Sociology of health lecture 4 and 5

state of complet physicial mental and social well being, and not merely the absence of disease

Health is a resource for everyday life, not the objective of living. Health is a positive concept emphasizing personal resources, as well as physical capacities.

improvement in healthcare has made only a minor contribution to the massive improvementsin population health between mid 19th and mid 20th centuries in the developed world.

increased sanitation and nutrition and social welfare

mckeown noticed that mortality was decreasing before scientific advances were made

a person's social and economic position in society exerts a powerful influence over their health throughout their life.

• 50% your life i(income, disability, race etc. )
• 25% your healthcarae
• 15% your biology
• 10% your environment (infrastructure, air quality etc. )

• flow in part from social stratification
• determine differences in exposure and vulnerability to risk
• ex. genetics, physiology,gender

• Flow from social stratification
• ex. family environments, peers, health knowledge, beliefs, school, community

related to economic and social resources and opportunities that influence an individuals access to health promoting living, working conditions, and healthy choices

economic/political/social welfare on a national scale

conditions in which people oare born, grow, work and age. These circumstances are shaped by the distribution of money,power and resources at a global, national, and local level.

actual deaths- predicted death

is a measure of preventable illness

no

education and income

susceptibility to cold virus

• unable to control events in your life leads to increased stress
• chronic streess elevation
• macaque monkeys: non-dominant monkeys had lower life expectancy even though they shared the same environment.

avoidable differencesin health status closely linked to social, economic and /or environmental disadvantage

Inequalities in population health status are related to inequalities insocial status

the idea is to reduce the disparity between each quintile of classes

• mortality in developed countries is affected more by relative than absolute living standards
• indirect effects: risky behaviours
• direct effects: physiological effects of chronic stress

• Increases in economic development has less influence on health outcomes after a certain point in economic development
• -country changes from disease burden to chronic disease burden because of expansion of health services"
• -thus diminishing returns on life expectancy after certain amount of economic growth

Tasks that threaten self-esteem or social status increase stress the most.

Not after a certain threshold. A Developed country's  population life expectancy can be more accurately predicted by socioeconomic status

more unequal distribution of wealth

Is associated with trust between citizens.

• mortality more related to relative income within countries than differences in absolute incomebetween them
• national mortality rates tend to be lowest in countries that have smaller income differences, thus lower levels of relative deprivation
• long-term rise in life expectancy seems
• unrelated to long-term economic growth rates

since Wilkinson's hypothesis highlights the importance ofrelativedeprivation, psychosocial pathways may be particularly important

• Income inequality has increased,richest increase their share while middle and lower class lost share. 
• Not a single province became more equal over the past 30 years
• richest 1% make 15% more than average Canadian

• not a significant problem in Canada overall
• but very high in Nunavut and other territories

The higher the education of immigrants, the greater the disparity between employment rates of immigrants and non-immigrants

• Increase in low income share, decrease in middle income share
• wealthier areas=lower diabetes=greater distance to grocery stores=greater concentration of fast food

SDOH accumulate over the course of a lifetime to affect an individual

• Medication therapy
• disease state manager
• public health advocate
• attitude/approach

• increase awareness of disparities
• more diverse health care force
• promote culturally competent care
• effective communication between HCP and patients
• multi-disciplinary teams + EBM
• collect and monitor data on health disparities 
• research health disparities

• patient's dont know how best to take meds or concerned about side-effects
• community health worker addresses their concerns (ppl intimidated by pharmacists); helps to reduce preventable drug related morbidity

• health
• human capital
• social relations