FPC3 Inequality Seminar (A&B Groups) Flashcards
What is Sociology?
The study of the development, structure and functioning of human society
Application of Sociology to Healthcare:
The sociology of health and illness (Medical Sociology) applies the methods and theories of sociology to the health field in what ways?
- Sociology studies peoples’ interactions with those engaged in medical occupations e.g. healthcare professional-patient relationships
- Sociology studies the way people make sense of illness e.g. illness versus disease
- Sociology studies the behaviour and interactions of health care professionals in their work setting e.g. professional values, interactions between health care professionals and other health care staff
how should health promotion in the society be done?
- 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, young and old
- Sociology provides health promotion with an analysis of the different groups in society
what is Medicalisation and some examples?
- The process where areas of behaviour or life become defined as medical problems, often with medical solutions
- Things that were previously seen as natural such as pregnancy and child birth are becoming more medicalised
- Problematic behaviours in relation to gambling, alcohol or sex become labelled as addictions and medically managed
- Normal responses to loss or adverse events requiring the intervention of doctors to legitimise them and manage them
Stress - adverse reaction to excessive pressure. Common affecting 1 in 6 of those in work. Significant consequents for who?
- The individual – poorer physical and mental health, poorer health behaviours e.g. smoking, alcohol, poor diet
- Society – loss of productivity and work days
- The health service – increased use of health services due to stress or its consequences
Work related stress associated with factors such as lack of power and control in the workplace, job security, low pay, changing job frequently or frequent redundancies
is work related stress medicalised?
- Often medicalised – person seen as unwell, encouraged to see a doctor or other expert (counsellor etc), sometimes signed off work
- But research suggests that organisational solutions that address the causes of stress e.g. workload, role clarity, support are more effective than those targeted at helping the individual cope better
what does the sick role involve for the patient?
- 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
What is the Sick role-healthcare professional role?
- 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
What are the social/socio-economic influences on our health?
A definition would be 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 / social status / financial security
- Health system
- Culture and social environment
WHO – ‘There is ample evidence that social factors, including education, employment status, income level, gender and ethnicity have a marked influence on how healthy a person is. In all countries – whether low-, middle- or high-income – there are wide disparities in the health status of different social groups. The lower an individual’s socio-economic position, the higher their risk of poor health.’
What are the social/socio-economic influences on our health - how does gener effect our health?
- In developed countries men have a higher mortality at every age; women outlive men by 4-5 years.
- Women have a higher morbidity:
- ?Just visit the doctor more
- ?due to living longer so more of the diseases of elderly
- Women may present differently but also some evidence that they are assessed differently e.g. receive poorer care for heart disease as assumed to be only common in men
•Women consult more frequently in General Practice settings
how does gender affect presentation and diagnosis?
•Cardiovascular diseases have been the most investigated
- Younger women higher rate of mortality after first MI and CABG (bypass) but men in all age groups have higher risk of ischaemic sudden death
- Women experience a greater variety of symptoms – ‘atypical presentation’
- AF is a greater risk of stroke in women than in men
•But are not the only areas where there is a significant gender difference
- Higher incidence asthma in young boys but in young adulthood more women affected
- Women have a greater sensitivity to negative effects of tobacco
- Most autoimmune diseases are more frequent in women
How is there Differences in Disease Management between gender?
- Women with MI receive less guideline based diagnosis and less invasive treatment than men
- Women with heart failure receive fewer guideline based diagnostic procedures and treatments, fewer implants and transplants but still have a better outcome than men
- Women obtain dialysis later than men and undergo fewer transplants
- Delay in referral of female patients with RA to clinic compared to men
- Osteoporosis and depression considered female diseases – both might be underdiagnosed in men
how does ethnicity affect health?
- South Asians living in Scotland have substantially higher rates of heart attacks than the general population, but they also have higher survival rates
- Prevalence of type 2 diabetes is higher in South Asian populations
- Admissions for Polish and Chinese groups are lower than white Scottish counterparts with higher rates in some Asian groups, white British
- There is greater prevalence of sickle cell disease in African origin groups
- Scottish data suggest that minority ethnic groups in Scotland, with some exceptions such as Gypsy/Travellers, have better general health than the majority of the white population
- Mortality in Scotland is higher in the majority ethnic (white) population than in the black and minority ethnic population
how does ethnicity relate to alcohol?
There is diversity both within and between ethnic groups:
- Most minority ethnic groups have higher rates of abstinence and lower levels of drinking compared to people from white backgrounds
- Abstinence is high amongst South Asians, particularly those from Pakistani, Bangladeshi and Muslim backgrounds.
- People from mixed ethnic backgrounds are less likely to abstain and more likely to drink heavily compared to other non-white minority ethnic groups
- People from Indian, Chinese, Irish and Pakistani backgrounds on higher incomes tend to drink above recommended limits
ethnicity and alcohol: Over time generational differences may emerge such as what?
- Frequent and heavy drinking has increased for Indian women and Chinese men
- Drinking among Sikh girls has increased whilst second generation Sikh men drink less than first generation
How might Education Influence Health?
Rates of major circulatory diseases, diabetes, liver disease, and several psychological symptoms (sadness, hopelessness, and worthlessness) show higher rates among adults with lower educational attainment
•Psycho-social environment:
- Effects social standing, sense of control and social support
- Bolsters individual capacity and autonomy / agency
•Access to different employment:
- Improves income – housing, environment, diet
- Improves benefits – sick pay, pension, holidays
- Improves working conditions – exposure to hazards and risk, improved autonomy and power in the work place
- Healthy knowledge - Benefits of lifestyle change, awareness of risk associated with health behaviours, capacity to negotiate the system.
- Direct effect – unexplained by above or by innate intelligence or other confounding factors.
Does distribution of GPs across Scotland reflect the levels of deprivation?
- The distribution of GPs across Scotland does not reflect the levels of deprivation
- There is evidence that services designed to improve whole population health e.g. eye checks, cancer screening, may widen health inequalities if uptake is lowest in those who would derive the greatest benefit
do diseases differ in deprived and non-deprived areas?
