ASBHDS - Session 1

Question 1

Give some reasons for the decrease in death rate in the UK observed over recent years.

Answer 1

MEDICAL ADVANCES (vaccines, new drugs, improvements in surgical techniques), SOCIAL IMPROVEMENTS (better housing, sanitation and diet).

Question 2

What is the biopsychosocial model?

Answer 2

A model of illness where PSYCHOLOGICAL factors (cognition, emotion, behaviour), SOCIAL factors (social class, employment, social support), and BIOLOGICAL factors (physiology, genetics and pathogens) all contribute to the maintenance of health and illness.

Question 3

Which model of illness is currently prevalent in Western medicine?

Answer 3

The biomedical model, where illnesses are understood in terms of biological and physiological processes and treated with physical intervention.

Question 4

What are “lay beliefs”?

Answer 4

Complex, socially embedded explanations of how people understand and make sense of health/illness.

Question 5

What is the negative definition of health?

Answer 5

Health equates to the absence of illness.

Question 6

What is the functional definition of health?

Answer 6

Health is the ability to do certain things.

Question 7

What is the positive definition of health?

Answer 7

Health is a state of wellbeing and fitness.

Question 8

What are the two issues addressed in “lay epidemiology”?

Answer 8

• how and why illness happens

- why it happened to a particular person at a particular time

Question 9

What is health behaviour?

Answer 9

Activity undertaken for purpose of maintaining health and preventing illness.

Question 10

What is illness behaviour?

Answer 10

Activity of ill person to define illness and seek solution.

Question 11

What is sick role behaviour?

Answer 11

Formal response to symptoms, including seeking formal help.

Question 12

Why might smoking be seen as a more rational behaviour among people of lower socioeconomic classes?

Answer 12

Higher social class more likely to have a positive definition of health, incentives of giving up more clear as they expect to remain healthy. Disadvantaged groups are trying to improve immediate environment, smoking may be normalised/a coping mechanism.

Question 13

Most symptoms are never seen by a doctor, as many people do nothing or use lay-care. What is this known as?

Answer 13

The symptom/illness iceberg

Question 14

What is lay referral?

Answer 14

The act of discussing symptoms with others before deciding to visit a doctor.

Question 15

Why is it important for us to understand lay referral?

Answer 15

Helps us to understand why people might have delayed in seeking help, why/when they see a doctor, and if they use alternative medicines/other services.

Question 16

Which four factors may influence someone in whether they seek treatment for rheumatoid arthritis?

Answer 16

Symptom experience, symptom evaluation, knowledge of rheumatoid arthritis and treatments, experience of health professionals

Question 17

Why is it difficult to measure socio-economic status?

Answer 17

It can be measured in many ways, eg individual occupation, area in which people live etc.

Question 18

True or false - deprivation is not routinely associated with ill health?

Answer 18

False - the more deprived a person is, the larger the proportion of their life will be spent in ill health, and the more likely they will die at a younger age.

Question 19

Which four explanations of health inequalities were included in the Black report?

Answer 19

Artefact, social selection, behavioural-cultural, materialist

Question 20

What is the name given to the theory that health inequalities are evident due to the way statistics are collected?

Answer 20

Artefact (this has been mostly discredited).

Question 21

What does the social selection explanation suggest about health?

Answer 21

Health causes social position, so sick individuals move down social hierarchy while healthy individuals move up.

Question 22

What is the name given to the theory that ill health is due to people’s choices/decisions? It suggests that people from disadvantaged backgrounds tend to engage in more health-damaging behaviours and vice versa.

Answer 22

Behavioural-cultural explanation

Question 23

Describe the Materialist explanation of health inequalities.

Answer 23

Inequalities in health arise from differential access to material resources - low income, unemployment, work environments, poor housing conditions. There is a lack of choice in exposure to hazards. This is the most plausible explanation.

Question 24

What is the psychosocial explanation of health?

Answer 24

The idea that psychosocial pathways act in addition to direct effects of (absolute material) living standards. Some stressors are distributed on a social gradient, eg job security.

Question 25

Describe the Income Distribution model of health inequality.

Answer 25

Relative income affects health, so countries with greater income inequalities have greater health inequalities. Most egalitarian societies have best health.

Question 26

Why is it difficult to measure access to healthcare?

Answer 26

Utilisation studies measure receipt of services, they don’t include people who don’t access care because they can’t/don’t know how.

Question 27

True or false - deprived groups seem to relatively overuse GP and emergency services and underuse preventative and specialist services?

Answer 27

True - linked with tendency to manage health as a “series of crises”.