Health and Illness: Chapters 1-5 Flashcards
(78 cards)
1
Q
WHO Definition of Health
A
a state of complete physical, mental, and social well-being, and not merely the absence of disease or injury
2
Q
Rene Dubos
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defined health as the ability to function and carry on normal, everyday roles
3
Q
Absence of disease
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many people define health as the absence of disease or injury
4
Q
Germ theory of Disease
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bacteriology: uncovered the cause of many diseases as germs; gives you a strategy to see how diseases spread and to treat them
5
Q
Magic bullets
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Dubos: medicine’s thinking was dominated in the 20th century by the search for drugs as “magic bullets” that could be shot into the body to kill or control all health disorders
6
Q
Social epidemiology
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looking at patterns of diseases, how they’re affected by environmental, social, biological, and cultural factors; primary focus of the epidemiologist is not on the individual, but on the health problems of social aggregates or large groups of people
7
Q
Etiology
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what causes a health condition ex. germs, radiation, injury, etc.
8
Q
Diet
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if it doesn’t include all nutrients, you can get a disease ex. scurvy- british navy
9
Q
Environment
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extreme weather, heat or cold, can cause disease
10
Q
Genetics
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diseases carried across generations, some more common in certain ethnic groups, other more common by location; mutation can cause diseases, sometimes people die of these or have shortened lifespans if born with or develop these diseases
11
Q
Sex
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biologically assigned gender: diseases b/c of biology/ chromosomes
12
Q
Gender
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how you define yourself; socially constructed; illness because of associated behaviors ex. men more likely to drink and be reckless because of gender roles
13
Q
SES
A
socioeconomic status; used to be referred to as social class: identifiable groups with some distinctive roles in society; a continuous rather than discrete variable; people with higher income/wealth tend to be healthier; people with diff education levels have diff jobs and health risks associated with those jobs; education is most important factor related to health - people with higher education are less likely to do things detrimental to their health
14
Q
Mortality
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death; its hard to detect what exactly killed someone because most diseases/ illnesses are intertwined
15
Q
Morbidity
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illness; it’s even harder to detect morbidity because people don’t always report when they’re sick
16
Q
Epidemiological transition
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diseases that people tend to die of later in life (heart disease, cancer, stroke) show the success in public health (transitioned from influenza/pneumonia, tuberculosis, gastritis) decrease in mortality because of cleaner living conditions: condition water, air, food, disposal of waste
17
Q
Case
A
an episode of illness, disorder, or injury involving a person (one instance is a case)
18
Q
Incidence
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the number of new cases of a specific health disorder occurring within a given population during a stated period of time; the rate at which cases first appear
19
Q
Prevalence
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the total number of cases of a health disorder that exist at any given time; the rate at which all cases exist
20
Q
Brain death
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brain stops functioning, declared dead even if still on life support; new way of detecting death developed from the last century, some religious faiths are opposed to concept of brain death
21
Q
Point prevalence
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the number of cases at a certain point in time, usually a particular day or week
22
Q
Period prevalence
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the total number of cases during a specified period of time, usually a month or year
23
Q
Lifetime prevalence
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the number of people who have had the health problem at least once during their lifetime
24
Q
Measurement issues
A
inexact rates of measurement because people don’t always report an illness correctly, can’t get data on everyone
25
Crude mortality rate
total number of deaths in a population in a certain year; # cases in a year per 1000 / total population times 1000 or other unit of population
26
Age-specific rates
rates used to show differences by age; calculated the same as crude rates, except numerator and denominator are confined to a specific age group; can also calculate sex-specific, race-specific, etc using this method
27
Infant mortality rate
a measure of the deaths of all infants in a geographical area under the age of one year; a common age-specific rate and used to judge the health of a country; # deaths among infants less than 1 year old per 100 people / # of live births times 100 (or whatever unit of people); deaths could be due to genetic conditions; inadequate prenatal care of the mom --> due to poverty most of the time; U.S. in 2004 ranks 29th in the world for infant mortality
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Cohort analysis
look at people born at a certain time, they belong to a specific age group
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Gender-specific mortality rate
ex. looking at deaths from child birth - wouldn't look at the male gender, would also look at a specific age range
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Race-specific mortality rate
race is self-defined (ambiguous); ex. genetics are different based on your ancestors/race - sickle-cell is more common among those with African ancestors
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Infectious diseases
crowded conditions of urban living ensured that infectious diseases would spread more quickly and that disease causing microorganisms would persist within the community for longer periods of time; the migrations of people from regions of the world spread disease; they are making a reemergence along with new ones such as west nile, avian flu, etc - they are returning through the effects of globalization, urbanization, and global warming
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Chronic and degenerative diseases
after medicine and living conditions improved, the focus of medicine shifted to controlling risk factors by modifying lifestyles, agents, or the environment; taking preventive measures and trying to control diseases that affect people of old age
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Modernization
it was accompanied by greater longevity and a steep decline in infectious diseases, but heart disease, cancer, and other physical ailments associated with modern living increased
34
Social class
a category or group of people who have approximately the same amount of wealth, status, and power in a society
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Five class model
1) upper class- defined by jobs but also how much wealth, the extremely wealthy top corporate executives and professionals
2) upper-middle class - affluent well-educated professionals and high-level managers, college and graduate degrees
3) lower-middle class - office and sales workers, small business owners, teachers, managers; distinguish the middle class by many factors - education, jobs, wealth, home owners, if they get benefits at work
4) working class - skilled and semi-skilled workers, lower-level clerical workers, craft trades, plumbers, electricians
5) lower class - semi-skilled and unskilled workers, cab drivers, fast food workers, the chronically unemployed
36
Wealth vs. Status
wealth is an objective dimension of a person's social rank based upon how much money or property he or she possesses; status is a subjective dimension consisting of how much esteem the person is accorded by other people
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Max Weber
said society has many different inequalities: wealth, power (political influence or leadership), social status (measuring prestige or lifestyle); you can belong to multiple status groups depending on your interests, and people make judgments because of them; status means social position - there are various positions but some can form the basis of social groups - ex. son, mother, student, etc
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Status group
Weber said that status groups are groups of people who are alike with respect to wealth, status, and power
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Status symbols
individual characteristics, behaviors, possessions associated with status
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Social mobility
moving between social classes, you can either move upward or downward - upward is easier in European countries than in U.S.; intragenerational - within 1 lifetime; intergenerational - across generations - changes from parents to kids
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Karl Marx
first person to define social class (proletariat (working class) vs. bourgeoisie); thought that the basic source of class distinctions was the unequal distribution of material good and wealth
42
Education
most important factor to explain health behavior and social inequality; education impacts: 1) work and economic conditions - better jobs/income
2) social and psychological resources - better control over their lives, more hope for the future, (internal locus of control) your choices make a difference; opposite of control: fatalism - its up to faith/fate AKA external locus of control; better education leads to more internal locus of control
3) health lifestyle - chronic illnesses - education effects when people acquire chronic illnesses and income affects how those diseases progress
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Conflict Theory
focused on groups
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Socioeconomic Status (SES)
consists of 3 variables: income (reflects spending power, housing, diet, medical care), occupational prestige (measures status, responsibility at work, physical activity, health risks associated with a job), and level of education (indicative of a person's skills for acquiring positive social, psychological, and economic resources
45
Gini Index
measure for society of how much inequality or equality exists
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Income Inequality hypothesis (Wilkinson)
societies that are more economically equal have a healthier population, societies with more inequality have worse health; this thesis is controversial because other studies failed to replicate his findings
47
Whitehall Studies
investigated the mortality of over 17,000 British male civil government employees; men were classified according to their job rankings, those with highest rank had lowest % of deaths; Britain has equal healthcare access, so the difference was not due to access to healthcare; strong evidence of social class differences in mortality - there's a gradient of health based upon SES factors other than access to healthcare (not the theory that there's a threshold, poor people at the bottom then everyone above the threshold is about the same in terms of health)
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Neighborhood effects of health
spatial or geographic factors affecting health. even if you have high SES but live in a poor neighborhood, you may exhibit same health as everyone else and vice versa; people are influenced by who they live around; including spouses/family; poor neighborhoods may also have less resources, worse education systems, and these all impact healthcare even if you have a high income
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SES as fundamental cause of mortality
SES influences multiple diseases, affects these diseases through multiple pathways of risks, is reproduced over time, and involves access to resources that can be used to avoid risks or minimize the consequences of disease if it occurs
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Life Expectancy
men have gotten closer to female life expectancy, but the gap is still about 5 years; women started smoking cigarettes (tobacco) more in the 60s --> reduced life expectancy; obesity causes the life expectancy to decrease; people with lower SES or lower education are more likely to be obese
51
Mortality vs. Morbidity with Gender
men have higher mortality than women, at any age; women have higher morbidity than men; women more likely to sustain more injuries, more cancer, more heart disease cases;
difference results because of biological, lifestyle and risk behavior, responses to symptoms, likelihood of seeking care, experience with care system
52
Gender disparities in mental health
women higher for depressions and anxiety disorders, men higher for personality disorders; women with employment outside of the home have better psychological well being
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Proportion of population over 65
it's raising every year, from 12.4% in 2004 to a projected 16.3% in 2020 and 20.7% in 2050; they're more likely to be healthier, better educated, and more affluent; puts pressure on medicare and social security system to maintain care for the elderly
54
Dependency ratio
ratio of those typically not in the labor force (the dependent part) and those typically in the labor force (the productive part); in 1955 - 8.6 taxpayers for every retired person, 2005 - 2.7 taxpayers, 2035 - 1.9 taxpayers; this is a serious problem because not enough people to cover medicare, the costs, retirement, social security of elderly people
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Aging and Health
many older people tend to rate their health positively, in spite of the fact that health declines with age
56
Compression of morbidity
burden of lifetime illness may be compressed into a shorter period before the time of death, if the age of onset of the first chronic infirmity can be postponed
57
Race
not considered a biological aspect; considered to be socially constructed - where you identify the culture you were brought up in; some races are more prone to certain diseases; within racial groups, there's as much diversity as there is across groups
58
Racial disparities in health status
differences in health b/w racial groups; asian americans have better health and lower rates of disease but there hasn't been much research done; not a lot of statistics kept on Hispanics either b/c people would group them along w/ blacks or whites; African american men live 4-5 years less than white men, same goes for AA women; AA more likely to get hypertension but prob not genetics alone, SES is the major explanation for differences (education!) - people with lower SES have fewer financial resources, can't access healthcare, have poor diet and exercise; even within same education levels, whites have better health than blacks (discrimination)
59
Hispanic paradox
hispanics have low SES but have lower mortality/morbidity than rate than even whites; maybe because its a lifestyle choice - recent immigrants are more healthy than assimilated people
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Stress
lifestyle, culture, psychosocial factors effect levels of stress: lower SES people experience more stress; how people respond to their environments and the physiological consequences of these responses - we encounter more social stressful threats than physical
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Discrimination
doctors don't offer the same treatments to blacks as they do to whites; blacks don't get the same healthcare services offered (people in equal situations get treated differently, but doesn't necessarily mean there's any animus); many AAs don't trust healthcare institutions - comes from history of distrust, exclusion ex. Tuskegee experiment - purposely didn't treat AA men with syphillis and didn't tell them
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Stereotype bias
doctors may think that AAs don't have the resources available to sustain treatments or they may make assumptions and judgments/stereotypes that limit AAs' choices
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Symbolic Interactionism
focuses on face to face interaction; deals with the concept of the "self" and who we are; how we get an idea about ourselves by interacting with other people - the self is socially constructed
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Looking glass self (Cooley)
we see ourselves in our imagination as we think we appear to the other person, we see in our imagination the other person's judgment of ourselves, as a result of what we see in our imagination about how we are viewed by the other person we experience some sort of self-feeling, such as satisfaction, pride, or humiliation; our idea about who we are is created by looking at how other people see us; we're very sensitive to the info provided to us in our social lives
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Definition of situation (Thomas)
our need to define each situation, the definition may be more important than actual reality, "if men define a situation as real, then it is real in its consequences"
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Presentation of self (Goffman)
the positive social value that individuals claim for themselves is termed a "face"- they project this to other people; the self viewed as 1) a role as an image of an individual formed from the flow of events in an encounter and 2) a kind of player in a ritual game who copes judgmentally with a situation; this kind of view identifies the calculative element in dealings between people and presents them as information managers and strategists maneuvering for gain in social situations
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Functionalism
focuses on the influence of the larger society on individuals
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Durkheim's causes of suicide
found that single people had higher suicide rates than married people; protestants had higher numbers than catholics (protestants believed relationship with god was individual, catholics believes in worship in groups);
1) egoistic suicide- people become so cut off from people, have no support, results in stress
2) anomie- people suffer a sudden dislocation of normative systems where their norms and values are no longer relevant, social changes causes lack of a normal
3) altruism- people are too connected to other people, sacrifice for other people, for their country, too strongly integrated into a demanding society that the only escape is suicide
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Socioeconomic trends and illness rates (Brenner)
looked at the rates of disease during economic good and bad time periods; when you're more stressed, you're more vulnerable to sickness
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Life events
life changes and accumulation of events that require us to respond to stress; life changes have 3 dimensions: 1) the degree of change evoked, 2) the undesirability of change and 3) the aspect of one's life that is affected
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Social Readjustment Rating Scale
the scale is based on the assumption that change, no matter how good or bad, demands a certain degree of adjustment on the part of an individual - the greater the adjustment, the greater the stress; as the total value of life change units mounts, the probability of having a serious illness also increases, particularly if a person accumulates too many life change units in too short a time
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Allostatic load
body is all charged up, all that adrenaline, cortisol wears down your body - not good for you, more likely to develop a disease
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Chronic strain
one of the two major types of social stressors (life events is the other one); relatively enduring conflicts, problems, and threats, which many people face on a daily basis; includes role overload and conflicts within role sets
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Stress and the social group
influence of group membership is important when considering a person's perception of an event; conformity to group-approved attitudes and definitions has been hypothesized as reducing anxiety
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Social capital
the social investments of individuals in society in terms of their membership in formal and informal groups, networks, and institutions; the quality of a person's social connections and integration into a wider community
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Social support
how much the individual feels loved and supported by other people such as family members
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Physiological response to stress
fight or flight concept to illustrate how the body copes with stress resulting from a social situation; ANS controls heart rate, breathing - parasympathetic system is dominant when at rest while the sympathetic system kicks in during an emergency
Endocrine glands secrete hormones into the bloodstream - norepinephrine and epinephrine
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Coping skills
a person's ability to cope with problems is influenced by a society's preparatory institutions, such as schools and the family, two entities designed to develop skills and competencies in dealing with society's needs; a person's ability to cope is also related to a society's rewards or punishments for those who did or did not control their behavior in accordance with norms
