Social Influences on Health

Question 1

Define sociology

Answer 1

Systematic study of society’s structure and culture. There are variations between cultures, structures within and between societies. We gain knowledge of ourselves, society and other societies distinct from our own in time and space.

Question 2

Define structure

Answer 2

How society is organised into social institutions

Question 3

Define culture

Answer 3

Everything aquired by society that is not physically inherited e.g. arts, political parties, weddings, funerals

Question 4

Define gender

Answer 4

The socially, psychologically and culturally constructed differences between males and females.

Question 5

Describe how community can be defined in terms of
Geography
Cultural
Social Stratification
Functional Group

Answer 5

People with something in common.
Geog: locality, in same proximity sp have similar needs e.g. neighbourhood watch.
Cultural: transgeographical - unite otherwise scattered or disparate groups. Assist one another in sharing resources.
Social stratification: layers of society e.g. working class or women. Sharing of knowledge and resources transcends barriers, even national ones
Functional groups: common interests and beliefs. Networks of resources, support and knowledge transcend other boundaries. e.g. Jehovah’s witnesses

Question 6

Define social capital

Answer 6

Experiences, resources and connections individuals can bring into lives when needed due tot health or social needs

Question 7

Define medical sociology

Answer 7

Micro level - how individuals experience illness and interact with healthcare professionals. Also how health professionals interact with each other. Macro level - patterns of disease related to physically damaging behaviours

Question 8

Define health promotion

Answer 8

Promotion of healthy lifestyle. This is only possible by understanding different age and gender groups. Eg tobacco consumption is affected by self image, key to altering smoking behaviour. There are differences in beliefs between smokers and non-smokers, old and young people, lower and higher socio-economic background and educational status. This allows specific target groups.

Question 9

Describe the sociology of the medical profession

Answer 9

Professions eg medicine, teaching different from occupations e.g. accountant, company director as institutionalism of altruistic values - commitment to providing services for the common good.
Systematic theory - theoretical basis
Authority recognised by clientele - patients come for advice or help
Broader community sanction - can’t practice medicine without a licence
Code of ethics - student ethical statement, hippocratic oath
Professional culture sustained by formal professional sanctions - GMC guards quality of work done by members

Question 10

List social influences on health and state what these are shaped by

Answer 10

Collective set of conditions people born in, grow up, live and work in
Gender
Ethinicity
Housing
Education
Employment
Financial security
Health system
Environment

Shaped by economics, social policy and politics

Question 11

Define health inequality

Answer 11

Difference in health status or the distribution of health determinants between different population groups. Inequitable and unfair or avoidable.

Question 12

Define the Inverse Care Law

Answer 12

Tudor Hart (1971) those in most need of medical care least likely to receive it and those with least need tend to use it more and more effectively.

Question 13

Describe the findings of the Black Report (1980)

Answer 13

Health inequality related to cultural, material, genetic (ethnicity and gender) and artefact factors. Biggest cause economic inequality. Re-distribution of resources and end to child poverty needed.

Question 14

Describe the findings of the Independent Enquiry into inequality in health (1998) (Acheson Enquiry)

Answer 14

All relevant health policies should be evaluated for health inequality impact. High priority to families and children, income inequalities and improved living standards in oil households.

Question 15

Describe the priority areas of Equally Well (2008)

Answer 15

Very early years
Big killers
Mental health
Drug and alcohol addicton

Question 16

Describe Fair society, Healthy Lives (2010)

Answer 16

Tackling health inequalities matter of social justice with real economic benefits and savings.

Question 17

Describe the Deep End Study (2013)

Answer 17

100 GP practices in most deprived areas. Proposed:
additional time for consultations
Attached alcohol workers
support for vulnerable families
more GP training practices in deprived areas
partnership between top and bottom of NHS

Question 18

Describe what the Scottish government did in 2011/12

Answer 18

£170M - 1.5% total NHS budget to NHS board to directly address health inequality

Question 19

Describe the effects of health inequality on life expectancy

Answer 19

Average life and healthy life expectancy have increased
Lower than any other part of UK for men and women
Women live longer but have more years living in poor health
Rural areas LE more than urban

Question 20

List the indicators of health inequality between deprived and affluent areas

Answer 20

Life expectancy
Breast feeding
Smoking
Alcohol related hospital admissions
GP consultations for anxiety

Question 21

Where is deprivation most concentrated in Scotland

Answer 21

The west

Question 22

Describe some of the health inequalities that affect children growing up in deprived areas

Answer 22

Lower birth weight
Poorer dental health
Higher rates of obesity
Higher rates of teenage pregnancy

Question 23

Define the social classes

Answer 23

1/A professional or higher managerial
2/B lower managerial or professional
3/C1 and C2 Intermediate occupations
4/C1 and C2 Small businesses or non professional self employed
5/C1 and C2 lower supervisory and technical
6/D Semi routine occupations
7/D Routine occupations
8/E Unemployed/student

Question 24

State the employment rate in Scotland

Answer 24

73.5% but compared to other countries there is a gap

Question 25

Describe how work affects health

Answer 25

Industrial accidents
Stress
Deafness

Question 26

Describe how health affects work

Answer 26

Diagnoses of chronic conditions affects ability to undertake work
Being off work may lead to further health issues.

Question 27

Describe the effect of deprivation on employment rate

Answer 27

You are approximately 20% less likely to be in employment if you are from a deprived area compared to the rest of Scotland

Question 28

Explain the advantages and disadvantages of car use

Answer 28

Adv
Social and economic benefits

Disadv
greater risk of RTCs with pedestrians and cyclists most vulnerable
long term exposure to air pollutants increases life expectancy
areas of high deprivation suffer most from air pollution related morbidity and mortality and the effects of noise pollution
Increased community severance as result of poor urban planning

Question 29

List the benefits of active travel e.g. walking, cycling and public transport

Answer 29

Active travel:
most sustainable
improved mental health
reduced risk of chronic diseases e.g. CHD, stroke, type 2 diabetes
integrate and increase activity in everyday life of general population (but lack of investment in walking and cycling infrastructure)

Public transport
Combining with active travel will help people achieve daily physical activity levels
Most sustainable for longer journeys but expensive and inconvenient
Rural areas lack infrastructure

Question 30

Describe the influences of the media on health

Answer 30

Shapes and stereotypes views and expectations e.g. patients mental health problems portrayed as being violent, disabled and unable to achieve a normal life. Social isolation, poor housing and unemployment linked to it, Stigma and discrimination impede access to treatment, Cycle of illness. Need first hand contact with people with mental health problems.. Also Equality Act 2010 makes it illegal to discriminate against people with mental health problems in terms of public services and functions, access to premises, work and education.

Question 31

Describe the distribution of GPs in deprived areas and the QOF

Answer 31

Most deprived areas don’t have most GPs but have twice as many pharmacies.
Quality Outcome Framework - additional funding for GP practices if achieve targets in care quality for cardiac care, COPD etc. Adjusted in 2009 so Deep End practices have different thresholds as more people suffer from these conditions.
Less uptake on eye checks and cancer screening aimed to improve whole population health.
More likely to miss appointments

Question 32

Describe the effect of housing on health

Answer 32

1 in 4 adolescents in cold home have mental health problems vs 1 in 20 in warm homes
Children in cold homes more likely to have respiratory conditions
3% more deaths occur in coldest quarter than warmest quarter

Question 33

Describe the effect of gender on health

Answer 33

Men have higher mortality. Women have higher morality and consult more frequently due to caregiving role

Men at higher risk of heart disease and up to 75 years stroke
Both 1 in 4 women and men smoke
61% adults active at recommended activity levels and 21% had very low activity. Men more likely to meet activity levels but equal at low levels
Men 10.8% more likely to attend A and E
Mean life satisfaction scores the same but women more likely than men to have psychiatric symptoms
Women twice as likely to claim carers allowance as men

Question 34

Describe the effect of ethnicity on health

Answer 34

Pakistani men have highest rate of diabetes but Chinese, and Afro-caribbean people have some of the lowest rates of diabetes
Black Afro-carribean, chinese, Pakistani and indian people are less likely to drink than the national average
Pakistani and Asian other are less likely to smoke than the national average
Most ethnic groups are more likely to consume the recommended 5 fruit and vegetables a day
But all are higher in at least 1 indicator of poverty

Question 35

Describe the sick and HCP roles

Answer 35

Sick role:
Exempt from daily responsibilities
Not responsible for being ill and can’t get better without healthcare professional’s help
Must seek help from HCP
Social obligation to get better as soon as possible
HCP role
Professional and objective, doesn’t judge patient morally
Must not act out of greed or self interest - puts patient first
Must obey professional code of practice
Have and maintain necessary skills and knowledge to treat pts
Right to examine patient intimately, prescribe treatment and wide autonomy in medical practice

Question 36

Describe the disadvantages of the sick and HCP roles

Answer 36

Lack of adherence to treatment. Can lack smoothie. Holds people personally responsible e.g. HIV, lung cancer. Secondary gains from being sick. Mismatch with mental health issues and disability

Question 37

Describe strategies to reduce health inequality

Answer 37

Effective partnership across range of sectors and organisations to promote health and improve patient education
Plans to integrate health and social care
Government policies and legislation e.g. keep well, smoking ban
Time to invest in more vulnerable patient groups
Improve access to health and social care professionals
Reduce poverty
Ensure employment opportunities for all
Ensure equal access to education in all areas
Improve housing in deprived areas

Keep well - 40 to 60 yo in deprived areas invited to do heath checks.
Also family nurse partnerships. NHS Lothian - support for vulnerable teenage mums until child two