TEST BANK for Medical Sociology, 15th Edition by William Cockerham

Test Bank for Medical Sociology, 15e William Cockerham (All Chapters) Chapter 1 Medical Sociology

Multiple Choice Questions 1. Which is NOT a major area of investigation in medical 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

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2. Medical sociology is an important area of study because: a. It promotes the role biology plays in social life. b. It represents a departure from the theory-heavy discipline of general sociology. c. It recognizes the role that social factors play in determining or influencing health. d. It is the result of a merger between medicine and sociology. e. None of the above.

Answer: C

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3. What influences how societies organize their resources to cope with health hazards and deliver health care to the population at large? a. Climate b. Available money c. Neighboring countries’ health care systems d. Social, cultural, economic, and political factors e. Uniqueness of medical education Answer: D

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4. Medical sociology, as a subdiscipline, began gaining strength: a. It was always part of sociology as a major focus of classical sociologists. b. When Max Weber published his work on suicide in the late nineteenth century. c. After World War II with the infusion of large amounts of federal funding for research. d. Only in the last two decades when major worldwide health crises highlighted the need for it.

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e. It never has been a major part of sociology and exists only as a small part of the medical field.

Answer: C

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5. Which circumstance(s) particularly affected the development of medical sociology in its early stages? a. Pressure to produce work that could be applied to medical practice and health policy. b. Rich development of theories unique to medical sociology by academic sociologists. c. Lack of attention on the role of medicine and health from classical theorists. d. A and B e. A and C Answer: E

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6. Why did sociology’s founders overlook medicine? a. Medicine was unorganized at the time. b. Medicine lacked any professionalization to study. c. Medicine was too secretive to study d. Medicine blocked sociologists from studying the discipline. e. Medicine did not shape the structure and nature of society.

Answer: E

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7. 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

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8. 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 Parsons’s 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

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9. Talcott Parsons’s 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

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10. 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

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11. In developing his concept of the sick role, Parsons linked his ideas to which two classical theorists? a. Marx and Goffman. b. Weber and Marx. c. Marx and Engels. d. Durkheim and Weber. e. Durkheim and Goffman.

Answer: D

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12. What is NOT a task of a sociologist in medicine? a. Analyze the social etiology or causes of health disorders b. Study the differences in social attitudes as they relate to health c. Understand the way in which the incidence and prevalence of a specific health disorder is related to social variables. d. Develop theory that assists in understanding social issues related to health. e. All of these are tasks of a sociologist in medicine.

Answer: D

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13. Most sociologists of medicine are employed as: a. Biostatisticians. b. Hospital workers. c. Professors at universities. d. Researchers in governmental agencies. e. Independent contractors.

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Answer: C

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14. 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

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15. What encourages medical sociologists working in health care and in academic settings to conduct research that deals with topics that have practical utility? a. The willingness of government agencies and private foundations to only fund health-related research that can help solve problems or improve health conditions. b. The influence of economic structures like capitalism on health care and academic settings. c. The need to develop new approaches to population-wide health disparities that can generate profit for health care and academic settings. d. The lack of interest in creating theoretical models to explain the health needs of a population. e. The pressure to abandon theoretical explanations of health and illness in the face of COVID-19.

Answer: A

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16. What is the social psychology of health and illness concerned with studying? a. The influence of social psychological processes on the distribution of health and disease b. The impact of the health care delivery system on social psychological processes c. The social psychological outcomes of health-related behaviors d. The social psychological processes that explain or modify health and healthrelated behaviors e. The influence of social psychological process in the education of health professionals Answer: D

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17. The World Health Organization defines health as: a. Normality. b. The absence of disease. c. Ability to function. d. A state of complete physical, mental, and social well-being e. All of the above.

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Answer: D

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18. 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

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19. 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 doctor–patient relationship. d. All of the above. e. None of the above.

Answer: D

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20. 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

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21. The medicine of social spaces is concerned with: a. Curing disease. b. Preventing disease. c. Understanding disease. d. Cataloging disease. e. All of the above.

Answer: B

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22. 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.

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c. The discovery of penicillin. d. Epidemiological transitions. e. All of the above.

Answer: A

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23. The germ theory of disease is a perspective which asserts: a. Diseases are caused by a biological agent. b. Medicine is the only true way to treat disease. c. Illness can be caused by lifestyle choices. d. Germs are conscious agents that intentionally harm their hosts. e. None of the above.

Answer: A

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24. 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

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25. 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

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26. Which of the following are TRUE about health lifestyles? a. They include behaviors like smoking, drinking, and alcohol consumption. b. They influence whether and how severely one becomes ill. c. They can be positive or negative. d. They are influenced by one’s social environment. e. All of the above.

Answer: E

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27. What particular problem occurs with newly emerging diseases? a. They have a very predictable pattern of appearance.

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b. c. d. e.

Their pathogenesis is nearly impossible to trace.

They are often difficult to control in the early stages.

Their origin is always in an underdeveloped country.

Their transmission becomes increasingly difficult to trace over time.

Answer: C

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28. 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. d. A and B. e. B and C. Answer: B

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29. How might the resurgence of infectious diseases shift the research perspective of medical sociologists? a. It may shift focus to acute diseases. b. It may shift focus away from chronic diseases. c. It may shift focus to infectious diseases. d. It may shift focus to both chronic and infectious diseases. e. It may shift focus away from both chronic and infectious diseases.

Answer: D

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True False Questions 1. Medical sociology focuses on the social causes and consequences of health and illness.

Answer: TRUE

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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

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3. Health includes a number of components which are not just biological, but also social, cultural, political, and economic.

Answer: TRUE

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4. Medical sociology is a relatively new field in sociology.

Answer: TRUE

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5. Unlike law, religion, politics, economics, and other social institutions, medicine was ignored by sociology’s founders in the late nineteenth century because it did not appear to shape the structure and nature of society.

Answer: TRUE

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6. The tremendous growth of medical sociology would have been possible even without financial support for applied studies provided by the government.

Answer: FALSE

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7. Talcott Parsons provided a theoretical approach for medical sociology in the 1950s that was important in the subdiscipline's early development.

Answer: TRUE

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8. The sick role presents an ideal representation of how people act when sick.

Answer: TRUE

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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

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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

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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

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12. There is a growing divergence between medical sociology and the general discipline of sociology.

Answer: FALSE

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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

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14. Good health is a prerequisite for the adequate functioning of any individual or society.

Answer: TRUE

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15. Early humans used primitive medicines made from plants or animals rather than some form of ritual to expel a harmful spirit from a diseased body.

Answer: FALSE

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16. Both Western religion and medical science sponsored the idea that the body was like a machine, disease was a malfunction of the machine, and the doctor’s job was to repair the machine.

Answer: TRUE

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17. According to Michel Foucault, the development of modern medicine transformed perceptions of disease from something beyond the boundaries of knowledge to something to be scientifically studied and controlled.

Answer: TRUE

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18. 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

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19. The poor have the highest rates of disease and disability of any socioeconomic group, demonstrating their greater biological disposition toward illness.

Answer: FALSE

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20. Lifestyles and social behavior have little effect in the transmission of infection.

Answer: FALSE

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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. 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 Organization’s definition of health?

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4. Explain the germ theory of disease and its effect on practice of medicine.

5. Discuss the role of chronic diseases in prompting a return to medicine’s focus on the “whole person.”

6. Has there been a re-emergence of infectious disease? Explain your answer.

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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. Individual’s diseases. e. Health problems of social aggregates.

Answer: E

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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

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3. In epidemiology, a “case” refers to: a. An investigation into an outbreak of disease or illness. b. The classification of a disorder, illness, or injury. c. A collection of a single type of disorder, illness, or injury. d. A single episode of a disorder, illness, or injury involving an individual. e. There is no such epidemiological term.

Answer: D

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4. A researcher is interested in reporting how many people in a community were diagnosed with HIV during the past month. He/she would measure the: a. Incidence. b. Prevalence. c. Crude rate. d. Cases. e. Age-specific rate.

Answer: A

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5. Which of the following is TRUE about incidence and prevalence? a. Prevalence is used to analyze the rate at which new cases occur. b. Incidence and prevalence are interchangeable terms.

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c. Incidence is reported in raw numbers while prevalence is expressed as a ratio. d. The incidence for a given disease can be low at the same time that its prevalence is high. e. None of the above Answer: D

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6. A ratio, such as the crude mortality rate, is expressed as: a. Total number of cases divided by prevalence. b. Total number of cases divided by incidence. c. Total number of cases divided by total population. d. Total number of cases times total population. e. Total number of cases times incidence.

Answer: C

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7. _________________ has special significance for a society because it is traditionally used as an approximate indicator of a society’s standard of living and quality of health care delivery. a. Prevalence of chronic diseases. b. Life expectancy. c. Infant mortality rate. d. Crude birth rate. e. Age adjusted fertility rate.

Answer: C

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8. What is NOT a factor in the increasing emergence of epidemics? a. Increase in international transportation channels. b. Migration from rural areas into urban cities. c. Increase in public sanitation. d. All of the above. e. None of the above.

Answer: C

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9. Which of the following ensured that infectious diseases would spread more quickly and also that disease-causing microorganisms would persist within the community for longer periods of time? a. The use of rodents as a food source b. The migration of birds from warmer to colder climates c. The crowded conditions of urban living d. The gathering of corpses in public cemeteries e. The introduction of unhygienic hospitals Answer: C

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10. Whose investigations into cholera outbreaks established the foundation of modern epidemiology? a. Louis Pasteur. b. John Snow. c. Karl Marx. d. Lister Hill. e. All these men helped lay the foundation of epidemiology.

Answer: B

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11. 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

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12. 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

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13. 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

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14. What is the leading cause of death in the United States, accounting for more than onethird of all deaths? a. Diabetes.

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b. c. d. e.

HIV/AIDS. Stroke.

Heart disease.

Cancer.

Answer: D

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15. The _____________ study was important for showing that heart disease 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

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16. What do studies on diet, exercise, and obesity suggest with respect to heart disease? a. Diet and physical activity have little effect on an individual’s likelihood of developing heart disease. b. Changing one’s 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

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17. What motivated the American Medical Association to officially recognize obesity as a disease? a. Obesity reached a threshold in how many deaths to which it contributed. b. In reaction to the U.S. government issuing an official declaration for public health legislation. c. To encourage physicians to give more attention to it and insurers to pay for treatment. d. As a way to prevent insurance fraud and misuse of medical services. e. Obesity needed to have an official definition to generate more research and to treat it in patients.

Answer: C

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18. What influence do social networks have on obesity? a. They influence people to adopt healthier eating habits when their neighbors do.

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b. They influence people to eat more junk foods when their sibling does. c. They encourage people to exercise more when their work friends do. d. They have no influence on obesity regardless of the nature of personal ties within a social network. e. The nature of personal ties within a social network vary in their influence on obesity.

Answer: E

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19. According to Abdel Omran, in which stage of the epidemiologic transition are infectious diseases the major causes of death? a. Age of Pestilence and Famine b. Age of Receding Epidemics c. Age of Degenerative and Man-Made Diseases d. Age of Genetic Diseases e. Age of Re-Emerging Infectious Diseases Answer: A

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20. According to Abdel Omran, in which stage of the epidemiologic transition are afflictions of old age the major causes of death? a. Age of Pestilence and Famine b. Age of Receding Epidemics c. Age of Degenerative and Man-Made Diseases d. Age of Genetic Diseases e. Age of Re-Emerging Infectious Diseases Answer: C

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21. In the early 21st century, the majority of HIV/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

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22. The lowest HIV/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: B

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23. HIV/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

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24. Which of the following plays a particularly important role in the transmission of HIV/AIDS in Sub-Saharan Africa? a. Government. b. Health delivery system. c. Migrant labor force. d. Homosexuals. e. Drug users.

Answer: C

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25. HIV/AIDS now affects _____________ in Africa more than ________________. a. Whites, natives. b. Children, adults. c. Homosexuals, heterosexuals. d. Men, women. e. Women, men.

Answer: E

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26. 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

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27. 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.

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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

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28. Which term describes an individual’s most important position in society and typically comes from one’s occupation? a. Default status. b. Ordinary status. c. Master status. d. Primary status. e. Main status.

Answer: C

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29. Which of the following best describes influenza pandemics? a. They occur frequently but the threat to worldwide health is minimal. b. They have been mostly eliminated due to the development of vaccines such as Tamiflu. c. They are easily contained to the region of outbreak. d. They are unpredictable and occur at irregular intervals. e. None of the above.

Answer: D

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True False Questions 1. Many sociologists working in the field of medicine are epidemiologists.

Answer: TRUE

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2. Present-day epidemiologists primarily study epidemic diseases and give little attention to other diseases such as chronic ailments or unhealthy behaviors.

Answer: FALSE

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3. Prevalence rates, when expressed as point prevalence, period prevalence, or lifetime prevalence, vary based on the disease being measured.

Answer: FALSE

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4. The simplest ratio computed by the epidemiologist is called the crude rate.

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Answer: TRUE

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5. Crude death and birth rates are too gross a measure to be meaningful for most sociological purposes Answer: TRUE

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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

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7. The bubonic plague was ended in 1750 with the development of penicillin.

Answer: FALSE

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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 individual’s life.

Answer: TRUE

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9. The social environment, referring not only to living conditions but also to norms and values, can cause sickness.

Answer: TRUE

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10. Developing nations are typically characterized by a high birth rate and a high death rate, with a relatively young population.

Answer: TRUE

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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

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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

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13. Pandemics are regional or local outbreaks of a disease and rarely happen.

Answer: FALSE

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14. HIV/AIDS first appeared in intravenous drug users in New York and San Francisco.

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Answer: FALSE

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15. HIV/AIDS potentially entered the U.S. through Haiti.

Answer: TRUE

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16. Much of the fear about HIV/AIDS arises from the fact that many people who carry the virus are not aware of it.

Answer: TRUE

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17. People most at risk for developing HIV/AIDS are those who have had multiple sex partners and know little about their partners’ past sexual behavior.

Answer: TRUE

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18. 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

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19. Among humans, Ebola is transmitted through cultural and social means, including caring for the sick and local African burial traditions of cleaning, touching, and kissing the deceased.

Answer: TRUE

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20. Zika causes such severe symptoms that it has been easy to track how many people have been infected.

Answer: FALSE

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Essay Questions 1. Define incidence and prevalence. Explain the relationship between the two, and identify which issues within each concept that pertain while 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.

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4. Modification in what four lifestyle areas would significantly reduce the risk of heart disease? Discuss how and why these modifications affect the risk of developing heart disease.

5. Explain the arguments for and against obesity being labeled as a disease.

6. Developing and developed nations have a different pattern of disease and illness. List the most prevalent diseases in both nation types, and then discuss why these differences exist.

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Chapter 3 COVID-19 Multiple Choice Questions 1. What marks the beginning of the “social” in causing the COVID-19 pandemic? a. The creation of refuges for wild animals b. Increased demand for rare foods in urban centers around the world c. The close contact between wild pangolins and humans d. The suburbanization of China e. Reduced levels of travel between China and other countries Answer: C

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2. What social desire contributed to the initiation of the COVID pandemic? a. The desire to live in rural towns near wild animals. b. The desire to keep wild animals as pets. c. The desire to kill wild animals for trophies. d. The desire to eat extremely fresh wild animals. e. The desire to work in close contact with wild animals.

Answer: D

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3. What is one factor that enabled the initial transmission of COVID-19 from animals to humans? a. The Huanan Seafood Wholesale Market lacked proper separation between different animal meats. b. An unhygienic wet market. c. Chinese cities expanded into the wild habitats where COVID-19 emerged in bats. d. Tourists in China interacted with wild pangolins who carried COVID-19. e. Bats carrying COVID-19 began to migrate to Wuhan, China and expose humans to their feces.

Answer: B

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4. What made the Chinese government’s ban on travel to and from Wuhan after COVID-19 emerged in early 2020 so significant? a. It was the first time a government had limited the travel of its citizens. b. It was the largest restriction of movement ever implemented. c. It would be damaging to the Chinese economy as Wuhan is a major commercial and industrial center in China. d. It would be damaging to the Chinese government as Wuhan is the home of many Chinese politicians. e. It could never be implemented as China’s government did not have the power to enforce it.

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Answer: C

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5. How did the World Health Organization respond to the outbreak of COVID-19 in China in 2020? a. It conducted a thorough investigation of all COVID-19 cases in China. b. It deciphered the genome of the virus and circulated the information. c. It helped develop the quarantine policies used in China. d. It investigated the Huanan Seafood Wholesale Market for violating food safety standards. e. It issued a report based on a Chinese-only investigation.

Answer: E

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6. What was one factor that led to a delay in preventative measures in China? a. Local officials repressed information about the new disease to maintain favor with the central government. b. Residents of Wuhan refused to submit to testing that could trace the source of the outbreak. c. Scientists could not identify how the new disease was transmitted to humans. d. The central government did not believe that a new disease was emerging and refused to act. e. Wuhan lacked the resources to quickly implement or enforce preventative measures.

Answer: A

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7. Which Middle Eastern country had the most cases of COVID-19 by the summer of 2021? a. Turkey b. Iran c. Iraq d. Israel e. Jordan Answer: A

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8. As of the summer of 2021, 65% of mortality from COVID-19 in Spain was concentrated in what age group? a. 0 to 19 years old b. 20 to 39 years old c. 40 to 59 years old d. 60 to 79 years old e. 80 years and older Answer: E

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9. What contributed to Italy’s high mortality rate from COVID-19?

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a. Italy began testing much later than other countries and could not trace infections quickly enough b. Italy did not restrict people’s movements after they became infected with COVID-19 c. Italy promoted a “natural immunity” approach that encouraged people to seek out COVID-19 infection d. Italy had a large elderly population that became infected with COVID-19 e. Italy’s population was densely packed into a few cities making infection much easier and quicker Answer: D

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10. What was France’s reasoning for easing restrictions after COVID-19 emerged in that country? a. France saw the incidence rate of COVID-19 decrease significantly. b. France could not afford to lose trade from other European countries. c. France believed it was necessary to adjust to COVID-19 as a new normal. d. France lacked the authority to continue restrictions for more than a few weeks. e. France needed tourists to visit the country to boost its economy.

Answer: C

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11. Out of all the European countries, COVID-19 caused the United Kingdom to suffer the greatest what? a. Economic recession b. Educational setbacks c. Fertility decline d. Political turmoil e. Prevalence of COVID variants Answer: A

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12. Which country in Europe had the highest mortality from COVID-19 by summer 2021? a. France b. Germany c. Italy d. Russia e. United Kingdom Answer: E

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13. What action by Germany is credited for the country’s relatively low mortality rates from COVID-19? a. Increasing the number of healthcare workers responding to new COVID-19 cases b. Quickly instituting lockdown measures and widespread testing c. Completely restricting non-essential face to face interactions

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d. Immediately shutting down travel from China and Europe e. Effectively contact tracing people exposed to COVID-19 and rapid testing Answer: B

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14. How did Sweden’s approach to COVID-19 differ from other European countries? a. It only created restrictions for the elderly in the population. b. It kept colleges and secondary schools open while elementary schools closed. c. It distributed several rapid tests to its residents every week for three months. d. It created relatively lax restrictions. e. It opened its borders to people leaving countries where COVID-19 was prevalent.

Answer: D

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15. What was the result of Sweden’s approach to COVID-19, as of summer 2021? a. A decreased probability of death b. A quicker spread of the virus c. An outcome equivalent to other European countries d. A slower spread of the virus e. An increased probability of death Answer: D

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16. Where did most deaths from COVID-19 occur in India? a. In rural areas b. In urban areas c. In the border towns d. In the coastal towns e. In the central areas Answer: B

Page: 63

17. Which of the following factors was expected to hinder African countries’ response to COVID-19? a. The lack of a continent-wide health care delivery system b. The extensive distrust of medical professionals c. The low quality of many countries’ health care delivery systems d. The widespread government corruption in many countries e. The restriction of foreign aid to provide medical necessities Answer: C

Page: 64

18. What factor likely helped prevent widespread COVID-19 infection in Africa? a. A lack of trade between countries in Africa and in Europe b. A surplus of antibiotics from the Ebola outbreak c. A cross-national quick response team of epidemiologists

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d. A quick lockdown preventing travel from China e. A young population Answer: E

Page: 64

19. What delayed the distribution of the COVID-19 vaccine to low-income countries? a. Wealthy countries bought all the available vaccines. b. Wealthy countries were prioritized for their higher infection rates. c. Wealthy countries were prioritized for how much they paid for research on the vaccine. d. Low-income countries could only distribute a few vaccines at a time. e. Low-income countries did not develop their own vaccines to distribute.

Answer: A

Page: 64

20. Who in Brazil had higher rates of death from COVID-19? a. Black and Hispanic Brazilians b. Indigenous Brazilians c. Pardo and Black Brazilians d. Hispanic Brazilians e. White Brazilians Answer: C

Page: 65

21. By summer 2021, which country had the highest number of deaths from COVID-19? a. Brazil b. China c. Nigeria d. Russia e. United States Answer: E

Page: 66

22. How did travel to and from Europe, large crowd gatherings, and socializing in bars affect the spread of COVID-19 in the United States? a. These factors accelerated the spread of COVID-19. b. These factors decelerated the spread of COVID-19. c. These factors had no impact on the spread of COVID-19. d. These factors clustered the spread of COVID-19 in urban areas. e. These factors clustered the spread of COVID-19 in wealthy areas.

Answer: A

Page: 67

23. What cultural influence in the United States had the greatest influence on its response to COVID-19? a. Constitutionalism

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b. c. d. e.

Fundamentalism Egalitarianism Individualism Neoliberalism

Answer: D

Pages: 68-69

24. What aspect of the system of governance in the United States complicated the response to COVID-19? a. Constitutionalism b. Federalism c. Individualism d. Neoliberalism e. Republicanism Answer: B

Page: 70

25. What was the most important action the federal government of the United States did in response to COVID-19? a. Ban travel to and from China b. Close places where large gatherings occur c. Deploy mobile medical units to underserved areas d. Fund research for the development of a vaccine e. Send medical supplies to places of need Answer: D

Page: 71

26. Which age group was the most affected by COVID-19? a. 0 to 19 years old b. 20 to 39 years old c. 40 to 59 years old d. 60 to 79 years old e. 80 years and older Answer: E

Page: 72

27. Why were racial minorities more likely to die from COVID-19 than whites? a. They were more likely to live near a hospital. b. They were more likely to live in rural areas. c. They were more likely to have comorbid conditions. d. They were less likely to work in service jobs. e. They were less likely to wear protective gear.

Answer: C

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Page: 73-74

28. In what way did COVID-19 affect men and women differently? a. Men were less likely to die from it than women were. b. Men were more likely to become a stay-at-home parent than women were. c. Men and women experienced the same outcomes. d. Women were less likely to be infected by it than men were. e. Women were more likely to face unemployment than men were.

Answer: E

Page: 75

29. How does a social ending to the COVID-19 pandemic occur? a. It occurs when the government declares it to be over. b. It occurs when people return to their normal social activities. c. It occurs when the incidence of infection decreases. d. It occurs when the prevalence of infection decreases. e. It occurs when vaccine compliancy creates herd immunity.

Answer: B

Page: 76

True False Questions 1. One factor that brought COVID-19 into contact with humans is climate change.

Answer: TRUE

Page: 56

2. China’s delay in implementing a travel ban likely contributed to more infections.

Answer: TRUE

Page: 59

3. The first cases of COVID-19 in Europe occurred in Switzerland and Hungary.

Answer: FALSE

Page: 59

4. Italy was the first country in Europe to reopen its international borders after instituting a travel ban due to COVID-19.

Answer: TRUE

Page: 60

5. Britain vaccinated people more quickly than any other country.

Answer: TRUE

Page: 61

6. The largest portion of mortality from COVID-19 in Sweden occurred in nursing homes.

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Answer: TRUE

Page: 63

7. Russia was the first country to claim it had produced a vaccine providing immunity to COVID-19.

Answer: TRUE

Page: 63

8. South Africa had the lowest rate of COVID-19 infection in Africa by summer 2021.

Answer: FALSE

Page: 64

9. COVAX is an international initiative to ensure that low- and middle-income countries have access to a COVID-19 vaccine.

Answer: TRUE

Page: 65

10. Brazil’s greatest problem in containing COVID-19 was widespread fraud in its medical system.

Answer: FALSE

Page: 65

11. Mexico’s response to COVID-19 included a stimulus given to every citizen to prevent widespread unemployment.

Answer: FALSE

Page: 66

12. Government inefficiency significantly hindered many Latin American countries’ efforts to curb the spread of COVID-19.

Answer: TRUE

Page: 66

13. The density of New York City’s population is partly why it became the initial epicenter of COVID-19 in the United States.

Answer: TRUE

Page: 67

14. The surge in COVID-19 the United States experienced in the summer of 2020 occurred despite an increase in lockdown restrictions.

Answer: FALSE

Page: 67

15. In the United States, nursing homes were a major site of infection for COVID-19.

Answer: TRUE

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Page: 68

16. Individualism in the American context is the belief in the right of a person to live their life how they wish without interference from the government.

Answer: TRUE

Page: 69

17. A much lower proportion of Black people were infected with COVID-19 compared to white people in both the United States and Canada.

Answer: FALSE

Page: 71

18. Racial minorities had a lower risk of mortality from COVID-19 if they also had a preexisting condition.

Answer: FALSE

Page: 74

19. Women were more likely to be infected by COVID-19.

Answer: TRUE

Page: 75

20. The medical ending to COVID-19 would see the incidence and mortality rates decrease.

Answer: TRUE

Page: 76

Essay Questions 1. Discuss the factors that led to the emergence of COVID-19.

2. What social factors aided the spread of COVID-19?

3. Compare the responses of different countries to COVID-19.

4. Discuss the patterns of infection and mortality from COVID-19 among the different racial groups.

5. What role did social class play in the COVID-19 pandemic?

6. Explain the various social effects COVID-19 has had on society.

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Chapter 4 The Social Demography of Health: Social Class

Multiple Choice Questions 1. Several studies find that the strongest and most consistent predictor of a person’s health and life expectancy is what? a. Psychological profile b. Neighborhood. c. Gender. d. Social class. e. Income.

Answer: D

Page: 84-85

2. A social class is a category or group of people who: a. Are in the same age range. b. Share similar ethnicity and culture. c. Live in the same neighborhood. d. Share similar levels of wealth, status, and power. e. None of the above.

Answer: D Page: 85 3. Which is NOT one of the five classes proposed by Weber? a. Upper class. b. Upper-lower class. c. Working class. d. Upper-middle class. e. All of these are correct.

Answer: B

Page: 85

4. In Weber’s five-class model, the lower class would include: a. Affluent well-educated professionals and high-level managers. b. Semi-skilled and unskilled workers, the chronically unemployed. c. Office and sales workers, small business owners, teachers, managers. d. Skilled and semi-skilled workers, lower-level clerical workers. e. All of the above.

Answer: B

Page: 85

5. The National Statistics Socio-Economic Classification (NS-SEC) is a measure of class position, which is based on differences in: a. Age and gender. b. Neighborhood.

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c. Income. d. Work/employment. e. Education.

Answer: D

Page: 85

6. The National Statistics Socio-Economic Classification (NS-SEC) is typically used by: a. CDC. b. Americans. c. British. d. Chinese. e. Unions.

Answer: C

Page: 85

7. 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.

Answer: B

Page: 86

8. According to Weber, _________ is the ability to realize one’s will even against the resistance of others. a. Power. b. Prestige. c. Presence. d. Principle. e. None of the above.

Answer: A

Page: 87

9. 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: 87

10. Which component of social class is consistently the strongest single predictor of good health?

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a. b. c. d. e.

Income.

Education.

Wealth.

Occupation.

Neighborhood.

Answer: B

Page: 87

11. 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: 88

12. 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? a. Physical. b. Biological. c. Psychological. d. Lifestyle. e. All of the above.

Answer: E

Page: 90

13. 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: 90

14. 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.

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Answer: E

Page: 90

15. 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: 90

16. 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: 91

17. 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: 92

18. According to Richard Wilkinson, which is the most important variable influencing a county’s 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: 92

19. 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.

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d. Reversed. e. Exaggerated.

Answer: B

Page: 93

20. 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: 94

21. 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.

Answer: A

Page: 94

22. What group uses preventative services the least? a. Upper class. b. Middle class. c. Working class. d. Lower class. e. None of the above.

Answer: D

Page: 94

23. 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: 95

24. According to Marmot and his colleagues, how does improved access to medical care impact the relationship between social class position and health?

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a. b. c. d. e.

It increases life expectancy and health gaps between classes.

It decreases life expectancy and increases health for the highest classes.

It decreases life expectancy and increases health for the middle class.

It decreases life expectancy and increases health for the lower classes.

It does not significantly impact the life expectancy and health gaps between classes.

Answer: E

Page: 95-96

25. 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: 96

26. Neighborhood disadvantage focuses on: a. Poor neighborhoods. b. Unhealthy urban living conditions. c. Southern states with high rates of poverty. d. Minority-populated neighborhoods. e. None of the above.

Answer: B

Page: 96

27. ______________ neighborhoods are clean and safe, houses and buildings are wellmaintained, and residents are respectful of each other and each other’s property. a. Orderly. b. Disorderly. c. Suburban. d. Urban. e. Government.

Answer: A

Page: 96

28. What is the effect of living in a disadvantaged neighborhood on people? a. Higher rates of depression b. Less stress since everyone is poor c. Lower rates of anxiety d. Structural features have less impact on health e. Positive self-rated health Answer: A

Page: 97

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29. In order for a social variable to qualify as a fundamental 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: 99

True False Questions 1. To be poor is, by definition, to have less of the good things in life, including health and longevity.

Answer: TRUE

Page: 85

2. Socioeconomic status or social class is the strongest predictor of a person’s life expectancy.

Answer: TRUE

Page: 84-85

3. Whereas Americans focus on a person’s occupation in determining that individual’s location in a class hierarchy, British sociologists use a broader measure.

Answer: FALSE

Page: 85

4. The concept of SES is derived from ideas about social stratification put forward by Weber.

Answer: TRUE

Page: 86

5. Status indicates a person’s level of social prestige, which typically corresponds to wealth.

Answer: FALSE

Page: 86

6. People with similar class standing generally have similar lifestyles.

Answer: TRUE

Page: 87

7. The well-educated are more likely to smoke and less likely to exercise than their lesseducated counterparts.

Answer: FALSE

Page: 87

8. The relative influence of income and education on health changes over the life course.

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Answer: TRUE

Page: 88

9. Hayward and colleagues determined that higher educational attainment among U.S. adults is related to increase mortality.

Answer: FALSE

Page: 88

10. Where people live impacts their life expectancy.

Answer: TRUE

Page: 89

11. Improved access to health services is the primary solution for advancing health.

Answer: FALSE

Page: 92

12. The lower class is disadvantaged with respect to physical, but not mental health.

Answer: FALSE

Page: 92

13. Wilkinson’s 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: 93

14. 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: 94

15. The social gradient in mortality links chance of death to differences in hierarchy rather than deprivation.

Answer: TRUE

Page: 95

16. The Whitehall studies found that expanding access to medical services to everyone improved health for all classes.

Answer: TRUE

Page: 95

17. Access to medical care can overcome the adverse effects of living conditions and harmful lifestyles on health.

Answer: FALSE

Page: 96

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18. Neighborhoods contain resources needed to produce good or poor health for its residents.

Answer: TRUE

Page: 96

19. Research finds that people living in disadvantaged neighborhoods suffer psychologically from their environment.

Answer: TRUE

Page: 97

20. The “fundamental social cause” thesis suggests that social class contributes to poor health and mortality but is not a direct cause.

Answer: FALSE

Page: 99

Essay Questions 1. Social class is made of multiple components. Identify these components, and then 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 then discuss why these are more prevalent.

3. Explain the findings of the Black Report.

4. What is “neighborhood disadvantage?” Discuss how it is related to health.

5. 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?

6. Discuss the Whitehall studies conducted by Marmot. What were the main findings in terms of social class and health?

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Chapter 5 The Social Demography of Health: Gender Multiple Choice Questions 1. 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: 110

2. What event contributed to the trend of women entering the workforce in large numbers? a. The Great Depression b. World War II c. The Baby Boom d. The second wave of feminism e. The spread of the Internet Answer: B

Page: 111

3. What effect does the strain of working and doing most of the work raising children have on women? a. It increases their susceptibility to physical disability. b. It decreases their likelihood of developing heart disease. c. It does not affect them. d. It increases the stress they feel. e. It decreases their fertility and chances of having more children.

Answer: D

Page: 111

4. ________________ is the leading cause of death for women after age 66. a. Osteoporosis. b. Cancer. c. Heart disease. d. Injuries. e. Suicide.

Answer: C

Page: 111

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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: 112

6. _____________babies die more often than _________________ babies. a. Healthy, sick. b. Female, male. c. Male, female. d. Younger, older. e. Older, younger.

Answer: C

Page: 112

7. What is one reason males and females have different life expectancies? a. Hormonal differences in the womb b. Telomere length differs at birth c. Delays in female prenatal development d. Neonatal care differences e. Differences in neurological fitness Answer: A

Page: 112

8. How does masculinity affect the health of men in the U.S.? a. It makes them less likely to delay physical check-ups. b. It makes them less likely to take care of their health. c. It makes them more susceptible to post-traumatic stress disorder. d. It makes them more likely to visit their physician for injuries. e. It does not affect their health.

Answer: B

Page: 113

9. The most dangerous job in the United States is that of a: a. Fisherman. b. Fireman. c. Police officer. d. Doctor. e. Logging worker.

Answer: E

Page: 113 29

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10. What effect does occupational competition and pressure have on health? a. It decreases the likelihood of developing neurodegenerative diseases. b. It decreases the life expectancy of people in professional positions. c. It increases the life expectancy for people who have greater job authority. d. It increases the healthy lifestyle of people who have higher paying jobs. e. It does not impact health.

Answer: B

Page: 114

11. Morbidity is: a. Sadness. b. The cause of illness. c. The sickness rate. d. The rate of death. e. All of the above.

Answer: C

Page: 114

12. Women have a higher incidence of what type of health condition compared to men? a. Cardiovascular disease b. Gout c. Emphysema d. Arthritis e. Injuries Answer: D

Page: 115

13. What is the relationship between morbidity and mortality for women? a. Women are sick less often and live longer. b. Women are sick less often and die sooner. c. Women are sick more often and live longer. d. Women are sick more often and die sooner. e. There is no relationship between morbidity and mortality.

Answer: C

Page: 115

14. What is the relationship between morbidity and mortality for men? a. Men are sick less often and live longer. b. Men are sick less often and die sooner. c. Men are sick more often and live longer. d. Men are sick more often and die sooner. e. There is no relationship between morbidity and mortality.

Answer: B

Page: 115

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15. In 2008, a nationwide study of mortality in the United States revealed that life expectancy for part of the nation’s women had ___________ significantly between 1983 and 1999. a. Stagnated. b. Fluctuated. c. Remained the same. d. Increased. e. Decreased.

Answer: E

Page: 116

16. What segment of the population experienced the most premature mortality since 1990? a. Asian women b. Black women c. Hispanic women d. Indigenous women e. White women Answer: E

Page: 117

17. What gender differences in health emerge in later life? a. Women are in better health overall than men. b. Women have more injuries in later life than men. c. Men are in better health overall than women. d. Men have more injuries in later life than women. e. There is no gender difference in health in later life.

Answer: C

Page: 115

18. Which of the following strongly predicted early mortality for white women? a. Long-term unemployment b. Marital status c. Parental status d. Psychological distress e. Religiosity Answer: A

Page: 118

19. When did both men and women experience the greatest increase in life expectancy? a. 1930s b. 1950s c. 1970s d. 1990s e. 2010s Answer: B

Page: 118

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20. Why does living in a rural area affect life expectancy? a. Rural areas have less access to high-quality health care services. b. Rural areas have fewer sources of industrial pollution. c. Rural areas have more opportunities for physical activity. d. Rural areas have fewer sources of healthy food. e. Rural areas have less alcohol and drug use.

Answer: A

Page: 120

21. About _____________ Americans die each year from smoking-related diseases. a. 250,000 b. 440,000 c. 800,000 d. 1,000,000 e. 1,250,000 Answer: B

Page: 121

22. What health behavior increased for women as they increasingly entered the workforce? a. Drinking alcohol b. Eating junk food c. Risky sexual activities d. Smoking tobacco e. Walking to work Answer: D

Page: 121

23. What mental health disorder is more prevalent among men than it is among women? a. Anxiety b. Depression c. Eating disorders d. Schizophrenia e. Suicidal ideation Answer: E

Page: 124

24. How does working outside the home appear to affect women’s overall psychological well-being? a. It decreases their sense of control over their lives. b. It decreases their levels of depression. c. It increases their happiness with their family. d. It increases their vulnerability to develop a personality disorder. e. It has both positive and negative effects.

Answer: E

Page: 125 32

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25. What makes sexual preferences a gender-related cause of health and disease? a. Sexual practices among LGBTQ people greatly reduce the chance of spreading a sexually transmitted infection. b. Discrimination based on sexual identity affects the health of LGBTQ people. c. Sexual preferences are largely hormonal based, which is associated with a higher risk of disease. d. LGBTQ people have fewer relationships that affect their physical and mental health. e. Some cancers are less prevalent among LGBTQ people.

Answer: B

Page: 126

26. Why does the health of LGBTQ people differ from heterosexual people? a. LGBTQ people lead overall healthier lives compared to heterosexual people. b. LGBTQ people utilize medical care more often compared to heterosexual people. c. LGBTQ people have lower substance use rates compared to heterosexual people. d. LGBTQ people engage in safer sexual activity compared to heterosexual people. e. LGBTQ people endure more chronic stressors than heterosexual people.

Answer: E

Page: 126

27. When was homosexuality removed from the Diagnostic and Statistical Manual of Mental Disorders? a. 1950 b. 1960 c. 1970 d. 1980 e. 1990 Answer: D

Page: 126-127

28. What theory explains the health outcomes that same-sex and bisexual people experience due to stigma and discrimination? a. Fundamental cause b. Gendered discrimination c. Minority stress d. Same-sex stress e. Weathering Answer: C

Page: 127

True False Questions

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1. Gender-specific behavior is one cause of the differences in the health outcomes of men and women.

Answer: TRUE

Page: 110

2. Women began to live longer than men in 1920.

Answer: FALSE

Page: 110

3. A decline in female life expectancy is expected in the wealthiest countries, with the highest spending on health care.

Answer: FALSE

Page: 110

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: 111

5. Patterns are emerging that show Americans moving toward greater inequality in mortality between the sexes.

Answer: FALSE

Page: 111

6. As women’s time in the workforce increased, men’s time doing household labor increased.

Answer: FALSE

Page: 111

7. 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: 111

8. Although white females live longer than white males, Black males live longer than Black females.

Answer: FALSE

Page: 111

9. Accidents cause more deaths among females than males.

Answer: FALSE

Page: 113

10. Heavy alcohol use and car accidents affect women’s life expectancy more than men’s life expectancy.

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Answer: FALSE

Page 114

11. Women in higher status occupations have a higher risk of developing breast cancer than women in lower status positions.

Answer: TRUE

Page: 114

12. There is an inverse relationship between mortality and morbidity when gender differences are considered.

Answer: TRUE

Page: 115

13. Studies of self-rated health typically show women rating their own health less positively than men do.

Answer: TRUE

Page: 115

14. A 2008 study found a decline in female life expectancy. The decline was most common in urban, low-income female populations.

Answer: FALSE

Page: 116

15. 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: 116-117

16. Life expectancy among rural residents is higher than that of urban residents.

Answer: FALSE

Page: 119

17. The current trend in the United States is toward a decrease in smoking for females, but an increase for males.

Answer: FALSE

Page: 121

18. Large numbers of adolescents and young adults began using e-cigarettes after “fruit” flavors were introduced.

Answer: TRUE

Page: 123

19. Depressive symptomology flows from a wife to her husband.

Answer: TRUE

Page 125

20. LGBTQ people have higher suicide rates than heterosexual people.

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Answer: TRUE

Page: 126

Essay Questions 1. Explain the social conditions that led to a gender gap in life expectancy in the eighteenth and nineteenth centuries.

2. Discuss the relationship between gender and overall health.

3. Amongst whom is the greatest decrease in life expectancy in the country found? Explain why.

4. Explain the gender differences in mental health.

5. Discuss the similarities and differences in how employment affects the health of men and women.

6. What is minority stress and how does it affect health?

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Chapter 6 The Social Demography of Health: Age and Race Multiple Choice Questions

1. In 2018, the average infant in the U.S. could expect to live for ______ years. a. 47.3 b. 65.2 c. 78.7 d. 85.8 e. 88.4 Answer: C

Page: 133

2. What percentage of children born in 1900 could expect to live to age 65? a. 0% b. Less than 50% c. 60% d. 70% e. More than 75% Answer: B

Page: 133

3. By 2050 it is projected that _______ of all Americans will be 65 or older. a. 11% b. 15% c. 21% d. 25% e. 31% Answer: C

Page: 133

4. The elderly population will depend on ________________ to keep them fit. a. Pensions. b. Social Security. c. Medicare. d. Medicaid. e. Medihealth.

Answer: C

Page: 134

5. Which of the following trends is most likely to strain health care delivery systems and the Social Security system in future years? a. Increasing proportion of elderly in the population. b. Increasing size of the Hispanic population.

28 Information Classification: General

c. Medical tourism. d. Reemergence of infectious diseases. e. All of the above.

Answer: A

Page: 134

6. 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. Just surviving to old age free of serious illness or disability is evidence of good health. c. The elderly are able to perceive their health as good if they can perform their usual daily activities successfully. d. Both A and B. e. Both B and C. Answer: E

Page: 135

7. What is the 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: 136

8. How do social expectations for roles and behaviors correspond to the stages of life? a. They differ at each life stage. b. They gradually loosen as one progresses through life stages. c. They become more strict as one progresses through life stages. d. There are none for older adults. e. There are none for infants or children.

Answer: A

Page 136

9. What is the main argument of life course theory? a. The stages of life course occur at different times for men and women. b. Socioeconomic advantages accumulate over the life cycle to create good health in older adults. c. Adults who have strong social bonds will have better health in later life. d. Chronic stress over the life course increases the likelihood of developing a disease in later life. e. Adverse childhood experiences create more resilient health in later life.

29 Information Classification: General

Answer: B

Page: 137

10. __________ 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: 140

11. Which racial group in the United States is especially disadvantaged in regard to health? a. Non-Hispanic white. b. Non-Hispanic Black. c. Hispanics. d. Asians/Pacific Islanders. e. American Indians/Alaskan Natives.

Answer: B

Page: 141

12. _______________ are the largest minority group in American society. a. Non-Hispanic white. b. Non-Hispanic Black. c. Hispanics. d. Asians/Pacific Islanders. e. American Indians/Alaskan Natives.

Answer: C

Page: 142

13. The _____________ hypothesis asserts that Black people are more prone to diseases such as pyelonephritis that may result in secondary hypertension. a. Associated disorder. b. Genetic. c. Psychological stress. d. Physical exertion. e. Diet.

Answer: A

Page: 144

14. Some research suggests that the _____________ hypothesis and the psychological stress hypothesis contribute the most to understanding the higher prevalence of hypertension in Black people, since Black people in general have higher rates of hypertension than white people have. a. Associated disorder.

30 Information Classification: General

b. c. d. e.

Genetic.

Psychological stress.

Physical exertion.

Diet.

Answer: B

Page: 144

15. For all causes of death, _____________ have the highest death rates. a. Non-Hispanic white. b. Non-Hispanic Black. c. Hispanics. d. Asians/Pacific Islanders. e. American Indians/Alaskan Natives.

Answer: B

Page: 146

16. For all causes of death, _____________ have the lowest death rates. a. Non-Hispanic white. b. Non-Hispanic Black. c. Hispanics. d. Asians/Pacific Islanders. e. American Indians/Alaskan Natives.

Answer: D

Page: 146

17. A major factor causing the infant mortality difference between Black and white people is: a. Sanitation. b. Health care. c. Poverty. d. Education. e. Insurance.

Answer: C

Page: 146

18. Many low-income individuals are obese; however _____________ have the highest rate. a. Non-Hispanic white. b. Non-Hispanic Black. c. Hispanics. d. Asians/Pacific Islanders. e. American Indians/Alaskan Natives.

Answer: B

Page: 148

19. What is the “Hispanic paradox”? a. Hispanics have a lower mortality rate despite many engaging in riskier health behaviors.

31 Information Classification: General

b. Hispanics have a lower mortality rate despite many having a lower socioeconomic status. c. Hispanics have a longer life expectancy despite many working more dangerous jobs. d. Hispanics have a longer life expectancy despite many having fewer social supports. e. Hispanics have a longer life expectancy despite many experiencing racial discrimination.

Answer: B

Page: 150

20. Research indicates that Hispanics have more exposure over time to hardship, stress, and health risks compared to which group? a. Non-Hispanic white. b. Non-Hispanic Black. c. Asians. d. Pacific Islanders. e. American Indians/Alaskan Natives.

Answer: A

Page: 151

21. What minority group is most likely to use hospital emergency rooms as their primary source of medical services? a. Non-Hispanic white. b. Non-Hispanic Black. c. Hispanics. d. Asians/Pacific Islanders. e. American Indians/Alaskan Natives.

Answer: C

Page: 151

22. What is the leading cause of death for Native Americans? a. Accidents b. Cancer c. Diabetes d. Heart disease e. Liver disease Answer: D

Page 152

23. Suicide is a major health concern for which minority group? a. Non-Hispanic white. b. Non-Hispanic Black. c. Hispanics. d. Asians/Pacific Islanders. e. American Indians/Alaskan Natives.

32 Information Classification: General

Answer: E

Page: 152

24. Why do Asian Americans have the lowest age-adjusted mortality rate? a. They engage in the healthiest behaviors. b. They experience the least amount of discrimination. c. They work the least dangerous jobs. d. They have the highest levels of income. e. They live in the cleanest neighborhoods.

Answer: D

Page: 153

25. What is the leading cause of death for Asian Americans? a. Automobile accidents b. Cancer c. Heart disease d. Homicide e. Stroke Answer: C

Page 153

26. Which group has the lowest infant mortality rate? a. Non-Hispanic white. b. Non-Hispanic Black. c. Hispanics. d. Asians/Pacific Islanders. e. American Indians/Alaskan Natives.

Answer: D

Page: 153

27. How do overall rates of mental disorder differ among races? a. There are significantly higher rates among non-Hispanic white. b. There are significantly higher rates among non-Hispanic Black. c. There are significantly lower rates among Hispanics. d. There are significantly lower rates among Asian Americans e. There is no significant difference in rates among races.

Answer: E

Page: 153-154

28. What is the primary reason race has been associated with mental disorder? a. Access to stress coping resources b. Class position c. Exposure to adverse childhood event d. Genetic expressions e. Prescence of pollutants at home Answer: B Page: 155 33 Information Classification: General

29. How does racial discrimination affect the mental health of people who experience it? a. It causes mental disorders. b. It leads to less effective coping strategies. c. It distresses people psychologically. d. It triggers a genetic expression of depression. e. It buffers against psychological distress.

Answer: C Page: 155

True False Questions 1. Aging involves changes in a person’s self-concept, social roles, behavior, and approach to daily life.

Answer: TRUE

Page 133

2. Life expectancy in 1900 was around 47 years.

Answer: TRUE

Page 133

3. Projections for 2050 put the number of older people at around 80 million.

Answer: TRUE

Page: 133

4. Demands for health and other services for older adults are likely to decrease as the proportion of older adults in the population increases.

Answer: FALSE

Page: 134

5. Typically, older people rate their health in a negative fashion.

Answer: FALSE

Page: 135

6. As they enter and exit each life stage, people are expected to behave in a manner characteristic of their age group.

Answer: TRUE

Page: 136

7. Life events only affect the people who experience them.

Answer: FALSE

Page: 138

8. According to cumulative advantage/disadvantage theory, the advantages/disadvantages a person encounters in childhood are associated with structural factors.

Answer: TRUE Page: 138 34 Information Classification: General

9. The stability of religious attendance and practices in adolescence and young adulthood is associated with better health and a lower burden of disease in adults over 50.

Answer: TRUE

Page: 138

10. Cumulative inequality perspective maintains that early disadvantage increases later life healthy behaviors.

Answer: FALSE

Page: 139

11. The relevance of race to everyday life is because it is a key aspect of social life and identity.

Answer: TRUE

Page: 140

12. A minority person who much be constantly on alert for subtle signs of racism will experience a wearing down of their body’s physiological defenses against disease.

Answer: TRUE

Page: 141

13. Perceptions of racism and racial harassment are associated with poor health.

Answer: TRUE

Page: 141

14. The overall health profile of Black Americans in the United States rests on a historical foundation of social, economic, and political disadvantage that persists for many.

Answer: TRUE

Page: 143

15. Obesity adversely affects physical and psychological well-being.

Answer: TRUE

Page: 148

16. The adverse health situation of Black Americans identifies a pattern that is generally produced by biological, not socioeconomic factors.

Answer: FALSE

Page: 149

17. Prior to 1976, Hispanics were counted as either white or Black and not as a separate racial category by federal, state, and local agencies.

Answer: FALSE

Page: 149

18. Hispanic immigrants are generally in poor health when they arrive in the United States.

35 Information Classification: General

Answer: FALSE

Page: 150

19. American Indians have an exceptionally high prevalence of alcoholism.

Answer: TRUE

Page: 152

20. Asians and Pacific Islanders are the healthiest racial group when considering mortality rates.

Answer: TRUE

Page: 153

Essay Questions 1. Discuss the relationship between a person’s racial group and their overall health.

2. Amongst which racial group is the greatest decrease in life expectancy in the country found? Explain why.

3. Various hypotheses have been advanced to explain the rates of hypertension in Black Americans. Six are discussed in this chapter. Identify these hypotheses and discuss their validity.

4. What is the “Hispanic paradox?” Provide a thorough explanation, examples of this phenomenon, and discuss what makes it less of a paradox.

5. Discuss patterns of morbidity and mortality between Black, white, Hispanic, and Asian groups of people.

6. What changes to our health care should be expected resulting from our aging population?

36 Information Classification: General

Chapter 7 Social Stress and Health Multiple Choice Questions 1. Stress can be defined as: a. A heightened mind-body reaction to stimuli inducing fear or anxiety. b. A physiological change due to an environmental agent. c. A disruption in daily life caused by primarily negative events. d. All of the above. e. None of the above.

Answer: A

Page: 168

2. What is an example of a stressful situation? a. Death. b. Divorce. c. Financial strain. d. Marriage. e. All of the above.

Answer: E

Page: 168

3. Symbolic interactionism is based upon the work of ________________ (founder). a. Parsons. b. Bourdieu. c. Cooley. d. Mead. e. Durkheim.

Answer: D

Page: 168

4. 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.

Answer: C

Page: 169

5. Which is NOT a component of Cooley’s theory? a. We see in our imagination the other person’s judgment of ourselves. b. We have a core sense of individuality, unique to each of us. c. We see ourselves in our imagination as we think we appear to the other person.

37

d. As a result of what we see in our imagination about how we are viewed by the other person, we experience some sort of self-feelings. e. All of these are components.

Answer: B

Page: 169

6. The work of ______________ reflects the symbolic interactionist approach to human behavior. a. Durkheim. b. Thomas. c. Marx. d. Brenner. e. None of the above.

Answer: B

Pages: 169

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 person’s appearance. b. A past experience with 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: 169-170

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: 170

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: 170

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10. The symbolic interactionist perspective, as outlined by Cooley, Thomas, and Goffman, asserts that: a. Certain situations are inherently stressful. b. Stress is caused by societal pressure to conform. c. Stress can result from an individual's perception of the meaning of a situation. d. Stress is constant. e. All four answers are correct.

Answer: C

Page: 171

11. As members of society, Durkheim maintained that 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: 171

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: 171

13. Which suicide type was not fully developed by Durkheim? a. Egoistic. b. Fatalistic. c. Altruistic. d. Anomic. e. None of the above.

Answer: B

Page: 171

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.

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Answer: A

Page: 171

15. __________________ suicide occurs when people suffer a sudden dislocation of normative systems where their norms and values are no longer relevant, so that controls of society no longer restrain them from taking their lives. a. Egoistic. b. Fatalistic. c. Altruistic. d. Anomic. e. None of the above.

Answer: D

Page: 171-172

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: 172

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 forced

to respond to conditions not of their own choosing e. None of the above.

Answer: D

Pages: 172

18. What is homeostasis? a. Changing constantly. b. Physiological adaptation. c. Not moving or adapting. d. Physically growing. e. None of the above.

Answer: B

Page: 173

19. The ______________ system controls heart rate, blood pressure, and gastrointestinal functions: processes that are not under the control of the central nervous system. a. Limbic.

40

b. c. d. e.

Respiratory.

Endocrine.

Autonomic.

None of the above.

Answer: D

Page: 174

20. Who developed the theory known as the general adaptation syndrome? a. Brenner. b. Siegrist. c. Selye. d. Goffman. e. Pearlin.

Answer: C

Page: 175

21. 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: 177

22. The extent of physiological damage or change within an individual experiencing a crisis depends on: a. The stimulus situation. b. An individual’s capacity to deal with the stimulus situation. c. The individual’s preparation by society to meet problems. d. The influence of society’s approved modes of behavior. e. All of the above.

Answer: E

Page: 177-178

23. 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: 179

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24. Putnam defines ____________ as a community-level resource reflected in social relationships involving networks, but also norms, and levels of trust. a. Social facts. b. Social networks. c. Social capital. d. Social circumstances. e. None of the above.

Answer: C

Page: 179

25. Hurricane Katrina is an example of a(n): a. Natural disaster. b. Large-scale disaster. c. Cause for grief. a. Extreme situation. b. All of the above.

Answer: E

Page: 181

26. What does Bourne suggest is the reason some soldiers do not become psychiatric casualties? a. Soldiers are subject to strong group pressures to be technically proficient and mobilize an internal discipline. b. Soldiers simply adapt to extremely harsh conditions without needing any training. c. Soldiers are given very effective mental wellness tools to protect their mental health. d. Soldiers learn to repress memories of the stress of combat to avoid mental distress. e. Soldiers are driven by the rewards the military gives to soldiers who perform well under combat conditions.

Answer: A

Page: 182-183

27. What is the assumption that underlies life events research? a. Accumulating several events builds up to a stressful impact b. Disadvantages accumulate to impact later life health c. Life events are either create stress or alleviate stress d. Stressful life events can enhance resilience if quickly alleviated e. Types of life events differ in their impact health Answer: A

Page 184

28. What measure has been used to analyze the relationship between stress and life experiences? a. Chronic Strain Ranking Scale b. Life Events Assessment 42

c. Measure of Adverse Childhood Experiences d. Social Readjustment Rating Scale e. Stress Model Answer: D

Page: 184-185

29. What do researchers in the area of gene-environment correlation study? a. The effect of social relationships on genetic expression. b. The role of genetic control over exposure to the social environment. c. The influence of genes on mental health outcomes. d. The genes associated with stress coping strategies. e. The influence of the social environment on telomere length.

Answer: B

Page: 187

True False Questions 1. Social situations can cause severe stress that, in turn, affects health and longevity.

Answer: TRUE

Page: 168

2. Stress typically starts with a situation that people find non-threatening.

Answer: FALSE

Page: 168

3. Symbolic interaction theory emphasizes interpersonal forms of interaction.

Answer: TRUE

Page: 169

4. Mead compares the reflection of our self in others to our reflections in a looking glass.

Answer: FALSE

Page: 169

5. Emile Durkheim focused his research on how the larger society influenced individuals.

Answer: TRUE

Page: 171

6. Selye formulated the concept of the “fight or flight” pattern of physiological change to illustrate how the body mobilizes its defenses to cope with stress resulting from a social situation.

Answer: TRUE

Page: 174

7. When a person experiences fear or anxiety, the body undergoes physiological changes that prepare it for vigorous effort and the effect of possible injury.

43

Answer: TRUE

Page: 174

8. Most threats in modern society are symbolic, not physical, and they do not usually require a physical response.

Answer: TRUE

Page: 175

9. Considerable evidence shows that persistently coping with chronic stressors can have a profound adverse effect on a person’s health.

Answer: TRUE

Page: 176

10. The outcome or effect of a crisis depends on how well a person comes to terms with the situation and adapts to it.

Answer: TRUE

Page: 177

11. People use the same skills and abilities to cope with problems.

Answer: FALSE

Page: 177

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: 177-178

14. People’s perceptions of an event may be influenced by their intelligence.

Answer: TRUE

Page: 178

15. Conformity to group-approved attitudes and definitions has been hypothesized to reduce anxiety.

Answer: TRUE

Page: 179

16. Social capital is a property of individuals, not a characteristic of networks.

Answer: FALSE

Page: 179

17. Social connectedness, in Putnam’s view, is one of the weakest determinants of health.

Answer: FALSE

Page: 179

18. The lower class is characterized as having the fewest resources to cope with stress.

44

Answer: TRUE

Page: 181

19. People typically flee in panic from the site of a potential disaster (natural/unnatural) area.

Answer: FALSE

Page: 181

20. Epigenetics focuses on researching the genetic expression of social relationships and experiences.

Answer: TRUE

Page: 186

Essay Questions 1. Define social stressors and life events. How do these concepts relate to stress?

2. How does symbolic interaction theory explain stress?

3. Describe the three types of suicide outlined by Durkheim. How do they relate to stress?

4. Describe Patricia Drentea’s research on stress, age, and debt.

5. What are the features of life events that cause stress in individuals?

6. What is a gene environment interaction? Provide an example, and then explain why they are significant.

45

Chapter 8 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: 194

2. What is defined as activity undertaken by individuals for the purpose of maintaining or enhancing their health, preventing health problems, or achieving a positive body image? a. Health lifestyles. b. Illness behavior. c. Health behavior. d. Health promotion. e. Premedical.

Answer: C

Page: 194

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: 195

4. Health lifestyles activities typically take place __________ the health care delivery system. a. Inside. b. Outside. c. Beyond. d. In conjunction with. e. Near.

Answer: B

Page: 195

46 Information Classification: General

5. ___________ suggested that a person’s social class position is determined exclusively by his or her degree of access to a society’s means of production. a. Weber. b. Durkheim. c. Marx. d. Wickrama. e. Bourdieu.

Answer: C

Page: 195

6. According to the sociologist Max Weber, lifestyles are based upon a person’s relationship to the means of: a. Consumption. b. Needs. c. Wants. d. Production. e. All of the above.

Answer: A

Page: 196

7. Lebensführung means ____________, and Lebenschancen means ________________. a. Life conduct; lifestyle. b. Life chances; lifestyle. c. Life conduct; life chances. d. Life chances; life conduct. e. Lifestyle; life conduct.

Answer: C

Page: 196

8. ____________ refers to the choices that people have in the lifestyles they wish to adopt. a. Life chances. b. Life conduct. c. Life behaviors. d. Agency. e. None of the above.

Answer: B

Page: 196

9. Weber maintains that life __________ are influenced by life chances. a. Realities. b. Choices. c. Modes. d. Demands. e. None of the above.

Answer: B

Page: 196 47

Information Classification: General

10. Health lifestyles are common to which social class? a. Upper classes. b. Upper and middle classes. c. Middle classes. d. Lower classes. e. All of the above.

Answer: E

Page: 196-197

11. Health lifestyles emphasizing exercise, a healthy diet, avoidance of unhealthy practices such as smoking, and so on, originated in the: a. Working class. b. Lower class. c. Upper lower class. d. Lower middle class. e. Upper middle class.

Answer: E

Page: 196-197

12. In what way are lifestyles based on choices, according to Weber? a. Choices usually depend on a person’s socioeconomic circumstances. b. Choices explain the adoption of health behaviors. c. Choices spread particular lifestyles across social groups. d. Choices encourage risky lifestyles. e. Choices encourage utilizing health-producing resources.

Answer: A

Page: 197

13. 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: 198

14. The ___________ generated by the habitus produce lifestyle practices for individuals that are similar to those of other people in their social class and distinctive from people in other classes, according to Bourdieu. a. Expectations. b. Practices. c. Lifestyles. d. Dispositions.

48 Information Classification: General

e. None of the above.

Answer: D

Page: 198

15. _______________ is the notion that the more distant a person is from economic necessity, the more freedom and time that 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: 198

16. Which 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: 199

17. What is 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: 199

18. At what age do health lifestyles begin? a. Childhood b. Teen age c. Early adulthood d. Middle age e. Older age Answer: A

Page: 199

19. Which health behavior declines as people reach old age? a. Alcohol abstinence b. Checkups 49 Information Classification: General

c. Healthy food consumption d. Exercise e. Relaxation Answer: D

Page: 200

20. 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: 201

21. What is primary socialization? a. The exposure to human language that occurs prior to a child’s ability to speak. b. All the training that occurs in primary school. c. The imposition of society’s norms and values. d. The training in basic human functions like walking, talking, etc. e. The later (adult) training a person experiences.

Answer: C

Page: 202

22. What is secondary socialization? a. The exposure to human language that occurs prior to a child’s ability to speak. b. All the training that occurs in primary school. c. The imposition of society’s norms and values. d. The training in basic human functions like walking, talking, etc. e. The later (adult) training a person experiences.

Answer: E

Page: 202

23. What provides the essential basis for agency’s practical and evaluative dimension to evolve over time as people learn? a. Experience b. Life choices c. Life chances d. Primary socialization e. Secondary socialization Answer: A

Page: 202

24. What two variables provide the basis for making life choices? a. Experience and social structure 50 Information Classification: General

b. c. d. e.

Experience and socialization Social structure and socialization Social structure and living conditions Socialization and living conditions

Answer: B

Page: 202

25. What do dispositions to act produce in health lifestyles? a. Habitus b. Life chances c. Life choices d. Practices e. Secondary socialization Answer: D

Page: 202

26. What severely affects the quality of participation in health lifestyles? a. Apathy b. Class position c. Cultural beliefs d. Habitus e. Occupational status Answer: B

Page: 204

27. 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: 206

28. What is the reason many low-income persons do not have a source of medical care? a. Health facilities may not be nearby. 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: 208

29. ______________ of preventive care among the poor is common.

51 Information Classification: General

a. b. c. d. e.

Underutilization.

Overutilization.

Utilization.

There is extensive utilization diversity even in the poor.

None of the above.

Answer: A

Page: 208

True False Questions 1. Health-oriented behavior pertains just to those activities concerned with recovering from disease or injury.

Answer: FALSE

Page: 194

2. Health behavior is the activity undertaken by sick people to regain their health.

Answer: FALSE

Page: 194

3. The focus in medical sociology is on the health behavior of the individual.

Answer: FALSE

Page: 194

4. A person’s life chances are largely determined by his or her class position.

Answer: TRUE

Page: 195

5. Members of the same status group share similar lifestyles.

Answer: TRUE

Page: 196

6. One’s lifestyle is a reflection of the types and amounts of goods and services one produces and desires.

Answer: FALSE

Page: 196

7. One’s life chances are rarely shaped by one’s socioeconomic circumstances.

Answer: FALSE

Page: 196

8. 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: 196-197

52 Information Classification: General

9. Most people try to do something to protect their health.

Answer: TRUE

Page: 197

10. The wealthy show the highest proportion of cigar and cigarette smokers.

Answer: FALSE

Page: 198

11. It appears that healthy lifestyles are spreading in U.S. society, and distinct differences between the social classes no longer remain.

Answer: FALSE

Page: 199

12. Health lifestyles tend to be intergenerational, passed from parents to their children.

Answer: TRUE

Page: 199

13. As people age, they tend to take less care of their health.

Answer: FALSE

Page: 200

14. Most studies on race address differences in sickness and mortality rather than health lifestyle practices.

Answer: TRUE

Page: 201

15. Some studies suggest that religious attitudes and behaviors can have a negative effect on numerous health-related activities.

Answer: FALSE

Page: 201

16. There has been extensive research performed linking living conditions to health lifestyles.

Answer: FALSE

Page: 202

17. Agency is a term referring to the process by which people critically evaluate and choose their course of action.

Answer: TRUE

Page: 202

18. Life chances can both enable and constrain life choices.

Answer: TRUE

Page: 202

19. The healthiest state in 2019 was Vermont, followed by Utah.

53 Information Classification: General

Answer: FALSE

Page: 205

20. An important facet of health behavior includes contact by healthy people with physicians and other health personnel for preventive care.

Answer: TRUE

Page: 206

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 does agency influence health lifestyles?

4. Discuss the role of class in adopting healthy lifestyles.

5. Explain the importance of class in utilizing preventive care as part of health lifestyles.

6. In what way has health become an achievement in contemporary society?

54 Information Classification: General

Chapter 9 Illness Behavior and the Sick Role Multiple Choice Questions 1. “A state or condition of suffering as the result of a disease or sickness” defines: a. The sick role. b. Illness. c. Disability. d. Disease. e. None of the Above.

Answer: B

Page: 213

2. The traditional identifying criteria for disease do NOT include: a. The patient’s experience of subjective feelings of sickness. b. The finding by the physician through examination and/or laboratory tests or other indicators that the patient has a disordered function of the body. c. The patient’s symptoms conforming to a recognizable clinical pattern. d. The patient’s significant other’s identification of a “sick pattern.” e. All of the above.

Answer: D

Page: 213

3. ________________ interpretations of feeling states are medically significant, because sometimes physical changes are not obvious. a. Objective. b. Subjective. c. Professional. d. Thoughtful. e. None of the above.

Answer: B

Page: 214

4. A pronouncement of deviant behavior involves making a _____________ about what is right and proper behavior according to a social norm. a. Psycho-social stand. b. Stigmatized assertion. c. Lasting proclamation d. Wide-sweeping statement. e. Social judgment.

Answer: E

Page: 215

5. The most common response to symptoms of illness by people throughout the world is: a. Health behavior.

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b. c. d. e.

Illness behavior.

Self care.

Doctor visits.

None of the above.

Answer: C

Page: 217

6. Which is a component of self-care? a. Taking preventive measures. b. Self-treatment of symptoms. c. Managing chronic conditions. d. Consultation with health care providers. e. All of the above are components of self-care.

Answer: E

Page: 217

7. A number of factors have promoted self-care on the part of laypersons. Which is 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: 217

8. 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 don’t know how long it has been occurring. e. None of the above.

Answer: C

Page: 218

9. The process of seeking medical help involving a group of potential consultants, beginning in the family, and extending outward to more select individuals until professionals are consulted, is known as the: a. Medical referral system. b. Lay-referral system. c. Professional referral system. d. Health networking process. e. None of the above.

Answer: B

Page: 218

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10. The process by which a family provides a child with a specific social identity is: a. Classification. a. Socialization. b. Enculturation. c. Brain washing. d. None of the above.

Answer: B

Page: 219

11. Which refers to the social relationships a person has during day-to-day interaction, which serves to suggest, advise, influence, or coerce an individual into taking or not

taking particular courses of action. a. b. c. d. e.

Intrapersonal affect.

Lay-referral system.

Family.

Social network.

None of the above.

Answer: D

Page: 219

12. Which is an example of an alternative medical practitioner? a. Pharmacist. b. Teachers. c. Social worker. d. Family members. e. None of the above.

Answer: E

Page: 220

13. Visits to physicians are higher for: a. Males. b. Females. c. Adults. d. No difference in the response options. e. None of the above.

Answer: B

Page: 221

14. Which group has the highest rate private health insurance coverage? a. American Indians/Native Alaskans b. Asians. c. Hispanics. d. Non-Hispanic Black. e. Non-Hispanic white.

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Answer: E

Page: 224

15. Koos’s 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: 225

16. Which social class visits doctors the least? f. Upper classes. g. Upper and middle classes. h. Middle classes. i. Lower classes. j. All of the above.

Answer: A

Page: 226

17. Consumerism in medicine means that people: a. Make informed choices about the services available to them. b. Spend money on health care. c. Buy and sell health services to one another. d. Sell their personal advice within the lay referral system. e. All of the above.

Answer: A

Pages: 228

18. Consumerism is more likely a feature characteristic of the: a. Lower class. b. Middle class. c. Upper class. d. Middle and upper class. e. Lower and middle class.

Answer: D

Page: 228

19. _______________ 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. c. The culture of medicine.

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d. Consumerism. e. None of the above.

Answer: C

Page: 229

20. Parsons’s 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: 230

21. 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: 230

22. 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: 230-231

23. The patient-physician relationship involves mutuality in the form of behavioral expectations, and the status and power of the parties are ______________. a. Balanced. b. Equal. c. Unequal. d. Unknown. e. None of the above.

Answer: C

Page: 232

24. The physician exercises leverage over the patient through three basic techniques. Which is NOT one?

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a. b. c. d. e.

Professional prestige.

Situational authority.

Situational dependency of the patient.

Objective authority.

All of the above are techniques used to exercise leverage.

Answer: D

Page: 233

25. Parsons’s concept of the sick role seems to typically apply only to _________ diseases. a. Chronic. b. Acute. c. Infectious. d. Catastrophic. e. None of the above.

Answer: B

Page: 234

26. 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: 234

27. Medicalization is: 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: 235

28. 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.

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Answer: D

Page: 236

29. __________________ 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: 237

True False Questions 1. Sociologists have typically viewed sickness as a form of deviant behavior.

Answer: TRUE

Page: 214

2. Conformity to prevailing norms is generally punished for lack of ingenuity.

Answer: FALSE

Page: 215

3. Deviant behavior always produces undesirable consequences for society.

Answer: FALSE

Page: 215

4. The biological view of deviance has been generally accepted by contemporary sociologists.

Answer: FALSE

Page: 215

5. Self-care consists of both health and illness behavior.

Answer: TRUE

Page: 217

6. Self-care is an action that is independent of the medical profession.

Answer: FALSE

Page: 217

7. The family represents a social experience that influences how a particular person perceives his or her health situation.

Answer: TRUE

Page: 219

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8. On average, females tend to visit physicians more often than males in the U.S. Answer: TRUE

Page: 221

9. Only 10 percent of all American physicians are of Hispanic origin.

Answer: FALSE

Page: 222-223

10. About 12 percent of the American population does not have health insurance.

Answer: FALSE

Page: 224

11. The culture of poverty includes traits of dependence, fatalism, inability to delay gratification, and a lower value placed on health.

Answer: TRUE

Page: 225

12. 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: 226

13. 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: 227

14. There is more of a consumer orientation toward health among socially advantaged persons.

Answer: TRUE

Page: 228

15. A major expectation concerning the sick is that they are able to take care of themselves.

Answer: FALSE

Page: 230

16. The physician’s role is, as Parsons tells us, to return the sick person to his or her normal state of functioning.

Answer: TRUE

Page: 232

17. The patient–physician relationship is not intended by society to be therapeutic in nature.

Answer: FALSE

Page: 232

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18. The role of the physician is based upon an imbalance of power and technical expertise favorable exclusively to the physician.

Answer: TRUE

Page: 232

19. Parsons’s concept of the sick role helps us understand medicine’s role in promoting social stability.

Answer: TRUE

Page: 234

20. Some criticisms of Parsons’ sick role are based upon a misunderstanding of Parsons.

Answer: TRUE

Page: 235

Essay Questions

1. Describe the basis for considering illness as a form of deviant behavior.

2. What are some patterns and trends we see amongst various racial/ethnic groups in illness behavior? Blacks, Hispanics, Native Americans, and Asians?

3. Examine the role of social networks on health behaviors.

4. Describe the relationship between socioeconomic status and illness behavior. Explain the reasoning behind your answer.

5. What are the major criticisms of Parsons' concept of the sick role? Should the concept be abandoned? Explain.

6. Describe the four basic categories of Parsons’ sick role.

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Chapter 10 Doctor–Patient Interaction

Multiple Choice Questions 1. _________________ is the notion that, 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. c. The medicalization belief. d. The medical decision rule. e. None of the above.

Answer: D

Page: 246

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: 246

3. ____________________ take(s) the position that the seriousness of the patient’s symptoms is the determining factor in doctor–patient interaction. a. Haug and Lavin. b. Parsons. c. Hayes-Bautista. d. Szasz and Hollender. e. All of the above.

Answer: D

Page: 247

4. ___________________ argue that physician–patient interaction falls into one of three possible models. a. Haug and Lavin. b. Parsons. c. Hayes-Bautista. d. Szasz and Hollender. e. All of the above.

Answer: D

Page: 247 74

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5. The ___________________ model applies when the patient is seriously ill or being treated on an emergency basis in a state of relative helplessness, due to a severe injury or lack of consciousness. a. Activity-passivity. b. Guidance-cooperation. c. React-revise. d. Mutual participation. e. None of the above.

Answer: A

Page: 247

6. The ___________________ 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: 247

7. The ___________________ model applies to the management of chronic illness in which the patient works with the doctor as a full participant in controlling the disease. a. Activity-passivity. b. Guidance-cooperation. c. React-revise. d. Mutual participation. e. None of the above.

Answer: D

Page: 247

8. 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: 248

9. The relevance of the ______________ model for understanding doctor–patient 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.

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c. Activity-passivity. d. Guidance-cooperation. e. React-revise.

Answer: A

Page: 248

10. People with middle and upper socioeconomic status tend to be more ________________ and active participants in the physician–patient encounter. a. Aggressive. b. Consumer-oriented. c. Focused on getting well. d. Disease-focused. e. None of the above.

Answer: B

Page: 248

11. Which model of interaction is the norm in most doctor–patient interactions? a. Activity-passivity. b. Guidance-cooperation. c. React-revise. d. Mutual participation. e. None of the above.

Answer: D

Page: 249

12. 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: 250

13. Physicians are more likely to ignore questions from which group? a. Disabled people b. Middle-class people c. Older women d. Poorly educated people e. Younger men Answer: D

Page: 250

14. What is the most important factor in engendering trust in the doctor-patient relationship? a. The patient’s education level 76 Information Classification: General

b. c. d. e.

The patient’s occupation The physician’s behavior towards the patient The physician’s communication style Both the patient’s and the physician’s social skills

Answer: C

Page: 252

15. As part of the women’s health movement, feminist health organizations have evolved that advocate: a. Equal access to medical technology. b. Abortion rights. c. More female physicians. d. All of the above. e. None of the above.

Answer: B

Page: 252

16. Male physicians tend to misdiagnose ______________ in female patients. a. Heart attack. b. Stroke. c. Anxiety. d. Cancer. e. None of the above.

Answer: A

Page: 252

17. _______________ 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: 252

18. 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: 253

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19. In 2020-2021, about ____________ of all students entering medical schools were women. a. 32.9%. b. 38.4%. c. 40.2%. d. 47.2%. e. 56.3%.

Answer: D

Page: 253

20. Which is NOT a barrier to communication between doctors and patients? a. Age. b. Gender. c. Culture. d. Socioeconomic status. e. None of the above.

Answer: E

Page: 250-256

21. 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. d. Acceptance. e. None of the above.

Answer: A

Page: 256

22. When did the image of the ideal doctor-patient relationship (a caring physician and the trusting patient) change? a. 1940s b. 1960s c. 1980s d. 2000s e. 2020s Answer: B

Page: 256-257

23. Dissatisfaction with the doctor-patient relationship is heavily dependent on one’s: a. Gender. b. Culture. c. Race. d. Social class. e. None of the above.

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Answer: D

Page: 257

24. The shift toward consumerism in health care means patients have more status in the doctor–patient 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: 257

25. Which is a relevant factor driving consumerism? a. Shift in the state’s role from protecting the medical profession to protecting corporate health care interests in order to reduce costs. b. Proliferation of commercial products for the body that the patient can use independent of the physician. c. Rise of chronic disease. d. All of the above. e. None of the above.

Answer: D

Page: 258

26. Expanding reliance on new technologies has promoted a shift away from ____________, with its focus on the patient’s 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: 258-259

27. 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: 259

28. How has telemedicine impacted the traditional doctor-patient relationship?

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a. b. c. d. e.

It has improved personal relationships.

It has created more conflict between physicians and patients.

It has made patients more powerful than physicians.

It has created more impersonal interactions.

Its impact has not yet been determined.

Answer: E

Page: 261

29. What is the studied in social epigenetics? a. The health behaviors that alter genetic information. b. The illness behaviors that result from altered gene expression. c. The environment’s influence on genetic adaptations. d. Social responses to genetic mutations. e. The interaction of genes and the social environment.

Answer: E

Page: 262

True False Questions 1. 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: 246

2. When people visit doctors for treatment and medical advice, doctors rarely take some type of action to satisfy the patient’s expectations.

Answer: FALSE

Page: 246

3. Szasz and Hollender focused on the manner in which patients try to modify treatment prescribed by a physician.

Answer: FALSE

Page: 247

4. 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: 248

5. A major barrier to effective communication lies in the differences in social characteristics of physicians and their patients.

Answer: TRUE

Page: 250

6. Well-educated persons are the most likely to have their questions treated impersonally.

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Answer: FALSE

Page: 250

7. Doctors from upper-middle-class backgrounds tended to communicate less information to their patients generally than doctors with lower-middle- or working-class origins.

Answer: FALSE

Page: 251

8. The lack of male sensitivity to women patients was a major factor in the formation of the women’s health movement to combat sexual discrimination in medicine.

Answer: TRUE

Page: 252

9. One example of male physician misperceptions about female patients is a tendency to misdiagnose heart attacks as anxiety problems.

Answer: TRUE

Page: 252

10. Research has found that female physicians were better at communicating, providing preventative care, and following clinical guidelines than male physicians.

Answer: TRUE

Page: 252-253

11. Some patients may perceive women physicians as less of an authority figure than male physicians.

Answer: TRUE

Page: 253

12. Surprisingly, the number of women physicians is decreasing.

Answer: FALSE

Page: 253

13. Some male doctors feel reduced in status by being referred to as health care “providers” instead of physicians.

Answer: TRUE

Page: 255

14. Modern-day medical practice is provided within the context of middle-class norms.

Answer: TRUE

Page: 256

15. Communication is the key for avoiding noncompliance.

Answer: TRUE

Page: 256

16. The belief among laypersons that the “doctor knows best” is still very accepted.

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Answer: FALSE

Page: 257

17. The Internet has become a major source of medical information for many lay people.

Answer: TRUE

Page: 259

18. Treatments normally available only in hospitals, like chemotherapy, may be reconfigured into pills and taken at home now.

Answer: TRUE

Page: 261

19. Genomic information may lead to the establishment of personalized health care to meet the specific needs of individuals.

Answer: TRUE

Page: 262

20. Reproductive cloning would allow human organs to be cloned and transplanted in sick people.

Answer: FALSE

Page: 265

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? Please explain and/or discuss.

3. Do cultural differences in communication exist? Explain your answer.

4. Explain why Riska believes that medicine will remain a masculine-dominated profession.

5. Describe ways in which the doctor-patient relationship has changed and, also, what it may look like in the future.

6. Describe the ways that progress in genetics may affect the doctor-patient relationship.

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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: 271

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: 271

3. Recognition on the part of clients, outside agencies, and the wider society of the profession’s 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: 271

4. Which is NOT a feature of professionalism? a. The profession determines its own standards of education and training. b. The student professional goes through a more stringent socialization experience than the learner in other occupations. c. Professional practice is often legally recognized by some form of licensure. d. Licensing and admission boards are staffed by members of the profession. e. All of the above are features.

Answer: E

Page: 271-272 92

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5. Physicians in the United States used to lack: a. A service orientation. b. Lengthy training in specialized knowledge. c. Male dominance. d. The desire to help patients. e. All of the above.

Answer: B

Page: 272

6. Most American medical practitioners in the period before the American Revolution were: a. Ship’s surgeons. b. Apothecaries. c. Clergy. d. Trained in Europe. e. All of the above.

Answer: E

Page: 272

7. Who was responsible for the germ theory of disease? a. Koch. b. Goode. c. Pasteur. d. Virchow. e. Grant.

Answer: C

Page: 272

8. Who unveiled a general concept of disease based on cellular pathology? a. Koch. b. Goode. c. Pasteur. d. Virchow. e. Grant.

Answer: D

Page: 272

9. The ____________ was founded in Philadelphia in 1847. a. American Medical Association. b. American College of Physicians. c. Health Care Workers, USA Chapter. d. Alliance of Physicians. e. All of the above.

Answer: A

Page: 273

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10. With the founding of the American Medical Association (AMA), _____________ 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: 273

11. 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: 274

12. In 2011, what percentage of all eligible physicians were members of the AMA? a. Less than 20%. b. 30%. c. 40%. d. 50%. e. Over 60%.

Answer: A

Page: 274

13. One of the most significant guiding principles of the AMA has been its view of the physician as a(n) ___________________________. a. Academic force for change. b. Articulate, charismatic healer. c. Societal leader. d. Independent practitioner. e. All of the above.

Answer: D

Page: 275

14. Which health policy did the AMA support? a. Medicare b. Medicaid c. Health Care Reform Act of 1994 d. Health Maintenance Organization Act e. Patient Protection and Affordable Care Act

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Answer: E

Page: 275

15. American medical schools in the 1800s were known to have: a. Low standards. b. Poor facilities. c. Incentive programs (e.g., trips to Europe). d. Students with money. e. All of the above.

Answer: E

Page: 276

16. 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: 276

17. The Flexner Report was sponsored by the: a. American government. b. European government. c. Carnegie Foundation. d. National Institutes of Health. e. All of the above.

Answer: C

Page: 276

18. The Flexner Report reviewed the state of: a. Medical education. b. The AMA. c. The professionalization of physicians. d. Infectious disease. e. None of the above.

Answer: A

Page: 276

19. Which of the following did the Flexner Report propose? a. All institutions should have part-time faculty to teach medical ethics. b. The admission of students should be on a case-by-case basis. c. All institutions should separate its teaching and research functions. d. Both laboratory and hospital facilities should be available to students. e. Faculty should be limited to either teaching courses or conducting clinical practice.

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Answer: D

Page: 277

20. By the mid-1920s, what had the medical profession accomplished? a. It had decentralized control over medical education from the state to the local level. b. It had shortened the amount of time and training necessary to become a physician. c. It had created its own standards of education and training. d. It had eliminated all licensing and admissions boards for new graduates. e. It had included formal lay evaluation and control into its educational boards.

Answer: C

Page: 278

21. 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: 279-280

22. Medical schools have begun to employ which method to help decrease doubt and improve the application of medical knowledge? a. Clinical rotations. b. Koch’s postulates. c. Evidence-based medicine. d. Grand rounds. e. None of the above.

Answer: C

Page: 281

23. Medical students shift from __________ to _____________ as part of a functional learning process fitted to the physician’s role of maintaining an objective perspective of health and disease. a. Excitement; dejection. b. Defeatism; hopefulness. c. Optimism; to pessimism. d. Idealism; cynicism. e. None of the above.

Answer: D

Page: 281

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24. How do medical students learn the norms, values, and viewpoints of the medical profession? a. Classroom lectures b. Continuing medical education c. Informal socialization d. Patient interactions e. Undergraduate counseling Answer: C

Page: 283

25. 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 public’s 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: 283

26. 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: 285

27. Why does a physician need to acquire a clientele, according to Hall? a. To build a profitable business b. To create a network of referrals in the community c. To establish their prestige within the medical profession d. To generate a consistent set of promoters e. To ensure a steady source of research subjects Answer: C

Page: 286

28. The “inner core” of physicians consists of which of the following groups? a. Student elite. b. Practitioner elite. c. Administrative elite. d. Surgeon elite. e. None of the above.

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Answer: C

Page: 287

29. 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: 287

True False Questions 1. In 2019, about 500,000 doctors were actively practicing medicine in the United States.

Answer: FALSE

Page: 271

2. Administrators generally control clinical work and the efforts of most other people who provide health care directly to patients.

Answer: FALSE

Page: 271

3. The status and prestige accorded to the physician is recognition of the physician’s expertise concerning one of society’s most essential functions—the definition and treatment of health problems.

Answer: TRUE

Page: 271

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: 271

5. About two-thirds of all women doctors belong to the AMA. Answer: FALSE

Page: 274

6. Power in the AMA is concentrated among a relatively limited number of physicians.

Answer: TRUE

Page: 274

7. Many influential appointments to AMA councils and committees are voted upon by either the general membership or the House of Delegates.

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Answer: FALSE

Page: 275

8. A larger percentage of physicians are AMA members today than were in years past.

Answer: FALSE

Page: 275

9. The AMA supported the implementation of Medicare.

Answer: FALSE

Page: 275

10. The AMA no longer yields influence in health legislation.

Answer: FALSE

Page: 255

11. The professionalization of medicine would not have been possible without control over the standards for medical education.

Answer: TRUE

Pages: 255

12. The Flexner Report led to the closure of all the women’s medical schools and six of the eight traditionally black medical schools.

Answer: TRUE

Page: 278

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: 279

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: 279

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.”

Answer: FALSE

Page: 279

16. Becker and his associates noted that most entering medical students assumed they would be well paid. Hence, making money was apparently secondary to helping patients.

Answer: TRUE

Page: 280

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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.

Answer: TRUE

Page: 280

18. While evidence-based medicine is a major improvement in reducing uncertainty, uncertainty is still attached to many aspects of medical practice.

Answer: TRUE

Page: 280

19. Several studies of medical education find that medical classes lead to increasing levels of idealism.

Answer: FALSE Page: 281 20. Osteopathy is recognized as a medical specialty by the AMA. Answer: TRUE

Page: 284

Essay Questions

1. Describe the features of professionalization and how the professionalization of the medical discipline occurred.

2. Medical education is having to adjust to new realities in medical practice. What are these realities?

3. What are three important factors in the establishment of prestige within the medical profession? Please explain and/or discuss.

4. Describe the history of the American Medical Association. What is this body? How does it contribute to the professionalization of medicine?

5. What is the Flexner Report, and how did it affect medical education?

6. Explain the power structure of the medical profession described by Hall.

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Chapter 12 The Physician 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.

Answer: C

Page: 291

2. __________________ considerations have become a primary motivation among physicians, hospitals, and private health insurance companies. a. Economic. b. Social. c. Governmental. d. Insurance. e. All of the above.

Answer: A

Page: 291

3. Which group may hold doctorates in their field? a. Nurses. b. Physical therapists. c. Pharmacists. d. Nutritionists. e. All of the above.

Answer: E

Page: 292

4. 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: 292

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5. Medicalization is a form of ______________ action. a. Socioeconomic. b. Individual. c. Collective. d. Physician-driven. e. None of the above.

Answer: C

Page: 292

6. 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: 293

7. 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: 293

8. Etiquette was a more important _______________ than accountability in undermining attempts at critical evaluation of physicians by physicians. a. Value. b. Belief. c. Norm. d. Opinion. e. All of the above.

Answer: C

Page: 293

9. Millman contended that a “gentlemen’s agreement” existed among the hospital physicians. What did this agreement allow for? a. Overlooking each other’s mistakes. b. Not to discuss personal issues with physician’s partners. c. Assisting in negotiating the highest pay possible for physicians. d. Doctors to be unreliable. e. Irresponsibility to patients.

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Answer: A

Page: 294

10. Bosk 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: 294

11. Bosk contended that _______________ errors resulted in unfavorable letters of recommendation for those seeking jobs and social isolation from other physicians in the hospital. a. Moral. b. Technical. c. Accidental. d. Real. e. Personal.

Answer: A

Page: 294

12. Bosk contended that _______ errors, if they were made in “good faith,” were less serious than _______ errors. a. Technical; moral. b. Moral; technical. c. Accidental; real. d. Real; accidental. e. Accidental; personal.

Answer: A

Page: 294

13. 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: 296

14. ______________were established in 1970 in conjunction with Medicaid and Medicare, to review and evaluate the medical care given to patients eligible to use these services.

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a. b. c. d. e.

PSROs. DRGs. HMOs. PPOs. AMAs.

Answer: A

Page: 296

15. _______________ 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: 296

16. 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: 296

17. A major defect in the professional autonomy argument arises from the fact that the autonomy granted to the medical profession is granted _____________, 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: 297

18. 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 doctor’s work “for them.”

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e. None of the above.

Answer: B

Page: 297

19. The “golden age” of doctoring was marked by: a. Escalating prices and overcharging to a degree previously unknown. b. Provider-structured insurance that paid for almost any mistakes. c. A proliferation of unnecessary tests, hospitalizations, prescriptions, and surgical operations. d. All of the above. e. None of the above.

Answer: D

Page: 297

20. 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: 298

21. 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: 298-299

22. _____________ are schedules of fees placing a ceiling on how much the government will pay for specific services rendered to Medicare patients by hospitals and doctors. a. PSROs. b. DRGs. c. HMOs. d. PPOs. e. AMAs. Answer: B

Page: 299

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23. ____________ 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. a. Health savings companies. b. Medicare and Medicaid. c. Health insurance. d. Managed care. e. None of the above.

Answer: D

Page: 299

24. What is a double agent? a. Physicians who look out for the interests of the patient and the interests of a managed care organization. b. Insurance agents who seem to be offering a great financial package, but are actually creating more profits for insurance companies. c. A physician who is also a patient. d. A nurse who reports on the mistakes of a physician who he/she works for. e. None of the above.

Answer: A

Page: 300

25. What is a gatekeeper? a. Typically, the government. b. A primary care physician who screens patients prior to referring them to a specialist. c. A physician who blocks the review of another physician in an attempt to protect him/her. d. None of the above. e. All of the above.

Answer: B

Page: 300

26. ______________ 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: 300

27. What attracted corporations to health care delivery is the potential for: a. Improving health care. b. Helping people.

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c. Financial profit. d. All of the above. e. None of the above.

Answer: C

Page: 300

28. Which is NOT a term used to describe free-standing emergency centers? a. Docs-in-a-Box. b. 7-Eleven Medicine. c. Quick-fix facilities. d. None of the above are correct terms. e. All of the above are correct terms.

Answer: C

Page: 301

29. Which is a feature of a free-standing emergency center? a. Open around 18-24 hours a day, 7 days a week. b. Attend to their patients with a minimum of waiting time. c. Treat cuts, broken bones, bruises, and minor ailments. d. Sometimes these are located in shopping centers or other convenient locations. e. All of the above are features.

Answer: E

Page: 301

True False Questions 1. Public attitudes toward the medical profession have shifted away from the unquestioning acceptance of physician authority to a more critical view of doctors today.

Answer: TRUE

Page: 291

2. Americans still have high regard for medicine as a social institution.

Answer: TRUE

Page: 291

3. The movement of public opinion has been toward less confidence in physician authority.

Answer: TRUE

Page: 291

4. The profit motive has bred resentment among consumers and demands that the professional power of doctors be increased.

Answer: FALSE

Page: 291

5. The social control of medical practice has been beneficial for American society.

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Answer: FALSE

Page: 293

6. Physicians are rarely judged by their patients. Typically, only health care professionals judge the performance of doctors.

Answer: FALSE

Page: 293

7. Bosk 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: 294

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: 295

9. 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: 295

10. Medical standards and practices continue to be regulated by the practitioners themselves.

Answer: TRUE

Page: 296

11. 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: 296

12. The medical profession has been strengthened through an oversupply of doctors.

Answer: FALSE

Page: 298

13. Rising costs of health care resulted in physician demands for government intervention.

Answer: FALSE

Page: 298

14. 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: 299

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15. Free-standing emergency centers do not take business from hospitals.

Answer: FALSE

Page: 301

16. About 24% of all U.S. hospitals are owned by profit-making organizations.

Answer: TRUE

Page: 301

17. The problem with a professional dominance thesis is that it does not allow for decline.

Answer: TRUE

Page: 304

18. 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: 304

19. Medical doctors are experiencing a process of increased professionalization due to pressures from consumers, government, and business corporations.

Answer: FALSE

Page: 305

20. Future generations of doctors are likely to have much lower levels of clinical autonomy and professional control.

Answer: TRUE

Page: 306

Essay Questions 1. Explain the problems that emerge in the social control of medicine.

2. What does the term “countervailing power” mean? What are the sources of this notion?

Please explain and/or discuss.

3. What is managed care? What is its role in health care delivery? What effect does it have on the work of physicians?

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 elements of this relationship and discuss trends contributing to this change.

6. Is there a deprofessionalization of physicians occurring? Why? Why not?

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Chapter 13 Nurses, Physician Assistants, Pharmacists, and Midwives MULTIPLE CHOICE 1. Registered nurses (RNs) are typically responsible for what? a. The submission of all physician paperwork on a patient b. The delivery of bad news to family members when a patient dies c. The sanitation of clinical settings where patients receive care d. The type and quality of all nursing care patients receive e. The orderliness of the surgical rooms Answer: D

Page: 312

2. In the past, the Nurse-Doctor relationship was typically a _________ matched occupationally with a _________ a. Male nurse, male physician b. Female nurse, female physician c. Male nurse, female physician d. Female nurse, male physician e. There is no typical relationship Answer: D

Page: 312

3. What major world event influenced the way nursing became a formal occupation? a. The Black Death b. The Rise of Christianity c. The Enlightenment d. The Fall of the Roman Empire e. The Discovery of the Western World Answer: B

Page: 312

4. Prior to the late-nineteen century, what was the original concept of nursing as conceived

by Christian nuns? a. A formal occupation for unmarried women b. An area of specialization in medical care for those concerned with holistic care c. A means by which those persons providing the services could attain spiritual salvation by helping those less fortunate d. An occupation for women held in high esteem by the general public

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e. An area of specialized training in patient’s physician and spiritual care Answer: C

Page: 313

5. In what way did Florence Nightingale change the role of nursing in Western society? a. She established nursing as a distinct and honorable occupation. b. She established the first non-religious training program for nurses. c. She created a system of education for midwives. d. She wrote a compendium of medical knowledge gathered by nurses. e. She led a public awareness campaign for hygiene and cleanliness to prevent wound infections.

Answer: A

Page: 314

6. Florence Nightingale’s nursing students: a. Were taught to be unengaged b. Were taught working class ideals c. Were taught the best qualities of ministers and doctors d. Were taught the best qualities of mothers and housekeepers e. Were seen as professional leaders Answer: D

Page: 314

7. Which is not an example of a traditional path of nursing education? a. Associates degree b. College-based programs c. Church training programs d. Hospital based degree programs e. These are all traditional paths Answer: C

Page: 315

8. What does the nursing baccalaureate program train a nurse to do? a. To deliver babies without the supervision of a physician b. To diagnose and manage common ailments c. To give advice, information, and instructions about drug use d. To provide primary patient care similar to a physician e. To become a nursing educator or leader Answer: E

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Page: 315

9. What led to an increase in the status and salary of nurses in the late 1980s? a. Economic recession b. Nursing shortage c. Cold War d. Nursing surplus e. None of these lead to an increase Answer: B

Page: 316

10. What are the social characteristics of many nurses currently entering nursing? a. They are increasingly working-class b. They are increasingly lower-class. c. They are increasingly lower-middle-class. d. They are increasingly upper-middle-class. e. They are increasingly upper-class.

Answer: D

Page: 316

11. Nursing instructors fail to support the lay image of the nurse in what stage of socialization, according to Davis? a. Initial innocence b. Labeled recognition of incongruity c. Psyching out d. Role simulation e. Provisional and stable internalization Answer: A

Page: 316

12. What stage of socialization for nursing students involves taking on a temporary selfidentity as a “professional” nurse, according to Davis? a. Initial innocence b. Labeled recognition of incongruity c. Psyching out d. Role simulation e. Provisional and stable internalization Answer: E

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Page: 317

13. According to Davis (1972) what was the deciding factor in whether an individual would make a career out of nursing? a. Marriage b. Acceptance to nursing school c. First nursing job d. Acceptance of the women’s movement e. A mentor’s advice Answer: A

Page: 317

14. The doctor-nurse game is changing due to which of the following? a. Greater assertiveness by nurses b. Increased numbers of male nurses c. The growing numbers of female doctors d. All of the above e. B and C only Answer: D

Page: 318

15. What is the central rule of the doctor-nurse game? a. Communicate clearly and succinctly b. Only speak in private c. Avoid open disagreement between the players d. Ignore existing power structures e. Only speak in public Answer: C

Page 319

16. Which best summarizes the “doctor-nurse game”? a. Nurses make recommendations to doctors without appearing to do so while doctors ask for a recommendation without appearing to do so. b. Nurses work to undermine physician authority and demand care for patients while doctors attempt to retain authority. c. Nurses manage the emotional care a patient needs while doctors manage the physical care. d. Nurses collaborate with doctors to encourage uncooperative patients to comply with medical care. e. Nurses collaborate with doctors to prevent malpractice lawsuits from patients.

Answer: A

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Page: 319

17. What does a nurse gain from the “doctor-nurse game”? a. Autonomy b. Medical knowledge c. Professional satisfaction d. Public esteem e. Trust Answer: C

Page: 320

18. Which is the highest status nursing job in hospitals? a. Nursing aide b. Nonspecialist Registered Nurse c. Licensed Practical Nurse d. Specialist Registered Nurse e. They are all equal Answer: D

Page: 321

19. The role of the Registered Nurse: a. Has not changed over time b. Has been led to include more bedside services c. Has changed to include an administrative role d. Has created a pathway to medical school e. Has not provided a manner for nurses to be promoted Answer: C

Page: 321

20. What is a nurse practitioner trained to do? a. To deliver babies without the supervision of a physician b. To diagnose and manage common ailments c. To give advice, information, and instructions about drug use d. To provide primary patient care similar to a physician e. To supervise practical nurses and other health personnel Answer: B

Page: 322

21. Which of the following is NOT true of nurse practitioners? a. In the future, nurse practitioners may provide much of the primary care for patients

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b. Nurses are concerned the role of nurse practitioner may be consumed by the medical profession c. There are new Doctoral of Nursing Practice degrees d. The role of the nurse practitioner is decreasing e. None of the above are true Answer: D

Page: 322-323

22. What would be the general job description of a physician assistant? a. Someone who provides nursing care for patients at a lower level than that of nurse aides. b. Someone who provides a level of primary patient care similar to or higher than that of nurse practitioners. c. Someone who performs administrative functions similar to non-medical administrators. d. Someone who provides research aid to physicians at a level similar to a medical fellow. e. Someone who gathers patient specimen samples and assists in analysis.

Answer: B

Page: 323

23. Physician assistant and nurse practitioners in the United States: a. Are both increasing both in use and numbers b. Are decreasing both in use and numbers c. Are neither increasing nor decreasing in use and numbers d. Decreasing in use but increasing in numbers e. Increasing in use but decreasing in numbers Answer: A

Page: 324

24. What is an important job of pharmacists in patient care? a. They provide hospice care for older adults. b. They are a key source of medication information for the public. c. They conduct routine check-ups in place of the physician. d. They make recommendations for medications to physicians. e. They replace physicians as patient counselors.

Answer: B 25. Which is true of pharmacists?

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Page: 325

a. b. c. d. e.

They work independently of the rest of the health care system.

They supplement rather than challenge the patient care tasks of providers.

They exist to offer an alternative to patient care tasks.

They are the least accessible of all health care personnel.

None of the above are true.

Answer: C

Page: 325

26. What happens in the interprofessional interactions between pharmacists and physicians when the physician makes an error in prescriptions? a. The pharmacist goes along with the physician’s prescribed treatment. b. The pharmacist carefully approaches the physician and suggests an alternative. c. The pharmacist calls the physician and points out their error. d. The pharmacist tells the patient the physician made an error. e. The pharmacist files a complaint with the physician’s certifying board.

Answer: B

Page: 326

27. Which is a job performed by lay midwives? a. They do work under the supervision of a physician to care for premature infants. b. They deliver babies without the supervision of a physician. c. They train physician assistants to deliver babies. d. They provide specialized care for first-time mothers. e. They work in hospitals to deliver babies.

Answer: B

Page: 327

28. What type of midwife is a registered nurse (RN)? a. Certified midwife b. Certified nurse-midwife c. Certified professional midwife d. Nursing aide-midwife e. Professional licensed midwife Answer: B

Page: 327

29. Why did the delivery of babies change from “women’s work” to be part of a physician’s job? a. The popularization of the germ theory and the belief that midwifes carried more germs than physicians.

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b. The industrialization of U.S. cities led to more care in hospitals rather than at home. c. The new regulations against providing health care at home and preventing midwives from working in hospitals. d. The growing belief in scientific progress and the development of obstetrics as a medical specialty. e. The increasing opposition to conducting patient care in the home and the increasing reliance hospital technology.

Answer: D

Page: 327

TRUE/FALSE 1. Nursing represents the largest single group of health workers in the United States.

Answer: TRUE

Page: 311

2. The social role of nurses has been affected by its identification with traditionally masculine functions.

Answer: FALSE

Page: 312

3. Secular nurses were treated the same as nuns.

Answer: FALSE

Page: 313

4. Florence Nightingale became a nurse by first becoming a Catholic nun.

Answer: FALSE

Page: 313

5. Florence Nightingale’s first hospital was successful.

Answer: FALSE

Page: 313

6. Early on, nursing students were seen as inexpensive and exploitable sources of hospital labor.

Answer: TRUE

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Page: 314

7. The first university-based nursing school was formed at the University of Michigan in 1909.

Answer: FALSE

Page: 314

8. Every nursing school follows a similar program of education leading to only type of degree.

Answer: FALSE

Page: 315

9. The overwhelming majority of nursing students today attend a hospital based diploma school.

Answer: FALSE

Page: 315

10. While the general push is for all nurses to be college graduates in the future, A.D. nurses have been called “technical” while baccalaureate degree nurses have been called “professional”.

Answer: TRUE

Page: 315

11. Nursing is a distinctly middle-class profession.

Answer: TRUE

Page: 316

12. Nursing has never appealed to the lower-middle and working classes.

Answer: FALSE

Page: 316

13. Current research shows the doctor-nurse game has not changed over time.

Answer: FALSE

Page: 320

14. Male nurses take part in the doctor-nurse game.

Answer: FALSE

Page: 320

15. Nurses question female physicians more than male physicians.

Answer: TRUE

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Page: 321

16. The nurse practitioner or nurse clinician is a relatively new type of health worker that uses skills nurses are not trained with.

Answer: FALSE

Page: 322

17. The development of primary care centers at retail stores is fueling the need for nurse practitioners.

Answer: TRUE

Page: 322

18. The role of physician assistant was initially intended provide a way for military medics to transition to the civilian workforce.

Answer: True

Page: 323

19. Pharmacists are the least accessible of all health care personnel.

Answer: False

Page: 325

20. Midwifery is a new form of care available to women.

Answer: False

Page: 327

ESSAY 1. Explain the power structure among the different types of nurses and how these are influenced by nursing education.

2. Explain the six stages of socialization of a nursing student.

3. Describe why nursing education originally appealed to almost exclusively women.

4. What is “the Doctor-Nurse Game”? How and why has it changed over the course of time?

5. Explain how the role of the nurse practitioner/clinician came to be, how it is expanding, and what concerns doctors have.

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6. Explain how midwifery has remained in existence, and also experienced a resurgence, despite the opposition of the medical profession.

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Chapter 14 Complementary and Alternative Medicine (CAM) Multiple Choice Questions

1. Which of the following is NOT a type of complementary and alternative medicine? a. Ayurveda b. Acupuncture c. Homeopathy d. Shiatsu e. Pharmacy Answer: E

Page: 332

2. Which of the following is an ancient Chinese technique of inserting fine needles into specific points in the body to ease pain and stimulate bodily functions? a. Ayurveda b. Acupuncture c. Crystal healing d. Homeopathy e. Naturopathy Answer: B

Page: 332

3. How effective are most CAM therapies studied by scientists? a. They cause immense harm to users. b. They cause a little harm to users. c. They have no effect at all on users. d. They have an immense benefit for users. e. They have not been studied enough to generate scientific evidence.

Answer: E

Page: 333

4. The Dietary Supplement Health and Education Act allows food products to be sold as cures for disease so long as: a. The claims are clearly on the label b. A member of the staff is educated on the use of the product c. The claims are not on the label d. The claims are only provided in signs, books, and pamphlets which may be in the store e. Both C and D Answer: E

Page: 334

5. What best describes the average CAM user based off research? a. Older upper-class adults

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b. c. d. e.

Older middle class/working class adults Middle age and younger middle class/working class adults Middle age and younger upper class All are equally likely to use CAM Answer: C

Page: 334

6. Why do some black people use CAM? a. There is a deep cultural history of using CAM in black communities in the U.S. b. They use CAM as a strategy to adapt to discriminatory practices in professional health care settings. c. CAM centers typically operate in neighborhoods that are black majority. d. They are more likely to be uninsured and use CAM as a way to avoid expensive medical bills. e. CAM offers a more scientific and rational approach to its practices than that offered by physicians.

Answer: B

Page: 334

7. Which statement is true of the Chiropractic approach to healing? a. There is broad support for it among the medical profession b. Chiropractic healing is being absorbed by medicine c. Chiropractors are not able to practice in all 50 states d. Chiropractors face opposition from medicine e. None of the above is true Answer: D

Page: 334

8. What has hampered chiropractors’ attempts at professionalization? a. The nursing profession has opposed their inclusion in hospitals and clinics. b. There is division among chiropractors over the expansion of their role. c. The people who utilize chiropractors want them to remain separate. d. There are state laws against the professionalization of chiropractors. e. The federal government does not recognize chiropractic medicine as legitimate.

Answer: B

Page: 335

9. Most studies find that religion: a. Is associated with positive health and lower mortality b. Is associated with negative health and higher mortality c. Is not associated with health or mortality d. Is associated with positive health and higher mortality e. Is associated with negative health and lower mortality Answer: A

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Page: 336

10. According to sociological research, how does religion promote good health? a. By making regular confessions to religious leaders b. By promoting riskier health behaviors c. By eliminating stressful behaviors d. By encouraging positive health lifestyle practices e. By limiting contact with unhealthy social environments Answer: D

Page: 336

11. Which is NOT a type of faith healing? a. Massage therapy b. Self-treatment through prayer c. Treatment with a layperson thought to communicate with God d. Treatment from an official church member e. Healing obtained from religious healers Answer: A

Page: 336-337

12. What did Glick find happened to people who participated in spiritual healing groups? a. Their health was the same as before they participated. b. Their symptoms were completely alleviated after they participated. c. They felt relief from psychological distress. d. Their health was worse than before they participated. e. They felt spiritually healed, but not physically healed.

Answer: C

Page: 337

13. What do most religious groups in the U.S. favor in treating health problems? a. Only spiritual healing b. Medical care provided by a religious leader c. A combination of spiritual practices and professional medical care d. Prayers and the laying on of hands e. Only professional medical care Answer: C

Page: 338

14. Regarding faith healing among parents and their children, the current trend in court decisions is: a. Parents may refuse all treatment for their children b. Parents may not refuse treatment for their children in life threatening cases c. Parents may not refuse treatment for their children in any case d. Parents may only refuse treatment in certain life-threatening cases e. There have been no cases brought to the courts Answer: B

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Page: 339-341

15. Folk healers are most commonly used among: a. Some low income racial and ethnic minority groups b. All parts of society c. The middle class d. The working class e. The upper class Answer: A

Page: 341

16. According to Baer (2001) how do its users typically view folk healing? a. A luxury because it complements other medicine b. A last resort due to poverty c. A resource grown from the historical experiences of their family and ethnic group d. Both A and C e. None of the above Answer: C

Page: 341

17. In African American folk medicine, the healing process usually focuses on: a. The symptoms b. The cause of the problem c. The long-term consequences of symptoms d. Symptom relief e. None of the above Answer: B

Page: 342

18. What are the differences between natural and unnatural illnesses in African American folk medicine? a. Natural illnesses are treated by physicians, unnatural illnesses by folk medicine. b. Natural illnesses are treated by folk medicine, unnatural illnesses by physicians. c. Natural illnesses are often ascribed to black magic, unnatural illnesses are ascribed to sin. d. Natural illnesses are often ascribed to sin, unnatural illnesses are ascribed to black magic. e. None of the above Answer: B

Page: 342

19. Black folk medicine: a. Provides no real healing b. Perform about as well as a placebo c. Eases anxieties that underlie many health problems d. Works on some specific symptoms e. None of the above

Information Classification: General

Answer: C

Page: 343

20. African American Folk healers: a. Are usually used as a last resort b. Are most frequently used simultaneously with traditional medicine c. Are usually referred to patients through family and neighbors d. Work closely with traditional healers e. None of the above Answer: C

Page: 343

21. Which is NOT true of curanderos? a. They blend religion and folk medicine b. Classify illnesses based on the symptoms c. Tend to not charge much if anything for their services d. Do not separate the natural from the supernatural in terms of diagnosis and treatment e. None of the above Answer: B

Page: 344

22. Curanderos and curanderas emphasize: a. The fact that their powers come from God b. The fact that they learned their powers c. The belief that suffering does not help God’s plan for the universe d. A and C e. None of the Above Answer: A

Page: 344

23. Curanderismo healing focuses on ________________ borrowed from the ________________ system of medicine. a. Yin and Yang; Chinese b. Four bodily humors; Hippocratic c. Herbal medicine; holistic d. The Wattuck; Incan e. Incantations; Aztec Answer: B:

Page: 344

24. What is the most dreaded type of disorder in curanderismo healing? a. Those caused by foods b. Those caused by animals c. Those caused by stress d. Those caused by witchcraft e. None of the above

Information Classification: General

Answer: D

Page: 344

25. The principle figure in a Navajo ritual is the: a. Shaman b. Diviner c. Singer d. Herbalist e. Bone setter Answer: C

Page: 345

26. In Native American healing, ceremonies: a. Play an important role in promoting well being b. Join the patient, family, and community in the process of healing c. Consist of songs, prayer, music, and dance d. Are unappreciated by traditional health care providers e. All of the above Answer: E

Page: 345

27. Which of the following points to a demise in native healing for the Navajos? a. The increasing numbers of Christian Navajos b. The loss of traditional land where ceremonies take place c. The declining number of singers d. The promotion of government medical services e. The closure of herbalist facilities Answer: C

Page: 346

28. What occurs in the initial phase of Cree healing ceremonies, according to Morse? a. A purification ritual is performed b. A contract with the Great Spirit is made c. An herbal tea is drunk d. A sweat-lodge ceremony is performed e. A closure of the ceremony is made Answer: A

Page: 346-347

29. What occurs in the second phase of Cree healing ceremonies, according to Morse? a. A purification ritual is performed b. A contract with the Great Spirit is made c. An herbal tea is drunk d. A sweat-lodge ceremony is performed e. A closure of the ceremony is made

Information Classification: General

Answer: B

Page: 346-347

True False Questions

1. There is clear scientific support for the effectiveness of all complementary and alternative medicine (CAM) techniques.

Answer: FALSE

Page: 333

2. CAM techniques are not commonly practiced by the medical profession.

Answer: TRUE

Page: 333

3. The lack of scientific evidence has led CAM techniques to be a profitless venture in the United States Answer: FALSE

Page: 333

4. Most people that use chiropractors also visit physicians for treatment.

Answer: TRUE

Page: 335

5. Chiropractors are the smallest group of primary health care providers.

Answer: FALSE

Page: 335

6. Some patients believe prayer should be classified as a form of complementary and alternative medicine.

Answer: TRUE

Page: 336

7. A common theme running through each of the categories of faith healing is an appeal to God to change a person’s physical or mental condition for the better.

Answer: TRUE

Page: 336-337

8. The Church of Scientology is the largest advocate of faith healing in the United States.

Answer: FALSE

Page: 338

9. In the late 1980s, four court cases established that parents have the right practice religion freely, which includes the liberty to expose a child to ill-health or death.

Answer: FALSE

Information Classification: General

Page: 339

10. It appears that faith healers are increasingly limited to only a few fundamentalist religious groups.

Answer: TRUE

Page: 341

11. According to Snow’s research on black folk healers, unnatural illnesses are outside of “God’s plan” and beyond self-treatment or treatment prescribed by friends and relatives.

Answer: TRUE

Page: 341

12. The term “healer” is reserved only for specific people involved in the healing process, according to Snow’s research on black folk healers.

Answer: FALSE

Page: 342

13. All folk healing must take place in person, according to Snow’s research on black folk healers.

Answer: FALSE

Page: 342

14. A disadvantage of black folk medicine is users have a difficult time finding black folk healers.

Answer: FALSE

Page: 343

15. There are two types of black folk healing: traditional and Caribbean.

Answer: TRUE

Page: 343

16. Both African American folk healers and curanderos/curanderas mix folk healing and religion.

Answer: TRUE

Page: 344

17. The curandero/curandera explains the patient’s suffering as being part of their burden for the world’s sin and ignorance and a necessary role in God’s plan for the universe.

Answer: TRUE

Page: 344

18. Both African American folk healers and curanderos/curanderas achieve a positive effect through anxiety reduction.

Answer: TRUE

Page: 343-345

19. Navajo healers focus on the symptoms of an illness rather than the cause.

Information Classification: General

Answer: FALSE

Page: 345

20. Cree healing treats the whole person, not just particular symptoms.

Answer: TRUE

Page: 347

Essay Questions

1. Based on the reading, who uses complementary and alternative medicine techniques?

Explain why.

2. Describe the relationship between medical physicians and CAM practitioners.

3. Why has folk medicine persisted despite the advancement of health care?

4. How are the different types of folk medicine similar?

5. Explain the five phases of the Cree healing ceremony identified by Morse.

6. Describe the likely health benefits from folk medicine.

Information Classification: General

Chapter 15 Hospitals Multiple Choice Questions 1. The ______________, as a major social institution for the delivery of health care in the modern world, has an important role in society. a. Government. b. Nonprofit sector. c. Walk-in Clinic. d. Hospital. e. All of the above.

Answer: D

Page: 354

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: 354-355

3. Which is NOT an example of a secular benefactor who founded hospitals? a. Kings. b. Churches. c. Merchants. d. Guilds. e. None of the above.

Answer: B

Page: 355

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: 355

5. During the Renaissance and the Reformation, an increasing numbers of hospitals were placed under the jurisdiction of _______________ authorities. a. Religious.

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b. c. d. e.

Secular.

Governmental.

Community.

None of the above.

Answer: B

Page: 355

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” 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: 355

7. The secular control of hospitals marked a period of ____________ for the development of Europe’s hospital system. a. Improvement. b. Decline. c. Fluctuation. d. Stagnation. e. None of the above.

Answer: B

Page: 355

8. Today in the U.S., 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: 355

9. ___________ hospitals tend to accept patients with acute disorders. a. Public. b. Private. c. For-profit. d. Nonprofit. e. None of the above.

Answer: B

Page: 336

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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. e. None of the above.

Answer: C

Page: 356

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: 356

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: 357

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: 358

14. Hospitals eventually became places where physicians also referred their _________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.

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Answer: C

Page: 358

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: 358

16. ________________ hospitals tend to lack prestige in comparison to other hospitals. a. Community. b. Nonprofit. c. Private. d. Government. e. None of the above.

Answer: D

Page: 361

17. America’s 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: 361

18. What is a part of the organization of a nonprofit community hospital? a. Satellite outpatient clinics. b. Affiliated group practices. c. Management organizations providing administrative services to physicians. d. Employing primary care doctors as part of their physician network. e. All of the above.

Answer: E

Page: 361

19. Who described bureaucracy as a rational and impersonal division of labor characterized by the principles of office hierarchy and levels of graded authority, and by fixed and official areas of jurisdiction governed by laws or administrative regulations? a. Weber. b. Perrow. c. Hillier.

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d. Durkheim. e. None of the above.

Answer: A

Page: 363

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: 364

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: 364

22. The occupational groups in the hospital most affected by its system of dual authority are the ______________ who perform health care tasks on the hospital’s wards. a. Physicians. b. Nurses. c. Pharmacists. d. Social workers. e. None of the above.

Answer: B

Page: 365

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.

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Answer: A

Page: 365

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 patient’s subjective experience of feeling sick. a. Depersonalization. b. Demoralization. c. Standardization. d. Assembly line medicine. e. None of the above.

Answer: A

Page: 369

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: 369

26. About _______ of all expenses for hospital services are now paid by third-party sources. a. 60%. b. 70%. c. 80%. d. 90%. e. None of the above.

Answer: D

Page: 370

27. About _____________ of all the money spent on health expenditures in the United States in 2019 was spent on hospital care. a. 30-35%. b. 36-39%. c. 40-45%. d. 46-50%. e. None of the above.

Answer: A

Page: 371

28. The most expensive hospitals in the United States are located in New England and the: a. South. b. Pacific Coast.

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c. Rocky Mountain states. d. Midwest. e. None of the above.

Answer: B

Page: 371

29. What action did hospitals take in response to the 1983 federal legislation that establishes a fixed rate for each medical procedure? a. They closed out-patient clinics. b. They decreased patient services. c. They expanded services. d. They cut nurses’ pay. e. They refused to serve the uninsured.

Answer: C

Page: 372

True False Questions 1. Hospitals have passed through four distinct phases of development.

Answer: TRUE

Page: 354

2. The Romans were the first to establish separate medical facilities that have been described as hospitals.

Answer: TRUE

Page: 354

3. The origin of the institution we know today as the hospital has usually been associated with the rise of Judaism.

Answer: FALSE

Page: 354

4. During the period of the Crusades, many hospitals were established along the routes to the Holy Land followed by the Christian armies.

Answer: TRUE

Page: 355

5. Secular benefactors rarely founded hospitals.

Answer: FALSE

Page: 355

6. By the end of the 15th century, an extensive network of hospitals existed throughout Eastern Europe.

Answer: FALSE

Page: 355

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7. A legacy of the hospitals as poorhouses is that of mental hospitals.

Answer: TRUE

Page: 356

8. Mental hospital admissions are always involuntary.

Answer: FALSE

Page: 356

9. In criminal cases, the claim of mental disorder is used as an excusing condition that relieves the individual of criminal responsibility for their crime.

Answer: TRUE

Page: 356

10. The first hospitals were founded in the United States more than 250 years ago.

Answer: TRUE

Page: 358

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: 359

12. Federal government participation in health care began in the late 1800s.

Answer: FALSE

Page: 359

13. Federal government participation in health care began with the U.S. Public Health Service hospital program for merchant seamen.

Answer: TRUE

Page: 359

14. State governments entered into health care delivery in the 1700s.

Answer: FALSE

Page: 359

15. State government early involvement in health care delivery was largely confined to the establishment of mental institutions.

Answer: TRUE

Page: 359

16. The most common type of hospital in the United States is the nonfederal and nonprofit community hospital.

Answer: TRUE

Page: 360

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17. The total number of hospitals in the United States has increased from 1975 to 2007.

Answer: FALSE

Page: 360

18. Controlled by a board of trustees, government hospitals are exempt from federal income taxes and many other forms of state and local taxes.

Answer: FALSE

Page: 360

19. For-profit hospitals have decreased, and nonprofit hospitals have increased in recent decades due to a focus on civil society.

Answer: FALSE

Page: 360

20. The primary goal of the non-profit community hospital is to provide medical treatment to its patients at the lowest cost to the taxpayer.

Answer: FALSE

Page: 361

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. Explain why Max Weber’s concept of bureaucracy is not completely compatible with the norms of hospital authority.

5. Describe what mental hospitals are, as well as the admissions/commitment processes.

6. Explain how the hospitalization experience affects patients.

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Chapter 16 Health Care Reform and Health Policy in the United States Multiple Choice Questions 1. What does DRG stand for? a. Diagnostic related groups. b. Drug review guide. c. DR (doctor) G (guild). d. Dermatology rheumatology groups. e. None of the above.

Answer: A

Page: 372

2. 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: 376

3. In 1980, an average of ____________ per person was spent on health care in the United States, which was the highest in the world at the time. a. $1,100. b. $7,681. c. $8,900 d. $11,582. e. None of the above.

Answer: A

Page: 377

4. In 2019, 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. $1,100. b. $7,681. c. $8,900 d. $11,582. e. None of the above.

Answer: D

Page: 377

5. Which is a contributor to the increase in health care expenditures? a. Aging of the population. b. Increases in hospital expenses.

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c. Higher costs for physician services. d. Increase in the number of prescriptions written. e. All of the above are contributors.

Answer: E

Pages: 378

6. 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: 378

7. 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: 378

8. 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: 379

9. The Medicare program is under the overall direction of the: a. Centers for Disease Control and Prevention. b. Secretary of Health and Human Services. c. American Association of Retired Persons. d. Health and Elderly Organization. e. None of the above.

Answer: B

Page: 380

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10. This organization provides for the federal government’s share 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.

Answer: B

Page: 380

11. What is the role of a managed care organization? a. Control the cost of health care. b. Monitor the work of doctors and hospitals. c. Limit visits to specialists. d. Require prior authorization for hospitalization. e. All of the above.

Answer: E

Page: 382

12. 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: 382

13. _________________ 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: 382

14. 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.

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d. Low-income persons under 65 will be covered by an expanded Medicaid program. e. Children may remain on their parent’s health insurance plan until age 26.

Answer: C

Pages: 386

15. 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: 393

16. 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: 393

17. 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: 393

18. 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: 394

19. Medical specialties like ____________ became increasingly popular in recent years. a. Dermatology. b. Anesthesiology.

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c. Radiology. d. Emergency-room medicine. e. All of the above.

Answer: E

Page: 394

20. ________________ are public organizations supported by tax funds, which are intended to support and conduct research, develop educational materials, protect the nation’s 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: 395

21. _________________ 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: 395

22. _________________ 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: 395

23. _________________ 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: 396 133

Information Classification: General

24. ___________________ are a 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. d. Preferred provider organizations. e. Allied health enterprises.

Answer: D

Page: 397

25. ________________ 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: 397

26. 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: 398

27. ___________ 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: 399

28. In the U.S., health care tends to be viewed as: a. A privilege based on ability to pay for a commodity.

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b. c. d. e.

A privilege based on citizenship.

A right granted regardless of living conditions or financial status.

A right based on participation in capitalist markets.

None of the above.

Answer: A

Page: 400

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: 401

True False Questions 1. 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: 376

2. Advertising drives up drug costs.

Answer: TRUE

Page: 378

3. Almost all drugs can reduce health spending by lowering the need for hospital care.

Answer: FALSE

Page: 378

4. In the early to mid-1990s, private health care in the United States experienced a dramatic reorganization into managed care plans.

Answer: TRUE

Page: 382

5. Managed care does not alter the patient-physician relationship; it exists above and beyond it.

Answer: FALSE

Page: 382

6. A feature of managed care is its reliance upon capitation financing.

Answer: TRUE

Page: 382 135

Information Classification: General

7. Despite initial resistance to rationing services by the middle class, the managed care model has continued to control escalating costs for health care.

Answer: FALSE

Page: 384

8. The death rate in Massachusetts immediately decreased after it adopted mandatory statewide health insurance coverage.

Answer: TRUE

Page: 386

9. A number of states sued the federal government over the 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: 389

10. The Supreme Court reaffirmed the legal basis of the Affordable Care Act in 2012 when it ruled that the law requiring most American to obtain health insurance or pay a penalty was constitutional under Congress’s power to levy taxes.

Answer: TRUE

Page: 390

11. In a free-market system lacking national health insurance, those persons who are economically disadvantaged are also medically disadvantaged when it comes to obtaining quality services.

Answer: TRUE

Page: 392-393

12. The urban poor have historically been dependent on public hospitals and clinics rather than private hospitals and practitioners for providing patient care.

Answer: TRUE

Page: 393

13. The rural poor are less likely to be treated by foreign medical school graduates.

Answer: FALSE

Page: 393

14. Physicians generally prefer to practice medicine in urbanized settings.

Answer: TRUE

Page: 393

15. Physicians in private practice are often found in neighborhoods characterized by large numbers of poor and nonwhite residents.

Answer: FALSE

Page: 394 136

Information Classification: General

16. Primary care or family practitioners are over-represented among physicians.

Answer: FALSE

Page: 394

17. Medical specialization has produced very few positive benefits.

Answer: FALSE

Page: 394

18. The people who tend to utilize emergency rooms for primary care are the underprivileged.

Answer: TRUE

Page: 394

19. HMOs are oriented toward preventive and ambulatory services intended to reduce hospitalization.

Answer: TRUE

Page: 395

20. 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: 398

Essay Questions 1. Identify and discuss the three major issues in the public debate about health care delivery in the United States.

2. Explain how managed care emerged in the U.S. 3. Present arguments for and against health reform.

4. “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?

5. Describe the Medicare and Medicaid programs in depth, with an evaluation for each in the context of health policy.

6. Explain the debate on whether health care is a right or a privilege.

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Chapter 17 Global Health Care Multiple Choice Questions 1. What country has a decentralized national health program? a. China b. Japan c. Russia d. United Kingdom e. None of the above Answer: B

Page: 406

2. 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: 406

3. What country established the first national health insurance program? a. U.K. b. Germany. c. Japan. d. Canada. e. Austria.

Answer: B

Page: 406

4. ________________ 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. e. None of the above.

Answer: D

Page: 406

5. Many Europeans receive: a. Comprehensive health insurance. b. Protection of lost income due to illness, injury, or unemployment.

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c. Allowances to supplement family expenses for the maintenance of children, such as clothing and school lunches. d. A and B only. e. All of the above.

Answer: E

Page: 407

6. 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: 407

7. What country had the lowest infant mortality rate in the world in 2018? a. Cuba. b. United States. c. Japan. d. Sweden. e. Germany.

Answer: C

Page: 407

8. What country had the highest life expectancy for males in the world in 2018? For females? a. United States; United States. b. Italy; Japan. c. Japan; Japan. d. Israel; Switzerland. e. Australia; Spain.

Answer: B

Page: 409

9. In what way(s) do decentralized national health programs differ from socialized medicine? a. There are both publicly and privately owned facilities. b. Public access to care is guaranteed. c. Private care plays only a limited role. d. Government regulation is indirect. e. All of the above.

Answer: D

Page: 410

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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. b. Canadian. c. German. d. Swedish. e. None of the above.

Answer: B

Page: 411

11. What is NOT covered by the Canadian insurance system? a. Prescription drugs for persons under age 65. b. Dental. c. Ambulance service. d. Eyeglasses. e. All of the above.

Answer: E

Page: 411

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: 412

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: 414

14. The Chinese health care system is best characterized as: a. A state-run socialist program. b. A system financed largely by fees by patients and private payers. c. A decentralized national health program. d. A comprehensive socialized program with traditional and Western elements. e. None of the above.

Answer: B

Pages: 411 141

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15. The first line of medical care in Great Britain is the: a. Nurse practitioner/physician’s assistant. b. General practitioner. c. Hospital, specifically the emergency room. d. Gatekeeper, a nurse who assigns physicians based upon need. e. None of the above.

Answer: B

Page: 414

16. Taxes in ______________ have been the highest in the world. a. Britain. b. United States. c. Canada. d. Sweden. e. Germany.

Answer: D

Page: 417

17. What is a major characteristic of the Swedish National Health Service? a. It is owned wholly by a conglomeration of hospitals. b. It consists of physicians employed by both private and public councils. c. It is funded by a special tax on pharmaceutical and biotechnology companies. d. It consists of hospitals owned by county and municipal governments. e. It is divided into preventative and curative agencies.

Answer: D

Page: 417

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: 420

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.

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Answer: C

Page: 420

20. What disease has been increasing in Japan due to a more Westernized lifestyle and increase in the consumption of animal fats and proteins? a. Asthma b. Diabetes c. Heart Disease d. Stomach cancer e. Urinary tract infections Answer: C

Page: 422

21. Approximately __________ of all Germans participate, involuntarily or voluntarily, in the nation’s public health insurance program. a. 55%. b. 66%. c. 77%. d. 88%. e. 99%.

Answer: D

Page: 424

22. The _____________ is responsible for Mexico’s 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: 426

23. 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: 427

24. About _________ of the Mexican population has health insurance. a. 50%. b. 60%. c. 70%.

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d. 80%. e. 90%.

Answer: A

Page: 427

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: 415

26. ____________ has more doctors per capita than any major nation. a. Mexico. b. Russia. c. China. d. Australia. e. Untied States.

Answer: B

Page: 430

27. What country has the highest per capita consumption of alcohol in the world? a. Ireland. b. Germany. c. Russia. d. United States. e. Mexico.

Answer: C

Page: 432

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: 435

29. Some __________ of China’s adult male population smoke. a. 20.8%.

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b. c. d. e.

35.7%.

52.9%.

70.2%.

None of the above.

Answer: C

Page: 437

True False Questions 1. All nations of the world are faced with the pressure of public demands for quality health care and faced with rising costs of providing that care.

Answer: TRUE

Page: 406

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: 406

3. A nation’s 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: 406

4. In Europe, the provision of health services became an important component of government policy in the last half of the eighteenth century.

Answer: FALSE

Page: 406

5. The social welfare systems of the U.S. are more advanced than in Europe.

Answer: FALSE

Page: 406-407

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: 407

7. Americans who receive welfare tend to be stigmatized and have low social status.

Answer: TRUE

Page: 407

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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.

Answer: TRUE

Page: 403

9. The United States has the lowest infant mortality rate of any nation.

Answer: FALSE

Page: 409

10. The United States has the highest rate of longevity of any nation.

Answer: FALSE

Page: 409

11. Socialized medicine refers to a system of health care deliver in which health care is provided in the form of a private consumer service.

Answer: FALSE

Page: 410

12. Canada has a single, national health care delivery system.

Answer: FALSE

Page: 412

13. Canada was late in adopting its version of socialized medicine.

Answer: TRUE

Page: 412

14. Canadians had a lower rate of infant mortality than Americans.

Answer: TRUE

Page: 412

15. The United Kingdom was the first country to enact national health insurance.

Answer: FALSE

Page: 414

16. The Swedish National Health Service is financed through taxation.

Answer: TRUE

Page: 417

17. A major characteristic of the National Health Service in Sweden is that general hospitals are not owned by the government.

Answer: FALSE

Page: 418

18. The Japan health care delivery system is by far the most expensive in the world.

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Answer: FALSE

Page: 420

19. The Japanese national health insurance plan covers all Japanese citizens.

Answer: FALSE

Page: 421

20. Whereas higher SES groups in the United States have healthier lifestyles, well-educated and higher-income groups in China tended to have worse health than the lower classes.

Answer: TRUE

Pages: 436

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? As an example, refer to the case of Mexico to illustrate this type of healthcare system.

5. Compare and contrast the following: fee-for-service, socialized medicine, decentralized national health, and social medicine systems. Pay close attention to conditions of regulation, provider payments, facility ownership, public access, and private care.

6. Describe the changes that have occurred in the socialist form of health care in Russia and China.

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