6. Health inequalities Flashcards
1
Q
What is sociology
A
The study of the development, structure and functioning of human society
2
Q
Defining medical sociology (the sociology of health and illness)
A
- This defines the sociology of health and illness - applying the methods and theories of sociology to the health field
- studies people’s interactions with those engaged in medical occupations, e.g. dr-pt relationship
- studies the way people make sense of illness, e.g. illness vs diseease
- studies the behaviour and interactions of health care professionals in their work setting, e.g. professional values, interactions between health care professionals
3
Q
Application of sociology to healthcare - example: health promotion
A
- Promoting healthy behaviour and preventing ill health is only possible if we understand the ways different groups in society operate, e.g., men and women, rich and poor
- Sociology provides health promotion with an analysis of the different groups in society - e.g. different groups may have different views to e.g. smoking.
- an understanding of this would mean health promotion could be tailored to the different groups, hopefully making it more effective.
4
Q
Application of sociology to healthcare - example: medicalisation
A
- The process where areas of behaviour or life become defined as medical problems, often with medical solutions
- Things previously seen as natural, e.g. child birth, are becoming medicalised
- problematic behaviours in realtion to gambling, alcohol, or sex = ‘addictions’ so medically managed
- normal responses to loss/adverse events requiring the intervention of doctors to legitimise them/manage them
5
Q
Application of sociology to healthcare - example: work related stress
A
-
Stress - adverse reaction to excessive pressure; consequences:
- individual - poorer physical/mental health, poor mental behaviours
- society - loss of productivty/work days
- health service - increased use of health services
- Often medicalised - person seen as unwell, encouraged to see a doctor or other expert, sometimese sighned of work
- Organisational solutions proven better to address stress rather than helping indivudal to cope with stress in medical sense
6
Q
Social/socio-economic influences on our health
A
The collective set of conditions in which people are born, grow up, live and work. These include:
- Gender
- Ethnicity
- Physical environment/housing
- Education
- Employment
- Income
- Health system
- Culture and social environment
All of these factors have an influence on how healthy a person is
7
Q
Influence of gender on health
A
- In devloped countries: men have a higher mortality at every age; women outlive men by 4-5 years
- Women have a high morbidity
- __women also consult more frequently in GP settings
8
Q
Influences of gender on presentation and diagnosis
A
- CV diseases - younger women have a higher rate of mortality after 1st MI/CABG, but men higher rate SCD
- Other areas significant gender difference include asthma & AI diseases
- Argued that differences in gender are not taken into consideration enough when making a diagnosis
- Rehabs/areas disease management not always adjsuted to the needs of each gender.
9
Q
Influences of gender in disease management
A
- E.g. delay in referral of female patients with RA to clinic compared to men, yet osteoporosis/depression often considered female diseases with underdiagnosis in both.
- Sometimes diagnosis is made late based on certain conditions being thought of as more likely in males and therefore not readily thought of in females.
10
Q
Application of sociology to healthcare - example: sociology of the medical profession
A
- Sociologists who studied professions in the 1950s identified characteristics of professions as opposed to other occupations:
- Systematic theory
- Authority recognised by its clientele
- Broader community sanction
- Code of ethics
- Professional culture sustained by formal professional sanctions
- Medicine incorporates all of the above features.
11
Q
Application of sociology to healthcare - example: the sick role
A
- Significant cultural variations in what are defined as symptoms and acceptable in an illness and what are defined as normal - not meriting the same levels of support or empathy, e.g. pain
- Often think of this when someone ‘adopts’ sick role: receiving benefits but not necessarily engaged with the responsiblities of the sick role
- Introduces idea of ‘secondary gains’ that may motivate continuatino within the sick role
- Role of doctor in this is potentially controversial as we are the ones who have to justify any significant level of sickness
12
Q
Define sick-role of patient
A
- The sick role exempts ill people from their daily responsibilities
- Patient is not responsible for being ill and is regarded as unable to get better without the help of a professional
- Patient must seek help from a healthcare professional
- Patient is under a social obligation to get better as soon as possible to be able to take up social responsibilities again
13
Q
Define sick role of healthcare professionals
A
- Professional must be objective and not judge patients morally
- Professional must not act out of self-interest or greed but put patient’s interests first
- He/she must obey a professional code of practice
- Professional must have and maintain the necessary knowledge and skills to treat patients
- Professional has the right to examine patient intimately, prescribe treatment and has wide autonomy in medical practice
14
Q
Ethnicity and health
A
- South Asians living in Scotland have higher rates of heart attacks than general population, but yet higher survival rates
- HIgher. revalance of T2DM in South Asian population
- Greater prevelance of sickel cell disease in African origin group
- Data suggeests that the minority ethnic gropus have better general health than the majority of the white population
*
15
Q
Ethnicity and alcohol
Sociology describes but also seeks to identify reasons for this
A
- Diversity both within and between ethnic groups
- most minority ethnic groups. have higher rates of abstinence compared to people from white backgrounds
- Generation differences emerge overtime - e.g. 2nd generation Sikh men drink less than 1st generation
- People from some ethnic groups ae more at risk of alcohol-rleated harm - e.g. Irish/Scottish men
- Greater understanding of cultural issues is needed in developing mainstream and specialist alcohol services
16
Q
Approaches of dealing with disparities in health relating to ethnic and cultural differences
A
- Identify the potential barriers to the use of health services
* patient level - language concerns, understanding system
* provider level - understanding of the differences due to ethnicity, provider skills and attititudes
* system level - organisation of appointments and referrals
- Identify the potential barriers to the use of health services
-
Culturally competent care
* combination of attitudes, skills and knowledge that allows an understanding and therefore better care of patients from different backgrounds to our own
-
Culturally competent care
- Recognizing when we are being culturally incompetent!
17
Q
Housing as a social factor
A
- Potential for health gains from housing may vary depending on individual vulnerability to the harmful effects of poor housing
- e.g. greatest improvement among those with poor health, eldery and very young
- Yet, some negative effects of improved housing - think about the increased financial burden posed.
18
Q
Housing as a social factor - one area of definite benefit
A
- Improvments to mental health have been consistently reported following housing improvements.
19
Q
Housing as a social factor - some specifics
A
- Indoor air quality - determined by levels of both indoor/outdoor pollutants
- Mould spores/faecal pellets from house dust mites are most common domestic allergens
- Elderly & very young at particular risk of both low and hgih indoor temperatures
- Lead exposure leads to physical, mental and intellectual problems
- Secure home ownership - linked to improved health
