Lecture 5: Fundamental Cause Theory

Question 1

concerns of fundamental cause theory

Answer 1

• Focus on individual-level risk factors leads to a loss of interest in the importance of social conditions whose health effects we need to explain
• Focus on individual-level risk factors does not help us completely understand how social factors act in a multifaceted, dynamic way to shape health

Question 2

argument of fundamental cause theory

Answer 2

• It is important to contextualize the risk factors that we study by examining the social conditions under which those risk factors arise
• This involves examining the cause of causes & related mechanisms

Question 3

social condition

Answer 3

factors that involve a person’s relationships with other people and/or the social structure

Question 4

fundamental cause of disease

Answer 4

a contextual factor whereby the health effects can not be eliminated by addressing the mechanisms that appear to link them to disease

Question 5

fundamental cause theory’s solution

Answer 5

We need to look upstream at fundamental causes

Question 6

4 tenets of fundamental cause theory

Answer 6

1. flexible resources
2. multiple mechanisms
3. multiple outcomes
4. persistence over time & place1

Question 7

flexible resources

Answer 7

Fundamental social causes involve access to flexible resources that can be used to avoid risks or to minimize the consequences of disease once it occurs

Question 8

5 flexible resources

Answer 8

• Money
• Knowledge
• Power: the ability to make things happen
• Prestige: people will listen to you
• Networks

Question 9

multiple mechanisms & outcomes

Answer 9

Fundamental causes influence 2. multiple risk factors and 3. multiple disease outcomes

Question 10

persistence over time and place

Answer 10

• The patterns between the fundamental cause and the disease outcome persist despite changes over historical time related to the diseases that afflict humans, the risk for those diseases, knowledge about disease risks, or the effectiveness of treatment for diseases as well as variations in context
• A fundamental cause will have a persistent association with disease despite changes in intervening mechanisms

Question 11

implications of fundamental cause theory

Answer 11

• Health inequalities resulting from a fundamental cause cannot be eradicated by addressing intervening mechanisms because enduring inequalities in flexible resources will ensure that those mechanisms are replaced
• Health inequalities can only be eradicated by fixing inequities in access to flexible resources

Question 12

flexible resources: gender

Answer 12

• Women = less prestige than men in the same environment (often)
• Gender wage gap; historical lack of financial autonomy
• Barriers to educational attainment
• Men may tend to have more powerful social networks

Question 13

multiple mechanisms: gender

Answer 13

• Most medical knowledge = based on male autonomy/ male cadavers/ male patterns of health
• More likely to be treated by a male doctor
• Women’s pain is conceived as overly dramatic and ignored

Question 14

multiple disease outcomes: gender

Answer 14

• Breast cancer
• Uterine cancer
• Complications from childbirth (c-sections)

Question 15

time and place: gender

Answer 15

Gender-based violence

Question 16

flexible resources: race

Answer 16

• Wage gap between minorities and white people for the same occupation and education level
• Barriers to educational attainment
• White people may be more likely to have more powerful social networks

Question 17

mutiple mechanisms: race

Answer 17

• Racial/ethnic minorities may have worse insurance coverage
• Conditions on reserves (less clean water)
• Poor living conditions (mold, etc.)

Question 18

multiple disease outcomes: race

Answer 18

• Heart attacks
• Chronic diseases (diabetes)
• Skin cancer

Question 19

flexible resources: place

Answer 19

• Isolated community = less access to resources
• Fewer options for good schools
• Smaller social networks (rural areas)

Question 20

multiple mechanisms: place

Answer 20

• Food access
• Health care access

Question 21

multiple disease outcomes: place

Answer 21

• Diabetes
• Heart disease
• Smoking/alcohol-related diseases (stroke, liver disease, cancer)
• Asthma, cancer
• Violence