4.4: Counting Techniques
There are times when the sample space or event space are very large, that it isn’t feasible to write it out. In that case, it helps to have mathematical tools for counting the size of the sample space and event space. These tools are known as counting techniques.
Definition \(\PageIndex{1}\)
Multiplication Rule in Counting Techniques
If task 1 can be done \(m_{1}\) ways, task 2 can be done \(m_{2}\) ways, and so forth to task n being done \(m_{n}\) ways. Then the number of ways to do task 1, 2,…, n together would be \(m_{1}^{*} m_{2}^{*} \stackrel{\Delta *}{r} m_{n}\) .
Example \(\PageIndex{1}\) multiplication rule in counting
A menu offers a choice of 3 salads, 8 main dishes, and 5 desserts. How many different meals consisting of one salad, one main dish, and one dessert are possible?
Solution
There are three tasks, picking a salad, a main dish, and a dessert. The salad task can be done 3 ways, the main dish task can be done 8 ways, and the dessert task can be done 5 ways. The ways to pick a salad, main dish, and dessert are
\(\dfrac{3}{\text { salad }} \dfrac{8}{\text { main }} \dfrac{5}{\text { dessert }}=120\) different meals
Example \(\PageIndex{2}\) Multiplication rule in counting
How many three letter “words” can be made from the letters a, b, and c with no letters repeating? A “word” is just an ordered group of letters. It doesn’t have to be a real word in a dictionary.
Solution
There are three tasks that must be done in this case. The tasks are to pick the first letter, then the second letter, and then the third letter. The first task can be done 3 ways since there are 3 letters. The second task can be done 2 ways, since the first task took one of the letters. The third task can be done 1 ways, since the first and second task took two of the letters. There are
\(\dfrac{3}{\text { first letter }} * \dfrac{2}{\text { second letter }} * \dfrac{1}{\text { third letter }}\)
Which is
\(3^{*} 2^{*} 1=6\)
You can also look at this in a tree diagram:
So, there are 6 different “words.”
In Example \(\PageIndex{2}\), the solution was found by find \(3*2*1=6\). Many counting problems involve multiplying a list of decreasing numbers. This is called a factorial . There is a special symbol for this and a special button on your calculator.
Definition \(\PageIndex{2}\)
Factorial
\(n !=n(n-1)(n-2) \cdots(3)(2)(1)\)
As an example:
\(5 !=5 * 4 * 3 * 2 * 1=120\)
\(8 !=8 * 7 * 6 * 5 * 4 * 3 * 2 * 1=40320\)
0 factorial is defined to be 0!=1 and 1 factorial is defined to be 1!=1.
Sometimes you are trying to select r objects from n total objects. The number of ways to do this depends on if the order you choose the r objects matters or if it doesn’t. As an example if you are trying to call a person on the phone, you have to have their number in the right order. Otherwise, you call someone you didn’t mean to. In this case, the order of the numbers matters. If however you were picking random numbers for the lottery, it doesn’t matter which number you pick first. As long as you have the same numbers that the lottery people pick, you win. In this case the order doesn’t matter. A permutation is an arrangement of items with a specific order. You use permutations to count items when the order matters. When the order doesn’t matter you use combinations. A combination is an arrangement of items when order is not important. When you do a counting problem, the first thing you should ask yourself is “does order matter?”
Definition \(\PageIndex{3}\)
Permutation Formula
Picking r objects from n total objects when order matters
\(_{n} P_{r}=\dfrac{n !}{(n-r) !}\)
Definition \(\PageIndex{4}\)
Combination Formula
Picking r objects from n total objects when order doesn’t matter
\(_{n} C_{r}=\dfrac{n !}{r !(n-r) !}\)
Example \(\PageIndex{3}\) calculating the number of ways
In a club with 15 members, how many ways can a slate of 3 officers consisting of a president, vice-president, and secretary/treasurer be chosen?
Solution
In this case the order matters. If you pick person 1 for president, person 2 for vice-president, and person 3 for secretary/treasurer you would have different officers than if you picked person 2 for president, person 1 for vice-president, and person 3 for secretary/treasurer. This is a permutation problem with n=15 and r=3.
\(_{15} P_{3}=\dfrac{15 !}{(15-3) !}=\dfrac{15 !}{12 !}=2730\)
Example \(\PageIndex{4}\) calculating the number of ways
Suppose you want to pick 7 people out of 20 people to take part in a survey. How many ways can you do this?
Solution
In this case the order doesn’t matter, since you just want 7 people. This is a combination with n=20 and r=7.
\(_{20} C_{7}=\dfrac{20 !}{7 !(20-7) !}=\dfrac{20 !}{7 ! 13 !}=77520\)
Most calculators have a factorial button on them, and many have the combination and permutation functions also.
Homework
Exercise \(\PageIndex{1}\)
- You are going to a benefit dinner, and need to decide before the dinner what you want for salad, main dish, and dessert. You have 2 different salads to choose from, 3 main dishes, and 5 desserts. How many different meals are available?
- How many different phone numbers are possible in the area code 928?
- You are opening a T-shirt store. You can have long sleeves or short sleeves, three different colors, five different designs, and four different sizes. How many different shirts can you make?
- The California license plate has one number followed by three letters followed by three numbers. How many different license plates are there?
- Find \(_{9} P_{4}\)
- Find \(_{10} P_{6}\)
- Find \(_{10} P_{5}\)
- Find \(_{20} P_{4}\)
- You have a group of twelve people. You need to pick a president, treasurer, and secretary from the twelve. How many different ways can you do this?
- A baseball team has a 25-man roster. A batting order has nine people. How many different batting orders are there?
- An urn contains five red balls, seven yellow balls, and eight white balls. How many different ways can you pick two red balls?
- How many ways can you choose seven people from a group of twenty?
- Answer
-
1. 30 meals
3. 120 shirts
5. 3024
7. 252
9. 1320
11. 10
Data sources
Aboriginal deaths in custody. (2013, September 26). Retrieved from http://www.statsci.org/data/oz/custody.html
Activities of dolphin groups. (2013, September 26). Retrieved from http://www.statsci.org/data/general/dolpacti.html
Car preferences. (2013, September 26). Retrieved from http://www.statsci.org/data/oz/carprefs.html
Encyclopedia Titanica. (2013, November 09). Retrieved from www.encyclopediatitanica.org/
Leprosy: Number of reported cases by country. (2013, September 04). Retrieved from http://apps.who.int/gho/data/node.main.A1639
Madison, J. (2013, October 15). M&M's color distribution analysis. Retrieved from http://joshmadison.com/2007/12/02/mm...tion-analysis/


21.3: Alcohols and Ethers
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Learning Objectives
By the end of this section, you will be able to:
- Describe the structure and properties of alcohols
- Describe the structure and properties of ethers
- Name and draw structures for alcohols and ethers
In this section, we will learn about alcohols and ethers.
Alcohols
Incorporation of an oxygen atom into carbon- and hydrogen-containing molecules leads to new functional groups and new families of compounds. When the oxygen atom is attached by single bonds, the molecule is either an alcohol or ether.
Alcohols are derivatives of hydrocarbons in which an –OH group has replaced a hydrogen atom. Although all alcohols have one or more hydroxyl (–OH) functional groups, they do not behave like bases such as NaOH and KOH. NaOH and KOH are ionic compounds that contain OH – ions. Alcohols are covalent molecules; the –OH group in an alcohol molecule is attached to a carbon atom by a covalent bond.
Ethanol, CH 3 CH 2 OH, also called ethyl alcohol, is a particularly important alcohol for human use. Ethanol is the alcohol produced by some species of yeast that is found in wine, beer, and distilled drinks. It has long been prepared by humans harnessing the metabolic efforts of yeasts in fermenting various sugars:
Large quantities of ethanol are synthesized from the addition reaction of water with ethylene using an acid as a catalyst:
Alcohols containing two or more hydroxyl groups can be made. Examples include 1,2-ethanediol (ethylene glycol, used in antifreeze) and 1,2,3-propanetriol (glycerine, used as a solvent for cosmetics and medicines):
Naming Alcohols
The name of an alcohol comes from the hydrocarbon from which it was derived. The final -e in the name of the hydrocarbon is replaced by -ol , and the carbon atom to which the –OH group is bonded is indicated by a number placed before the name. 5
Example \(\PageIndex{1}\): Naming Alcohols
Consider the following example. How should it be named?
Solution
The carbon chain contains five carbon atoms. If the hydroxyl group was not present, we would have named this molecule pentane. To address the fact that the hydroxyl group is present, we change the ending of the name to -ol . In this case, since the –OH is attached to carbon 2 in the chain, we would name this molecule 2-pentanol.
Exercise \(\PageIndex{1}\)
Name the following molecule:
- Answer
-
2-methyl-2-pentanol
Ethers
Ethers are compounds that contain the functional group –O–. Ethers do not have a designated suffix like the other types of molecules we have named so far. In the IUPAC system, the oxygen atom and the smaller carbon branch are named as an alkoxy substituent and the remainder of the molecule as the base chain, as in alkanes. As shown in the following compound, the red symbols represent the smaller alkyl group and the oxygen atom, which would be named “methoxy.” The larger carbon branch would be ethane, making the molecule methoxyethane. Many ethers are referred to with common names instead of the IUPAC system names. For common names, the two branches connected to the oxygen atom are named separately and followed by “ether.” The common name for the compound shown in Example \(\PageIndex{2}\) is ethylmethyl ether:
Example \(\PageIndex{2}\): Naming Ethers
Provide the IUPAC and common name for the ether shown here:
Solution
IUPAC: The molecule is made up of an ethoxy group attached to an ethane chain, so the IUPAC name would be ethoxyethane.
Common: The groups attached to the oxygen atom are both ethyl groups, so the common name would be diethyl ether.
Exercise \(\PageIndex{1}\)
Provide the IUPAC and common name for the ether shown:
- Answer
-
IUPAC: 2-methoxypropane; common: isopropylmethyl ether
Ethers can be obtained from alcohols by the elimination of a molecule of water from two molecules of the alcohol. For example, when ethanol is treated with a limited amount of sulfuric acid and heated to 140 °C, diethyl ether and water are formed:
In the general formula for ethers, R— O —R, the hydrocarbon groups (R) may be the same or different. Diethyl ether, the most widely used compound of this class, is a colorless, volatile liquid that is highly flammable. It was first used in 1846 as an anesthetic, but better anesthetics have now largely taken its place. Diethyl ether and other ethers are presently used primarily as solvents for gums, fats, waxes, and resins. Tertiary -butyl methyl ether, C 4 H 9 OCH 3 (abbreviated MTBE—italicized portions of names are not counted when ranking the groups alphabetically—so butyl comes before methyl in the common name), is used as an additive for gasoline. MTBE belongs to a group of chemicals known as oxygenates due to their capacity to increase the oxygen content of gasoline.
Link to Learning
Want more practice naming ethers? This brief video review summarizes the nomenclature for ethers.
Chemistry in Everyday Life: Carbohydrates and Diabetes
Carbohydrates are large biomolecules made up of carbon, hydrogen, and oxygen. The dietary forms of carbohydrates are foods rich in these types of molecules, like pastas, bread, and candy. The name “carbohydrate” comes from the formula of the molecules, which can be described by the general formula C m (H 2 O) n , which shows that they are in a sense “carbon and water” or “hydrates of carbon.” In many cases, m and n have the same value, but they can be different. The smaller carbohydrates are generally referred to as “sugars,” the biochemical term for this group of molecules is “saccharide” from the Greek word for sugar (Figure 20.12). Depending on the number of sugar units joined together, they may be classified as monosaccharides (one sugar unit), disaccharides (two sugar units), oligosaccharides (a few sugars), or polysaccharides (the polymeric version of sugars—polymers were described in the feature box earlier in this chapter on recycling plastics). The scientific names of sugars can be recognized by the suffix -ose at the end of the name (for instance, fruit sugar is a monosaccharide called “fructose” and milk sugar is a disaccharide called lactose composed of two monosaccharides, glucose and galactose, connected together). Sugars contain some of the functional groups we have discussed: Note the alcohol groups present in the structures and how monosaccharide units are linked to form a disaccharide by formation of an ether.
Organisms use carbohydrates for a variety of functions. Carbohydrates can store energy, such as the polysaccharides glycogen in animals or starch in plants. They also provide structural support, such as the polysaccharide cellulose in plants and the modified polysaccharide chitin in fungi and animals. The sugars ribose and deoxyribose are components of the backbones of RNA and DNA, respectively. Other sugars play key roles in the function of the immune system, in cell-cell recognition, and in many other biological roles.
Diabetes is a group of metabolic diseases in which a person has a high sugar concentration in their blood (Figure \(\PageIndex{1}\)). Diabetes may be caused by insufficient insulin production by the pancreas or by the body’s cells not responding properly to the insulin that is produced. In a healthy person, insulin is produced when it is needed and functions to transport glucose from the blood into the cells where it can be used for energy. The long-term complications of diabetes can include loss of eyesight, heart disease, and kidney failure.
In 2013, it was estimated that approximately 3.3% of the world’s population (~380 million people) suffered from diabetes, resulting in over a million deaths annually. Prevention involves eating a healthy diet, getting plenty of exercise, and maintaining a normal body weight. Treatment involves all of these lifestyle practices and may require injections of insulin.
Even after treatment protocols were introduced, the need to continually monitor their glucose levels posed a challenge for people with diabetes. The first tests required a doctor or lab, and therefore limited access and frequency. Eventually, researchers developed small tablets that would react to the presence of glucose in urine, but these still required a relatively complex process. Chemist Helen Free, who was working on improvements to the tablets, conceived a simpler device: a small test strip. With her husband and research partner, Alfred Free, she produced the first such product for measuring glucose; soon after, she expanded the technology to provide test strips for other compounds and conditions. While very recent advances (such as breath tests, discussed earlier in the text) have shown promise in replacing test strips, they have been widely used for decades and remain a primary method today.
Footnotes
- 5 The IUPAC adopted new nomenclature guidelines in 2013 that require this number to be placed as an “infix” rather than a prefix. For example, the new name for 2-propanol would be propan-2-ol. Widespread adoption of this new nomenclature will take some time, and students are encouraged to be familiar with both the old and new naming protocols.


12.4: Chapter Summary
This chapter provided an overview of epilepsy, migraine headaches, and intracranial emergencies. A brief pathophysiology was provided, as well as discussion on etiology, diagnostic testing, and clinical manifestations for each of the conditions.
Anticonvulsant drugs and drugs used to treat epilepsy were discussed. Common classifications of these drugs include hydantoins, barbiturates, succinates, benzodiazepines, iminostilbene, and valproates. An overview of nursing implications and client education was provided.
Drugs used to treat migraine headaches were briefly presented. Drug cases discussed included triptans, ergot alkaloids, selective serotonin receptor agonists, and CGRP receptor antagonists. Consideration was given to nursing implications and client education.
Additionally, drugs used in the treatment of intracranial hypertension and increased intracranial pressure during intracranial emergencies were presented, including CAIs and osmotic diuretics. Special consideration is given to nursing implications and client education for this drug classifications.


8.15A: Diverse Cell Forms of Methanogens
Diverse Cell Forms of Methanogens
There are over 50 described species of methanogens, sharing over 30 signature proteins.
LEARNING OBJECTIVES
Outline the physical characteristics associated with methanogens
KEY TAKEAWAYS
Key Points
- Methanogens are usually either coccoid (spherical) or bacilli (rod shaped).
- Methanogens have a cell wall that is composed of pseudopeptidoglycan, which offers lysozyme resistance.
- There are many diverse strains of methanogens, including M. smithii (found in the human gut), M. kandleri (discovered on the wall of a black smoker), and M acetivorans (found in oil wells, trash dumps, and deep-sea hydrothermal vents ).
Key Terms
- polysaccharide : Complex sugars. A polymer made of many saccharide units linked by glycosidic bonds.
Methanogens belong to the domain archaea, which are distinctly different than bacteria. There are over 50 described species of methanogens, sharing over 30 signature proteins. These species do not form a monophyletic group, but are split into three clades. Therefore, the large numbers of proteins uniquely shared by all methanogens may be due to lateral gene transfers.
Methanogens are usually either coccoid (spherical) or bacilli (rod shaped). The cell walls of of Methanogens, like other Archaea, lack peptidoglycan, a polymer found in the cell walls of the bacteria. Instead, some methanogens have a cell wall that is composed of pseudopeptidoglycan. Pseudopeptidoglycan differs in chemical structure from bacterial peptidoglycan, but resembles eubacterial peptidoglycan in morphology, function, and physical structure. These differences makes these archaea resistant to the enzyme, lysozyme, which only breaks down β (1,4) sugar linkages like those found in peptidoglycan. Those that do not contain pseudopeptidoglycan have at least one paracrystalline array (S-layer) made up of proteins that fit together like a jigsaw puzzle.
There are many diverse strains of methanogens. Methanobrevibacter smithii is the dominant archaeon in the human gut. M. smithii is pivotal in the removal of excess hydrogen from the human gut. They are important for the efficient digestion of polysaccharides, allowing for an increase in the transformation of nutrients into calories.
Methanocaldococcus jannaschii thermophilic methanogen isolated from a hot spring at Woods hole. It was the first archaeon to have its complete genome sequenced, identifying many genes and synthesis pathways unique to the archaea.
Methanopyrus is a genus of methanogens, with a single described species, M. kandleri. M. kandleri is a hyperthermophile, discovered on the wall of a black smoker from the Gulf of California at a depth of 2000 m, at temperatures of 84-110 °C.
Methanosarcina acetivorans is a versatile methane producing microbe which is found in such diverse environments as oil wells, trash dumps, deep-sea hydrothermal vents, and oxygen-depleted sediments beneath kelp beds. Only M. acetivorans and microbes in the genus Methanosarcina use all three known metabolic pathways for methanogenesis.


Describe a normal delivery, including the stages of childbirth
Approaches to Childbirth
Prepared childbirth refers to being not only physically in good condition to help provide a healthy environment for the baby to develop, but also helping a couple to prepare to accept their new roles as parents and to get information and training that will assist them for delivery and life with the baby as much as possible. The more a couple can learn about childbirth and the newborn, the better prepared they will be for the adjustment they must make to a new life. Nothing can prepare a couple for this completely. Once a couple finds that they are to have a child, they begin to conjure up images of what they think the experience will involve. Once the child is born, they must reconcile those images with reality (Galinsky, 1987). Knowing more of what to expect does help them in forming more realistic images thus making the adjustment easier. Let’s explore some of the methods of prepared childbirth.
HypnoBirthing
Grantley Dick-Read was an English obstetrician and pioneer of prepared childbirth in the 1930s. In his book
Childbirth Without Fear
, he suggests that the fear of childbirth increases tension and makes the process of childbearing more painful. He believed that if mothers were educated, the fear and tension would be reduced and the need for medication could frequently be eliminated. The Dick-Read method emphasized the use of relaxation and proper breathing with contractions as well as family support and education. Today this method is known as the Mongan Method or HypnoBirthing. Women using this method report feeling like they are lost in a daydream, but focused and in control.
The Lamaze Method
This method originated in Russia and was brought to the United States in the 1950s by Fernand Lamaze. The emphasis of this method is on teaching the woman to be in control in the process of delivery. It includes learning muscle relaxation, breathing through contractions, having a focal point (usually a picture to look at) during contractions and having a support person who goes through the training process with the mother and serves as a coach during delivery. The Lamaze Method is still the most commonly taught method in the U.S. today.
The Bradley Method
This method originated in the late 1940’s and helps women deliver naturally, with few or no drugs. There are a series of courses that emphasize excellent nutrition and exercise, relaxation techniques to manage pain, and the involvement of the partner as a coach. Parents-to-be are taught to be knowledgeable consumers of birth services and to take responsibility in making informed decisions regarding procedures, attendants and the birthplace. In turn, this will lead to keeping mothers healthy and low-risk in order to avoid complications that may lead to medical intervention.
Nurse Midwives
Historically in the United States, most babies were born under the care of lay midwives. In the 1920s, middle-class women were increasingly using doctors to assist with childbirth but rural women were still being assisted by lay midwives. The nursing profession began educating nurse-midwives to assist these women. Nurse-midwives continued to assist most rural women with delivery until the 1970s and 1980s when their growth is thought to have posed a threat to the medical profession (Weitz, 2007). Women who are at low risk for birth complications can successfully deliver under the care of nurse-midwives. Some hospitals give privileges to nurse-midwives to deliver there. They may also deliver babies at home or in birthing centers.
Home Birth
Because one out of every 20 births involves a complication, most medical professionals recommend that delivery take place in a hospital. However, some couples choose to have their baby at home. About 1 percent of births occur outside of a hospital in the United States. Two-thirds of these are home births and more than half of these are assisted by midwives. In the United States, women who have had previous children, who are over 25 and who are white are most likely to not give birth in a hospital (MacDorman et al., 2010).
Birthing Centers
A birthing center presents a more home-like environment than a hospital labor ward, typically with more options during labor: food/drink, music, and the attendance of family and friends if desired. Other characteristics can also include non-institutional furniture such as queen-sized beds, large enough for both mother and father and perhaps birthing tubs or showers for water births. The decor is meant to emphasize the normality of birth. In a birth center, women are free to act more spontaneously during their birth, such as squatting, walking or performing other postures that assist in labor. Active birth is encouraged. The length of stay after a birth is shorter at a birth center; sometimes just 6 hours after birth the mother and infant can go home. One-third of out-of-hospital births occur in freestanding clinics, birthing centers, or in physicians offices or other locations.
Water Birth
Laboring and/or giving birth in a warm tub of water can help a woman relax. The buoyancy of the water can help alleviate discomfort and pressure for the mother. Many hospitals have birthing tubs that allow women to labor in them. However, only some hospitals allow for the birth to take place in the water. Some believe that water birth gives a more calm and tranquil transition for the baby from the womb. Water births are more common to occur at home or in birthing centers.
watch it
Watch this family’s approach to childbirth by having a water birth in their home with a midwife and a doula.
A link to an interactive elements can be found at the bottom of this page.
Not many pregnancies or births go exactly as planned, as seen in the following story of this mother who had to quickly deliver her baby at 30 weeks.
Most births in the U.S. occur in hospitals. Mothers have the choice to have a medicated or unmedicated delivery. Some women do fine with “natural methods” of pain relief alone. Many women blend “natural methods” with medications and medical interventions that relieve pain. Building a positive outlook on childbirth and managing fear may also help some women cope with the pain. Labor pain is not like pain due to illness or injury. Instead, it is caused by contractions of the uterus that are pushing the baby down and out of the birth canal. In other words, labor pain has a purpose.
The most common pain relief method used during labor and delivery is an epidural. An epidural is a procedure that involves placing a tube into the lower back, into a small space outside the spinal cord. Small doses of medicine can be given through the tube as needed throughout labor. With an epidural, pain relief starts 10 to 20 minutes after the medicine has been given. The degree of numbness felt can be adjusted. An epidural can prolong the first and second stages of labor. If given late in labor or if too much medicine is used, it might be hard to push when the time comes.
watch it
What are the advantages and disadvantages of receiving an epidural? Watch this video to see how the procedure is done.
A link to an interactive elements can be found at the bottom of this page.
Another form of pharmacologic pain relief available for laboring mothers is inhaled nitrous oxide. This is typically a 50/50 mixture of nitrous oxide with air that is an inhaled analgesic and anesthetic. Nitrous oxide has been used for pain management in childbirth since the late 1800’s. The use of inhaled analgesia is commonly used in the UK, Finland, Australia, Singapore, and New Zealand, and is gaining in popularity in the United States.
[1]
Making A Birth Plan
As you can see, women have many choices when it comes to the approach they want to take in preparing for childbirth. What decisions would you make?
Learn how to create a birth plan
.
The first stage
of labor is typically the longest. The First Stage of labor begins with uterine contractions that may initially last about 30 seconds and be spaced 15 to 20 minutes apart. These increase in duration and frequency to more than a minute in length and about 3 to 4 minutes apart. Typically, doctors advise that they should be called when contractions are coming about every 5 minutes. Some women experience false labor or Braxton-Hicks contractions, especially with the first child. These may come and go. They tend to diminish when the mother begins walking around. Real labor pains tend to increase with walking.
During this stage, the cervix or opening to the uterus dilates to 10 centimeters or just under 4 inches. This may take around 12-16 hours for first children or about 6-9 hours for women who have previously given birth. It takes one woman in 9 over 24 hours to dilate completely. Labor may also begin with a discharge of blood or amniotic fluid. If the amniotic sack breaks, which happens for one out of eight pregnancies, labor will be induced if necessary to reduce the risk of infection.
The second stage
involves the passage of the baby through the birth canal. This stage takes about 10-40 minutes. Contractions usually come about every 2-3 minutes. The mother pushes and relaxes as directed by the medical staff. Normally the head is delivered first. The baby is then rotated so that one shoulder can come through and then the other shoulder. The rest of the baby quickly passes through. The baby’s mouth and nose are suctioned out. The umbilical cord is clamped and cut.
The third stage
is generally less painful, at least when compared to the other stages. During this stage, the placenta or afterbirth is delivered. This typically occurs within 20 minutes after the delivery of the baby. If tearing of the vagina occurred during birth, the tear may be stitched at this time.
Cesarean Section
Cesarean section
, also known as
C-section
, or
cesarean delivery
, is the use of surgery to deliver babies. A cesarean section is often necessary when a vaginal delivery would put the baby or mother at risk. This may include obstructed labor, twin pregnancy, high blood pressure in the mother, breech birth, or problems with the placenta or umbilical cord. Cesarean delivery may be performed based upon the shape of the mother’s
pelvis
or history of a previous C-section. A trial of vaginal birth after C-section may be possible. The World Health Organization recommends that cesarean sections be performed only when medically necessary. Some C-sections are performed without a medical reason, upon request by someone, usually the mother.
Modification, adaptation, and original content.
Authored by
: Julie Lazzara for Lumen Learning.
Provided by
: Lumen Learning.
License
:
CC BY: Attribution
Home Birth Water Birth with Doula and Midwife.
Provided by
: Yema Mamas.
Located at
:
https://www.youtube.com/watch?v=wczscWXk8e4
.
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Other
.
License Terms
: Standard YouTube License


1.5: Introduction to the Lifespan Perspective
What you’ll learn to do: explain the lifespan perspective
Contributors and Attributions
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As we have learned, human development refers to the physical, cognitive, and psychosocial changes and constancies in humans over time. There are various theories pertaining to each domain of development, and often theorists and researchers focus their attention on specific periods of development (with most traditionally focusing on infancy and childhood; some on adolescence). But isn’t it possible that development during one period affects development in other periods and that humans can grow and change across adulthood too? In this section, we’ll learn about development through the lifespan perspective, which emphasizes the multidimensional, interconnected, and ever-changing influences on development.


2.2: Basics of Singing 6- Singing in Different Styles
The world is filled with different styles and genres of music. Music is found in every culture, and although there are commonalities, each style of singing is different. Because of this, the music of one’s own culture growing up has a profound impact on the singer. Think about it: you can most likely make your voice sound like someone else, and even your accent is enculturated from the people you talk with day by day. In some cases, a person will not even realize he or she has an accent until moving to another place, even for a few months. I remember going to camp as a kid, and people would arrive from other parts of the country, they would leave worried they would sound different “back home.” I went overseas to teach, and the students thought I had a “funny accent.” Singing is no different than speaking in this case. The difference is singing “accent,” or style.
Most people have a favorite singer who they emulate, and wish to sound just like them. Here’s the problem with the idea of copying someone else’s voice: we were all made with different voices. The only way to sound like someone else requires the singer to modify his or her voice in an unnatural way, causing tension in the throat. So how can one sing different styles of music without tension? The keys is keeping to the basics of singing (correct breathing, open throat, and free of tension), and modify the vowels/consonants naturally. This will not create perfect copying of an artist’s sound, but it can create the proper style of singing.
The basic principle of all vocal music is the telling of a story through music and lyrics. Whether the genre is Hip Hop, Broadway, Classical, or any other, the singer’s job is to tell the story, both verbally and nonverbally. The verbal aspect of singing is the creation of stylistically appropriate sound with the voice, and the use of the articulators (tongue, teeth, and lips) to communicate the words. I’m sure you have heard a song on the radio you enjoyed, and could not understand part or all of the lyrics (until you looked them up online of course). If the singer does not communicate the lyrics effectively, the story of the song is incomplete and will not have the full effect on the audience. Even covers of someone else’s song can be told with a twist in the story through text emphasis. You may have heard a song done as a cover and thought differently of the lyrics. This is due to the singer either articulating the text (better or worse) differently, or a change in musical emphasis.
The singing is not the end of the storytelling, but rather the beginning. Studies have shown people communicate more nonverbally than verbally. In other words, you judge what a person means more by their body language than what is said. There have even been studies where people were shown video of different singers, using the same vocal recording for all the singers. People thought they heard differences in the music because they saw a different person “singing” the song. The singer is not just about communicating with the voice. The whole body must be involved. Too many singers forget this concept, and believe they are perceived a certain way (“I sound really good”) when the audience could not get past the singers body language (“He looked like he was not interested in the song at all”). There are several acting techniques that can begin to assist the singer’s awareness of body language. Look up pantomime skits online, and pay attention to the body language.
How does a singer know what the audience sees and hears? The simplest way is to either visually record yourself, or have someone watching you perform and critique it. The video recording may reveal more to the singer about posture and facial expression, but the singer is still biased (you either think you look great or horrible, in my experience with singer’s self examinations). The outside observe should not be too close to the singer, otherwise their bias will also show through, connecting their knowledge of the person outside of the performance to the singer.
Try and practice standing in front of a mirror and singing different types of songs. It is important to show visually what each line in the song is depicting. If the line is about death, a smile and raised eyebrows may not be the correct nonverbal. Likewise, an upbeat positive song should not look like a dirge. Another technique to focus energy on the nonverbal is to audiate, or sing the song in your head, while lip syncing along with the correct nonverbal. This eliminates one of the variables, the voice, and allows the singer to focus on the physical portrayal of the song. This technique may seem silly at first, but remember practice makes permanent.
Another technique to achieve the appropriate level of communication for any song is to visualize in your head the perfect performance of the song repeatedly. People captured in war use this technique to survive. By imagining they are somewhere else, they do not give in to despair. One military officer visualized the perfect round of golf on his favorite golf course, every day several times a day for the years he was incarcerated. After his release, he played the best golf game in his life, even though he was locked in a small cell for years. The key was envisioning every aspect of it: what the weather was like, how the club felt in his hand, the direction of the wind, where the ball went after each stroke, etc. If the singer envisions the performance in its ideal state, the mind can recreate that state in the actual performance.
Since every genre and style of music is different, I will not give specifics about each genre of music and how to sing it. Instead, I would encourage you to listen to different singers from different genres. Try singing that style, keeping the head free of tension while staying true to the music. In the demonstration video, there will be some examples.
Supplementary Videos
Assignment on Videos
After watching the demonstration video, enter the secret number at the top of your assignment.
Write in complete sentences answers to the following questions.
1. In your own words, what was the content of the video?
2. What are two things you found most interesting about the content of the video?
3. Think of a singer you have seen and heard. Who are they, and what do they demonstrate in terms of this concept?
4. Name 3 positive things you do while singing that relate to this concept.
5. What 2 things can you improve on relating to this concept?


6.2: Lab Activities
A list of words is provided below that you are expected to learn and label on the models provided. Note that not all models will have some of the organs/structures, so be sure to find them on an alternate model. You must use all the words provided. Using the colored tape provided, write the number that corresponds to the organ/structure and place it on your model. When complete, notify your TA so they may check your work.
For each additional station, directions will be provided for the activity.
Station One: Upper Respiratory
Label the models of this station with the number that corresponds to the appropriate structure of the peripheral nervous system using the colored tape. When you are finished, ask your TA to check your labeling. Before leaving the station, remove all the labels you have placed on the model.
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#1 nose |
#6 septal nasal cartilage |
#12 nasal conchae* |
#16 laryngopharynx |
#21 soft palate |
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#2 root |
#7 major alar cartilages |
#12 nasal meatuses* |
#17 lingual tonsils |
#22 uvula |
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#3 bridge |
#8 minor cartilages |
#13 pharynx |
#18 palatine tonsils |
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#4 apex |
#9 external naris |
#14 nasopharynx |
#19 pharyngeal tonsil (adenoid) |
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#5 lateral nasal cartilages |
#10 nasal cavity |
#15 oropharynx |
#20 hard palate |
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*There are Superior, Middle, and Inferior parts to these structures.
Station Two: Lower Respiratory
Label the models of this station with the number that corresponds to the appropriate structure of the peripheral nervous system using the colored tape. When you are finished, ask your TA to check your labeling. Before leaving the station, remove all the labels you have placed on the model.
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#1 larynx |
#8 corniculate cartilages |
#15 esophagus |
#22 alveolar sacs |
#29 middle lobe |
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#2 epiglottis |
#9 cuneiform cartilage |
#16 carina |
#23 alveoli |
#30 cardiac notch |
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#3 vestibular folds |
#10 cricothyroid ligament |
#17 primary (main) bronchi |
#24 L/R lungs |
#31 horizontal fissure |
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#4 vocal folds |
#11 cricoid cartilage |
#18 secondary (lobar) bronchi |
#25 apex of lung |
#32 oblique fissure |
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#5 thyrohyoid membrane |
#12 cricotracheal ligament |
#19 tertiary (segmental) bronchi |
#26 base of lung |
#33 hilum |
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#6 thyroid cartilage |
#13 tracheal cartilages |
#20 respiratory bronchioles |
#27 superior lobe |
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#7 arytenoid cartilages |
#14 trachea |
#21 alveolar ducts |
#28 inferior lobe |
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Station Three: Muscles of Respiration
Label the models of this station with the number that corresponds to the appropriate structure of the peripheral nervous system using the colored tape. When you are finished, ask your TA to check your labeling. Before leaving the station, remove all the labels you have placed on the model.
Muscles of Inspiration
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#1 diaphragm |
#2 external intercostals |
#3 scalenes |
#4 sternocleidomastoid |
*Make note of which muscles are the primary muscles of inhalation, and which are the accessory muscles.
Muscles of Exhalation
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#5 internal intercostals |
#6 external oblique |
#7 internal oblique |
#8 transverse abdominis |
#9 rectus abdominis |
Station Four: Histology
Sketch the slides available for today’s lab and specify the magnitude at which you are observing/ sketching. Be sure to identify and label your sketch with the corresponding structures listed beneath each slide.
Lung
Terminal bronchioles, Respiratory bronchioles, Alveolar ducts, Alveolar sacs, Alveoli
Station Five: Lung Dissection
- First, identify the trachea and observe if it is flexible or stiff, does it collapse in on itself? Note the ringed structures along the trachea that support it and allow it to stay open. Identify any other structures along the outside of the lungs and trachea such as the pleural membrane or larynx if still attached.
- Lay the lungs where they both lay flat on the table. Using the dissecting scissors make a cut along the frontal plane beginning at the top of the trachea and working your way down to the branching of the primary bronchi.
- Cut along one of the bronchi, along the corresponding lung until you make a complete frontal plane cut.
- Use the pins provided and label as many structures as you can identify. Your TA will come around and ask you to identify the pins you have placed.
- Before leaving the station, remove all the pins you have placed.
*If you are the last table to use this station, be sure to clean off the dissection kits in the lab’s sink.
Station Six: Flow of Oxygen and Pulmonary Circulation
As a group, determine the path that oxygen travels starting from the nostrils to the alveoli. Be sure to identify where along that path each of the structures on the vocabulary list is located.
As a group, determine the route of pulmonary circulation. Be mindful of the fact that several structures are directly connected to the heart. Label the models/posters of this station with the # that corresponds to the appropriate vessels involved in pulmonary circulation using the colored tape. When you have finished, have your TA check your labeling. Before leaving the station, remove all of the labels you have placed on the models/posters.
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#1 pulmonary trunk |
#2 pulmonary arteries |
#3 pulmonary capillaries |
#4 pulmonary veins |


6.1.1: The Aging Population
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Aging
Aging is the process of people growing older.
Learning Objectives
Key Points
- Population aging is a demographic phenomenon which involves the rise in the median age of a country or region.
- Traditionally, the extended family was primarly responsible for taking care of the elderly, a fact which is no longer the case in many societies.
- Today, the state and various charitable organizations are largely responsible for providing care for the elderly.
- In the U.S., two major problems associated with an aging population are the pension crisis and the strain on the healthcare system, particularly Medicare.
Key Terms
- Growing Old : In the 1961 book Growing Old, Cumming and Henry formulated the disengagement theory of aging. It was the first theory of aging that social scientists developed.
- disengagement theory : The disengagement theory of aging states that “aging is an inevitable, mutual withdrawal or disengagement, resulting in decreased interaction between the aging person and others in the social system he belongs to.”
Aging
As people grow older, they become less self-sufficient in terms of taking care of their own finances, health, and general day-to-day needs and obligations. For example, most societies have a generally accepted age of retirement (based on both societal norms as well as a country’s tax laws and pension rules) after which point an individual ceases to engage in employment. The rest of society typically assumes some level of responsibility in ensuring that the elderly are cared for. The elderly can receive care from a variety of different sources, including their families, the state, the private sector, and charitable institutions. Nevertheless, even in societies that have a strong system in place to provide for the aged, an aging population poses a significant financial and economic burden. In the U.S. specifically, the pension system and the healthcare sector are two important examples of this problem.
History of Elderly Care
Traditionally, the extended family would look after the older generation. While this role is still attributed to the family in many parts of the world, particularly in non-Western nations, the modern family has evolved in such a way that care for the aged is now provided for by the state and various charitable organizations. Some of the main reasons why elders are less likely to be taken care of exclusively by their families include the decreasing size of families, the increased longevity of the elderly, the geographic dispersion of families, and the fact that women have become more educated and commonly work outside the home. While this trend is widespread in Europe and North America, there is growing evidence of it in many parts of Asia, too. The various forms that elderly care services can take include assisted living, adult day care, long-term care, nursing homes, hospice care, and in-home care. The different institutions can further be classified as medical (skilled) care and non-medical (social) care.
Several countries today are facing an aging population, where the median age of the population has increased and a larger portion of the population is considered to be older. Two primary reasons for this are increased life expectancy and lower birth rates. Currently, the majority of the countries facing this demographic phenomenon consists of advanced economies, such as Japan and many parts of Europe. However, it is predicted that the greatest future impact will occur in Asia.
Advantages of an Older Population
There may be some economic advantages to having an older population. For example, since older people have higher accumulated savings per head than younger individuals do, a large aged population can result in lower interest rates as well as a lower rate of inflation. However, for the most part, a substantial aged population leads to a lot of financial pressure on both the public and private sectors.
Disadvantages of an Older Population
One of the problems that may arise from a large segment of society being aged is a pension crisis. In the U.S., it is probably going to become increasingly difficult to pay corporate, federal, and state pensions, because the number of workers relative to retirees is shrinking. In order to improve the sustainability of the pension system, a few measures can be undertaken. For example, the worker-retiree ratio can be rectified by increasing the retirement age or by changing employment and immigration policies. Alternatively, it may be possible to reduce the amount owed to retirees. Finally, it may become necessary to expand resources to fund pensions through increased contributions or higher taxes. Trying to implement any of these solutions will likely result in some level of controversy and public debate.
Another significant source of problems related to an older population resides in the healthcare sector. In 1965, Congress created Medicare under the Social Security Act in order to provide health insurance to U.S. citizens over the age of 65, regardless of their income and medical history. Aside from premiums paid by Medicare enrollees along with the fund source itself, Medicare is financed by revenue levied on employers and workers through the Federal Insurance Contributions Act and the Self-Employment Contributions Act. However, due to rising enrollment as the population ages and a decreasing ratio of workers to enrollers, Medicare is facing financial difficulties. While the Patient Protection and Affordable Care Act is supposed to address many issues confronting the healthcare sector today, the rising cost of healthcare remains a national problem, as patients are paying more in order to receive the same care as before.
Composition of the Older Population
The elderly proportion of the population is growing around the world, but it is greater in developed countries.
Learning Objectives
Examine the sociological factors that allow people to live longer lives in industrialized versus non-industrialized nations, such as better access to health care
Key Points
- All over the world, people are living longer. Population experts estimate that more than 50 million Americans, or 17 percent of the population, will be 65 or older in 2020.
- Biological markers for old age (such as wrinkles, grey hair, memory loss, etc.) exist, but old age can also be defined by when an individual begins to fill certain social roles, such as becoming a grandparent or retiring.
- There is a disparity between industrialized and non-industrialized nations; people live longer in industrialized countries.
- The population of people aged 65 and older has been growing at a faster rate than the total population. While women still live longer than men, the gender gap among seniors is narrowing.
- There appear to be regional divides in the demographic breakdown of senior citizens.
Key Terms
- centenarian : Being at least 100 years old.
- United States Census : The United States Census provides more specific information about the make up of older Americans. According to the census, there has been rapid growth amongst the elderly segment of the population in recent years.
The number of individuals living into old age is growing worldwide. While the trend of an aging population is obvious, it can be difficult to assess because the definition of “old age” depends entirely on the cultural norms of a given society. Biological markers for old age (such as wrinkles, grey hair, memory loss, etc.) exist, but old age can also be defined by when an individual begins to fill certain social roles, such as becoming a grandparent or retiring. All of these factors vary by culture.
Statistics on Age
Nevertheless, the fact is that people are living longer and are therefore more prone to encounter issues associated with old age. In industrialized nations, life expectancy has increased consistently over the last decades. In the United States, the proportion of people aged 65 or older increased from 4 percent in 1900 to about 12 percent in 2000. In 1900, only about 3 million Americans were 65 or older, out of a total population of 76 million Americans. By 2000, the number of senior citizens had increased to 35 million out of 280 million Americans. Population experts estimate that more than 50 million Americans, or 17 percent of the population, will be 65 or older in 2020. The number of older Americans has spiked in recent years due to the age of baby boomers—the generation that was born in the twenty years following World War II. As soldiers returned from war, families began to grow. This generation is now beginning to enter their older years.
The United States Census provides more specific information about the make up of older Americans. According to the census, there has been rapid growth among the elderly segment of the population in recent years. The population of people aged 65 and older grew at a faster rate than the total population. While women still live longer than men, the gender gap among seniors is narrowing. Further, there appear to be regional divides in the demographic breakdown of senior citizens. The South had the largest number of people aged 65 and up, while the Northeast had the largest percentage of people aged 65 and up. In 2010, 53,364 centenarians, or people over the age of 100, lived in the United States, a 5.8 percent increase from the number of centenarians in 2000. This means that 1 out of every 5,786 Americans is over the age of 100.
While the trend of an older population appears worldwide, people in industrialized nations are older than people in non-industrialized nations. While people in almost all countries are living longer than prior generations, people in industrialized nations still live longer than people in non-industrialized nations. According to the Population Research Bureau, the average life expectancy in Africa is 53, in North America is 78, in Latin America is 73, in Asia is 68, in Europe is 75, and in Oceania is 75. Some of this difference can be attributed to disparities in health care—easier access to pervasive biotechnology in industrialized nations means that people live longer. Other factors include poverty and a generally more strenuous lifestyle, which can cause health problems and a lower life expectancy.
Gender Differences in Aging
Aging to sex ratios show women living longer than men, but this gap has been quickly narrowing since 1990.
Learning Objectives
Analyze the gender gap that exists leading to women generally living longer than men
Key Points
- Women tend to live longer than men, and the ratio of women to men is high among the elderly.
- The percentage of men aged 65 and up grew faster than the percentage of women aged 65 and up, according to the 2010 census.
- The longevity of women relative to men is likely due to their better cardiovascular health, the fact that they are less likely to engage in risky behavior, and the fact that traditionally, physical labor is more frequently performed by men.
Key Terms
- centenarian : Being at least 100 years old.
Women tend to live longer than men in almost every country. In Japan, men generally live to about 79, whereas women live to 83. However, in the United States, that gender gap is beginning to close. The percentage of men aged 65 and up grew faster than the percentage of women aged 65 and up, according to the 2010 census. For example, the number of men aged 85 to 94 grew 46.5% between 2000 and 2010, but the number of women in that age group grew only 22.9%.
However, for the very oldest members of the population, the gender gap still holds true. The United States Census reports that of the 53,364 centenarians, or people over the age of 100, 82.8% are women and only 17.2% are male. In other words, out of the entire American population, 1 out of every 3,551 females is a centenarian while only 1 out or 16,566 males is a centenarian. Thus, even though the gender gap is narrowing, women are still expected to live longer than men.
These figures could be due, in part, to the sex ratio. The sex ratio is the ratio of men to women in a given society or country. The current sex ratio for the world is 986 females to 1000 males. In the United States, the ratio is 105 males to every 100 females. However, men tend to live riskier lives, are more prone to heart disease and cancer, and women are therefore likely to live longer than men. In fact, cancer deaths among men are 200 per 100,000 cases, whereas women are only 150 per 100,000 (from the National Cancer Institute).
Why women live longer than men is not perfectly understood. Several factors contribute to the overall trend. For example, men statistically engage in more behaviors that put their lives at risk than women, which reduces their life expectancy. Men are also more “successful” when attempting suicide, which also brings down their life expectancy. Another factor that may contribute to the greater life expectancy of women is the different types of jobs men and women tend to have during their lifetimes, with men more frequently doing physical labor that could wear the body down or increase the odds of injury. Other biological factors likely play a role, including greater cardiovascular health among women.
Aging and Race
Individuals with different racial backgrounds tend to have different experiences with old age.
Learning Objectives
Examine the racial implications of aging, particularly for minority groups
Key Points
- Minority populations are more likely to experience elder abuse from relatives and caretakers.
- Minority populations are also more likely to experience health problems associated with old age.
- Many of the medical differences between different racial groups are better explained by differences in socioeconomic status rather than race.
Key Terms
- elder abuse : Elder abuse is a general term used to describe certain types of harm to older adults.
- social determinants of health : The economic and social conditions that influence individual and group differences in health status.
Individuals of different racial backgrounds experience aging —and the health issues associated with it—differently. Before turning to the medical concerns that accompany aging, one should note that elders of different racial backgrounds also experience different frequencies of elder abuse. Elder abuse is a general term to describe certain types of harm that are inflicted upon older adults. The most common form of elder abuse is neglect or improper care for vulnerable seniors. Unfortunately, this is usually inflicted by people whom the elder trusts and who are responsible for caring for the elder, such as family members or caretakers at elder homes. Research indicates that black senior citizens are more likely to be abused than white citizens.
Further, medical concerns present differently for white seniors and minority seniors. Black and Hispanic seniors are more likely to encounter cardiac problems earlier than white seniors. However, these outcome disparities are not usually the result of biological determinants of health, which means that minority populations are not biologically less healthy than white populations. Rather, the disparity in medical outcomes is more likely attributed to social determinants of health, which are socioeconomic conditions that bear on health.
For example, black and Hispanic populations are more likely to encounter financial hardship and therefore eat less healthy food, which potentially leads to health problems. In addition, individuals from a poorer socioeconomic background are less likely to have had access to healthcare throughout their whole lives. This lack of access ultimately leads to medical concerns in old age. Thus, while one can make generalizations about elder health by comparing racial categories, these differences are frequently caused by differences in socioeconomic status rather than race.
Aging and Wealth
In order to assist the elderly with their living and healthcare costs, the U.S. government established assistance programs like Medicare.
Learning Objectives
Examine the programs made available to the elderly to assist with quality of life, such as Social Security and Medicare, and the looming crises with these particular programs
Key Points
- American seniors face serious financial troubles due to the fact that they are no longer earning an income, but face increased expenses as a result of diminishing health.
- Social Security and Medicare are federal programs designed to help seniors, though both programs face financial difficulties themselves.
- The Patient Protection and Affordable Care Act, also known as Obamacare, would help cut down seniors’ expenses by lowering healthcare costs and increasing public services.
Key Terms
- Obamacare : a colloquial term for the Patient Protection and Affordable Care Act of 2010 which expands health care coverage for Americans
- baby boomer generation : The baby boomer generation, or those born during the spike in births in the twenty years following World War II, is starting to reach senior citizenship, and will soon pull from the public funds of Social Security and Medicare.
- Patient Protection and Affordable Care Act : an American law passed in 2010 that expands health care coverage
Managing the Aging Population
The elderly have financial difficulties primarily because they are too old to hold a job, and thus have no regular income, yet they incur large medical expenses as a result of diminishing health. However, due to the improvement in medical technology, more seniors are living longer and more fulfilling lives, yet still struggle financially. Because of this trend of impoverishment, the United States has enacted social policies designed to help the elderly manage their financial woes. Major policy efforts include Social Security, a social welfare program that taxes the current working sector to give money to individuals in retirement, and Medicare, a federal program that subsidizes medical costs for seniors. Prior to the introduction of Social Security, the elderly were the poorest age group in the United States. With the introduction of Social Security, poverty rates of the elderly in the United States have dropped dramatically. Between 1960 and 1995, the official poverty rate of those aged 65 and above fell from 35 percent to 10 percent, according to the National Bureau of Economic Research. However, due to a lack of funds, that number is beginning to increase once again.
Social Security
Social Security is designed to redistribute wealth temporarily in order to help seniors finance their lives after retirement. In this program, the current workforce is taxed, the results of which flow into a special fund designated for Social Security. Payments are then made from this fund to retirees. This is not, however, simple redistribution. The workforce that is currently contributing to the fund will then retrieve payments once they retire. Thus, Social Security has features of both a redistribution system and a savings account.
Medicare
In addition to Social Security, the other primary social support for the American elderly is Medicare. Medicare is a social insurance program that provides health care for American citizens over the age of 65. Medicare subsidizes hospital visits, doctors’ appointments, and prescription drugs. Created in 1965, Medicare was intended to address the fact that seniors spend more on healthcare than any other segment of the population, despite having the least income. Recent studies have confirmed that Medicare enrollees typically have lower incomes and more healthcare expenses than the average American. In 2006, the average household income of Medicare enrollees was $22,600, far less than the median American income of $48, 201. In 2008, 16% of Medicare enrollees were living below the poverty line, compared to 13% of the general population. Further complicating things, the typical senior household has only $66,900 in savings, yet the average American male needs $124,000 to cover healthcare during retirement, and the average American female needs $152,000.
Because Medicare enrollees are, by definition, senior citizens, their healthcare costs also far higher than average. About 87% of Medicare enrollees have at least one chronic condition and close to half have three or more. Thirty percent of enrollees visit the emergency room in any given year, and 21% have an inpatient stay. Roughly 66% of seniors require some form of long-term care over their lifetimes, and 18% live in a nursing home for at least one year. These disparities demonstrate the complicated problems most senior citizens encounter as they age.
Looming Crises with Medicare and Social Security
Social Security could soon be in crisis if current trends to not change. Right now, more money is being garnished through taxing the current workforce than is being paid out to retirees. However, this will soon change. If the laws governing Social Security are not changed by 2017, the program will begin paying out more funds than it receives. Medicare faces even more dire financial problems than Social Security. Like Social Security, Medicare gains revenue through taxation, but by 2009, Medicare was expending more than it was earning, and its Trust Fund had already been tapped to access emergency funds. The Trust Fund for Medicare will be exhausted by 2017, at which point, the federal government will only be able to cover about 80% of the costs of medical treatment for its senior citizens, which is around 48 million Americans.
Part of the reason both Social Security and Medicare face looming crises is the rising population of seniors. The baby boomer generation, those born in the 20 years following World War II, is starting to reach senior citizenship and pull from these public funds. At the same time, the working population in the United States has decreased. Thus, Social Security and Medicare are both being called upon to support greater numbers of senior citizens while having fewer workers to tax in order to gain revenue. The respective conditions of Social Security and Medicare contributed significantly to the discussion surrounding the Patient Protection and Affordable Care Act, passed by President Barack Obama in 2010. The act, commonly referred to as Obamacare, provides a public insurance option through the government to help drive down insurance costs. By lowering healthcare costs and requiring insurance, the government hopes to better address the needs of the nation’s elderly. However, the constitutionality of the Act is currently being debated by the U.S. Supreme Court and the Act could be overturned. Regardless of what the Supreme Court decides, American seniors face serious financial troubles, compounded by their healthcare needs.
Global Aging
Global aging differs depending on the access to economic and social resources; thus, industrialized countries tend to have older populations.
Learning Objectives
Discuss the impact of an aging population on the economy, for example, in terms of health care costs
Key Points
- People are living longer than ever before across the world.
- However, on average, people in industrialized nations live longer than people in non-industrialized nations. This is largely due to poorer health in non- industrialized countries, and fatalities associated with HIV/AIDS.
- Difference in lifespan is also attributed to better access of healthcare in different industrialized and non-industrialized nations.
- The economic effects of an aging population are considerable.
Key Terms
- biotechnology : The use of living organisms (especially microorganisms) in industrial, agricultural, medical and other technological applications
- HIV/AIDS : An infectious disease, caused by HIV, that causes the gradual degeneration of the body’s immune system.
All over the world, people are living longer than ever before. However, while the trend of a growing older population appears world over, people in industrialized nations are older than people in non-industrialized nations. According to the Population Research Bureau, the average life expectancy in Africa is 53, in North America is 78, in Latin America is 73, in Asia is 68, in Europe is 75, and in Oceania is 75. Worldwide, about 8% of the total global population is over the age of 65, while about 12% of Americans are over the age of 65.
Some of this difference can be attributed to disparities in health care. Easier access to pervasive biotechnology in industrialized nations means that people live longer. Unfortunately, in some countries HIV/AIDS has ravaged the population to the point where the average life expectancy drops. Most of these countries have lower levels of development and industrialization.
The economic effects of an aging population are considerable. Older people have higher accumulated savings per head than younger people, but spend less on consumer goods. Depending on the age ranges at which the changes occur, an aging population may thus result in lower interest rates and the economic benefits of lower inflation. Some economists see advantages in such changes, notably the opportunity to progress automation and technological development without causing unemployment. They emphasize a shift from GDP to personal well-being.
However population aging also increases some categories of expenditure, including some from public finances. The largest area of expenditure in many countries is now health care, the cost of which is likely to increase dramatically as populations age. This would present governments with hard choices between higher taxes, including a possible reweighing of tax from earnings to consumption, and a reduced government role in providing health care.
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