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Lecture

HLTC05H3 Lecture Notes - Wses, Cortisol, Warren Buffett


Department
Health Studies
Course Code
HLTC05H3
Professor
R Song

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2012-09-25
Lecture 3
Social Origins of Illness and Disease
Lecture:
Direct cultural factors that affect health as well as how structures of society are
determinants of health
Biomedicine hierarchy in western medicine
The importance of context= social, cultural, economic, physical
Innate biological factors s/a age, sex, genetics
Social and psychological factors incl. behaviour
Helman 2007
oEconomic situation has the capacity to affect behavioural and cultural
factors that make individual more or less vulnerable to disease
oThe importance of diet/nutrition on health (short-term and long-term)
All factors co-occur
Proximate social factors= direct behavioural determinants
of health
Distal social factors= macroeconomic contexts
oUnderstanding how culturogenic stress can affect health through
transnational spaces
Know and understand the case studies highlighted in the Helman
article
oIn terms of looking at health and health difference, how methods of
diagnoses or looking at certain diseases and how the various practices of
biomedicine can vary and often times ignore subjective experiences of
symptoms and onset of illness/disease
Different medical systems can over/under diagnose illness/disease
in people depending on the society/culture of where treatment and

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diagnoses are being applied and vary according to society, culture,
and country (i.e differences between UK, US, and Canada in terms
of medical treatment for caesareans)
Overall society’s perspective on healthcare
oBiomedicine has become a part of our daily living and the understanding
that our health is in our own hands
Healthism= health is in the hands of the individual and is an
outcome from the lifestyle behaviours (risks) that the individual
takes
Economic engine behind it
Neoliberalism= blaming the individual for lack of responsibility
rather than looking at macroeconomic entities that apply to one’s
health
The notion of risk which also goes back to individual responsibility
Can be used to blame people for their circumstances that is
often times purely not in the hands of the individual as we
exclude the larger factors contributing to ill health
oThere is a difference how doctors perceive lay people’s definitions of
disease and
oVarying perception between science (western biomedicine) and “native”
science (non-western science)
oDifferentiating between disease and illness
oCultural epidemiology= the layperson’s understanding of illness and
disease such as susto in many Latin American cultures
Singer 2004
oBiomedicine= objective understanding of disease
oMedical anthropology= disease/illness are social constructions of
experience in a given culture
Medical technological advances influence how disease is looked at
and treated
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Patterns of inequality are reinforced with the introduction of
advanced medical technologies within a population
There is always change; diseases change as well depending on
who is defining them and how the disease and information is
disseminated
o1) making of disease= how biomedicine defines something as disease (i.e.
erectile dysfunction in middle-aged men)
How disease is constructed; sometimes in accordance to the
interests of pharmaceutical companies
o2) making of individual of diseases= how disease can be tied back to
individual behaviour and lifestyle; illness is defined as the patient’s
subjective experience that is not recognized by doctors as a disease
Ideology of biomedicine= convinces people that their experiences
are subjective and are of suspect and not scientific; while
biomedicine is scientifically grounded
Creation of disease/illness is a cultural process
Medicalization
o3) making social of disease= alternative way of understanding health and
constantly questioning the structure of disease and illness in terms of
social roles and relationships
Hegemony= treating poor health through biomedicine rather than other methods
of treating illness/disease
Film Questions:
As described in the film, (not according to Wikipedia), what is the wealth-health
gradient? Give specific film examples/case studies of how this concept,
combined with the importance of power, and control over one’s destiny, is
demonstrated in the video.
Describe examples from the film that illustrate how racism imposes an additional
health burden on people of colour. Give examples of both “everyday” racism and
“structural” racism, and describe how these might affect health in different ways.
Film: In Sickness and In Wealth
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