What are lay beliefs?
How people with no specialised knowledge understand and make sense of health and illness.
Socially embedded and complex (drawn from many different sources).
What are the 3 different perceptions of health?
- Negative def - health = absence of illness
- Functional def - health = ability to do certain things
- Positive def - health = state of wellbeing and fitness
What are the 3 types of behaviour relating to health/disease?
- Health behaviour - activity undertaken for purpose of maintaining health and preventing illness.
- Illness behaviour - activity of ill person to define illness and seek solution.
- Sick role behaviour - formal response to symptoms, inc. seeking formal help and action, of person as a patient.
What is the lay referral system?
Chain of advice-seeking contacts which the sick make with other lay people prior to - or instead of - seeking help from health care professionals.
Which 4 main factors can influence when a person seeks medical help?
- Symptom experience
- Symptom evaluation
- Knowledge of disease and treatments
- Experience of, and attitudes towards, health professionals.
Which 6 explanations can explain inequalities in terms of health?
Black Report:
- Artefact
- Social selection
- Behavioural-culture
- Materialist
- Pyschosocial
- Income distribution
What is the artefact explanation? Is it reliable?
- Heath inequalities are evident due to the way statistics are collected.
- Unlikely, data problems may even lead to underestimation of inequalities.
Describe the social selection explanation. Is it plausible?
- Direction of causation is from health to social position (e.g. Sick individuals move down social hierarchy).
- Plausible but studies suggests this makes only minor contribution.
Describe the behavioural-cultural explanation. Is it plausible?
- Ill health is due to people’s choices/decisions, knowledge and goals (e.g. Disadvantaged background people engage more in health-damaging behaviour).
- Limitations:
- behaviours are outcomes of social processes, not simply individual choice.
- “choices” may be difficult to exercise in adverse conditions.
- “choices” may be rational for those whose lives are constrained by their lack of resources.
Describe the materialist explanation. Is it plausible?
- Inequalities in health arise from differential access to material resources (e.g. Low income, poor housing conditions).
- lack of choice in exposure to hazards and adverse conditions.
- accumulation of factors across life-course.
- More plausible but further research needed.
Describe the psychosocial explanation. Is it plausible?
- Psychosocial pathways act in addition to direct effects of absolute material living standards.
- Some stressors are distributed on a social gradient (e.g. Negative life events, social supports job security…).
- Stress impacts on health via different pathways:
- direct (physiological, immune system)
- indirect (health related behaviours, mental health)
Describe the income distribution explanation. Is it plausible?
- Relative (not average) income affects health.
- Countries with greater income inequalities have greater health inequalities - it is not the richest, but the most egalitarian societies that have the best health.
- Associated with psychosocial explanation.
- Redistributive policies: reducing income inequality in a society can improve social well-being, and in turn many other health and social factors.
How are there inequalities in access the healthcare?
- More deprived groups have
- higher rates of use of GP services and emergency services
- under-use of preventive services and specialist services
- Tendency to manage health as a series of crises - normalisation of ill health.
