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The psychological capacity to act autonomously and instrumentally
Environment that propels people towards unhealthy behaviors and causes large amounts of mortality and illness (Brownell 1994)
Environment which contains affordable but nasty, fatty, salty or sugary foods. i.e. hot dogs with 0% meat.
assumes that health and illness have physical, psychosocial and cultural determinents.(Engel 1977)
Set of theories that consider how our reality is constructed in everyday social interaction. Reality is a social construction (Berger & Luckmann 1966)
Problems with Western Health beliefs
- lacks ecological validity (cannot be generalized from the lab to the outside world)
- Indogenous (non-applicable to other cultures, race, or tribal group)
- Individualism (individuals are responsible for their own culture)
- Ethnocentric (bias in perception, thinking, due to membership oa an ethnic or cultural group)
Access to Healthcare
- Predisposition factors; age, education, gender, ethnicity, health beliefs
- Enabling factors; insurance, available medical care
- Need; perception of need for care (Anderson & Newman, 1973)
Four Levels of Influence on Health Care Systems (Dahlgren & Whitehead, 1991)
- Level 1: Individual Lifestyle
- Level 2: Social and Community Influences
- Level 3: Living and Working Conditions
- Level 4: General Socio-economic, cultural and environmental conditions
Social Inequalities in Health care
- 1. Health and illness are determined by social conditions.
- 2. There is a relationship between income and health leading to the development of a social gradation.
- 3. Psychosocial explanation: perceived inequalities, stress, lack of control, and less social connection.
- 4. Material explanation: reduced income and reduced acees to service.
Balck Report in England named after Sir Douglas Black
- Relationship between occupation and health.
- unskilled manual labors consistently had poorer health status compared to professionals.
Culture and Health
- Human thoughts and practices are culturally immersed.
- Different ways of explaining health and illness are different in different cultures and sociaeties - Known as casual ontologies
- Moral discourse of suffering is pervasisve in all cultures
- Sytems of health are considered either expert or folk. They interact with EO
- Western health has moved through classic=>Religious=>scientific stage.
- Chinese medicine is an expert system in china
- Ayurvedic medicine is popular in Southern Asia.
- Africa emphasizes spiritual aspects and communal orientation.
Disease (Clinical Health Psychology in Medical settings - Belar & Deardroff - Ethics)
- abnormality in physical structure or bodily function
- focus of biomedicine.
Illness (Clinical Health Psychology in Medical settings - Belar & Deardroff - Ethics)
- Human experience of sickness
- Is influenced by interpersonal, social and cultural variables (Hoffman 2002; Landrine and Klonoff, 1992)
Sickness (Clinical Health Psychology in Medical settings - Belar & Deardroff - Ethics)
Is thecombination of Disease and Illness
Cultural issues - Kleiman et al. (1978) on how to address patient's belief model
- Elicit patient's belief model with simple, straightforward questions
- Formulate the physician's model in terms the patient can understand
- Openly compare models to identify contradictions.
- Help the physician and patient engage in negotiation toward shared models related to treatment and outcome.
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