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Sociology of Health and Illness (Exam 1) > What has the trend been for the use of global health vs international health? > Flashcards

What has the trend been for the use of global health vs international health? Flashcards

Global health has been increasing steadily since the 1960s, and international health has been fluctuating but decreasing recently.

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Sociology 101 flashcards
1
Q

What are the predecessors of global health?

A
  • Colonial health (19th-20th century)
  • Topical health (late 19th century to 20th century
  • International health (20th century)
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2
Q

What is colonial medicine?

A

Health in European colonies - health of colonized and mainly colonizers
(this was defined by geography and power relations)

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3
Q

What is tropical health?

A

Health in tropical places (defined by geography)

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4
Q

What is international health?

A

Health work abroad, typically used to describe practice or research in developing countries; often linked to economic development projects

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5
Q

What is the trend for global health vs. international health?

A

Global health has been increasing since the 1960s, international health is fluctuating but decreasing overall

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6
Q

What is global health?

A

Health is the state of complete physical, mental, and social well-being not merely the absence of disease or infirmity.

On a global scale, it is the whole of something, and it implies moving beyond boundaries. It describes a health issue that is bigger than the country’s systems can support/deal with on its own.

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7
Q

How is global health used in practice?

A
  • preventative/ community based focus
  • developing countries and vulnerable populations
  • Attention to equity and social justice
  • Importance of social structures
  • collaboration on multiple fronts
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8
Q

What are the characteristics of Ebola that influences the response and consequences to the outbreak?

A
  • high fatality rate
  • no approved treatment for it as of yet
  • continued risk of transmission even after treatment
  • highly stigmatized disease
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9
Q

What are the characteristics of the CONTEXT that influenced response to ebola?

A
  • individual behavior: hand washing, social interaction
  • culture: burial practices
  • lack of economic resources
  • unsophisticated health care systems
  • history of conflict making the disease difficult to decrease
  • resulted in high rates of orphanhood
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10
Q

Is Ebola a global health problem? Why?

A

YES, the context of the issue was beyond the realm of what the states could deal with on their own

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11
Q

What were the immediate health consequences of the tsunami and where were they felt?

A

Tsunami: results were immediate; countries in SEA were impacted, about 183,000 deaths, there was a lot of damage to land and physical infrastructure, Relatively few injured survivors because most deaths are from drowning

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12
Q

What were the long term consequences of the tsunami?

A
  • infrastructure rebuilding

- little to no long term injuries

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13
Q

Who responded to the natural disasters and how?

A
  • the immediate response is primarily local but local leaders died in both natural disasters
  • foreign governments and private citizens intervened
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14
Q

How can we think about the social causes of a natural disaster?

A
  • little to no early warning systems in tsunami

- look at inequality and where people were affected more. people with little resources often faced more damage and death

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15
Q

What were the short term consequences of the earthquake?

A
  • immediate loss of life, displacement of people, destruction of infrastructure
  • trauma and mental health issues
  • health problems related to living in temporary housing (poor sanitation, sexual violence)
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16
Q

What are the long term consequences of the earthquake?

A

-largely unsuccessful economic development

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17
Q

Social consequences of tsunami

A
  • more women than men died
  • death rates for women and children are lower in households with more prime age men
  • women and men were more likely to have died if their spouse died
  • if son died, parents were more likely to die but not for daughters
  • overall both men and women tried to save other family members
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18
Q

What are the long term consequences of the tsunami?

A
  • resolution of political conflict

- largely successful economic recovery

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19
Q

Is it more appropriate to study female genital cutting as a health issue or as a human rights issue?

A

human rights issue because it was largely unsuccessful as a health issue

  • bodily integrity
  • freedom from violence
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20
Q

Why is FGMC practiced?

A
  • origins unknown
  • religious requirements
  • to protect women purity
  • to mark social adulthood
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21
Q

Theories of FGMC

A
  • Modernization theory
  • Feminist Theory
  • Social norms theory
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22
Q

Negative outcomes associated with FGMC

A
  • negative mental health
  • short term consequences like infection, bleeding, and shock
  • long term bladder and uni infections, poor maternal/infant health outcomes
  • exact prevalence is hard to determine
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23
Q

FGMC comparison to other global health issues? Acute or chronic?

A

Chronic, problem initially defined by outsiders

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24
Q

Modernization theory

A
  • Why?: FGMC practiced because men own land and resources, and women gain access via marriage
  • as economic production shifts away from family lineage based, individuals will become less important on land through marriage and it will be come less important
  • predictors of change: education, wage labor, urbanization
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25
Q

Feminist theory

A
  • why?: its a way of controlling women sexuality
  • persists cus women need to be cut in order to get married
  • as women’s roles shift and women gain alternate routes to economic and social support, FGMC will decline
  • predictors of change: women education and employment, later marriage and lower birth rates
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26
Q

Social norms theory

A
  • Why?: it is a social norm where it is practiced, people do it because its expected
  • social costs of breaking the norm is high for marriage
  • if parents think their daughters will be okay not circumcised then they will stop, one tipping point is reached change will happen quickly
  • predictors of change: strength of community norms about circumcision, marriage pool for uncircumcised women
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27
Q

Efforts toward abandoning FGMC in the colonial period

A

-huge backlash and it increased due to independence and national identity from colonizers

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28
Q

Efforts toward abandoning FGMC in early national and international actions

A
  • Feminist activism in 70s from US and Europeans
  • WHO involvement in 70s and 80s, 1979 Khartoum Seminar human rights addition
  • Unicef and UNFPA involved gradually
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29
Q

Approaches to addressing FGMC - medicalization

A

early on it was a health consequence, and this wasn’t effective. increased medicalization and so it moved to infancy and doctors doing it

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30
Q

Approaches to addressing FGMC - human rights

A
  • combination of local groups, international orgs, and national governments
  • interventions on education, alternative rituals like pricking, women empowerment, public pledges in community
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31
Q

What works for FGMC?

A

don’t know - little evaluation
its declined in some countries but not in others
ex. Kenya declined before interventions, Senegal no signs of decline but good interventions, central african republic recent decline with little intervention

32
Q

Two ways change can happen/ be measured with FGMC

A
  • direct intervention and formal evaluation

- variation in prevalence of cutting as a way of understanding people’s decisions and testing theories

33
Q

What are the social causes of intestinal worms?

A

-poor sanitation and hygiene

34
Q

What are the social consequences of worms?

A
  • diarrhea and ab pain
  • weakness
  • loss of appetite
  • anemia
  • long term: reduced ability to absorb nutrients and slow growth
  • chronic poor health reducing school attendance, lower earnings and employment
35
Q

Basics of intestinal worms

A

more than 25% of the world’s population, transmitted through soil, east to treat (cheap and few side effects)

36
Q

Approaches to worm treatment

A
  1. treat only those infected
  2. treat everyone at regular intervals of primary care
  3. mass treatment on one day in schools - some kids may be missing from school
37
Q

Recommendations for WHO levels

A
  • 1-2 times per year for regular

- at risk: women of childbearing age and school kids

38
Q

Externalities

A

benefits or consequences for someone who didn’t choose the action - positive ones are good for interventions

39
Q

Philosophical complications with cost benefit analysis

A

-are economic metrics appropriate for making health decisions?

40
Q

How to gather evidence on what works other than cost-effectiveness analysis

A

-RCT and observational data

41
Q

Issue with observational data?

A

-unable to see confounding factors

42
Q

Issue with RCTs?

A

-only highly controlled settings which doesn’t come often and hard to account for errors

43
Q

Cluster randomization

A

-cluster to receive treatment instead of individuals

44
Q

Costs of mass deworming programs

A
  • 1-6 cents US
  • low side effects
  • in total 50 cents per child BUT this can still be expensive for developing countries
45
Q

Early success vs recent success in mass deworming?

A
  • initially successful at decreasing hookworms, increased school performances
  • recently decrease worms but little impact on overall health, increases school attendance but not test scores
  • not effective as health intervention, mainly as educational
46
Q

Common measures of health

A
  • mortality
  • morbidity
  • summary measures - more info
  • individual measures - easiest to deal with
47
Q

Measures must be ____ and ____

A

consistent and widely applicable

48
Q

Death rate

A

number of deaths divided by population size

49
Q

Vital statistics

A

centralized records of births and deaths kept by government agencies

50
Q

Government statistics

A
  • vital stats
  • health info/surveillance systems
  • census data “gold standard”
51
Q

Dealing with incomplete government stats

A
  • verbal autopsies

- survey data

52
Q

Challenges to measuring maternal morbidity

A
  • unreliable hospital records
  • maternal deaths not classified properly
  • unable to ask moms directly cus they died
  • surveys have to have large samples for reliable results
53
Q

Solutions to measuring maternal morbidity

A
  • expand data collection to third parties
  • improve death classification
  • use demographic techniques to adjust numbers from existing and measures
54
Q

Stages of demographic transition theory

A
  1. high birth rates, high death rates
  2. high birth rates, declining death rates, high population grown
  3. declining birth rates and low pop growth
  4. low birth and death rates, low pop growth
55
Q

demographic transition as modernization theory

A
  • coincides with both

- some say that den change is as a result of economic growth, some say its vice versa

56
Q

Nutrition transition theory?

A

undernutrition (hunger, malnourishment) –> to over nutrition (obesity)

57
Q

Proposition 2:

A

communicable –> non communicable disease

  1. age of pestilence and famine
  2. age of receding pandemics
  3. age of man made diseases
58
Q

Proposition 3:

A

changes in age specific death rates

-declined most drastically for kids and teens

59
Q

Proposition 4:

A

epi transition as component of modernization

-related to economic development

60
Q

Causes of epi transition

A

-standards of living, public health, medical technology

but this has very little role in declining disease in 20th century

61
Q

Proposition 5:

A

3 models

  1. classis or western model: gradual decline in death and birth rates
  2. accelerated epi model: gradual decline in mortality then rapid change
  3. contemporary delayed model: mortality declines that started in 20th century
  4. transitional variant of the delayed model: late transition but eventually had declines in birth and death
62
Q

epidemiological transition as modernization theory

A

-one path toward progress of a shared goal

63
Q

Critique of ETM

A
  1. Omran didn’t anticipate reveals in mortality decline ex. HIV
  2. different phases of epi transition aren’t always clearly distinguished
  3. Omran’s approach didn’t adequately account for different pathways through the epi transition
64
Q

Critiques of modernization approach

A
  • assumes that all countries follow same pathway and that change happens automatically
  • inequality within and between countries
65
Q

Proximate causes

A

closer to the health condition

66
Q

Distal causes

A

farther away from health condition, don’t have a relationship unless there is a pathway

67
Q

Distal vs fundamental

A

distal dont relate unless pathway is drawn, fundamental will always be connected

68
Q

Biomedical approaches to health

A
  • focus primarily on carriers of disease and physiological processes
  • social causes can be important to the extent that they inform biomedical understandings (ex. hand washing, burial practice, clean water, air pollution) but they aren’t the REAL causes
69
Q

contextualizing risk factors

A

-understanding causes of health is to work toward uncovering more and more proximate causes

70
Q

distribution vs causation

A

way of understanding theory

-is it explaining the cause or why things are spread out?

71
Q

level of analysis in theory

A

-can be micro or macro

72
Q

structure vs agency in theory

A
  • agency: people ability to make and implement decisions

- structure is bound by institutions and social rules at the macro and mess levels

73
Q

social construction of health and illness

A
  • people create meaning through social interactions, knowledge is constructed not discovered
  • health and illness are socially constructed
  • ex. ADHD LGBTQ+
74
Q

Health behavior theories

A

behavior is determined by attitudes, self-efficacy, norms and social environment, risk and emotional response, intentions and planning

75
Q

structural violence

A

structural conditions can cause illness and sugaring, especially in social inequalities

Sociology of Health and Illness (Exam 1) (1 decks)

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