One significant factor in the 20-year push for health care reform has been the yawning gap between the health care options available to the wealthy and those available to the poor. Over the years, those disparities have proven to be dangerous, even deadly, to some patients—and the inequities have been profoundly expensive for the health care system itself, in part because delays in seeking care make care more expensive.
In a recently published special issue of the Journal of Health and Social Behavior, a number of Robert Wood Johnson Foundation (RWJF) scholars contributed articles to an examination of the health care system from a sociological perspective. The issue reviews key findings from 50 years of medical sociology.
RWJF Health & Society Scholar Alumnus Stefan Timmermans, Ph.D., and UCLA graduate student Hyeyoung Oh, B.A., jointly authored “The Continued Social Transformation of the Medical Profession.” They note some observers’ concern that “the medical profession’s mandate to take care of clients has been undermined by the influx of money into health care,” and go on to explore the role of “patient consumerism,” the impact of evidence-based medicine, and the increasing power of the pharmaceutical industry on medical decision-making.
Other RWJF-related contributors include:
· David R. Williams, Ph.D., 1994 RWJF Investigator Awards in Health Policy Research recipient, co-author of “Understanding Racial-Ethnic Disparities in Health: Sociological Contributions.” The article offers an overview of sociological work exploring the relationship between race and health. The authors revisit the evidence of health disparities in the United States. They examine how discrimination discourages African Americans from using health care services, the role of social structures in creating health disparities and various factors that affect the health of immigrants.
- Jo C. Phelan, Ph.D., 1995 RWJF Investigator Awards in Health Policy Research recipient, and Bruce G. Link, Ph.D., a current RWJF Health & Society Scholar, co-authors of “Social Conditions as Fundamental Causes of Health Inequality: Theory, Evidence and Policy Implications.” The article describes the various mechanisms by which socioeconomic status drives health inequalities.
- Karen Lutfey, Ph.D., an alumna of the RWJF Scholars in Health Policy Research Program, co-author of “Examining Critical Health Policy Issues Within and Beyond the Clinical Encounter: Patient-Provider Relationships and Help-Seeking Behaviors.” The article explores the interactions between patients and providers, and considers the ways that help-seeking behaviors affect disparities in care.
- Charles L. Bosk, Ph.D., a 2005 RWJF Investigator Awards in Health Policy Research recipient, author of “Bioethics, Raw and Cooked: Extraordinary Conflict and Everyday Practice.” In the article, Bosk examines bioethics as a language for framing ethical questions in public forums and as a set of organizational policies, formal procedures and work routines.
- David Mechanic, Ph.D., a 1994 RWJF Investigator Awards in Health Policy Research recipient and now director of the Investigator Awards national program office, co-author of “Sociology of Health Care Reform: Building on Research and Analysis to Improve Health.” The article notes that patient distrust of the health care system is an obstacle to successful reform efforts, and goes on to discusses ways to reform the system to improve quality and lower costs.