Heath & Society Exam 2

Michael Marmot

-The author of "Status Syndrome: A Challenge to Medicine."

-A physician and researcher who studied how social status affects health.

Status Syndrome

- The connection between a person's social status and their health.

- People with lower social status tend to have worse health and higher death rates.

Social Gradient in Health

- Health improves at each step up the social hierarchy.

- It is not just the poorest people who have worse health. People in the middle generally have worse health than those above them, too.

Social Determinants of Health

- Social and economic conditions that affect health.

- Examples include education, income, employment, housing, and working conditions.

Socioeconomic Status (SES)

A person's social and economic position, often measured by income, education, and occupation.

Autonomy

-Having control over decisions and one's own life.

-Lower autonomy can contribute to stress and poorer health.

Social Participation

- Being included in society and having meaningful relationships with others.

- Social isolation and lack of support can harm health.

Chronic Stress

- Long-term stress that can affect the body over time.

- It can contribute to heart disease and other health problems.

Absolute Poverty

Not having enough resources to meet basic needs, such as food, shelter, and clean water.

Relative Social Status

- A person's position compared with other people in society.

- Someone can have basic necessities and still experience worse health because of their lower position in the social hierarchy.

Health Inequalities

- Differences in health between social groups that are often connected to unequal living and working conditions.

Psychosocial Factors

Social and psychological experiences, such as stress, lack of control, and social exclusion, that influence health.

Biological Effects of Stress

- Long-term stress can change how the body functions, including hormone activity, metabolism, and cardiovascular function.

Health Behaviors

- Factors such as smoking, diet, and exercise influence health.

- Marmot argues that these matter, but they do not fully explain health inequalities.

Social Hierarchy

- The ranking of people based on their social position, power, status, or resources.

The Whitehall Study

- A major study of British civil servants discussed by Marmot.

- It found that employees lower in the workplace hierarchy had higher death rates than those in higher positions.

British Civil Servants

- The workers were studied in the Whitehall study.

- Importantly, even people who had jobs and were not living in extreme poverty showed differences in health based on their rank.

The Whitehall Social Gradient

- The pattern found in the study where health generally improved with each higher employment grade.

- It showed that health differences existed throughout the hierarchy, not only between the richest and poorest.

Individual-Level Explanations of Health

- Explanations that focus on personal choices, such as diet, exercise, and smoking.

- Marmot argues these explanations alone cannot account for the full social gradient in health.

Structural or Social Explanations of Health

- Explanations that focus on the conditions people live and work in.

- Examples include unequal opportunities, low job control, poor housing, and limited social support.

Kristin Harper and George Armelagos

Authors of "The Changing Disease-Scape in the Third Epidemiological Transition"

Epidemiological transition

A change in the major causes of illness and death over time.

A. R. Omran

Developed the epidemiological transition theory.

First epidemiological transition

Shift to agriculture and settled communities; infectious diseases increased.

Second epidemiological transition

Infectious disease deaths declined, and chronic diseases became more prominent.

Third epidemiological transition

New and returning infectious diseases, alongside continuing chronic diseases.

Infectious diseases

Diseases caused by pathogens that can spread between hosts or through the environment.

Chronic diseases

Long-lasting conditions, such as heart disease and diabetes.

Nutritional deficiencies

Health problems caused by lacking essential nutrients.

Globalization

Increased worldwide connections through travel, trade, and movement of people and goods.

Antibiotic resistance

When bacteria become resistant to antibiotics that once worked against them.

Emerging diseases

Diseases that are newly appearing or increasing in a population.

Re-emerging diseases

Diseases that return after previously declining.

Zoonosis

An infectious disease that passes between animals and humans.

Public health

Efforts to protect and improve the health of entire populations.

Hygiene hypothesis

The idea that reduced exposure to certain microbes early in life may contribute to increased allergies and some immune-related conditions.

Old Friends Hypothesis

The idea that losing contact with microbes humans historically encountered may affect immune-system development.

Disease ecology

How environmental conditions and interactions among organisms influence disease.

Epidemiology

The study of how diseases and health outcomes emerge and are distributed across populations.

Abdel Omran

The researcher who published the original epidemiological transition model in 1971 to explain changes in causes of illness and death over time.

First Epidemiological Transition

The shift from hunting and gathering to agriculture, which increased infectious disease spread due to crowded living conditions, contact with domestic animals, and poorer nutrition.

Second Epidemiological Transition

The shift toward longer life expectancy and fewer infectious disease deaths due to improvements in sanitation, nutrition, vaccination, and antibiotics. Chronic diseases such as cancer, diabetes, and heart disease became more prominent.

Third Epidemiological Transition

The modern shift characterized by globalization-related disease spread, antibiotic resistance, resurgent infections, and continued chronic diseases. Social inequalities mean these health changes do not affect everyone equally.

James A. Morone

- The author of "Morality, Politics, and Health Policy."

- Explains how American political beliefs and moral judgments influence health policies.

Individualism

- The belief that people should be responsible for themselves and have freedom to make their own choices.

- In health policy, this can lead to opposition to government involvement in personal decisions.

Interest Group Politics

- Different groups compete to influence government decisions based on their own interests.

- Even strong scientific evidence may not lead to policy changes if powerful groups oppose them.

Community / Communitarianism

- The belief that people share responsibility for one another and the common good.

- Supports collective efforts to improve public health instead of focusing only on individual interests.

Morality Politics

- When political debates are shaped by beliefs about right and wrong.

- Health policies can become moral debates about who is deserving of help and who is to blame for illness.

The Puritan Approach

- Focuses on individual wrongdoing and personal responsibility.

- Views problems such as drug abuse as moral failures that should be controlled through restrictions, punishment, or discipline.

The Social Gospel

- Focuses on social and economic conditions that contribute to people's problems.

- Argues that society should address inequality and provide support rather than simply blaming or punishing individuals.

Deserving vs. Undeserving Poor

- The idea that some people deserve assistance while others do not because of judgments about their behavior or character.

- Morone argues these judgments strongly influence American social and health policies.

Personal Responsibility

The idea that individuals are responsible for their own health-related choices.

Often used to support policies emphasizing self-discipline rather than social support.

Public Health

Efforts to protect and improve the health of entire populations.

Morone shows that public health measures can be affected by political and moral disagreements.

David Brooks

- The author of "Why I Am Not a Liberal."

- Argues that poverty and social problems cannot be solved through financial assistance alone.

Materialism (in political thought)

The belief that material and economic conditions are the main forces shaping people's lives and society.

Brooks argues that progressives often rely too heavily on this explanation.

Human Capital

- Personal qualities and abilities that help people succeed, including skills, diligence, honesty, good health, and reliability.

- Brooks argues that society should do more to help people develop these qualities.

Cultural Factors

- Shared values, traditions, habits, and beliefs that influence behavior and outcomes.

- Brooks argues that culture can affect poverty and social mobility beyond income alone.

Social Mobility

- The ability of people to improve their economic or social position.

- Brooks argues that financial assistance may help, but people also need the skills and support to build independent lives.

Material Conditions

- The economic resources and circumstances in which people live, such as income and access to basic necessities.

- Brooks believes these matter, but they do not explain everything about human behavior or success.

Neoconservatism

- A movement that sought to address the limitations of earlier social programs.

- Brooks describes thinkers who supported spending to fight poverty but also wanted programs to encourage hard work, education, family stability, and community involvement.

Politicization

Turning an issue into a political dispute involving power and competing interests.

Value Commitments

Beliefs and principles that shape political decisions.

Puritanism

Moral framework emphasizing individual responsibility, religious values, and skepticism of government interference.

Communal Tradition

Emphasis on collective responsibility and cooperation.

Social Gospel

Applying Christian ethics to social problems, emphasizing social justice and helping vulnerable people.

Common Good:

What benefits society as a whole.

Moral Framing

Using language and moral arguments to influence how people understand an issue.

Health Disparities

Differences in health outcomes or healthcare access between groups.

James Morone:

Author of Hellfire Nation: The Politics of Sin in American History (2003), whose framework explains how moral traditions shape American public health policy.

Health behaviors

Individual actions that improve or harm health.

Sedentary lifestyle

Not getting enough physical movement or exercise.

Social gradient

Health tends to improve as social status increases.

Stress response

How your body and mind react to stress.

Mindset

Your beliefs and attitudes about yourself and your abilities.

Fixed mindset

Believing your abilities cannot really change.

Growth mindset

Believing you can improve through effort and learning.

Resilience

Ability to recover and adapt after challenges.

Agency

Ability to make choices and take action.

Oxytocin

Hormone involved in social connection and empathy.

Mindfulness

Paying attention to the present moment.

Intrinsic motivation

Doing something because you personally enjoy or value it.

Extrinsic motivation

Doing something for outside rewards or approval.

Self-talk

The way you speak to yourself about your experiences and abilities.

Nordic Model

Economic system combining capitalism with strong public benefits and worker protections.

Social Safety Net

Government programs that protect people from poverty and financial hardship.

Social Democracy

A political approach that combines a market economy with policies that reduce inequality.

Wage Compression

Reducing the gap between high-paying and low-paying jobs.

Human Capital

People's education, skills, and abilities that make them productive workers.

Labor Force Participation

The share of people working or actively looking for work.

Social Norms

Shared expectations and values that influence how people behave in society.

Socioeconomic Status (SES)

A multidimensional measure of social class based on income, wealth, education, and occupation.

Federal Poverty Level (FPL)

An income threshold that varies by family size and helps determine eligibility for government assistance.

Social Determinants of Health (SDOH)

Nonmedical conditions, such as housing, education, and employment, that influence health outcomes.

Psychosocial Stressors

Social and psychological pressures, such as financial insecurity and lack of control, that contribute to chronic stress.

Wage and Wealth Inequality

Unequal distribution of earnings and accumulated financial resources across social groups.

Diverging Longevity

The growing gap in life expectancy between higher-income and lower-income populations.

Deaths of Despair

Deaths involving suicide, drug overdoses, and alcohol-related diseases, linked to worsening economic and social conditions.

Social Capital

Resources and support gained through relationships, social networks, and connections.

Cultural Capital

Knowledge, credentials, behaviors, and social signals that communicate status and create opportunities.

Educational Divide

Growing differences in income, opportunities, and life expectancy between college graduates and non-graduates.