HSBH1003
Allied health providers eligible for chronic disease management scheme.
(1) Aboriginal and Torres Strait Islander Health Practitioner (2) Audiologists (3) Chiropractors (4) Diabetes educators (5) Dieticians (6) Exercise physiologists (7) OTs (8) Osteopaths (9) Physios (10) Podiatrists (11) Psychologists and Mental health workers (12) Speechies
Key issues that people from culturally, linguistically diverse backgrounds (CALD) experience
(1) Language differences (2) Lack of knowledge about available services (3) Varying cultural attitudes to health and services (4) Professionals lack of understanding of cultural issues (5) Patient-practitioner interactions
How does one's social status affect their health status?
- It can determine the types of health behaviours including risk-taking (e.g. smoking, alcohol abuse) and positive behaviours (exercise, healthy eating). - Australians who belong to the low SES experience higher rates of illness and premature death - Affect on the tedency to use preventive health services Example: The life expectancy of Indigenous Australians is 12 years less than the national average.
Criterion used to diagnose someone as abnormal
-Distress or disability -Maladaptiveness -Irrationality -Under Predictability -Unconventionality -Observer discomfort -Violation of moral and ideal standard.
Social Anxiety Disorder
-Distress or impairment that interferes with is or her ordinary routine in social settings at work or school -Person's fear or anxiety is out of proportion to the actual situation.
The five explanations of health inequality
1) Artefact - suggests class related health differences are due to biases involved in the measurement and recording process -certain measures both of class and health are bias and of imperfect validity -sometimes it's due to the relative size of occupational class groups - class and health believed as artificial and that statistics create an inaccurate measure of social phenomena. I.e. "The premise of this argument is that everybody' health is getting better and that the widening inequalities are caused by a small, shrinking group in the poorest occupational classes." (Wilkinson, 1997; Evans et al., 1994) Example: people belonging to low SES have higher numbers working in dangerous working conditions and thus they would have higher rates of illness However, this explanation does not acknowledge that there's a clear relationship between social class and health rather than solely on differences in income (wealth I.e. Poor/rich). 2) Natural/Social selection - derived from social darwinism, suggesting that health inequalities are normal and proposes that poor health in early life will result in health disadvantages e.g. disability and thus social disadvantage e.g. poverty. Example: Cogenital disabilities (inherited) However it neglects the social and environmental factors affecting health and illness. 3) Cultural/Behavioural - focus on individualistic behaviours (risk-taking and illness-related behaviour) that cause health inequality such as smoking, drug-taking, excess alcohol consumption, poor dietary intake - as the primary causes of health and illness. It is criticised for victim blaming and over simplistic account of inequality. 4) Materialistic/Structural -Focus on the role of social, economic, and political factors determining distribution of health and illness such as poor living and working conditions. Examples: Poverty, discrimination, lack of education, and employment opportunities, inadequate nutrition, and housing on illness. It avoids victim blaming and explores the class structure of society (proposed by Marxist and Weberian theories) However it neglects the individual and natural selection approaches. 5) Psychosocial/social capital - concerned with the social origins of illness with a main focus on the income inequality and psycho-social factors Examples: Stressful work environments and unemployment causing increased levels of stress, insecurity, anger, depression in the community. It highlights that health inequality is due to unequal distribution of wealth. If society was more egalitarian it would promote better life expectancy and hence less likely to experience health inequality.
Styles of Parenting
1) Authoritarian: High on Control, Low on support 2) Authoritative: High on Control and rules but also high in warmth and support 3) Indulgent/Permissive: Low control, High Warmth 4) Neglecting: Low on control, low on warmth
Issues with trait theory
1) Fail to explain why AHPs are poorly paid and have low status and are subordinated to medicine. 2) Ignores the political and historical conditions under which occupations professionalise 3) Lack recognition of relationship between gender and professionalisation.
The benefits of the social model of health
1) Focuses on the social determinants of health and illness that results in health inequalities: class, gender, ethnicity and occupation. 2) Provides equal opportunities to access health services and treatments 3) Considers the how culture and social influences affect on the perception of health and illness e.g. cultural beliefs, social practices and institutions.
What are the four elements of social imagination?
1) Historical factors: How the past influences the present. 2) Cultural factors: Cultural values, beliefs 3) Structural factors: How particular forms of social organisation affect our lives e.g. roles, work duties on health of workers 4) Critical factors: how to improve the health of individuals by improving the social environment
Limitations of the biological model
1) It leads to victim blaming. - By placing the cause on the victim and cure of the disease on the individual. The health and illness is viewed as the "individual's responsibility". It focuses on the effect of personal factors on health such as poor genetics, poor lifestyle choices. 2) It ignores the social factors that affect on health and illness such as living condition, and working environment, education. E.g. Accessibility to nutritious food, and public housing
What characteristics is used to classify class in the three-class model based on a hybrid of Marxist and Weberian perspectives?
1) Ownership and control of scarce economic resources (mining) 2) Acquiring marketable skills and qualifications 3) Wage labour
What are the social, cultural and historical factors that influences the change in health of indigenous people?
1) Poverty 2)Unemployment 3) Lack of education about foreign illnesses 4) Foreign illnesses 5) Inadequate access to health service 6) Poor nutrition
The reasons for low service participation rates among Indigenous people include:
1) Sociological reasons: - historical, cultural, low SES and low rates of health determinants 2) Resistance against colonial oppression (mistreatment/abuse) and the concept/stigma/label of disability 3) Lack of aboriginal community services 4) History of distrust between Aboriginal and Non-aboriginal
What are the three dimensions of the social model of health
1) The social production and distribution of health a and illness (structural factors)- how illnesses are socially produced. e.g. illness arising from exposure to hazardous work which should be addresed at a societal level such as occupational health and safety legislation) e.g. examines the role of living and working conditions in causing and alleviating illness 2) Social construction of health and illness (cultural factors): how culture and time can impact on definitions of health and illness e.g. homosexuality viewed as a psychiatric disorder 3) Social organisation of healthcare (critical factors and structural factors): the way a particular society organises, funds and utilises health services e.g. unequal relationship between the HPS can prevent effecent use of health services and optimal delivery of healthcare to patients.
Medical dominance is defined by
1. Doctors as the most superior medical health profession 2. Doctors have great control over the work of other occupations (such as nurses and allied professionals) 3. Doctors are socially recognised as experts in matters relating to health.
The elements of the intergenerational cycle of disadvantage and health
1. Early childhood 2. Level of education 3. Employment 4. Housing/environment 5. Lifestyle 6. Stress 7. Unemployment 8. Control over one's life 9. Self-esteem 10. Substance and alcohol use 11. Food access 12. Social support 13. Socioeconomic status
Name social factors of health and illness that cause difference in health statuses.
1. Gender (Men vs Women) 2. Wealth( poor vs wealthy) 3. Socio-economic status (lower, medium, high) 4. Aboriginality (Indigenous vs Non-indigenous) 5. Class (Upper, middle, lower) 6. Age 7. Sexuality 8. Religion 9. Culture 10. Ethnicity
In which age group was the difference in the prevalence of the disability most significant between Indigenous and Non-indigenous australians?
40-59 age group - Indigenous people almost 3 times more likely
E-health
A form of communication technology i.e. any technological channels that influence and inform people about health behaviour's, knowledge, and needs; such as, internet, phone apps, print media and television. The limitation: - Older people and less educated people may not have access or ability to use E-health
Deprofessionalism
A general theory predicting the decline of medical status and power due to the public's increased education about health issues and diminishing trust in medical practice as a result of media exposes of medical fraud and negligence.
Dementia
A syndrome with the following clinical features... Impairments in.... -Memory, Judgement, Language -Executive abilities -Visuospatial Abilities -Abstract Thinking -Appropriate behavior
What process is used to minimise cultural conflict?
Acculturation - which is a process where members of one cultural group adopt the beliefs and behaviours of another cultural group.
Anxiety Disorder
Anxiety is a mood state characterized by symptoms of tension and apprehension about the future. Physiological symptoms -Restlessness or feeling on edge -Feeling Fatigues -Difficulty concentrating or mind going blank -Irritability -Muscle Tension -Sleep Disturbance
What are the two classes proposed by Marxist theory?
Bourgeoisie - middle class includes owners of production: factories, businesses and resources for wealth. Proletariat - lower class consists of workers Marx hypothesized that as more people are getting richer, the working class will rise up in global revolution and then the workers will own the means of production and the world will become a communist. However his theory did not come true, the working class developed skills and consequently gained higher wages but they were are still controlled by labour laws and protected by unions.
What functions do different parts of the brain carry out?
Brainstem: Controls breathing, HR and consciousness Frontal lobe: Planning Goals and Decision making Primary visual and motor cortex: (self explanatory) Limbic system... Amygdala: Controls emotions and formation of emotional memories. Hippocampus: Memory Acquisition Hypothalamus: Regulates motivated behavior
Piaget's Insights
Children Learn through two processes Assimilation-fitting new information into what is already known -> existing schema remain unchanged Accommodation- Restructures existing schemes or creates a new scheme, so new information is accounted for more completely.
What is the difference between class and socioeconomic status?
Class is based on the differences in life experiences such as lifestyles and cultural values that establish personal identity. Whereas socio-economic status is determined statistically by ranking people in terms of the social determinants of health and illness e.g. income, occupation and education levels; and dividing them intro three distinct groups: low, medium and high socioeconomic status.
Medicalisation
Defining and treating social issues or natural biological events (non medical problems) as medical issues such as illnesses, disorders or syndromes.
Professionalising projects
Defined as the strategies utilised to achieve occupational closure by increasing control over the provision of certain skills and competencies in a market for services. Social closure is described as setting boundaries around specified professional domains which consequently lead to power being exercised and exclude outsiders from privileges of social membership (in social classes, professions or status groups). Aims to achieve status that offers prestige and respect within the health system and facilitate optimal outcomes for patient care. E.g. AHPs and nursing tend to adopt professionalising projects of medicine, as subordinate groups they internalise the norms of the dominant group.
Ethnic minorities
Ethnic groups that are not the dominant ethnic group thus experience disadvantaged due to differences between different ethnic groups in society.
Negative Symptoms of Schizophrenia
Experienced by 25% of Schizophrenics Avolition -Apathy inability to initiate and persist in activities -Little interest in even basic daily functions Alogia -Poverty or relative absence of speech Anhedonia -Lack of pleasure of indifference in acts that would normally be pleasurable Affective flattening -An absence of normally expected emotional responses.
Explain Weberian's perspective of class
He believed that social class determined by ownership of property and wealth in addition to power and prestige. He proposed that property and prestige are interlinked as people who have property usually elicit prestige (reputation). He also reinforced that people who are wealthy often have more power and power can come from prestige.
Kasl and Lobb 1966 3 types of health behaviors.
Health behavior Illness behavior sick role behavior
Matarazzo 1984
Health-impairing habits Health protective behavior
Bipolar Disorder
Manic Episodes -Periods of persistently elevated, expansive or irritable mood with 3 of the following. -Inflated self esteem, grandiosity -Decreased need for sleep -Talkative, Racing thoughts -Distractibility -Increase in goal directed activity or psychomotor agitation. -Excessive involvement in pleasurable activities with potentially painful consequences.
What occurred in the twentieth century that increased the awareness of the role of social origins on health and illness?
In Australia there was a decline in the number of deaths from infectious diseases (i.e. tuberculosis and typhoid) and increase in life-expectancy. This was not due to medical treatments but the consequence of improvement in living conditions such as nutrition and resistance to the disease. (Proposed by McKeown's work) Szreter, S. suggested that the increased life expectancy was due to the state's redistribution of economic resources through improved working conditions and various public health measures such as better housing, food regulation, education and sanitation reforms.
Define health inequalilty
It is described as the different health statuses due to differences in population groups such as class, gender, age, ethnicity and aboriginality (i.e. the social determinants). Health equality is the outcome of equity when individuals belonging to a social group are given adequate resources and support in order to achieve the same healthcare opportunities as those belonging to more privileged individuals.
Define social class
It is the position in a system where individuals are placed in groups that are based on shared power, wealth, income, and status hence they typically share life chances. It is a social determinant of health and illness.
Define health inequity
It occurs when the distribution and access to opportunities are unfair amongst social groups. Health equity is the process of making sure that everyone is receiving equal opportunity to obtain health services.
Vygotsky's socio-cultural theory on
MKO (More knowledgable other) Zone of Proximal Development Scaffolding
Outline different methods to deal with stress
Physiological Techniques -Meds -Physical Activity Psycho-Physiological techniques -meditation Psychological technique Coping! -problem focused -Emotion focused
Stages of development
Prenatal Period (conception to birth) -single cell zygotes rapidly divides -Embryo appears organs form Infancy and Childhood -Prewired to survive-innate reflexes -able to recognize mother's voice -rapid development Adolescence -Sexual maturity -Brain Changes -Limbic System -Frontal Lobes Adulthood -Height and weight stabilize -Hormonal Changes -loss of skin elasticity -thinning/greying of hair
Outline cognitive methods of dealing with obesity
Problem solving Cognitive Restructuring (refer to notes)
Assimilation
Refers to the expectation that indigenous people and migrants will 'shed' their culture and be indistinguishable from Anglo-australians.
What contributes to the increase in rates of disabilities in aboriginal communities?
Risky behaviours e.g. lack of exercise etc.
Common risky behaviours in Indigenous people and consequences.
Risky behaviours: 1) Smoking 2) Harmful consumption of alcohol 3) Obesity Consequences: 1) Hospitalisation - for assault related injuries 2) Self harm (suicide and attempted suicide) -more frequently 3) Physical and sexual violence - prevalent in indigenous women
Feminist theory
Seeks to explain the subordinate position of women in society i.e. how the production of labour by women can reduce economic costs. E.g. Allied health professionals who are predominantly female cheapen the cost of labour in the acute care setting by being paid significantly less than doctors. - Female allied health professions aligns with the traditional notions of 'women's work' and associated 'devalued tasks'. -The feminist views the division of labour in the health system in a context of patriarchy I.e. the society wide system of male dominance. Doctors are predominantly male dominant and most allied health professionals are female. Thus females often experience negative wage discrimination, with a median wage of less than $5000 USD as compared with males.
The highest reported disability types in ATSI communities include:
Sensory, physical, cognitive and psychological
Outline Behavioral therapy strategies to reduce obesity
Stimulus Control- Using classical and operant conditioning to break associations between various stimulus and eating. Behavioral substitution -> replace the use of eating as a coping mechanism with a different action.
What are the subjective and objective dimensions of class?
Subjective dimension of class can be explained as how shared life experiences, class-based values and identities forms social groups. Objective dimensions of class can be explained as the unequal distribution of wealth and power embedded in the social structure, thus people are categorised by social hierachy of distinct classes.
The problem with the social organisation of healthcare
The dominant role of medical profession has the power to influence health policy and funding to benefit their own interests and degrading the value of preventive approaches, nursing, allied and alternative health practitioners. The discord b/w HP can prevent the optimal delivery of healthcare to patients.
Medical-industrial complex
The growth of profit oriented medical companies and industries whereby one company may own a chain of health services such as hospitals, clinics, and radiology and pathology services.
Ethnocentric or Ethnocentricism
Viewing other cultural perspectives as inferior to own's own due to being unable to understand or accept the practices and beliefs of other cultures.
Common long term conditions in indigenous population
Vision problems (long sighted/hyperopia; short sighted/myopia) Respiratory diseases (including asthma- twice as likely), Back pain, Arthritis Hearing problems Circulatory disease Diabetes- 3.3 times more likely in indigenous people than non indigenous
Are norms powerful and who can control them?
Yes They can influence behaviours that are expected within society. Individuals with power can establish norms of behaviour such as the pope and politicians. Power can be exercised directly or indirectly by these individuals.
Pharmaceuticalisation
an element of medicalisation, which social, bheavioural or bodily conditions are treated as medically e.g. drugs.
Elderly Iranian immigrants experience more poor health outcomes compared to the population of older Australians.
had higher levels of psychological distress, - -more limited physical function, - greater need for help or assistance with activities of daily living, - lower feelings of wellbeing, - much less likely to use aged care services than the general population of older Australians
Multiculturalism
is a policy that emerged due to the failure of the assimilation policy which disregarded the special needs of immigrant.
Trait theory
proposes that professional status can be attained by meeting a set of criteria that is usually defined as specialised expertise and training and self-regulation through code of conduct. Reflects the functionalist theory- in the assumption that the professions perform necessary functions for society and hence the criteria that define a profession represent essential characteristics.
Terra nullis
the Latin term used by the British to define Australia as a land that is unoccupied and belonging to no one and therefore open to colonization.
Dispossession
the removal of people from land to which they have traditional claims of ownership
Disease mongering
when the media and marketing campaigns aim to widen the diagnostic boundaries of illnesses and aggressively promoting their public awareness in order to expand the markets for treatment.
