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Deborah L. Balk is a social demographer at Columbia University’s Center for International Earth Science Information Network (CIESIN). Her prior work has focused on fertility, marriage, health and gender in Asia and north Africa. Her current work integrates demography with geography, applying both geospatial and demographic data and techniques to one another. Her current research includes a study of climate, health and migration interactions in sub-Saharan Africa, and analysis of the global spatial distribution of population with particular attention to estimates of urban extents.Alejandro Cervantes-Carson is assistant professor of sociology at Mary Washington College. Born in Mexico City, he studied both in Mexico and the United States, obtaining a Ph.D. in sociology from the University of Texas, at Austin. His primary areas of interest and research are political sociology, social inequality, and Latin America. He has written articles on gender, human rights, population policies and reproductive rights in Mexico. He is currently part of a research team studying a transnational community that connects northern Virginia, U.S., and southern Puebla, Mexico, and developing a project on deliberative democracy in the Zapatista movement.Denise A. Copelton is visiting assistant professor of sociology at Franklin and Marshall College in Lancaster, Pennsylvania where she teaches courses on women’s health, medical sociology, and sociology of families. She received her Ph.D. in sociology from Binghamton University (SUNY) in 2003. Her dissertation examined the social experience of pregnancy in the U.S., focusing both on the social construction of prenatal norms in popular pregnancy advice books and on the ways in which pregnant women accommodate and resist these norms in their daily lives.Vasilikie Demos is professor emeritus of sociology at the University of Minnesota-Morris. She has studied ethnicity and gender in the United States and is currently completing a monograph on her study of Kytherian Greek women based on interviews in Greece and among immigrants in the United States and Australia. With Marcia Texler Segal, she is co-editor of the Advances in Gender Research series and Ethnic Women: A Multiple Status Reality (General Hall, 1994). She is a past president of Sociologists for Women in Society and of the North Central Sociological Association, and has been an Honorary Visiting Professor at the University of New South Wales.Lara Foley is assistant professor of sociology and governing board member of the women’s studies program at the University of Tulsa. Among the courses she teaches are Sociology of Medicine and Sociology of Reproduction and Birth. Her work in this volume is based on her dissertation research examining the work narratives of midwives. Another article from this project, co-authored with Christopher Faircloth, entitled “Medicine as a Discursive Resource: Legitimation in the Work Narratives of Midwives” appears in Sociology of Health and Illness, 2003, 25, 165–184. She is currently working on a book project examining the experiences and roles of male partners in pregnancy and childbirth.Jennie Jacobs Kronenfeld is professor in the Department of Sociology, Arizona State University. She conducts research in the areas of health policy, health across the life course, health behavior including preventive health behavior, and research into AIDS in geographically mobile populations. She has recently authored Health Care Policy: Issues and Trends (Praeger, 2002). She has conducted research in a variety of topics related to child health, including recruitment into CHIP (child health insurance program) and has published a book on the impact of school-based health clinics, Schools and the Health of Children (Sage, 2000). She is a past president of Sociologists for Women in Society and past chair of the Medical Sociology Section of the American Sociological Association.Marcia Texler Segal is Associate Vice Chancellor for Academic Affairs, Dean for Research and professor of sociology at Indiana University Southeast. Her research and consulting focus on education and on women in Sub-Saharan Africa and on ethnic women in the United States. With Vasilikie Demos, she is co-editor of the Advances in Gender Research series and Ethnic Women: A Multiple Status Reality (General Hall, 1994). She is a past president of the North Central Sociological Association and past chair of the American Sociological Association Sections on Sex and Gender and Race, Gender and Class.Chikako Takeshita is a Ph.D. candidate in the Graduate Program in Science and Technology Studies at Virginia Tech University. Her research interests include socio-cultural and political aspects of biodiversity prospecting and indigenous rights. She is the author of the article “Bioprospecting and its Discontents: Indigenous Resistances as Legitimate Politics” (Alternatives, 2001, 26, 259–282). More recently, she has been researching the social and scientific development of intrauterine devices, politics of medical representations of female bodies, and reproductive rights and population policies from a gender perspective. She has a M.S. degree from the Science and Technology Studies at Virginia Tech, an M.B.A. from INSEAD in Fontainebleau, France, and a B.A. from Keio University in Tokyo.Carol A. B. Warren is Professor Emerita and former chair of sociology at the University of Kansas. Her former appointment was as associate to full professor of sociology at the University of Southern California. Among her recent publications are Gender Issues in Ethnography with Jennifer K. Hackney (Sage, 2000), “Qualitative Interviewing” in the Handbook of Interview Research (J. Gubrium & J. Holstein (Eds), Sage, 2002), Pushbutton Psychiatry: A History of Electroshock in America with Timothy Kneeland (Praeger, 2002) and “Sex and Gender in the 1970s,” in Qualitative Sociology (Winter 2003). She is working on a book, Discovering Qualitative Methods: Field Research, Interviews, and Images, with Tracy X. Karneer, to be published by Roxbury, and on articles (with Timothy Kneeland) on “Mineral Magnetism in Psychiatric Treatment” and “Natural Electricity in Psychiatric Treatment: Amber, Fish and Eels.”Terri A. Winnick earned a B.S. in psychology at Indiana University-Purdue University, Indianapolis (IUPUI), and an M.A. and Ph.D. in sociology at Indiana University, Bloomington. She is an Assistant Professor at The Ohio State University, Mansfield. Her area of interest is medical sociology, with a focus on professions; she is currently doing research on the reaction of the established medical profession to alternative medicine.Kathryn M. Yount is a social demographer specializing in the measurement of morbidity and mortality in less developed settings and in the integration of qualitative and quantitative data in sociodemographic analysis. She is currently an Assistant Professor in the Departments of International Health and Sociology and Affiliated Faculty of the Department of Women’s Studies at Emory University. Her research focuses primarily on multi-method case studies and comparative analyses of the determinants of disparities by gender in survival, health, and access to care over the life course. Yount has received grants from the National Science Foundation, the University Research Committee at Emory, and the National Institute on Aging to study these issues in the Middle East.

While Americans have often believed that the United States has the best health care system in the world and that, as one of the wealthiest nations, we therefore must have the best health care available to our citizens, researchers in medical sociology, public health and health services research have emphasized for decades that America tolerates extremes of wealth and poverty much greater than in many European countries. This toleration of extremes extends to the approach to the delivery of social and health services, as well as to consumer goods. Over 40 million Americans do not have health insurance and thus have limited access to expensive health care services (Morone & Jacobs, 2005b). Even more may have very poor health coverage, so that if a serious illness were to occur, the person would have a very hard time finding care and paying for that care. Even if people have coverage for major health care problems, many people do not have insurance that covers areas of health care such as vision care, dental care and audiology services. While these are not life threatening health care concerns, they are health care concerns that impact quality of life and even ability to achieve. A child who cannot see well has trouble succeeding in school. A person in pain from tooth problems has trouble concentrating on tasks, and poor oral health is one contributor to nutrition concerns among the elderly. Lack of access to hearing aids increases the social isolation of the elderly, but these services are not covered by Medicare, the federal program that does provide access to health care services for most of the elderly in the United States.

This chapter will initially review some health care system issues with a focus on the US health care system. It will then review some of the sociological literature about race/ethnicity, immigration, socioeconomic status (SES) and gender and how these factors link to health and health care. In addition, the chapter will serve as an introduction to the volume and will briefly review the contents of the other sections and chapters in this volume.