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SOC243 Lecture Sept 23.docx

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William Magee

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SOC243 Lecture Sept 23 Chronic Illness • Some information about cancer epidemiology • Some network processes in the social shaping of disease and illness • Causal chains, causal webs, and the notion of fundamental causes, and upstream  and downstream 1. Cancer Morbidity and Morality • Globally the number of cancer deaths is expected to grow from 12 million  new cases and 7 million deaths in 2008 to a projected 26 million new cases  and 11.4 million deaths in 2030 • In 2007 approximately 72% of cancer deaths occurred in low and middle  income countries, where the leading causes of cancer mortality are lung,  stomach, liver, colon, and rectum, and cervix cancers.  • Impact of infectious diseases on cancers, especially in developing  countries o Some 18% of cancers world­wide can be linked to chronic infections  such as hepatitis, HPV, Epstein­Barr virus, HIV, herpes, Helicobacter  pylori, and schistosoma o More than 25% of cancer incidence in developing countries could be  avoided If infectious causes of cancer were prevented 2. Some network processes in the social shaping of disease and illness • Smoking: statistical evidence that smoking causes cancer initially came from  statistical models­ observed lung cancer incidence to be proportional to  cigs/day • The long struggle to get evidence accepted did not immediately lead to  smoking reductions, smoking was (is) reflective of lifestyle and identity to  some extent • Smoking Identity and Choice o There is an inverse relationship between socioeconomic status (SES)  and smoking o But classes are not uniform  Within groups defined by class, preferences for classical  music are associated with lower smoking, while preferences  for bluegrass, jazz, and heavy metal music are associated with  higher smoking  This suggests that people use smoking, like other cultural  tastes, to distinguish their lifestyle group from those of others • Boundaries on diffusion of information as structuring instrumental support o Social networks structure the dissemination/diffusion of health­ related information and the ability to act effectively on information,  shaping health­related practices o Much of social support is information  What to do, (ex, how to get help)  Social influence on how to interpret and react to information o Social characteristics and categories  Race, class, gender  Associated with network structure may influence differential  health outcomes • Moderation in the statistical sense o Moderation is when the relation between two variable depends on a  third variable o Effects of historical time on morality rates depends on skin color, or  black/white differences in morality depend on / vary with time  • Exceptions that prove the point o Lung cancer and colorectal 
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