MIDTERM 1 Flashcards
Define paradigms
Basic assumptions and ways of thinking that are commonly accepted by members of a scientific community
How is health a social construction
Because health is subjective. Our interpretations through personal experiences, culture, and social/political and historical contexts
Ways to conceive health (6):
- Normality
- Balance
- Adaptation to environment
- Being fit
- Absence of disease
- Resource for living
Define health
State of complete physical, mental, and social well-being and not merely the absence of disease of infirmity
Define health state
Present health of individual
Define health status
Characteristics of being healthy/unhealthy; longer term attribute
Measurements of personal health (5):
- Medical history
- Psychological functioning
- Physical examination
- Tests
- Symptom checklists
Define population health (2):
- Health status and outcomes within a group of people rather than considering health of one person at a time
- The focus on community and social level factors that influence health
What is population health affected by
Through the interactions between factors such as biology, genetics, access to health care services, living/work conditions, income, physical/social environment
Measurements of population health status (5):
- Mortality
- Life expectancy
- Quality of life
- Self rated health
- Health assets
Difference in goals between population health and personal health
Population health focuses on maintaining health of entire population and addresses inequities between groups. Whereas, personal health focuses on the health of individuals and the absence of illness and disease
Define fact
Something generally accepted to be true
Define data
Observations that are measured/measurable
Define metaphor
Word, concept, or symbol used as a way to understand an abstract concept
Define theory
Set of ideas (concepts) and statements that link together supported by different types of evidence
Define illness
Perception of ill health, based on a person’s response to particular symptoms (Eg. pain, nausea) that cannot be directly observed
Illness behaviour
How we act when we are ill
Mechanic’s explanation of processes that transform bodily sensations to illness (4):
- How visible are the symptoms or the strengths of perception
- Are the symptoms frequent or persistent
- Are there any psychological processes contributing to the experience
- Are the symptoms disruptive
Factors influencing perception of symptoms (7):
- Gender
- Age
- Education
- Occupation
- Health status/previous experience with symptoms
- Family
- Culture
The Illness Iceberg
Epidemiological model used in identifying progress of a disease from its subclinical stages to apparent disease state
The Illness belief dimensions (4):
- Casualty
- Controllability
- Susceptibility
- Seriousness
What is casualty in the illness belief dimension (2):
- Examines what causes people to ascribe to their symptom
- People look for causal explanations to make sense of their experiences of illness and disease
What is controllability in the illness belief dimension (2):
- Examines the extent to which people believe illness is controllable
- Associated with self-rated health, preventive are, behaviour during illness, use of physician services, compliance with medical treatment
Perceived Susceptibility
Subjective perception of risk of contracting a disease or susceptibility to illness
Perceived Severity
person’s belief about the seriousness or severity of a disease
Health belief model
Perceived threat = perceived susceptibility + perceived severity
Define disease
any harmful deviation from the normal structural or functional state of an organism
Why do health, illness, and diseases change? (5):
- Scientific knowledge changes
- Disease change
- Distribution of disease in population change
- New ideas about health are built on other existing ideas
- Culture and societies change and culture and societies influence health illness and disease
Aaron Antonvsky
Health sociologist who argued that researchers should focus on finding answers on what keeps good health, hence introduced the salutogenic model of health
Salutogenic model of health
Created by Antonovsky that Idea of health results from everyday interactions and emphasizes to protect and promote good health
Define wellness
Inclusive concept that incorporates not only good health, but also the quality of life and satisfaction with general living conditions
Basic idea behind the sociological understanding of health
People’s locations in the social world affect their behavior and ultimately, their health and issue
Ottawa Charter for Health Promotion
Was released by the WHO in 1986 and provides guidelines that governments throughout the world are encouraged to adopt for population health promotion strategies
Fundamental conditions and resources for health (9):
- Peace
- Shelter
- Education
- Food
- Income
- Stable eco-system
- Sustainable resources
- Social justice
- Equity
Hypertension
High blood pressure (The silent killer)
Biological determinism
Belief that human characteristics, physical and mental are determined at conception of hereditary factors (Often relied on by scientists)
Health consciousness
Degree to which an individual is aware of and attentive to health, shown through eating habits, etc
A study in 2000’s reported how many websites offer health information?
70,000 websites
Statistics of Canadians using the internet for health information
1/3
Top five webMD searches in 2011
- Ringworm
- Hemorrhoids
- Turf toe
- Strep throat
- Pregnancy symptoms
How much did Canadians spend on dental care, eyecare, and prescriptions in 2011
About $29.4 billion
M-health
Use of mobile electronic technologies containing apps to monitor/promote health. It allows people to share aspects of their health status/behavior with others
What does it mean when we say western societies have a consumer culture?
The products/services we purchase make statements about our identity and place in the social word. We buy goods not necessarily for their “use of value”, but because of the impression it makes on our self-identity
Medical consumerism
Movement to make delivery of healthcare services more efficient and accessible
Health promotion
Process of enabling people to increase control over, and to improve, their health
How are health promotion and medical consumerism interrelated
Health promotion is the government attempting to encourage the health of the population. While with medical consumerism, a private firm holds a financial interest in selling a particular health-care product/service
Hippocratic Corpus
Collection of early Ancient Greek medical books from Greek physician Hippocrates. Corpus makes references to social determinants of health and illness
Michel Foucault
French social philosopher who showed efforts to understand and control morbidity and resulted in a convergence of medical and social science
Morbidity
Distribution of disease in human groups
Cause of decline in infectious disease
Result of the advancing biomedical practice of antibiotics, immunizations, and vaccines, as well as living conditions
Sir william Osler
Canadian physician who states how its more important to know what patient has the disease, rather than the kind of disease they suffer
Medical sociology major interests (4):
- Distribution of disease in human groups called social epidemiology
- Social patterning of health and illness beliefs/behaviors
- Exploring the social institutions that people have developed
- Social organizations and delivery of health-care services
Medical sociology importance
Reinforced the importance of broadening research perspectives in health to include an analysis of both disease pathology and the impact of the social environment
Medico-centric bias
An approach to understanding health, illness, and the body in a manner that privileges the medical perspective
The sociology of medicine
Subspecialty of sociology with the purpose to improve theoretical understanding of social phenomena in which patients/practitioners interact. It offers a critical analysis of both patient compliance and medical dominance of health
Health sociology
Focuses on population health behavior rather than patient illness
Shifts from medical sociology to health sociology (2):
- Concentrating exclusively on the diseased person including psychological dimensions and social roles
- Unit of analysis from the individual to society and redirecting to explore structural determinants of population
Coburn and Eakin’s review of development in health sociology (3):
- Social determinants of health status
- Health and illness behavior
- Health care system
Social Determinants of Health (4):
- Investigates health status of Canadians through population surveys
- Social factors are the most important determinants of health status
- Social status = health status
- Examined the impact of social environment on health like workplace and exposure to hazardous materials/dangerous conditions as well as family life
Health and illness and behavior (3):
- Studying the way people behave to maintain their health
- Studies show differences between men and women in lifestyle
- This field of research is the less descriptive and more interpretive
The Health-Care System:
- Received the most research attention
- Focuses on questions about access and utilization of health-care systems, health policy issues, and reorganization of services
- Shifting health-care from disease prevention to health promotion, transferring care from institutions to community, enhancing self heath and redefining practitioners
How does health sociology avoid a medico-centric bias
Because the basis is formed through how society shapes and is shaped by human behaviour
Theoretical paradigm
Conceptual framework or school of thought in which interrelated ideas and concepts about an aspect of reality are formulated
5 main theoretical paradigms
- Structural Functionalist paradigm
- Conflict paradigm
- Symbolic Interactionist paradigm
- Feminist paradigm
- Sociology of the body paradigm
Structural Functionalist paradigm
- Views society as a harmonious social system made up of several institutions that function to maintain stability
- emphasizes that good health and effective health care are essential for a society’s ability to function
- Health and illness defined as “Social roles”
- Uses surveys and statistical analysis
- Examples: Sick role by Talcott Parsons
Talcott Parsons
Leading US sociologist who developed “the sick role” in The Social System. He used medicine to illustrate the structural functionalist approach to understand importance of social role as a key concept between culture, social structure, institutions, and behavior. He believes there are a set of behavioral expectations about how a sick person is supposed to behave is built into the social system
Criticism of sick role (4):
- Only applying to “temporary” acute illnesses and not for chronic conditions
- Not suitable for those that suffer emotional/psychological illnesses
- Failure to consider other influences of culture, gender, location
- Medico-centric bias
Duties of an occupant with sick role (2):
- Expected to try to get well and resume normal everyday duties as quickly as possible
- Seek help and comply with medical treatment if needed
Conflict Paradigm
- Viewed society as a capitalist social system comprised of inequality completing interest groups, and power struggles
- Theory that society is in a state of conflict because of competition for limited resources
- Power group struggles (Social class, gender, ethnic relationships)
- Health and illness is defined as “Professional constructs”
- Research done through participatory action
- Eliod Friedson
- Example: Medical dominance
Political economy
Interdisciplinary field of social science that analyzes the political, economic, and social relations
Medical ideology
Dominant beliefs of organized medicine
Eliot Friedson
US sociologist of professions working within the conflict paradigm. He explored effects of medical dominance on health, society, and healing professions
Social medicine
States that the way to make people healthy is to make society healthier
What did Illich, Navarro, Waitzkii state
Illness is a consequence of the capitalist mode of production that exploits workers, and how professional medicine is criticized as a way to gain profit
The Symbolic Interactionist Paradigm
- Views society as a socially constructed product of everyday interactions and individuals
- Society is made up of several unique individuals who make their lives meaningful through social interaction
- Symbolic interactionism provides a means for understanding the “problem with two languages” (eg. two differing medical beliefs)
- Health and illness is defined as “Interpersonal meanings”
- Research done through participation observation
- Erving Goffman
Erving Goffman
Canadian sociologist who was a highly influential symbolic interactionist. He used participant observation of a mental hospital to study the ways in which the social context affects behavior
Feminist Paradigm
- Views society as a patriarchal form of social organization in which men dominate women by exercising social, economic, and political power
- Western science is dominated by “malestream” thinking, or the privileging of masculine perspectives on life. Therefore, lots of bias with androcentric thinking
- Health and illness is defined as “Gendered experiences”
- Research was done through mixed methods
- Ann Oakley
Patriarchy
Form of social organization in which men dominate women
Ann Oakley
Internally renowned UK feminist sociologist who explores mothers’ personal experiences of childbirth and becoming mothers, while still providing account of development of a masculine assembly-line
Why is Canada falling behind in population health
Due to the lack of progress in understanding how aspects of social factors like gender, social class, age, etc produce overlapping disadvantages in health
The Sociology of the Body paradigm
- Society and social relations shape and shaped by human bodies
- A branch of sociology studying the representations and social uses of the human body in modern societies
- Health and illness is defined as “Embodied Cultural Facts”
- Research is done through a narrative analysis
- Michel Foucault
Embodiment
Human perception and experience of society and culture happen through our bodies
Why is embodiment overlooked
Because there are two arguments to this controversy. One side states that if we want to understand human beings, we must understand our biological nature. Whereas, the otherside states that we must understand how aspects of our social environment shapes our behavior
Michel Foucault
French philosopher and historian who studied the roles of madness, medicine, prisons and sexuality in the control of the body. He is interested in the origins of the current biomedical way in which we understand the reality of our bodies
Michel Foucault beliefs/concerns
- Believes that doctors are doctor-oriented, and not patient oriented, and thus medicine creates an abusive power structure evident through how med school teaches students more about biomedicine than patients
- Foucault also believes that power is a productive force because of the way it produces ways of understanding ourselves when combined with knowledge
Biopower
When power is exercised in modern societies
Pierre Bourdieu
Central theorist in sociology of the body whose ideas have influenced health sociology. His approach provides a means of understanding the relationship between bodies, society, and behavior by overcoming the dichotomy
Habitus
Refers to the embodiment of social location and culture within human bodies
Life course perspective
- Views society as the dynamic intersections of individuals biographies and historical events
- What happens to us earlier in our lives affects our present and future health for cardiovascular, respiratory diseases, stroke, gum disease, and cancer
- Health and illness is defined as “Unfolding across time”
- Research was done through longitudinal analysis
- Glen H. Elder, jr
Humoral Theory
Theory of Ancient Greek where the human body consists of four humors representing the cardinal fluids of blood, yellow bile, black bile, and phlegm. Each is associated with a different organ/season
What year was homosexuality removed as a disease
1973
Sick role
A set of behavioural expectations about how a sick person is to behave built into our social system
Life course
An age graded sequence of multiple stages or phases and roles embedded in a network of social relationships
3 original people of Canada
- First nations 58%
- Metis 38%
- Inuit 5%
- Multiple identities 2%
European accounts of First Nations Traditional Health Systems
- Biased
- Traditions described as primitive, fraudulent, harmful
- Healers described as magicians and pretenders
- Patients described as ignorant
- Practices were not seen as knowledge
Indigenous people’s take on health (5):
- Disease = result of disruption of balance and harmony among and between humans or with spiritual entities
- Goal of healing system = restoration of balance
- Power to heal; power to cause harm
- Serious illness = consequence of past breaching of moral order
- Communal = Needed communal solutions
Traditional Indigenous healers and medical practices (4):
- Herbalists
- Medicine men
- Shamans
- Belief that traditional healing roles are only filled by men
Potlach
Ceremonial feast of Indigenous peoples at which possessions are given away or destroyed to display wealth or enhance prestige and was banned in 1994
Medicine Wheel
Ancient symbol used by Indigenous People showing 4 quadrants representing concepts and interrelationships to each other, universe and individuals (mental, spiritual, physical, and emotional)
First Nations Perspective of Wellness (3):
- Claimed to be passed down from elders and traditional healers
- Wellness belongs to every human being and their reflection of this perspective is unique
- 66% of First Nations peoples believe that relatively poor state of Aboriginal health is caused by or linked to residential school experiences or loss of culture, or loss of lands
Determinants of health for Aboriginals (8):
- Colonization
- Globalization
- Migration
- Cultural Continuity
- Access
- Territory
- Poverty
- Self-determination
Normal health
- Blend of feelings of healthiness, physical fitness and performance of one’s usual well roles. Normal health can also include living with daily symptoms (pain), or chronic illnesses
Population health status (4):
- Focus on general population (Eg. Health of Canadians)
- Finds significance in social/psychological aspects of health (Eg. Quality of life).
- Recognizes there are multiple determinants such as biology, genetics, diet, physical activity, etc
- Requires a multi-level analysis of connections of community and individual characteristics
Significance of population health perspective (3):
- Focuses on need of attention for sociological framework for why some Canadians are more healthier than others
- Highlights the social production of health and well-being as well as the ways in which social relations contribute to maintenance of good health
- Emphasizes importance of gaining insight into ways in which social factors affect health
Something Antonvosky said
Each individual’s unique view of life and capacity to respond to stressful situations help explain why some people manage to stay well and improve health
Sickness
Involves both presence of disease and experience of illness
Why is illness considered subjective
It is based on personal perception, evaluation and response. We rely on individuals to report symptoms because it cannot be directly observed
How did Bruhn and Colleagues describe wellness
Described wellness as a continually ongoing process characterized by an integration of all aspects of the individuals physical, mental, social, and environmental well-being
Functional ability
Aspect of wellness that our well roles and life tasks are an interconnected network of supportive relationships that contribute to our social well-beings
Optimum capacity
Personal goals of an individual to perform socially defined roles in a way that meets cultural expectations
Social capacity for performing well roles
Level of fitness and sense of healthiness in defining one’s position on the good health dimensions of wellness
Ill health dimension
Consists of experiencing illness and disease
Good health dimension
Consists of feeling healthy, being fit, and having the social capacity to achieve one’s life goals
Health Utilities Index (HUI)
Consists of a series of questions intended to measure both quantitative and qualitative aspects of health, designed to be a summary measure of overall health status
9 questions of the HUI
- Vision
- Hearing
- Speech
- Mobility
- Dexterity
- Cognition
- Emotion
- Pain
- Discomfort
Prevalence rate
Proportion of people in the general population who have a diagnosed disease at a given point in time
Incidence rate
Number of new cases of a specific disease identified over a period of time such as a year
The National Population Health Survey (NPHS)
Collects information about the presence of disease by documenting the type of chronic health conditions that are prevalent in the Canadian population
Chronic disease
Long-term physical health problem that lasts more than 6 months and has been diagnosed by a health professional
Co-morbidity
Presence of different diseases at the same time
5 most prevalent chronic disease in Canada
- Osteoarthritis
- Diabetes
- Asthma
- High blood pressure
- Depression
Health assets
Factors that enhance the ability of individuals or populations to maintain health and well-being and include social, economic, and environmental resources (Eg. Support system, employment, education)
Comprehensibility
The extent to which one perceives life events as making sense (view that life is ordered, consistent, etc)
Manageability
The expectation that things will work out as well as you can reasonably be expected (view that one has the resources to deal with life’s demands or a sense of confidence in one’s ability to cope)
Meaningfulness
The extent to which one feels that life makes sense emotionally (the view that there are areas of life that are worthy of commitment)
Differences between life expectancy and health expectancy
Life expectancy involves finding effective means of preventing premature death and potential years of life lost. Whereas, health expectancy is the expected number of remaining years of life spent in good health from a particular age, birth, etc
First national household health survey
The Canadian Sickness Survey 1950. Major focus was the indicators of ill health, such as morbidity patterns and health-are utilization
Another major national health survey
The Canada Health Survey 1978. Major focus was measuring disease, disability and utilization of formal health AND emotional health and lifestyle practices
The National Population Health Survey (2):
- Measures of both good health and ill health and monitor changes in health status and behavior
- Data collection was longitudinal
The Canadian Community Health Survey:
Introduced in 2000s to provide a cross-sectional health data at the sub-provincial level to assist regions in evaluating health services delivery and planning health promotion campaigns
The Canadian Health Measures Survey:
- Information gather is intended to evaluate the relationship between disease risk factors and types of health problems associated with diseases such as cardiovascular disease, hypertension, and diabetes, as well as obesity
- Goal to overcome data gaps in Canada’s health information
The Canadian Longitudinal Study of Aging
Launched in 2009 and reflects importance of adopting a life course perspective for measuring health. They take a random sample of 50,000 Canadian women/men ages 45-85 with data collection every 3 years for 20 years. Their goal is to gain an understanding of complex interplay over time and learn more about impact of non-medical factors to improve health and quality
Health diaries:
Health diary is well suited for gathering information about transient symptomatic conditions that do not restrict daily activities or prompt medical care and for gaining a more complex picture of population health
Pros and cons of health diaries
- Pros: reduced recall error, increased validity, higher levels of reporting
- Cons: increased respondent burden, conditioning effects, complexity of data collection/analysis
Illness narrative accounts
Enable people and patients, particularly those living with chronic illness, to recount their stories and describe factors that they believe have influenced the onset of condition
Importance of illness narrative
Gaining a more meaningful understanding of the suffering that accompanies serious, disabling, chronic illness
Objective of the Aboriginal adults/youths article
To explore perspectives on the meaning of health to aboriginal adults and youth living in a northern Manitoba First Nations community
Results of the Aboriginal adults/youths article
Adults and older youth used aspects of health depicted in the Medicine Wheel to describe being healthy, but younger youth were not as specific. Both generations spoke about the importance of positive adult role models with the incorporation of traditional First Nations practices into everyday life
What is common illness among First Nations youth
Obesity and type 2 diabetes
Cultural frame work of health in Aboriginal adults/youths article
Balance and harmony of spiritual, emotional, and mental aspects of life
What types of interviews were conducted in the Aboriginal article
Individual in-depth with adults and focus groups for youth
Zoonotic disease
Infectious diseases of animals that can cause disease when transmitted to humans
3 types of disease categories
- Communicable (Infectious) disease
- Chronic (non-communicable) disease
- Accident and injuries
Communicable (Infectious) disease (5):
- Caused by pathogenic microorganisms, such as bacteria, viruses, parasites, or fungi
- Person to person
- Vehicle-born infection (contaminated objects like towels, doors, food, etc)
- Airborne infection (spread of particles in the air)
- Vector-borne infection (Animate living insects of animals that transmits disease agents like Lyme disease carried by ticks, or malaria by mosquitos)
Chronic disease (4):
- Not passed from person to person
- Slow progression
- Increases with age
- Examples: Cariovascular disease, respiratory infections, diabetes
Injury
- Resulting from traffic collisions, drowning, poisoning, falls/burns, violence
DSM v Criteria
Diagnostic and Statistical Manual of Mental Disorders
In the same two week period, five or more of the following symptoms means you’re in a depressed mood or lost interest/pleasure…. (9):
- Depressed mood
- Diminished interest
- Significant weight loss when not dieting
- Insomnia/hypersomnia
- Psychomotor agitation or retardation
- Fatigue
- Feelings of worthlessness
- Diminished ability to think/concentrate or indecisiveness
- Recurrent thoughts of death
Pellagra
Systemic disease by a severe deficiency of niacin (vitamin B3)
Significance of paradigms in the case of pellagra
There was a widespread belief that pellagra was caused by bacteria, which shifted the perspective and area of focus
4 D’s in pellagra
- Dermatitis
- Diarrhea
- Dementia
- Death
Diet of pellagrins
Ate corn + little meat
Where did the outbreaks of pellagra mostly take place
- Orphanages
- Mental hospitals
- Prisons
Joseph Goldberger
Physician working for US Public Health Service. He is a Hungarian immigrant and was sent to the South to investigate the epidemic of pellagra
Central ideas of the Biomedical Model (5):
- Mind body dualism
- Physical reductionism
- Specific etiology
- Machine metaphor
- Individualized regimen and control
Mind body dualism in Biomedical model
Philosophical separation of mind and body = rationale for focusing solely on the individual biophysical body as a way to understand health and illness. Allowed healthcare to focus on biology aspect of patient instead of other determinants
Physical reductionism in Biomedical model
An approach to understanding the world that breaks phenomena into smaller parts to understand them. Allowed an inward-directed search for genetic causes of sickness
Specific etiology in Biomedical model
Each disease has a particular cause. Belief that discovering the cause will, in turn, lead to intervention and treatment that will cure disease
Machine metaphor in Biomedical model
A machine = dominant metaphor by which the biomedical model understands human body. Other cultures have different metaphors by which they understand human body
Individualized regimen and control
Disease can be fought/minimized through regimen and control. Assumption that we can discipline our bodies by eating, exercising, managing stress, and seeking health care
iceberg morbidity
Action that people undertake on their own to deal with everyday illness and common symptoms
Above water (iceberg)
Visible or measured morbidity like illnesses with permanent limitations
Below waster (iceberg)
Larger expanse of unmeasured morbidity like day to day problems that prompt self-care or no care
Formal care
Visible part of the iceberg (above waterline) - includes physicians and professional health-care providers, hospitals and health-care institutions, pharmaceutical industry and medical
Informal care
Invisible part of iceberg (below waterline) - includes lay health beliefs, self-care practices, mutual aid and social support networks, and self-help groups
What is the most leading cause of preventable morbidity/potential years of life lost in Canada
Injury
Lay beliefs
Represents an individual’s subjective and informal explanation for the world around them. It helps shape the importance that we attach to good health and our feelings about illness experiences
3 components on how we judge our health (Baumann’s study)
- Symptom orientation
- Feeling state orientation
- Performance orientation
Symptom orientation (Baumann’s study)
Belief that good health means an absence of symptoms of illness
A feeling-state orientation (Baumann’s study)
Belief that good health means a sense of well-being
Performance orientation (Baumann’s study)
Belief that good health means being able to carry out one’s usual daily activities
Differing meanings of health and wellness (5):
- Health as absence of illness and disease
- Health as fitness
- Health as sense of well-being
- Health as functional ability
- Health as a resource for living
Health as absence of illness and disease:
It is important to recognize the presence of disease and that it is not incompatible with a conception of good health. The layperson can have a symptom orientation to health and believe that the absence of illness means that she is a whole and healthy person
Health as fitness
Lay beliefs about health as fitness combine being physically active and having a healthy body with energy and vitality
Health as a sense of well-being
Sense of well-being is based on psychological and social components of health, reflecting feelings of happiness and healthiness along with rewarding relationships. This conception of good health can be expressed with the satisfaction with their quality of life
Health as functional ability
Individual ability to carry our daily tasks. This conception is tied to beliefs about physical and psychological fitness (being fit for activities such as child care, house work, etc)
Health as a resource for living
Conceptualized as a type of capital that can be invested in by individuals and societal institutions to achieve positive health returns. Health is a resource to support an individual’s function in wider society
Mildred Blaxter
UK sociologist who played a leading role in the first UK Health and Lifestyles survey
Health belief system
Systematic set of ideas regarding health, healing, and self-care shaped by aspects of culture and social locations
Self-health management
Reflects the fact that members of the public routinely engage in personal health practices, including health-protective and illness treatment activities
Self-health groups
Small, voluntary special purpose organizations intended to help people deal with specific common health-related problems (AA)
Health behaviour
Routine health-protective activities (Eg. Exercise, nutrition)
Regulatory self-care
Daily habits of living that effect health (Eg. Eating enough, sleep)
Preventive self-care
Consists of deliberate health actions undertaken to reduce the risk of illness (Eg. Flossing, brushing)
Illness behaviour
Self-care that refers to perception and evaluation of the meaning of daily symptoms
Relative self-care
Based on recognition and evaluation of symptoms and includes self-initiated responses to symptoms that have not been diagnosed
Sick role
Refers to both informal and formal help-seeking behavior such as lay consultation and use of formal health-care services
Restorative self-care
To overcome health problems in the case of an acute disease or adjusting to one’s daily life to achieve optimum level of functioning in a chronic disease
3 branches of self-care behaviour
- Health behaviour
- Illness behaviour
- Sick role behaviour
How does social support protect health
It intervenes between stressful life events and health outcomes
3 primary forms of support
- Instrumental support
- Emotional support
- International support
Instrumental support
Functional assistance offered by social network members for transportation, housing, banking
Emotional support
To have companions with whom we feel comfortable discussing personal matters with
Informational support
Advice, suggestions, and other information offered by social network members to help us make critical decisions
Fibromyalgia
Medical condition of widespread musculoskeletal pain accompanied by fatigue, sleep, memory, and mood
3 types of work related to different challenges posed by chronic illness
- Illness related work
- Everyday life work
- Biographical work
Illness-related work
Taking care of long-term symptoms like persistent pain
Everyday life work
Responding to the demands created by the impact of chronic illness on activities of daily living
Biographical work
Cognitive and emotional components of chronic illness and the need to reconstruct their life
Medicalization
Term used by health sociologists to describe tendency to understand aspects of life as medical issues requiring intervention and control on medicine
Bedside medicine (3):
- “What is the matter with you?”: symptom
- Doctors had no need to physically examine patients but had to pay attention to their demands and experiences
- Medical knowledge during beside medicine (middle ages to 18th century) was characterized by humoral theory
Hospital medicine (5):
- “Where does it hurt?”: pathological lesion
- Emerged through development of social relations of healing through industrialization and urbanization
- Goal was to identify underlying biophysical defect or pathological lesions within body that caused disease
- Diagnoses found through physical examination
- Many medical instruments were developed (stethoscope, etc)
Laboratory medicine:
- “Lets wait and see what the tests say”
- Founded upon the world-view of the scientific research worker
- Search for the cause of disease moved from the anatomical level to microscopic research for cellular pathology
ADHD
Disease experienced by persons who demonstrate short attention span, restlessness and impulsivity
Peter Conrad
Medical sociologist specializing in medicalization
Conrad’s three levels of medicalization:
- Conceptual level: medical vocabulary is used to define a problem
- Institutional level: organizations adopt a medical approach to treating a problem
- Interactional level: occurs as part of doctor-patient interaction
Demedicalization
Situation where a problem is no longer defined in medical terms and the involvement of medical personnel is no longer deemed appropriate
Iatrogenesis
Causation of sickness and injury caused by the health-care system popularized by Ivan Illich
Three types of iatrogenesis
- Clinical iatrogenesis
- Social iatrogenesis
- Cultural iatrogenesis
Ivan illich
Argues that modern medicine is the major threat to health and popularized the term “Iatrogenesis”
Clinical iatrogenesis (3):
- Illness or injury caused directly by the health-care system
- 60 Canadians die each day in hospitals due to preventable medical errors
- Clinical iatrogenesis can be reduced through focus on developing a “safety culture” within health-care systems
Social iatrogenesis (2):
- Indirect harm that medicalization causes to society in general by defining more and more aspects of life, from birth through sorrow, suffering, and sickness, to death, as medical issues
- When biomedical ideas, images, languages, and practices become the lens through which our culture understands questions of life and morality, then we have reached the point of social iatrogenesis
Cultural iatrogenesis
The way in which the increasing medicalization of life would eventually comprise our abilities to look after our own health without professional medicine’s help
Goals of medical screening
To assess individuals for presence of disease that has not yet appeared symptomatically
Examples of screening programs
Physical exams, blood/pap tests, breast screening, high-tech imagining and advanced genetic testing
Pharmaceuticalization
Intersection of medicalization and the role of pharmaceuticals. It is the process by which social, behavioral, or bodily conditions are treated or deemed to be in need of treatment/intervention, with pharmaceuticals by doctors, patients, or both
10 main causes of death in US 1900:
- Pneumonia
- Tuberculosis
- Diarrhea
- Diseases of the heart
- Intracranial lesions of vascular origin
- Nephritis
- All accidents
- Cancer
- Senility
- Diptheria
8 main causes of death In Canada 2019:
- Accidents
- Cerebrovascular disease
- Chronic lower respiratory disease
- Diabetes
- Influenza and pneumonia
- Alzheimer’s disease
- Suicide
- Kidney disease
Lyme disease
Bacterial infection transmitted to humans through the bite of infected blacklegged ticks
Early symptoms of Lyme (7):
fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes
Later symptoms of Lyme (11):
- Severe headaches and neck stiffness
- EM rashes
- Arthritis
- Facial palsy
- Intermittent pain in tendons, muscles, joints, and bones
- Heart palpitations
- Episodes of dizziness or shortness of breath
- Inflammation of brain and spinal cord
- Nerve pain
- Shooting pains, numbness, tingling in hands/feet
- Short-term memory
Erythema migrans rash
Rash that may appear on any area of the body and begins at the site of a tick bite
2 most influential factors for establishment of tick in Canada
Warmer temperatures and dispersion of ticks on animal hosts
Risk maps
Provides model against which different surveillance methods can be compared and hypotheses on the likelihood of expanding geographic range tested
Where is Lyme found especially in Canada
BC, Manitoba, and Ontario
Post Lyme disease syndrome
Experiencing symptoms of Lyme continuing for more than six months
When was the Federal Framework of Lyme disease Act developed
2016
When did Lyme become a notifiable disease in Canada
2009
Notifiable disease
Any of various health conditions that upon detection are required to be reported to public health authorities
What happens when Lyme is left untreated
It may attack tissues including heart and nervous system and trigger an immune response that can lead to Lyme arthritis
Public health
Health of a population as a whole, especially as the subject of government regulation and support
4 elements in most definitions of public health:
- Decision making based on data and evidence (vital statistics, surveillance, outbreak investigations and laboratory science)
- Focus on population vs individual
- Goal of social justice and equity
- Emphasis on prevention vs cure
Stream metaphor
Metaphor in healthcare relating to the fact that many people get sick; thus hard to save, and therefore, we should find the cause for the diseases
Upstream factors
Factors that affect patient behaviors such as smoking, poor nutrition, low physical activity, violence, alcohol, sexual behavior
Downstream factors
Factors that affect patients through disease and injury such as chronic/communicable, or intentional/intentional injury
Features of public health:
- Underlying social justice philosophy
- Political
- Expanding agenda - new problems and issues
- Connected to governments
- Grounded in sciences (biology, physical, quantitative, social, behavioural)
- Focus on prevention
- Interdisciplinary
3 responsibilities of a public health system
Health emergencies, chronic disease, and injury prevention, and health promotion
Core disciplines in public health (5):
- Biostatistics
- Epidemiology
- Health policy/management
- Environmental health sciences
- Social and behavioral sciences
Prevention
The action of stopping something from happening or arising
Primary prevention
Preventing the initial development of a disease (Eg. Immunization, reducing exposure to risk factor)
Secondary prevention
Early detection of existing disease to reduce severity and complications (Eg. Screening for cancer)
Tertiary prevention
Reducing the impact of the disease (Eg. Rehabilitation for stroke)
3 headings of morbidity:
- Hospital morbidity: defined as sickness requiring hospitalization
- Non-hospital morbidity: Treatment given outside hospital
- Untreated morbidity: Sickness which was self-treated or self-limiting, or undetected morbidity
How do drugs act as self-imposed risks
Alcohol addiction, cigarettes, abuse of pharmaceuticals, use of psychotropic drugs
How does diet and exercise act as self-imposed risks
Over eating, high-fat intake, high carbohydrate intake, lack of exercise, malnutrition
Environmental risks (6):
- Pollution
- Contaminated drinking water
- Urbanization
- Working conditions
- Effect of rapid social change on mental/physical health
- Inadequate housing and clothing
Health Field Concept
Envisages that the health field can be broken up into four elements of human biology, environment, lifestyle, and health care organization
Human Biology in HEALTH FIELD CONCEPT (2):
- Includes all aspect of health (physical and mental)
- Genetic inheritance, aging, internal systems, skeletal, nervous, muscular, cardio-vascular
Environment in HEALTH FIELD CONCEPT:
- External factors to the human body in terms of things we cannot control
Lifestyle in HEALTH FIELD CONCEPT:
Decisions made by individuals that affect their health in which they most likely do have control
Health care organization in HEALTH FIELD CONCEPT:
- Quantity, quality, arrangement, nature, and relationships of people and resources in provision of health care
- Includes medical practice, nurses, nursing homes, drugs, etc
Average consumption of absolute alcohol
2.6 gallons a year per drinking adult
Health promotion
Process of enabling people to increase control over, and improve their health
Prerequisites for health
Peace, shelter, education, food, income, stable eco-system, sustainable resources, social justice, and equity
Some examples of how the health promotion is committed by the charter
- To respond to the health gap within and between societies, and to tackle the inequities in health produced by rules and practices of these societies
- To reorient health services and their resources towards promotion of health and share power with other sectors, other disciplines, and most importantly with people themselves
- To recognize health and its maintenance as a major social investment and challenge; and address overall ecological issue of our ways of living
How smallpox was eradicated?
Vaccines
Explain the challenges of the polio campaign in India.
Among them was the high population density and birth rate, poor sanitation, widespread diarrhoea, inaccessible terrain and reluctance of a section of the population, notably members of the Muslim community in certain pockets, to accept the polio vaccine. Religion played in as a factor of refusal of the vaccine
Values of population and public health practice
Equity, social justice, participation, efficiency, effectiveness, acceptability, affordability and accessibility
What skills do people in public health need to have (7):
- Being patient
- Understanding one another
- Communication skills.
- Leadership skills.
- Knowledge of sociology.
- Problem-solving skills.
- A strong work ethic.
3 levels of preventative care
- Primary Prevention—intervening before health effects occur, through.
- Secondary Prevention—screening to identify diseases in the earliest.
- Tertiary Prevention—managing disease post diagnosis to slow or stop.
