Midterm 1 (Simplified) Flashcards
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
Health state
Present health of individual
Health status
Characteristics of being healthy/unhealthy; longer term attribute
Population health
- 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
Illness
Perception of ill health, based on a person’s response to particular symptoms (Eg. pain, nausea) that cannot be directly observed
Factors influencing perception of symptoms (7):
- Gender
- Age
- Education
- Occupation
- Health status/previous experience with symptoms
- Family
- Culture
The Illness belief dimensions (4):
- Casualty
- Controllability
- Susceptibility
- Seriousness
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
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
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
Salutogenic model of health
Created by Aaron Antonovsky of an idea that health results of continuous everyday life interactions between the individual and inevitable social-, economic-, cultural-, physical-, mental- and biochemical stressors
Wellness
Inclusive concept that incorporates not only good health, but also the quality of life and satisfaction with general living conditions
Fundamental conditions and resources for health (9):
- Peace
- Shelter
- Education
- Food
- Income
- Stable eco-system
- Sustainable resources
- Social justice
- Equity
Health promotion
Process of enabling people to increase control over, and to improve, their health
Cause of decline in infectious disease
Result of the advancing biomedical practice of antibiotics, immunizations, and vaccines, as well as living conditions
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
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
5 main theoretical paradigms
- Structural Functionalist paradigm
- Conflict paradigm
- Symbolic Interactionist paradigm
- Feminist paradigm
- Sociology of the body paradigm
Structural Functionalist paradigm (5):
- 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.
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 (4):
- Exemption from responsibilities
- Temporarily exempt from usual well roles and task obligations
- Try and get well and resume responsibilities
- Seek technically competent help & cooperate in process of getting well
Conflict Paradigm (7):
- 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
The Symbolic Interactionist Paradigm (6):
- 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
Feminist Paradigm (5):
- 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
The Sociology of the Body paradigm (5):
- 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
Biopower
When power is exercised in modern societies (Term by Foucault)
Habitus
Refers to the embodiment of social location and culture within human bodies
Life course perspective (5):
- 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
European accounts of First Nations Traditional Health Systems (5):
- Biased
- Traditions described as primitive, fraudulent, harmful
- Healers described as magicians and pretenders
- Patients described as ignorant
- Practices were not seen as knowledge
Indigenous peoples 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
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
Determinants of health for Aboriginals (8):
- Colonization
- Globalization
- Migration
- Cultural Continuity
- Access
- Territory
- Poverty
- Self-determination
Sickness
Involves both presence of disease and experience of illness
The Illness Iceberg
Epidemiological model used in identifying progress of a disease from its subclinical stages to apparent disease state
Traditional Indigenous healers and medical practices (4):
- Herbalists
- Medicine men
- Shamans
- Belief that traditional healing roles are only filled by men
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
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
3 types of disease categories
-Communicable (Infectious) disease
- Chronic (non-communicable) disease
- Accident and injuries
Communicable (Infectious) disease (4):
- Caused by pathogenic microorganisms, such as bacteria, viruses, parasites, or fungi
- 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
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
Where did the outbreaks of pellagra mostly take place
Orphanages
Mental hospitals
Prisons
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 in Biomedical model
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
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
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)
Regulatory self-care (HEALTH BEHAVIOR)
Daily habits of living that effect health (Eg. Eating enough, sleep)
Preventive self-care (HEALTH BEHAVIOR)
Consists of deliberate health actions undertaken to reduce the risk of illness (Eg. Flossing, brushing)
Relative self-care (ILLNESS BEHAVIOR)
Based on recognition and evaluation of symptoms and includes self-initiated responses to symptoms that have not been diagnosed
Restorative self-care (SICK ROLE BEHAVIOR)
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 primary forms of support
- Instrumental support
- Emotional support
- Informational 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
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 (3):
- “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
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
Iatrogenesis
Causation of sickness and injury caused by the health-care system popularized by Ivan Illich
Three types of iatrogenesis
- Clinical iatrogenesis: Illness or injury caused directly by the health-care system
- Social iatrogenesis: 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
- 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
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 host
Post Lyme disease syndrome
Experiencing symptoms of Lyme continuing for more than six months
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
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
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)
Health Field Concept
Envisages that the health field can be broken up into four elements of human biology, environment, lifestyle, and health care organization
How smallpox was eradicated?
Ring vaccination method where they vaccinate those who are likely to have the virus rather than vaccinating the whole population
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 (8):
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.
Humoral theory
Perspective of Disease in ancient Greece
(elements of the body connected to element of the world - ENVIRONMENT!!)
-elements of world divided into air, fire, water & earth linked to blood, bile, phlegm, black bile
Also linked to: hot, dry, cold &wet
Compare good health and ill health.
- Good health is feelings of healthiness plus adequate performance at the physical, social. and psychological levels (more than just absence of illness and disease)
- ill health is the experience of illness and presence of disease
Can health and disease co-exist? Why?
Yes, people can be diagnosed with a disease but can still report feeling well.
