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In the past half-century, medical sociology has provided significant insights about the social dimensions of health and health care, ranging from causes and consequences of health disparities to the organization, delivery, and financing of health care. The purpose of this extra issue of the Journal of Health and Social Behavior is to review key findings over the past 50 years on eleven core topics, from sociological studies of health and illness to healing. The authors highlight policy implications of these key findings and discuss the future in each of these domains.
Since 1959-when the Medical Sociology Section of the American Sociological Association was founded and the first issue of JHSB (then called the Journal of Health and Human Behavior) was launched-health status and the delivery of health care have dramatically changed. Life expectancy at birth in the United States was about 70 years in 1959, with large gaps in life expectancy between whites and nonwhites. Fifty years ago, Medicare and Medicaid did not exist. There were no safety nets for the elderly, the poor, and the medically needy who required health care. The United States spent only 5.1 percent of its GDP on health. Treatments for cancer, heart disease, and stroke were limited. There were no warning labels on cigarette packages or alcoholic beverage containers. Feefor- service payments for medical care prevailed. Doctors were the "captains of the team." Medical technology and high power drugs were limited.
Fifty years later, life expectancy at birth in the United States exceeds 78 years. While the gaps in longevity for whites and nonwhites have narrowed, significant differences persist. Medicare covers over 45 million elderly and disabled persons, while Medicaid pays for the care of 46 million low-income children and parents. Nonetheless, an estimated 46 million Americans do not have health insurance. The United States spends more than 18 percent of its GDP on health. Cancer, heart disease, and stroke are no longer death sentences, but people are living longer with chronic, disabling diseases. Warning labels appear on cigarette packages and alcoholic beverage containers. Managed care and salary or capitation arrangements have supplanted fee-forservice. The professional dominance of physicians has eroded. Medical technology and high power drugs have exploded. There have been numerous incremental initiatives to improve our health...