Chapter 11: CAGE(s) and Health Flashcards

Question

How does gender affect morbidity?

Answer 1

Historically, women have experienced a higher degree of morbidity than men. Although Canadian women’s life expectancy at birth (83.6 years) is longer than men’s (79.3 years), women have more disability during their lifetime. In Canada, women generally have higher disability rates than men, and these differences increase over the life course, with women over the age of 75 having a disability rate of 57.8% and their male counterparts 54%. Women are also more likely to experience pain and limitations of mobility and agility. For almost all chronic health conditions (except diabetes), women are more often afflicted than men; that is particularly the case for arthritis and rheumatism.

Answer 2

Too many women are unnecessarily suffering and dying from heart disease. They have been left behind because they are under-researched, under-diagnosed and under-treated, and under-supported during recovery. It is shocking we are only beginning to understand women’s hearts, and gains in knowledge are so slow to reach the bedside. Heart disease is the leading cause of premature death for women in Canada (dying before reaching their expected lifespan). - early heart attack signs were missed in 78% of women - every 20 minutes a woman in Canada dies from heart disease - five times as many women die from heart disease as breast cancer - two-thirds of heart disease clinical research focuses on men - women who have a heart attack are more likely to die or suffer a second heart attack compared to men.

Answer 3

1. The differential exposure hypothesis argues that women are subject to more stressors than men on account of their heavier domestic and caring responsibilities. 2. The differential vulnerability hypothesis argues that women are more affected by stressors than men on account of a “generalized female disadvantage in social roles and coping resources.”

Answer 4

The life expectancy and the overall health of Canadians increased over the 20th century. Whereas an infant born in the 1920s could expect to live only 59 years, an infant born in 2014 could expect to live about 81 years. The improvement is largely attributable to public health programs, sanitation, and immunization. Sadly, the distribution of these amenities remains inequitable. Infants born in the territories have a life expectancy of 75 years compared with just over 81.1 years for Canada.

Answer 5

Women were thought to suffer worse mental health than men, specifically depression. However, research has shown that men and women experience similar levels of mental illness but it manifests itself in different ways. - men are more likely to suffer from substance abuse, women more likely to suffer mood disorders

Answer 6

Mothers spend 10 more hours each week multi-tasking, compared with fathers. Multi-tasking was associated with an increase in negative emotions, stress, psychological distress, and work-family conflict.

Answer 7

The length of time one can expect to live and the diseases one is likely to die from have varied considerably over time, partly because of historical variation in the social factors that influence health. The influence of the persistence of poverty, fluctuations in socio-economic status, marital status, and changing conceptualizations of race, ethnicity, and gendered meanings over the life course all contribute to health status, and all have changed historically. The majority of seniors (81%) report at least one chronic health condition. but over 1/3 of seniors rank their heath high, with 37% rating their health as "excellent" or "very good". Women aged 65 and older drunk less alcohol, smoke less and use illicit drugs less than any other age or gender group.

Answer 8

in 1926 Canadians aged 5-64 accounted for 54% of deaths. In 2002 Canadians aged 5-64 accounted for only 21% of deaths.

Answer 9

The majority of seniors (58%) aged 65-74 who are university graduates rated their health as "excellent" or "very good" compared to 48% of 25-64 year old's who did not graduate from high school.

Answer 10

Mental health varies considerably over the life course. - 70% of young adults with mental health issues report their symptoms began in childhood - young adults aged 15-24 have the high prevalence of mood, anxiety, or substance-use disorder Socio-economic and environmental factors in the mental health of children and youth are significant. Mental health and well-being are increasingly being conceptualized as cumulative effects, with experiences across the life course, particularly early experiences, shaping and determining later health outcomes. Aktar-Danesh and Landeen found that low levels of education and other SES characteristics predicted higher levels of depression and that this relationship intensified with age. - neighbourhood factors were more strongly associated with symptoms of mental health than family SES Gender and the meaning of gender as it changes over the life course has an impact on mental health status. - women express far more distress than men over the life course - as people get older, women's self-esteem becomes increasingly lower than mens

Answer 11

Lower socio-economic status has been associated with less healthy behaviours, such as tobacco use, physical activity, and poor nutrition. Low SES individual living in poor communities have less access to grocery stores and affordable fruit and vegetables. They have less access to gyms. Children in the poorest communities gained the greatest amount of weight over an eight-year period. It is the negative effect of poverty (rather than the protective effect of higher income) that accounts for weight increases over time. Canadians in the highest income groups are more likely to be physically active, to take vitamins, and to eat fruits and vegetables than are those with lower family incomes. However, high SES get 35% of their dietary intake from fat, compared to 15% from low SES.

Answer 12

Smoking is on the decline in Canada, with 16.1% of Canadians smoking in 2014 compared to almost 30% in the early 1990s. Immigrants tend to smoke significantly less than Canadian-born citizens. Smoking accounts for much preventable illness and death - in 2014 about 26,000 Canadians were diagnosed with lung cancer and about 20,000 (27% of all cancer deaths) people died from lung cancer. - men are still somewhat more likely to develop lung cancer than women, but the gap is narrowing. When the number of cigarettes smoked is controlled for, the ill effects of smoking are greater among those from lower SES groups than among those of higher SES groups.

Answer 13

Although men are more likely to be physically active than women, the fact that women are less likely than men to engage in binge drinking, to smoke, or to be overweight contributes to the higher risk of premature death from heart diseases among men. Men engage in riskier activities than women and are more likely to die as a result of suicide and motor vehicle accidents. Men are also less likely than women to visit a physician and more likely to have emergency-room visits, while women tend to survive longer than men with the same chronic conditions (e.g., heart disease, lung cancer).

Answer 14

Access to health care, even within the “equal access” Canadian system, varies on the basis of class, gender, ethnicity, race, and age. Poverty, for example, can impede access to health care in concrete ways. - mothers of many children in low SES attend many less appointment than mothers in high SES - people in low income households are 10 times more likely to report unmet health care needs than people in middle- to high-income households. - higher rates of morbidity in low-income neighbourhoods are thought to explain the higher levels of hospital utilization Immigrant status does not appear to lead to differences in physician visits. - for both Canadian-born and immigrant populations with low incomes, the number of physician contacts is higher than for similar high-income Canadians

Answer 15

Even though people from lower-income and poorer neighbourhoods use hospitals more often than people from higher income neighbourhoods, they undergo less surgery. Roos and Mustard argue that this is due to the underuse of specialist services by lower-income individuals, possibly owing to better access and a stronger communicative relationship on the part of individuals from higher SES. Specialists and surgeons offer more treatment to people with higher SES, perhaps as a result of referral decisions from a treating physician. Specialists visits are significantly less for those living in low-income households, visible minorities, Aboriginal people, and those over the age of 75.

Answer 16

The decisions people make about whether to smoke, how much to drink, how much physical activity to get, whether to engage in risky activities, whether to participate in preventative health actions, etc. are all "lifestyle behaviours".

Answer 17

Aboriginals face higher levels of smoking, obesity, and alcohol consumption. Likely due to the poverty and discrimination faced.

Answer 18

Whites drink more alcohol over their lives than blacks or hispanics, however blacks and hispanics drink more in later life per occasion than whites. Men drink more than women, and people who had many children or were regular churchgoers were found to drink less. Using alcohol and illicit drugs is much more common for male young adults.

Answer 19

Aboriginals living on reserves have very little access to physicians and hospitals; in the territories, only 31% of off-reserve Aboriginals reported having a regular doctor compared with 67% of non-Aboriginals in the region. 52 communities across Inuit Nunaat did not have year-round access to doctors and that only a few communities had hospitals.

Answer 20

The actions and decisions of health care providers have been shown to be influenced by racial or ethnic backgrounds of their patients. Geiger notes that “disparaging racial stereotyping, not clinical data, was predictive of refusal to recommend bypass surgery for many African-American patients in one large series of cases.” These findings suggest that once a person is in the medical system, the services that are made available to them vary on the basis of race. - African-American patients and patients from lower-income groups are perceived in a variety of more negative ways than white patients and patients from higher-income groups; believing they are less compliant and less intelligent - patients are less likely to ask questions and be active health care consumers when they are aware of hostility or negativity on the part of their physician

Answer 21

Men are much less likely to visit physicians or consult a specialist than women. - in 2010, 20% of men reported not having a regular medical doctor According to the constructs of masculinity, health-conscious behaviour fails to connote a “strong” persona and is considered to be “feminine.” This is an instance where gender structures work against both men and women. Physicians provide less information to men than women and spend less time with men, and this may jeopardize men’s health. The fact that physicians spend more time with women may also be the reason for the overmedicalization and pathologization of women’s bodies. Hence, although women’s use of the medical system is thought to be due to their greater tendency to be ill and their overuse of health services, men’s utilization of health care is considered a sign that they are healthier than women.

Answer 22

The defining of a natural biological event or progression as a form of illness requiring medical intervention and treatment (ex. menopause has been treated with hormone replacement therapy.) When women voice dissatisfaction or anger about their life circumstances, physicians have tended to see the problem as an internal one requiring a medical solution (e.g., psychotropic drugs) rather than as a symptom of societal inequality requiring a societal solution.

Answer 23

That HRT causes breast cancer. After this finding came to light, 14 000 cases of breast cancer were avoided. The author is questioning why more women aren't outraged by this finding.

Answer 24

1. The authoritative role played by medical discourse in discouraging strenuous exercise for both younger and older women; 2. The impact of media and beauty standards that see physical fitness only as a means to reach unattainable standards, along with the perception that women are naturally weaker and less physically able; 3. Ageist assumptions about physical abilities of older women, along with the reliance on drug therapies; and 4. Racial and ethnic bias in accounts of physical activity, with young, white women idealized in sport. Women’s positioning within the processes of production, reproduction, and distribution means that women of various ages and racial and ethnic backgrounds tend not to have as much money or time to spend on physical activity as men do. This suggests that ideological structures combine with material structures to influence lifestyle “choices.”

Answer 25

There seems to be a "cost of caring". Engaging in unpaid work can lead to higher stress and lower levels of health. Walter and colleagues studied registered nurses and found that unpaid work substantially affected health for women. Women were much more affected by caregiver burdens and time constraints and had to contend with "having to divide themselves up in pieces and juggle things". They have the burden of "double days". Men suffer from greater occupational concerns which affect their health more negatively than for women.

Answer 26

Poverty, geographic isolation, lack of housing | - as many as 47% of Aboriginal lone parents are in need of core housing

Answer 27

The situation in which disproportionate numbers of minority-group members are located in impoverished, dangerous, and environmentally polluted neighbourhoods. Poor African-Americans more often live in extremely disadvantaged neighbourhoods than do poor non-Hispanics whites. The hypersegregation or ‘housing discrimination that blacks face at every level of socio-economic status but especially at the low end . . . May partially explain the disparity in health outcomes between poor blacks and poor whites."

Answer 28

1. Home care 2. Primary patient care 3. "Catastrophic" drug care, ex. HIV/AIDS

Chapter 11: CAGE(s) and Health Flashcards

(52 cards)