Session 1 Flashcards
What is the biomedical model?
Traditional medicine not interested in psychological or social factors
E.g. In western medicine illness understood in terms of biological and physiological process so fix using drugs or surgery
Why have we seen a decrease in infant mortality and an increase in life expectancy in the last 150 years?
Medical advances- vaccines, new drugs and surgical improvements
Social improvements- better housing, sanitation and diet
Shown by change in top killers- from TB, Pneumonia, measles and Diphtheria to heart disease, cancer, stoke and respiratory diseases
What is the biopsychosocial model?
Health is related to phycological, biological and social factors
What are lay beliefs?
How people understand and make sense of health and illness
Made by people with no specialist knowledge
Not watered down version of medical knowledge
Socially embedded
Complex as drawn from different sources
What is a negative perception of health?
Health equates to the absence of illness
What is a positive perception of health?
Health is the state of wellbeing and fitness
What is a functional perception of health?
Health is the ability to do certain things
What do people want to understand?
Want to understand why and how illness happens
Want to understand why it happened to that particular person
Is there an interplay between medical and public beliefs?
Difficult to know if publics concepts are developed independently of medical professionals
But professional concepts make sense of in light of everyday life experiences
What is health behaviour?
Activity undertaken for purpose of maintaining health and preventing illness
What is illness behaviour?
Activity of an ill person to define illness and seek solution
What is sick role behaviour?
Formal response to symptoms like seeking formal help and action of person as a patient
What socioeconomic group is more likely to smoke?
Lower
2014:
30% of routine or Manuel group smoked
13% of managerial or professional group smoked
Why is smoking more prevalent in lower socioeconomic class?
Higher social class- more likely to have a positive definition of health
More likely to focus on long term investments as focus on remaining healthy- quitting is a rationale choice
Lower social class- less clear advantage as want to improve immediate environment, may be normalised and be a coping mechanism- smoking is a rationale choice
What influences illness behaviour?
Culture Visibility or salience of symptoms How much symptoms disrupt life Frequency and persistence of symptoms Tolerance threshold Information and understanding Availability of resources Lay referral
What is the lay referral system?
The chain of advice seeking contacts which the sick make before or instead of seeking help from a health care professional
Why is lay referral important?
Helps you understand: Why people delay seeking help How why and when you might consult a doctor Your role as a doctor in their health Use of health services and medication Use of alternative medicine
Why do people delay seeing the doctor?
Symptom experience
Symptom evaluation
Knowledge of treatments
Experience of health professionals
How is socioeconomic status measured
Individual occupation
Area in which people live
Life expectancy
Infant mortality
How do you measure deprivation?
Index of multiple deprivation
This is calculated by census data looking at:
Income, employment, health and disability, education skills and training, barriers to housing and services, living environment, crime
What is the social patterning of health?
Deprivation is strongly associated with health
The more deprived a person is, the larger the proportion of their life will be spent in ill health and die at young age
What is the black report?
Artefact= health inequalities are evident due to the way statistics are collected
Social selection= direction of causation is from health to social position e.g. Sick individuals move down social hierarchy and healthy move up
Behavioural-cultural= I’ll health is due to people’s choices, knowledge and goals
Materialist= inequalities in health arise from differential access to material resources - most plausible
What is the psychosocial explanation?
Act in addition to material living standards
Some stressors are distributed on a social gradient e.g. Negative life events
How does income distribution effect health?
Greater income inequality
Greater social evaluative threat
Greater stress
Poorer health
How can we measure access to healthcare?
Utilisation studies measure receipt of services
This is difficult to interpret
What to deprived groups seem to have higher rates of use of?
GP services
Emergency services
What do deprived groups have under use of?
Preventive services and specialist services
What is the theory and evidence of deprivation and access?
Manage health as series of crises
Normalisation of ill health
Event based consulting may be required to legitimise consultations
Difficulty marshalling the resources needed for negotiation and engagement with health service
Tendency to use more porous services
May reflect lack of cultural alignment between health service and lower socioeconomic background
Adjudications of the technical and social eligibility by doctors affect referrals and offers
