Social Science 1 Flashcards
what is the biopsychosocial model, and why is it important ?
it is the ideal that health (and illness) is determined by
three interlinked factors
your biological factors - genetics, disease, pathogens,physiology
your social factors - social class does determine how ill you will get and how long you will live , employment, family/social support networks
your psychological factors - cognition, emotional/mental well being, behaviour - there are links to say poorer mental health is associated with poorer physical health
what are lay beliefs ?
the average member of public’s level of understanding on health and illness
peoples definitions of health and illness vary , health may mean different things to different people
this can impact if a patient will comply with the treatment regime or not
cultural, social and religious factors will affect peoples beliefs - often medical knowledge is rejected
example - a misunderstanding of genetics and inheritability
person may say - fat bill drank and smoked all the time and lived till 99 - so i dont need to change - misunderstand that we are talking about risk factors, some anomalies will always exist
what are the three perceptions of health
Negative definition - health is the absence of illness - associated with low socio economic groups
Functional definition - health is the ability to do what i need in life - older generation and lower socio economic groups
Positive definition - health is a state of well being and fitness that must continually be strived towards - an achievable goal - associated with higher socioeconomic groups
what are health and illness behaviours
health behaviour - activity done to maintain health and prevent illness
illness behaviour - a person defining their illness and seeking a solution
this is determined by culture, visibility of symptoms, level that symptoms disrupt life, tolerance threshold ect
what is lay referral
• Relatively rare for someone to decide to visit a doctor
without first discussing their symptoms with others
• Up to three-quarters of those visiting a doctor have
discussed their symptoms with another person
Lay referral system
• The chain of advice-seeking contacts which the sick make with other lay people prior to – or instead of – seeking help from health care professionals.
can lead to use of ‘alternate’ medicines, and why some people may not see a doctor until critical, as they can treat it with their ‘olis’
how do lay beliefs impact adherence to treatment
deniers and distancers
Half of the sample denied either having asthma at all
(deniers) or denied having “proper” asthma (distancers)
• Claimed symptoms did not interfere with everyday life
• Used complex or drastic strategies to hide it
• Taking medication relies on accepting asthmatic
identity - didn’t take drugs or attend asthma clinics
Acceptors
Accepted diagnosis and doctors’ advice completely
Normal life involved having control over symptoms through medication
Asthma was not a stigmatised identity – happy
to use inhalers in public.
Pragmatists
Did use preventive medication but only when asthma was bad Accepted they had asthma but saw it as a mild acute illness
what are chronic ilness’ and long term conditions
problems with no cure - persons life is permanently altered
we can attempt to control condtions
LTC’s increase with an ageing population - rheumatoid arthritis
LTC’s take up 70% of funding and 50% of GP’s time
we must focus on a sociological approach - how does the chronic illness affect social interactions, jobs, mental health ect
what is a functional theory of illness experience
not vital
Parsons sick role -
Relationship between society and individual
• Not directly acknowledging
role of the body
a temporary illness - ignores chronic problems
what are illness narratives
Not vital
How individuals make sense of their illness, drawing on
their physical experience and social understandings.
• How individuals rebuild their identity and sense of self
the sociological theory on chronic illness
5 kinds of work go into working to manage a chronic illness
illness work - nervous pre diagnosis, shocking and nasty to be diagnosed
it involves dealing with the physical problems - coping with eating , shower ect
requires self management, interventions and management programmes help people learn to cope
everyday life work - coping mentally and a strategy with doctor to manage problems
new life becomes the new normal
emotional work - help to protect persons emotional well being, try maintain friendships and hobbies (difficult)
biographical work - a loss of self image and identity
need to develop new image to feel valued still
identity work - work to maintain a self identity, how other people react to you , dont let illness define who you are
outline burys biographical disruption model
Disruption of taken-for granted behaviours
- i cant do simple stuff any more
Disruption in explanatory systems
medicine cant cure me, why me? not fair, will my children get it ?
Mobilisation of resources
rearrange life to accommodate problem
get support networks
Limitations
Does not deal with conditions from birth
• Some social groups expect illness more than
others
• Later work has shown that older people may see
chronic illness as ‘biographically normal’
goffmans stigma
the discrepancy between someones perceived identity / social standing and the new actual identity
the person will feel a social stigma for who they are now
ie was a doctor, now im paralysed
there are discreitable stigmas - unseen - HIV and Mental illness - if found out - ie they dont have a problem, just being a baby
there are discredited - physical trait - a physical disability - they are discredited
there is felt stimga - fear of people looking at you/ finding out - feel shame
and enactred stigma - real experience of prejudice
health inequalities and inequalities in health
what determines our health
varies with social class - ethnicity - gender and more
wealthy live longer
deprivation of the area is strongly associated with ill health - live in a poorer community , and you will spend a longer portion of your life unwell, die earlier
theories and explanations why poor are live shorter worse lives
artefact is discredited shite
social selection
Sick individuals move down social hierarchy, healthy
individuals move up
• Chronically ill and disabled people are more likely to be disadvantaged
• Plausible explanation,.
Behavioural-cultural explanation
Ill health is due to people’s choices/decisions, knowledge and goals
• Useful explanation - e.g. for health education
• Limitations
– Behaviours are outcomes of social processes, not simply individual choice
– “Choices” may be difficult to exercise in adverse conditions
– “Choices” may be rational for those whose lives are constrained by their lack of resources
Materialist explanation
Inequalities in health arise from differential access to
material resources ie healthcare , good food ect
• Lack of choice in exposure to hazards and adverse
conditions
• Accumulation of factors across life-course
• Most plausible
• Limitations
Psychosocial explanation
Health is influenced more by differences in income than
actual income
• Some stressors are distributed on a social gradient
– e.g. negative life events, social support, autonomy at work; job security
• Stress impact on health via different pathways
– Direct (physiological, immune system)
– Indirect (health related behaviours, mental health)
Income Distribution (Wilkinson)
• Relative (not average) income affects health
• Countries with greater income inequalities have greater health inequalities
• It is not the richest, but the most egalitarian societies
that have the best health
associated with psycho social model - inequalities causes stressors and reduced health
do deprived people have less access to health care
Inequities in Access to Healthcare • More deprived groups seem to have: – Higher rates of use of • GP services • Emergency services – Under-use of • Preventive services (e.g. screening, asthma, outpatients) • Specialist services (e.g. cancer treatments)
Deprivation and access –
• Tendency to manage health as a series of crises
• Normalisation of ill-health
Difficulty marshalling the resources needed for
negotiation and engagement with health services
but
Differences in service use are associated with social
disadvantage ( + ethnicity + gender, age, disability and homelessness)
• Inequities in access are also mediated by complex
forms of social advantage and disadvantage
