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SOC243 Lecture 3

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William Magee

SOC243 Lecture 3 09/24/2012 Agenda: 1. Global Rates of Cancer: Links to Infections 2. Cancer, Lifestyle & Upstream vs. downstream intervention 3. The Experience of Cancer in Context of History of Science & Medicine 4. Phenomenology of Physical & Mental Disintegration (in Old Age) Proximal Cancer - Experience of illness depends on how it is perceived/conceptualized through the culture o The moralized experience Global Rates of Cancer: Links to Infections - Globally the number of cancer deaths is expected to grow from 12 million new cases and 7 million deaths from cancer in 2008 to a projected 26 million new cases and 11.4million deaths in 2030 - Approx. 72% of cancer deaths occurred in low and middle income countries in 2007, where the leading causes of cancer morality are lung, stomach, liver, colon and rectum, and cervix - Age population the average age of the population is getting older o A global problem, a global rise in cancer - Cancer is the leading causes of death in all provinces for the first time: StatsCan 2008 Time Trends in incidence - 1983-2012 the raw incidence rates are raising Time Trends in Mortality - Mortality rates are going down - Age adjusted, rates are going down o Treatments are advancing, people are able to live longer with Cancer o Early detection thanks to technology also helps Predicted relative survival ratios, by type of cancer and survival duration, population 15-99 at diagnosis 2004-2006 - Breast / prostate cancer have better treatment, hence the larger survival ratio - Incidence is not getting better, we need a better solution - Infectious diseases are related to chronic diseases o Has a large impact on the global rate The impact of infectious diseases on cancers in developing countries - some 18% of cancers world-wide can be linked to chronic infectious such as hepatitis, human papillomavirus (HPV), Epstein-Barr virus, HIV herpes, Helicobacter pylori and schistrosoma - schistrosoma, parasite disease carried by snails > bladder cancer - a lot of the diseases above are highly related to lifestyle factors/habits - Smoking causes more than just lung cancer, bladder, cervix, kidney, oral, pancreatic - More than 25% of cancer incidence in developing countries could be avoided if infectious causes of cancer were prevented Cancer, Lifestyle and Prevention - Smoking: statistical evidence that smoking causes caner initially came from statistical models - Why do people smoke? o Through identity … class, gender > lifestyles - the long struggle to get evidence accepted did not immediately lead to smoking reductions, smoking was (is) part of the lifestyle Smoking Identity and Choice - SES groups may use smoking, like other cultural tastes to distinguish their lifestyles from those of others - Class based identity associated with richer people smoking, now richer people smoke less o As income raises, smoking is the option, lifestyle reflects their consumption in a way that leads to poor health, higher mortality rates - SES pattern does not hold for Hispanic men and women in the United States - Higher SES, had a lower risk factor - Focusing on lifestyle is basically saying that individuals are responsible and blamed for the outcome of Cancer Causal Chains & Upstream vs. Downstream Intervention - Inequality, income (poverty) ecology - Behavior, lifestyle, identity, choice - Biology, illness, mortality o Focused on shaping individual lifestyles - “Smoking for a long time can benefit from quoting” Obesity & Cancer - One study predicts that only 3% of cancers in high-income countries to overweight and obesity that study considers only cancers of breast, colon, and uterus. - Lack of physical activity “clearly causes cancers of the breast and colon” (5% of all cancers independent of obesity) - SES is associated with obesity o SES and the relationship with obesity has weaken over the past 3 decades o Class is becoming less of a tie Some Upstream Factors in Child Obesity 1. Parental control of eating & exercise 2. The local food economy is associated with lower obesity 3. Access to recreational facilities, controlled traffic intersections – traffic density within 150 meters Heavy in school, burdened for life - Decreased education was the key mechanism that reduced the career achievement of overweight women - There is a stigmatizing effect on women over men Downstream Causal Chain 1
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