Midterm- Structuralist Approach to Health

Question 1

describe the US healthcare paradox

Answer 1

the US is the biggest spender in healthcare, but we have some of the lowest return on investment

Question 2

define supply side policy interventions

Answer 2

to maintain and improve population health by supplying more and better health care to more and more americans while trying to manage/reduce the costs of that care

Question 3

describe demand-side policy intervention

Answer 3

focus on making the population healthier by means other than health care and insurance. A healthier population should need, demand, and utilize less and probably less expensive healthcare… so, expenditures for health care and insurance at all levels of society should be reduced.

These savings could help fund critical investments in other areas to improve population health and society more generally

Question 4

define Fundamental Cause Theory

Answer 4

• social conditions like poverty, inequality, and employment explain most of the variation in rates of disease; discrimination and poverty will always lead to bad health
• we should treat these factors as the fundamental causes of disease and specific etiological factors as more downstream causes
• disease will self-correct; specific diseases may change or be cured but others will arise to take their place

Question 5

Define McKeown Hypothesis

Answer 5

• looking at timing of decreases in mortality of tuberculosis with invention of sulfa drugs
• improvements in medicine don’t explain initial change in tuberculosis (toxic/close quarters in environment)

Question 6

Define Biomedical Industrial Complex

Answer 6

over-investment in medical technologies and the health sciences as opposed to public health and other sciences, which leads to increase in jobs in the medical field and a reinforcing cycle

Question 7

What is specific etiology?

Answer 7

the theory that each disease has a specific biological cause that can be identified and then effectively treated, prevented, or eradicated by modern biomedical science and practice

Question 8

What’s Jim House’s argument about supply/demand side interventions

Answer 8

we need to make a shift from supply to demand side interventions (from biomedical determinants to social determinants)
- Social determinants provide the necessary lever for improving population health while reducing the need and demand, and hence expenses, for health care and insurance.
- A combination of demand side policy and social determinants of health will improve population health and control/reduce spending for healthcare and insurance better than health care reform.

Question 9

describe epidemiological transition

Answer 9

first came to prominence in the US and other developed countries in the 1950s and 1960s. As human life expectancy grew with the decline of infectious disease, people became more susceptible to diseases whose etiology and course developed over decades rather than days

ex: death due to obesity from fast food or smoking

Question 10

structural vs. non structural issue

Answer 10

structural issues involve the facts that:

• Socialization integrates people into society (through their social roles)
• People come to internalize their social structures and thereby reproduce them