(NOTE: THIS VERSION OF THE SYLLABUS WAS DEVELOPED FOR SUBMISSION TO A PROJECT ON CURRICULUM INCLUSION AT SUNY-PLATTSBURGH, MAY 1992. BOTH COURSES WERE TAUGHT SPRING 1992 SEMESTER) Sociology of Health and Medicine Issues in Women's Health Care /Soc. 315 /WST 196 Ms. Lynn Schlesinger Ms. Lynn Schlesinger Sociology Women's Studies SUNY-Plattsburgh UVM COURSE DESCRIPTION This course will examine social and historical factors that have affected women as health care clients and providers. Focusing on the United States, we will look at how changes in medicine, demographics, etc. influenced both how women have participated as providers of care (e.g., decline in midwifery, rise of nursing) and as clients (e.g., move from home to hospital, class and race based differen ces in care). We will also investigate recent changes that have taken place bot h within and outside of medicine (nurse practitioners, women's health care movement, reproductive technologies). Though the course materials will concentrate on health in this country, we will also do some comparative readings about women and health in other cultures. Throughout the course we will pay particular attention to the interplay between women's status in society and their role definitions as participants in the health care system. One theme that we will follow th rough the course is "women and disability." As part of this course you will interview a woman about her experiences as a health care client and/or provider. REQUIRED TEXTS Brown, Phil 1989 Perspectives in Medical Sociology. Belmont, CA: Wadsworth. Browne, Susan E., Debra Connors and Nanci Stern 1985 With the Power of Each Breath, A Disabled Women's Anthology. San Francisco: Cleis Press. Wertz, Richard W. and Dorothy C. Wertz 1989 Lying-In, A History of Childbirth in America. New Haven: Yale. The course outline refers to these 3 texts as PB, SB and WW respectively. REQUIRED ARTICLES (listed in the order you will read them as noted in course outline below) Charmaz, Kathy 1991 Intensive interviewing. Teaching Sociology 19:384-395, July. McCrea, Frances B. 1986 The politics of menopause. Pp. 296-307 in The Sociology of Health and Illness, Second Edition, edited by Peter Conrad and Rochelle Kern. New York: St . Martin's. Morantz, Regina Markell Morantz 1982 From art to science: Women physicians in American medicine, 1600-1980. Pp. 3-44 in In Her Own Words, Oral Histories of Women Physicians, edited by Regina Markell Morantz, Cynthia Stodola Pomerleau and Carol Hansen Fenichel. New Haven: Yale. Rothman, Barbara Katz 1986 Midwives in transition. Pp. 345-353 in The Sociology of Health and Ill ness, Second Edition, edited by Peter Conrad and Rochelle Kern. New York: St. Martin's. Lorber, Judith 1975 Women and medical sociology. Pp. 75-105 in Another Voice, edited by Ma rcia Millman and Rosabeth Moss Kanter. Garden City, NY: Doubleday. Danziger, Sandra Klein 1986 The uses of expertise in doctor-patient encounters during pregnancy. P p. 310-321 in The Sociology of Health and Illness, Second Edition, edited by Pet er Conrad and Rochelle Kern. New York: St. Martin's. Zola, Irving Kenneth 1983 Problems of communication, diagnosis and patient care. Pp. 121-132 in Socio-Medical Inquiries. Philadelphia: Temple University Press. Robinson, Ian 1988 Reconstructing lives: Negotiating the meaning of Multiple Sclerosis. Pp. 43-66 in Living with Chronic Illness, edited by Robert Anderson and Michael Bury. London: Unwin Hyman. Asch, Adrienne and Michelle Fine 1988 Shared dreams: A left perspective on disability rights and reproductiv e rights. Pp. 297-305 in Women with Disabilities, edited by Michelle Fine and A drienne Asch. Philadelphia: Temple University Press. Gallin, Rita Gallin 1989 Women and work in rural Taiwan. Journal of Health and Social Behavior 30(4):374-385. Rapp, Rayna 1984 XYLO, A true story. Pp. 313-328 in Test-Tube Women, edited by Rita Arditti, Renate Duelli Klein and Shelley Minden. Boston: Pandora Press. Saxton, Marsha 1984 Born and unborn: The implications of reproductive technologies for peo ple with disabilities. Pp. 298-312 in Test-Tube Women, edited by Rita Arditti, Renate Duelli Klein and Shelley Minden. Boston: Pandora Press. Weitz, Rose 1991 The future of HIV. Pp. 165-186 in Life with Aids. New Brunswick, NJ: Rutgers University Press. INCLUSIVE PEDAGOGY I have tried to encourage people of color, white women and people, particularly women, with disabilities to participate by using women and health, and women and disability as central themes, and by choosing readings that also address race and class. I have tried to encourage participation and power sharing by breaking students up into small groups for class exercises, and by assigning an interview project that required students to do some independent research during which they also had the opportunity to evaluate the project itself. COURSE OUTLINE AND READING ASSIGNMENTS INTRODUCTION WEEK 1 Course Overview, Introduction to Sociological Perspective on Gender and Health, and Discussion of Interview Project PART I -- WOMEN, HEALTH AND ILLNESS WEEK 2 Epidemiology and Gender Readings in PB: Dutton, Social class, health, and illness (ch. 2) Nathanson, Sex, illness, and medical care (ch. 3) Woolhandler, et al, Medical care and mortality, racial differences in preventable deaths (ch. 4) Readings in SB: Altman, Social structure (pp. 69-76) Reserve Readings: Charmaz, Intensive interviewing WEEK 3 Medicalization and Women's Health I Readings in PB: Riessman, Women and medicalization (ch. 13) Readings in WW: chapter 1, Midwives and social childbirth in colonial America; chap. 2, The new midwifery; chapter 3; Modesty and morality WEEK 4 Medicalization and Women's Health II Readings in PB: Rosenberg, The rise of the modern hospital (ch. 20) Readings in WW: chapter 4, The wounds of birth; chapter 5, Birth in the hospital. Reserve Readings MacCrea, The politics of menopause YOU SHOULD HAVE COMPLETED PART I OF THE INTERVIEW PROJECT -- DETERMINED AN INTERVIEWEE PART II -- WOMEN AS PROVIDERS AND CLIENTS OF HEALTH CARE WEEK 5 Women as Health Care Providers I Readings in PB: Reverby, A caring dilemma (ch. 32) Reserve Readings Morantz, From art to science Rothman, Midwives in transition WEEK 6 Women as Health Care Providers II Readings in PB: Zola, Helping one another, (ch. 44 in PB) Readings in SB: Ch. 1, Shut in, shut out, shut up; Surviving the system Reserve Readings Lorber, Women and medical sociology BY WEEK 6 YOU SHOULD HAVE COMPLETED PART II OF INTERVIEW PROJECT -- DRAFT OF INTERVIEW GUIDE -- DUE AT BEGINNING OF CLASS WEEK 7 EXAM I WEEK 8 Women as Health Care Clients I Readings in PB: Charon, To Listen, To Recognize (ch. 37) Zola, Pathways to the doctor (ch. 14 Reserve Readings Danziger, The uses of expertise in doctor-patient encounters during pregnancy Zola, Problems of Communication, diagnosis and patient care WEEK 9 Women as Health Care Clients II Readings in PB: Bell, Political gynecology (ch. 41) Readings in SB: Chapter 2, Shout out - Using our anger; and chapter 3, Growing up in our families FILM: Tell Them I'm A Mermaid PART III -- SPECIFIC TOPICS -- DISABILITY; COMPARATIVE HEALTH CARE WEEK 10 Women and Disability Readings in PB: West, Talcott Parsons' sick role (ch. 9) Reserve Readings Robinson, Reconstructing lives Asch and Fine, Shared dreams Readings in SB: Chapter 4, Invisible and on center stage Asch and Fine, Shared dreams, (reserve) FILM: Children of a Lesser God WEEK 11 Women and Health -- International Perspectives Readings in PB: Ruzek, Feminist visions of health (ch. 40) Lorber, Women physicians in three countries (ch. 31) Readings in SB: Chapter 5, This body I love Reserve Readings Gallin, Women and work in rural Taiwan COMPLETED INTERVIEW NOTES DUE WEEK 11 PART IV -- WOMEN AND HEALTH, CURRENT CHALLENGES WEEK 12 Reproductive Technologies Readings in PB: Guillemin, Babies by caesarean (ch. 39) Readings in WW: Chapter 7, Government involvement; chapter 8, Creating the perfect child; epilogue, Everybody's search for the best Readings in SB: Chapter 6, Becoming mothers; chapter 7, Finding our friends Reserve Readings Rapp, XYLO, A true Story Saxton, Born and unborn WEEK 13 Aids, Aging Readings in PB: Conrad, The social meaning of Aids (ch. 27) Readings in SB: Chapter 8, United we stand, sit and roll Reserve Readings Weitz, The future of HIV WEEK 14 Summary, Review -- Instructor will hand out summary of class interview project (2 copies per student; 1 for the student and 1 for the interviewee, if she requested a copy) Exam Week EXAM II INTERVIEW PROJECT SOCIOLOGY OF HEALTH AND MEDICINE SOC 315/WST 196 -- SPRING, 1992 MS. LYNN SCHLESINGER Your class project for this course will be to interview a woman about her experi ences as a health care client and/or provider. This project has 5 parts; Parts 1-4 are worth 30% of your grade. Part 5 will be included in the final exam. PART I -- DETERMINE AN INTERVIEWEE -- DUE WEEK 4 By the above date you should find a woman who is willing to talk with you once during the month of March about her experiences with health care -- either as a client and/or as a provider (assume that this will take at least an hour). You do not need to stick with traditional medical care -- for example, you may interview someone who uses acupuncture, or who is an acupuncturist, etc. Among the things that you want to find out about: how women define health, what issues are important to them, what their experiences have been like and whether they even think their being women makes a difference. If possible try to find someone you don't know too well (e.g., try not to choose a family member). I'll say more about this in class. Be sure to explain that her identify will be known only to you, and that you will protect her confidentiality. I will say more about these ethical issues in class. For week 4 you should turn in to me the type of person you have found to interview -- DO NOT give me specific names or agencies. Howev er, DO give the person my name and numbers in case she has any questions about t he class project. PART II -- DEVELOP AN INTERVIEW GUIDE -- DUE WEEK 6 During February we will discuss interview questions, how to develop them, what questions you might want to ask. Your drafts are due at the beginning of class. I will return them to you the following week. They should be typewritten and you should leave a double space between interview questions. We will look at interview guides and transcripts from my work on women and pain. PART III -- THE INTERVIEW -- BETWEEN WEEKS 7 AND 11 If at all possible (i.e.if you can get the equipment and if your interviewee agrees) you should tape your interviews. We will discuss this in class and I encourage you to share equipment if some of you don't have access to your own tape recorders. If it is not possible to use a tape recorder be prepared to take very thorough notes. We will also have discussed interviewing strategies in class. PART IV -- THE WRITE-UP -- DUE WEEK 11 Your write-up of the interview is due Week 11 and should include the following: A brief description of the interview, including what were the most important points you learned, the most interesting exchanges, etc.? What did you learn about women and health? Provide a brief transcribed example of one exchange that you found particularly interesting and that highlights issues we've discussed in class Summarize how you felt about doing this interview -- Did you enjoy it? Was ther e anything that you found particularly difficult? Is there anything that you wo uld do differently next time? This report should be brief, between 3-5 double-spaced typewritten pages. PART V -- FINAL EXAM ESSAY One of the essays on the final exam will involve your integrating what you learned from the interview with specific class materials. You will receive more information about this in April, and will get a copy of the essay question prior to the exam so that you will have adequate time to think about it. If at any time during this project you have questions, problems, etc. please call me at the numbers listed on your syllabus.