Final Flashcards
Major determinants of population health?
- the use of formal health care behaviour
- human biology
- environment
- lifestyle behaviour
Four key areas of the Lalonde report
1) human biology (genetic disposition)
2) environment (social, physical)
3) lifestyle (personal health practices)
4) health care (access to physician/hospital care)
Determinants of good health/ill health according to Antonovsky?
Good health:
- sense of coherence
- coping skills
- supportive social environments
- health resource management
- enhanced self-health care capacity
Ill health:
- microorganisms
- viruses
- infectious disease
- preventative medical care
- risk reduction
Personal vs structural determinants of health
Personal:
- evident at the personal level
- genetic makeup, beliefs, attitudes, personal health behaviours
Structural:
- evident at the societal level
- social/economic environment (income distribution, unemployment, living/working conditions)
Horizontal vs vertical structures
Horizontal (more immediate factors):
- family environment
- workplace conditions
- quality of housing
Vertical (more distant, macro-level):
- political/economic policies
- taxation
Primary vs secondary determinants
Primary (socioeconomic factors, direct effects):
- household income
- education level
- employment status
Secondary (daily behavioural practices, psychosocial wellbeing):
- smoking
- sense of coherence
Social gradient
Definition: a graded association between the indicator of socioeconomic status and population health
how does social exclusion affect health?
unequal access to social, cultural, political and economic resource
Relationship between income equality and population health
As income inequality goes up, life expectancy goes down
Demand-control model
-HIGH DEMAND + HIGH CONTROL/SUPPORT = ACTIVE
-LOW DEMAND + LOW CONTROL = PASSIVE
-LOW DEMAND + HIGH CONTROL = LOW STRAIN
-HIGH DEMAND + LOW CONTROL = HIGH STRAIN
-High demand + low control = negative health
outcomes
Effort-reward imbalance model
Adverse effects on health if time and effort devoted to work are not matched by adequate rewards
- income
- advancement opportunities
- job security
3 Explanations of social gradient of health
-Materialist explanations: focus on the effects of
harmful environments on health;
-Cultural behavioral explanations: focus on the poorer
coping skills and behaviors associated with being
lower on the socioeconomic ladder
-Psychosocial explanations: emphasize that people’s
perceptions of hierarchy shape patterns of health
across populations
Differentiate among inequity, inequality, and health disparity
-inequity: unfair, avoidable differences arising from poor
governance, corruption or cultural exclusion
-inequality: the uneven distribution of health or
health resources as a result of genetic or other factors or the lack of resources
-Health disparity: differences in access to or availability of facilities and services (due to health inequities)
Social inequality vs social exclusion
social inequality: relatively stable differences between individuals and groups of people in the distribution of power and privilege. Where some have superior access to economic, political, and ideological power
Social exclusion: A process of marginalization reflecting unequal power relationships between groups in society that involve unequal access to social, cultural, political and economic resource and have adverse health effects
Gender differences in healthcare
1) Women live longer than men
2) The Genders differ in major causes of death
3) Women are diagnosed as suffering from more ill
health than men
4) Women make more frequent use of formal health care
than men
5) Gender differences in the social determinants of
health
Hypotheses to explain gender differences in health
- The role-accumulation hypothesis suggests that taking on multiple roles leads to positive health effects
- The role-strain hypothesis states the opposite: women’s multiple roles are harmful to health.
- The social acceptability hypothesis suggests that women have been socialized into accepting the sick role.
- The risk-taking hypothesis suggests that men engage in risky behavior, because they are socialized to do so.
Ethnic differences in health
1) Ethnic differences in perception and understanding of
symptoms
2) Ethnic differences in health-care behaviour
3) Ethnic differences in the social determinants of health
4) Aboriginal peoples have poorer health outcomes
5) The “health immigrant effect” that deteriorates over
time
Causes of Aboriginals’ poorer health
colonization
racism
intergenerational trauma
social exclusion
