Health and Illness Exam 1

What is Sociology?

The study of social life, social change, and the social causes and consequences of human behavior

What is the sociological imagination?

The ability to connect personal experiences to broader social structures and historical forces
Health-related examples: asthma, obesity, suicide

Kunitz and lecture- what are the main factors that contributed to the decline in mortality rates from the early 18th century onward?

The states were better able to respond to outbreaks- quarantine
Changes in nature of warfare- lesser impact on civilian populations- reduced major source of mortality
Fewer soldiers- fewer disease vectors
Improvements in agriculture and nutrition

What were the most common causes of death in the U.S. before 1990?

Infectious disease

Why did life expectancy increase in the U.S. after 1990? What was responsible for the epidemiological transition?

Decline in infectious disease
Sanitation and food safety

What role did medicine play in declines in mortality over the 20th century, according to John and Sonja McKinlay?

Relatively small role, rates of each disease were already dropping before the intervention of medication

Historical demography

Population dynamics, including birth and death rates over time

Chronic disease

Long lasting, can persist for months or years (diabetes, arthritis, cerebral palsy). Can be born with them, most cannot be cured. 

Acute disease

Develop suddenly and typically last for a short period, often resolving within a few days or weeks (flu, broken bone).

Life expectancy

Refers to the average number of years a person can expect to live from a given age onward.

Epidemiological transition

Shift from societies characterized by infectious disease and short life expectancy to societies characterized by degenerative and chronic conditions and high life expectancy

What did the 1980s Black Report suggest about the role of health care access in achieving health equity?

Suggested that there were differences with poverty, nutrition, hazardous employment, poor housing, etc.

What is meant by absolute material deprivation as an explanation of social inequalities in health?

Material deprivation is associated with poverty and includes inadequate food, clothing, shelter, water, and sanitation. It fueled the sanitary movement and social hygiene movement.

What is the social gradient in health? What were the implications of the Whitehall Studies, as discussed in class?

discovered in the study which presented that there is a continuous positive gradient relationship between health and social class. Implicating that as you look higher up in socioeconomic status, you will see better health.

What does it mean that social inequality itself promotes conditions unfavorable to health?

There is a larger gap between rich and poor → worse health outcomes population including wealthy

Everyone, not just poor, fares worse compared to peers in more equal societies

When you have inequality, it creates status anxiety, less certain stability in people’s lives

Why is it important to focus on upstream rather than downstream determinants of health, according to Braveman?

This is because the upstream factors are the fundamental drivers

What contributes most to health inequalities, according to fundamental cause theory?

SES- associated with access to key flexible resources: money, knowledge, power, prestige, social conditions, occupation with health benefits. People with resources are able to protect their health.

According to Phelan, et. al., to address health inequalities, it is inadequate to eliminate the health risks (smoking, alcohol use, poor diet) that most affect people of lower SES. Why?

This is because it does not get rid of the underlying social conditions, it is a root cause that influences health challenges later on. They do not have key flexible resources such as money, knowledge, power, prestige, social conditions, occupations with health benefits.

According to Phelan, et. al., why are inequalities in mortality greater for causes of death that are highly preventable?

This is because of the less access people of lower SES have to different levels of health care

What are the policy implications of fundamental cause theory?

Reduce disparities in SE resources (minimum wage increases, housing for unhoused, parental leave, head start programs, etc.)

Develop interventions that automatically benefit people irrespective of resources (airbags, health screening in schools, workplaces, health centers, window guards, folic acid in grains, lead paint abandonment laws, etc)

social determinants of health

Non medical conditions which help determine the outcomes of peoples’ health

The condition in which people are born, grow, work, and age and the fundamental drivers of these conditions

Morbidity

The rate of disease in a population
Prevalence of a diseas

Mortality

Death and death rates in a population

Social gradient in health

Where higher SES correlates with better health and longer life expectancies, lower SES correlates with worse health and shorter life expectancies.

Upstream determinants of health

The fundamental drivers

Downstream factors

Occur at a distance from upstream factors and closer to health outcome

What’s the difference between income and wealth?

Wealth is monetary value of net assets (home, real estate, savings, investments), minus debt

Income is earnings over a specified time period

Does income or wealth confer greater health benefits?

Wealth because when there are emergencies it matters what is saved and what they have. Key to generating more wealth and health promoting resources, education, increase social status, offers greater “distance from necessity”

What do the studies, cited in Braveman and class, by Evans & Garthwaite; Schoeni, House & Herd and Aizer, Eli, Ferrie & Lleras-Muney suggest about the link between income and health?

Suggested that increases in income led to better health outcomes

They showed that people have better health when they have less stress, better nutrition and housing, more access to healthcare, and long term educational gains.

What about the studies above lend credence to the claim that a rise in income, especially for the poor, has clear health benefits?

You have better access to medicine and doctors. You could also move to a better area which would help with the social and environmental factors.

What is allostatic load and how has it helped advance understanding of the relationship

between cumulative disadvantage and poor health?

It is measured by biomarkers associated with the neuroendocrine, cardiovascular, immune, and metabolic systems. It is strongly correlated with socioeconomic status. Lower SES=higher allostatic load.

Wear and tear on the body over time due to social factors.

socioeconomic status

a combination of an individual's or group's economic and social standing, determined by income, education, and occupation, and it influences their access to resources and opportunities

Income

Earnings over a specific period of time

Wealth

Monetary value of net assets (home, real estate, savings, investments), minus debt

Social drift theory

Poor mental health, particularly conditions like schizophrenia, causes individuals to decline in social status, leading to lower SES attainment and movement into deprived areas, rather than these factors causing the mental illness themselves.

Allostatic load

Measured by biomarkers associated with the neuroendocrine, cardiovascular, immune and metabolic systems. Cumulative physiological wear and tear on the body due to stress.

Can health disparities observed between racial groups be explained by the biological differences of race, according to lecture? Why not?

No, this was a theory from the 17th century to the 20th century. This was largely discredited by the 1940s

What is Dorothy Roberts’ critique of race-based medicine, such as BiDil? What are the political implications of race-based medicine, like BiDil?

She argues that race is a social construct, not a biological category, and that using it in medicine distracts from and reinforces the true causes of health disparities: social and structural inequalities

Implies naturalization of racial categories- encourages return to thinking of race as a marker of significant biological differences

Why do epidemiologists study rates of disease?

Better captures magnitude of health risks and burdens
They make comparisons possible

What’s the difference between incidence and prevalence?

Prevalence- proportion of cases (disease, birth, deaths) within a specified population at a specific time or time period

Incidence- Refers to the proportion of new cases within a specific population at a specified time period

Which rate measures health burden and which measures health risk?

Prevalence- health burden
Incidence- health risk

What is the so-called Hispanic paradox and how is it usually explained?

It is the idea that hispanics (esp. Mexican immigrants) have comparable or better levels of health to native born population

Because of influence of origin culture- family cohesion and social support

Health selection → often assume borders are natural and poor treatment, have to be in good health and fit

What patterns are revealed by the epidemiological paradox?

Immigrants of many racial/ethnic groups tend to have better health than native born peers

Health advantage declines for each success of generation

What is weathering? What health patterns does weathering seek to explain?

The early physiological deterioration due to impact of cumulative disadvantages

Minorities get sicker at earlier age and die sooner

Infant mortality decrease for white and Mexican women who delayed 1st births to 20s compared to teens- opposite true for black women

Is poor health among racial minorities attributable to the correlation between racial minority status and low SES?

Yes but it is not the sole cause, as other factors like like racial discrimination, stress, and access to quality healthcare also contribute significantly to these health disparities

Williams states that “indicators of socioeconomic status are not equivalent across race” (p. 284). What does he mean?

A given measure of socioeconomic standing such as income, education, or wealth does not represent the same level of advantage or opportunity for people of different racial backgrounds

How does Williams explain what he calls “the added burden of race”?

Residential segregation by race → SES and health
Experience of discrimination

Race

Social construct used for dividing people into groups based on common physical characteristics or ancestry, accompanied by the belief that such physical characteristics (physiognomy, skin color, anatomy, genotype) are markers of significant human differences (intelligence, character, morality)

Ethnicity

Category of people organized by common ancestry, language, history, society, culture, or national origin.

Prevalence

Prevalence rates → proportion of cases within a specific population at a specific time

Incidence

Proportion of new cases within a specific population at a specific time

Race science (scientific racism)

Sought to lend scientific support to racial ideologies

What were the principal aims of the Women’s Health Movement, according to lecture?

Sought to promote women's knowledge and control of their bodies and health, challenge doctor- patient relationship, challenge medicalized childbirth, raised awareness of relationship between health and society

What did the Women’s Health Initiative reveal about gender and cardiovascular disease, according to lecture?

Sought to address major health challenges (CVD, cancer, osteoporosis), challenged male centric focus on CVD

Revealed CVD is not a male disease, but presents itself in women later in life course

What does “women are sicker and men die quicker” mean, according to lecture?

This means that women generally live longer than men but have higher rates of morbidity

Do sex differences or gender differences explain patterns in health between men and women?

Research has shown men and women are equally likely to have health issues- they just cope differently 

As discussed in lecture, what factors have contributed to improvements in women’s reported health, according to Schnicker?

Women have self reported better health from 1974 to 2004

Increase in their educational attainment

Increase in their employment and income

According to lecture, what behavioral differences contribute to health differences between men and women?

Risk taking behaviors- men often engage more in behaviors harmful to health

Men engage in higher levels of regular exercise but eat less healthy than women

Women have more routine contact with medical care

According to the lecture, do women have poorer mental health than men? Why is there reason to believe this is not true?

There is reason to believe that this is not true because research has shown that men and women are equally likely to have mental health issues, they just cope differently. For example, men are more likely to abuse alcohol.

Is masculinity a health risk, according to lecture?

Sudden increase in made deaths caused by suicide, overdose, and alcohol related disease\post soviet union there was a decline in mens life expectancy

According to Eyal Press, what explains the high and rising rates of cervical cancer in Alabama?

Alabama is among other states denied Medicaid expansion under ACA which covers families who earn 138% of poverty line- Alabama's qualification standard is 18%

What makes the high rates of cervical cancer in Alabama a good illustration of fundamental cause theory?

Inequalities in health more common for conditions that are highly preventable

Prevention depends on access to health care

What “upstream” factors were described in Press’s article and highlighted in lecture that contributed to high prevalence of cervical cancer in Alabama?

Political attitudes/ values- opposition to expanding public resources, assumed to burden tax payers and encourage dependency

Field by racism and xenophobia- public benefits associated with minorities and immigrants

Religious conservatism

Values shared across class line