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SOSC 2150 Mid-Term Review

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York University
Social Science
SOSC 2150

SOSC 2150 Mid-Term Exam Review SOSC 2150 9.0 HEALTH IN CRISIS: ISSUES OF HEALTH, ENVIRONMENTS AND POVERTY FIRST TERM TEST – STUDY GUIDELINES Two of the following three questions will be on the mid-term test. Students will be required to answer both of the questions that appear on the test. Each question will be weighted equally. 1. Discuss the implications of neoliberalism for health from the perspective of the social gradient theory. Be sure to explain the concept of the social gradient in health status in your answer.  Lecture (Nov/4): o Social gradient theory: Whitehall Study (Marmot) 1980s → health declines each SES category. Wilkinson (1990s) → variations health status between countries with greater or lesser degrees class stratification (ex: Britain v. Sweden)  Film: In sickness and in wealth film o is inequality making us sick? o although America is so economically developed, their health is not the best o 47 million of them dont have health coverage o there are ways in which society is organized that is bad for our heal and there are ways we can reconfigure ourselves to better our health o louiseville data maps show the highest rate if heart disease is in the west end o excess death:how many people in a population will actually die o Jim Taylor: CEO. earns 6 figures. is part of top 1%. lives in a neighbourhood whee he safe and can walk. o excess death is not a problem there in district 16, it is 2 years longer (life expectancy) o marmond and whitehall study. chartered health of thousands of british officials. they found that the lower on the social ladder you were the worse your health is. death rates and illness re correlated to status. o found social gradients of disease in US as well o tandra Young is 27 , middle class, college and full time work, cost of college has increased 35%. life expectancy in here neighbourhood id 4 years less than that of jim taylors. o north West is c district 2. corry. corrys mom worked full time then lost her job, and became really ill and it took a tool mentally and physically. corry and his wife work full time and their combined income is 48 thousand a year and half of americans live like this. one third of the residents of his district has hypertension and life expectancy is 2 years less than tanyas, o no zoning laws to regulate fast food restaurants in poor neighborhoods. more mixed housing o district 5. a third dont have highschool degree. nine years less life expectancy than jim taylors 12% unemployed if she gets a job she might loose her medical coverage o life expectancy should not be dependant on the resources you gave available to you o increased stress at high levels also affects your health o maquacks and stress. chronic sttress is prevalent in monkeys who are subordinate and less control of their environment o another study saw that the higher your income , the less stress o the more stress, the easier it is for you to contract a cold than those with less stress o jim has the time to make the food he had the money to buy o most of the poor in american are actually white. o constant stress is actually bad for the development of the brain o being constantly en guard can biologically affect you. over 83000 excess deaths per year in african american community o reducing health inequality is not impossible. a century ago ave american only lived to 48 and through social reforms the life expectancy has increased. in the 1930s an array of policies prevented the economic crisis from being a health crisis o health improvements werent medical. they were about wealth distribution, better housing, education, o economic policy is health policy o when we improve economic circumstances can improve health. o but since the 1980s we have gone in the other direction. govs reduced taxes on the rich o tax law changes have benefited the rich. wealth inequality was at a low in the 1970s but now its high o ***warren buffet speech in tax laws o wealth is health  Readings:  “Beyond the income inequality hypothesis: class, neo-liberalism, and health inequalities” David Coburn o This paper describes and critiques the income inequality approach to health inequalities. It then presents an alternative class-based model through a focus on the causes and not only the consequences of income inequalities. o Global and national socio-political-economic trends have increased the power of business classes and lowered that of working classes. The neo-liberal policies accompanying these trends led to increased income inequalities but also poverty and unequal access to many other health-relevant resources. o Countries with Social Democratic forms of welfare regimes (ie those that are less neo-liberal) have better health than do those that more neo-liberal o Here are discussed the class-based production of inequalities o The income inequality hypothesis is the dominant approach to discussion about health inequalities between and within developed nations o In Unhealthy Societies: the afflictions of inequality (1996) Richard Wilkinson argued that, amongst the less developed nations, GNP/Capita is the most important correlate of average levels of health status. o Wilkinson contends that it is the degree of income inequality , rather than national wealth which is the most important determinant of national differences in health status o Following Wilkinson, the major focus here is on income inequality and health status within and between the 14-20 most developed nations o Social hierarchies are said to produce disease because of the poor self-esteem associated with lower status which, I turn, through psycho-neurobiological pathways, negatively influences health o Wilkinson and colleagues claim that there are two major dimensions of society, degree of hierarchy (vertical separation) and social cohesion or fragmentation (horizontal separation) which, measuring the „quality of life‟ determine average national or regional health status o That tat sense Wilkinson and colleagues built on, but went much beyond earlier empirical studies of the relationship between income inequality and health status o Neoliberalism and welfare regimes to point to ways in which we can begin to understand inequalities in historical and cross-sectional perspective. In this model, income inequality but also numerous other forms of health-relevant social inequalities o I argue that the forceful enactment of neo-liberal ideologies and policies exacerbates differences amongst rich and poor within the market, and, at the same time, undermines those social institutions which might help reduce poverty or income inequalities or which buffer the effects of income inequalities on health o Welfare regimes can be categorized according to the extent to which they decommodify citizens‟ relationships to the market o Decommodification refers to the degree to which citizens have an alternative to complete dependence on the labour market (on working for money) in order to have an acceptable standard of living o Esping-Anderson notes three major types of welfare state: the Social Democratic welfare states (greatest decommodification and emphasis on citizenship rights), the Liberal Welfare state o (the most market-dependent and emphasizes means and income testing) and the Conservative or Corporatist or Familist welfare states (characterized by class and status-based insurance schemes and a heavy reliance on the family to provide support) o income inequality may be more important for health in more neo-liberal societies than in others o 2. What accounts for significantly reduced health status amongst Aboriginal populations?  Lecture (Nov 11): o Aboriginal Health Status: infant mortality 2-4 times higher than non-aboriginal population, youth suicide 5-7 times higher (Inuit 11 times higher) higher rates chronic diseases and infectious diseases o Income and poverty o Effects of colonization o 1876 Indian Act o Displaced from traditional lands o Food insecurity o Inadequate and culturally inappropriate health care services o Prohibitions against language and culture o Residential school system and assimilation o Substandard living conditions (homes, communities) o Lower levels employment and education o Social exclusion/marginalization  Film: "Bad Sugar" o Tohono, half of their residents have type two diabetes and rates for children are also on the rise (Tohono o'odham people) o for hundreds of years they lived on crops irrigated by rain and ground water, today this has changed o they never said they had diabetes they would just say they had bad sugar, o Gila River reservation: Henrietta Lopez works on irrigation project. Her ancestors were water engineers, over centuries they transformed the desert into a farmland o Healthier times for the Pima people, understanding the importance of water, but also a rise in diabetes o thought it was something in their biology o the national insittue of health collected blood samples and medical histories of Pima people. After 40 years the knowledge on diabetes increased without a cure o some people do have higher incidence of disease o pacific islanders, african americans, aboriginals, all suffer from type 2 diabetes at double the national averages. In every case we are talking about people who have been dispossessed of their land and history. People who have been uprooted manifest the same type of disease o For tohono and many others, land has disappeared in the past century o half of Pima live below poverty line, this condition is the real risk factor of diabetes o Health problems occur long before people get to the clinic o insulin isnt used efficiently and glucose is produced which can lead to blindness o direct connect between living in poverty and stress o when stress levels remain high glucose production i
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