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94 Cards in this Set
- Front
- Back
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meaning of health
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Physical, emotional, environmental well-being
Subjective Experienced in a social context Differences based on gender, racial ethnic, social class, physical ability, sexual orientation, type of illness Continuum |
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definition of disease
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Abnormality occurring in the structure and function of body organ and systems
Physiological |
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definition of illness
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Experience of disvalued changes in social functioning and state of being
Human experience of sickness |
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development of concept of health - pre 1900
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Health as an absence of disease
An unidimensional state |
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development of concept of health - 1950s
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State of complete physical, mental and social well-being (WHO)
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development of concept of health - 1974
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Lalonde Report
Health is influenced by a range of factors i.e. biology, lifestyle, health care organizations, social and physical environment |
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development of concept of health -1970s-80s
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Health is a way of living that involves learning, coping and development (Allen, McGill Model)
Multidimensional process of living |
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development of concept of health -1986
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“Achieving Health for All: A framework for health promotion” (Jake Epp)
Quality of life Health is a nation’s greatest resource |
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some determininants of health
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Income and social status
Education Social support networks Employment and working conditions Physical environment Biology and genetic endowment Personal health practices and coping skills Healthy child development Available health services |
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smith's four models of health
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Clinical Model
Role Performance Model Adaptive Model Eudiamonistic Model |
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smith's four models of health - clinical
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Narrowest and most limited model
Medical therapy restores the patient to health Diseases have the same symptoms in any social context Medicine is a socially neutral application of science to individuals just tracks the movement from signs and symptoms of disease to no signs and symptoms of disease |
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smith's four models of health - Role Performance Model
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Based on ability to perform work / fulfill societal roles
“Sick role” model “permission” to stay home when you’re sick, but obligation is to get better But…can have obligations that you don’t have to fulfill, but not always the case for women Making dinner, child care Potential loss of income sick = failure to perform social role, healthy is fulfill social role/ maximize output |
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smith's four models of health - adaptive model
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Goes beyond medicine to include illness prevention
Illness seen as a failure to adapt to your environment An individual who can cope is considered healthy But…an individual may fail to achieve health even if they are free of disease If their standard of living is too low, they may not have the means to adapt sick = failure of individual to adapt and respond, healthy = flexible and can adapt to environment |
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smith's four models of health - Eudiamonistic Model
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Broadest view of health
Most holistic—includes physical and psychosocial problems Illness is something that prevents an individual from attaining their potential Ability to become self-actualized sickness = failure to realize one's potential/deabilitated, health = able to realize one's potential, exuberant |
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Refreshing recollection
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Can use ANYTHING to jog the memory of the witness
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principles of medicare - universality
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every canadian is covered. But…waiting period for immigrants; Aboriginals are federal jurisdiction so leads to arguments between provinces and feds
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principles of medicare - accessibility
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Access to necessary health services
But…Innui flown south to have babies; poverty can stop people from going to see a doctor; buildings not adapted for the disabled |
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principles of medicare - comprehensive
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Birth to death health care coverage
Was originally supposed to include dental care, but…, what about medications? Long-term care facilities? Home care? |
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principles of medicare - portability
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You can carry your Medicare from province to province
But…differing pay scales may mean paying more |
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principles of medicare - administrative
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Each province should have a centrally controlled bureaucracy
But…differences in health care between provinces |
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Epp - Health promotion goals
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Reduce the inequities
Increase prevention efforts, Aimed at lifestyle Improve people’s ability to cope |
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Epp - Health Promotion Strategies
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Fostering public participation -Help people assert control over the factors that affect their health, E.g. self help programs, volunteer orgs
Strengthening community health services- Should coordinate services e.g. home care, respite care, Coordinating healthy public policy- All policies directly affecting health should be coordinated e.g. income security, employment, education, housing etc. |
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Epp - Limitations
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Focused on behaviour change
Based on an inadequate understanding of the determinants of the behaviour Overlooks the importance of other factors, e.g. SES, gender, social roles, race, ethnicity etc. Fails to examine the context of behaviours |
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Royal Commission on the Future of Health Care in Canada “Romanow Report” (2002)
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Royal Commission on the Future of Health Care in Canada “Romanow Report” (2002)
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UN Definition of Illiteracy
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An illiterate person is someone “who cannot, with understanding, both read and write a short simple statement on his everyday life”
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The International Adult Literacy Survey - definition of literacy
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Defined literacy as: “the ability of adults to use written information to function in society, to achieve their goals and to develop their knowledge and potential”
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The International Adult Literacy Survey - Types of Literacy
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Prose Literacy
Document Literacy Quantitative Literacy |
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The International Adult Literacy Survey - Prose Literacy
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The ability to understand and use information from texts such as new stories or fiction
canada ranked 5th |
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The International Adult Literacy Survey -Document Literacy
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The ability to find and use information from documents such as maps or tables
ranked 8th |
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The International Adult Literacy Survey - Quantitative Literacy
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The ability to make calculations with numbers embedded in text, i.e. balancing a chequebook
ranked 9th |
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The International Adult Literacy Survey - Canadian Results
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Level 1: 22% Difficulty reading; few basic skills or strategies for working with text; aware they have a literacy problem
Level 2: 26% Limited skills; read, but not well; need simple and clearly laid out materials; may not recognize their limitations Level 3: 33% Can read well but may have problems with complex tasks; the minimum skill level for successful participation in society Levels 4 & 5: 20% Strong literacy skills was very high on rankings but there is a large range between very high and very low scores. women do better on prose, men do better on document and quantitative |
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The International Adult Literacy Survey - Lessons
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There is a strong influence by a child’s family environment and parental educational background on the development of literacy
A nation’s population is more likely to have healthier habits where literacy is higher People with higher literacy tend to be more involved citizens Literacy is linked to economic success Contributes to a country’s overall economic and social performance Literacy is not fixed Education affects literacy, but it’s not the only factor |
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Definition of Information Literacy
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The ability to “recognize when information is needed and have the ability to locate, evaluate, and use effectively the needed information”.
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Links between Literacy and Health
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systemic: limits opportunities, resources, and ability to make lifestyle choices. affects nutrition, mental health, ability o prevent illness. negative effect of life expectancy, higher rate of disease. more likely to live or work in an unsafe environment.
health specific: may prevent people from understanding health info, lacks ability to understand instructions, unaware of resources, makes people feel powerles when dealing iwth health care professionals. their health: poorer overall health, misuse medications or misunderstand health information, not use services appropriately, may wait longer to seek healthcare (so their health problems are always reaching crisises) |
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information literacy - skills
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Determine the extent of information needed
Access the needed information effectively and efficiently Evaluate information and its sources critically Incorporate selected information into one’s knowledge base Use information effectively to accomplish a specific purpose Understand the economic, legal, and social issues surrounding the use of information, and access and use information ethically and legally |
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health literacy - definition
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“The wide range of skills and competencies that people develop over their lifetimes to seek out, comprehend, evaluate, and use health information and concepts to make informed choices, reduce risks, and increase quality of life.”
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Zarcadoolas, Pleasant and Greer, 2006 - multidimensional model of health literacy
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Fundamental literacy
Scientific literacy Civic literacy Cultural literacy |
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Zarcadoolas, Pleasant and Greer, 2006 - multidimensional model of health literacy - Scientific Literacy
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Knowledge of fundamental scientific concepts
Ability to comprehend technical complexity An understanding of technology An understanding of scientific uncertainty and that rapid change in the accepted science is possible |
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Zarcadoolas, Pleasant and Greer, 2006 - multidimensional model of health literacy - Civic Literacy
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Media literacy skills
Knowledge of civic and governmental systems and processes Knowledge of power, inequity and other hierarchical relationships Knowledge that personal behaviours and choices affect others in a larger community and society |
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Zarcadoolas, Pleasant and Greer, 2006 - multidimensional model of health literacy - Cultural Literacy
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Recognizing, understanding and using the collective beliefs, customs, worldview and social identity of diverse individuals to interpret and act on information
Should be bilateral |
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Benefits of Health Literacy
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Empowerment
Shared decision making Improved clinical decision making Improved self care and self management in chronic disease Improved patient safety Reduced health inequalities |
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scientific basis of women's oppression - early 1900s
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Ovaries & uterus are the controlling organs.
Thought to be the cause of common ailments Normal processes seen as diseases (e.g. menstruation, pregnancy, menopause) Oppression of woman through “womanness” |
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scientific basis of women's oppression - psychology
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Freud
Basic (gender) differences exist, rooted in biology -“anatomy is destiny”, Normal women are docile, passive, Penis envy: Women are masochistic: enjoyed being humiliated Erikson - ‘The Eight Stages of Man’: human development based on male life cycle, Women= abnormal Vaillant & Levinson Linear timing of events model: childhood, schooling, work, marriage, childrearing, retirement, death. |
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Popular health movement
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1930s: began. hydrotherapy, herbalism, and natural health developed from it. very connected to the beginnings of organized feminist movement. ama developed as a resopnse to divergent views
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women's health movement in women's lib
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abortion law reform, product safety, self-help. our bodies, ourselves. more than just reproductive issues, but a beginning of women-centered care, with the establishment of women's resource centers in hospitals
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sex vs gender
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sex is a biological construct that can influence reaction to various stimuli. estrogen gives us a biological advantage. gender: socially-mediated norms and expected roles in society- dimension of social organization shaping our access to resources and how we interact and think about ourselves.
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benoit and shumka - health determinants - 4 types
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fundamental determinants (macro), access to key resources (meso), proximal determinants (micro), morbity and or mortality
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benoit and shumka - health determinants - fundamental determinants
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sex, gender, social class, race, ethnicit, immigrant status, age, geographic location
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benoit and shumka - health determinants - access to key resources
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employment, education, childcare, safe neighborhoods, health services
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benoit and shumka - health determinants - proximal determinants
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smoking, diet excercise
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women's knowledge of gender differences (study)
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diabetes - women are the biggest rise in this illness but 48% of women thought men and women experiencing same rise
heart disease - has significantly different symptoms for women, but only 36% of women are aware, arthritis- 2/3 of canadians living with arthritis are women are women are 2ce as likely to be disabled by arthritis, but only 45% of women didn't know depression - women are twice as likely to experiece depression (thought to be due to lower serotonin secretion), but 61% were unaware that rates are different lung cancer- women are 1.5 times as likely to develop lung cancer (even if they have never smoked), but 1/3 of women believe men and women develop at same rate |
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biological differences in relation to drugs
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smoking- more negative effect on cardiovascular health inwomen, women are less successful in quitting than men and have more withdrawal symptoms
anesthesia- women tend to wake up faster alcohol- women will have higher blood aldohol level even when corrected for size, because of their fat composition and less gastric enzyme that breaks down ethanol. side effects to drugs (esp. antihistamines, antibiotics) effectiveness of drugs (antihypertensive) pain (some pain medications are more effective in women - kappa-opiates) |
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heart disease: differences between men and women: statistics
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kills more women than men, different risk factors, diabetes increases the risk more in women, symtpoms are different, relative effectiveness of certain tests/treatents, women more likely to have 2nd heart attack wtihin a year;
women with heart disase often not taken seriously, do not receive the apporpiate tests and treatment to prevent complications, older women at clear disadvantage (esp after menopause, because they live alone more often and have a lower income/education, |
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gender stratification
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women are more likely to be poor (pay inequalities), more likely to live in inadequate housing, less represented politicallymore likely to report multiple chronic conditions and disability than men (But men have higher rates of premature death and potentially avoidable mortality), longer life, but lower quality of life.
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gender stratification : STI's
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less control over bodies, so while men are more likely to be infected with HIV, one quarter of new infections are women (this is rising), ad the risk factors vary. gonorrhea in adolescent women is twice as high. lowdermilk 2007
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women and healthcare system- attitudes of health professionals
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women recieve less throrough evaluations, less attention to their symptoms, fewer interventions for same disease
more likely to believe women's illnesses are 'emotional in nature' recieve less explanation in response to questions women have pap tests and mammograms more frequently if health professional is female |
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future of women's health
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increased funding for research, aging population (increased life expectancy, women as caregivers), policy and legislation
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health research- defintion
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studies designed to provide information on health, illness or disease. purpose is to learn how our bodies work, why we get sick, and what we can do to get and stay well. goal: improve health, advance knowledge of condition, and to find new ways to treat and prevent disease
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types of health research
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observational, epidemiological, intervention, prevention, clinical, qualitative, quantitative
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health research - observational studies
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follow the same group of people over time. ex: framington heart study, nurse's study
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health research - epidemiological studies
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epidemiological studies: look for patterns of disease in large groups of people - for example following flue outbreaks
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health research - intervention studies
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intervention studies: look at ways to change behaviours that effect health, ex: how increasing excercise affects weight and diabetes
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health research - prevention studies
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look for ways to keep people form getting sick, often involve people who are at risk of getting sick or a particular disease. if it's a drug or vaccine then it's a clinical trial. if it's a change of behavior it's an intervention study
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health research - clinical trials
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begin after lab and animal studies, show that hte therapy is safe and likely to be effective, volunteers are used to monitor the expected effects and side effects.
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health research - qualitative
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use the participants' words to try and understand meanings and experiences of health, illness and disease; use methods such as semi-structured interviews of participant observation
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gender bias in research
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androcentric bias in defining research priorities. focus of "objective but really it's gender biased. gender is a factor you ahve the control for.
lack of funding for clinical researh on women (except to control her reproductive health) (1991- NIH launches the Women's Health Initiative so there is $$ for research. CIHR's Institute for gender in health 2000) failure to recognize the effects of gender on health and illness - women have been treated based upon information primarily gathered from men, some diseases are defined as 'male' like HD, important differences between the sexes |
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beliefs that exclude women from research
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research organizations were afraid they'd damage women's reproductive systems, research dominated by men who believe the male body is the norm, belief that controlling for women's fluctuating hormones would add to cost, belif that women couldn't leave kids, fear of women becoming pregnant.
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women in research is important cuzz
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provide information on new ways to treat women-only diseases or diseases that disproportionately affect women. allows for identification of differences in response before it is widely available, help to identify how diseases affect women and men different. help answer questions abou thelaht differences,but must have women of all races, ethnicities, and economic groups in order to ensure research data is complete
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how can we overcome gender bias in research
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understand the difference it makes to recognize gender bias
researchers should acknowledge how their background influences studies have people with more backgrounds doing research multi-disciplinary or cross-disciplinary research methods to gain an understanding from a variety of perspectives, have more women in decision making positiosn, |
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women and CVD: doctor knowledge
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1/3 doctors surveyed said they did not know that CVD is the leading cause of death among of women. lack of awareness due to: exclusion of women from clinical trails, so unclear diagnostic criteria and treatment; inability to recognize women's 'atypical' symptoms, tendancy to minimize CVD symptoms in women and attribute them to emotional issues
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women's work - historical perspective
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because of how women in the workforce have historically been seen, now their paid work is often considered as temporary and supplementary income as compared to their husband's. women have always worked, it ust depends on whether or not it is valued (aka unpaid work is not valued).
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women's work- demographic perspective
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labor force participation ^ as children ages, women do remain in the workforce in childbearing age, lone parents are less likely to be employed than partnered, represents change from 70s but mainly represents change of social assistance programs and changing nature of marriage (married women are allowed to work)
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women's work - double shift
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work is any form of productive labor activity that contributes fo the supply of valued goods and services. women still fulfill most childcare respnsbilities, unpaid but important. women's work is regulary unpaid and invisible.
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multiple roles - role strain
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goode 1960 - women burdened by multiple roles. has a detrimental effect on mental health.
role overload: women have lack fo resources to meet all goals role conflict: incongruity of expectations of roles |
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multiple roles: role enhancement
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each additional role brings a benefit. more social support because of more networks, satisfied in one role may offset difficulties in another
People who are able to fully participate in & perform multiple roles role balance: Less role strain, lower rates of depression, higher self-esteem and innovation express individuality and act autonomously in accordance with or in opposition to normative expectations important factor for personality, intellectual development. multiple roles = better health for many. financial stability can have buffer effect and make them feel more socially connected |
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multiple roles: contemporary
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harmful vs. beneficial effect depends on: characteristics of role, specific combination of roles, socio-economic context of women's lives
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multiple roles: factors that influence stress
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role balance (priorities)
flexibility (job flexibility, trust in caregiver, spousal help) conflict (compartamentalize!, Greater conflict between roles equals greater distress) children (depends on relaitonship) time stress - may be an upper limit to beneficial effects, caring for elderly parent single strongest predictors of stress in women income - high income = more options for childcare, more flexible work schedules, reduced stress, single mothers with low-paying jobs have less flexibility and poorer health outcomes "gendered" social policies - daycare policies, maternity leaves aboriginal status- more likely to report lower job, parental and marital quality than canadian population social support- need to feel integrated into network to reap benefits |
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2003 women's health surveillance report - partnered vs single
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partnered mothers report better mental health; employment didn't have a significant effect on distress or chronic stress levels, rates of personal stress are lowest among unemployed partnered mothers. probably based upon economic stability and proven mental health benefits of tempering stress in teh domestic sphere with work pursuits.
irrespective or employment status, single mothers are signficantly more likely than partnered mohters to be poor, have financial stress and food insecurity and be more stressed. unemployed single mothers report high levels of distress. children raise stress levels, especially if the mother is single |
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women's roles - workforce participation
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3 year study - women who increased workforce participation less depression, women who decreased had increase in symptoms of depression
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multiple roles in midlife
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midlife transition- departure of children form home "empty nest"- may lead to depression or liberation. adult children returning home may lead to renewed tension
mother + wife + caregiver role - negative and positive effects (role straing from balancing all responsibilities, lots of assistance needed, affect job performance, absetneeism, increased job stress vs. enhanced self-esteem, strengthens identity, informal support networks, improved access to resource,s improved relaitonship with husband) |
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workplace health risks
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gendered- men's jobs have obvious physical risks, but women face more subtle, cumulative risks. women's are slow developing and have fewer accidents
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workplace health risks - musculoskeletal disorders
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injuries/disorders involving muscles/bones. usually long-term. represent a serious health problem for working women, many factors predispose women to these types of injuries (design of equipment and workstations, repetative motions, prolonged standing).
prevention - identify and alleviate risks of repetitive movements and prolonged standing, equipment and owrk areas should be designed to be safe for all employees, proper body mechanics when lifting, use proper posture and positioning when working at a computer. |
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workplace health risks - toxic exposure
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exposure to chemical and biological toxins- leads to development of allergic reactions, cancer or respiatory disease, can be reproductive hazards. research in these areas has focused primarily on men
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causes of workplace stress
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Lack of supportive workplace policies
Unfair pay Childcare concerns Inflexible scheduling Lack of control at work Boring, repetitive work Strained work relationships Workplace violence/sexual harassment |
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psychosocial effects of stress
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low job satisfaction and poor sense of wellbeing
long term exposure to job stress can lead to higher levels of depression and anxiety but research consistently shows that working women are healthier than nonworking women |
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barrier to research in women's workplace safety
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health advocates may not adequately identify occupational health problems
fear of being viewed as complainers fear that women may not be viewwed as fit for the job not wanting to state that women have specific workplace health problems difficulty working wtih male-dominated unions |
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joliette institution - healthcare assumptions
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The human body, mind, and spirit form a whole.
Women have the capacity for self-care and self healing. Events and interactions in the family, the community and the world affect the health care of women. Health care is a shared responsibility. Health reflects integrity, flexibility and capacity to develop and transcend difficult situations. Control over one's body is a basic right. Lived experiences are the starting point for future action. Women's health settings vary. The health of all is improved by focusing on women's health |
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joliette institution - main health problems
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Cardiac problems-16%
Diabetic-4% Hep C and/or B-24% HIV-5% AIDS -0% Colposcopy-22% Chronic headaches-10% Gastro-intestinal problems-46% Constipation-21% Asthma/Chronic Bronchitis-25% Eating disorders- 5% Methadone- 3% much higher rates of HIV and HPV than the non-incarcerated population |
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joliette institution - percentages requiring psychiatric care
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psychiatric counselling needed - 64%
one or more suicide attempts - 65% most common conditions: victims of sexual violence during childhood- 73% substance abuse - 52 antisocial personnality disorder - 28 serious depression 15 schizophrenia 4 |
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definition of mental illness
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“Mental illnesses are medical conditions that disrupt a person's thinking, feeling, mood, ability to relate to others and daily functioning.” according to NAMI, they are characterized by DSM
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Wright - Gender Specific mental illness
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Hormonal changes and women’s sexuality have explained why women are given diagnoses such as depression or anxiety disorders
Construction of madness has been the way to control women The 19th century saw a growth of asylums Men sought to control women’s reproductive biology Women were seen to be dangerous and their madness was due to their sexuality and biology (menopause, hormones, etc) “rest cure” was one of the most prescribed repressive treatments - usually used to treat outspoken women During the 19th century, mental illness was considered to be feminine Once women are labeled as disturbed, they are treated unfavorably compared to men |
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mental illness- women specifics
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women dominate in common mental disorders. many risk factors disproportionalely affect women (gender based violence, socioeconomic disadvantages, low income and income inequality, low social status and rank, unremitting responsibility for care of others). women have higher emotional intelligence, whcih means they have greater risk
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anxiety - definition
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Anxiety disorders are a group of disorders which affect behaviour, thoughts, emotions and physical health. People suffering from an anxiety disorder are subject to intense, prolonged feelings of fright and distress for no obvious reason. The condition turns their life into a continuous journey of unease and fear and can interfere with their relationship with family, friends and colleagues.
types: panic disorder, phobias, post-traumatic stress disorder, obsessive-compulsive disorder, generalized anxiety disorder most common disorder (18.1%), more common among women |
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personality disorder- definition
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American Psychiatric Association (APA) defines as "an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it”
Consequently: diagnosis is somewhat subjective and sensitive to cultural norms women have always sought therapy more than men, women generally get different diagnoses (dependent, histrionic, or borderline vs eccentric) |
