SSCI E-122 Who Lives, Who Dies: Social Medicine in the United States
If you are sick or hurt, whether you live or die depends not only on biological factors, but social ones: are you wealthy or poor? Do you have a stable home and health insurance? How far away is the closest trauma center or pharmacy? Do people believe your illness is your fault, or even something you deserve? This course explores how social factors create health disparities in the United States. We gain foundational knowledge of key concepts in social medicine, including an overview of health care policy in the United States and the arguments for health as a human right. We then turn to what we can call chronic emergencies—case studies of people and communities who have been denied health care and allowed to suffer and die, because they are poor, uninsured, undocumented, or otherwise social outcasts. Our examples are drawn from across the United States, from the heroin epidemic in Massachusetts, to the water crisis in Flint, to the suffering of Mexican migrants in California, to the maternal mortality epidemic in Texas. We give significant attention to the lived experience of poverty, chronic hunger, addiction, discrimination, and HIV/AIDS. As we encounter these examples, we hold them against arguments for the use of the private market to distribute health care and see what happens when institutions try to sell drugs to starving people. In the final section, we turn from studying how harm falls unevenly to considering how social determinants can be incorporated into action plans; students apply the themes and concepts from the course to explore topics of their own choosing. By the end of the course, students not only have a knowledge of concepts and case studies in social medicine, but also knowledge about how to close the gaps that we study. For premedical students, this course reviews concepts found on the psychological, social, and biological foundations of behavior section of the MCAT, including how sociocultural factors and access to resources have an impact on health.