Session 1

Question 1

What is the biomedical model?

Answer 1

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

Question 2

Why have we seen a decrease in infant mortality and an increase in life expectancy in the last 150 years?

Answer 2

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

Question 3

What is the biopsychosocial model?

Answer 3

Health is related to phycological, biological and social factors

Question 4

What are lay beliefs?

Answer 4

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

Question 5

What is a negative perception of health?

Answer 5

Health equates to the absence of illness

Question 6

What is a positive perception of health?

Answer 6

Health is the state of wellbeing and fitness

Question 7

What is a functional perception of health?

Answer 7

Health is the ability to do certain things

Question 8

What do people want to understand?

Answer 8

Want to understand why and how illness happens

Want to understand why it happened to that particular person

Question 9

Is there an interplay between medical and public beliefs?

Answer 9

Difficult to know if publics concepts are developed independently of medical professionals
But professional concepts make sense of in light of everyday life experiences

Question 10

What is health behaviour?

Answer 10

Activity undertaken for purpose of maintaining health and preventing illness

Question 11

What is illness behaviour?

Answer 11

Activity of an ill person to define illness and seek solution

Question 12

What is sick role behaviour?

Answer 12

Formal response to symptoms like seeking formal help and action of person as a patient

Question 13

What socioeconomic group is more likely to smoke?

Answer 13

Lower
2014:
30% of routine or Manuel group smoked
13% of managerial or professional group smoked

Question 14

Why is smoking more prevalent in lower socioeconomic class?

Answer 14

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

Question 15

What influences illness behaviour?

Answer 15

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

Question 16

What is the lay referral system?

Answer 16

The chain of advice seeking contacts which the sick make before or instead of seeking help from a health care professional

Question 17

Why is lay referral important?

Answer 17

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

Question 18

Why do people delay seeing the doctor?

Answer 18

Symptom experience
Symptom evaluation
Knowledge of treatments
Experience of health professionals

Question 19

How is socioeconomic status measured

Answer 19

Individual occupation
Area in which people live
Life expectancy
Infant mortality

Question 20

How do you measure deprivation?

Answer 20

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

Question 21

What is the social patterning of health?

Answer 21

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

Question 22

What is the black report?

Answer 22

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

Question 23

What is the psychosocial explanation?

Answer 23

Act in addition to material living standards

Some stressors are distributed on a social gradient e.g. Negative life events

Question 24

How does income distribution effect health?

Answer 24

Greater income inequality
Greater social evaluative threat
Greater stress
Poorer health

Question 25

How can we measure access to healthcare?

Answer 25

Utilisation studies measure receipt of services

This is difficult to interpret

Question 26

What to deprived groups seem to have higher rates of use of?

Answer 26

GP services

Emergency services

Question 27

What do deprived groups have under use of?

Answer 27

Preventive services and specialist services

Question 28

What is the theory and evidence of deprivation and access?

Answer 28

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