Health and Illness: Chapters 1-5

Question 1

WHO Definition of Health

Answer 1

a state of complete physical, mental, and social well-being, and not merely the absence of disease or injury

Question 2

Rene Dubos

Answer 2

defined health as the ability to function and carry on normal, everyday roles

Question 3

Absence of disease

Answer 3

many people define health as the absence of disease or injury

Question 4

Germ theory of Disease

Answer 4

bacteriology: uncovered the cause of many diseases as germs; gives you a strategy to see how diseases spread and to treat them

Question 5

Magic bullets

Answer 5

Dubos: medicine’s thinking was dominated in the 20th century by the search for drugs as “magic bullets” that could be shot into the body to kill or control all health disorders

Question 6

Social epidemiology

Answer 6

looking at patterns of diseases, how they’re affected by environmental, social, biological, and cultural factors; primary focus of the epidemiologist is not on the individual, but on the health problems of social aggregates or large groups of people

Question 7

Etiology

Answer 7

what causes a health condition ex. germs, radiation, injury, etc.

Question 8

Diet

Answer 8

if it doesn’t include all nutrients, you can get a disease ex. scurvy- british navy

Question 9

Environment

Answer 9

extreme weather, heat or cold, can cause disease

Question 10

Genetics

Answer 10

diseases carried across generations, some more common in certain ethnic groups, other more common by location; mutation can cause diseases, sometimes people die of these or have shortened lifespans if born with or develop these diseases

Question 11

Sex

Answer 11

biologically assigned gender: diseases b/c of biology/ chromosomes

Question 12

Gender

Answer 12

how you define yourself; socially constructed; illness because of associated behaviors ex. men more likely to drink and be reckless because of gender roles

Question 13

SES

Answer 13

socioeconomic status; used to be referred to as social class: identifiable groups with some distinctive roles in society; a continuous rather than discrete variable; people with higher income/wealth tend to be healthier; people with diff education levels have diff jobs and health risks associated with those jobs; education is most important factor related to health - people with higher education are less likely to do things detrimental to their health

Question 14

Mortality

Answer 14

death; its hard to detect what exactly killed someone because most diseases/ illnesses are intertwined

Question 15

Morbidity

Answer 15

illness; it’s even harder to detect morbidity because people don’t always report when they’re sick

Question 16

Epidemiological transition

Answer 16

diseases that people tend to die of later in life (heart disease, cancer, stroke) show the success in public health (transitioned from influenza/pneumonia, tuberculosis, gastritis) decrease in mortality because of cleaner living conditions: condition water, air, food, disposal of waste

Question 17

Case

Answer 17

an episode of illness, disorder, or injury involving a person (one instance is a case)

Question 18

Incidence

Answer 18

the number of new cases of a specific health disorder occurring within a given population during a stated period of time; the rate at which cases first appear

Question 19

Prevalence

Answer 19

the total number of cases of a health disorder that exist at any given time; the rate at which all cases exist

Question 20

Brain death

Answer 20

brain stops functioning, declared dead even if still on life support; new way of detecting death developed from the last century, some religious faiths are opposed to concept of brain death

Question 21

Point prevalence

Answer 21

the number of cases at a certain point in time, usually a particular day or week

Question 22

Period prevalence

Answer 22

the total number of cases during a specified period of time, usually a month or year

Question 23

Lifetime prevalence

Answer 23

the number of people who have had the health problem at least once during their lifetime

Question 24

Measurement issues

Answer 24

inexact rates of measurement because people don’t always report an illness correctly, can’t get data on everyone

Question 25

Crude mortality rate

Answer 25

total number of deaths in a population in a certain year; # cases in a year per 1000 / total population times 1000 or other unit of population

Question 26

Age-specific rates

Answer 26

rates used to show differences by age; calculated the same as crude rates, except numerator and denominator are confined to a specific age group; can also calculate sex-specific, race-specific, etc using this method

Question 27

Infant mortality rate

Answer 27

a measure of the deaths of all infants in a geographical area under the age of one year; a common age-specific rate and used to judge the health of a country; # deaths among infants less than 1 year old per 100 people / # of live births times 100 (or whatever unit of people); deaths could be due to genetic conditions; inadequate prenatal care of the mom –> due to poverty most of the time; U.S. in 2004 ranks 29th in the world for infant mortality

Question 28

Cohort analysis

Answer 28

look at people born at a certain time, they belong to a specific age group

Question 29

Gender-specific mortality rate

Answer 29

ex. looking at deaths from child birth - wouldn’t look at the male gender, would also look at a specific age range

Question 30

Race-specific mortality rate

Answer 30

race is self-defined (ambiguous); ex. genetics are different based on your ancestors/race - sickle-cell is more common among those with African ancestors

Question 31

Infectious diseases

Answer 31

crowded conditions of urban living ensured that infectious diseases would spread more quickly and that disease causing microorganisms would persist within the community for longer periods of time; the migrations of people from regions of the world spread disease; they are making a reemergence along with new ones such as west nile, avian flu, etc - they are returning through the effects of globalization, urbanization, and global warming

Question 32

Chronic and degenerative diseases

Answer 32

after medicine and living conditions improved, the focus of medicine shifted to controlling risk factors by modifying lifestyles, agents, or the environment; taking preventive measures and trying to control diseases that affect people of old age

Question 33

Modernization

Answer 33

it was accompanied by greater longevity and a steep decline in infectious diseases, but heart disease, cancer, and other physical ailments associated with modern living increased

Question 34

Social class

Answer 34

a category or group of people who have approximately the same amount of wealth, status, and power in a society

Question 35

Five class model

Answer 35

1) upper class- defined by jobs but also how much wealth, the extremely wealthy top corporate executives and professionals
2) upper-middle class - affluent well-educated professionals and high-level managers, college and graduate degrees
3) lower-middle class - office and sales workers, small business owners, teachers, managers; distinguish the middle class by many factors - education, jobs, wealth, home owners, if they get benefits at work
4) working class - skilled and semi-skilled workers, lower-level clerical workers, craft trades, plumbers, electricians
5) lower class - semi-skilled and unskilled workers, cab drivers, fast food workers, the chronically unemployed

Question 36

Wealth vs. Status

Answer 36

wealth is an objective dimension of a person’s social rank based upon how much money or property he or she possesses; status is a subjective dimension consisting of how much esteem the person is accorded by other people

Question 37

Max Weber

Answer 37

said society has many different inequalities: wealth, power (political influence or leadership), social status (measuring prestige or lifestyle); you can belong to multiple status groups depending on your interests, and people make judgments because of them; status means social position - there are various positions but some can form the basis of social groups - ex. son, mother, student, etc

Question 38

Status group

Answer 38

Weber said that status groups are groups of people who are alike with respect to wealth, status, and power

Question 39

Status symbols

Answer 39

individual characteristics, behaviors, possessions associated with status

Question 40

Social mobility

Answer 40

moving between social classes, you can either move upward or downward - upward is easier in European countries than in U.S.; intragenerational - within 1 lifetime; intergenerational - across generations - changes from parents to kids

Question 41

Karl Marx

Answer 41

first person to define social class (proletariat (working class) vs. bourgeoisie); thought that the basic source of class distinctions was the unequal distribution of material good and wealth

Question 42

Education

Answer 42

most important factor to explain health behavior and social inequality; education impacts: 1) work and economic conditions - better jobs/income

2) social and psychological resources - better control over their lives, more hope for the future, (internal locus of control) your choices make a difference; opposite of control: fatalism - its up to faith/fate AKA external locus of control; better education leads to more internal locus of control
3) health lifestyle - chronic illnesses - education effects when people acquire chronic illnesses and income affects how those diseases progress

Question 43

Conflict Theory

Answer 43

focused on groups

Question 44

Socioeconomic Status (SES)

Answer 44

consists of 3 variables: income (reflects spending power, housing, diet, medical care), occupational prestige (measures status, responsibility at work, physical activity, health risks associated with a job), and level of education (indicative of a person’s skills for acquiring positive social, psychological, and economic resources

Question 45

Gini Index

Answer 45

measure for society of how much inequality or equality exists

Question 46

Income Inequality hypothesis (Wilkinson)

Answer 46

societies that are more economically equal have a healthier population, societies with more inequality have worse health; this thesis is controversial because other studies failed to replicate his findings

Question 47

Whitehall Studies

Answer 47

investigated the mortality of over 17,000 British male civil government employees; men were classified according to their job rankings, those with highest rank had lowest % of deaths; Britain has equal healthcare access, so the difference was not due to access to healthcare; strong evidence of social class differences in mortality - there’s a gradient of health based upon SES factors other than access to healthcare (not the theory that there’s a threshold, poor people at the bottom then everyone above the threshold is about the same in terms of health)

Question 48

Neighborhood effects of health

Answer 48

spatial or geographic factors affecting health. even if you have high SES but live in a poor neighborhood, you may exhibit same health as everyone else and vice versa; people are influenced by who they live around; including spouses/family; poor neighborhoods may also have less resources, worse education systems, and these all impact healthcare even if you have a high income

Question 49

SES as fundamental cause of mortality

Answer 49

SES influences multiple diseases, affects these diseases through multiple pathways of risks, is reproduced over time, and involves access to resources that can be used to avoid risks or minimize the consequences of disease if it occurs

Question 50

Life Expectancy

Answer 50

men have gotten closer to female life expectancy, but the gap is still about 5 years; women started smoking cigarettes (tobacco) more in the 60s –> reduced life expectancy; obesity causes the life expectancy to decrease; people with lower SES or lower education are more likely to be obese

Question 51

Mortality vs. Morbidity with Gender

Answer 51

men have higher mortality than women, at any age; women have higher morbidity than men; women more likely to sustain more injuries, more cancer, more heart disease cases;
difference results because of biological, lifestyle and risk behavior, responses to symptoms, likelihood of seeking care, experience with care system

Question 52

Gender disparities in mental health

Answer 52

women higher for depressions and anxiety disorders, men higher for personality disorders; women with employment outside of the home have better psychological well being

Question 53

Proportion of population over 65

Answer 53

it’s raising every year, from 12.4% in 2004 to a projected 16.3% in 2020 and 20.7% in 2050; they’re more likely to be healthier, better educated, and more affluent; puts pressure on medicare and social security system to maintain care for the elderly

Question 54

Dependency ratio

Answer 54

ratio of those typically not in the labor force (the dependent part) and those typically in the labor force (the productive part); in 1955 - 8.6 taxpayers for every retired person, 2005 - 2.7 taxpayers, 2035 - 1.9 taxpayers; this is a serious problem because not enough people to cover medicare, the costs, retirement, social security of elderly people

Question 55

Aging and Health

Answer 55

many older people tend to rate their health positively, in spite of the fact that health declines with age

Question 56

Compression of morbidity

Answer 56

burden of lifetime illness may be compressed into a shorter period before the time of death, if the age of onset of the first chronic infirmity can be postponed

Question 57

Race

Answer 57

not considered a biological aspect; considered to be socially constructed - where you identify the culture you were brought up in; some races are more prone to certain diseases; within racial groups, there’s as much diversity as there is across groups

Question 58

Racial disparities in health status

Answer 58

differences in health b/w racial groups; asian americans have better health and lower rates of disease but there hasn’t been much research done; not a lot of statistics kept on Hispanics either b/c people would group them along w/ blacks or whites; African american men live 4-5 years less than white men, same goes for AA women; AA more likely to get hypertension but prob not genetics alone, SES is the major explanation for differences (education!) - people with lower SES have fewer financial resources, can’t access healthcare, have poor diet and exercise; even within same education levels, whites have better health than blacks (discrimination)

Question 59

Hispanic paradox

Answer 59

hispanics have low SES but have lower mortality/morbidity than rate than even whites; maybe because its a lifestyle choice - recent immigrants are more healthy than assimilated people

Question 60

Stress

Answer 60

lifestyle, culture, psychosocial factors effect levels of stress: lower SES people experience more stress; how people respond to their environments and the physiological consequences of these responses - we encounter more social stressful threats than physical

Question 61

Discrimination

Answer 61

doctors don’t offer the same treatments to blacks as they do to whites; blacks don’t get the same healthcare services offered (people in equal situations get treated differently, but doesn’t necessarily mean there’s any animus); many AAs don’t trust healthcare institutions - comes from history of distrust, exclusion ex. Tuskegee experiment - purposely didn’t treat AA men with syphillis and didn’t tell them

Question 62

Stereotype bias

Answer 62

doctors may think that AAs don’t have the resources available to sustain treatments or they may make assumptions and judgments/stereotypes that limit AAs’ choices

Question 63

Symbolic Interactionism

Answer 63

focuses on face to face interaction; deals with the concept of the “self” and who we are; how we get an idea about ourselves by interacting with other people - the self is socially constructed

Question 64

Looking glass self (Cooley)

Answer 64

we see ourselves in our imagination as we think we appear to the other person, we see in our imagination the other person’s judgment of ourselves, as a result of what we see in our imagination about how we are viewed by the other person we experience some sort of self-feeling, such as satisfaction, pride, or humiliation; our idea about who we are is created by looking at how other people see us; we’re very sensitive to the info provided to us in our social lives

Question 65

Definition of situation (Thomas)

Answer 65

our need to define each situation, the definition may be more important than actual reality, “if men define a situation as real, then it is real in its consequences”

Question 66

Presentation of self (Goffman)

Answer 66

the positive social value that individuals claim for themselves is termed a “face”- they project this to other people; the self viewed as 1) a role as an image of an individual formed from the flow of events in an encounter and 2) a kind of player in a ritual game who copes judgmentally with a situation; this kind of view identifies the calculative element in dealings between people and presents them as information managers and strategists maneuvering for gain in social situations

Question 67

Functionalism

Answer 67

focuses on the influence of the larger society on individuals

Question 68

Durkheim’s causes of suicide

Answer 68

found that single people had higher suicide rates than married people; protestants had higher numbers than catholics (protestants believed relationship with god was individual, catholics believes in worship in groups);

1) egoistic suicide- people become so cut off from people, have no support, results in stress
2) anomie- people suffer a sudden dislocation of normative systems where their norms and values are no longer relevant, social changes causes lack of a normal
3) altruism- people are too connected to other people, sacrifice for other people, for their country, too strongly integrated into a demanding society that the only escape is suicide

Question 69

Socioeconomic trends and illness rates (Brenner)

Answer 69

looked at the rates of disease during economic good and bad time periods; when you’re more stressed, you’re more vulnerable to sickness

Question 70

Life events

Answer 70

life changes and accumulation of events that require us to respond to stress; life changes have 3 dimensions: 1) the degree of change evoked, 2) the undesirability of change and 3) the aspect of one’s life that is affected

Question 71

Social Readjustment Rating Scale

Answer 71

the scale is based on the assumption that change, no matter how good or bad, demands a certain degree of adjustment on the part of an individual - the greater the adjustment, the greater the stress; as the total value of life change units mounts, the probability of having a serious illness also increases, particularly if a person accumulates too many life change units in too short a time

Question 72

Allostatic load

Answer 72

body is all charged up, all that adrenaline, cortisol wears down your body - not good for you, more likely to develop a disease

Question 73

Chronic strain

Answer 73

one of the two major types of social stressors (life events is the other one); relatively enduring conflicts, problems, and threats, which many people face on a daily basis; includes role overload and conflicts within role sets

Question 74

Stress and the social group

Answer 74

influence of group membership is important when considering a person’s perception of an event; conformity to group-approved attitudes and definitions has been hypothesized as reducing anxiety

Question 75

Social capital

Answer 75

the social investments of individuals in society in terms of their membership in formal and informal groups, networks, and institutions; the quality of a person’s social connections and integration into a wider community

Question 76

Social support

Answer 76

how much the individual feels loved and supported by other people such as family members

Question 77

Physiological response to stress

Answer 77

fight or flight concept to illustrate how the body copes with stress resulting from a social situation; ANS controls heart rate, breathing - parasympathetic system is dominant when at rest while the sympathetic system kicks in during an emergency
Endocrine glands secrete hormones into the bloodstream - norepinephrine and epinephrine

Question 78

Coping skills

Answer 78

a person’s ability to cope with problems is influenced by a society’s preparatory institutions, such as schools and the family, two entities designed to develop skills and competencies in dealing with society’s needs; a person’s ability to cope is also related to a society’s rewards or punishments for those who did or did not control their behavior in accordance with norms