2 differences in health Flashcards
What are necessary conceptualisations of views of health?
evidence led to the assumption that SES predicts health
Kittleson et al. (2006) - students with low SES in childhood were twice as likely to develop coronary heart disease, despite becoming a doctor in later life
→ health-damaging behaviours
Different views on health - what is considered healthy in your culture?
”Normality”
individuals generally act in ways that correspond to cultural influences and
expectations
What is the sociocultural understanding of health?
biomedical view - health = absence of disease
replaced by a view that emphasizes the role played by socio-cultural forces in the shaping of health (and illness) and related psychological experiences (Engel, 1977; Taylor, 1978)
WHO, 1948 - “a complete state of physical, mental and social wellbeing and not merely the absence of disease or infirmity”
→ complexity and multidimensionality
social wellbeing → the individual is a social being → part of a bigger entity
recent psychological approaches focus on the larger networks that the individuals are part of
→ environmental influences
medical anthropologists: illness across cultures (e.g., Helman, 1994; Kleinman,
1980).
How does culture influence health? Three examples
- menopause and pain
Lock (1986) - Japanese women view menopause as natural life-cycle transition with biological marker of cessation of menstruation being not important
symptoms were also different compared to the West: fewer symptoms
→ historical view
reaction to painkillers might differ as well
Poliakoff (1933) - Chinese fear medication will give them a feeling of loss of control - reluctant
Hindus - may wish to face death “clear-headed”
- health-care seeking behaviour
knowledge and beliefs, associated symptoms, consequences, trust in physicians
determining priorities (preventative healthcare?)
→ put others first (south-asian women and chinese women)
- doctor-patient relationships
cultural sensitivity
gender relationships
What is an important framework for understanding cultural differences in the psychology of health and illness?
culture = a set of structures and institutions, values, traditions, and ways of engaging with the social and nonsocial world that are transmitted across generations (e.g. Shweder & LeVine, 1984)
proposed features of cultures to be used as organizing constructs
individualistic vs collectivist
American’s desire to maintain their health with their desire be autonomous individuals.
illness = to be avoided breakdown in ones abilities to carry out obligations
Having a healthy body can be characterized as a resource that facilitates fitting into the social order within a collectivistic frame.
What is the self-regulation model of illness cognition and behaviour?
stimuli
-> cognitive representations
-> emoitonal representations
=> coping responses
=> evaluation of coping responses
- feedback loop
How is religion related to health?
Kohli and Dalal (1998) show that belief in fate and God’s will is negatively correlated with perceived controllability, implying that those who attribute
their illness to fate and God’s will perceive little control over the course of the illness.
Patients who believe God’s will to be the cause of their illness, show greater perceived recovery; patients who perceive bodily weakness as the cause of their illness, are less effective in dealing with the crisis and their psychological recovery is poor.
How does health communication need to adapt to culture?
interplay of individual difference factors (motivational orientation), socio-cultural factors (cultural background), and situational factors (message frame) is likely to influence important factors related to health behaviour change
priming the dominant cultural frame, reminding of cultural values/expectations helps the persuasiveness
How does coping differ between cultures?
seeking support concerns
sense of control
social support
emotional comfort
…
How can cultural appropriateness be achieved?
Peripheral - Appropriate appearance (colours, images, fonts, pictures of group members, declarative titles)
Evidential - Presenting evidence of health issue impact on target group
Linguistic - Dominant or native language of target group, also, using words and sentences that are both understandable and familiar.
Constituent-involving - Directly include members of the target group in intervention
Sociocultural - Discuss health-related issues in context of broader socio cultural values and characteristics of target group
How can cultural targeting be achieved?
in public health (e.g., addressing problems in the populations most affected) and health education (e.g., making programs relevant to the populations they serve).
What is cultural tailoring?
“any combination of information or change strategies intended to reach one specific person, based on characteristics that are unique to that person, related to the outcome of interest, and have been derived from an individual
assessment.”
paradox: culture is a shared group characteristic, tailoring depends on individual differences
What are factors causing health-discreptancies in a country?
vulnerability factors related to social status
→ chronic stress
immune system
physiological processes are affected uniquely
causes of chronic stress
low SES
weak social connections
stress in early life
white-coat hypertension
larger or smaller income differences
problems at the bottom of society → more common in societies with bigger income differences
amongst the whole society
affects the social fabric, damages social cohesion
inequality is socially divisive
significant difference in problem prevalence!!
makes status more important
downward prejudice
status competition, status insecurity
the material differences create the social distances
For western cultures specifically, what is the health problem?
gap between image and reality
Mental Health Foundation commissioned a large survey last year, it found that74% of adults were so stressed they felt overwhelmed or unable to cope. Almost a third had had suicidal thoughts and 16% had self-harmed at some time in their lives (2018)
consumerist culture also leads to unhappiness
measures of a persons inner worth change
rising narcissism
self-enhancement
dominance and subordination axacerbated by inequality
How does gender influence health inequalities?
gender gap is closing
certain health and wellbeing issues are more commonly associated with one gender
dementia, depression, arthritis is more common in women
lung cancer, cardiovascular disease, suicide more common in men
biological differences?
social differences?
gender-specific medicine
biology only influences health, it does not determine it
gender specific roles
gender = social construct
social determinant of health
medicalisation of menstruation (PMT)
natural reproductive function
mood changes
women consult doctors and hospitals more often
body has been constructed as a medical issue to a greater degree
regulated more by medical officials
What are contribution of feminist and marxist perspectives to health?
Feminism:
society disadvantages women by constraining them and limiting their opportunities
exploited by society´s structural organisation - social control
Marxism:
capitalism - increasing accumulation of profit, exploitation of labour force, oppression, inequality
social institutions such as the government, family, media and health system are influenced by the needs of capitalism
at the expense of the majority
division of labour between work and home
interaction between patriarchy and the needs of capitalism
