, hospitals have passed through four distinct phases of development. Name
and describe each phase.
4. Why is Max Webers concept of bureaucracy not totally compatible with the norms of
hospital authority?
5. Describe what mental hospitals are, as well as the admissions/commitment processes.
Chapter 15
Health Care Reform and Social Policy in the United States
Multiple Choice Questions
126
1. In 2008, an average of ____________ per person was spent on health care in the United
States, which was the highest in the world at that time.
a. $1,072.
b. $5,568.
c. $7,681.
d. $9,307.
e. None of the above.
Answer: C
Page: 320
2. Estimates for 2019 indicate that health costs may average _________for every man,
woman, and child.
a. $5,568.
b. $7,026.
c. $10,008.
d. $13,387.
e. None of the above.
Answer: D
Page: 320
Pages: 321
4. What are the primary issues in debates about health care delivery in the U.S.?
a. Rising costs of services
b. Equity in the provision and distribution of care.
c. Which country to model reforms on.
d. Both A and B.
e. Both B and C.
Answer: D
Page: 319
5. Which of the following is NOT one of the provisions included in the 2010 U.S. health
care reforms?
a. Persons with preexisting conditions can no longer be denied coverage.
b. A minimum level of benefits set by the government must be provided in all health
insurance plans.
c. Businesses with three or more employees are required to provide health insurance
for both full-time and part-time employees.
127
Pages: 331-332
Page: 323
7. In the public sector, the federal government instituted cost controls for services to
_______________ patients by establishing set fees for DRGs.
a. Welfare.
b. SCHIP.
c. Medicare.
d. Medicaid.
e. None of the above.
Answer: C
Page: 323
8. DRGs:
a. List what the government would pay for medical procedures.
b. Help physicians diagnose the proper illness to classify a patient with.
c. Create a monthly payment schedule for physicians, depending on the number of
patients they see.
d. Are organizations of physicians that regulate expenditures in clinics throughout
the United States.
e. None of the above.
Answer: A
Page: 323
9. In 2006, about ___________ of all Americans with health insurance were enrolled in
managed care programs:
a. 35%.
b. 48%.
c. 53%.
d. 61%.
e. None of the above.
Answer: C
Page: 326
a.
b.
c.
d.
e.
Answer: E
Page: 326
11. The ______________ represents the bill payer and certifies that the care to be rendered is
both effective and the least costly alternative.
a. Case manager.
b. Social worker.
c. HMO.
d. Hospital administrator.
e. All of the above.
Answer: A
Page: 326-327
12. _________________ financing is a fixed monthly sum paid by the subscriber and his or
her employer that guarantees care, with little or no additional cost.
a. Pro-rated.
b. Capitation.
c. Partial.
d. Health insurance.
e. None of the above.
Answer: B
Page: 327
13. What is the main health care problem in rural areas with respect to equity?
a. Quality.
b. Cost.
c. Access.
d. Pharmaceuticals.
e. All of the above.
Answer: C
Page: 333
14. The more financially rewarding medical practices are those in __________ sized cities.
a. Small.
b. Rural.
c. Medium.
d. Large.
e. None of the above.
Answer: D
Page: 334
129
15. One out of every _______ counties in the United States does not have a single doctor.
a. 10.
b. 20.
c. 30.
d. 40.
e. None of the above.
Answer: B
Page: 334
16. Medical specialties like ____________ became increasingly popular in recent years.
a. Dermatology.
b. Anesthesiology.
c. Radiology.
d. Emergency-room medicine.
e. All of the above.
Answer: E
Page: 334
17. ________________ are public organizations supported by tax funds, which are intended
to support and conduct research, develop educational materials, protect the nations
health, and provide services designed to minimize public health problems.
a. Official agencies.
b. Voluntary agencies.
c. Health maintenance organizations.
d. Preferred provider organizations.
e. Allied health enterprises.
Answer: A
Page: 336
18. ________________ are the manufacturers of pharmaceuticals and medical supplies and
equipment, which play a major role in research, development, and distribution of medical
goods.
a. Official agencies.
b. Voluntary agencies.
c. Health maintenance organizations.
d. Preferred provider organizations.
e. Allied health enterprises.
Answer: E
Page: 337
19. ___________________ are a relatively new form of managed care health organization, in
which employers who purchase group health insurance agree to send their employees to
particular hospitals or doctors in return for discounts.
a. Official agencies.
b. Individual practice associations.
c. Health maintenance organizations.
130
Page: 336-337
20. _________________ solicit funds from the general public and use them to support
medical research and provide services for disease victims.
a. Official agencies.
b. Voluntary agencies.
c. Health maintenance organizations.
d. Preferred provider organizations.
e. Allied health enterprises.
Answer: B
Page: 336
21. _________________ are managed care prepaid group practices, in which a person pays a
monthly premium for comprehensive health care services.
a. Official agencies.
b. Individual practice associations.
c. Health maintenance organizations.
d. Preferred provider organizations.
e. Allied health enterprises.
Answer: C
Page: 336
22. _________________ are solo practitioners or small groups of physicians who contract
independently with HMOs to provide care to patients enrolled in their plans.
a. Official agencies.
b. Individual practice associations.
c. Health maintenance organizations.
d. Preferred provider organizations.
e. Allied health enterprises.
Answer: B
Page: 336
23. This method of payment is consistent with the principle of the open market, in which the
consumers of health care, like the consumers of other products, are free to choose which
health care providers offer the best services at prices they can afford:
a. Fee-for-service.
b. Capitation.
c. Managed care.
d. Credit cards.
e. All of the above.
Answer: A
Page: 338
131
24. The medical profession in the United States has had a consistent record of ____________
to social legislation.
a. Compliance.
b. Resistance.
c. Deference.
d. Defiance.
e. None of the above.
Answer: B
Page: 323
25. Which is one reason medical students tend to specialize rather than go into general
practice?
a. Specialties usually represent a more manageable body of knowledge.
b. Specialties may be less demanding of personal time.
c. Specialties usually have greater prestige and better income.
d. All of the above.
e. A and C only.
Answer: D
Page: 334
Page: 340
Page: 324
28. This organization provides for the federal governments sharing in the payments made by
state welfare agencies to health care providers for services rendered to the poor:
a. Medicare.
b. Medicaid.
c. DRGs.
d. HMOs and PPOs.
e. None of the above.
132
Answer: B
Page: 325
29. The establishment of the welfare state is the latest phase in the evolution of citizens
rights in the West. Which was the first group of rights granted to citizens in the 18th
century?
a. Basic.
b. Political.
c. Civil.
d. Social.
e. All of the above.
Answer: C
Page: 341
30. ___________ theory takes the position that social inequality leads to clash, which leads
to change.
a. Structural functionalism.
b. Conflict.
c. Symbolic interaction.
d. Health lifestyles.
e. None of the above.
Answer: B
Page: 339
Page: 329
2. A number of states have sued the federal government over the recent health care reforms
on the basis that it is unconstitutional and unprecedented to require people to buy any
commercial good or service as a condition of lawful residence in the U.S.
Answer: TRUE
Page: 332
3. Not having health insurance drastically undermines the ability of people to obtain health
care, since they cannot pay for it and may therefore be denied it.
Answer: TRUE
Page: 319
4. Sometimes not having health insurance can contribute to the death of a patient.
Answer: TRUE
Page: 320
Answer: FALSE
Page: 321
6. Almost all drugs can reduce health spending by lowering the need for hospital care.
Answer: FALSE
Page: 321
7. The greatest single increase since 198284 has been in the cost of prescription drugs.
This category is followed by increases in hospital costs.
Answer: FALSE
Page: 322
8. Since the early 1980s, physician costs have remained fairly stable, neither rising nor
falling.
Answer: FALSE
Page: 322
9. In the early to mid-1990s, private health care in the United States experienced a dramatic
reorganization into managed care plans.
Answer: TRUE
Page: 326
10. Managed care does not alter the patient-physician relationship; it exists above and beyond
it.
Answer: FALSE
Page: 326
Page: 327
12. The urban poor have historically been dependent on public hospitals and clinics rather
than private hospitals and practitioners for providing patient care. </P>
Answer: TRUE
Page: 333
13. The rural poor are less likely to be treated by foreign medical school graduates.
Answer: FALSE
Pages: 333
14. The laws of a competitive marketplace do not apply well to medicine, because physicians
define what patients need and provide their services at prices they, their employers, or the
federal government set.
Answer: TRUE
Page: 338
134
Page: 333
Page: 333
17. There are more than 50 specialty boards affiliated with the American Medical Association
that certify physicians to practice in as many as 115 medical specialties.
Answer: FALSE
Page: 335
Page: 335
19. The people who tend to utilize emergency rooms for primary care are the
underprivileged.
Answer: TRUE
Page: 335
20. HMOs are oriented toward preventive and ambulatory services intended to reduce
hospitalization.
Answer: TRUE
Page: 336
Essay Questions
1. Identify and discuss the three major issues in the public debate about health care delivery
in the United States.
2. Present arguments for and against health reform.
3. The problem of equity with respect to health services is and remains a serious problem
in American society. Why is this a problem, and how does it relate to policy?
4. Provide an overview of the health care delivery system in the United States.
5. Describe the Medicare and Medicaid programs in depth, with an evaluation for each in
the context of health policy.
Chapter 16
Global Health Care
Multiple Choice Questions
135
Page: 350
3. In some European countries, providing national health insurance was a means to reduce
the chance that the working class would:
a. Die.
b. Revolt.
c. Get sick and be out of work.
d. Unionize.
e. None of the above.
Answer: B
Page: 345
Page: 345
5. ________________ are aimed at providing people with welfare and health benefits,
regardless of their position in society.
a. Pensions.
b. Employer sponsored health care plans.
c. Benefits.
d. Entitlements.
136
Page: 345
Page: 345
7. Except for the __________, participation in the welfare system is not considered
normative in the United States.
a. Poor.
b. Elderly.
c. Unwed.
d. Young.
e. None of the above.
Answer: B
Page: 345
8. What country had the lowest infant mortality rate in the world in 2005?
a. Cuba.
b. United States.
c. Japan.
d. Sweden.
e. Germany.
Answer: C
9. What country had the highest life expectancy for males in the world in 2005? For
females?
a. United States; United States.
b. Switzerland; Japan.
c. Japan; Japan.
d. Israel; Switzerland.
e. Australia; Spain.
Answer: B
10. The _____________ system of health care delivery is of particular interest to Americans,
because it is the system most often discussed as a future model for the United States.
a. British.
137
b.
c.
d.
e.
Canadian.
German.
Swedish.
None of the above.
Answer: B
Page: 350
Page: 351
12. The major problem facing Canada with respect to health care delivery is:
a. Rising costs.
b. Physicians dissatisfaction with reimbursement.
c. Patient dissatisfaction with wait-times for procedures.
d. Program administration.
e. None of the above.
Answer: A
Page: 351
13. What country established the first health care system in any Western society to offer free
medical care to the entire population?
a. Britain.
b. United States.
c. Canada.
d. Sweden.
e. Germany.
Answer: A
Page: 353
Pages: 373
b.
c.
d.
e.
General practitioner.
Hospital, specifically the emergency room.
Gatekeeper, a nurse who assigns physicians based upon need.
None of the above.
Answer: B
Page: 354
16. In Britain, _______________ are responsible for paying for health care in their area,
managing the provision of that care, and planning in accordance with regional and
<DOCPAGE NUM="335"></DOCPAGE>national guidelines.
a. executive councils.
b. local health authority services.
c. district health authorities.
d. hospital and specialist services.
e. None of the above.
Answer: C
Page: 355
Page: 357
18. Japanese patients pay _______ of the cost of health services, with the national plan
paying the remainder.
a. 20%.
b. 30%.
c. 40%.
d. 50%.
e. 60%.
Answer: B
Page: 360
19. About ________ of Japanese doctors are in private practice and are paid on a fee-forservice basis.
a. 12%.
b. 25%.
c. 33%.
d. 50%.
e. None of the above.
Answer: C
Page: 360
139
20. The ________________ use more prescription drugs than patients anywhere.
a. Japanese.
b. Italians.
c. Mexicans.
d. Americans.
e. Chinese.
Answer: A
Page: 360-361
Page: 364
22. The largest health plan in Mexico covers workers in the private sector and is administered
by the:
a. Mexican Social Insurance Institute.
b. National Health Service.
c. Federal Ministry of Labor and Social Affairs.
d. Secretariat of Health and Welfare.
e. None of the above.
Answer: A
Page: 366
23. The _____________ is responsible for Mexicos overall health policy and provides health
care directly to the urban poor through its own hospitals and clinics.
a. Mexican Social Insurance Institute.
b. National Health Service.
c. Federal Ministry of Labor and Social Affairs.
d. Secretariat of Health and Welfare.
e. None of the above.
Answer: D
Page: 366
Answer: A
Page: 366
25. Which of the following is one of the general trends affecting health policy worldwide?
a. Attention to the cost of health care and implementation of cost control measures.
b. Increasing emphasis on preventive medical services.
c. Improving efficiency in the administration of large health care systems.
d. Demands that governments increase efforts to provide a health care system that
meets national needs.
e. All of the above.
Answer: E
Page: 376-377
26. ____________ has more doctors per capita than any major nation.
a. Mexico.
b. Russia.
c. China.
d. Australia.
e. Untied States.
Answer: B
Page: 369
27. What country has the highest per capita consumption of alcohol in the <DOCPAGE
NUM="357"></DOCPAGE>world?
a. Ireland.
b. Germany.
c. Russia.
d. United States.
e. Mexico.
Answer: C
Page: 372
28. What was the effort in China in which 1.8 million paramedical personnel were trained in
rudimentary medicine and sent to rural areas to provide basic medical treatment and
assist in efforts at preventive medicine and public health called?
a. Barefoot doctors movement.
b. Rural outreach.
c. People-to-people in health care.
d. Grassroots medicine.
e. None of the above.
Answer: A
Page: 374
c. 55%.
d. 70%.
e. None of the above.
Answer: D
Page: 375
Page: 344
2. The value of studying the health care delivery systems of different countries is the insight
provided into the norms, values, culture, and national outlook of those societies, as well
as the lessons learned from their experiences.
Answer: TRUE
Page: 344
3. A nations approach to health care is based upon its historical experience, culture,
economy, political ideology, social organization, level of education and standard of
living, economic resources, and attitudes toward welfare and the role of the state.
Answer: TRUE
Page: 344
Page: 344
5. The social welfare systems of the U.S. are more advanced than in Europe.
Answer: FALSE
Page: 345
6. Europeans have historically been less committed to government welfare programs and
more in favor of private enterprise in dealing with economic and social problems.
Answer: FALSE
Page: 345
7. Americans who receive welfare tend to be stigmatized and have low social status.
Answer: TRUE
Page: 345
8. The German health service organization represents a form of corporatism in which a set
of institutions situated between the government and its citizens have the authority to
manage health care.
142
Answer: TRUE
Page: 364
9. The Japan health care delivery system is by far the most expensive in the world.
Answer: FALSE
Page: 346
10. The United States has the lowest infant mortality rate of any nation.
Answer: FALSE
Page: 346
11. The United States has the highest rate of longevity of any nation.
Answer: FALSE
Page: 347
Page: 350
13. Canada has a single, national health care delivery system. </P>
Answer: FALSE
Page: 350
Page: 351
Page: 351
16. The U.K. was the first country to enact national health insurance.
Answer: FALSE
Page: 353
17. Whereas higher SES groups in the U.S. have healthier lifestyles, the well-educated and
higher-income in China tended to have worse health than the lower classes. </P>
Answer: TRUE
Pages: 375
Page: 357
19. A major characteristic of the National Health Service in Sweden is that general hospitals
are not owned by the government.
143
Answer: FALSE
Page: 358
20. The Japanese national health insurance plan covers all Japanese citizens.
Answer: FALSE
Page: 361
Essay Questions
1. What are the four general trends appearing in developed societies, which are likely to
have an effect on health care policy in the future? Discuss.
2. What is socialized medicine? Discuss the systems in three countries that have socialized
medicine.
3. Discuss in detail the health care system in Germany.
4. What is a decentralized national health program? Use the case of Mexico to illustrate this
type of healthcare system.
5. Compare and contrast fee-for-service, socialized medicine, decentralized national health,
and social medicine systems in terms of regulation, provider payments, facility
ownership, public access, and private care.
144