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Poplhlth 102 > Test > Flashcards

Test Flashcards

1
Q

Why is smoking a major cause of lung cancer

A

20th Century smoking was very popular however there has been a significant decrease
Due to this smoking companies are targeting developing countries who are ‘unprepared’ to fight marketing companies off

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2
Q

Biomedical model- Definition

A
  • Dominant view of the 20th Century
  • Focuses on biological (proximal) causes

It assumes that…

  • illness is caused by bacteria, a faulty gene, a virus or an accident
  • illnesses can be identified and classified by medical professionals
  • diagnosis of symptoms is objective
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3
Q

When was the Biomedical model helpful…..

A

In the 1900’s when people were dying from infectious diseases

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4
Q

What are the main social models?

A

Whitehead and Dahlgren’s Social model
Biopsychosocial model
WHO social determinants model

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5
Q

What makes the social models different from the biomedical model?

A

Include biological (proximal) AND psychosocial (distal) factors

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6
Q

Social models of health assess these factors…

A

Biological/genetic
Behavioural
Psychological
Social

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7
Q

What is wrong with the WHO model?

A

Only focuses on the obesity epidemic

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8
Q

What is inequality?

A
  • Being unequal
  • Quantitative judgement
  • Health inequality = Differences in health between groups
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9
Q

What is inequity?

A
  • An ethical judgement

- Health inequity = Differences in health between groups that are unfair or unjust

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10
Q

The Marmot approach to a health inequality is an inequity…

A

Inequalities that are preventable by reasonable mean are unfair. Putting them right is a matter of social justice

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11
Q

What could we do to reduce health inequalities

A

We could ensure that every person has equal opportunity to have equality in health
However this would require…
- A society that values equity, fairness and justice for all
- More ‘health’ resources to reduce inequalities AND/OR
- A more fair, and probably unequal distribution of ‘health’ resources to reduce inequities
- BUT resources are scarce

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12
Q

What is unavoidable scarcity?

A

The resources are finite and not able to be reallocated from other sources

  • e.g. Organ donors, land available for health facilities, etc…
  • could be solved by giving resources to those who need it the most
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13
Q

What is Economic Scarcity?

A

The size of a the resource is determined by its priority

- e.g. Health budget vs spending on other areas, personal/household budget, etc…

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14
Q

Rationing options for unavoidable scarcity

A

Capacity to benefit- those who would benefit most from that health resource have priority
Equal chances- Everyone has an equal chance of accessing the health resources

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15
Q

Rationing options for economic scarcity

A

Market solution- give all the resources to the people and let them spend as much as they want on health
Equal distribution- give everyone the same amount of health resource
Equitable distribution- distribute the health resources in a way that reduces inequities

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16
Q

Problems with rationing for unavoidable scarcity

A

Capacity to benefit- is very difficult to judge

Equal chances- will often waste resources

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17
Q

Problems with rationing for Economic Scarcity

A

Market solution- will increase inequalities and will often waste resources
Equal distribution- will not reduce inequalities and may increase them
Equitable distribution- will not be seen as ‘fair’ by those with less need

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18
Q

What should we do to reduce health inequities?

A
  • Prioritise the most important issues that need to be solved
  • To improve inequalities there must be resources moved from somewhere else
  • HOWEVER this is not realistic when dealing with scarce resources
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19
Q

A realistic social model should be based on?

Four points

A

Material/structural resources
Culture and behaviour
Historical context
Social selection/discrimination

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20
Q

The black report 1980 states…

A

Large differences between scio-economic position
Cultural & behavioural aspect leads to discrimination
Artefact- isn’t really a social difference in health inequalities it occurs by the way we measure health

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21
Q

Material & Structural resources….

A

Material resources- e.g. Income, food, shelter, etc…
Physical structural resources- e.g. Access to health services, education, healthy environments (parks, shops, etc.)
Non-physical structural resources- e.g. Social support/capital, policies and legislation/ regulation, etc… (Protect people at risk of health inequalities)

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22
Q

Culture & Behaviour

A

Different groups in society have different cultures and behaviours, which might be more or less healthy
- if you focus on this they don’t look at other factors = VICTIM BLAMING

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23
Q

Historical context

A

Some historical events leave ever lasting effects on social groups

  • e.g. Health issues that result due to migration- Pacific Islanders post WW II
  • Natural disaster- earthquake in Christchurch- increase in bad heart health
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24
Q

Obesity facts- WHO model

A

Those living in LEAST deprived areas- more obese MALES than females
Those living in MORE deprived areas- More obese FEMALES than males
Prevalence of obesity- highest in Pacific Ethnicity
- This is due to unhealthy foods being forced upon them making it culturally acceptable= result of historical context (migration)

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25
Q

Definition of Social Economic Status

A

A complex mix of social and economic circumstances of an individual or a group of individuals. Measures of SES often include indices of social class, income, occupation, employment status, area of residence, housing quality, household composition and social integration

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26
Q

Describe relationship between SES & Health

A

Statistics consistently show that social groups with generally lower SES experience poor health and lower life expectancy than those with higher SES

27
Q

What are the common health problems of today?

A
  • Cancer
  • Cardiovascular Disease
  • Respiratory Disease
  • obesity
  • Diabetes
  • transport accident
  • intentional self-harm
28
Q

Measures of social economic status- occupational based measures

A

NZ standard classification of Occupation (NZSCO)
NZ Socio-economic index (NZSEI)
Register General scale- 1999 Managers get paid more

29
Q

Measures of Social economic status- Non-Occupational measures

A

Income (poverty)- e.g. Individual income, household income, poverty line, etc…
- Individual income doesn’t assess social factors e.g. Family members who are sick/disabled or dependants (children)
Deprivation- e.g. NZDep
Living standards- e.g. ELSI (economic living standards index)

30
Q

NZ Deprivation Index- 9 variables (eight domains)

A 
Income x2
Communication access- internet access 
Employment 
Transport access
Qualifications 
Living Space- how many rooms & people
Home ownership 
Support- single or double parent household
31
Q

How might material/structural explanation help us understand SES related inequalities in health

A

Intrauterine development

  • low birth weight= influenced by socio-economic position
  • babies born into a low socio-economic status they are more likely to have low birth weight
  • poor maternal nutrition results in extreme low and high birth weights

Physical environment
Environmental stress
Opportunity structures

32
Q

Material & structural health inequalities- physical environment

A

Damp housing= more health problems; Poverty= damp housing; therefore lack of material resources is the cause

33
Q

Material & structural health inequalities- environmental stress

A

Stress= more health problems; less control over work conditions= stress; lower SES= less control over work conditions; therefore lack of structural resources is the cause

34
Q

Material and structural health inequalities- opportunity structures

A

Sedentary behaviour= health problems; less availability of safe recreational areas/facilities in lower SES areas= more sedentary ; therefore structural resources is the cause

35
Q

Absolute poverty

A

“Welfare level below a reasonable minimum”

A condition characterised by severe deprivation of basic human needs, including food, safe drinking water, sanitation facilities, health, shelter, education and information. It depends not only on income but also on access to services

36
Q

Measures of absolute poverty- income based

A

Looks solely at income

  • less than US$1.25/day= EXTREME POVERTY
  • less than US$2/day= MODERATE POVERTY
37
Q

Measures of absolute poverty= food-share method

A

Based on the cost of basic food and non-food items

- income less than 3x the cost of US department of agriculture’s “economy food plan”

38
Q

Measures of absolute poverty- food-energy method

A

Consumption less than level that meets the food energy requirement

39
Q

Absolute poverty and health

A

Absolute poverty is an extreme lack of material and/or structural resources, so fundamentally limits the ability to live a healthy live
Culture & behaviour, social selection and history are also important in understanding the causes and effects of absolute poverty on health.

40
Q

Relative Poverty

A

Individuals, families, and groups in the population can be said to be in relative poverty when they lack the resources to obtain the type of diet, participation in activities and have the living conditions and amenities which are customary, or at least widely encouraged, or approved, in the societies to which they belong. They are, in effect, excluded from ordinary living patterns, customs and activities

41
Q

Measures of relative poverty- income based

A

Looks at income relative to the population

  • e.g. OECD criteria
  • less than 50% of the median household income
42
Q

Measures of relative poverty- deprivation measures

A

Looks at things that people don’t have relative to the population
- e.g. NZDep

43
Q

Measures of relative poverty- living standard measures

A

Looks at things people have relative to the population

- e.g. ELSI= economic living standards index

44
Q

Relative Poverty and health

A

Economic inequality weakens community and societies as a whole

  • they tend to have greater levels of absolute poverty
  • provide fewer social safety nets
  • have weaker social cohesion
  • larger differences in living standards can cause stress and anxiety can damage people’s health
45
Q

Economic inequality and health

A

What matters in determining mortality and health in society is less the overall wealth of the society and more how evenly wealth is distributed. The more equally wealth is distributed the better the health of that society.

46
Q

Definition of Social Support

A

Social support is measured by the amount and frequency of contact with social network members and in terms of the perceived quality and stability of supportive relationships.

47
Q

Definition of social capital

A

Individuals, families, and groups in the population can be said to be in relative poverty when they lack the resources to obtain the type of diet, participation in activities and have the living conditions and amenities which are customary, or at least widely encouraged, or approved, in the societies to which they belong. They are, in effect, excluded from ordinary living patterns, customs and activities

48
Q

Measuring social support/capital

A

Relational content
- satisfaction with quality of support, trust, reciprocity, etc.

Social network composition
- social network density, homogeneity, gender, etc.

Social integration
-whether the person has social relationships; how often they meet; marital status; membership of church, etc.

49
Q

Positive social support/capital

A

Mutual support, cooperation, trust, etc…

50
Q

Negative social support/capital

A

Sectarianism, ethnocentrism, corruption, etc.

51
Q

Social support/capital and health

A

Social support/capital can be a very powerful variable in times of crisis or stressful life events.
Many studies have shown a strong relationship between the amount of social support/capital available and health outcomes

52
Q

SES effect on health- behaviour and culture

A

Lower SES groups behave in ways more likely to damage their health and higher SES groups behave in ways that are less likely to damage their health
- e.g. Smoking, drinking, bad diet, sedentary, etc.

53
Q

SES effect on health- natural/ social selection

A 
Traditionally this explanation has suggested that health is a cause of social class rather than a consequence 
- healthier individuals are 'selected' into higher classes based on their genetic superiority
54
Q

SES effect on health- social selection perspective (natural/social selection)

A

Healthier individuals are selected into higher classes based on their ability to thrive in society-not genetic advantage but society is structured so that healthy people are advantage
- e.g. Discrimination based on health status

55
Q

Social selection perspective- intragenerational vs intergenerational

A

Intragenerational= individual moving up or down in SES during their life
- develop chronic illness then unable to keep working

Intergenerational= individual moving up or down SES relative to their class of origin 
- born with impairment so unable to thrive as much as their parents/siblings
56
Q

Social selection perspective- direct vs indirect

A

Direct= selection based on actual health status
- not hiring someone with a hearing impairment

Indirect= selection based on a potential health marker
- not hiring smokers because they may have/develop health problems

57
Q

SES effect on health- historical context

A

Groups that have experiences significant and/or traumatic events are often those in lower SES groups OR are more likely to end up in lower SES groups as a result of the event
- Loss of land for the Maori leads to structural/material loss as well as change in culture and behaviour

58
Q

Reducing SES inequalities in obesity- solution 1: Improving Resources

A

We can try to reduce health inequities relating to obesity by improving:

  • material resources
  • physical structural resources
  • non-physical structural resources
59
Q

Obesity reduction- material resources: sales tax exemptions

A

Issue: limited $ = limited choices
Solution: some countries have sales tax exemptions to reduce inequalities and improve health
- UK: most food VAT exempt
- Australia: GST exemptions for some medical aids and services, as well as ‘basic foods’ and cars for disabled
- NZ government says no as there is limited evidence

60
Q

Obesity= non-physical structural resources: Mandatory Calorie Information

A

Issue: people have very poor understanding of the number of calories in different foods
Solutions: NYC implemented a law in 2007 forcing chain restaurants (15+ outlets) to post the calorie count of each food in the same size and font as the price

61
Q

Obesity= material resources: tax unhealthy foods

A

Issue: limited $ = limited choices + cheap unhealthy foods
Solution: some countries have taxes on unhealthy foods
- fast foods taxes
–at least 13 states in the U.S. imposed a sales tax on ‘prepared food’

  • sugar and soft drink tax
  • -more than 20 states in the U.S. have a tax on soft drinks
  • -France has recently introduced a tax on soft drinks
  • -Denmark introduced a tax on sugar and fat, and then removed it
62
Q

Obesity= physical structural: better community parks

A

Issues: people in poorer areas have fewer safer places to engage in physical activity
Solution: the lets beat diabetes programme in Counties Manukau worked with a number of stakeholders to turn some unsafe and unused open space into safe parks for families

63
Q

NZ stakeholder

A 
Housing NZ corporation 
CMDHB Let's Beat Diabetes 
Manukau City Council Parks Department 
Manurewa Community Board
Habitat for Humanity 
Clendon Community Action Group
64
Q

Obesity= non-physical structural: Healthy food policies for School

A

Issue: Schools has historically offered a lot of unhealthy food options and few healthy options
Solution: National policies controlling the foods that schools can offer students
- e.g. Mission-on
–food and beverage classification system
–resources for schools and students
–regulation around food offered (only healthy foods)

Poplhlth 102 (1 decks)

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