Lecture 3 and 4 Flashcards
What are the common causes of health problems?
biological/genetic causes
behavioural causes
psychological causes
social causes
Transition :Transition from communicable –> non-communicable diseases
What are Proximal causes of health problems?
Downstream causes
Physiological factors/Biological and genetic Factors
Diet
Activity level and exercise
Alcohol consumption
Self-identity
What are common causes of mortality in NZ?
Cancer Heart/CVD Respiratory Diabetes (also a proportion of CVD mortality) Transport Accident Intentional Self-Harm
What are Distal causes of health problems?
Middle stream:Behavioural , Psychological Factors Diet, Physical activity, Upstream: Social causes: Cultural context Political context Education Poverty Social connections
What are the Models of Health and Illness?
Medical Model: focuses on biological factors, and proximal causes
Social Model: includes Biological AND psychosocial factors. Focuses on proximal AND distal causes
What is the Medical model of health?
Also known as the Biomedical Model
Assumes that:
Illness is caused by bacteria, a faulty gene, a virus, or an accident
Illness can be identified and classified
Illness is identified by medical professionals
Diagnosis of symptoms is relatively objective
Illnesses can be treated
Focuses on the Proximal causes
Was the dominant view until the late 20th Century
Was helpful when the main cause of mortality was communicable diseases
What is the Social Models of Health?
Multiple models
Clarify the broader determinants of health, including:
Biological/genetic
Behavioural (sometimes)
Psychological (sometimes)
Social
Both proximal and distal
Health status is the result of these determinants, individually as well as through complex interactions
e.g. Biopsychosocial Model, Dahlgren and Whitehead Social Model, WHO social determinants model etc
What are the three main sections of the Biopsychosocial model?
Biological –>
Psychological –>
Social –>
What are the layers of the Dahlgren and Whitehead Social Model of Health?
- general socioeconomic, cultural and environmental conditions
- living and working conditions
- social and community networks
- individual lifestyle factors
- Age, Sex, and constitutional factors
Which Model is more helpful with dealing with the causes of mortality in the present day.
Social Models
Different models are more effective for different causes
What is the overall conclusion for Health Models?
Contemporary health issues are better understood within a social model framework
The “social” component is often large when we try to understand the causes of common contemporary health issues
Many of the models are fairly vague about what is included in the ‘social’ component
What are inequalities?
Disparities: Being unequal
Usually a quantitative judgement
Health inequality = differences in health between groups
What are Inequities?
Injustice or unfairness
More difficult judgment to make
An ethical judgement
Health inequity= differences in health between groups that are unfair or unjust
What is the relationship between Inequalities and Inequities?
All inequities are inequalities, but not all inequalities are inequities
How do you use Contemporary Principles of Health Ethics to Judge Inequities?
Often tend to focus on the Principle of justice
But it may also relate to other principles
What are the four contemporary Principles of Health Ethics?
Beneficence Non-Maleficence Respect for Autonomy Justice -These principles are all related with one another, they are not independent principles
What does the contemporary principle of Justice involve?
Is the inequality as a result of the unfair distribution of resources? , respecting some groups’ rights more than others? , or applying laws that protect some groups more than others?
Does society systematically disadvantage certain groups?
What does the contemporary principles of Beneficence and Non-Maleficence involve?
Is the inequality the results of some groups getting more health benefits from something? or groups having unfair exposure that will harm their health?
What does the contemporary principles of Respect for Autonomy involve?
Is the inequality the result of some groups having an unfair inability to make informed decisions?
What is the Marmot approach?
Inequalities that are preventable by reasonable means are unfair. Putting them right is a matter of social justice
- a good first stopping point
What is the downfall of the Marmot approach?
What about the inequalities that are unjust but would require a much larger societal change or input of resources to reduce?
- excludes inequities due to this “unreasonableness” of health inequalities
What can we do the improve health inequalities?
We could ensure that every person in society has an equal opportunity to have equality in health
i.e. equal: access to health care, access to healthy environments, access to understandable information to make informed choices, protection of rights, protection under the law, fair distributions of all resources
What would ensuring every person in society has an equality in health require?
A society that values equity, fairness and justice for all
Resources: - More”health” resources to reduce inequities, AND/OR a more fair, and probably unequal, distribution of “health” resources to reduce inequities
BUT resources are scarce
When does Rationing Exist?
Rationing occurs when there is scarcity
