Health Inequalities Flashcards
What is sociology?
Sociology = the study of the development, structure and functioning of human society
What does medical sociology study?
Sociology of health and illness (medical sociology):
- Sociology studies peoples interactions with those engaged in medical occupations
- Studies way people make sense of illness
- Illness vs disease
- Studies behaviour and interactions of health care professionals in their work setting
- Professional values, interactions between each other and patients
What are some examples of applications of sociology to healthcare?
-
Sociology of medical profession
- Systemic theory
- Authority recognised by its clientele
- Broader community sanction
- Code of ethics
- Professional culture by formal professional sanctions
-
Health promotion
- Promotion healthy behaviour and preventing ill-health is only possible if we understand how different groups operate
- Sociology provides health promotion an analysis of different groups in society
- Men/woman, old/young, rich/poor
-
Medicalisation
- Process where areas of behaviour or life become defined as medical problems
- Things that were previously seen as natural such as pregnancy and child birth are becoming more medicalised
- Examples are behaviour in relation to gambling, alcohol or sex becoming labelled as addiction and becoming medically managed
-
Work related stress
- Stress = adverse reaction to excessive pressure
- Significant consequents for the individual (poorer physical and mental health and health behaviours), society (loss productivity) and health service (increased use of service)
- Often medicalised but evidence suggests organisational solutions are better that address cause such as looking at workload, role clarity, support etc
-
The sick role
- Sick role patient
- Exempts people from daily responsibilities
- Patient is not responsible for being ill
- Patient must seek help from healthcare professional
- Under social obligation to get better soon and be able to take up social obligations
- Sick role healthcare professional role
- Must be objective and not judge patients morally
- Act not out of self-interest but in patients interest
- Obey professional code of practice
- Have and maintain knowledge and skills to treat patient
- Right to examine patient intimately, prescribe treatment and wide autonomy in medical practice
- Sick role patient
Describe some aspects for the sociology of the medical profession?
- Systemic theory
- Authority recognised by its clientele
- Broader community sanction
- Code of ethics
- Professional culture by formal professional sanctions
Describe some aspects for the sociology of health promotion?
- Promotion healthy behaviour and preventing ill-health is only possible if we understand how different groups operate
- Sociology provides health promotion an analysis of different groups in society
- Men/woman, old/young, rich/poor
Describe some aspects of sociology for medicalisation?
- Process where areas of behaviour or life become defined as medical problems
- Things that were previously seen as natural such as pregnancy and child birth are becoming more medicalised
- Examples are behaviour in relation to gambling, alcohol or sex becoming labelled as addiction and becoming medically managed
What is stress?
- Stress = adverse reaction to excessive pressure
What are some consequences of stress?
Significant consequents for the individual (poorer physical and mental health and health behaviours), society
What are some socio-economic influences on our health?
-
Gender
- Men greater mortality
- Woman higher morbidity
- Maybe due to visiting doctor more or living longer
- Evidence woman are assessed differently and receive poorer care
- Gender affects presentation and diagnosis
- Younger woman higher rate of mortality after MI and CABG but men in all age groups higher risk of ischaemic sudden death
- Woman experience more atypical symptoms
- AF greater risk in stroke in woman than men
- Most autoimmune diseases are in woman
- Gender effects disease management
- Woman with MI receive less guideline based diagnosis and less invasive treatment than men
- Woman obtain dialysis later than men and undergo fewer transplants
- Delay in referral of woman with RA compared to men
- Osteoporosis and depression considered female disease, both might be underdiagnosed in men
-
Ethnicity
- South Asians have substantially higher rates of heart attacks and type 2 diabetes
- Admission for Polish and Chinese groups lower than white Scottish counterparts
- Greater prevalence of sickle cell disease in African origin groups
- Mortality higher in white population than in black and minority populations
- Ethnicity impacts alcohol
- Most minority groups have higher rates of abstinence and lower levels of drinking, highest amongst South Asians
- People from Indian, Chinese, Irish and Pakistani backgrounds on higher incomes tend to drink above limits
- Over time generational differences may emerge, such as increased heavy drinking for Indian woman and Chinese men
- People in some ethnic groups greater risk of alcohol related harm, Irish and Scottish men and woman have higher rates of alcohol related deaths than rest of UK
- Stats may be impacted by minority ethnic groups being under-represented in seeking treatment and advice for drinking problems
- Sociology describes and seeks to identify reasons, dealing with disparities in health relating to ethnic differences
- Identify potential barriers to use of NHS
- Personal – language, understanding, belief
- Provider – understanding differences due to ethnicity, provider skills and attitude
- System – organization of appointments and referrals
- Culturally competent care is a combination of attitudes, skills and knowledge to allow for understanding and better care of patients with different backgrounds to our own
- Identify potential barriers to use of NHS
-
Physical environment / housing
- Cold homes greater risk of mental and physical health problems
- Excess winter deaths 3x higher than in warmest
- Indoor air quality is determined by indoor and outdoor pollutants, most detrimental to elderly and asthmatics
- Mould spores and faecal pallet from house dust mites
-
Education
- Worse education level associated with poorer health
- Effects of education persist throughout life
- How education might affect health
- Psycho-social environment
- Effects social standing, bolsters individual capacity and autonomy
- Access to different employment
- Different employment improves income and benefits and working conditions
- Healthy knowledge
- Lifestyle changes, awareness of risk associated with behaviours
- Psycho-social environment
-
Employment
- Provides: income and financial security, social contacts, status in society, purpose in life
- Unemployment associated with increased morbidity and premature mortality
- Income / social status / financial security
-
Health system
- Greater spending per capita associated with less mortality and longer life expectancy
- Distribution of GPs across Scotland does not reflect levels of deprivation, services designed to improve whole population health (such as screening) may widen health inequalities if uptake lowest in those who would get most benefit
-
Culture and social environment
- Transport
- Greater air pollution increases CVS and respiratory diseases, cancer and adverse birth outcomes
- RTA, speed has a great impact in mortality
- Increased walking and cycling benefits mental and physical
- Media
- Shapes our views and expectations, such as how has decreased previous stigma associated with mental health
- Transport
Describe some aspects of gender influencing our health?
- Men greater mortality
- Woman higher morbidity
- Maybe due to visiting doctor more or living longer
- Evidence woman are assessed differently and receive poorer care
- Gender affects presentation and diagnosis
- Younger woman higher rate of mortality after MI and CABG but men in all age groups higher risk of ischaemic sudden death
- Woman experience more atypical symptoms
- AF greater risk in stroke in woman than men
- Most autoimmune diseases are in woman
- Gender effects disease management
- Woman with MI receive less guideline based diagnosis and less invasive treatment than men
- Woman obtain dialysis later than men and undergo fewer transplants
- Delay in referral of woman with RA compared to men
- Osteoporosis and depression considered female disease, both might be underdiagnosed in men
Describe some aspects of ethnicity influencing our health?
- South Asians have substantially higher rates of heart attacks and type 2 diabetes
- Admission for Polish and Chinese groups lower than white Scottish counterparts
- Greater prevalence of sickle cell disease in African origin groups
- Mortality higher in white population than in black and minority populations
- Ethnicity impacts alcohol
What are some examples of ethnicity impacting alcohol intake?
- Most minority groups have higher rates of abstinence and lower levels of drinking, highest amongst South Asians
- People from Indian, Chinese, Irish and Pakistani backgrounds on higher incomes tend to drink above limits
- Over time generational differences may emerge, such as increased heavy drinking for Indian woman and Chinese men
- People in some ethnic groups greater risk of alcohol related harm, Irish and Scottish men and woman have higher rates of alcohol related deaths than rest of UK
- Stats may be impacted by minority ethnic groups being under-represented in seeking treatment and advice for drinking problems
What are some potential barriers for people of various ethnicities using the NHS?
- Personal – language, understanding, belief
- Provider – understanding differences due to ethnicity, provider skills and attitude
- System – organization of appointments and referrals
What are some examples of physical environment/housing influencing health?
- Cold homes greater risk of mental and physical health problems
- Excess winter deaths 3x higher than in warmest
- Indoor air quality is determined by indoor and outdoor pollutants, most detrimental to elderly and asthmatics
- Mould spores and faecal pallet from house dust mites
What are some examples of education influencing health?
- Worse education level associated with poorer health
- Effects of education persist throughout life
- How education might affect health
- Psycho-social environment
- Effects social standing, bolsters individual capacity and autonomy
- Access to different employment
- Different employment improves income and benefits and working conditions
- Healthy knowledge
- Lifestyle changes, awareness of risk associated with behaviors
- Psycho-social environment