HLTA02 Midterm Lecture Definitions

Mortality

Mortality

the rate of deaths in a population over a period of time

Morbidity

the prevalence and/or incidence of a disease in a given population

Prevalence

number of diseases in a certain time frame

Incidents

all-time number of diseases

Culture (WHO 2004 definition)

the learned, shared, and transmitted values, beliefs, norms, and lifetime practices of a particular group that guide thinking, decisions, and actions in patterned ways

Race

based on common assumed or imagined genetic/biological characteristics and ancestry

Ethnicity

More about country or region or origin

Professional health sector

health care workers who have been licensed and regulated (eg. nurses, physicians)

Folk health sector

healer-led medicine outside of the professionalized realm of biomedicine (eg. herbalist, shaman)

Popular health sector (informal health care system)

individual personal experience with health or illness

Social identity

our sense of self in relation to society as a whole and its border social structures

Gender

Socially-constructed roles, behaviours, expressions and identities

Sex

Biological attributes of humans and animals, including physical features, chromosomes, gene expression, hormones, anatomy

Intersectionality

the fact that each person can experience different sorts of discrimination/privilege (eg. May be white, but disabled bias. Maybe smart, but sexuality bias)

Social Determinants of Health (SDH)

Social factors affect where people live, work, and grow

Canada’s History With Social Determinants of Health

The Lalonde Report: A new perspective on the Health of Canadians, 1974 (1981)

Ottawa Charter for Health Promotion, 1986

The Epp Report, 1986

Action Statement for Health Promotion in Canada, 1996

Population health was introduced mid-1990s

The Lalonde Report: A New Perspective on the Health of Canadians, 1974 (1981)

Concept of health field was introduced

Ottawa Charter for Health Promotion, 1986

Highlighted what is needed for wellbeing

The Epp Report, 1986

“Achieving health for all” framework

Challenges healthcare and advocates for health promotion as a strategy to reduce health inequalities

—> Liberation

Action Statement for Health Promotion in Canada, 1996

Basically want public health and public care to be better

Population health introduced in mid-1990s

Similar to health promotion

Emphasizes importance of social determinants of health (social factors that can impact health)

Biomedical model

illness is the result of a biological/psychological problem

Behavioural model

illness is the result of poor choices made by individuals

Socio-environmental model

considered the broader structural factors that shape individual health

Political Regimes and Welfare States (lowest inequality to highest)

• Social Democrat

• Christian Democratic

• Liberalism

• Conservative/Fascist

Ecological Mode

Focuses on the ecology or environments of health behaviours

Descartes

person; Mind and body are two separate entities

Physical Reductionism

The idea that everything can be understood if it is broken into smaller pieces

Biomedical model 5 factors

• Mind body dualism

• Machine metaphor

• Physical reductionism

• Etiology

• Regimen and control

Etiology

Origins of the cause

Nosology

classification of diseases into subgroups

Machine Metaphor

Body as machine

Each part is essential to the whole, but performs own function

Regimen and Control

Manage disease through control of body and use of specific regimens (routines/systems)

Secularization

when society becomes less influenced by religious beliefs

Allopathic

traditional

3 levels of medicalization

Conceptually, Institutionally, Interactions

Thomas Szasz

Argues mental health disorders are not illnesses

Eugenics

movement to genetically ‘purify’ human species (19th – 20th c.)

Three levels of iatrogenesis

Clinical

Social

Cultural

Clinical iatrogenesis

Physician-induced illness as a direct result of medical practice

Social iatrogenesis

Society’s growing dependence on medical practice

Cultural iatrogenesis

Our culture aims to escape pain, suffering, decline, and death via biomedicine

Mild/Contextual Constructivism

Objective reality exists, but our experiences of it is medicated by the meanings we give to it (aka the meaning we give something affects how we experience it)

Radical/Strict Constructivism

We cannot say objectively say whether reality exists since we cannot know if anything is real beyond our own experiences

Eliot Freidson (1970)

Became dominant over other traditions (medicine monopoly)

Thomas Kuhn (1962)

Science does not proceed as a linear process of discovery

Instead, paradigm (framework/mindset) shifts

Michel Foucault (1970s, 80s)

Concerned with power

Power isn’t simply something an individual or group has

Power is exerted through systems of language and knowledge

Medicalization

Process by which conditions and behaviours come to be defined as a medical problem

Demedicalization

Reconceptualizing conditions and behaviours once understood as medical problems

Irving Zola (1972)

Argued medical establishment was major institution of social control

Ivan Illich (1976)

Medicalization of life itself

Labelling Theory

Behaviours once defined as immoral, sinful, or criminal now increasingly being given medical labels

Healthism

Being proactive in health matters by making right lifestyle choices

Contributes to medicalization

Sick role

diagnosis gives people permission to be ill, excused from social expectations

World Health’s Organization definition of health

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

Health Studies

• Health sociology (relationships between society and health)

• Health geography (how the area represents health and health care)

• Medical anthropology (bio-cultural/ecological aspects of health and health care)

• Health psychology (cognitive and behavioural aspects of health and health care)

• Health economics (how to allocate resources for health depending on outcomes)

Health Science

Occupational categories

(eg. nursing, occupational therapy, pharmacy)

Medical categories & basic sciences (eg. anesthesiology, genetics, microbiology)

Clinical specialties

(eg. Pediatrics, geriatrics, family medicine, mental health care)

Characteristics Of Being Critical

Challenging social/institutional norms

Questioning normal and social practices

Advocating marginalized communities (eg. LGBTQ+, disabled people)

Addressing social/health issues that affect people

Drawing on philosophy to back up/inform research

Involving the public in research

Thinking “outside the box”

Understanding the global effect of local situations and events

Expressing the goals of individuals & societies

Being humble and aware of individual impacts

Expressing unity

Marxism

social justice, class struggle and general society inequality

Discipline

specific branch of knowledge or area of study

Theories

Idea or explanation to make sense of something based on observation, reasoning, and evidence

Methodologies

Way or approach used to conduct research

Disciplinary Approaches

1. Social sciences

• Eg. sociology, psychology, geography, political science

2. Humanities

• Eg. English, history, arts

3. Conceptually based fields (fields that kind of overlap other disciplines)

• Eg. cultural studies, women's studies

4. Professional practice

• Eg. nursing, medicine, social workers

Iatrogenic

harm that accidentally happens because of medical treatments

Medicalization

problem/behaviour becomes a medical issue and is treated in a medical way

Meso level

focusing on small groups/organizations (you can think of it as a level in between individual and local levels)

Behavioural model

Illness is the result of poor choices made by individuals

Downstream-level

addressing the symptoms of the root cause

Upstream-level

addressing the root cause

Socio-economic status (SES)

individual/groups social standing/class often measure by a combination of education, income, and occupation

Income inequality

how income is shared among people in a group (higher inequality = shorter lifespans)

Narrative shift

discovered → constructed stories about medical knowledge

Discovery narrative

discoveries, not inventions (uncritical amoount of steps that led to a medical discovery that always existed “out there”)

Construction narrative

how social context helps/hinders certain claims

Biographical disruption

Experience that leads to a fundamental rethinking of one’s life and self-concept

Narrative reconstruction

Strategies to respond to disruption in sense of self