Module Two

Question 1

What is the social model of health

Answer 1

Shift in focus from individual (psychological), biological and genetic attributes (biomedical) to social attributes

Highlights role of governments and policy makers in health determinants

Question 2

What are the two main components of social model of health

Answer 2

1. Social circumstances of the individual (education, employment, age, gender, culture)
2. Broader social, economic, political and welfare policies of the country (also the way the social circumstances are mediated by the socio-political-economy)

Question 3

Examples of social structures

Answer 3

Medicare
PBS
Private health
Health promotion (advertisements, etc.)

(Refer to diagram)

Question 4

Define structural determinants

Answer 4

Health partly attributed to social circumstances of individuals and populations
e.g. gender, class, education, occupation, culture, income

Example: low-income people have worse health, Indigenous have worse health

Question 5

Define socioeconomic and political determinants

Answer 5

The impact of economic, social and public policy by governments on the population e.g. welfare, taxation, health care system, education system, labour laws, housing, culture norms

Government focus should be across all sections not just health

Question 6

Define intermediary determinants

Answer 6

Forms bridge between structural determinants affecting individuals and socio-economic and political determinants of health inequality - 3 main categories:

• material circumstances (housing, transport)
• psychosocial (stress, coping style, social support)
• behavioural/biological (nutrition, physical activity, tobacco, genetics)

Question 7

What was the Alma Ata Declaration

Answer 7

Focus on primary health care and health prevention (social justice perspective) - things such as clean water, education, housing, rehabilitative services, etc.

Question 8

What health care system does Aus have

Answer 8

Mixed
Free universal and private health
UK is free universal and US is private system and free is means tested (US ignores WHO)

Question 9

What is an individualistic culture

Answer 9

The smallest economic unit is the individual and independence is valued - attribute responsibility for health to the individual

Question 10

What is a collectivist culture

Answer 10

The smallest economic unit is the family and human interdependence is valued - recognise role of extended family and community

Example: Maori beliefs ascribe 4 domains to health: family/community, physical, spiritual and emotional

Question 11

What is meant by social capital and social cohesion

Answer 11

Access to social network, friends, neighbours and relatives who support individuals have better health outcomes (positive intermediary determinant)
Communities with strong culture and collaboration enjoy better health

Question 12

How can intermediary determinants be modified

Answer 12

By community health programs and individual interventions e.g. The Heart Foundation WA’s Heart Health programs for Aboriginals

Question 13

Describe health inequalities between countries

Answer 13

Money and income underpin health – wealth is associated with better health outcomes (poor are worse off so are Indigenous)

Question 14

What is the disease burden equation

Answer 14

Disease burden is the disability adjusted life years (DALYs) = YLLs (years of life lost – early death) + YLDs (years living with disability)

Calculates cost of society from lost productivity

Question 15

How should disease burden reduction be achieved

Answer 15

At individual level (lifestyle changes) AND at societal level (policy, programs, addressing inequalities)

Question 16

What is a health behaviour

Answer 16

Any activity undertaken by a person who believes himself to be healthy, for the purpose of preventing disease or detecting disease in an asymptomatic stage

Question 17

What are the models of behaviour - learning theories

Answer 17

Classical conditioning

Operant conditioning

Question 18

What are the models of behaviour - cognitive and behavioural theories

Answer 18

Health belief model (HBM)
Theory of planned behaviour (TPB)
Transtheoretical model of behaviour change
Motivational therapy

Question 19

What is the health belief model

Answer 19

Explain and predicts health-related behaviours
Developed in 1950s to explain low-levels participation in health screening and illness prevention programs
Focuses on attitudes and beliefs of individuals

Question 20

What is the health belief model based on

Answer 20

Based on:

• Individual’s perception of threat to health (susceptibility and severity)
• Belief that a health strategy will be effective in reducing the threat (benefits and barriers)
• Moderating factors (demographic variables)

Look at diagram

Question 21

What is the theory of planned behaviour

Answer 21

Recognises that cognitive and behavioural theories cannot explain health behaviours or produce change - Takes social influences/processes into account
Surrounds three beliefs that are predictive of individual health behaviour and outcomes

Question 22

What are the three beliefs associated with the theory of planned behaviour

Answer 22

Individual attitude to behaviour (belief and evaluation of outcome)

Subjective norms (normative view of others and motivation to comply)

Perceived behavioural control (individual’s belief in capacity to achieve the desired outcome e.g. self-efficacy and the social context in which behaviour occurs)

Look at diagram

Question 23

What is the transtheoretical model of behaviour change

Answer 23

1. Precontemplation - not recognising the need to change/ no interest
2. Contemplation - thinking about change
3. Preparation - planning for change
4. Action - adopting new habits
5. Maintenance - ongoing, practice of new health behaviour

Question 24

What are some limitations of theories and models of health behaviour

Answer 24

Predictors of health behaviour intentions rather than actual health behaviour

Models do not take sufficient account of:

• Physiological factors
• Lifespan
• Social and cultural factors

Should be inclusive of the social context of the person’s life