Module 6, Living with Chronic Illness and Disease

Question 1

Chronic & Acute Diseases

Answer 1

• chronic diseases are health problems that required ongoing management over a period of year
• in contrast, acute diseases are conditions that have abrupt onset and usually only short term

my notes:
- chronic diseases are diseases that are enduring over a long period of time and are thought to have no cause where it can be managed but it is going to be with them (ex. nerve damage, Alzheimer’s (a disease some can live with many many years but it progresses and cannot be turned around), diabetes, asthma)
- ex. flu, covid - can get over them but sometimes acute can go to chronic as with covid - related but different diseases than covid

Question 2

Categories of Chronic Conditions (2)

Answer 2

• chronic diseases are categorized and classified in many different ways by many different organizations. In this class, we will focus on two categories of ‘chronic diseases’
  ◦ noncommunicable diseases
  (ex. diabetes, Alzheimers - are
  not contagious or transmitted
  between others)
  ◦ persistent communicable
  diseases (ex. HIV - contagious
  or infectious disease and once
  you have it is is persistent, cold
  sore)
• majority of diseases are noncommunicable

Question 3

Chronic Diseases (how has it changed overtime?)

Answer 3

• chronic diseases are the leading cause of death and impairment worldwide
• rates of chronic disease are accelerating globally across every region and in every socioeconomic group
• WHO states that non communicable and chronic diseases account for 74% of deaths globally
• this trend has been pretty persistent for 50 years
• infectious diseases were the leading cause of death for most of the 19th century where shifts started to happen around 1970’s when vaccines were introduced
• a lot of what were considered responsible for deaths globally previously have decreased due to medical advancements and as a result this is is one of the reasons for the shifting towards chronic diseases
• cannot treat chronic diseases in the same way you can with infectious
• identify and diagnose better now
• we have seen increase in some types of chronic disease a lot more than others (CV disease, hypertension, diseases associated to sedentary behaviour) that are associated with changes globally and the structure of our societies - diseases of civilization
• we have seen increase in aging population as rates of chronic disease increase with age - fewer people are born with chronic disease when compared to those who die with it

Question 4

Symbolic Interactionism

Answer 4

humans create reality through their actions and the meanings they give them. therefore, society is the cumulative effect of human action, interaction, and interpretation
- our reality is what we construct and our experiences of the world are the reality of the world
- our understanding of society, ourselves and our role in society is always changing and constantly being created and recreated - this happens through our individual actions, collective actions and the meanings we sign to this
- culture and society is a cumulative effect of all the interactions

Question 5

Symbolic Interactionism (origins)

Answer 5

• key theorists include George Mead, Erving Goffman and Herbert Blumer
• developed as a reaction/response to structural functionalism (counter story - says society is not like a machine and does not go through a set program and rather it is constantly changing even if some of those changes are small to observe)
• interactionists privilege agency and how people create reality through their interactions
• our societies are constantly evolving and more on agency spectrum as it emphasizes on the fact that individuals engage in society and create their own realities through their interactions

Question 6

Symbolic Interactionism (meaning)

Answer 6

• interactionists believe that humans act on the basis of meaning (rather than instinct or nature, for example)
• meanings arise out of interactions between social actors
• social order (different hierarchies, structures and relationships within society) is created by people as they interact with each other and reinforce certain meanings and types of interactions
• foundation to this prospect is that we all act on the basis of meanings in that the values or beliefs that we attribute to difference things
• our meanings are shaped by the interactions with others and the environment which change overtime also leading to change within society

Question 7

Symbolic Interactionism: assumptions

Answer 7

a. we develop a sense of identity (or identities) through interactions with others
b. the meanings of words, behaviours and labels shape and constrain people’s identity and experiences of inclusion/exclusion

my notes:
- we all have an identity and identities (our identity is shaped by many things such as nationality, gender, race, age and our relationship with others)
- the definition of the identities is the result of ones actions but also others reaction to that person
- our identity can be changed when collective understanding or what happens when certain types of meanings take on a significance in society as the meaning is no longer static but it can also feel oppressive or restrictive
- have agency but also encountering the different meanings these identities have in our societies (you can resist them, challenge them or make them mean something else within your life but we are always part of this process)
- changing understanding of gender and gender roles in both individual level and people’s reactions - ongoing conversations between individuals and at a societal level

Question 8

Symbolic Interactionism: key concept (1)

Answer 8

social construction
- based on the idea that people actively ‘construct’ reality – meaning that it neither natural or inevitable
- therefore, notions of normal/abnormal, right/wrong and even health/illness are subjective human creations and should not be considered universal or unchanging/unchangeable (not constant) - context specific (how we treat illness disease, why someone might become ill or whether or not it was preventable or if the individual is responsible needs to be situated in a particular moment, culture and context)
- what we call illness or disease changes overtime - mental illness was not previously included but now it is commonly accepted as being a disease and we can diagnose it
- there is not reality outside or independent of our experience of it as our reality is our experience (construct this and can shape our behaviours moving forward)
- symbolic interactionism can be macro or micro

Question 9

Symbolic Interactionism: key concept (2)

Answer 9

stigma
- ‘an attribute that is deeply discrediting’ - proposes 3 types
- a physical or social trait, such as an impairment or a criminal record, that results in negative social reactions such as discrimination and exclusion (oppression and marginalization)
- stigma is called attribute or state that is discrediting - when stigma is linked to someone, it is devaluing, discrediting and delegitimizing of that person and their identities
- the first step to stereotyping is the attachment of a stigma and that we discredit the individual or the identity and behaviour first which then leads to stereotype
- stigma is the idea that you associate a negative attribute to a particular characteristic which then allows you to other the person and see them different from yourself as an outside or at the margins of society with can be lead to stereotyping

Question 10

What are the 3 types of Attributes that are proposed by Symbolic Interactionism?

Answer 10

abominations of the body, blemishes of character and stigma of race, nation or religion

Question 11

1. Abominations of the Body

Answer 11

• physical characteristics that are deemed to be deformities, unnatural and/or undesirable
• historically this has included: physical disabilities, obesity, visible illness or disease, tattoos or other counter-culture body modifications
• something associated with someone’s physical appearance, body form, structure and function that are frequently stigmatized in our society and seen as lesser than or undesirable
• tattoos is something that has changed overtime

Question 12

2. Blemishes of Character

Answer 12

• stigma associated with perceptions that an individual is weak willed, dishonest, has ‘unnatural desires’ or other undesirable character traits
• historically this has included: addictions, homosexuality, radical or unpopular political beliefs (counterculture in their political orientations)
• individuals do not have the strength of character or the quality of character that is most values within society
• sexual orientation - behaviours that are seen as lesser than or degrading

Question 13

3. Stigma of Race, Nation or Religion

Answer 13

• traits with negative associations or stereotypes that are passed through generations
• historically this has included: stereotypes or representations that label certain ethnic groups as lazy, dirty, dumb, greedy
• assigned to people on the basis of their affiliation with a particular race, nation, religion, culture more broadly
• all 3 of the factors serve the same purpose in that they do the same work of discrediting an individual or marginalizing them

Question 14

Stigma (implications)

Answer 14

the implications of stigma are:
- contributes to various forms of discrimination
- often done ‘unthinkingly’ without acknowledgement or reflection on how these meanings are created
- reduces individual’s opportunities!
- the only way we can behave badly towards another is if we see them as different than ourselves and not having the same value as ourselves - so that’s the process of othering, that then allows for discrimination
- making an assumption about what a person can and cannot do and about their value which then leads us to act in certain ways that deny others opportunities having a real impact on someone’s life chances
- our social construction has a real impact in shaping someone’s experiences

Question 15

The Social Construction of Illness

Answer 15

• in the same way that we socially construct the definition of ’health,’ we socially construct the definition of illness and disease
• different conditions are constantly being added to the Diagnostic and Statistical Manual (the DSM 5 includes hoarding, caffeine withdrawal, cannabis withdrawal, binge eating disorder)
• what meaning to we describe to a disease and the key point being that disease is the diagnostic and disease is the label, illness is someone’s experience of that disease and someone’s experience of the disease is shaped by the meaning we give to it

Question 16

The Social Construction of Illness (2)

Answer 16

• it is through our social interactions that we start to understand and label some things as diseases instead of simply ‘variation’ in the human population (ie. autism spectrum)
• also assign different meanings to different diseases based on assumptions about underlying causes
• so it’s through our social interactions that we start to understand and develop different definitions of different understandings of diseases.
• seeing some things as pathologized as medical diagnosis to seeing some things as variations in humans, normal variations, not diseases
• something like addiction and HIV is associated with how we think these diseases are caused and how we associate them with certain behaviours and particularly with certain stigmatized behaviours and so our perceptions of that disease are going to change as our perceptions of the behaviours change

Question 17

The Social Experience of Illness (disease and illness)

Answer 17

disease: refers to a biophysical condition with a specific diagnosis

illness: The subjective response to the disease - includes how people perceive, experience, make sense of and respond to disease (people can have the exact same disease but have very different experiences of that disease) - brings in acts factors of age, culture, gender, social class, economic status, ability, disability

Question 18

The Social Experience of Illness

Answer 18

• the experience of illness is shaped by many contextual and individual factors including age, culture, gender, social class, etc
• different people can have the same disease but will experience it and perceive it differently (ie. different experience of illness)