Ch.1-16 Answers Combined

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
Page: 1
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
Page: 1-2
3. Medical sociology, as a subdiscipline, began gaining strength:

a. It was always part of sociology as a major focus of classical sociologists.
b. After World War II with the infusion of large amounts of federal funding for
research.
c. Only in the last two decades when major worldwide health crises highlighted the
need for it.
d. It never has been a major part of sociology and exists only as a small part of the
medical field.
Answer: B
Page: 2
4. 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
Page: 3
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5. The scholar who first provided a major theoretical approach for medical sociology was:
a. Durkheim.
b. Parsons.
c. Weber.
d. Mead.
e. Goffman.
Answer: B
Page: 4
6. What important event occurred in 1951 that began to reorient American medical
sociology toward the use of theory?
a. The Vietnam War.
b. The publication of Parsonss The Social System.
c. The increase in chronic diseases.
d. The growth of universities.
e. The political swing towards a more conservative era.
Answer: B
Page: 4
7. Talcott Parsonss book The Social System contained which concept important for medical
sociology?
a. Micro theory.
b. Medicalization.
c. Patient power.
d. Culture.
e. Sick role.
Answer: E
Page: 4
8. In the case of the sick role, illness is seen as __________, and its undesirable nature
reinforces the motivation to be healthy.
a. Deviance.
b. Normal.
c. Biological.
d. Social.
e. A stimulus.
Answer: A
Page: 4
9. In developing his concept of the sick role, Parsons linked his ideas to which two classical
theorists?
a. Marx and Goffman.
b. Weber and Marx.
c. Marx and Engels.
d. Durkheim and Weber.
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e. Durkheim and Goffman.

Answer: D
Page: 4
10. 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
Page: 5
11. Most sociologists of medicine are employed as:

a. Biostatisticians.
b. Hospital workers.
c. Professors at universities.
d. Researchers in governmental agencies.
e. Independent contractors.
Answer: C
Page: 5
12. What trend(s) reduced tensions between sociologists in medicine and sociologists of
medicine?
a. Most government funding is awarded to research with practical application.
b. Medical sociology itself is converging with general sociology.
c. Sociology of medicine became the more dominant side of medical sociology.
d. A and B
e. B and C
Answer: D
Page: 5-6
13. 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.
Answer: D
Page: 7
14. One of the earliest attempts in the Western world to formulate principles of health care,
based upon rational thought and the rejection of supernatural phenomena, is found in the
work of the Greek physician:
a. Hippocrates.
3
b.
c.
d.
e.
Socrates.
House.
Aristotle.
Dioceses.
Answer: A
Page: 8
15. The Hippocratic Oath requires the physician to swear that he or she will:
a. Help the sick.
b. Refrain from intentional wrongdoing or harm.
c. Keep confidential all matters pertaining to the doctorpatient relationship.
d. All of the above.
Answer: D
Page: 8
16. The so-called clinical gaze is best associated with which of the following perspectives?
a. Medicine of social spaces.
b. Medicine of the species.
c. Public health paradigm.
d. Whole person medical care.
Answer: B
Page: 9
17. The medicine of social spaces is concerned with:

a. Curing disease.
b. Preventing disease.
c. Understanding disease.
d. Cataloging disease.
Answer: B
Page: 9
18. Decline in deaths from infectious diseases in the second half of the nineteenth century
was mainly due to:
a. Improvements in diet, housing, and public sanitation.
b. Better training of physicians.
c. The discovery of penicillin.
d. Epidemiological transitions.
Answer: A
Page: 10
19. The germ theory of disease is a perspective which asserts:

4
a.
b.
c.
d.
e.
Diseases are caused by a biological agent.

Medicine is the only true way to treat disease.
Illness can be caused by lifestyle choices.
Germs are conscious agents that intentionally harm their hosts.
None of the above.
Answer: A
Page: 10-11
20. Unlike infectious diseases, chronic diseases typically are _____________ and
______________.
a. Short term; incurable.
b. Short term; curable.
c. Long term; incurable.
d. Long term; curable.
e. There is no difference.
Answer: C
Page: 11
21. With the transition to a greater prevalence of chronic diseases, physicians have
increasingly had to take which approach to medical care?
a. The clinical gaze.
b. Use of magic bullets.
c. Whole person care.
d. The re-mystification of disease.
e. Assembly-line care.
Answer: C
Page 11
22. 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 ones social environment.
Answer: E
Page: 12
23. Which of the following have been significant factors in the most recent epidemiologic
transition, which has seen a reemergence of infectious diseases?
a. Decreased attention to public sanitation.
b. Globalization of trade and travel.
c. Global warming and climate change.
d. A and B.
e. B and C.
Answer: E
Page: 13
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24. The appearance of the West Nile virus in New York city reflects:
a. An example of bioterrorism.
b. The role of globalization in the spread of infectious diseases.
c. Evidence of the declining prevalence of infectious diseases.
d. The transition of infectious diseases into chronic ones.
Answer: B
Page: 15-17
25. One of the greatest threats from infectious diseases worldwide comes from:
a. Ebola and the avian bird flu.
b. Sexually transmitted diseases.
c. Food contaminated with E. coli.
d. Cancer and heart disease.
Answer: B
Page: 17
26. What caused the prevalence of STDs to soar around the globe?
a. The birth control pill.
b. A worldwide ideology of sexual liberation and permissiveness.
c. A new pattern of employment in developing nations.
d. Greater availability of multiple sexual partners.
Answer: E
Page: 17
27. There are two categories of bioterrorism:

a. Overt and covert.
b. Latent and manifest.
c. Balanced and skewed.
d. International and domestic.
e. Medical and behavioral.
Answer: A
Page: 18
28. A disgruntled coworker infects a box of pastries with dysentery, causing several staff to
become ill. This is an example of:
a. Bioterrorism.
b. Bioethics.
c. Epidemiological transitions.
d. Social causes of disease.
Answer: A
Page: 18
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29. In which study were syphilis patients intentionally not treated and allowed to die?
a. Nazi experiments.
b. Tuskegee.
c. STD1976.
d. Belmont.
e. Zimbardo prison.
Answer: B
Page: 20
30. Which is not a major bioethical issue?

a. Embryonic stem cell use.
b. Abortion.
c. Euthanasia.
d. Use of adult stem cells.
e. Cloning.
Answer: D
Page: 20-21
True False Questions

1. Medical sociology focuses on the social causes and consequences of health and illness.
Answer: TRUE
Page: 1
2. Medical sociology is important because it focuses on the critical role social factors play
in determining or influencing the health of individuals, groups, and the larger society.
Answer: TRUE
Page: 1
3. Health includes a number of components which are not just biological, but also social,
cultural, political, and economic.
Answer: TRUE
Page: 2
4. Medical sociology is a relatively new field in sociology.

Answer: TRUE
Page: 3
5. Unlike law, religion, politics, economics, and other social institutions, medicine was
ignored by sociologys founders in the late nineteenth century because it did not appear to
shape the structure and nature of society.
Answer: TRUE
Page: 3
6. The tremendous growth of medical sociology would have been possible even without
financial support for applied studies provided by the government.
Answer: FALSE
Page: 3
7. Talcott Parsons provided a theoretical approach for medical sociology in the 1950s that
was important in the subdiscipline's early development.
Answer: TRUE
Page: 4
8. The sick role presents an ideal representation of how people act when sick.
Answer: TRUE
Page: 4
9. Working within an atheoretical, applied approach, Parsons was the first to demonstrate
how medicine functions to exert social control within the larger social system.
Answer: FALSE
Page: 4
10. The sociologist in medicine is one who collaborates directly with the physician and other
health personnel in studying the social factors that are relevant to a particular health
problem.
Answer: TRUE
Page: 5
11. The sociology of medicine deals with such factors as the organization, role relationships,
norms, values, and beliefs of medical practice as a form of human behavior.
Answer: TRUE
Page: 5
12. There is a growing divergence between medical sociology and the general discipline of
sociology.
Answer: FALSE
Page: 6
13. At present, medical sociologists constitute the largest and one of the most active groups
of people doing sociological work in the United States and Europe.
Answer: TRUE
Page: 6
14. 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
Page: 9
15. The practice of medicine in the twentieth century was based on the premise that every
disease had a specific pathogenic cause and was best addressed within a biomedical
framework.
Answer: TRUE
Page: 11
16. The poor have the highest rates of disease and disability of an socioeconomic group,
demonstrating their greater biological disposition toward illness.
Answer: FALSE
Page: 13
17. The number of sex partners an individual has is the most important risk factor in
exposure to sexually transmitted diseases.
Answer: TRUE
Page: 17
18. Bioterrorism represents a relatively old threat of infectious diseases.

Answer: FALSE
Page: 18
19. Drug companies are typically non-profit agencies and do not benefit when academics
publish articles about the effectiveness of their drugs.
Answer: FALSE
Page: 20
20. The development of institutional review boards and the Health Insurance Portability and
Accountability Act have eliminated ethical concerns about issues such as clinical care,
informed consent, and drug testing.
Answer: FALSE
Page: 20
Essay Questions
1. What factors have been important in the development of medical sociology?
2. Explain the differences between sociology in medicine and the sociology of medicine.
3. Has there been a re-emergence of infectious disease? Explain your answer?
4. What was the Tuskegee Study and why is it an important reminder of the need for ethical
oversight in research?
5. Although there is no standard definition of health, there are many concepts. Provide your
own definition of health. How does it relate to the World Health Organizations definition
of health?
Chapter 2
9
Epidemiology
1. The primary focus of the epidemiologist is on:
a. Catastrophic disease outbreaks.
b. Societal demographics.
c. Health and wellness of children.
d. Individuals diseases.
e. Health problems of social aggregates.
Answer: E
Page: 23
2. A scientist who studies the origin and distribution of all types of diseases is best
described as a(n):
a. Biochemist.
b. Social worker.
c. Epidemiologist.
d. Demographer.
e. Sociologist.
Answer: C
Page: 23
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
Page: 24
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
Page: 24
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.
c. Incidence is reported in raw numbers while prevalence is expressed as a ratio.
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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
Page: 24
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
Page: 24-25
7. _________________ has special significance for a society because it is traditionally used

as an approximate indicator of a societys 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
Page: 25
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.
Answer: C
Page: 26
9. Whose investigations into cholera outbreaks established the foundation of modern

epidemiology?
a. Louis Pasteur.
b. John Snow.
c. Karl Marx.
d. Ralph Paffenbarger.
e. All these men helped lay the foundation of epidemiology.
Answer: B
Page: 27
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10. Germ theory provided a framework for understanding the causal agents of disease. What
are the five agents recognized today?
a. Biological, social, psychological, toxic, and environmental.
b. Biological, physical, social, mental, and metaphysical.
c. Biological, physical, social, mental, and psychological.
d. Biological, nutritional, chemical, mental, and psychological.
e. Biological, nutritional, chemical, physical, and social.
Answer: E
Page: 28
11. The science of epidemiology has passed through three eras and is entering a fourth. In
what order did it pass through the first three eras?
a. Sanitary, Infectious, Chronic.
b. Sanitary, Chronic, Infectious.
c. Chronic, Sanitary, Infectious.
d. Chronic, Infectious, Sanitary.
e. Infectious, Sanitary, Chronic.
Answer: A
Page: 28
12. As a nation shifts from primarily rural-agricultural to urban-industrial, what changes are
seen in the health profile of the nation?
a. Leading causes of death change from mostly chronic diseases to infectious
diseases.
b. Leading causes of death change from mostly infectious diseases to chronic
diseases.
c. Infectious diseases are eliminated entirely
d. Both infectious and chronic diseases are reduced to a minimum.
e. There is no difference
Answer: B
Page: 29
13. What is the leading cause of death in the United States, accounting for more than onethird of all deaths?
a. Diabetes.
b. HIV/AIDS.
c. Stroke.
d. Heart disease.
e. Cancer.
Answer: D
Page: 30
14. The _____________ study was important for showing that arteriosclerosis does not strike
people at random as they age, but that highly susceptible individuals can be identified in
advance.
a. CVD1960.
12
b.
c.
d.
e.
Framingham.
Tuskegee.
Whitehall.
Engels.
Answer: B
Page: 30
15. What do studies on diet, exercise, and obesity suggest with respect to heart disease?
a. Diet and physical activity have little effect on an individuals likelihood of
developing heart disease.
b. Changing ones eating habits toward a diet low in saturated fat can reduce the risk
of developing heart disease.
c. Obesity is the result of individual choices and relates little to the development of
heart disease.
d. Only lengthy, vigorous physical activity has been shown to provide some
protection against heart disease.
Answer: B
Page: 31-35
16. At the end of 2007, the majority of AIDS cases in the U.S. were found in:
a. Homosexual and bisexual men.
b. Homosexual and bisexual women.
c. Intravenous drug users.
d. Blood transfusion patients.
e. Children of a parent with AIDS.
Answer: A
Page: 38
17. The lowest AIDS mortality rates for American males are found in:
a. Native Americans.
b. Non-Hispanic whites.
c. Hispanics.
d. Non-Hispanic African Americans.
e. Asians.
Answer: E
Page: 39
18. Since 2000, the number of AIDS cases has sharply increased in what region of the U.S.?
a. Northwest.
b. West.
c. Midwest.
d. Northeast.
e. South.
Answer: E
Page: 40
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19. AIDS is transmitted in Africa and some parts of Asia primarily by:
a. Heterosexual contact.
b. Homosexual contact.
c. Intravenous drug use.
d. Blood transfusions.
e. Infected mother to child.
Answer: A
Page: 40-41
20. Which of the following plays a particularly important role in the transmission of AIDS in
Sub-Saharan Africa?
a. Government.
b. Health delivery system.
c. Migrant labor force.
d. Homosexuals.
e. Drug users.
Answer: C
Page: 41
21. AIDS now affects _____________ in Africa more than ________________.

a. Whites, natives.
b. Children, adults.
c. Homosexuals, heterosexuals.
d. Men, women.
e. Women, men.
Answer: E
Page: 41
22. ___________ appears to be a major channel for AIDS transmission in India.

a. Marijuana use.
b. Mother to child transmission.
c. Prostitution.
d. Improper sanitation.
e. Overcrowding.
Answer: C
Page: 42
23. The HIV outbreak in China initially occurred among ____________ in Yunnan Province.
a. Bisexuals.
b. Homosexuals.
c. Intravenous drug users.
d. Blood transfusions recipients.
e. Infected mothers to children.
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Answer: C
Page: 42
24. People who become infected with HIV may be subjected to discrimination, which can
isolate them socially. This social outcome is:
a. Stigma.
b. Stagflation.
c. Disintegration.
d. Disentanglement.
Answer: A
Page: 42
25. _______________ activity by Latin American men is believed to be important in the

infection of a large proportion of females.
a. Bisexual.
b. Heterosexual.
c. Intravenous drug use.
d. Homosexual.
e. Illegal.
Answer: A
Page: 42
26. Which of the following demonstrates the sociological implications of the HIV/AIDS
epidemic?
a. Its influence on modifying social norms, values, and lifestyles.
b. How certain social behaviors lead to the transmission of the disease and result in a
pandemic.
c. The social rejection of AIDS patients.
d. Moral and religious debates over the meaning of the disease and treatment
options.
Answer: E
Page: 43
27. Which term describes an individuals most important position in society and typically
comes from ones occupation?
a. Default status.
b. Ordinary status.
c. Master status.
d. Primary status.
e. Main status.
Answer: C
Page: 43
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28. Since AIDS results from a private act that has extreme social consequences, serious moral
and legal questions also arise about the rights of ____________ versus the welfare of
_______________.
a. Individuals, government.
b. Individuals, society.
c. Hospitals, individuals.
d. Hospitals, society.
e. Government, society.
Answer: B
Page: 43
29. The current public policy approach to dealing with AIDS is:
a. Through banning high-risk behaviors.
b. Through mandatory universal testing.
c. Through quarantine of infected individuals.
d. Through safe-sex education.
Answer: D
Page: 43
30. 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.
Answer: D
Page: 44

1. Many sociologists working in the field of medicine are epidemiologists.
Answer: TRUE
Page: 23
2. Present-day epidemiologists primarily study epidemic diseases and give little attention to
other diseases such as chronic ailments or unhealthy behaviors.
Answer: FALSE
Page: 23
3. Prevalence rates, when expressed as point prevalence, period prevalence, or lifetime

prevalence, vary based on the disease being measured.
Answer: FALSE
Page: 24
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4. The simplest ratio computed by the epidemiologist is called the <ITAL>crude rate.
Answer: TRUE
Page: 24
5. Crude death and birth rates are too gross a measure to be meaningful for most
sociological purposes
Answer: TRUE
Page: 25
6. The living conditions of early nomadic humans, with close proximity to others and
exploration of new environments, was favorable to widespread and frequent epidemics.
Answer: FALSE
Page: 26
7. The bubonic plague was ended in 1750 with the development of penicillin.
Answer: FALSE
Page: 27
8. What a person does, who a person is, and where a person lives can specify what health
hazards are most likely to exist in that individuals life.
Answer: TRUE
Page: 28
9. The social environment, referring not only to living conditions but also norms and values,
can cause sickness.
Answer: TRUE
Page: 28
10. Developing nations are typically characterized by a high birth rate and a high death rate,
with a relatively young population.
Answer: TRUE
Page: 29
11. About twice as many males die from heart disease as females, and men are more likely
than women to have a worse prognosis if they survive the first serious heart attack.
Answer: FALSE
Page: 30
12. Smoking is the leading cause of sudden cardiac death in the United States and quitting
smoking nearly eliminates this risk after a year or two.
Answer: TRUE
Page: 31
13. Pandemics are regional or local outbreaks of a disease and rarely happen.
Answer: FALSE
Page: 36
17
14. HIV/AIDS first appeared in intravenous drug users in New York and San Francisco.
Answer: FALSE
Page: 37
15. AIDS potentially entered the U.S. through Haiti.

Answer: TRUE
Page: 38
16. Much of the fear about AIDS arises from the fact that many people who carry the virus
are not aware of it.
Answer: TRUE
Page: 38
17. People most at risk for developing AIDS are those who have had multiple sex partners
and know little about their partners past sexual behavior.
Answer: TRUE
Page: 38
18. In states like Mississippi and North Carolina, more black women than white men have
contracted HIV.
Answer: TRUE
Page: 40
19. Estimating the number of individual flu cases in an outbreak is an easy task, since almost
everyone who becomes sick with the flu requires medical care.
Answer: FALSE
Page: 44
Essay Questions
1. Define incidence and prevalence. Explain the relationship between the two, and identify
which issues with each pertain when examining chronic and acute illnesses.
2. Recognition that germs were causal agents of disease served as a precursor to scientific
findings that people come into contact with a variety of causal agents. Define all five
agents, and provide examples of each type.
3. Describe the four eras of epidemiology.
4. Modification in what four lifestyle areas significantly reduce the risk of heart disease?
Discuss how and why these modifications affect the risk of developing heart disease.
5. Developing and developed nations have a different pattern of disease and illness. List the
most prevalent diseases in both nation types, and discuss why these differences exist.
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Chapter 3
The Social Demography of Health: Social Class
1. Historically, many urban clinics providing treatment for the poor were established
primarily as:
a. A way to use tax dollars.
b. Religious facilities.
c. Medical research facilities.
d. Safe houses.
e. Teaching facilities.
Answer: E
Page: 48
2. Several studies find that the strongest and most consistent predictor of a persons health
and life expectancy is
a. Psychological profile
b. Neighborhood.
c. Gender.
d. Social class.
e. Income.
Answer: D
Page: 49
3. Susan is a white, middle-aged doctor who lives in an affluent neighborhood. Max is a

young, African American lawyer living in a trendy loft district. What social variable are
they most likely to share in common?
a. Ethnicity.
b. Social class.
c. Number of doctor visits.
d. Life expectancy.
e. Good self-rated health.
Answer: B
Page: 49
4. 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.
Answer: D
Page: 49
5. Which is NOT one of the five classes proposed by Weber?
19
a.
b.
c.
d.
e.
Upper class.
Upper-lower class.
Working class.
Upper-middle class.
All of these are correct.
Answer: B
Page: 51
6. 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.
Answer: B
Page: 51
7. 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.
c. Income.
d. Work/employment.
e. Education.
Answer: D
Page: 51
8. 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: 51
9. Social status is a(n) ___________ dimension in social class consisting of how much
esteem the person is accorded by other people.
a. Objective.
b. Subjective.
c. Quantifiable.
d. Hidden.
Answer: B
Page: 51
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10. According to Weber, _________ is the ability to realize ones will even against the
resistance of others.
a. Power.
b. Prestige.
c. Presence.
d. Principle.
Answer: A
Page: 52
11. In quantitative studies, what variables are used to measure socioeconomic status?
a. Social and human capital.
b. Income, occupational prestige, and education.
c. Income and wealth.
d. Status, wealth, and power.
e. Neighborhood characteristics.
Answer: B
Page: 52
12. Which component of social class is consistently the strongest single predictor of good
health?
a. Income.
b. Education.
c. Wealth.
d. Occupation.
e. Neighborhood.
Answer: B
Page: 52
13. New research is showing that the relationship between occupation, income, education,
and health changes over the life course, with __________ becoming more important for
health as a person moves toward older age.
a. Occupation.
b. Education.
c. Income.
Answer: C
Page: 53
14. People living in poverty have the greatest exposure to risk factors producing ill health.
Which of the following is a risk factor that is influenced by socioeconomic
circumstances?
a. Physical.
b. Biological.
c. Psychological.
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d. Lifestyle.
Answer: E
Page: 54
15. In the United States, heart disease has ______________ over the past 30 years.
a. Increased.
b. Decreased.
c. Stayed the same.
d. Been eradicated.
e. Mildly increased.
Answer: B
Page: 55
16. Changes in lifestyle patterns over the past decades has meant that coronary heart disease
is now concentrated more among which group?
a. Upper class.
b. Upper-middle class.
c. Middle class.
d. Working class.
e. Poor/lower class.
Answer: E
Page: 55
17. The type of lifestyle that promotes a healthy existence is typical in which class?
a. Upper class.
b. Middle class.
c. Working class.
d. Both A and B.
e. Both B and C.
Answer: D
Page: 55
18. Which of the following are more prevalent among the upper and middle classes?
a. Schizophrenia.
b. Anxiety and mood disorders.
c. Substance-related disorders.
d. All of the above
Answer: B
Page: 55
19. According to Richard Wilkinson, which is the most important variable influencing a
countys overall level of health?
a. Degree of modernization.
b. Access to quality health care.
22
c. Income inequality within a country.

d. Overall wealth of the country.
e. Cultural lifestyles that promote health.
Answer: C
Page: 56
20. Several studies in Britain, with its universal health care, have shown that the equalization
of health care alone has _____________ the disparity in health between social classes.
a. Reduced.
b. Not reduced.
c. Eliminated.
d. Reversed.
e. Exaggerated.
Answer: B
Page: 56
21. Compared to other social classes, lower class individuals visit physicians _________.
a. The same amount.
b. Less often.
c. More often.
d. Not at all.
Answer: C
Page: 57
22. What 1980 report in Great Britain dispelled the notion that social class differences were
becoming less important because of the growth of state welfare services?
a. Health in Britain.
b. Disparities Report.
c. Black Report.
d. Whitehall Report.
Answer: C
Page: 57
23. The Whitehall studies conducted in Britain demonstrated that regardless of cause of
death, which group had the lowest rates of mortality?
a. Senior administrators.
b. Professional/executives.
c. Clerical.
d. Other low status jobs.
e. No relation to rank.
Answer: A
Page: 57
23
24. The finding that even the upper middle class lives shorter than the uppermost class, and
that every class lives longer than the one directly below it is evidence of what?
a. Educational differences.
b. Influence of deprivation.
c. Social gradient in mortality.
d. Social patterning of disease.
Answer: C
Page: 59
25. The cause(s) of the social gradient is most likely related to differences between
socioeconomic groups and classes in:
a. Self-esteem and stress levels.
b. The effects of income inequality.
c. Deprivation through the life course.
d. Health lifestyles and social support.
e. Some combination of all of the above.
Answer: E
Page: 60
26. What group uses preventative services the least?

a. Upper class.
b. Middle class.
c. Working class.
d. Lower class.
Answer: D
Page: 60
27. Neighborhood disadvantage focuses on:

a. Poor neighborhoods.
b. Unhealthy urban living conditions.
c. Southern states with high rates of poverty.
d. Minority-populated neighborhoods.
Answer: B
Page: 62
28. Which of the following is NOT one of the features of neighborhoods that can influence
health?
a. Physical environment.
b. Support services.
c. Sociocultural aspects.
d. Reputation of an area.
e. Racial makeup of the neighborhood.
24
Answer: E
Page: 62
29. ______________ neighborhoods are clean and safe, houses and buildings are wellmaintained, and residents are respectful of each other and each others property.
a. Orderly.
b. Disorderly.
c. Suburban.
d. Urban.
e. Government.
Answer: A
Page: 62
30. In order for a social variable to qualify as a cause of sickness and mortality it must meet
which criteria?
a. Influence multiple diseases.
b. Affect diseases through multiple pathways of risks.
c. Be reproduced over time.
d. Involve access to resources that can be used to avoid risks.
Answer: E
Page: 64

1. To be poor is by definition to have less of the good things in life, including health and
longevity
Answer: TRUE
Page: 48
2. Improved access to health services is the primary solution for advancing health.
Answer: FALSE
Page: 49
3. Socioeconomic status or social class is the strongest predictor of a persons life

expectancy.
Answer: TRUE
Page: 49
4. Whereas Americans focus on a persons occupation in determining that individuals

location in a class hierarchy, British sociologists use a broader measure.
Answer: FALSE
Page: 51
5. The concept of SES is derived from ideas about social stratification put forward by
Weber.
25
Answer: TRUE
Page: 51
6. Status indicates a persons level of social prestige, which typically corresponds to wealth.
Answer: FALSE
Page: 51
7. People with similar class standing generally have similar lifestyles.

Answer: TRUE
Page: 52
8. The well-educated are more likely to smoke and less likely to exercise than their lesseducated counterparts.
Answer: FALSE
Page: 52
9. The relative influence of income and education on health changes over the life course.
Answer: TRUE
Page: 53
10. Income is significant with respect to differences in the onset of chronic disease and
physical limitations, but education is more strongly associated with the manner in which
the health problems progressed over time.
Answer: FALSE
Page: 53
11. Heart disease has been decreasing in Japan due to the spread of Western medicine. 
Answer: FALSE
Page: 54-55
12. The lower class is disadvantaged with respect to physical, but not mental health.
Answer: FALSE
Page: 55
13. Wilkinsons theory of the relationship of inequality to population health has received
strong support from numerous other studies and is currently the leading explanation of
health disparities.
Answer: FALSE
Page: 56
14. The social gradient in mortality links chance of death to differences in hierarchy rather
than deprivation.
Answer: TRUE
Page: 59
15. The Black Report provided strong evidence that the lower a person is on the social scale,
the less healthy that person is likely to be.
26
Answer: TRUE
Page: 60
16. Recent evidence has found that unemployment itself does not cause deterioration in
mental health.
Answer: FALSE
Page: 60
17. Poor housing quality is a problem in less-developed countries, but not in industrialized
nations.
Answer: FALSE
Page: 61
18. Neighborhoods contain resources needed to produce good or poor health for its residents.
Answer: TRUE
Page: 62
19. The fundamental social cause thesis suggests that social class contributes to poor health
and mortality, but is not a direct cause.
Answer: FALSE
Page: 64
20. White-collar jobs tend to be more dangerous and stressful than blue-collar jobs and to
carry inferior health benefits.
Answer: FALSE
Page: 65
Essay Questions
1. Social class is made of multiple components. Identify these components, and comment on
their contribution to the overall idea of social class.
2. The poor fall victim to different diseases at different rates compared to more affluent
classes. Identify some diseases of the lower class, and discuss why these are more
prevalent.
3. What is neighborhood disadvantage? Discuss how it is related to health.
4. In order for a social variable to qualify as a cause of mortality, Link and Phelan
hypothesize that it must meet four criteria. List those criteria. Does social class meet
these criteria? How so, or why not?
5. Discuss the Whitehall studies conducted by Marmot. What were the main findings in
terms of social class and health?
Chapter 4
27
The Social Demography of Health: Gender, Age, and Race

1. In 2008, a nationwide study of mortality in the United States revealed that life expectancy
for part of the nations women had ___________ significantly between 1983 and 1999.
a. Stagnated.
b. Fluctuated.
c. Remained the same.
d. Increased.
e. Decreased.
Answer: E
Page: 69
2. What has been the general pattern in life expectancy during the 20th century with respect
to men and women?
a. Women outlive men only in a handful of countries.
b. Both men and women gained approximately the same amount.
c. Men gained more than women in the first half of the century, but dramatic social
change in recent decades has meant that women are catching up to men.
d. Women gained more than men in the first half of the century but since then men
have made greater gains and the gap is narrowing.
Answer: D
Page: 70
3. Today, women outlive men by how many years?

a. 1
b. 3
c. 5
d. 7
e. 10
Answer: C
Page: 71
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: 72
28
5. Compared to women, men usually have substantial health inferiority in terms of life
expectancy because of the combination of two major effects: biological and ___________
effects.
a. Physical exertion.
b. Developmental.
c. Social-psychological
d. Environmental.
e. Marital.
Answer: C
Page: 72
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: 72
7. The most dangerous job in the United States is that of a:

a. Fisherman.
b. Fireman.
c. Police officer.
d. Doctor.
e. Landscaper.
Answer: A
Page: 73
8. Morbidity is:
a. Sadness.
b. The cause of illness.
c. The amount of sickness.
d. The rate of death.
Answer: C
Page: 73
9. About _____________ Americans die each year from smoking-related diseases.

a. 250,000
b. 450,000
c. 800,000
d. 1,000,000
e. 1,250,000
Answer: B
Page: 75
29
10. ________________ has been found to make women particularly vulnerable to

psychological distress.
a. Lack of control.
b. Astrological patterns.
c. Climate change.
Answer: A
Page: 79
11. In 2006, the average infant in the U.S. could expect to live for ______ years.
a. 68
b. 72
c. 78
d. 85
e. 88
Answer: C
Page: 80
12. What is the fertility rate?

a. The age until a female remains fertile.
b. The number of births per women of childbearing age.
c. The rate of fertile women in a given country, region, etc.
d. The number of pregnancies a woman has.
Answer: B
Page: 80
13. By 2050 it is projected that _______ of all Americans will be 65 or older.

a. 10%
b. 15%
c. 20%
d. 25%
e. 30%
Answer: C
Page: 80
14. What federal program provides health insurance to those 65 years and older?
a. Pensions.
b. Social Security.
c. Medicare.
d. Medicaid.
e. Medihealth.
Answer: C
Page: 81
30
15. Which of the following trends is most likely to strain health care delivery systems and
public health insurance in future years?
a. Increasing proportion of elderly in the population.
b. Increasing size of the Hispanic population.
c. Medical tourism.
d. Reemergence of infectious diseases.
Answer: A
Page: 81
16. Many elderly rate their health as good despite the health problems that often accompany
aging. What does this phenomenon suggest about the usefulness of self-rated heath as a
tool to measure health?
a. It is not accurate and probably should not be used.
b. Self-assessments are relative, since people compare themselves to others similar
in age and sex.
c. As people become older they revise their definition of healthy to fit their
circumstances.
d. Both A and B.
e. Both B and C.
Answer: E
Page: 82
17. What is most prevalent health problem of persons over the age of 65?
a. Heart disease.
b. Stroke.
c. Cancer.
d. Hypertension.
e. Arthritis.
Answer: E
Page: 83
18. Which racial group in the United States is especially disadvantaged in regard to health?
a. Non-Hispanic whites.
b. Non-Hispanic blacks.
c. Hispanics.
d. Asians/Pacific Islanders.
e. American Indians/Alaskan Natives.
Answer: B
Page: 83
19. The _____________ hypothesis asserts that blacks are more prone to diseases such as
pyelonephritis and syphilis that may result in secondary hypertension.
a. Associated disorder.
b. Genetic.
31
c. Psychological stress.
d. Physical exertion.
e. Diet.
Answer: A
Page: 84
20. Some research suggests that the _____________ hypothesis and the psychological stress
hypothesis contribute the most to providing an answer for the higher prevalence of
hypertension in blacks, since blacks in general have higher rates of hypertension than
whites.
a. Associated disorder.
b. Genetic.
c. Psychological stress.
d. Physical exertion.
e. Diet.
Answer: B
Page: 84
21. For all causes of death, _____________ have the highest death rates.
a. Whites.
c. Hispanics.
Answer: B
Page: 85
22. For all causes of death, _____________ have the lowest death rates.
c. Hispanics.
Answer: D
Page: 86
23. A major factor causing the infant mortality difference between blacks and whites is:
a. Sanitation.
b. Health care.
c. Poverty.
d. Education.
e. Insurance.
Answer: C
Page: 86
32
24. __________ represents the convergence of biological factors with geographic origins,
and cultural, economic, political, and legal factors.
a. Race.
b. Age.
c. Ethnicity.
d. Gender.
Answer: A
Pages: 86
25. Although obesity affects people of all races, low-income _____________, have the
highest concentration of obesity in American society.
c. Hispanics.
Answer: B
Page: 87
26. What is the intra-racial network effect?

a. It says that there is no difference in STDs across different racial groups.
b. It discusses how health is improved by cross-cultural alliances and relationships.
c. The IRNE is a theory, which says that Hispanics are more likely to have an STD
due to their residence in enclaves.
d. It asserts that because of cross-cultural sex partners, STDs are spreading.
e. It suggests that segregation contributes to the high rate of STDs in the black
population.
Answer: E
Page: 88
27. _______________ are the largest minority group in American society.

c. Hispanics.
Answer: C
Page: 90
28. In 2050, nearly _______ of Americans will be Hispanic.

a. 15%
b. 20%
c. 25%
d. 30%
e. 35%
33
Answer: C
Page: 90
29. What minority group is most likely to use hospital emergency rooms as their primary
source of medical services?
c. Hispanics.
Answer: C
Page: 91
30. Suicide is a major health concern for which minority group?

c. Hispanics.
Answer: E
Page: 92

1. A 2008 study found a decline in female life expectancy. The decline was most common in
urban, low-income female populations.
Answer: FALSE
Page: 69
2. The downturn in female life expectancy was due to a rise in mortality from chronic
diseases related to smoking, obesity, and high blood pressure.
Answer: TRUE
Page: 69
3. A decline in female life expectancy is expected in the wealthiest countries, with the
highest spending on health care.
Answer: FALSE
Page: 69
4. The lives of men and women used to be more predictable in that men typically behaved
in certain distinct ways and women in others.
Answer: TRUE
Page: 70
5. Patterns are emerging that show Americans moving toward greater inequality in mortality
between the sexes.
34
Answer: FALSE
Page: 70
6. Women tend to suffer from more frequent illnesses and disability, but their usual health
disorders are not as serious or as life threatening as those encountered by men
Answer: TRUE
Page: 72
7. Although white females live longer than white males, black males live longer than black
females.
Answer: FALSE
Page: 72
8. Accidents cause more deaths among females than males.

Answer: FALSE
Page: 72
9. There is an inverse relationship between mortality and morbidity when gender differences
are considered.
Answer: TRUE
Page: 74
10. Studies of self-rated health typically show women rating their own health less positively
than men do.
Answer: TRUE
Page: 75
11. The current trend in the United States is toward a decrease in smoking for females, but an
increase for males.
Answer: FALSE
Page: 76
12. Prior to 1979, Hispanics were counted as either white or black and not as a separate racial
category by the National Center for Health Statistics.
Answer: FALSE
Page: 77
13. It appears that Hispanics have lower rates of smoking than either non-Hispanic whites or
blacks.
Answer: TRUE
Page: 77
14. Projections for 2010 put the number of elderly at around 40 million.
Answer: TRUE
Page: 80
35
15. Typically, older people rate their health in a negative fashion

Answer: FALSE
Page: 82
16. The adverse health situation of black Americans identifies a pattern that is generally
produced by biological, not socioeconomic factors.
Answer: FALSE
Page: 86
17. Perceptions of racism and racial harassment are associated with poor health.
Answer: TRUE
Page: 86
18. Obesity adversely affects physical and psychological well-being.

Answer: TRUE
Page: 88
19. Hispanic immigrants are generally in poor health when they arrive in the United States.
Answer: FALSE
Page: 90
20. American Indians have an exceptionally high prevalence of alcoholism.

Answer: TRUE
Page: 92
Essay Questions
1. Discuss the relationship between gender and overall health.
2. Various hypotheses have been suggested to explain the rates of hypertension in African
Americans. Six are discussed in this chapter. Identify these hypotheses and discuss their
validity.
3. What is the Hispanic paradox? Provide a thorough explanation, examples of this
phenomenon, and discuss what makes it less of a paradox.
4. Discuss patterns of morbidity and mortality between blacks, whites, Hispanics, and
Asians.
5. What health care changes should be expected resulting from our aging population?
Chapter 5
Social Stress and Health
36
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.
Answer: A
Page: 97
2. What is an example of a stressful situation?

a. Death.
b. Divorce.
c. Marriage.
d. A and B only.
Answer: E
Page: 97
3. The work of ______________ reflects the symbolic interactionist approach to human

behavior.
a. Durkheim.
b. Thomas.
c. Marx.
d. Brenner.
Answer: B
Pages: 98
4. Symbolic interactionism is based upon the work of ________________ (founder).

a. Drentea.
b. Bourdieu.
c. Cooley.
d. Mead.
e. Durkheim.
Answer: D
Page: 98
5. The theory of the _______________ maintains that our self-concepts are the result of
social interaction in which we see ourselves reflected in other people.
a. Looking mirror.
b. Glass selfish sense.
c. Looking-glass self.
d. Mirror in mirror.
Answer: C
Page: 98
37
6. Which is NOT a component of Coleys theory?

a. We see in our imagination the other persons 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.
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: 98
7. Goffman believed that in order for social interaction to be possible, people need
information about the others in a joint act. Such information is communicated through:
a. A persons appearance.
b. A persons experience with other similar individuals.
c. The social setting.
d. The information communicated about her/himself through words and actions.
Answer: E
Page: 99
8. The positive social value that individuals claim for themselves by the line that others
assume they have taken during a particular encounter is termed a _____________.
a. Veil.
b. Form.
c. Face.
d. Shield.
e. Self.
Answer: C
Page: 99
9. The _____________ is more important than anything else to us, because it represents
who we are and is always with us.
a. Veil.
b. Form.
c. Face.
d. Shield.
e. Self.
Answer: E
Page: 100
10. The symbolic interactionist perspective, as outlined by Cooley, Thomas, and Goffman
asserts that:
a. Certain situations are inherently stressful.
b. Stress is caused by societal pressure to conform.
c. Stress can result from an individual's perception of the meaning of a situation.
38
d. Stress is constant.
e. All four answers are features.
Answer: C
Page: 100
11. As members of society, individuals are constrained in their behavior by laws and
customs. These constraints are ______________.
a. Imagined.
b. Realities.
c. Social nuances.
d. Social facts.
e. Norms.
Answer: D
Page: 100
12. Durkheim suggests that society has an existence __________ the individual.
a. Outside.
b. Inside.
c. Beside.
d. Within.
Answer: A
Page: 100
13. Which suicide type was not fully developed by Durkheim?

a. Egoistic.
b. Fatalistic.
c. Altruistic.
d. Anomic.
Answer: B
Page: 101
14. ______________ suicide occurs when people become detached from society and,
suddenly on their own, are overwhelmed by the resulting stress.
a. Egoistic.
b. Fatalistic.
c. Altruistic.
d. Anomic.
Answer: A
Page: 101
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.
39
a.
b.
c.
d.
e.
Egoistic.
Fatalistic.
Altruistic.
Anomic.
None of the above.
Answer: D
Page: 101
16. ______________ suicide occurs when people feel themselves so strongly integrated into
a demanding society that their only escape seems to be suicide.
a. Egoistic.
b. Fatalistic.
c. Altruistic.
d. Anomic.
Answer: C
Page: 101
17. The importance of Emile Durkheim's work for understanding stress lies in his:
a. Typology of three specific types of suicide.
b. Denial of biological influences on human behavior.
c. Insight into the link between the state of the economy and certain types of illness.
d. Notion of the capability of society to create situations where people are
constrained to respond with certain behavior.
Answer: D
Pages: 101-102
18. Brenners thesis is that there are few areas of our lives not intimately affected by the state
of the _________________.
a. Economy.
b. Family.
c. Political system.
d. Environment.
e. Self.
Answer: A
Page: 102
19. Brenner offers two hypotheses to explain the relationship between the economy and
mental health. What are they?
a. Provocation and complacency.
b. Inflation and uncovering.
c. Inflation and stagflation.
d. Provocation and reduction.
e. Provocation and uncovering.
40
Answer: E
Page: 102-103
20. What is homeostasis?

a. Changing constantly.
b. Physiological adaptation.
c. Not moving or adapting.
d. Physically growing.
Answer: B
Page: 103
21. The ______________ system controls heart rate, blood pressure, and gastrointestinal
functions: processes that are not under the control of the central nervous system.
a. Limbic.
b. Respiratory.
c. Endocrine.
d. Autonomic.
Answer: D
Page: 104
22. Who developed the theory known as the <ITAL>general adaptation syndrome?
a. Brenner.
b. Siegrist.
c. Selye.
d. Goffman.
e. Pearlin.
Answer: C
Page: 105
23. Who suggests two major types of stressors: life events and chronic strains?
a. Brenner.
b. Siegrist.
c. Selye.
d. Goffman.
e. Pearlin.
Answer: E
Page: 106
24. The extent of physiological damage or change within an individual depends on:
a. The stimulus situation.
b. An individuals capacity to deal with the stimulus situation.
c. The individuals preparation by society to meet problems.
d. The influence of societys approved modes of behavior.
41
Answer: E
Page: 107
25. What is defined by Turner as the social investments of individuals in society in terms of
their membership in formal and informal groups, networks, and institutions?
a. Social facts.
b. Social networks.
c. Social capital.
d. Social circumstances.
Answer: C
Page: 108
26. 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.
Answer: C
Page: 109
27. Hurricane Katrina is an example of a(n):

a. Natural disaster.
b. Life event.
c. Chronic stressor.
d. Extreme situation.
Answer: E
Page: 110
28. Antonovsky argues that ______________ is a personal orientation that allows an

individual to view the world with feelings of confidence, faith in the predictability of
events, and a notion that things will most likely work out reasonably well.
a. Confidence.
b. Coherence.
c. Delusion.
d. Optimism.
Answer: B
Page: 112
29. Which situations are more stressful in the long term?

a. Extreme situations.
b. Non-extreme situations.
c. Extraordinary life events.
42
d. Ordinary life events.

Answer: D
Page: 113-114
30. Besides the type of change and the speed with which it occurs, the extent to which
change affects a persons life may also be important. Libby Ruch (1977) investigated this
over 30 years ago and suggested that life change actually has three dimensions. Which is
NOT a dimension?
a. Degree of change evoked.
b. Undesirability of change.
c. Depth of change expected.
d. Aspect of ones life that is affected.
e. None are dimensions.
Answer: C
Page: 115

1. Social situations can cause severe stress that, in turn, affects health and longevity.
Answer: TRUE
Page: 97
2. Stress typically starts with a situation that people find non-threatening.

Answer: FALSE
Page: 97
3. Mead compares the reflection of our self in others to our reflections in a looking glass.
Answer: FALSE
Page: 98
4. Symbolic interaction theory emphasizes interpersonal forms of interaction.

Answer: TRUE
Page: 100
5. Functionalist theory focuses on the influence of individuals on the larger society.

Answer: FALSE
Page: 100
6. Functionalist theory is derived from the initial work of Emile Durkheim.

Answer: TRUE
Page: 100
7. Brenner formulated the concept of the fight or flight pattern of physiological change to
illustrate how the body copes with stress resulting from a social situation.
43
Answer: FALSE
Page: 104
8. When a person experiences fear or anxiety, the body undergoes psychological changes
that prepare it for vigorous effort and the effect of possible injury.
Answer: TRUE
Page: 104
9. Most threats in modern society are symbolic, not physical, and they do not usually
require a physical response.
Answer: TRUE
Page: 105
10. A number of studies have shown that the human organisms inability to manage the
social, psychological, and emotional aspects of life can lead to health problems.
Answer: TRUE
Page: 105
11. The outcome or effect of a crisis depends on how well a person comes to terms with the
situation. 
Answer: TRUE
Page: 106
12. Mechanic believes that in social situations people use the same skills and abilities in
coping with problems.
Answer: FALSE
Page: 106
13. Most people have an equal degree of control in managing emotional defenses or similar
motivation and personal involvement in a given situation.
Answer: FALSE
Pages: 106-7
14. Peoples perceptions of an event may be influenced by their intelligence.

Answer: TRUE
Page: 107
15. Conformity to group-approved attitudes and definitions has been hypothesized to reduce
anxiety. 
Answer: TRUE
Page: 108
16. Social capital is a property of individuals, not a characteristic of networks.

Answer: FALSE
Page: 109
17. Social connectedness, in Putnams view, is one of the weakest determinants of health.
44
Answer: FALSE
Page: 109
18. The lower class is characterized as having the fewest resources to cope with stress.
Answer: TRUE
Page: 109
19. The upper class and the upper middle class have about the same longevity, which is
greater than the lower class.
Answer: FALSE
Page: 110
20. People typically flee in panic from the site of a potential disaster (natural/unnatural) area.
Answer: FALSE
Page: 110
Essay Questions
1. Define social stressors, life events, and life changes. How do these concepts relate to
stress?
2. How does functionalist theory explain stress? How does symbolic interaction theory
explain stress? How do the two viewpoints differ?
3. Describe Patricia Drenteas (2000) research on stress, age, and credit card debt.
4. What are the features of life events that cause stress in individuals?
5. Describe the three types of suicide outlined by Durkheim. How do they relate to stress?
Chapter 6
Health Behavior and Lifestyles
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.
Answer: B
Page: 120
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?
45
a.
b.
c.
d.
e.
Health lifestyles.
Illness behavior.
Health behavior.
Health promotion.
Premedical.
Answer: C
Page: 120
3. What are collective patterns of health-related behavior based on choices from options
available to people according to their life chances?
a. Health lifestyles.
b. Illness behavior.
c. Health behavior.
d. Health promotion.
e. Premedical.
Answer: A
Page: 121
4. According to the World Health Organization, significant improvements in health in the

19th century were brought about by what might be called ____________ methods.
a. Engineering.
b. Medical.
c. Preventative.
d. Health lifestyles.
e. Health behavior.
Answer: A
Page: 121
5. According to the World Health Organization, we are currently living in the

_____________ era.
a. Engineering.
b. Medical.
c. Postmedical.
d. Hypermedical.
e. Premedical.
Answer: C
Page: 121
6. Crawford points out, there has been a growing recognition of positive health behaviors,
facilitated by:
a. Mass media.
b. Word of mouth.
c. The spread of disease.
d. Education.
e. Technology.
46
Answer: A
Page: 122
7. What disease is, typically, NOT caused by particular styles of living?

a. Alcoholism.
b. AIDS.
c. Lung cancer.
d. Heart disease.
e. All of these are caused by individual behaviors.
Answer: E
Page: 122
8. ___________ suggested that a persons social class position is determined exclusively by

his or her degree of access to a societys means of production.
a. Weber.
b. Durkheim.
c. Marx.
d. Wickrama.
e. Bourdieu.
Answer: C
Page: 122
9. According to the sociologist Max Weber, lifestyles are based upon a persons relationship
to the means of:
a. Consumption.
b. Needs.
c. Wants.
d. Production.
Answer: A
Page: 123
10. Lebensfhrung 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: 123
11. ____________ refers to the choices that people have in the <DOCPAGE
NUM="103"></DOCPAGE>lifestyles they wish to adopt.
a. Life chances.
b. Life conduct.
c. Life behaviors.
d. Agency.
47

Answer: B
Page: 123
12. Weber maintains that life __________ influence life conduct/life choices.
a. Realities.
b. Chances.
c. Modes.
d. Demands.
Answer: B
Page: 123
13. Health lifestyles are common to which social class?

a. Upper classes.
b. Upper and middle classes.
c. Middle classes.
d. Lower classes.
Answer: E
Page: 124
14. Health lifestyles emphasizing exercise, sports, a healthy diet, avoidance of unhealthy
practices such as smoking, and so on originated in the:
a. Working class.
b. Lower class.
c. Lower middle class.
d. Upper middle class.
e. Upper class.
Answer: D
Page: 124
15. What is a class-based set of durable dispositions to act in particular ways that shape
particular facets of health lifestyles?
a. Life chances.
b. Norms.
c. Habitus.
d. Lifestyles.
e. Life conduct.
Answer: C
Page: 125
16. _______________ is the notion that the more distant a person is from economic
necessity, the more freedom and time that <DOCPAGE
NUM="105"></DOCPAGE>person has to develop and refine personal tastes in line with
a more privileged class status.
48
a.
b.
c.
d.
e.
Distance from norm.

Distance from normality.
Distance from mean (average).
Distance from poverty.
None of the above.
Answer: E
Page: 126
17. What is NOT a category of social structural variables that have the potential to shape
health lifestyles?
a. Class circumstances.
b. Age, gender, and race/ethnicity.
c. Collectivities.
d. Languages/linguistics.
e. Living conditions.
Answer: D
Pages: 126
18. What is the likely the most powerful influence on lifestyle forms?
a. Class circumstances.
b. Age, gender, and race/ethnicity.
c. Collectivities.
d. Languages/linguistics.
e. Living conditions.
Answer: A
Pages: 126
19. What are collections of actors linked together through particular relationships, such as
kinship, work, religion, and politics?
a. Guilds.
b. Collectivities.
c. Knitting circles.
d. Social groups.
Answer: B
Page: 129
20. The interaction between life choices and life chances produces ___________ toward
particular forms of action. These constitute a habitus, according to Bourdieu.
a. Expectations.
b. Practices.
c. Lifestyles.
d. Dispositions.
Answer: D
Page: 129
49
21. _____________ may be either positive or negative, but nonetheless comprise a persons
overall pattern of health lifestyles.
a. Expectations.
b. Practices.
c. Lifestyles.
d. Dispositions.
Answer: B
Page: 129-30
22. ____________ consumption of red wine is beneficial for preventing heart disease.
a. Abstinence from.
b. Mild.
c. Moderate.
d. Heavy.
e. Sporadic.
Answer: C
Page: 135
23. The French norm of duty to be healthy was strongest in the _______________.
a. Working class.
b. Lower class.
c. Middle class.
d. Upper class.
e. All classes.
Answer: C
Page: 135
24. In 2008, the average life expectancy for a Russian male was _______ years.
a. 56.
b. 62.
c. 66.
d. 69.
e. 73.
Answer: B
Page: 136
25. Health lifestyles activities typically take place __________ the health care delivery
system.
a. Inside.
b. Outside.
c. Beyond.
d. In conjunction with.
e. Near.
50
Answer: B
Page: 137
26. What refers to routine physical examinations, immunizations, prenatal care, dental
checkups, screening for heart disease and cancer, and other services intended to ensure
good health and to minimize the effects of illness if it occurs?
a. Routine checkups.
b. Health behavior.
c. Preventive care.
Answer: C
Page: 137
27. What is the reason many low-income persons do not have a source of medical care?
a. Health facilities may not be near.
b. Costs may not be covered by health insurance.
c. They may lack health insurance.
d. B and C only.
Answer: E
Page: 137
28. ______________ of preventive care among the poor is common.

a. Underutilization.
b. Overutilization.
c. Utilization.
d. There is extensive utilization diversity even in the poor.
Answer: A
Page: 137
29. One influential social-psychological approach designed to account for the ways in which
healthy people seek to avoid illness is:
a. The health lifestyles model.
b. Maslows hierarchy of care.
c. The health belief model.
d. The illness behavior model.
e. The health-seeking behavior system.
Answer: C
Page: 138
30. In Rosenstocks model, what would NOT be an example of an external trigger?

a. Personal knowledge of someone affected by the health problem.
b. Mass media communication.
c. Interpersonal interaction.
d. Perception of bodily states.
51
e. All of these are examples of external triggers.

Answer: D
Page: 138

1. Health-oriented behavior pertains just to those activities concerned with recovering from
disease or injury.
Answer: FALSE
Page: 120
2. Health behavior is the activity undertaken by sick people to regain their health.
Answer: FALSE
Page: 120
3. The focus in medical sociology is on the health behavior of the individual.

Answer: FALSE
Page: 121
4. A persons life chances are largely determined by his or her class position.
Answer: TRUE
Page: 121
5. The first 60 years of the 20th century was the premedical era.
Answer: FALSE
Page: 121
6. Members of the same status group share similar lifestyles.

Answer: TRUE
Page: 122
7. Ones lifestyle is a reflection of the types and amounts of goods and services one
produces and desires.
Answer: FALSE
Page: 123
8. Ones life chances are rarely shaped by ones socioeconomic circumstances.

Answer: FALSE
Page: 124
9. There is evidence to show that health lifestyles emphasizing exercise, healthy diet, and
avoidance of unhealthy habits such as drugs, alcohol, and smoking are spreading across
class boundaries in Western society.
Answer: TRUE
Page: 124
52
10. The wealthy show the highest proportion of cigar and cigarette smokers.
Answer: FALSE
Page: 125
11. Most studies on race address differences in sickness and mortality rather than health
lifestyle practices.
Answer: TRUE
Page: 126
12. Some studies suggest that religious attitudes and behaviors can have a negative effect on
numerous health-related activities. 
Answer: FALSE
Page: 129
13. There has been extensive research performed linking living conditions to health lifestyles.
Answer: FALSE
Page: 129
14. Agency is a term referring to the process by which people critically evaluate and choose
their course of action.
Answer: TRUE
Page: 129
15. The healthiest state in 2009 was Vermont, followed by Louisiana.

Answer: FALSE
Page: 131
16. Germany has an extensive system of national health insurance that covers over 90 percent
of the total population. 
Answer: TRUE
Page: 132
17. The more paternalistic German system of health insurance coverage appears to
undermine personal incentives to stay fit in comparison to the American system, where
individuals are more responsible for their own health.
Answer: FALSE
Page: 132
18. It appears that health lifestyles are spreading in British society, and distinct differences
between the social classes no longer remain.
Answer: FALSE
Page: 133
19. The case cannot be made that healthy lifestyles have spread completely throughout
Western society on the basis of the existing studies.
53
Answer: TRUE
Page: 135
20. An important facet of health behavior includes contact by healthy people with physicians
and other health personnel for preventive care.
Answer: TRUE
Page: 137
Essay Questions
1. What are the major components of Weber's concept of lifestyles and how do these
components influence each other?
2. Why are health lifestyles gaining in significance as the 21st century approaches? Explain
your answer.
3. How do agency and structure influence health lifestyles?
4. Explain Rosenstocks health belief model.
5. An extensive ten-year survey of the health lifestyles of nearly 7,000 adults in Alameda
County, California, identified seven good health practices. What are these practices, and
how to they relate to health and longevity?
Chapter 7
Illness Behavior
1. The most common response to symptoms of illness by people throughout the world is:
a. Health behavior.
b. Illness behavior.
c. Self care.
d. Doctor visits.
Answer: C
Page: 143
2. Visits to physicians are higher for:

a. Males.
b. Females.
54
c. Adults.
d. No difference in the response options.
Answer: B
Page: 144
3. The data in the Dutton (1978) study on health care utilization among the poor favored the
_______________ hypothesis.
a. Systems barrier.
b. Financial coverage.
c. Culture of poverty.
d. Disparities.
Answer: A
Page: 153
4. Which group has the highest percentage of persons without health insurance?
a. Non-Hispanic white.
b. Non-Hispanic black.
c. Hispanic, Mexican.
d. Asians.
e. European migrants.
Answer: C
Page: 149
5. Which social class visits doctors the least?

a. Upper classes.
b. Upper and middle classes.
c. Middle classes.
d. Lower classes.
Answer: A
Page: 152
6. 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.
Answer: B
Page: 145
7. Persons with a strong internal locus-of-control tend to have:

55
a.
b.
c.
d.
e.
More self-initiated preventive care.

Less self-initiated preventive care.
More optimism about the effectiveness of care.
Less pessimissim about the effectiveness of care.
None of the above.
Answer: A
Page: 157
8. Which stage of Suchman's concept of the illness experience requires decision-making by

the sick person?
a. The symptom experience.
b. Medical care contact.
c. Assumption of the sick role.
d. Dependent-patient role.
Answer: E
Page: 161
9. According to Suchman, persons in a cosmopolitan group were found to:

a. Demonstrate high ethnic exclusivity.
b. Distrust health professionals.
c. Be very dependent on others while sick.
Answer: E
Page: 145
10. ________________ interpretations of feeling states are medically significant, because

sometimes physical changes are not obvious.
a. Objective.
b. Subjective.
c. Professional.
d. Thoughtful.
Answer: B
Page: 142
11. Which is NOT 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: 143
56
12. A number of factors have promoted self-care on the part of laypersons. Which is NOT a
factor?
a. The shift in disease patterns from acute to chronic illnesses.
b. Dissatisfaction with professional medical care that is depersonalized.
c. Recognition of the limits of modern medicine.
d. The increasing awareness of alternative healing practices.
e. All of the above are factors promoting self-care.
Answer: E
Page: 143
13. People have been doing self-care for ______________ and it is made easier today by
access to the Internet with its abundance of medical information.
a. A couple years.
b. Decades.
c. Centuries.
d. Self-care is relatively new, and we dont know how long it has been occurring.
Answer: C
Page: 143
14. People engage in self-care in a manner ____________ with medical norms, values, and
information.
a. Consistent.
b. Inconsistent.
c. At odds with.
d. In tandem.
Answer: A
Page: 143
15. Studies of the utilization of medical services by the aged indicate that such use is
determined more by ___________ need than any other single factor.
a. Actual.
b. Perceived.
c. Medically directed.
d. Economic.
Answer: A
Page: 144
16. Which point in the life course is NOT a peak period for when women visit doctors the
most?
a. Childhood.
b. Childbearing years.
c. After 35.
d. After 45.
57
e. All of these are peaks in the visitation pattern for females.

Answer: C
Page: 144
17. Womans reproductive role accounts for less than _________ of all doctor visits.
a. 10%.
b. 20%.
c. 30%.
d. 40%.
e. 50%.
Answer: B
Page: 144
18. Who is NOT part of the lay-referral system?

a. Family.
b. Friends.
c. Neighbors.
d. All are part of the lay-referral system.
e. None are part of the lay-referral system.
Answer: D
Page: 145
19. The process by which a family provides a child with a specific social identity is:
a. Classification.
b. Socialization.
c. Enculturation.
d. Brain washing.
Answer: B
Page: 146
20. Which refers to the social relationships a person has during day-to-day interaction, which
serves as the normal avenue for the exchange of opinion, information, and affection?
a. Intrapersonal affect.
b. Lay-referral system.
c. Family.
d. Social network.
Answer: D
Page: 146
21. Which is NOT an example of an alternative medical practitioner?

a. Faith healers.
b. Folk healers.
c. Osteopaths.
d. Acupuncturists.
58
e. Herbalists.
Answer: C
Page: 147-148
22. Which is NOT an example of a modern medical practitioner?

a. Podiatrists.
b. Chiropractors.
c. Druggists.
d. Optometrists.
e. Orderlies.
Answer: B
Page: 147-148
23. The higher an individuals socioeconomic position, the __________ ethnic the person
often becomes.
a. Less.
b. More.
c. Balanced.
d. Really.
Answer: A
Page: 148
24. Approximately _________ of Americans have private health insurance.

a. 55%.
b. 58%.
c. 65%.
d. 67%.
e. 75%.
Answer: D
Page: 149
25. Which group has a higher rate of those covered by private insurance than the national
average?
a. Blacks.
b. Hispanics.
c. Asians.
d. Native Americans.
Answer: C
Page: 149
26. Kooss study helped establish the premise that _______________ persons are less likely
than others to recognize various symptoms as requiring medical treatment and that these
beliefs contribute to differences in the actual use of services.
a. Lower-class.
59
b.
c.
d.
e.
Middle-class.
Upper-class.
Middle- and upper-class.
Lower- and middle-class.
Answer: A
Page: 152
27. Dutton tested different explanations concerning why the poor would show lower use rates
in relation to actual need than the non-poor. Which was NOT a tested explanation?
a. Financial coverage.
b. Level of education.
c. Culture of poverty.
d. Systems barrier.
e. All of these were tested.
Answer: B
Page: 153
28. 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.
Answer: A
Pages: 156
29. 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: 156
30. _______________ does not promote equality among laypersons when direct physician
patient interaction is required, nor does it provide a context within which such an
orientation can grow within the medical environment.
a. Health care philosophy.
b. The lay-referral system.
c. The culture of medicine.
d. Consumerism.
Answer: C
Page: 158
60

1. Christakis and Fowler found that obese persons were highly likely to have social
networks of family and friends who were similarly obese people with shared outlooks.
Answer: TRUE
Page: 146-147
2. Puerto Rican Americans are among those most likely to report that they could not afford
health insurance as the main reason they did not have coverage.
Answer: FALSE
Page: 150
3. Given that the poor are visiting doctors in greater numbers, it is generally accepted that
they use the same sources of medical treatment as those of higher income groups.
Answer: FALSE
Page: 152
4. On average, females tend to visit physicians more often than males in the U.S.
Answer: TRUE
Page: 144
5. A person's opinion of their own health is a critical variable in whether they will seek
formal health care.
Answer: TRUE
Page: 163
6. Self-care consists of both health and illness behavior.

Answer: TRUE
Page: 143
7. About 12 percent of the American population does not have health insurance.
Answer: FALSE
Page: 149
8. Self-care is an action that is independent of the medical profession.

Answer: FALSE
Page: 143
9. It appears that men generally know more about health matters than women, but women
take better care of themselves.
Answer: FALSE
Page: 144
10. The family represents a social experience that influences how a particular person
perceives his or her health situation.
61
Answer: TRUE
Page: 146
11. The strategies that people employ for seeking health care are socially organized around
the opportunities they have for interacting with people in a position to help.
Answer: TRUE
Page: 148
12. Ethnicitys influence on physician utilization appears wide-sweeping and goes beyond its
role in providing a cultural context for decision making within social networks. 
Answer: FALSE
Page: 148
13. Surprisingly, socioeconomic status does not confound the effects of ethnicity on help
seeking.
Answer: FALSE
Page: 148
14. The culture of poverty includes traits of dependence, fatalism, inability to delay
gratification, and a lower value placed on health.
Answer: TRUE
Page: 151
15. Only some 10 percent of all American physicians are of Hispanic origin. 
Answer: FALSE
Page: 151
16. When actual need for health services is taken into account, low-income persons appear to
use fewer services relative to their needs.
Answer: TRUE
Page: 153
17. Dutton found the culture of poverty explanation to have little to no validity when
combined with measures of income.
Answer: FALSE
Page: 153
18. Beliefs can have an impact on the use of physician services that is independent of
financial constraints and the structural organization of services.
Answer: TRUE
Page: 156
19. Blacks and less educated individuals have gained less equitable access to the health care
system with the advent of Medicare and Medicaid.
Answer: FALSE
Page: 156
62
20. There is more of a consumer orientation toward health among socially advantaged
persons.
Answer: TRUE
Page: 156
Essay Questions
1. Describe the relationship between socioeconomic status and illness behavior. Explain the
basis for your answer.
2. Define Mechanics ten determinants. Discuss this model. How does it relate to illness?
3. Compare and contrast the systems barrier and culture of poverty theories. How are they
similar? How are they different?
4. Define Medicare and Medicaid. How have Medicare and Medicaid affected health care
access and utilization across various groups?
5. What are some patterns and trends we see amongst various racial/ethnic groups in illness
behavior? Blacks, Hispanics, Native Americans, and Asians?
Chapter 8
The Sick Role
1. Which theorists work was not included as part of Parsonss concept of the sick role?
a. Emile Durkheim.
b. Max Weber.
c. Sigmund Freud.
d. Erving Goffman.
e. All of the above are theorists whose work was included.
Answer: D
Page: 171
2. 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: 166
3. The traditional identifying criteria for disease do NOT include:

63
a. The patients 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 patients symptoms conforming to a recognizable clinical pattern.
d. The patients significant others identification of a sick pattern.
Answer: D
Page: 166
4. The sick role is oriented toward which group?

a. Upper class.
b. Upper and middle class.
c. Middle class.
d. Lower class.
Answer: C
Page: 182
5. The term <ITAL></ITAL>___________ has been characterized as an adverse physical

state, consisting of <UL><ITEM>a physiological dysfunction within an individual.
a. The sick role.
b. Illness.
c. Disability.
d. Disease.
Answer: D
Page: 167
6. The physician exercises leverage over the patient through three basic techniques. Which
is NOT one?
a. Professional prestige.
b. Situational authority.
c. Situational dependency of the patient.
d. Objective authority.
e. All of the above are techniques used to exercise leverage.
Answer: D
Page: 173
7. Medicalization is:
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.
64
d. Purely about the shift in expectation from birthing at home to delivering at a

hospital.
Answer: B
Page: 176
8. Which is NOT a criticism of Parsonss sick-role theory?

a. Behavioral variation.
b. Types of diseases.
c. Behavioral modification.
d. The patientphysician relationship.
e. All of the above are criticisms.
Answer: C
Page: 178
9. _______________ is where the deviants are temporarily exempted from normal

obligations and gain some extra privileges, provided that they seek help in order to rid
themselves of their deviance.
a. Conditional legitimacy.
b. Unconditional legitimacy.
c. Illegitimacy.
d. Forgiveness.
Answer: A
Page: 184
10. ________________ is where the deviants are exempted from some normal obligations by
virtue of their deviance, for which they are technically not responsible, but gain few if
any privileges.
c. Illegitimacy.
d. Forgiveness.
Answer: C
Page: 185
11. ________________ is where deviants are exempted permanently from normal

obligations and are granted additional privileges in view of the hopeless nature of their
deviance.
c. Illegitimacy.
d. Forgiveness.
65
Answer: B
Page: 184-185
12. People who are physically handicapped typically fall into which category of stigma?
a. Abominations of the body.
b. Blemishes of individual character.
c. Disability of the form and mind.
d. Feeling of lack of control.
Answer: A
Page: 189
13. A pronouncement of deviant behavior involves making a <ITAL>_____________ 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: 167
14. The functionalist perspective on deviance:

a. Is based on the concept that what is regarded as deviant behavior by one person or
social group may not be so regarded by other persons or social groups.
b. Relies on the ideas of what is good and what is bad to define illness, but also
incorporates biological components.
c. Stresses societal-level processes, systems, equilibrium, and interrelationships,
representing a homeostatic approach to deviance.
d. Purely focuses on health and well-being and disregards other forms of deviance,
such as criminality.
Answer: C
Page: 169
15. The symbolic interactionalist perspective on deviance:

a. Is based on the concept that what is regarded as deviant behavior by one person or
social group may not be so regarded by other persons or social groups.
b. Relies on the ideas of what is good and what is bad to define illness, but also
incorporates biological components.
c. Stresses societal-level processes, systems, equilibrium, and interrelationships,
representing a homeostatic approach to deviance.
d. Purely focuses on health and wellbeing and disregards other forms of deviance,
such as criminality.
Answer: A
Page: 184
66
16. Who was one of the leading proponents of labeling theory?

a. Emile Durkheim.
b. Max Weber.
c. Sigmund Freud.
d. Howard Becker.
e. All of these were proponents.
Answer: D
Page: 183
17. As Goffman points out, stigma represents a rupture between an individuals

<ITAL>__________ and <ITAL></ITAL>___________ social identity that is regarded
in some way as failing.
a. Perceived; real.
b. Virtual; actual.
c. Imagined; socially assigned.
d. Pre-illness; post-illness.
Answer: B
Page: 190
18. Processes such as crime and mental illness which disrupt the social order are:
a. Functional.
b. Dysfunctional.
c. Unnecessary.
d. Rare.
Answer: B
Page: 169
19. Which is NOT used as a form of sanction?

a. Jails.
b. Prisons.
c. Mental hospitals.
d. Juvenile detention.
e. All of the above are examples of sanctions.
Answer: E
Page: 169
20. Parsonss concept of the sick role is based on the assumption that:
a. Illness is normal and routine.
b. Being sick is not a deliberate and knowing choice of the sick person.
c. There are different types of illnesses resulting in different reactions.
d. Illness always subsides and is replaced by well-being.
67
Answer: B
Page: 170
21. A person may desire to retain the sick role more or less permanently because of what
Parsons calls a _______________, which is the exemption from normal obligations and
the gaining of other privileges commonly accorded to the sick.
a. Primary reward.
b. Secondary gain.
c. Tertiary exemptions.
d. Primary reaction.
Answer: B
Page: 171
22. Whose views on religious values are utilized by Parsons in describing the role of the
physician?
a. Emile Durkheim.
b. Max Weber.
c. Sigmund Freud.
d. Howard Becker.
e. All of the above are theorists whose work was included.
Answer: B
Page: 172
23. Parsons was the first to demonstrate the function of medicine as a form of:
a. Social control.
b. Deviance.
c. Medicalization.
d. Stigmatization.
Answer: A
Page: 172
24. 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.
Answer: C
Page: 173
25. The American Psychiatric Association releases a guide to identifying disease called:
a. The Manual to Diagnosing Disease and Illness.
b. The Guide to Illness and Health.
c. Health U.S.
68
d. The Diagnostic and Statistical Manual of Mental Disorders.

Answer: D
Page: 176
26. __________________ has become the dominant form of health care delivery in the U.S.,
which makes insurance companies as third-party payers important in both bolstering
medicalization through its coverage of particular services and a constraint in placing
limitations on those services.
a. Managed care.
b. Fee-for-service.
c. Medicare/Medicaid.
Answer: A
Page: 177
27. Twaddle found that the sick role, as defined by Parsons, was much more applicable to
which religious group?
a. Catholics.
b. Muslims.
c. Protestants.
d. Jews.
e. Hindus.
Answer: D
Page: 178
28. Which ethnic group was more susceptible to pain in the Zborowski study?
a. Italians.
b. British.
c. Americans.
d. Chinese.
e. Mexicans.
Answer: A
Page: 179
29. Parsonss concept of the sick role seems to typically apply only to _________ diseases.
a. Chronic.
b. Acute.
c. Infectious.
d. Catastrophic.
Answer: B
Page: 181
30. Many people in the ______________ may tend to deny the sick role.
69
a.
b.
c.
d.
e.
Upper class.
Upper and middle class.
Middle class.
Lower class.
All of the above.
Answer: D
Page: 182

1. Functionalist theorists conceptualize social systems as composed of various connected
parts. They argue that changes, decisions, and definitions made in one part of the system
affects the other parts of the system.
Answer: TRUE
Page: 169
2. Parson's concept of the sick role applies to chronic illnesses as well as to acute illnesses.
Answer: FALSE
Page: 181
3. Parson's concept of the sick role adequately accounts for variations in the way people
perceive illness and illness behavior.
Answer: FALSE
Page: 180
4. In medical sociology, a sickness is a social state, signifying an impaired social role for
those who are ill.
Answer: TRUE
Page: 167
5. Deviant behavior always produces undesirable consequences for society.

Answer: FALSE
Page: 168
6. Parsons insists that sickness is functional because it provides the basis for social control
of the ill.
Answer: FALSE
Page: 171
7. Labeling theory does not explain the cause of deviance other than by the reaction of other
people to it.
Answer: TRUE
Page: 185
8. Sociologists have typically viewed sickness as a form of deviant behavior.
70
Answer: TRUE
Page: 167
9. Conformity to prevailing norms is generally punished for lack of ingenuity.

Answer: FALSE
Page: 167
10. The biological view of deviance has been generally accepted by contemporary
sociologists.
Answer: FALSE
Page: 169
11. A major expectation concerning the sick is that they are able to take care of themselves.

Answer: FALSE
Page: 171
12. Deviance in a social system is reduced through the application of social <DOCPAGE
NUM="147"></DOCPAGE>sanctions against the offender.
Answer: TRUE
Page: 169
13. Psychoanalytic theories of the structure of personality and the unconscious played little
role in Parsons development of his notion of individual motivation.
Answer: FALSE
Page: 171
14. Ideas on the function of moral authority and views on religious values are utilized by
Parsons in describing the role of the patient.
Answer: FALSE
Page: 172
15. The physicians role is, as Parsons tells us, to return the sick person to his or her normal
state of functioning. 
Answer: TRUE
Page: 172
16. The role of the patient depends on the conception that the patient holds of the his/her role.
Answer: FALSE
Page: 172
17. The role of the physician is based upon an imbalance of power and technical expertise
favorable exclusively to the physician.
Answer: TRUE
Page: 173
18. The patientphysician relationship is not intended by society to be therapeutic in nature.

71
Answer: FALSE
Page: 172
19. Parsonss concept of the sick role helps us understand medicines role in promoting social
stability.
Answer: TRUE
Page: 176
20. Some criticisms of Parsons sick role are based upon a misunderstanding of Parsons.
Answer: TRUE
Page: 183
Essay Questions
1. What are the major criticisms of Parsons' concept of the sick role? Should the concept be
abandoned? Explain.
2. What are the strengths and weaknesses of the labeling theory view of sickness?
3. What are the four basic categories of Parsons sick role? Describe thoroughly.
4. Describe Riers story/experience. Why was this a unique experience? Were any
conclusions made?
5. What is stigma? Define Goffmans types of stigma. How does stigma relate to the sick
role and illness in general?
Chapter 9
DoctorPatient Interaction
1. _________________ is the notion that, <DOCPAGE NUM="212"></DOCPAGE>since
the work of the physician is for the good of the patient, physicians tend to impute illness
to their patients rather than to deny it and risk overlooking or missing it.
a. Choice v. health theory.
b. Health care paternalism.
c. The medicalization belief.
d. The medical decision rule.
Answer: D
Page: 193
72
2. Distress may not be only physical; purely ____________ needs can trigger a visit to a
doctor as well.
a. Sociological.
b. Psychological.
c. Metaphysical.
Answer: B
Page: 193
3. ____________________ take(s) the position that the seriousness of the patients

symptoms is the determining factor in doctorpatient interaction.
a. Haug and Lavin.
b. Parsons.
c. Hayes-Bautista.
d. Szasz and Hollender.
Answer: D
Page: 194
4. ___________________ argue that physicianpatient interaction falls into one of three

possible models.
a. Haug and Lavin.
b. Parsons.
c. Hayes-Bautista.
d. Szasz and Hollender.
Answer: D
Page: 194
5. The <ITAL>___________________ 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.
Answer: A
Page: 194
6. The <ITAL>___________________ model arises most often when the patient has an
acute, often infectious illness, like the flu or measles.
c. React-revise.
73
Answer: B
Page: 194
7. The <ITAL>___________________ model applies to the management of chronic illness

in which the patient works with the doctor as a full participant in controlling the disease.
c. React-revise.
Answer: D
Page: 194
8. The <ITAL>___________________ model applies to the management of hypochondriacs

who falsely develop symptoms.
c. React-revise.
Answer: E
Page: 194
9. Physicians have to take on a variety of roles to induce patient adherence to their treatment
regimens. Which is NOT a role?
a. Educator.
b. Salesperson.
c. Cheerleader.
d. Detective.
Answer: E
Page: 195
10. The relevance of the ______________ model for understanding doctorpatient relations
is the view of the interaction as a process of negotiation, rather than the physician simply
giving orders and the patient following them in an automatic, unquestioning manner.
a. Hayes-Bautista.
b. Szasz and Hollender.
c. Activity-passivity.
d. Guidance-cooperation.
e. React-revise.
Answer: A
Page: 195
74
11. People with middle and upper socioeconomic status tend to be more ________________
and active participants in the physicianpatient encounter.
a. Aggressive.
b. Consumer-oriented.
c. Focused on getting well.
d. Disease-focused.
Answer: B
Page: 195
12. Which model of interaction is the norm in most doctorpatient interactions?

c. React-revise.
Answer: D
Page: 195
13. A major barrier to effective communication lies in the differences between physicians and
their patients with respect to:
a. Status.
b. Education.
c. Training.
d. Authority.
Answer: E
Page: 198
14. Cassell explains that information can be an important therapeutic tool in medical
situations if it meets which test(s)?
a. Reduces uncertainty.
b. Provides a basis for action.
c. Strengthens the physicianpatient relationship.
Answer: D
Page: 198
15. Mary Boulton and her colleagues explain that the influence of social class on the doctor
patient relationship is best understood in <DOCPAGE NUM="219"></DOCPAGE>terms
of:
a. Social distance.
b. Social space.
c. Power and space.
75

Answer: A
Page: 201
16. As part of the womens health movement, feminist health organizations have evolved that
advocate:
a. Equal pay.
b. Abortion rights.
c. Ms. over Mrs.
Answer: B
Pages: 201
17. Male physicians tend to misdiagnose ______________ in female patients.

a. Heart attack.
b. Stroke.
c. Anxiety.
d. Cancer.
Answer: A
Page: 202
18. _______________ is thought to protect women against heart attacks until menopause,
when levels drop.
a. Testosterone.
b. Progesterone.
c. Estrogen.
Answer: C
Page: 202
19. Women have been historically underrepresented in medical school classes owing to
which of the following?
a. Differences in the academic performance of boys and girls.
b. Perceptions that women are unfit for medical work.
c. Differences in the socialization experiences of boys and girls.
d. Different career choices of boys and girls due to innate differences between them.
Answer: C
Page: 204
20. It was not until the 1970s that women accounted for at least ________ of all first-year
medical students.
a. 5%.
76
b.
c.
d.
e.
10%.
15%.
20%.
25%.
Answer: B
Page: 204
21. In 2009-10, about ____________ of all students entering medical schools were women.
a. 30%.
b. 35%.
c. 40%.
d. 45%.
e. 50%.
Answer: E
Page: 204
22. Which medical specialty have women been more likely to go into?
a. Surgery.
b. General practice.
c. Urology.
d. Orthopedics.
Answer: B
Page: 205
23. Which is NOT a barrier to communication between doctors and patients?

a. Age.
b. Gender.
c. Culture.
d. Socioeconomic status.
Answer: E
Page: 217
24. Physicians prescribe medications, diets, and the like and expect patients to follow them
faithfully. This is called:
a. Compliance.
b. Doctor-patient expectation.
c. The contract.
d. Acceptance.
Answer: A
Page: 208
25. Doctorpatient relationships in the U.S. have seriously _______________ in recent years.
a. Improved.
77
b.
c.
d.
e.
Eroded.
Stagnated.
Morphed.
None of the above.
Answer: B
Page: 209
26. Dissatisfaction with the doctor-patient relationship is heavily dependent on ones:

a. Gender.
b. Culture.
c. Race.
d. Social class.
Answer: D
Page: 209
27. The shift toward consumerism in health care means patients have more status in the
doctorpatient relationship. However, this relationship is significantly affected by an
external influence:
a. Third-party payers.
b. Social class.
c. The state.
d. Religious groups.
Answer: A
Page: 209-210
28. Which is a relevant factor driving consumerism?

a. Shift in the states 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.
Answer: D
Page: 210
29. Expanding reliance on new technologies has promoted a shift away from ____________,
with its focus on the patients oral account of his or her medical history.
a. Folk medicine.
b. Biographical medicine.
c. Hereditary medicine.
d. Verbal medicine.
78
Answer: B
Page: 211
30. Which involves the extensive use of advanced technology for testing, diagnosis, and the
scientific determination of treatment in a more differentiated world of health care
delivery?
a. Techno-medicine.
b. Electronic medical records.
c. eMedicine.
d. WebMD.
Answer: A
Page: 211

1. Talcott Parsonss concept of the sick role provides some basic guidelines for
understanding doctorpatient interaction.
Answer: TRUE
Page: 193
2. Parsons explains that the relationship between a physician and patient is one that is
oriented toward the patient helping himself/herself deal effectively with a health problem.
Answer: FALSE
Page: 193
3. When people visit doctors for treatment and medical advice, doctors rarely take some
type of action to satisfy the patients expectations.
Answer: FALSE
Page: 193
4. Szasz and Hollender focused on the manner in which patients try to modify treatment
prescribed by a physician.
Answer: FALSE
Page: 194
5. Better educated and younger adults tend to be more skeptical of physician motives in
providing treatment.
Answer: TRUE
Page: 195
6. When a patient is extremely ill or there is an emergency, doctors still cannot make lifesaving decisions about patients without consulting them.
Answer: FALSE
Page: 196
79
7. A major barrier to effective communication lies in the differences between physicians and
their patients.
Answer: TRUE
Page: 198
8. Well educated persons are the most likely to have their questions treated impersonally.
Answer: FALSE
Page: 200
9. 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: 200-1
10. The lack of male sensitivity to women patients was a major factor in the formation of the
womens health movement to combat sexual discrimination in medicine.
Answer: TRUE
Page: 201
11. One example of male physician misperceptions about female patients is a tendency to
misdiagnose heart attacks as anxiety problems.
Answer: TRUE
Page: 202
12. Some patients may perceive women physicians as less of an authority figure than male
physicians.
Answer: TRUE
Page: 203
13. Surprisingly, the number of women physicians is decreasing.

Answer: FALSE
Page: 204
14. Zola found that Italian patients tended to understate their symptoms, while Irish patients
tended to overstate them. 
Answer: FALSE
Page: 207
15. Some male doctors feel reduced in status by being referred to as health care providers
instead of physicians.
Answer: TRUE
Page: 206
16. Modern-day medical practice is provided within the context of middle-class norms.
Answer: TRUE
Page: 208
80
17. Communication is the key for avoiding noncompliance.

Answer: TRUE
Page: 208
18. The belief among laypersons that the doctor knows best is still very accepted.
Answer: FALSE
Page: 209
19. The Internet has become a major source of medical information for many lay people.
Answer: TRUE
Page: 211
20. Treatments normally available only in hospitals, like chemotherapy, may be reconfigured
into pills and taken at home now.
Answer: TRUE
Page: 213
Essay Questions
1. Depending on the severity of symptoms, Szasz and Hollender argue that physician
patient interaction falls into one of three possible models. Describe each model.
2. What is the relationship between communication and class? Discuss.
3. Do cultural differences in communication exist? Explain your answer.
4. Will medicine remain a masculine-dominated profession?
5. What does the future hold for doctor-patient relations?
Chapter 10
Healing Options
1. For many years, ________________was viewed by the medical profession as a form of
quackery. But gradually, professional respectability was achieved by moving away from
an exclusive focus on spinal manipulation techniques to treat general health problems.
a. Shamanism.
b. Acupuncture.
c. Chiropractic medicine.
d. Osteopathy.
Answer: D
Page: 219
81
2. Today, _______________ are part of mainstream medicine and they work as physicians.
a. Osteopaths.
b. Chiropractors.
c. Podiatrists.
d. Accupuncturalists.
Answer: A
Page: 219
3. By the mid-20th century, osteopaths were receiving scientific medical training in such
areas as _______________ and ___________________.
a. Spinal alignment; neurology.
b. Surgery; pharmacology.
c. Obstetrics; spinal alignment.
d. Acupuncture; surgery.
Answer: B
Page: 219
4. Osteopaths earn which degree?

a. MD.
b. MBBS.
c. D.O.
d. MD.O.
Answer: C
Pages: 219-220
5. Which occupation does not require an internship and residency?

a. Osteopath.
b. Chiropractor.
c. Family practice.
d. Gastroenterologist.
Answer: B
Page: 222
6. Which is NOT an osteopathic specialty?

a. Anesthesiology.
b. Psychiatry.
c. Pediatrics.
d. Radiology.
Answer: E
Page: 220
82
7. Which is NOT a form of CAM?

a. Visits to chiropractors.
b. Treatment by faith healers.
c. Care by homeopaths.
d. Work by acupuncturists.
Answer: E
Page: 220
8. _______________ is based on the idea that disease arises from blockages in a persons
life force in the body.
a. Naturopathy.
b. Homeopathy.
c. Acupuncture.
d. Osteopathy.
Answer: A
Page: 220
9. Which is a centuries-old Indian technique of using oils and massage to treat insomnia,
hypertension, and digestive problems?
a. Aromatherapy.
b. Ayurveda.
c. Shiatsu.
d. Biofeedback.
e. Crystal healing.
Answer: B
Page: 220
10. Which uses machines to train people to control involuntary bodily functions?
a. Aromatherapy.
b. Ayurveda.
c. Shiatsu.
d. Biofeedback.
e. Crystal healing.
Answer: D
Page: 220
11. The ___________________ industry alone has sales of over one billion dollars annually.
a. Dietary supplement.
b. Acupuncture.
c. Massage.
d. Chiropractic.
83
Answer: A
Page: 222
12. It appears that many persons who use some form of alternative or new age medicine
have ____________________ social background(s).
a. Middle-class.
b. Working- or lower-class.
c. Upper- or middle-class.
d. Middle- or working-class.
Answer: D
Page: 222
13. It appears that many persons who use some form of alternative or new age medicine
are:
a. Younger.
b. Older.
c. Middle age or younger.
d. Middle age or older.
Answer: C
Page: 222
14. People use CAM techniques because they are:

a. Dissatisfied with physician care.
b. Dislike haggling with insurance providers.
c. Want to be in control of their own health.
Answer: D
Page: 222
15. Those who use faith and folk healers typically come from a _____________ background.
a. Upper-class.
b. Middle-class.
c. Working-class.
d. Lower-class.
Answer: D
Page: 222
16. Like osteopathy, the ______________ approach to healing also involves manipulation of
bones in the spinal column.
a. Ayurveda.
b. Acupuncture.
c. Chiropractic.
d. Homeopathic.
84

Answer: C
Page: 222
17. _________________ today are restricted solely to nonmedical techniques.

a. Osteopaths.
b. Chiropractors.
c. Podiatrists.
d. Neonatologists.
Answer: B
Page: 222
18. Chiropractors may be favored by some patients because they have a reputation for:
a. Charging less.
b. Being friendly.
c. Giving more time to patients.
Answer: D
Page: 223
19. ______________ are the second largest category of primary health care practitioners in
the United States.
a. Osteopaths.
b. Chiropractors.
c. Podiatrists.
d. Massage therapists.
Answer: B
Page: 223
20. Those belonging to __________________ used divine healing as a central aspect of

dogma; it did not prohibit members from seeking professional medical care.
a. Hinduism.
b. The Pentecostal church.
c. Islam.
d. The Church of Snakes.
Answer: B
Page: 224
21. Research suggests that faith healing accomplishes for patients:

a. Alleviation of symptoms.
b. Relief from psychological distress.
c. Acceptance of ones health or life situation.
85
d. Adoption of another <DOCPAGE NUM="176"></DOCPAGE>perspective about

ones situation.
Answer: E
Page: 225
22. The most prominent group in American society advocating a preference for religious
healing is the:
a. Christian Science Church.
b. Islamic Coalition.
c. Church of Latter Day Saints.
d. Greek Orthodox Church.
Answer: A
Page: 225
23. Persons with the highest levels of religious involvement showed the lowest rates of:
a. Knowledge.
b. Disability.
c. Income.
d. Education.
Answer: B
Page: 227
24. Few _______________ go to folk healers.

a. Blacks.
b. Whites.
c. Asians.
d. Hispanics.
e. Native Americans.
Answer: B
Page: 228
25. Some elderly persons living in poverty and rural areas may be prone to use ___________
in treating ailments.
a. Folk healers.
b. Folk remedies.
c. Faith healers.
d. Only prayer.
Answer: B
Page: 228-229
26. Practicing _____________ are most likely to be found among African Americans,
Hispanics, and American Indians.
86
a.
b.
c.
d.
e.
Folk healers.
Faith healers.
Shamans.
Accupuncturalists.
None of the above.
Answer: A
Page: 229
27. All life events, including illness, are viewed in relation to the total environment as
natural or unnatural, good or evil Thus, life is <ITAL>generally</ITAL> good or bad,
and the cure for <ITAL>one</ITAL> problem might cure <ITAL>all</ITAL> problems.
These healers typically charge for their services. This view is of __________ folk healers.
a. Native American.
b. Hispanic.
c. Non-Hispanic black.
d. Asian.
e. Non-Hispanic white.
Answer: C
Page: 229
28. The most dreaded form of disorder, either physical or mental, is that caused by
witchcraft. Witches are evil persons who supposedly have made pacts with the devil and
use supernatural powers in the form of curses, magic, herbs, or ghosts to harm other
people. This view is of __________ folk healers.
a. Native American.
b. Hispanic.
c. Non-Hispanic Black.
d. Asian.
e. Non-Hispanic White.
Answer: B
Page: 234
29. Black folk healers claim to have received their ability to heal<NL><ITEM><INST>:
a. As a result of learning.
b. During an altered state of consciousness.
c. At birth.
Answer: D
Page: 230
30. The _________________ healer views helping the patient accept suffering as a major
task. In this context, suffering is explained as being part of the patients burden for the
worlds sin and ignorance and a necessary role in Gods plan for the universe.
a. Native American.
b. Hispanic.
87
c. Non-Hispanic black.
d. Asian.
e. Non-Hispanic white.
Answer: B
Page: 233

1. The majority of persons in developed societies turn to medical doctors for help when they
are sick or injured.
Answer: TRUE
Page: 219
2. Osteopathy is not a part of mainstream medicine; rather osteopaths are alternative

practitioners.
Answer: FALSE
Page: 219
3. Ayruveda is an ancient technique of inserting fine needles into specific points in the body
to ease pain and stimulate bodily functions.
Answer: FALSE
Page: 220
4. Allopathic medicine is the use of microdoses of natural substances to bolster immunity.

Answer: FALSE
Page: 220
5. Homeopathy is based on the idea that disease arises from blockages in a persons life
force in the body and treatments such as acupuncture and homeopathy are needed to
restore the energy flow.
Answer: FALSE
Page: 220
6. CAM rarely includes the use of dietary supplements.

Answer: FALSE
Pages: 220
7. Some procedures like acupuncture appear effective and show some possibility of being
considered by mainstream medicine.
Answer: TRUE
Pages: 220-1
8. Some CAM practitioners are allowed to provide their services in hospitals and clinics.
Answer: TRUE
Page: 222
88
9. Rather than attempt to absorb the chiropractor into medicine, some physicians have
preferred to eliminate the field altogether.
Answer: TRUE
Page: 223
10. Chiropractors are licensed to practice in 80 percent of the Unites States.

Answer: FALSE
Page: 223
11. Chiropractors are not authorized to receive Medicare payments.

Answer: FALSE
Page: 223
12. Chiropractors are part of the mainstream of medicine.

Answer: FALSE
Page: 223
13. In the United States, some faith healers hold services in a church or in their homes. 
Answer: TRUE
Page: 225
14. The doctrines of a few religious groups prohibit their members from seeking modern
medical treatment.
Answer: TRUE
Page: 225
15. The medical profession does not hold faith healing in high esteem, but large segments of
the general public do.
Answer: FALSE
Page: 226
16. An appeal to a spiritual or divine being promotes a sense of psychological well-being in

the individual.
Answer: TRUE
Page: 227
17. Folk healers are widely used in the United States. 
Answer: FALSE
Page: 228
18. Folk medicine is often regarded as a residue of health measures left over from prescientific historical periods.
Answer: TRUE
Page: 229
19. Folk practices have disappeared in modern societies.

89
Answer: FALSE
Page: 229
20. Folk diagnosis of a health problem emphasizes the cause of the problem, not the
symptoms.
Answer: TRUE
Page: 229
Essay Questions
1. Compare and contrast three different types of folk healers.
2. Compare and contrast: complementary and alternative medicine (CAM), chiropractors,
faith healers, and folk healers.
3. Discuss the professionalization of chiropractors.
4. Denton offers five general categories of faith healing. Describe each one.
5. What is the storefront church about?
Chapter 11
Physicians
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.
Answer: B
Page: 238
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.
Answer: A
Page: 238
90
3. Recognition on the part of clients, outside agencies, and the wider society of the
professions claim to _____________________ is necessary if professional decisions are
not to be reviewed by outside authorities.
a. Professionalism.
b. Dominance.
c. Competence.
d. Being service-oriented.
Answer: C
Pages: 238-239
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: 239
5. Which is NOT a feature of professionalism?

a. Most legislation concerned with the profession is shaped by that profession.
b. As the occupation gains income, power, and prestige, it can demand high-caliber
students.
c. The practitioner is relatively free of lay evaluation and control.
d. Members are strongly identified by their profession.
Answer: E
Page: 239
6. Who defined the guidelines for analyzing the development of the medical profession in
American society?
a. Goode.
b. Koch.
c. Durkheim.
d. Brown.
e. Grant.
Answer: A
Page: 239
7. Physicians in the United States used to lack:

a. A service orientation.
b. Lengthy training in specialized knowledge.
c. Male dominance.
91
d. The desire to help patients.

Answer: B
Page: 239
8. Most American medical practitioners in the period before the American Revolution were:
a. Ships surgeons.
b. Apothecaries.
c. Clergy.
d. Trained in Europe.
Answer: E
Page: 239
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.
Answer: A
Page: 241
10. Who was responsible for significant advancements in the germ theory of disease?
a. Koch.
b. Goode.
c. Pasteur.
d. Virchow.
e. Grant.
Answer: C
Page: 239
11. Who unveiled a general concept of disease based on cellular pathology?

a. Koch.
b. Goode.
c. Pasteur.
d. Virchow.
e. Grant.
Answer: D
Page: 240
12. With the founding of the American Medical Association (AMA) in Philadelphia,
_____________ could mark the beginning of a new era in medicine.
a. Nurses.
b. Physicians.
c. The government.
92
d. Hospitals.
Answer: B
Page: 241
13. In 2007, what percentage of all eligible physicians were members of the AMA?
a. Less than 30%.
b. 40%.
c. 50%.
d. 60%.
e. Over 70%.
Answer: A
Page: 242
14. AMA local societies have the power to enforce conformity at their level because they
determine:
a. Dues.
b. Membership qualifications.
c. Participation in events.
d. Membership size (maximum size of the AMA).
Answer: B
Page: 241
15. One of the most significant guiding principles of the AMA has been its view of the
physician as a(an) ___________________________.
a. Academic force for change.
b. Articulate, charismatic healer.
c. Societal leader.
d. Independent practitioner.
Answer: D
Page: 242
16. President Bill Clinton referred to the AMA as just another ___________________.
a. Special interest group.
b. Lobbyist organization.
c. Powerful force trying to shape American policy.
d. Civil society group.
Answer: A
Page: 243
17. American medical schools in the 1800s were known to have:

a. Low standards.
b. Poor facilities.
93
c. Incentive programs (e.g., trips to Europe).

d. Financially strong students.
Answer: E
Page: 243
18. In the developing American West, anyone who had ___________ could obtain a medical
degree and practice medicine.
a. Ambition.
b. Money.
c. Enthusiasm.
d. Noble blood/heritage.
e. All of the Above.
Answer: B
Page: 243
19. The Flexner Report was sponsored by the:

a. American government.
b. European government.
c. Carnegie Foundation.
d. National Institutes of Health.
Answer: C
Page: 244
20. The Flexner Report reviewed the state of:

a. Medical education.
b. The AMA.
c. The professionalization of physicians.
d. Infectious disease.
Answer: A
Page: 244
21. Oswald Hall pointed out that the decision to study medicine is largely ___________ in
character:
a. Biological.
b. Humanitarian.
c. Psychological.
d. Social.
Answer: D
Page: 246
22. Physicians from a lower-class social origin were more likely than upper-class doctors to
emphasize success values as reasons for going into medicine. Those physicians who were
94
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.
Answer: A
Page: 247
23. Rene Fox found that medical students at Cornell Medical School acquired two basic
traits as a result of their medical training: the ability to be emotionally detached from the
patient and to ___________________.
a. Understand the limitations of medicine.
b. Convey bad news.
c. Tolerate uncertainty.
Answer: C
Pages: 247-248
24. Medical schools have begun to employ which method to help decrease doubt and
improve the application of medical knowledge?
a. Clinical rotations.
b. Kochs postulates.
c. Evidence-based medicine.
d. Grand rounds.
Answer: C
Page: 248
25. Medical students shift from __________ to _____________ as part of a functional

learning process fitted to the physicians role of maintaining an objective perspective
<DOCPAGE NUM="202"></DOCPAGE>of health and disease.
a. Excitement; dejection.
b. Defeatism; hopefulness.
c. Optimism; to pessimism.
d. Idealism; cynicism.
Answer: D
Page: 250
26. What is a purpose of medical slang?

a. Creating a sense of belonging.
b. Establishing a unique identity.
c. Providing a private means of communication.
95
d. Creating opportunities for humor and wit.

Answer: E
Page: 251
27. Medical education is adjusting to new realities in medical practice. Changes include the
transition in American health care delivery from:
a. A system run by doctors to one shaped by the purchasers of care and the
competition for profits.
b. A decline in the publics trust in doctors to greater questioning and even distrust.
c. A change in emphasis on specialization and subspecialization to primary care and
prevention.
d. Less hospital care to more outpatient care in homes and doctors offices.
Answer: E
Page: 253
28. Which is NOT an important factor in establishing prestige within the medical profession?
a. Hospital affiliation.
b. Race of the practitioner.
c. Clientele.
d. The inner fraternity.
e. All are important factors.
Answer: B
Page: 254
29. The inner core of physicians is divided into two major groups
<NL><ITEM><INST>. Which of the following is one of these groups?
a. Student elite.
b. Practitioner elite.
c. Administrative elite.
d. Surgeon elite.
Answer: C
Page: 256
30. Which group exercises influence over medical work through its research productivity
rather than focusing on individual diagnosis and treatment?
a. Knowledge elite.
b. Research elite.
c. Policy elite.
d. Management elite.
Answer: A
Page: 256
96

1. In 2005, there were about 200,000 doctors actively practicing medicine in the United
States.
Answer: FALSE
Page: 238
2. Administrators generally control clinical work and the efforts of most other people who
provide health care directly to patients.
Answer: FALSE
Page: 238
3. The status and prestige accorded to the physician is recognition of the physicians
expertise concerning one of societys most essential functionsthe definition and
treatment of health problems.
Answer: TRUE
Page: 238
4. The social importance of medical practice and the limited number of people with the
requisite training are not the only criteria explaining the professional status of physicians.
Answer: TRUE
Page: 238
5. After 1935, the number of American medical schools began to increase rapidly.
Answer: FALSE
Page: 239
6. About two-thirds of all women doctors belong to the AMA.

Answer: FALSE
Page: 242
7. There is no forum for effective dissent within the AMA.

Answer: TRUE
Page: 242
8. Many influential appointments to AMA councils and committees are voted upon by either
the general membership or the House of Delegates.
Answer: FALSE
Page: 242
9. The AMA supported the implementation of Medicare.

Answer: FALSE
Page: 243
10. A larger percentage of physicians are AMA members today than were in years past.
97
Answer: FALSE
Page: 242
11. The AMA no longer yields influence in health legislation. 

Answer: FALSE
Page: 243
12. The professionalization of medicine would not have been possible without control over
the standards for medical education.
Answer: TRUE
Pages: 243
13. Past studies on the social origins of American medical students show that most are from
upper- and upper-middle-class families.
Answer: TRUE
Page: 246
14. Family influence is an especially important variable in encouraging and reinforcing the
ambitions of the future recruit to the medical profession.
Answer: TRUE
Page: 246
15. The primary reason given by many medical students for choosing a career in medicine
has been that of wanting to have a higher income. 
Answer: FALSE
Page: 247
16. Becker and his associates noted that most entering medical students
<ITAL>assumed</ITAL> they would be well paid. Hence, making money was
apparently secondary to helping patients.
Answer: TRUE
Page: 247
17. Evidence-based medicine utilizes clinical practice guidelines, providing highly detailed
step-by-step instructions on medical care that the students can refer to in clinical
situations.
Answer: TRUE
Page: 248
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: 248
19. One aspect of medical training that appears in several studies of medical students is the
finding that the experience tends to promote emotional attachment to patients.
98
Answer: FALSE
Page: 249
20. Some physicians do not need to spend a lot of time with patients in order to make
diagnoses.
Answer: TRUE
Page: 250
Essay Questions
1. According to Robert Coombs et al., what purpose does medical slang serve? Provide
examples of medical slang.
2. Medical education is having to adjust to new realities in medical practice. What are these
realities?
3. What are three factors important in establishing prestige within the medical profession?
Discuss.
4. Describe the history of the American Medical Association. What is this body? How does
it contribute or hurt the professionalization of medicine?
5. What is the Flexner Report, and how did it affect medical education?
Chapter 12
Physicians in a Changing Society
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.
Answer: C
Page: 259
2. The decline in the status and autonomy of physicians is largely due to greater:
a. Government regulation
b. Corporations in the health care market
c. Changes in the physician-patient relationship
d. All of the above
Answer: D
Page: 266
99
3. __________________ considerations have become a primary motivation among

physicians, hospitals, and private health insurance companies.
a. Economic.
b. Social.
c. Governmental.
d. Insurance.
Answer: A
Page: 259
4. Which group may hold doctorates in their field?

a. Nurses.
b. Physical therapists.
c. Pharmacists.
d. Nutritionists.
Answer: E
Page: 260
5. What is medicalization?
a. Path by which a student becomes a medical professional.
b. Process of turning commonly regarded normal human conditions into medical
ailments.
c. Process where a traditionally non-medical professional/occupational sphere
becomes labeled as medical (e.g. insurance companies).
d. None of the above.
Answer: B
Page: 260
6. Medicalization is a form of ______________ action.

a. Socioeconomic.
b. Individual.
c. Collective.
d. Physician-driven.
Answer: C
Page: 260
7. Which is NOT an important feature of a positive relationship for patients with their
physician?
a. High levels of trust.
b. General satisfaction.
c. Participation in decision-making.
d. Gender matching.
100

Answer: D
Page: 261
8. What restricted the evaluation of work and discouraged the expression of criticism within
physician circles?
a. Rules of etiquette.
b. Laws.
c. Formal sanctions.
d. Hospital guidelines.
Answer: A
Page: 261
9. 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.
Answer: C
Page: 261
10. Millman contended that a gentlemens agreement existed among the hospital
physicians. What did this agreement allow for?
a. Overlooking each others mistakes.
b. Not to discuss personal issues with physicians partners.
c. Assisting in negotiating the highest pay possible for physicians.
d. Doctors to be unreliable.
e. Irresponsibility to patients.
Answer: A
Page: 262
11. Millman contended that ________________ errors could be forgiven and often had the
result of motivating the offending physician to work harder, spend more time with
patients, double-check procedures, and learn from the mistake.
a. Moral.
b. Technical.
c. Accidental.
d. Real.
e. Personal.
Answer: B
Page: 262
12. Millman contended that _______________ errors resulted in unfavorable letters of

101
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: 262
13. Millman contended that _______ errors, if they were made in good faith, were less
serious than _______ <DOCPAGE NUM="238"></DOCPAGE>errors.
a. Technical; moral.
b. Moral; technical.
c. Accidental; real.
d. Real; accidental.
e. Accidental; personal.
Answer: A
Page: 262
14. Freidson argues that it can be ___________ that physicians are dedicated to their patients.
a. Guessed.
b. Believed.
c. Denied.
d. Assumed.
Answer: D
Page: 264
15. ______________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.
a. PSROs.
b. DRGs.
c. HMOs.
d. PPOs.
e. AMAs.
Answer: A
Page: 264
16. _______________ are composed of licensed physicians and osteopaths who determine if
the services rendered are medically necessary, meet professional standards of quality, and
are provided as efficiently and effectively as possible.
a. PSROs.
b. DRGs.
c. HMOs.
d. PPOs.
102
e. AMAs.
Answer: A
Page: 264
17. Mistakes and errors in medical practice, through neglect or ignorance, can sometimes be
defended as:
a. Cultural latitude.
b. A difference of opinion.
c. Accidental.
d. Unintentional.
Answer: B
Page: 265
18. A major defect in the professional autonomy argument arises from the fact that the
autonomy granted to the medical profession is granted <ITAL>_____________,</ITAL>
on the assumption that it will resolve significant issues in favor of the public interest.
a. Partially.
b. Completely.
c. Conditionally.
d. Unconditionally.
Answer: C
Page: 265
19. What situation has reduced public confidence in medicine more than any other single
issue?
a. Refusal to be regulated by an external body.
b. Resistance to cost controls.
c. Acceptance of HMOs and PPOs.
d. Adoption of medical technology which does the doctors work for them.
Answer: B
Page: 265
20. 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.
Answer: D
Page: 265
103
21. At the beginning of the 21st century we are witnessing that the dominance of medical
profession is:
a. Declining.
b. Expanding.
c. Increasing.
d. Stagnating.
Answer: A
Page: 266
22. Support through planning grants and loan guarantees was provided to encourage the
development of _______________; a form of prepaid group practice emphasizing
preventive care.
a. PSROs.
b. DRGs.
c. HMOs.
d. SCHIPs.
e. AMAs.
Answer: C
Page: 267
23. _____________ are schedules of fees placing a ceiling on how much the government will
pay for specific services <DOCPAGE NUM="242"></DOCPAGE>rendered to Medicare
patients by hospitals and doctors.
a. PSROs.
b. DRGs.
c. HMOs.
d. PPOs.
e. AMAs.
Answer: B
Page: 267
24. ____________ refers to health care organizations that control the cost of health care by
monitoring how doctors treat specific illnesses, limit referrals to specialists, and require
authorization prior to hospitalization, among other measures.
a. Health savings companies.
b. Medicare and Medicaid.
c. Health insurance.
d. Managed care.
Answer: D
Page: 267
25. What is a double agent?

a. Physicians who look out for the interests of the patient and the interests of a
managed care organization.
104
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.
Answer: A
Page: 268
26. 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.
Answer: B
Page: 268
27. ______________ are forced to spend time as patient advocates, convincing various
bureaucrats that more specialized and expensive care is warranted.
a. Specialists.
b. Physicians assistants.
c. Nurses.
d. Primary care physicians.
Answer: D
Page: 268
28. What attracted corporations to health care delivery is the potential for:
a. Improving health care.
b. Helping people.
c. Financial profit.
Answer: C
Page: 269
29. 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: 270
105
30. Which is NOT 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.
Answer: E
Page: 270

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: 259
2. Americans still have high regard for medicine as a social institution.

Answer: TRUE
Page: 259
3. The movement of public opinion has been toward less confidence in physician authority.
Answer: TRUE
Page: 259
4. The profit motive has bred resentment among consumers and demands that the
professional power of doctors be increased.
Answer: FALSE
Page: 259
5. The social control of medical practice has been beneficial for American society.
Answer: FALSE
Page: 261
6. Physicians are rarely judged by their patients. Typically, only health care professionals
judge the performance of doctors.
Answer: FALSE
Page: 261
7. Millman contended that a technical error was making the mistake of being unreliable,
uncooperative, lacking in responsibility to patients, and failing to acknowledge
subordination to superiors.
Answer: FALSE
Page: 262
106
8. Rates for malpractice insurance have declined as states have set limits on the amount of
money awarded in malpractice lawsuits and physicians have become more careful in
dealing with patients.
Answer: TRUE
Page: 263
9. Instances of Medicare/Medicaid fraud are common.

Answer: FALSE
Page: 264
10. Physicians cannot be arrested and/or sentenced to prison for misrepresenting care they
claimed they gave to Medicare and Medicaid patients, because of the veil.
Answer: FALSE
Page: 264
11. Medical standards and practices continue to be regulated by the practitioners themselves.
Answer: TRUE
Page: 265
12. It is generally difficult to find a physician who will be openly critical of another physician
or who will publicly testify against a colleague.
Answer: TRUE
Page: 265
13. The problem with a professional dominance thesis is that it does not allow for decline.

Answer: TRUE
Page: 266
14. The rise of the profit orientation in medicine signifies a trend in medical practice away
from formal rationality toward greater substantive rationality.
Answer: FALSE
Page: 273
15. The medical profession has been strengthened through an oversupply of doctors.
Answer: FALSE
Page: 266
16. Rising costs of health care resulted in physician demands for government intervention.
Answer: FALSE
Page: 266
17. The AMA was a major proponent supporting the creation of Medicare. 
Answer: FALSE
Page: 266
107
18. Free-standing emergency centers were established in the 1940s.

Answer: FALSE
Page: 270
19. One of the most extensive changes in health care delivery, reducing the authority of
physicians, has been the introduction of managed care.
Answer: TRUE
Page: 267
20. About 15 percent of all U.S. hospitals are owned by profit-making organizations.
Answer: TRUE
Page: 269
Essay Questions
1. What does the term countervailing power mean? What are the sources of this notion?
Discuss.
2. What is managed care? What is its role in health care delivery? What effect does it have
on the work of physicians?
3. Is there a deprofessionalization of physicians occurring? Why? Why not?
4. The social control of medical practice has traditionally presented special problems for
American society. How so? What kind of problems?
5. There is a changing relationship between physicians and their patients. Identify and
discuss trends contributing to this change.
Chapter 13
Nurses, Physician Assistants, Pharmacists, and Midwives
1. Other than a few consulting professions such as ________________, the occupations
performing tasks of patient care are organized around the work of the physician, and are
usually under the physicians direct control.
a. Clinical psychology.
b. Physical therapy.
c. Pharmacy.
d. Nursing.
Answer: A
Page: 277
108
2. Technical knowledge employed in health occupations (other than medicine) needs to be

approved by:
a. Occupational organizations (e.g., the AMA).
b. The government.
c. Patients.
d. Physicians.
Answer: D
Page: 277
3. Among the various occupational roles in the health field, _____________ have the
greatest prestige.
a. Midwives.
b. Physicians.
c. Pharmacists.
d. Administrators.
Answer: B
Page: 277
4. About 75 percent of licensed registered and practical nurses in the United States work in:
a. Doctors offices.
b. Public health agencies.
c. Schools and industrial plants.
d. Hospitals and nursing homes.
Answer: D
Page: 278
5. In many European languages, the word <ITAL>____________ not only refers to nuns
but also generically identifies the nurse.
a. Sister.
b. Mother.
c. Priestess.
d. Angel.
Answer: A
Page: 278
6. The role of nursing in Western society was changed in the middle of the 19th century,
through the insight and effort of:
a. Louie Pasteur.
b. Florence Nightingale.
c. The Nursing Coalition of America.
d. Universities.
109
Answer: B
Page: 279
7. The early approach to nursing training emphasized a code of behavior that idealized
nurses as being:
a. Responsible.
b. Clean.
c. Courageous.
d. Obedient to the physician.
Answer: E
Page: 280
8. Nightingale incorporated the best attributes of the _____________ and the

_________________ into her ideal nurse.
a. Physician; nanny.
b. Maid; physician.
c. Sister; wife.
d. Mother; housekeeper.
Answer: D
Page: 281
9. During the late 19th and early 20th centuries, increasing numbers of women entered the
labor market as a result of:
a. Immigration.
b. The womens rights movement.
c. The depression.
d. Boredom.
Answer: A
Page: 281
10. Which nursing program may qualify the student as a registered nurse (RN)?
a. Hospital-based diploma schools.
b. Two-year associate degree programs.
c. University baccalaureate programs.
Answer: D
Page: 281
11. Which registered nurse (RN) program is intended to provide training not only in nursing
skills and theory, but also to provide the background for becoming a nursing educator or
leader?
a. Associate degree programs.
110
b.
c.
d.
e.
Hospital-based diploma schools.

University baccalaureate programs.
Post-baccalaureate advanced programs.
Military nursing programs.
Answer: C
Page: 282
12. Which type of program produces the fewest registered nurses today?
b. Hospital-based diploma schools.
d. Post-baccalaureate advanced programs.
e. Military nursing programs.
Answer: B
Page: 282
13. The _________________ are relatively inexpensive, require only two years of training,
and yet place their graduates on the same career track as graduates of other programs.
b. Hospital-based diploma schools.
d. Post-baccalaureate advanced programs.
e. Military nursing programs.
Answer: A
Page: 282
14. Nursing is ranked by sociologists as a distinctly ____________ class occupation.

a. Working.
b. Lower.
c. Middle.
d. Upper.
Answer: C
Page: 283
15. This stage of <ITAL>socialization in the nursing students education</ITAL> consisted

of nursing students wanting to do things for patients within a secularized Christianhumanitarian ethic of care and kindness, consistent with the lay image of nursing:
a. Initial innocence.
b. Labeled recognition of incongruity.
c. Psyching out.
d. Role simulation.
e. Provisional internalization.
Answer: A
Page: 283
111
16. What socialization stage was characterized by students performing so as to elicit

favorable responses from the instructors?
c. Psyching out.
d. Role simulation.
Answer: D
Page: 283
17. Nursing students begin to collectively articulate their disappointment and openly question
their choice of becoming a nurse at what stage?
c. Psyching out.
d. Role simulation.
Answer: B
Page: 283
18. The central rule of the doctor-nurse game is to avoid:

a. Administrator intervention in day-to-day activities.
b. A shift in the balance of power.
c. Medical errors.
d. Open disagreement between the players.
Answer: D
Page: 286
19. Researchers find that many nurses are no longer willing to be treated as mere
subordinates by physicians. Several reasons are offered for this change. What is NOT a
reason for this change?
a. Declining public esteem for doctors.
b. Increased number of women doctors.
c. The nursing shortage.
d. Most nurses today are educated in academic settings.
e. Increase in nursing salaries.
Answer: E
Page: 287
20. Although this was not always the case, nursing students today tend to view their
occupation as:
a. Secondary to life goals of marriage and family.
b. A career to be followed throughout their working lives.
c. The pathway to better jobs in hospital administration.
d. A second choice because they couldnt get into medical school.
112

Answer: B
Page: 284
21. Registered nurses, especially those with baccalaureate degrees, have expanded their range
of services to include:
a. Hospital administration.
b. Primary-care healing.
c. Nurse anesthetists.
d. Cardiovascular nurse specialists.
Answer: E
Page: 288
22. _______________ allows nurses to develop, demonstrate, and communicate to

physicians their superiority in certain important spheres of patient care.
a. Medicalization.
b. Nurse specialization.
c. Nurse socialization.
d. Nursing education.
Answer: B
Page: 289
23. From the perspective of hospital administrators, _____________ can be used more
economically in managerial and supervisory positions.
a. Registered nurses.
b. Licensed practical nurses.
c. Nurses aids.
d. Orderlies.
Answer: A
Page: 289
24. Students of what program will be taught advanced clinical skills, collaboration with other
health professionals to solve complex clinical problems, leadership, and other topics?
a. Registered nurse.
b. Nurse practitioner.
c. Certified nurses aide.
d. Doctor of nursing practice.
e. Licensed practical nurse.
Answer: D
Pages: 290
113
25. ______________ typically have a bachelors degree, experience in health care as a nurse
or paramedic, and become qualified after completing a training program of approximately
26 months.
a. Registered nurses.
b. Physician assistants.
c. Pharmacists.
d. Midwives.
Answer: B
Page: 290
26. Who are the key sources of medication information for the general public?
a. Doctors/Physicians.
b. Nurses.
c. Pharmacists.
d. Physicians Assistants.
e. Midwives.
Answer: C
Page: 291
27. The word drug is of _____________ origin.

a. American.
b. Arab.
c. French.
d. British.
e. Chinese.
Answer: B
Page: 292
28. What was one of the earliest forms of care available to women?
a. Midwifery.
b. Hospitalization.
c. Home health care.
d. Clinic care.
Answer: A
Page: 292
29. Lay midwives have remained in existence because they:

a. Use special sterilization techniques.
b. Act as emotional coaches for pregnant women.
c. Deliver babies in the home.
d. Move in with the patient during her third trimester.
Answer: C
Page: 293
114
30. While opposition to midwifery by <DOCPAGE NUM="268"></DOCPAGE>the medical

profession continues, approximately how many states today license or register lay
midwives?
a. 12.
b. 16.
c. 20.
d. 24.
e. 28.
Answer: B
Page: 293

1. Modern medical treatment has come to involve a great variety of health professionals.
Answer: TRUE
Page: 277
2. More than ten million people in the U.S. are employed in non-physician health care tasks.
Answer: FALSE
Page: 277
3. Nursing represents the largest single group of health workers in the United States.
Answer: TRUE
Page: 278
4. Florence Nightingales ideas formed the basis for establishing the first accredited schools
of medicine in the United States.
Answer: FALSE
Page: 281
5. The most prestigious of the nursing education programs is the hospital-based program.
Answer: FALSE
Page: 282
6. A major source of nurses in the United States has traditionally been the two-year
associate degree programs.
Answer: FALSE
Page: 282
7. Nursing faculties have tended to insist on students viewing their patients objectively, and
this tendency has operated to de-emphasize an intimate nursepatient relationship.
Answer: TRUE
Page: 283
115
8. There are signs that gender inequality is gaining greater power in nursedoctor
relationships.
Answer: FALSE
Page: 285
9. Nursing has attracted larger numbers of males in recent years with increasing pay.
Answer: TRUE
Page: 287
10. Male physicians tend to regard male nurses as more competent than female nurses.
Answer: TRUE
Page: 287
11. Female physicians were more likely to play the doctornurse game with both male and
female nurses.
Answer: FALSE
Page: 287
12. Female physicians are more likely than male physicians to have their actions questioned
by nurses.
Answer: TRUE
Page: 287
13. Competent nurses cannot be rewarded by promotion to the higher rungs of the medical
profession. 
Answer: TRUE
Page: 289
14. The nurse practitioner is intended to occupy a work position similar to that of the
physician assistant role.
Answer: TRUE
Page: 289
15. A formal role for nurses who practice medicine as well as nursing, as nurse practitioners,
is developing within the context of patient care.
Answer: TRUE
Page: 290
16. Only half of the United States allows nurse pr<DOCPAGE NUM="265"><<FNIND
NUMBER="1"/>actitioners to prescribe medications and only 6 states allow them to
prescribe controlled substances.
Answer: FALSE
Page: 290
17. A general job description of the physician assistant would be to provide a level of
primary patient care similar to or lower than that of nurse practitioners. 
116
Answer: FALSE
Page: 290
18. It appears that the use of nurse practitioners and physician assistants will increase, as long
as they extend the medical functions of physicians without competing for or challenging
their authority and autonomy.
Answer: TRUE
Page: 291
19. Pharmacists are the least accessible of all health care personnel, especially in hospitals.
Answer: FALSE
Page: 291
20. Arabs founded the first pharmacies.

Answer: TRUE
Page: 292
Essay Questions
1. Compare and contrast the occupational roles of nurses, physician assistants, pharmacists,
and midwives.
2. Describe the history and current state of nursing.
3. What is the doctor-nurse game? Describe.
4. What are the future trends in nursing? Explain the basis of your answer.
5. Who was Florence Nightingale? What role did she have in the development of nursing?
Chapter 14
The Hospital in Society
1. The ______________, as a major social institution for the delivery of health care in the
modern world, offers considerable advantages to both patient and society.
a. Government.
b. Nonprofit sector.
c. Institution of medicine.
d. Hospital.
Answer: D
Page: 297
117
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.
Answer: A
Page: 298
3. Which is NOT an example of a secular benefactor?

a. Kings.
b. Churches.
c. Merchants.
d. Guilds.
Answer: B
Page: 298
4. These hospitals were community centers for the care of the lower-class sick:
a. Nonprofit hospitals.
b. For-profit hospitals.
c. Medieval hospitals.
d. Renaissance hospitals.
Answer: C
Page: 298
5. During the Renaissance and the Reformation, an increasing numbers of hospitals were
placed under the jurisdiction of _______________ authorities.
a. Religious.
b. Secular.
c. Governmental.
d. Community.
Answer: B
Page: 298
6. Which is NOT a basic feature of the modern hospital derived from the influence of the
Church?
a. Concept of a service oriented toward helping others.
b. Having a universalistic <DOCPAGE NUM="273"></DOCPAGE>approach.
c. The custodial nature of hospital care.
d. A fee-for-service philosophy where penance equals payment.
118
Answer: D
Page: 298
7. The secular control of hospitals marked a period of ____________ for the development
of Europes hospital system.
a. Improvement.
b. Decline.
c. Fluctuation.
d. Stagnation.
Answer: B
Page: 298
8. People with chronic health problems requiring long-term hospitalization tend to be sent to
______________ institutions.
a. Public.
b. Private.
c. For-profit.
d. Nonprofit.
Answer: A
Page: 299
9. ___________ hospitals tend to accept patients with acute disorders.

a. Public.
b. Private.
c. For-profit.
d. Nonprofit.
Answer: B
Page: 299
10. About 70 percent of all resident patients in psychiatric facilities enter ______________.
a. Due to a criminal act.
b. Involuntarily.
c. Voluntarily.
d. Through family commitment.
Answer: C
Page: 317
11. Involuntary commitment proceedings are of two types: ____________ and ___________.
a. Criminal; civil.
b. Forcible; uncontested.
c. Violent; non-violent.
d. Chronic; acute.
119
Answer: A
Page: 317
12. Physicians began to associate themselves with hospitals in the 14th century. Initially they
had little influence because they provided their services on a _____________ basis.
a. Part-time.
b. Hourly.
c. Consultant.
d. Voluntary.
Answer: D
Page: 300
13. Since the end of the _________ century, a new image of hospitals evolved as institutions
where patients of all social classes could generally expect to find the highest quality
medical care and could reasonably expect to be cured of their disorders.
a. 17th.
b. 18th.
c. 19th.
d. 20th.
Answer: C
Page: 300
14. Hospitals eventually became places where physicians also referred their <DOCPAGE
NUM="276"></DOCPAGE>_________and _________ class patients, since the most
advanced medical technology was located there.
a. Lower; working.
b. Middle; lower.
c. Middle; upper.
d. Upper; working.
Answer: C
Page: 300-301
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.
Answer: B
Page: 301
16. ________________ hospitals tend to lack prestige in comparison to other hospitals.

120
a.
b.
c.
d.
e.
Community.
Nonprofit.
Private.
Government.
None of the above.
Answer: D
Page: 303
17. Americas hospital system remains a _____________ class system of medical care.
a. Single.
b. Two.
c. Three.
d. Four.
Answer: B
Page: 303
18. What is NOT 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.
Answer: E
Page: 303-305
19. Who described bureaucracy as a rational and impersonal division of labor characterized
by the principles of <ITAL>office hierarchy</ITAL> and levels of graded authority, and
by <ITAL>fixed and official areas of jurisdiction</ITAL> governed by laws or
administrative regulations?
a. Weber.
b. Perrow.
c. Hillier.
d. Durkheim.
Answer: A
Page: 305
20. Which is NOT a reason that trustee domination succumbed to medical domination in the
1930s?
a. The emphasis on free care declined significantly as hospital services became
oriented toward patients who could pay.
b. The facilities to support a complex system of medical technology were developed,
and the quality of care provided patients was improved.
c. The hospital sought prestige through medical research in terms defined by
physicians.
121
d. The hospitals differentiated and offered specialized care to certain segments such
as cancer patients.
Answer: D
Page: 306
21. In the 1940s and 1950s, the role of the hospital ______________ gained in importance.
a. Physician.
b. Nurse.
c. Administrator.
d. Social worker.
Answer: C
Page: 306
22. The occupational groups in the hospital most affected by its system of dual authority are
the ______________ who perform health care tasks on the hospitals wards.
a. Physicians.
b. Nurses.
c. Pharmacists.
d. Social workers.
Answer: B
Page: 307
23. To make the hospital organization function effectively, it has been necessary to construct
a _______________ system of authority organized around a central objective of service
to the patient.
a. Decentralized.
b. Loose.
c. Dual.
d. Hierarchical.
Answer: A
Page: 309
24. The process of ________________ is not just a result of the manner in which large
numbers of patients are managed or the work conditions, but is also related to the
patients subjective experience of feeling sick.
a. Depersonalization.
b. Demoralization.
c. Standardization.
d. Assembly line medicine.
Answer: A
Page: 311
122
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.
Answer: B
Page: 312
26. ___________ occurs when the hospital systematically divests the person of these past
representations of self.
a. Stripping.
b. Removal.
c. Fading.
d. Standardization.
Answer: A
Page: 312
27. The ________________ and ________________ educated the patient, the less likely the
patient was to express highly conforming attitudes.
a. Older; better.
b. Older; worse.
c. Younger; better.
d. Younger; worse.
Answer: C
Page: 313
28. About _______ of all expenses for hospital services are now paid by third-party sources.
a. 60%.
b. 70%.
c. 80%.
d. 90%.
Answer: D
Page: 314
29. About _____________ of all the money spent on health in the United States in 2007 was
spent on hospital services.
a. 30-35%.
b. 36-39%.
c. 40-45%.
d. 46-50%.
123

Answer: A
Page: 314
30. The most expensive hospitals in the United States are located in New England and the:
a. South.
b. Pacific Coast.
c. Rocky Mountain states.
d. Midwest.
Answer: B
Page: 315

1. The Romans were the first to establish separate medical facilities that have been
described as hospitals.
Answer: TRUE
Page: 298
2. The origin of the institution we know today as the hospital has usually been associated
with the rise of Judaism.
Answer: FALSE
Page: 298
3. Hospitals have passed through four distinct phases of development.

Answer: TRUE
Page: 298
4. During the period of the Crusades, many hospitals were established along the routes to
the Iran followed by the Christian armies.
Answer: FALSE
Page: 298
5. Secular benefactors rarely founded hospitals. This was primarily the role of the Church.
Answer: FALSE
Page: 298
6. By the end of the 15th century, an extensive network of hospitals existed throughout
Eastern Europe.
Answer: FALSE
Page: 298
7. A legacy of the hospitals as poorhouses is that of mental hospitals.

Answer: TRUE
Page: 317
124
8. Mental hospital admissions are involuntary.

Answer: FALSE
Page: 317
9. In criminal cases, the claim of mental disorder is used as an excusing condition that
relieves the individual of criminal responsibility for his or her crime.
Answer: TRUE
Page: 317
10. The first hospitals were founded in the United States more than 250 years ago.
Answer: TRUE
Page: 301
11. Early hospitals were largely based on voluntary initiative by private citizens who wanted
medical care available on a nonprofit basis. They were generally intended to provide
treatment for patients who had incurable disorders.
Answer: FALSE
Page: 301
12. Federal government participation in health care began in the late 1800s.
Answer: FALSE
Page: 301
13. Federal government participation in health care began with the U.S. Public Health
Service hospital program for merchant seamen. 
Answer: TRUE
Page: 301
14. State governments entered into health care delivery in the 1700s.
Answer: FALSE
Page: 301
15. State government early involvement in health care delivery was largely confined to the
establishment of mental institutions.
Answer: TRUE
Page: 301
16. The most common type of hospital in the United States is the nonfederal and nonprofit
community hospital.
Answer: TRUE
Page: 302
17. Controlled by a board of trustees, government hospitals are exempt from federal income
taxes and many other forms of state and local taxes. 
125
Answer: FALSE
Page: 302
18. Large nonprofit hospitals are less dependent than smaller hospitals on local physicians,
because of more extensive facilities and higher ratio of staff positions for doctors.
Answer: TRUE
Page: 302
19. The total number of hospitals in the United States has increased from 1975 to 2007.
Answer: FALSE
Page: 302
20. For-profit hospitals have decreased from 1975 to 2007, and nonprofit hospitals have
increased due to a focus on civil society.
Answer: FALSE
Page: 302
Essay Questions
1. Patients are alienated from their usual lives and reduced to a largely impersonal status in
the hospital through three basic mechanisms. Name and explain each one.
2. What are multipurpose health institutions? List five health-related functions they provide.
3. Historically, hospitals have passed through four distinct phases of development. Name
and describe each phase.
4. Why is Max Webers concept of bureaucracy not totally compatible with the norms of
hospital authority?
5. Describe what mental hospitals are, as well as the admissions/commitment processes.
Chapter 15
Health Care Reform and Social Policy in the United States
1. In 2008, an average of ____________ per person was spent on health care in the United
States, which was the highest in the world at that time.
a. $1,072.
b. $5,568.
c. $7,681.
d. $9,307.
Answer: C
Page: 320
126
2. Estimates for 2019 indicate that health costs may average _________for every man,
woman, and child.
a. $5,568.
b. $7,026.
c. $10,008.
d. $13,387.
Answer: D
Page: 320
3. Which is NOT a contributor to the increase in health care expenditures?

a. Aging of the population.
b. Increases in hospital expenses.
c. Higher costs for health insurance.
d. Increase in the number of prescriptions written.
e. All of the above are contributors.
Answer: E
Pages: 321
4. What are the primary issues in debates about health care delivery in the U.S.?
a. Rising costs of services
b. Equity in the provision and distribution of care.
c. Which country to model reforms on.
d. Both A and B.
e. Both B and C.
Answer: D
Page: 319
5. Which of the following is NOT one of the provisions included in the 2010 U.S. health
care reforms?
a. Persons with preexisting conditions can no longer be denied coverage.
b. A minimum level of benefits set by the government must be provided in all health
insurance plans.
c. Businesses with three or more employees are required to provide health insurance
for both full-time and part-time employees.
d. Low-income persons will be covered by an expanded Medicaid program.
e. Children may remain on their parents health insurance plan until age 26.
Answer: C
Pages: 331-332
6. What does DRG stand for?

a. Diagnostic related groups.
b. Drug review guide.
c. DR (doctor) G (guild).
d. Dermatology rheumatology groups.
127
Answer: A
Page: 323
7. In the public sector, the federal government instituted cost controls for services to
_______________ patients by establishing set fees for DRGs.
a. Welfare.
b. SCHIP.
c. Medicare.
d. Medicaid.
Answer: C
Page: 323
8. DRGs:
a. List what the government would pay for medical procedures.
b. Help physicians diagnose the proper illness to classify a patient with.
c. Create a monthly payment schedule for physicians, depending on the number of
patients they see.
d. Are organizations of physicians that regulate expenditures in clinics throughout
the United States.
Answer: A
Page: 323
9. In 2006, about ___________ of all Americans with health insurance were enrolled in
managed care programs:
a. 35%.
b. 48%.
c. 53%.
d. 61%.
Answer: C
Page: 326
10. 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.
Answer: E
Page: 326
11. The ______________ represents the bill payer and certifies that the care to be rendered is
both effective and the least costly alternative.
a. Case manager.
128
b.
c.
d.
e.
Social worker.
HMO.
Hospital administrator.
All of the above.
Answer: A
Page: 326-327
12. _________________ financing is a fixed monthly sum paid by the subscriber and his or
her employer that guarantees care, with little or no additional cost.
a. Pro-rated.
b. Capitation.
c. Partial.
d. Health insurance.
Answer: B
Page: 327
13. What is the main health care problem in rural areas with respect to equity?
a. Quality.
b. Cost.
c. Access.
d. Pharmaceuticals.
Answer: C
Page: 333
14. The more financially rewarding medical practices are those in __________ sized cities.
a. Small.
b. Rural.
c. Medium.
d. Large.
Answer: D
Page: 334
15. One out of every _______ counties in the United States does not have a single doctor.
a. 10.
b. 20.
c. 30.
d. 40.
Answer: B
Page: 334
16. Medical specialties like ____________ became increasingly popular in recent years.
a. Dermatology.
129
b.
c.
d.
e.
Anesthesiology.
Radiology.
Emergency-room medicine.
All of the above.
Answer: E
Page: 334
17. ________________ are public organizations supported by tax funds, which are intended
to support and conduct research, develop educational materials, protect the nations
health, and provide services designed to minimize public health problems.
a. Official agencies.
b. Voluntary agencies.
c. Health maintenance organizations.
d. Preferred provider organizations.
e. Allied health enterprises.
Answer: A
Page: 336
18. ________________ are the manufacturers of pharmaceuticals and medical supplies and
equipment, which play a major role in research, development, and distribution of medical
goods.
Answer: E
Page: 337
19. ___________________ are a relatively new form of managed care health organization, in
which employers who purchase group health insurance agree to send their employees to
particular hospitals or doctors in return for discounts.
b. Individual practice associations.
Answer: D
Page: 336-337
20. _________________ solicit funds from the general public and use them to support
medical research and provide services for disease victims.
130

Answer: B
Page: 336
21. _________________ are managed care prepaid group practices, in which a person pays a
monthly premium for comprehensive health care services.
Answer: C
Page: 336
22. _________________ are solo practitioners or small groups of physicians who contract
independently with HMOs to provide care to patients enrolled in their plans.
Answer: B
Page: 336
23. This method of payment is consistent with the principle of the open market, in which the
consumers of health care, like the consumers of other products, are free to choose which
health care providers offer the best services at prices they can afford:
a. Fee-for-service.
b. Capitation.
c. Managed care.
d. Credit cards.
Answer: A
Page: 338
24. The medical profession in the United States has had a consistent record of ____________
to social legislation.
a. Compliance.
b. Resistance.
c. Deference.
d. Defiance.
Answer: B
Page: 323
131
25. Which is one reason medical students tend to specialize rather than go into general
practice?
a. Specialties usually represent a more manageable body of knowledge.
b. Specialties may be less demanding of personal time.
c. Specialties usually have greater prestige and better income.
e. A and C only.
Answer: D
Page: 334
26. In the U.S., health care tends to be viewed as:

a. A privilege based on ability to pay for a commodity.
b. A privilege based on citizenship.
c. A right granted regardless of living conditions or financial status.
d. A right based on participation in capitalist markets.
Answer: A
Page: 340
27. 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.
Answer: B
Page: 324
28. This organization provides for the federal governments sharing in the payments made by
state welfare agencies to health care providers for services rendered to the poor:
a. Medicare.
b. Medicaid.
c. DRGs.
d. HMOs and PPOs.
Answer: B
Page: 325
29. The establishment of the welfare state is the latest phase in the evolution of citizens
rights in the West. Which was the first group of rights granted to citizens in the 18th
century?
a. Basic.
b. Political.
c. Civil.
d. Social.
132
Answer: C
Page: 341
30. ___________ theory takes the position that social inequality leads to clash, which leads
to change.
a. Structural functionalism.
b. Conflict.
c. Symbolic interaction.
Answer: B
Page: 339

1. 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: 329
2. A number of states have sued the federal government over the recent health care reforms
on the basis that it is unconstitutional and unprecedented to require people to buy any
commercial good or service as a condition of lawful residence in the U.S.
Answer: TRUE
Page: 332
3. Not having health insurance drastically undermines the ability of people to obtain health
care, since they cannot pay for it and may therefore be denied it.
Answer: TRUE
Page: 319
4. Sometimes not having health insurance can contribute to the death of a patient.
Answer: TRUE
Page: 320
5. The idea that advertising drives up drug costs is a myth.

Answer: FALSE
Page: 321
6. Almost all drugs can reduce health spending by lowering the need for hospital care.
Answer: FALSE
Page: 321
7. The greatest single increase since 198284 has been in the cost of prescription drugs.
This category is followed by increases in hospital costs.
133
Answer: FALSE
Page: 322
8. Since the early 1980s, physician costs have remained fairly stable, neither rising nor
falling.
Answer: FALSE
Page: 322
9. In the early to mid-1990s, private health care in the United States experienced a dramatic
reorganization into managed care plans.
Answer: TRUE
Page: 326
10. Managed care does not alter the patient-physician relationship; it exists above and beyond
it.
Answer: FALSE
Page: 326
11. A feature of managed care is its reliance upon capitation financing.

Answer: TRUE
Page: 327
12. The urban poor have historically been dependent on public hospitals and clinics rather
than private hospitals and practitioners for providing patient care. 
Answer: TRUE
Page: 333
13. The rural poor are less likely to be treated by foreign medical school graduates.
Answer: FALSE
Pages: 333
14. The laws of a competitive marketplace do not apply well to medicine, because physicians
define what patients need and provide their services at prices they, their employers, or the
federal government set.
Answer: TRUE
Page: 338
15. Primary care or family practitioners are over-represented among physicians.

Answer: FALSE
Page: 333
16. Physicians generally prefer to practice medicine in urbanized settings. 

Answer: TRUE
Page: 333
17. There are more than 50 specialty boards affiliated with the American Medical Association
that certify physicians to practice in as many as 115 medical specialties.
134
Answer: FALSE
Page: 335
18. Medical specialization has produced very few positive benefits.

Answer: FALSE
Page: 335
19. The people who tend to utilize emergency rooms for primary care are the
underprivileged.
Answer: TRUE
Page: 335
20. HMOs are oriented toward preventive and ambulatory services intended to reduce
hospitalization.
Answer: TRUE
Page: 336
Essay Questions
1. Identify and discuss the three major issues in the public debate about health care delivery
in the United States.
2. Present arguments for and against health reform.
3. The problem of equity with respect to health services is and remains a serious problem
in American society. Why is this a problem, and how does it relate to policy?
4. Provide an overview of the health care delivery system in the United States.
5. Describe the Medicare and Medicaid programs in depth, with an evaluation for each in
the context of health policy.
Chapter 16
Global Health Care
1. What country does NOT have a centralized national health program?
a. Japan.
b. Russia.
c. Germany.
d. Mexico.
Answer: B
Page: 344
135
2. 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.
Answer: D
Page: 350
3. In some European countries, providing national health insurance was a means to reduce
the chance that the working class would:
a. Die.
b. Revolt.
c. Get sick and be out of work.
d. Unionize.
Answer: B
Page: 345
4. What country established the first national health insurance program?

a. U.K.
b. Germany.
c. Japan.
d. Canada.
e. Austria.
Answer: B
Page: 345
5. ________________ are aimed at providing people with welfare and health benefits,
regardless of their position in society.
a. Pensions.
b. Employer sponsored health care plans.
c. Benefits.
d. Entitlements.
Answer: D
Page: 345
6. Many Europeans receive:

a. Comprehensive health insurance.
b. Protection of lost income due to illness, injury, or unemployment.
c. Allowances to supplement family expenses for the maintenance of children, such
as clothing and school lunches.
d. A and B only.
136

Answer: E
Page: 345
7. Except for the __________, participation in the welfare system is not considered
normative in the United States.
a. Poor.
b. Elderly.
c. Unwed.
d. Young.
Answer: B
Page: 345
8. What country had the lowest infant mortality rate in the world in 2005?
a. Cuba.
b. United States.
c. Japan.
d. Sweden.
e. Germany.
Answer: C
Page: 346, 348
9. What country had the highest life expectancy for males in the world in 2005? For
females?
a. United States; United States.
b. Switzerland; Japan.
c. Japan; Japan.
d. Israel; Switzerland.
e. Australia; Spain.
Answer: B
Page: 347, 349
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.
Answer: B
Page: 350
11. What is NOT covered by the Canadian insurance system?

a. Prescription drugs for persons under age 65.
b. Dental.
137
c. Ambulance service.
d. Eyeglasses.
Answer: E
Page: 351
12. The major problem facing Canada with respect to health care delivery is:
a. Rising costs.
b. Physicians dissatisfaction with reimbursement.
c. Patient dissatisfaction with wait-times for procedures.
d. Program administration.
Answer: A
Page: 351
13. What country established the first health care system in any Western society to offer free
medical care to the entire population?
a. Britain.
b. United States.
c. Canada.
d. Sweden.
e. Germany.
Answer: A
Page: 353
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.
Answer: B
Pages: 373
15. The first line of medical care in Great Britain is the:

a. Nurse practitioner/physicians assistant.
b. General practitioner.
c. Hospital, specifically the emergency room.
d. Gatekeeper, a nurse who assigns physicians based upon need.
Answer: B
Page: 354
16. In Britain, _______________ are responsible for paying for health care in their area,
managing the provision of that care, and planning in accordance with regional and
<DOCPAGE NUM="335"></DOCPAGE>national guidelines.
138
a.
b.
c.
d.
e.
executive councils.
local health authority services.
district health authorities.
hospital and specialist services.
None of the above.
Answer: C
Page: 355
17. Taxes in ______________ have been the highest in the world.

a. Britain.
b. United States.
c. Canada.
d. Sweden.
e. Germany.
Answer: D
Page: 357
18. Japanese patients pay _______ of the cost of health services, with the national plan
paying the remainder.
a. 20%.
b. 30%.
c. 40%.
d. 50%.
e. 60%.
Answer: B
Page: 360
19. About ________ of Japanese doctors are in private practice and are paid on a fee-forservice basis.
a. 12%.
b. 25%.
c. 33%.
d. 50%.
Answer: C
Page: 360
20. The ________________ use more prescription drugs than patients anywhere.
a. Japanese.
b. Italians.
c. Mexicans.
d. Americans.
e. Chinese.
Answer: A
Page: 360-361
139
21. Approximately __________ of all Germans participate, involuntarily or voluntarily, in

the nations public health insurance program.
a. 60%.
b. 70%.
c. 80%.
d. 90%.
e. 100%.
Answer: D
Page: 364
22. The largest health plan in Mexico covers workers in the private sector and is administered
by the:
a. Mexican Social Insurance Institute.
b. National Health Service.
c. Federal Ministry of Labor and Social Affairs.
d. Secretariat of Health and Welfare.
Answer: A
Page: 366
23. The _____________ is responsible for Mexicos overall health policy and provides health
care directly to the urban poor through its own hospitals and clinics.
a. Mexican Social Insurance Institute.
b. National Health Service.
c. Federal Ministry of Labor and Social Affairs.
d. Secretariat of Health and Welfare.
Answer: D
Page: 366
24. About _________ of the Mexican population has health insurance.

a. 50%.
b. 60%.
c. 70%.
d. 80%.
e. 90%.
Answer: A
Page: 366
25. Which of the following is one of the general trends affecting health policy worldwide?
a. Attention to the cost of health care and implementation of cost control measures.
b. Increasing emphasis on preventive medical services.
c. Improving efficiency in the administration of large health care systems.
d. Demands that governments increase efforts to provide a health care system that
meets national needs.
140
Answer: E
Page: 376-377
26. ____________ has more doctors per capita than any major nation.
a. Mexico.
b. Russia.
c. China.
d. Australia.
e. Untied States.
Answer: B
Page: 369
27. What country has the highest per capita consumption of alcohol in the <DOCPAGE
NUM="357"></DOCPAGE>world?
a. Ireland.
b. Germany.
c. Russia.
d. United States.
e. Mexico.
Answer: C
Page: 372
28. What was the effort in China in which 1.8 million paramedical personnel were trained in
rudimentary medicine and sent to rural areas to provide basic medical treatment and
assist in efforts at preventive medicine and public health called?
a. Barefoot doctors movement.
b. Rural outreach.
c. People-to-people in health care.
d. Grassroots medicine.
Answer: A
Page: 374
29. Some __________ of Chinas adult male population smoke.

a. 20%.
b. 35%.
c. 55%.
d. 70%.
Answer: D
Page: 375

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.
141
Answer: TRUE
Page: 344
2. The value of studying the health care delivery systems of different countries is the insight
provided into the norms, values, culture, and national outlook of those societies, as well
as the lessons learned from their experiences.
Answer: TRUE
Page: 344
3. A nations approach to health care is based upon its historical experience, culture,
economy, political ideology, social organization, level of education and standard of
living, economic resources, and attitudes toward welfare and the role of the state.
Answer: TRUE
Page: 344
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: 344
5. The social welfare systems of the U.S. are more advanced than in Europe.
Answer: FALSE
Page: 345
6. Europeans have historically been less committed to government welfare programs and
more in favor of private enterprise in dealing with economic and social problems.
Answer: FALSE
Page: 345
7. Americans who receive welfare tend to be stigmatized and have low social status.
Answer: TRUE
Page: 345
8. The German health service organization represents a form of corporatism in which a set
of institutions situated between the government and its citizens have the authority to
manage health care.
Answer: TRUE
Page: 364
9. The Japan health care delivery system is by far the most expensive in the world.
Answer: FALSE
Page: 346
10. The United States has the lowest infant mortality rate of any nation.
Answer: FALSE
Page: 346
142
11. The United States has the highest rate of longevity of any nation.
Answer: FALSE
Page: 347
12. There are three different forms of socialized medicine.

Answer: FALSE
Page: 350
13. Canada has a single, national health care delivery system. 
Answer: FALSE
Page: 350
14. Canada was late in adopting its version of socialized medicine.

Answer: TRUE
Page: 351
15. Canadians had a lower rate of infant mortality than Americans.

Answer: TRUE
Page: 351
16. The U.K. was the first country to enact national health insurance.
Answer: FALSE
Page: 353
17. Whereas higher SES groups in the U.S. have healthier lifestyles, the well-educated and
higher-income in China tended to have worse health than the lower classes. 
Answer: TRUE
Pages: 375
18. The Swedish National Health Service is financed through taxation.

Answer: TRUE
Page: 357
19. A major characteristic of the National Health Service in Sweden is that general hospitals
are not owned by the government.
Answer: FALSE
Page: 358
20. The Japanese national health insurance plan covers all Japanese citizens.
Answer: FALSE
Page: 361
Essay Questions
143
1. What are the four general trends appearing in developed societies, which are likely to
have an effect on health care policy in the future? Discuss.
2. What is socialized medicine? Discuss the systems in three countries that have socialized
medicine.
3. Discuss in detail the health care system in Germany.
4. What is a decentralized national health program? Use the case of Mexico to illustrate this
type of healthcare system.
5. Compare and contrast fee-for-service, socialized medicine, decentralized national health,
and social medicine systems in terms of regulation, provider payments, facility
ownership, public access, and private care.
144

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Chapter 1

2. Medical sociology is an important area of study because:

3. Medical sociology, as a subdiscipline, began gaining strength:

4. Which circumstance(s) particularly affected the development of medical sociology in its

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Copyright 2012 Pearson Education, Inc. All rights reserved.

e. Durkheim and Goffman.

10. What is NOT a task of a sociologist in medicine?

11. Most sociologists of medicine are employed as:

13. The World Health Organization defines health as:

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17. The medicine of social spaces is concerned with:

19. The germ theory of disease is a perspective which asserts:

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Diseases are caused by a biological agent.

22. Which of the following are TRUE about health lifestyles?

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27. There are two categories of bioterrorism:

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30. Which is not a major bioethical issue?

True False Questions

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

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14. According to Michel Foucault, the development of modern medicine transformed

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18. Bioterrorism represents a relatively old threat of infectious diseases.

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3. In epidemiology, a case refers to:

4. A researcher is interested in reporting how many people in a community were diagnosed

5. Which of the following is TRUE about incidence and prevalence?

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6. A ratio, such as the crude mortality rate, is expressed as:

7. _________________ has special significance for a society because it is traditionally used

8. What is NOT a factor in the increasing emergence of epidemics?

9. Whose investigations into cholera outbreaks established the foundation of modern

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Copyright 2012 Pearson Education, Inc. All rights reserved.

Copyright 2012 Pearson Education, Inc. All rights reserved.

21. AIDS now affects _____________ in Africa more than ________________.

22. ___________ appears to be a major channel for AIDS transmission in India.

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25. _______________ activity by Latin American men is believed to be important in the

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30. Which of the following best describes influenza pandemics?

True False Questions

3. Prevalence rates, when expressed as point prevalence, period prevalence, or lifetime

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Copyright 2012 Pearson Education, Inc. All rights reserved.

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

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3. Susan is a white, middle-aged doctor who lives in an affluent neighborhood. Max is a

4. A social class is a category or group of people who:

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6. The lower class would include:

7. The National Statistics Socio-Economic Classification (NS-SEC) is a measure of class

8. The National Statistics Socio-Economic Classification (NS-SEC) is typically used by:

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Copyright 2012 Pearson Education, Inc. All rights reserved.

Copyright 2012 Pearson Education, Inc. All rights reserved.

c. Income inequality within a country.

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26. What group uses preventative services the least?

27. Neighborhood disadvantage focuses on:

21. AIDS now affects _ in Africa more than ____.

6. _babies die more often than _____ babies.