Lecture 3

Individual and population health

individual

Age, sex, genetic inheritance, risk factors associated with one’s behaviour and environment are all relevant health factors at the level of the ______

1. Biomedical variant → focuses on the interaction of host and agent

2. Behavioural variant → focuses on health behaviours and lifestyle factors

Explain biomedical and behavioural variants of the individual-level model of health and disease (risk factor model)?

behavioural

According to the individual-level analysis, external factors like pathogens and toxins interact with _____ factors and susceptibilities

• variation

• living

• different

→ informative

Age as an individual characteristic is not a powerful predictor of health outcomes because:

• There is substantial _______ at all ages in the health, resilience, and susceptibility of people

• There is variability in the potential for healthy _____ → we live longer and healthier

• There are vast differences in health and life expectancy at different ages in _______ populations

→ We can make generalizations with age BUT they aren’t very _______; we need other factors

• spectrum

• gender

  → expectations

Sex as an individual characteristic is not a weak predictor of health outcomes because:

• The dichotomization of sex leads to treating individuals as either wholly male or female → ignore that sex is on a _______

• Sex is confounded with ______

  → Gendered social ______ may impact health behaviours even more than sex

• blame

• socially

• cause

Specifying individual behaviours as risk factors is problematic because:

• It puts ______ on individuals → they are either irresponsible or uneducated

• Health-relevant behaviours are _______ determined (can depend on others that are there, the time and place…)

• It’s reductionist because it reduces a complex phenomenon into a single _______ and doesn’t take collective variables into account

The social patterning of behaviour

How do we call the study of the social determination of health behaviour?

• Even with intense education, group support, and a range of incentives, health-related behaviours and the health outcomes associated with them failed to shift significantly

• It illustrates the problems with individual-risk factor modification

  • It is difficult to change people’s habits in a lasting way

  • The risk factors the trial focused on accounted for only a minority of heart attacks

What were the conclusions of the Multiple Risk Factor Intervention Trial (MR FIT) study in relation to the population approach?

failed

The Women’s Health Initiative Dietary Modification Trial, aimed at shifting the eating habits of women in order to improve health, also ______ to show positive results

Caused by the public being misled to believe that non-smoking campaigns were effective in reducing smoking rates

• Smoking rates are decreasing mostly because the fashion for tobacco is dying out

• Cultural variables and the norms of given groups are more influential than education, regulation, and pricing strategies

• The decrease in smoking rates is observed even in countries where there were no campaigns and policies targeting this (Ex: UK → late adopter of smoking control measures, still decreasing rates)

Why do governments and public health authorities continue to rely almost exclusively on individual-level measures intended to change personal behaviour?

• higher

• social, economic

• conditions

• social, capitalist

Friedrich Engels:

• Observed that the death rates of poor people in urban centers were much _____ than the death rates of poor people in rural settings

• Claimed that ______ and _______ change can substantially affect health and longevity

• Argued that living and working _______ are the major determinants of human health and well-being

• Asserted that unhealthy behaviours were the result of the _______ conditions people live in, which are imposed by the ______ system

Human artifacts that arise from the interaction of people in groups

According to Émile Durkheim, what are social facts?

determinants

Social facts also have the capacity to act as _______ of human behaviour (ex: social norms)

norms

Social regulation describes how behaviours are regulated by ______

conditioned

What we experience as “choice” is substantially _______ by our social setting