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HLTC05H3 (59)
Lecture

Lecture 3

19 Pages
115 Views

Department
Health Studies
Course Code
HLTC05H3
Professor
Rhan- Ju Song

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Description
Social Origins of Illness and Disease Context Social Cultural Economic Physical WHO 2010 Human Variables in Disease Incidence • Demography : age, sex, ethnicity, SES status • Biology : genes, degree of immunity, nutritional status, susceptibility • Behaviour : nature of risk behaviours, cultural traditions influencing disease transmission and persistence, and psychological factors influencing manifestation of disease • Economic situation • Family structure • Gender roles • Marriage patterns • Sexual behaviour • Contraceptive patterns • Population policy • Pregnancy & childbirth practices • Child-rearing practices • Body-image alterations • Diet / Nutrition (food prep, taboos) • Dress • Personal hygiene • Housing arrangements • Sanitation • Occupations • Religion • Funerary customs • Culturogenic stress • Migrant status • Seasonal travel • Use of ”chemical comforters” • Leisure pursuits • Domestic/household animals • Self-treatment and lay strategies Case Studies (Helman 2007) • Cervical cancer in Latin America • Hepatitis B and cultural practices • Coronary heart disease among Japanese • AIDS and sexual practices in Brazil Variations in Medical Treatment and Diagnosis • Variations in surgical rates b/w US, Canada, England, Wales • Notable diffs in caesareans, hysterectomy • Factors: cultural values of surgeon, patient and society (value systems, priority to health care, technology changes) where they live play a part in determining frequency with which surgery used as treatment for conditions Individual Behaviour, Risk and “Healthism” • Increasingly today: origin of health problems in the individual • A consumerist movement as well....lifestyles and material goods: health food, equipment, pills, vitamins, etc. • “Healthism” as a new religion • But often ignores large social causes of ill health, i.e., poverty, inequality, overcrowding, pollution, etc. • Reinforced by medical perspective of “individual risk factors”, common in epidem. reports • Personal risk management Cultural Perception of Disease • Lay definitions of abnormality or disease • What is/isn’t presented at doctors’ offices depending on someone’s beliefs, e.g., menstrual pain/lack of, hip dislocation, backache and SES • “Disease” vs. “Illness” • “Cultural epidemiology”, investigating local concepts of illness and social context; interested in patterns of stress in a community, perceptions of causes, the meanings they give to it, and their help-seeking behaviour Differing Perspectives on Disease Biomedicine: disease is an objectively defined and discrete biological entity that exists separately from social groups and social contexts; “disease as a category in nature, a finite and objective reality discoverable through scientific endeavour” (Singer 2004: 9) Medical Anthropology: disease is culturally defined; there are “social origins of both the biomedical conception of disease and the expression of the sicknesses labelled diseases by doctors” (Singer 2004: 9) Medical Technological Advances • Significant factor in disease construction • With technological development: must consider who controls the funding and implementation of new technologies, who operates and determines the way technology is actually used, and who interprets the use or meaning of its product (Singer 2004) • Biomedical technology (and how it is used differentially) clearly reflects how power, expressed both as ideology and as action, is manifested in the health domain (Singer 2004) .... reproduces patterns of social inequalities Diseases, as social constructions, change because society changes (Singer 2004) “Disease” as an explanatory model....reflecting a cultural process (Singer 2004) Frankenberg (1980) 1. Th
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