Chapter 2: Ways of Knowing- Health Policy and Health Studies Flashcards
Four paradigms for understanding health
- Medical
- Behavioural/lifestyle
- Socio-environmental
- Structural/critical
What is the most dominant health paradigm?
Medical
What does the medical paradigm define health as?
Absence of disease and disability and defines health issues in terms of physiological risk factors and disease
What is the medical paradigm rooted in?
Individualism
What interventions does the medical paradigm include?
Medical intervention such as surgery, drugs provided by health care professionals
What is health policy focused on regarding the medical paradigm?
Medical delivery
How does the behavioural/lifestyle paradigm define health?
In terms of individual energy, functional ability and disease preventing lifestyles and defines health issues as behavioural risk factors such as smoking, diet etc.
What interventions are implemented in behavioural/lifestyle paradigm?
Health promotion and social marketing to promote and support lifestyle changes
Who is involved in the behavioural/lifestyle paradigm?
Individuals responsible for adopting healthy behaviours
How does the socio-environmental paradigm define health?
Connectedness to family, friends and community and defines health problems in terms of social factors such as poverty, living or working conditions
Interventions implemented with the socio-environmental paradigm
Community development, political action and advocacy
What is a limitation to the socio-environmental paradigm?
Doesn’t direct attention to influence of larger, political, economic and social forces
Who is involved in the socio-environmental paradigm?
Individuals
What is the socio-environmental paradigm also called?
Materialistic
What is the structural/critical paradigm also called?
Neo-materialistic
How does the structural/critical paradigm define health?
In terms of unequal distributions and control of economic and social power within a society
What is the structural/critical paradigm concerned with?
Focuses on ideology and the organization of society
Who does the structural/critical paradigm focus on?
Collective/whole society, rejects individualism
Interventions implemented with the structural/critical paradigm
Policy change to address inequalities
What is a knowledge paradigm?
A set of beliefs or assumptions about knowledge and how it is created
Ontology
Form in which reality and its objects are said to exist (nature of reality or what can be known)
Epistemology
How the inquirer creates knowledge through research and experience; shapes how knowledge is believed to be acquired and understood (what is knowledge?)
Methodology
What tools can be used to generate and acquire knowledge; scientific methods, interactive approaches (interviews)
Social theories
- Positivism/rationalism
- Post positivism
- Critical theory
- Interpretivism
Postitivism/rationalism
States that the only authentic knowledge is scientific knowledge and this can only come from positive affirmation of theories through the scientific method such as universal laws of natural phenomena and human behaviour
Beliefs of positivism (ontology)
A natural world exists outside of human interpretation
We can acquire objective knowledge about the world
Epistemology of positivism
Physicial, biological and health sciences
Methodology of positivism
Collection and analysis of quantitative data using hypothesis testing
Limitations of positivism
Ignores social, economic and political factors
Shifts focus to downstream factors such as pharmaceutical, medical etc.
Post-positivism (critical realism)
A natural reality exists outside of human interpretation, but we cannot study it objectively due to researcher bias
What type of research do post-positivists use?
Mixed
What is the focus of interpretivism?
How people understand the world using the shared meanings we use to make sense of things
All views are equal
What type of research does interpretivism use?
Qualititative research based on lived experiences
(ethnography, grounded theory)
Examples of instruments interpretivists may use in their research
Open-ended interview questions
Focus group questions
Ethnographic field notes
Limitations of interpretivism
Fails to take into account impact of social relations
Fails to investigate structural systems
Doesn’t question what health and health problems are the first place
Goals of the critical theory
Critique and transform society as a whole and describe structures and processes of power and hierarchy not considered by positivists or interpretivists
What does the critical theory focus on?
Social, political and economic context
What does the critical theory investigate?
Distribution of resources and lived experiences
What research paradigm falls under the medical approach to health?
Positivism
What research paradigm falls under the behavioural/lifestyle approach to health?
Positivism and post-positivism
What research paradigm falls under the socio-environmental approach to health?
Interpretive
What research paradigm falls under the structural/critical approach to health?
Critical theory
