Chapter 2 Health Notes.docx

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12 Apr 2012
Chapter 2 Health Notes
In the 19th century, scholars began to connect the health of populations to living population
Social scientists have also linked structures and political ideology to explain the organization of
health care and health outcome
The scope of health studies now includes the determinants of health, the meaning of health
held by individuals, and identifying public policy approaches by which health can be maintained
Social inequality can refer to any of the differences b/n people (or the socially defined positions
they occupy) that are consequential for the lives they lead, for the rights or opportunities they
exerceise and rewards or privileges they enjoy
o Figure 2.1 very important
o Could even use for 1st essay
Redefining Health
Health and its maintanence is more complex than examining ohysical health and treating
Health is a multidimensional concept
The political economy perspecetive is concerned with identifying the economic, political, and
social structures that influence health. Takes two forms:
o Directs attention to a broad range of health issues that include how the production and
distribution of economic, political, and soial resources shape the health care system, as
well as broad determinants of health
Ways of thinking about health
Understanding different conceptions of health is important because these ideas can strongly
influence how health care services are organized and delivered, and how health-related policy is
defined and implemented
Four major paradigms or approaches to health that influence Canadian health policy:
1. Medical paradigm
2. Behavioural/lifestyle approach
3. Socio-environmental paradigm
4. Structural/critical approach
Medical paradigm
The medical paradigm is the traditional biomedical paradigm that defines health as the absence
of disease and/or disability
o The primary health issues are defined in terms of disease categories and physiological
risk factors
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o The medical paradigm considers disease as having an independent existence from the
individual’s social environment and ideas
Also considers a cause-effect reasoning i.e. condition A does something to B
which results in C
o The medical paradigm is focused on physical symptoms and clinical outcomes
o Intervention is primarily through health care workers via treatment
o Target are those affected by a disease or high risk
o The approach is highly individualized (maybe because the intervention is through
o The medical paradigm is clearly the dominant manner by which the media, policy
makers, and public think about the meaning of determinants of health and means by
which health can be promoted
Could use for paper
Behavioural/Lifestyle Approach
Behavioural/lifestyle approach also provides an individualized concept of health
Health is defined primarily in terms of individual energy, functional ability, and disease-
preventing lifestyle
o Primary health problems are seeing as behavioural risk factors e.g. smoking, drinking
o principal intervention methods for changing risky behaviours are health education,
social marketing, and advocacy for public policies that support and promote lifestyle
o targets are those at high risk, particularly youth and children
o intervention is primarily in the hands of municipal and regional public health
departments, advocacy groups (e.g. Canadian Cancer Society), and the different levels of
o the individual, however, is held responsible for their health, individualism
o social marketing include public campaigns run by government e.g. anti-smoking ads
o the Canadian public thinks this is the best way to promote health, the
behavioural/lifestyle approach
unlike the medical paradigm, the behavioural/lifestyle approach emphasises prevention rather
than treatment
Socio-Environmental Paradigm
the socio-environmental paradigm is concerned with risk conditions rather than risk factors
o health is defined as a positive concept in terms of connectedness to family, friends, and
o directs attention to community and social factors that support health
o health problems defined in terms of psychosocial and socio-environmental risk factors
e.g. poverty, hazardous working conditions, stressful environments
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