Yr 3 Flashcards
Sociology
study of development, structure and functioning of human society
Sociology studies
- People’s interactions with those engaged in medical occupations, e.g. health-care professional relationships
- The way people make sense of illness, e.g. illness vs disease
- The behaviour & interactions of healthcare professionals in their work setting, e.g. professional values, interactions between healthcare professionals and other healthcare staff
Characteristics of Professions as opposed to other occupations:
- Systemic theory
- Authority recognised by its clientele
- Broaded community sanction
- Codes of ethics
- Professional culture sustained by formal professional sanctions
Role of patient in sick role
Exempted from daily responsibilities
Not responsible for being ill
Regarded as unable to get better without help of professional
Must seek help from healthcare professional
Under social obligation to get better as soon as possible to be able to take up social responsibilities again
Role of dr in sick role
Be objective, do not judge patients morally
Not act out of self-interest/greed but in patients interests first
Must obey professional code of practice
Maintain the necessary knowledge and skills to treat patients
Has right to examine patient intimately
Prescribe medical Rx and has wide autonomy in medical practice
Social Class
Group Description NRS equivalent
1 Higher professional & managerial workers A
2 Lower managerial and professional workers B
3 Intermediate occupations C1 and C2
4 Small employers and non-professional self employed C1 and C2
5 Lower supervisory and technical C1 and C2
6 Semi-routine occupations D
7 Routine occupations D
8 Long-term unemployed E
What are socio-economic influences on our health?
Collective set of conditions in which people are born, grow up, live and work, including gender, ethnicity, housing, education, employment, financial security, health system, environment
Socio-economic influences on health - gender
Men higher mortality
Woman higher morbidity and consult with GP more
Socio-economic influences on health - ethnicity
Social, cultural, genetic factors Low socio-economic groups in ethnic communities have higher morbidity than non-ethnic counterparts Communication big factor Stereotypes are concerning Difference between ethnic groups
Socio-economic influences on health - education
Higher level tends to be more healthy - better understanding of health, more effective engagement in healthcare services, e.g. screening
Socio-economic influences on health - employment
Income and financial security
Social contacts, status in society, purpose in life
Unemployment assoc with morbidity and premature mortality
Socio-economic influences on health - health system
Healthy must subsidise the sick
Burden of financing fairly shared by having better off subsidise the less well-off
Services designed to improve whole population health may widen health inequalities if uptake lowest in those who would have biggest benefit
Socio-economic influences on health - transport & environment
Adverse effects on health due to car use, e.g. pollution, RTA
Active travel –> health benefits, e.g. better mental health, prevention of chronic dx
Combining public transport and active travel - people can achieve recommended daily activity levels
Socio-economic influences on health - media and health
Shapes/stereotypes our views/expectations
Define health inequality
Differences in health status/in distribution of health determinants in different population groups
Factors leading to health inequality incl. deprivation, age, gender, ethnicity
Health inequalities in children
Deprived children have significantly worse health, more likely to have lower birth weight, poorer dental health, higher obesity, higher rates of teenage pregnancy
What are the other vulnerable groups to health inequalities (apart from children?
Homeless - alcohol, drugs, difficult to sustain tenancy, susceptible to infections, poor oral health, may not be registered with GP
Learning disability - shorter life expectancy, barriers stopping people with LDs from getting good quality care
Refugees
Prisoners - drinking, smoking, feel less loved/close to others, drugs, live in poorer areas
LBGT - homophobia, higher rates of anxiety, depression
What are the health care inequalities that refugees must face?
Family integration, social adjustments, competing demands of distinct services, e.g. education, housing, mental health etc. may be overwhelming and limit resources, underdeveloped healthcare system in country of origin –> poorly controlled/undiagnosed medical conditions, unfamiliarity with preventative medicine/primary care, language barrier, urgent and complex medical problems that are unable to establish care and speciality referrals in timely manner, public health’s infectious disease screening results are not communicated to those providing on going medical care, exposure to violence, torture, interment, anti-immigrant segments, loss upon loss is the nature of the refugee life so depression, PTSD, anxiety in high prevalence and not always recognised
What barriers stop people with LDs from getting good care?
Lack of accessible transport links
Not being identified with LD
Staff having little understanding about LD
Failure to recognise when a person with a LD is unwell
Failure to make correct diagnosis
Anxiety/lack of confidence for people with LD
Lack of joint working from different healthcare providers
Not enough involvement from carers
Inadequate follow up/aftercare
What is the inverse care law?
Those who need the medical care the most are least likely to receive it and conversely, those with the least need of healthcare tend to use health services more and more effectively
Equally Well Scottish Government 2008 Key Points
HI remains a big problem in Scotland
Poorest die early, have higher rates of dx, incl. mental health problems
Healthy LE needs to be increased across the board to achieve Scottish Government’s overallpurpose of sustainable economic growth
Tackling HI req. action from national and local government and other agencies, e.g. NHS, schools, third sector
Priority areas: children (esp, heart disease, mental health, alcohol, drugs, violence)
Radical cross-cutting action to address Scotland’s health gap to benefit its citizens, communities and country
What factors reduce HIs?
Effective partnership across a range of sectors and organisations, e.g. to promote health, improve patient education about health
Evaluate and refine integration of health and social care
Government policies and legislation, e.g. smoking ban
Time to invest in more vulnerable patient groups
Improve access to health and social care services and professionals
Reduction in poverty
Social inclusion policies
Improved employment opportunities for all
Ensured equal access to education in all areas
Improved housing in deprived areas
If third sector parties are effective at meeting local outcomes and priorities they should be…
Given the resources by their funders and commissioners to allow services to be maintained, developed and made more financially stable
Wilson & Junger 1968 Criteria for Screening?
Is the disease an important public health problem?
Is the natural history of the disease adequately understood?
Will the test detect the condition at a pre-clinical stage?
Is a test available for the condition?
Is the test safe?
Is the test sensitive?
Is the test specific?
Is the test acceptable to the public and professionals involved?
Is the cost of the test feasible?
Does the overall cost benefit analysis make it worthwhile, i.e. no of tests req to save one life
Is the treatment of the condition being screened for of proven effectiveness?
Is the treatment of the disease being screened for safe?
Is the treatment of the disease being screened for acceptable to the public and professionals?
Are facilities available for treatment and diagnosis?
Describe case control studies
Two groups of people are compared
A group of individuals who have the disease of interest are identified (cases) and a group of individuals who don’t have the disease (controls)
Data is gathered on each individual to determine whether he or she has been exposed to the suspected aetiological factor(s) and whether or not a conclusion can be drawn that the suspected aetiological agent is a likely cause of the disease in question
Describe cohort studies
Baseline data on exposure are collected from a group of people who do not have the disease under study
The group is then followed through time until a sufficient number have developed the disease to allow analysis
Sources of epidemiological data
Mortality data Hospital activity statistics GP morbidity/disease registers Health and household surveys/population consensus data Social security statistics NHS expenditure data
Occupational history
Do you work with chemical irritants?
How much exposure do you have to the hazardous chemicals? (intensity/duration)
Do symptoms improve when you are not at work, e.g. on holiday/at the weekends?
Is PPE used?
Do you comply with PPE?
Does the company enforce PPE use?
Do other colleagues have similar symptoms?
Do you have any hobbies/other activities/pets which may be a likely cause?
Do you use anything you may be allergic to?
Psychological/social issues facing offshore industry workers
Anxiety re travel
Depression, e.g. due to loneliness/being away from family
Stress due to shift pattern
Pressure to maintain standard of living
Difficulty adjusting back to family life when onshore
Abuse of alcohol/drugs
Anxiety re. job security
Difficulties in consultations due to cultural differences
Language barriers
Religious beliefs
Third party may be present in the room, e.g. translator or family member
Examination taboos
Fear and distrust
Racism
Stereotyping
Gender difference between the doctor and patient
Differences in perceptions/expectations
Ritualistic behaviours
Lack of knowledge about some health issues/NHS
Reasons for differing trends in age distribution from 1951 to 2031
Decrease in premature mortality/increase in LE
Decrease in fertility rates/birth rates
Migration
Baby bloom after the war - increased sexual freedom and soldiers returned
Contraception more widely available
Improvements in housing and sanitation
Health education programmes, e.g. healthy eating, smoking, exercise
Improved safety and reduction of injury
Issues presenting to healthcare due to shifting demographics
Increased need for geriatricians, or other allied healthcare professionals
Increased demand for nursing homes, ward beds for the elderly
Increasing prevalence of long-term conditions, e.g. DM, CVD, renal dx
Need for specific health campaigns
