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