HLTB03 - Chapter 17

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12 Dec 2012

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CHAPTER 17: Well -Being At Mid-Life: Determinants of Preventive Health
- Preventative health: powerful potential to reduce health care costs and delay or prevent the
onset of established chronic disease
- Mid-life: seen as transition, opportunity and challenge
o Heightened re-evaluation and reorientation, which involve turning points aimed at
making the most of the second half of lives
- There is no single biological marker which indicated middle age, instead the definitions vary in
the literature, in this book 45-60 years old
o Usually indicated by the beginning of the bodily decline: drop in hormonal levels, failing
of physiological functions, mental acuity wanes and inevitable deterioration of health
- Demographic perspective: midlife- general age for having kids, and parents of midlife people are
aging, and times of career transitions
- Morbidity at midlife ages- connected with many high profile diseasesheart disease, diabetes,
obesity, stroke and the beginnings of osteoporosis and arthritis, and other forms of cancer
(breast, ovarian, prostate)
- Disease- based biomedical model used to identify diseases, discovering underlying etiology, and
then treating and hopefully curing the disease
Social Determinants of Health:
- 12 factors- listed as determinants of health (Public Health Agency)
o Gender
o Culture
o Income and social status
o Health child development
o Biology and genetic endowment
o Physical environment
o Employment and work conditions
o Personal health practices and coping skills
o Education
o Health services
o Social support networks
o Social environments
- Continues to be a need for better understanding of steps taken to seek and attain health and
- Midlife- considered the time when range of determinants of health whose effect accumulate to
affect one’s well being
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- At social level: risk associated with stresses related to employment, balancing demands of busy
lives, migration and limited resources which effect well-being negatively on day to day basis
Population Health
- Approach requires ecological lens and understanding that world comprises complex systems
- Health of populations effected by combination of context, locality, and health
- Focuses on entire population and recognizes the importance of investigating the health
disparities in populations
Lifecourse as an Approach to Aging
- Lifecourse: sociological term life stages in social and cultural contexts
o Approach: acknowledges the fluidity of the interaction between people and their
environment, and social and cultural contexts of biological change
o Tendency for professions to put emphasis on existence of set of structurally defined, but
culturally experienced life stages
o “aging is visible and the distinctions between the public and private sides of aging
further create dynamic of midlife perceptions
o Differences in experiences are significant when focusing on midlives of different cohorts
o Hunt (2002): notes variability in experiences in professional employment, family
structure, marital status, retirement and other socio-economic variables between
women as little as twenty years apart
Life Choices and Life Chances:
- 2 terms that are often misused by unfamiliar with the determinants of health and well-being,
and use the blanket term lifestyle to praise and/or critique people who seem to have made
unwise choices and or practices
- Bolaria and Bolaria: lack of formal education effects literacy, low income that forces food
choices, housing and employment environments and other factors at a structural societal level,
may make what seem like personal choice the only choice
o Lifestyle is strongly mediated and influenced by life choices that place individuals and
their agency in context of social and structural institutions
o Message like stop smoking or cut down- has highly differential meaning to preventative
health advice for someone trying to dampen hunger pangs with mooched cigarette
o Or: keep physically active by walking everyday is unthinkable to someone who earns her
living, either now or in the past, on prostitution stroll
o Also stated: life choces are shaped by life changes
- Lifecourse access to materials resources and the social and cultural environments which
influence our health and well being especially at midlife
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