HLTA02H3 Chapter Notes - Chapter 25: Health Promotion, Food Security, Social Epidemiology

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12 Dec 2012

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Chapter 25- Personal and Structural Determinants of Health and Illness; Lifestyles and life chances
-lifestyles, healthy living, health promotion have emerged as important areas of investigation in medical
-distinction is often made b/w societal factors that are beyond one’s control and influence health, and
individual behavioural factors, over which one presumably has control and for which one can make
healthy choices
-for societal factors, the focus is on the social-structural conditions, including economic and social
inequality, that influence health status
- in terms of behavioural factors, the approach focuses on overall aggregate patterns of health
behaviour and health practices which constitute lifestyles, such as smoking, alcohol consumption,
exercise, and diet
-it is assumed that lifestyles are matters of individual choice, and that these choices have either positive
or negative health consequences
-within this framework, the responsibility for staying healthy is shifted to individuals
-one perspective suggests there would be a decrease in mortality if focus was put toward changing
-on the other hand, the studies from a historical, materialistic, epidemiological perspective argue that
the solution lies in changing the social, economic and environmental conditions that produce illness and
-life chances: consumer behaviour and lifestyle choices individuals make within the limits and
constraints imposed upon them by the social and cultural environment and their material conditions
-this constitutes the study of the relative importance of the role of structure (chances) and
agency (choices) in shaping social behaviour in teh structure=agency debate in the sociological literature
-structuralists give primacy to institutional factors, which both enable and constrain individuals to act,
whereas agency refers to the ability of the individuals to act and to choose their behaviours regardless
of structural constraints
-specific studies of health lifestyles and health behaviour would make significant contributions to the
structure-agency debate
-sociological perspective allows us to take into account social-structural factors in the discussion of
-discussion of reductionist orientation in medicine will take place
Background to Reductionism in Medicine
-there are individualistic, biomedical and reductionist orientations in medicine
-individualasitic approach has been taken, whereby humans are looked at as something that can be fixed
-diseases are looked at as malfunctions-technical defects in body machinery-treatments are
oriented to restoring “normal” function of human body
-mechanistic-individualistic concept of disease which engenders a disease centered, high0technology
orientation in medical practice and research, also largely absolves teh economic and political systems of
responsibility for disease, and denies the social foundations and social causation of disease
- reductionist approach
-emphasizes individual lifestyles
-idea that causes of disease lie in individual lifestyles and behaviours and solution to the
diseases results from changing these lifestyle behaviours
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