W2

Answer 1

-“A set of interrelated decisions taken by a political actor or group of actors concerning the selection of goals and the means of achieving them within a specified situation where these decisions should, in principle, be within the power of these actors to achieve.”(Jenkins, 1978)

Question 2

Where is Policy?

Answer 2

Everywhere

Question 3

Does Policy need to written down?

Answer 3

Not necessarily

Question 4

Can there be “No” decision in Policy

Answer 4

Yes there can be “No” decision in Policy

Question 5

Policy is a _____ or a ____ can be a means to an end

Answer 5

Policy is a decesion or a choice can be a means to an end

Question 6

Intent doesn’t always = _____
-sometimes policy decisions can have …..

Answer 6

Intent doesn’t always = results
- sometimes policy decisions can have good or bad outcomes

Question 7

What is Public Policy?
What does it do?

Answer 7

-a course of action or inaction CHOSEN by public authorities
-Addresses a given problem or interelated problems
-Anchored in a set of beliefs about the best way to achieve those goals
(Bryant, 2016)

In canada health policy is a subset of policies- includes what we define as healthcare whats included and whats not f

Question 8

Health Policy

Answer 8

is a sub-set of Public Policy
-Who has power and who does not have it to influence policy and outcomes?
-Who benefits/does not benefit?
-shows what is included in health care and what is not

Question 9

Why study policy?

Answer 9

-Central instrument for helping to organize and manage modern societies
- key in advocacy work (a lot of policy work is advocacy)
-Not just why and how to act, but also the assignment of resources

Question 10

Policy can be thought of as _____, and, also as _______ and ____
Understanding the evidence that guides policy AND the beliefs that guide what we do/do not do
Essential programs that work to change society

Answer 10

Policy can be thought of as ‘intent’, and, also as ‘understanding’ and ‘process’
Understanding the evidence that guides policy AND the beliefs that guide what we do/do not do
Essential programs that work to change society

Question 11

What Constitutes “Good” Policy?

Answer 11

-timely
-consultation with stakeholders
-clearly articulated purpose
-has a sound logical basis–links between fact and assumptions identified
-evidentiary basis
-balanced
-viable options for action
-relevant-current and anticipated developments
-concise and organized
-pragmatic–considers implementation issues
-Policy formation is effectively a circle, starting with ———-identifying and define it
Missing from circle: is peoples worldcviews, perceptions, ideologies, biases = they underlie everyone of the circles
Underlying all of these things is individuals

Question 12

The Scope of Health Policy:some examples

Answer 12

-Health policy scope is really broad
-What things are covered by OHIP and what is not
-Health care and other health-related services
-The “state” determines the organization of health care and resource allocations for the delivery of services
e.g. USA = Market Driven;Canada = NHIP (well, PHIP)
-Financing and delivery
-Improving and Maintaining Health
e.g. environmental and social determinants of health
Monitoring health
e.g. Health status indicators
-need to be aware of the different types of policies

Question 13

How to form a health policy?

Answer 13

• We have many possibilities
  -Limits are endless
  -Policy actors have these number of balls at their disposal and they have conscious choices to pick and they put in the blender and you end up with is at the end
  -How you mix them together is the outcome you re going to achieve
  -Its about how people banks what their priorities are and what they choose to do

Question 14

Theories of Public Policy What we end up with!
-NB* understanding the dimensional nature of policy requires an understanding of ______/_______ approaches that try to explain how policy is made and implemented
Can be sorted into two large buckets:
1.C
2.C/ C
-Both assume policy choices are based on rational consideration of _____
–Each has __ place in explaining ________/______-reasons
-TWO different orientations of how we can look at ___ ____and make choices and look at them
-Policy is ________so its important to talk about thinking

Answer 14

Theories of Public Policy What we end up with!
NB* understanding the dimensional nature of policy requires an understanding of theoretical/philosophical approaches that try to explain how policy is made and implemented
Can be sorted into two large buckets:
1.Consensus
2.Conflict/ Critical
-both assume policy choices are based on rational consideration of alternatives
–Each has own place in explaining development/implementation-reasons
–TWO different orientations of how we can look at public health and make choices and look at them
Policy is multidimensional so its important to talk about thinking

Question 15

CONSENSUS POLICY THEORY
-Policy made using _____ consideration of alternative courses of action
-choices are based on ___ and ___ and e____
-Focus on small improvements that can be made to improve existing services
-Emphasis on technical issues such as ___-__-___ organization, financing, delivery –not much about the forces (economical, political social) that shape overall organization
-Often neglects importance of ____, ______ and ____ and misses the ‘big picture’
-AKA:”___ and ___” lens
-When we implement a policy - look at ___, efficiency
-Not usually large change
-If you work in a hospital and run health care administrations this is what hospital is about, How ___ do we expect on a specific day, do they have somewhere to ___, how much are patients gonna get ____ = nuts and bolts
-does not think about the ____ (ideology, value, power)
-It misses the part that 80% of the clients are ___, —–Women treated different than men? No one takes care of them?

Answer 15

-Policy made using RATIONAL consideration of alternative courses of action
-choices are based on COST and BENEFITS and EVIDENCE
-Focus on small improvements that can be made to improve existing services
-Emphasis on technical issues such as DAY-TO-DAY organization, financing, delivery –not much about the forces (economical, political social) that shape overall organization
-Often neglects importance of IDEOLOGY, VALUES and POWER and misses the ‘big picture’
-AKA:”NUTS and BOLTS” lens
-When we implement a policy we look at COST, efficiency
-Not usually large change
-If you work in a hospital and run health care administrations this is what hospital is about, How MUCH do we expect on a specific day, do they have somewhere to PARK, how much are patients gonna get CHARGED = nuts and bolts
-does not think about the PEOPLE (ideology, value, power)
-It misses the part that 80% of the clients are ELDERLY, Women treated different than men? No one takes care of them?

Question 16

CONFLICT/ CRITICAL POLICY THEORY
-One is not more ___ form the other its just _____
-Consider ____ issues in the organization and development of policy
-Policy debates are influenced by ____ ____, ____and _____ in influence and power including gender, race, class, disability, etc.
-Acknowledges ____ differential
-___ will be affected –for better or for worse –by policy decisions
AKA:”___-_____-____” lens
-Looks at ___ experiences, the doctor has more ____ over you
-Different researchers tend to take this approach one way or the other
-More of this is _____in terms of health care services in Canada ____ a bill was passed

Answer 16

Conflict / Critical Policy Theory
-One is not more RIGHT form the other its just DIFFERENT
-Consider BROADER issues in the organization and development of policy
-Policy debates are influenced by SOCIAL CLASS, POLITICS AND INEQUALITIES in influence and power including gender, race, class, disability, etc.
-Acknowledges POWER differential
-WHO will be affected –for better or for worse –by policy decisions
AKA:”SOCIO-CULTURAL-ECONOMIC” lens
Looks at LIVED experiences, the doctor has more POWER over you
-Different researchers tend to take this approach one way or the other
More of this is IMPLEMENTED in terms of health care services in Canada AFTER a bill was passed

Question 17

Based on these two approaches, we can reflect on…
-Using these two different approaches you can sit back and look at things you ___ to change
-Policy as an ______ process of change
-The intentions of a policy –____, goals, understandings, principles and plans that will ___ activities, establish accountability and responsibility
-Policy as reflected in the way things are _____
-Policy is experienced through what happens in ____
-Policy as practice (routine decisions, activities, understandings and achievements)
-Policy as written ______
-Policy as people’s ______ and _____
-Policy as ____ and policy as ____
-We can ____ the nuts and bolts
-Understanding patients - what they___, what they were ___ ____
-______ matters and you cannot be addressed through _____ ______

Answer 17

-Using these two different approaches you can sit back and look at things you WANT to change
-Policy as an INTENDED process of change
-The intentions of a policy –VISION, goals, understandings, principles and plans that will GUIDE activities, establish accountability and responsibility
-Policy as reflected in the way things are DONE
-Policy is experienced through what happens in PRACTICE
-Policy as practice (routine decisions, activities, understandings and achievements)
-Policy as written DOCUMENTS
-Policy as people’s UNDERSTANDING and ACTIONS
-Policy as HISTORY and policy as CHANGE
-We can CHANGE the nuts and bolts
-Understanding patients - what they SAW, what they were NOT GIVEN
-EXPERIENCE matters and you cant address experiences through CONSENSUS THEORY

Question 18

What are the Levels of Study in Health Policy?

Answer 18

-Use those two lenses to filter out the health policy system further:
-Philosophical → the thing that holds it all together
System (more nuts and bolts)
-Social
-Legal - might think of consent and capacity board (may have lost some of their faculties and cant make their own decisions/ formal way of knowing what patients can make their own decisions) - children/psychiatric patients
-Economic
-Standards and rules in treatment (nuts and bolts)
-Level of medical care practice - how does moral decision making fall into standard medical care practice? → do no harm, making ethical and moral decisions for patients that are in their best interests
These different levels help us to ask really good questions
Focuses not only on whether they can consent or not but taking MORAL and ETHICAL decisions

Question 19

Martsolfand Thomas, 2019
“Positions on key public policy issues are driven by largely implicit and unarticulated _______ presuppositions that guide individuals’
-notions of the nature of ______
- individuals’ moral _____ to each other
-how society assesses ___ _ ___,
- and what it means to be a _________.
If faculty in schools of nursing are to prepare graduate nurses to enter into these heated public policy debates, we must help students understand, identify, and articulate the philosophical presuppositions that undergiad reasoning related to health policy issues.”
Decision makers themselves have implicit unarticulated spots they stand in, everyone who is in the system sees that as well
People have _____ views

Answer 19

Martsolfand Thomas, 2019
“Positions on key public policy issues are driven by largely implicit and unarticulated PHILOSOPHICAL presuppositions that guide individuals’
-notions of the nature of GOVERNMENT,
-individuals’ moral OBLIGATIONS to each other,
-how society assesses QUALITY OF LIFE,
-and what it means to be a COMMUNITY.
If faculty in schools of nursing are to prepare graduate nurses to enter into these heated public policy debates, we must help students understand, identify, and articulate the philosophical presuppositions that undergird reasoning related to health policy issues.”
Decison makers themselves have implicit unarticulated spots they stand in, everyone who is in the system sees that as well
People have DIFFERENT views

Question 20

Musings( a period of relfection and thought) in Health Policy

Answer 20

What do we value?
What do we need? - americans dont have a pubblicyl funded healthcare system do they need them?
How do we know?
How do we decide?
How do we decide who knows?
How do we decide who gets to decide?
How are people important?

Why is policy developmnet challenging? = because you cant please all the people all the time

Question 21

Why Philosophy?

Answer 21

How/what people think about “knowledge, reason, free will, morality, objectivity and rationality, facts and values, and freedom”.
Ontological concerns -defining health, disease, and causation.
Knowledge, logic and scientific discovery, including the absence of rigorous proof or disproof and causal inferences.
Helps us to better understand the problems of the health of society and how they are related to problems of medicine, science, and society.
Philosophy married with History helps to understand the significance of future changes in knowledge. What we “know” today will evolve, as history indicates, into something different.
Ontology = nature of being
Philosophy + historical context = how we know what we know
Philosophy drives how knowledge is generated, the whole ontological thing, the most basic level of human understanding is subjective
How do we do research in these subject? - they have standards and are subject to change

Question 22

Philosophy Cannot be Ignored in Policy because…
-How _____ is generated
studies in biology, epidemiology, and social science, etc.
-Our understanding of ____
-Basis for choosing and undertaking _______
-Reflect community values - :r/n/scommunity
-Reflect ____ ______values, worldviews and philosophies
Acceptable policy levers
How do you get people to do what you want? = restrictions around buildings to stop people form smoking, photos on the packages, fines
Philosophy ____ our thinking

Answer 22

-How KNOWLEDGE is generated studies in biology, epidemiology, and social science, etc.
-Our understanding of HEALTH
-Basis for choosing and undertaking INTERVENTIONS
-Reflect community values - religous/neighbourhood/social community
Reflect policy maker’s values, worldviews and philosophies
Acceptable policy levers
How do you get people to do what you want? = restrictions around buildings to stop people form smoking, photos on the packages, fines
Philosophy guides our thinking

Question 23

Epistemology
-“Episteme” = “______” or “______”;
-“logos” = “____” or “_____” or “____”.
-Focuses on the creation and dissemination-of knowledge in particular areas of inquiry
-Determines the nature of knowledge; that is, what does it mean to say that someone knows, or fails to know, something?
- How do we distinguish between cases in which someone knows something and cases in which they don’t?
Determine the extent of human knowledge; that is, how much do we, or can we, know?
How can we use our reason? Are there limits to what we can know? Are some things unknowable? Is it possible that we do not know nearly as much as we think we do?
How you do your science is based on epistemology

Answer 23

Epistemology
“Episteme” = “knowledge” or “understanding”;
“logos” = “account” or “argument” or “reason”.
-Focuses on the creation and dissemination-of knowledge in particular areas of inquiry
-Determines the nature of knowledge; that is, what does it mean to say that someone knows, or fails to know, something?
-How do we distinguish between cases in which someone knows something and cases in which they don’t?
-Determine the extentof human knowledge; that is, how much do we, or can we, know? How can we use our reason? Are there limits to what we can know? Are some things unknowable? Is it possible that we do not know nearly as much as we think we do?
How you do your science is based on epistemology

Question 24

Middle ages
-Mental illness was not identified as mental illness it was a ________ thing
You were either a which/demonic possession
Sufferers were often tortured, burnt at the stake, hanged or decapitated to release demonic presence

Answer 24

Mental illness was not identified as mental illness it was a supernatural thing
You were either a which/demonic possession
Sufferers were often tortured, burnt at the stake, hanged or decapitated to release demonic presence

Question 25

Worldviews

Answer 25

Comprehensive
Internally coherent
Connection to normative ethical theory (ergo, what is right or wrong) •Aspirational and acted upon
(Boylan, 2004, 2012)
Schiff, 1968:
Cognitive
Affective
Behavioural
You see a stimuli: see a puppy - feel a way - psychological

Question 26

Ideology

Answer 26

Political scientists -identify packages of positions, often seen as consolidated in a single preferred optimal state
Result of forces in the material environment that shape what people think
Can be used to denote the beliefs, attitudes and opinions of those with whom we disagree
Political and social analysts tend to give extremely broad definitions, e.g. beliefs, attitudes and values. This basically runs the gamut of all possible cognitive elements.
(Martin, 2015)
Ideology is often based on worldviews

Question 27

Ideology

Answer 27

“An ideology is what is believed to be right.

Question 28

Worldviews

Answer 28

A worldview is what is believed to be true. Worldview is a lens through which self and reality are interpreted, including beliefs about what can be known and done.

Question 29

Personality

Answer 29

Personality Is a way of being, with styles of feeling, thinking, and acting.

Question 30

Ideology ,Worldviews ,Personality

Answer 30

These qualities relate to perceptions of human nature, social relationships, and relationship to the natural world. Each of these has implications for how counselors and psychotherapists view themselves, their roles, and their clients.(Brown, 2019)

Question 31

Decision Theory

Answer 31

-reasoning underlying someone’s choices
mundane or complicated or life changing choices
on any given occasion, a person is guided by beliefs and desires/values
-a theory of beliefs, desires and other relevant attitudes AND a theory of choice; what matters is how these various attitudes (call them “preference attitudes”) meld together.
what criteria someone’s preference attitudes should satisfy in any generic circumstance.
-Could be suggested that this amounts to a minimal account of rationality, one that sets aside more substantial questions about appropriate values and preferences, and reasonable beliefs, given the situation at hand.
-Things that you do that you don’t stop to question(things you do on an instict

Question 32

All People are Inherently Biased!
“The concept of _____ bias, also termed unconscious bias, and the related Implicit Association Test (IAT) rests on the belief that people act on the basis of internalized schemas of which they are unaware and thus can, and often do, engage in discriminatory behaviours without conscious intent.”
Pritlove et. al, 2019 as published in The Lancet
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32267-0/fulltext
Challenge:Take the Implicit Bias Test HEREor use the link: (https://implicit.harvard.edu/implicit/takeatest.html)
Not required
But it helps you understand your biases

Answer 32

“The concept of implicit bias, also termed unconscious bias, and the related Implicit Association Test (IAT) rests on the belief that people act on the basis of internalised schemas of which they are unaware and thus can, and often do, engage in discriminatory behaviours without conscious intent.”
Pritlove et. al, 2019 as published in The Lancet
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32267-0/fulltext
Challenge:Take the Implicit Bias Test HEREor use the link: (https://implicit.harvard.edu/implicit/takeatest.html)
Not required
But it helps you understand your biases

Question 33

Another Element to Consider: Moral DecisionMaking
Virtue Ethics -Aristotle
______ is determining factor in deciding if someone is a good person
In health care:
C
H
Morally correct actions
Antithesis –German war-time experimentation & Nuremberg Trials

Answer 33

Another Element to Consider: Moral Decision Making
Virtue Ethics -Aristotle
Character is determining factor in deciding if someone is a good person
In health care:
Compassion
Honesty
Morally correct actions
Antithesis –German war-time experimentation & Nuremberg Trials

Question 34

Utilitarian -Mill

Answer 34

-Moral (correct) decisions are identified based on extent to which they promote more happiness than unhappiness
-Ratio of happy: unhappy is not consistent in all situations (e.g. dropped $20 –homeless vs. Jeff Bezos)
-Options initially accepted as moral may be rejected in specific circumstances
Health care: professionals make decisions based on best interest of a particular collective of patients (e.g. quarantine)
Often lead to further moral issues/conflict
Deducing the ration of unhappiness, Ex getting service faster, pain management

Question 35

Deontological -Kant

Answer 35

-Human actions are evaluated relative to obligation or duty
-Universal and applicable in all circumstances
-An immoral choice is one where a promise or the means-to an-end to achieve the promise are not possible
E.g. continue to treat vs. palliative care
-Faith in inherent goodwill of people
If your a physician your obligation to do no harm
-Simple action of triage is similar to this moral decision approach
-Its a policy choice using morally correct underpinnings
Deontological effect of triage = people who need it the most get it first = obligation our duty

Question 36

Causistry

Answer 36

-Essentially the case law of ethics
-Precedent-setting situations
-Need for similarly salient characteristics and moral issues
-Previous cases are a social construct in terms of being reflective of prevailing ideology, popular culture, or societal bias
-If you have done something in the past and it was not morally ethical then you will not sue that
-If you follow bad decisions it just creates more bad decisions

Question 37

Feminist
- Skeptical towards traditional ethical concepts like ______
-Social, _____ suppression of women
-Often care focused and ____ focused
-______, freedom, equality
-Distributive justice
-In health care –Belmont Report, 1978
-Feminist decision making - about autonomy related to helath care where not everyone has the same privilege Who has the power

Answer 37

• Skeptical towards traditional ethical concepts like autonomy
  -Social, political suppression of women
  -Often care focused and power focused
  -Compassion, freedom, equality
  -Distributive justice
  -In health care –Belmont Report, 1978
  -Feminist decision making - about autonomy related to helath care where not everyone has the same privilege who has the power

Question 38

Ethics of Care
Decision making based on abstract ___ and principles
Rights and duties are ____ in terms of interacting with others in moral decision-making situations
Pay attention to specific circumstances
E.g. in Health care –treating patients holistically, nursing adopts ethics of care
Not nuts and bolts - specific circumstances of individuals
Breast cancer patient is not just another breast cancer patient they are all unique different people and they are treated as such
Relates to things like DNR orders - about making ethical decisions in the best interest of that person

Answer 38

Decision making based on abstract theories and principles
Rights and duties are unsatisfying in terms of interacting with others in moral decision-making situations
Pay attention to specific circumstances
E.g. in Health care –treating patients holistically, nursing adopts ethics of care
Not nuts and bolts - specific circumstances of individuals
Breast cancer patient is not just another breast cancer patient they are all unique different people and they are treated as such
Relates to things like DNR orders - about making ethical decisions in the best interest of that person

Question 39

Personalism
-Emphasis on ___ ____ and subjectivity cannot be ______ to material objects and natural instincts
-Phenomenology
-Common good
-Everyone should have access - to treatment choices
-Everyone should have wide possibilities of choice in treatment therefore, need access to ______ to promote decision making
System should enable staff and patient participation
System performance principles should be clearly specified - bc a portion of their salary gets taken if they have a bad performance
All about human dignity and individual experience
This is where health care in ontario is trying to go
We have “access to care” - have to measure wait times, surgical procedures in every hospital in canada

Answer 39

Personalism
Emphasis on human dignity and subjectivity cannot be reduced to material objects and natural instincts
Phenomenology
Common good
Everyone should have access - to treatment choices
Everyone should have wide possibilities of choice in treatment therefore, need access to information to promote decision making
System should enable staff and patient participation
System performance principles should be clearly specified - bc a portion of their salary gets taken if they have a bad performance
All about human dignity and individual experience
This is where health care in ontario is trying to go
We have “access to care” - have to measure wait times, surgical procedures in every hospital in canada

Question 40

Principlism Arose as a response to the failings of the theories outlined above
A
J
B
N
E.g. _______ Declaration, _____ Report, Tri -council
E.g. development of different health systems (e.g. Bismarck, Beveridge, or NHIP)
Research ethics comes in, every individual is entitled to their ______ (medical assistance in dying, DNR)
J
B
N

Answer 40

Autonomy
Justice
Beneficence
Non-Maleficence
E.g. Helsinki Declaration, Belmont Report, Tri -council
E.g. development of different health systems (e.g. Bismarck, Beveridge, or NHIP)
Research ethics comes in, every individual is entitled to their autonomy (medical assistance in dying, DNR)
Justice - just as many research subjects being men and women
Beneficence - doing a good thing
Non-maleficence - do no harm

Question 41

Health is…
-WHO (1948) -“a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”
-Lalonde Report (1974)–identifies two main objectives:
(1) the ___ care system;
(2)and _____ of health problems and promotion of good health. Considers the “Health “Field” (more broad view of health than in the past –determinants);
-H
-H
-E
-L
-P
“the combination of science, practical skills , and ___ directed to the _____ and improvement of the health of all people” (Last, 1988)
the art and science of preventing disease, prolonging life and promoting health through the organized efforts of society (WHO, 1988)
Health is a _____ construct - what is healthy is different now than it was 50 years ago

Answer 41

Health is…
-WHO (1948) -“a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”
-Lalonde Report (1974)
(1)identifies two main objectives: the health care system;
(2)prevention of health problems and promotion of good health. Considers the “Health “Field” (more broad view of health than in the past –determinants);
-Human biology
-Environment (physical and social)
-Lifestyle
-Health care organization
-Public Health
“the combination of science, practical skills , and values directed to the maintenance and improvement of the health of all people” (Last, 1988)
the art and science of preventing disease, prolonging life and promoting health through the organized efforts of society (WHO, 1988)
Health is a social construct - what is healthy is different now than it was 50 years ago

Question 42

Health has a definition, but…
Health is also a ______ construct!
Traditional WHO definition leaves out a lot of people (or conversely, says they are not “healthy”)
Social construction of illness:
Some illnesses are embedded with _____ meaning –not directly related to condition
Illness and disease (_____ constructed- how we treat people with certain conditions), at the experiential level, are socially constructed (there’s a biological and experiential piece)
Medical knowledge is created within the social norms and priorities (there is also a social construction of treatment)
All depends on conscious choices that are guided by ideologies, worldviews, ethical decision making

Answer 42

Health has a definition, but…
Health is also a SOCIALconstruct!
Traditional WHO definition leaves out a lot of people (or conversely, says they are not “healthy”)
Social construction of illness:
Some illnesses are embedded with cultural meaning –not directly related to condition
Illness and disease (socially constructed- how we treat people with certain conditions), at the experiential level, are socially constructed (there’s a biological and experiential piece)
Medical knowledge is created within the social norms and priorities (there is also a social construction of treatment)
All depends on conscious choices that are guided by ideologies, worldviews, ethical decision making

Question 43

Are There Other Ways We Can Conceptualize Health Policy?
-Interaction between i, i and i in the policy process
-How you think about health and health policy influences the _______ you make (or don’t make)

Answer 43

Are There Other Ways We Can Conceptualize Health Policy?
-Interaction between institutions, interests and ideas in the policy process
-How you think about health and health policy influences the choices you make (or don’t make)

Question 44

SUMMARIZATION OF LECTURE:
Social Theory Approaches to Health
-Helps us to _____ our ______ around how we approach health policy
-Four main theories –each supports the various approaches to health -e.g. social & enviro. determinants, medical model, behavioral/lifestyle model
-P
-I
-C
-S

Answer 44

SUMMARIZATION OF LECTURE:
Social Theory Approaches to Health
-Helps us to organize our thinking around how we approach health policy
-Four main theories –each supports the various approaches to health -e.g. social & enviro. determinants, medical model, behavioral/lifestyle model
-Positivism
-Interpretivism
-Critical theory
-Structural Functionalism

Question 45

Matching Approaches to Health with Social Theory
Approach to Health
-____ approach-individual based or micro
-_______/Lifestyle approach-individual based or micro
-_______ approach-both individual and environmentally based
-Structural/____ Approach-socially based, structural, ___
Social Theory that Endorses this Approach
-Positivism-objective, ____
-Structural Functionalism-objective, rational
-Interpretivism-subjective
-Critical Theory and Political Economy-both objective and subjective

Answer 45

Matching Approaches to Health with Social Theory
Approach to Health
-Medical approach-individual based or micro
-Behavioral/Lifestyle approach-individual based or micro
-Socio-Environmental approach-both individual and environmentally based
-Structural/Critical Approach-socially based, structural, macro
Social Theory that Endorses this Approach
-Positivism-objective, rational
-Structural Functionalism-objective, rational
-Interpretivism-subjective
-Critical Theory and Political Economy-both objective and subjective

Question 46

Positivism
Only _____knowledge is scientific (scientific methods)
Strict ______ to the scientific method
Hypothesis testing and identifying _____
Predict and ____
Bottom up (a _____ approach
e.g. biological and physical science, much of health sci
EX: Washing your hands - infection control

Answer 46

Positivism
Only authentic knowledge is scientific (scientific methods)
Strict adherence to the scientific method
Hypothesis testing and identifying relationships
Predict and control
Bottom up (a posteriori) approach
e.g. biological and physical science, much of health sci
EX: Washing your hands - infection control

Question 47

Structural Functionalism
-Apply positivist notions of knowledge and ______
-Views society as an ______, a system of parts whose function together creates overall societal effectiveness
-Shared norms and values; cooperation
e.g. herd immunity - polio is coming back
Really what public health is about
This is just one model that summarizes everything we talked about
So hand washing and mask wearing: done in a lab under controlled conditions then apply them to society

Answer 47

Structural Functionalism
-Apply positivist notions of knowledge and methodology
-Views society as an organism, a system of parts whose function together creates overall societal effectiveness
-Shared norms and values; cooperation
e.g. herd immunity - polio is coming back
Really what public health is about
This is just one model that summarizes everything we talked about
So hand washing and mask wearing: done in a lab under controlled conditions then apply them to society

Question 48

Interpretivism
Critique of ______ - you cant find everything out just by the scientific method
______ –how individuals understand themselves through shared systems of meaning
All views considered equally valid
Can lead to removal of important contexts that help explain individual understandings and experiences
e.g. experience of an individual with health conditions
Socio-environmental approach as it emphasizes lived experience
Example of wearing masks: What’s it like to wear a mask? - can’t breathe, acne, backs of ears start to hurt, glasses fog up

Answer 48

Interpretivism
Critique of positivism - you cant find everything out just by the scientific method
Hermeneutics –how individuals understand themselves through shared systems of meaning
All views considered equally valid
Can lead to removal of important contexts that help explain individual understandings and experiences
e.g. experience of an individual with health conditions
Socio-environmental approach as it emphasizes lived experience
Example of wearing masks: What’s it like to wear a mask? - can’t breathe, acne, backs of ears start to hurt, glasses fog up

Question 49

Critical Theory

Answer 49

-Structures and processes that are usually hidden and ignored by positivists
-Critique and transformation of society as a whole
Considers haves and have-nots in society
Nature and distribution of power
Who has the ability to bring about social and political change
e.g. Enviro and Social Determinants •How political and economic structures shape the health care system
Mask wearing: How does mask wearing form a critical theory lens? Haves and Have nots in society?
Do homeless people have access to masks?
How do we make sure those people are safe?
High risk groups were given vaccinations first