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Chapter 2

Health Science Chapter 2 Review

5 Pages

Health Sciences
Course Code
Health Sciences 1002A/B
Anita Cramp

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Health Science Review Chapter 2- Social Structure, Living conditions and Health Individual Approaches: - Biomedical risk there is screening and testing and some form of mandated regime or treatment - Behavioural risk there is a usual approach of exhorting the individual to carry out series of changes in their behaviour - Little evidence to support the assumption that those most at risk can change their behaviours by making healthy choices and the behavioural and biomedical approached play a relatively minor role in predicting chronic diseases and such - Individualist approaches dominate but they are not always the best approaches Social Determinants of Health and Living Conditions - Specifying the material and social living conditions that people experience - Quality of these social determinants is a reflection of the organization of society and how society distributes economic and social resources - Brunner and Marmot model: 3 pathways that link social structure to health status o Direct link between social structure, material factors and health status o Social structure shapes social and work environment to create psychological and behavioural responses that determine health status o One that sees these same environments creating behavioural responses that directly impair bodily organs thereby determining health o Do not take in complexity however Materialist Explanations for the Social Determinants of Health and Health Status Relationship - Sees objective living conditions as explaining how social determinants of health shape health status - 3 mechanisms o Experience of material living conditions o Experience of psychosocial stress o Adoption of health-supporting or health-threatening behaviours - Individuals living within society experience differing exposures to positive and negative living conditions throughout their lives that accumulate to provide adult health outcomes - Socio-economic position in a society (like Canada) is a powerful predictor of health as it is an indicator of material advantage or disadvantage over lifespan (i.e. nourishment, housing, employment/unemployment etc.) - Quality of material life conditions are associated with the likelihood of physical, developmental, social and educational problems - Benzeval and colleagues o Income potential: accumulation of abilities, skills and educational experiences in childhood that are important determinants of adult employability and income capacity. o Health capital: accumulation of health resources, both physical and psychosocial, inherited and acquired during early stages of life which determine current health and future health potential o Childhood circumstances are a result of their parents’ characteristics, their objective living conditions and other aspects of social environment…. Contribute to immediate health status and potential to acquire income in adulthood - Social structure is characterized by a finely graded scale of advantage and disadvantage, with individuals differing in terms of the length and level of their exposure to a particular factor and in terms of the number of factors to which they are exposed - Van de Mheen, Stronks and Mackenbach o Socio-economic circumstances:  Are explicitly related to childhood health  Set a trajectory that, if left unchanged, will continue to accumulate socio- economic advantage or disadvantage over time  Have both direct influence upon adult health and an indirect effect upon adult health through mediating processes of personality and health behaviours o Selection process of what unhealthy adults fall into lowering socio-economic conditions o Works for Canada - Living conditions determine presence or absence of health-threatening stress - Fight or flight (will eventually weaken immune system)(from low income, bad housing/environment, etc.) - Experience of varying quality social determinants of health and the levels of stress associated with these experiences lead to the adoption of health-supporting or health- threatening behaviours (i.e. smoking, alcoholism) - Views these behaviours as reflecting life circumstances rather than making unwise choices Life-Course Perspectives on the Social Determinants of Health and Health Status Relationship - Concerned with how exposures to varying economic and social conditions have a cumulative effect upon health - Focuses on immediate health effects of various social determinants of health but also the cumulative effects - Latent effects: biological or developmental factors early life experiences that influence health later in life… can have lifelong effects regardless of later circumstances (ex. Malnutrition, tobacco etc).. are results of exposures to varying quality social determinants of health - Pathway effects: are experiences that set individuals onto trajectories that influence health, well-being and competence over the life course (i.e. living conditions affect child’s vocabulary going into school and therefore effect educational experience) - Cumulative effects: represent the accumulation of these advantages or disadvantages over time; combination og latent and pathway effects… involve individual, family a
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