Geographies of Health Flashcards
WHO, 1946 definition of health
‘state of complete physical, mental and social wellbeing and not merely the absence of infirmity.’
composition
places with poor health have poor health because they are composed of people with characteristics of poor health. (health of the place is the sum of the individuals)
context
aspects of the place matter in determining health over and above characteristics od the individuals
Bourdieu
Habitus, deeply ingrained habits, dispositions that shape ones behaviours and attitudes towards healthcare. communities may avoid due to culture or historical inequalities
Putnam
Social capital, networks, norms and strust lead to a sense of belonging, therefore promote health
Mosely & Chen model (1984)
five groups of proximate determinants of health. Maternal, environmental, nutrient, injury, personal illness control.
overlooks deeper socio-politcal-economic issues.
dahlgren & whitehead (1991)
age, sex in center.
individual lifestyle
social and community networks
education, work, living, unemployment, health services
general socio-economic, cultural and political
Gender
women live 3-5 years longer, 1-2 is biological
work-related hazards, risk-taking, health-seeking, smoking
Demographic transition model
mortality fell first amongst children and young adults (most vulnerable to infections disease)
range of causes changes, led to epidemiologic transition
Omran (1971)
epidemiologic transition
- three phases: age of pestilence and famine (high mortality rates due to infectious disease, sanitation and malnutrituion)
- age of receding pandemics, declining mortality due to public health improvements
- age of degenerative and ‘man-made’ diesease - non communicable
Income
siocio-economic status, heirarchal system. stronger health correlation with women than men.
income can affect access in US, link to education
fundamental cause theory
Link & Phelan (1995)
socio-economic standing is fundamental cause
SES will always find way to cause health differences
In US rich had access to sanitation first, when introduced to poor health differences did not hcange, new set of socio-economic problems emerged
looks to solve root causes
Preston curve
(1975), argue that most significant improvements between 1930 and 1960 were due to advances in technology and medicine.
after 1960 income has played a role
same increase in income will benefit the poor more than the rich.
Inequality
Measuered by ratioing richest and poorest 20%
Wilkinson & Pickett produced graphs showing correlation, not necessarily causation
routes to poor health through inequality
pure income - concavity effect, health increases with income but at decreasing rate, health disparities worsen as inequality rises. even if average increases, health disparities remain.
contextual - neo-material effect, public spending and resourcing, less spending in deprived areas, lower quality and less accessible
psycho-social - position in heirarchy affects stress. W&P argue everyone is worse off
W&P critiques
argued pure income has little affect, social spending has poor correlation to health, psycho social is most important.
ignore material pathways from income to health, does not work for sall areas or countries or international comparisons of self-rated health
education
female schooling, interacted with other determinants so hard to identify the extent of its benefit
systematic reviews
useful in determining succesful interventions on health. most focus on modification of lifestyle factors, easy to identify and treat
Kerela
example of income not being only factor, mortality unusually low for economic standing. government impact, promotion of gender equality, education and culture of health
