Hlsc120

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What is Sociology?

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The study of the relationship between the individual and society; it examines how human behaviour both shapes and is shaped by society or how “we create society at the same time we are created by it”

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Culture

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the values, beliefs, behaviours, practices and material objects that constitute a person’s way of life.

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What are some components of culture?

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symbols, language, values and beliefs, norms, mores (norms that are more crucial to our lives than others), folkways.

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WHO definition of health

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- “Health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity”

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Globilisation

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“a social process in which the constraints of geographical social and cultural arrangements receded and in which people are becoming increasingly aware they are receding”.

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Postmodernity

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a blurring of boundaries, a breaking down of structures, a levelling of hierarchies, generalised lack of trust in designated order and expertise, difficulties in preserving identity and focus on surface and image, a move from a labour economy to a market economy, anxiety and fear of the void, modernity did not solve problems, it created them.

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A blurring of boundaries

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more focus on global than on nation states (ordering goods online), gender blurred (reassignment, unisex clothing, bisexuality), blurring between real and virtual, multiculturalism, break down of gender specific roles.

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A breakdown of structures

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increased marriage/relationship breakdowns, society structures, loss of trust in previously stable institutional structures.

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Lack of trust in designated order and expertise

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lack of confidence in “experts”, people often use internet to confirm doctors diagnoses, loss of confidence in society’s institutions.

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- Difficulty in preserving identity and focus on surface and image

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people can express individuality through their image, focus on surface and image, people change their image frequently.

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- Move from labour to market economy:

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people will go into debt to live in the global marketplace, people in developing countries used as cheap labour

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- Culture shock:

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a state of bewilderness and distress experienced by an individual who is exposed to a new, strange or foreign environment. Behaviour that seems normal to us may deeply offend others from a different culture.

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- Ethnocentrism:

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viewing others from one’s own cultural perspective with an implied sense of cultural superiority based on inability to understand or accept the practices and beliefs of other cultures.

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- Cultural safety

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: key features include awareness and respect for cultural differences, self-reflection and analysis of power inequalities and trust defined by the patient.

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the iceberg effect

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observable behaviours appearance etc. (may or may not be obvious), out of own or others awareness (beliefs, norms, expectations.

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cultural revitalism

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different cultures respect the legitimate adaptation of different peoples to various historical, natural, social and political environments.

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how does the federal government define an aboriginal person?

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someone who is of Aboriginal descent, identifies as an Aboriginal person.

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what was the purpose of the 2012 recognition bill

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amend the constitution to recognise Aboriginal and Torres strait islander people.

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what was life like for indigenous people pre-invasion?

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boundaries of geographic and language, the dreaming, nutritional differences (hunter gatherers had more adequate diet) and quality of life determined all aspects of life.

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mythology

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‘truths’ expressed in stories for daily living to secret importance.

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dance

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concerns everyday living, influence of creator beings, incorporates community.

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totems

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symbols of relationship between people and nature.

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rituals

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contact with supernatural world renews spiritual vitality, creation stories, and physical markings.

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What impact did government involvement have on the indigenous population?

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people forced to live outside land/country, loss of rights, large numbers on reserves, removed access to traditional foods, social structures changed and forced cultural changes.

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what does QOL determine

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- Quality of life determines all aspects of life, including control over their physical environment, of dignity, of community self-esteem and of justice.

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What is the indigenous approach to disease?

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cause of disease is a breaking of taboos or the supernatural, sick individuals seen in context of social and spiritual.

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What is involved in the biomedical model?

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individual approach to diagnoses and therapy. Social/physical is seen as outside the professional realm. Surgical/medical interventions.

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What is the purpose of the 'close the gap' program?

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to ensure that Aboriginal or Torres strait islander people enjoy a healthy life equal to that of the general population.

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what is needed to improve Aboriginal health?

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integrated approach to community development, indigenous control of decision making, adequate resources, improve workforce skill level.

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What are the primary health care principles?

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social justice and equity commitment, consumer/community decision making, accessible services, affordable technology, services based on the needs of the population.

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what is the aim of the Vic Aboriginal Health Strategy 2012-2022?

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reducing rate of Aboriginal perinatal mortality, increasing proportion of children participating in health visits, reducing smoking among teenagers, reducing number of adults who currently smoke, helping older people access information and support.

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what is discrimination?

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distinction, exclusion or restrictions affecting a person.

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what is stigmatisation?

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to mark out or describe as something bad. Generally based on stereotypical and uninformed impressions.

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What is stigma?

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any personal characteristic associated with social rejection or discrediting.

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what are the three types of stigma?

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tribal stigma, deviations in personal traits, overt or external deformations.

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- Primary and secondary deviance:

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primary – person begins to employ his/her behaviour or role based upon stigma as means of defence or attack. Secondary – ultimate acceptance of stigma or label.

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What is marginalisation?

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process through which individuals or groups are peripheralised on the basis of their identities, associations, experiences and environments.

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What is social exclusion?

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driven by unequal power relationships across economic, political, social and cultural environments.

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what are the levels of marginalisation?

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individual prejudice attacks, institutional, cultural assumptions, values and presumptions.

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what is discrimination ?

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referring to treatment taken towards or against a person of a certain group based on class or category.

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what is the social inclusion agenda?

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learning by participating in education and training, working by participating in employment, volunteer work, family and caring, engaging by connecting with people and using local community resources.

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what are some health issues in the indigenous population?

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significantly more likely to have a long term illness, health problem or disability. High infant mortality, perinatal and maternal death rates.

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how were missions and missionaries involved when indigenous Australian's lost their land?

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controlling by restricting their movements while settler moves in and takes over, lost most of their cultural heritage, aboriginal language and initiation not allowed.

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what did the northern territory intervention do?

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2006 – NT established another review to report all government must contribute to preventing sexual abuse against children. 2007 – little children are scared report. Resulted in a national emergency response to protect Aboriginal children.

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NTER

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acts of parliament passed as there was support for the political commitment and resources promised.

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What is NTER?

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Northern territory emergency response

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what were some concerns of the NTER

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use of army to lead implementation, suspension of sections of racial discrimination act, compulsory health checks for children.

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What were the 5 areas of health impact assessment

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physical health, psychological health, social health and wellbeing, spirituality, cultural integrity.

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what will national congress do?

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advocate for the recognition of rights, work towards securing a good future and build new relationships within communities.

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what won't national congress do?

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provide service delivery or funding for public programs, have representatives handpicked by government, and be dependent on the good will of parliament.

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why was the constitution changed to recognise indigenous Australian's?

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amending to acknowledge special place of first peoples, important to build a nation based on strong relations and mutual respect.

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what does the federal government fund?

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medical services, pharmaceuticals, public hospitals, residential aged care, and community care.

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local government funding

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clean water, garbage control, health inspections, and immunisation programs.

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state government funding

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acute and psychiatric hospital, community and public health services ie schools, dental, maternal and child health, occupational health, disease control, health inspections.

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medicare

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access by all eligible Australian residents for free or low-cost medical, optometric and public health care. Admission to public hospital and aftercare is free.

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pharmaceutical benefits scheme

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provides subsidy for agreed prescribed medications. Safety net covers people with high medication expenses.

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international visitors and healthcare

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reciprocal agreements with some other countries. These visitors are eligible for Medicare assistance for medically necessary treatment.

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health expenditure

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direct out of pocket expense of the GP chooses to charge more than scheduled fee. 75% of scheduled fee paid by Medicare.

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choice of private health care

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private hospital make up 1/3 of hospital beds, most dental and allied health services are provided by private practitioners.

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private health insurance

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government subsidises cost and provides incentives for people to maintain insurance. People will high income pay levy if they don’t have insurance. - Ambulance services: Medicare does not cover ambulance transport.

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issues with the current health care system

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bed shortages, staff shortages, lack of rural services, hospitals need to be upgraded, lack of funding.

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what can you do for good health?

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get vaccinated, fluoridated toothpaste, reduce alcohol intake/illicit drug use, eat more fruit and veggies, and increase physical activities.

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what are some preventative strategies?

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shared responsibility, act early and throughout life, engage communities, influence markets and develop coherent policies, reduce inequality through targeting, ‘close the gap’, refocus healthcare toward prevention.

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what does APHRA do?

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works to make sure appropriate organisations investigate community concerns, supports boards in development of registration standards, codes and guidelines.

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what are the different registration types?

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general registration, limited registration, non-practicing registration, student registration.

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what are the social determinants of health

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- social and economic circumstances affect health

- stress harms health,

- social exclusion creates misery and costs lives,

- job security increases health wellbeing and job satisfaction,

- healthy food is important,

-good social relations improve health at home and in the community.

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what is the S.A.F.E strategy?

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surgery, antibiotics therapy, facial cleanliness, environmental improvements.

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what are the problems with access to mainstream services?

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cultural chasm between clients and providers, impersonal clinic nature, large numbers of non-indigenous people.

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what is good practice?

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Recognised set of sound procedures and practices, successful achievement of outcomes, inclusive and respectful interpersonal behaviour.

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debunking myths

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specific government programs have been introduced for indigenous people because they are the most socially and economically disadvantaged group in Australia.

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cross-cultural connections

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initial attitudes – openness, acceptance, trust, suspicion, fear, prejudice. Inevitable reactions – frustration, confusion, tension, embarrassment. Coping strategies – observe, listen, and inquire. Reactive responses – criticize, rationalise, and withdraw. Results – rapport and understanding, alienation and isolation.

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before you make contact

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build your knowledge of the community you are working with my getting to know people.

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gaining trust

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maintain confidentiality, don’t act or speak in a superior manner, share your own experiences, don’t generalise about stereotypes, and listen to needs.

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building trust

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it may take a while, a breach of trust will get back to the client.

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phone contact

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leave a message if they don’t answer saying you will call back if you don’t hear from them today.

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referrals

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some people need to be directed to appropriate service, don’t assume yes means yes, admit you don’t know and don’t promise anything you can’t deliver.

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cultural competency

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capacity of professionals to work efficiently, effectively with individuals within cultural beliefs and benefits.

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3 components of cultural competency

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knowledge – a broad understanding.

Values – being aware of own values and being able to move apart from them.

Skills to develop – in order to work more efficiently.

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what is social stratification?

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Sociological study of the distribution of power wealth and income in society

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what are the levels of marginalisation?

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Individual acts of prejudice, ignorance and hatred (intentional and unintentional)Institutional policy, practices and norms (intentional and unintentional)Cultural assumptions, values and practices.

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levels of interaction

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The four dimensions – economic, political, social & cultural - interact at different levels

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findings of the burdekin report 1993

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People affected by mental illness are among the most vulnerable and disadvantaged in our community. They suffer from widespread systemic discrimination and are consistently denied the rights and services to which they are entitled.

Individuals with special needs - children and adolescents, the elderly, the homeless, women, Aboriginal and Torres Strait Islander people, people from non-English speaking backgrounds, those with dual or multiple disabilities, people in rural and isolated areas and prisoners - bear the burden of double disadvantage and seriously inadequate specialist services.

The level of ignorance and discrimination still associated with mental illness and psychiatric disability in the 1990s is unacceptable and must be addressed.

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people with mental illness

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Today people experiencing mental illness may receive treatment and care against their will.Each State or Territory has a specific Act which governs the care and treatment of people with mental illness.

Within these Acts specific requirements are set out to protect the rights of people with mental illness.

However, people with mental illness still experience stigma, exclusion and physical ill health compared to the rest of the population.

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Health professionals interface with the concept of marginalisation in 3 important ways:

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We must be able to understand the experiences of marginalised people;

We need to understand the physical and psychological consequences of social marginalisation;

We must understand the process of marginalisation.

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Prevention paradox

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Treating diseased or high risk individuals does not have much impact on the population as a whole. But changing a risk factor across a whole population by just a small (and often clinically in significant amount) can have a large impact on the incidence of a disease or problem in the community

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why focus on a healthy public policy?

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Acceptance that major influences on health status that are outside the immediate control of the individual.HPP regarded as means to create:

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Social inclusion priorities

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Supporting children at greatest risk of long term disadvantage – health, education and family relationship servicesHelping jobless families with children – unemployed into sustainable employment and children to a good start in lifeFocusing on locations at greatest disadvantage – tailoring place based approaches in partnership with the communityAssisting the employment of people with disability or mental illness – creating employment opportunities and building community support servicesClosing the gap for indigenous Australians – with respect to life expectancy, child mortality, access to early childhood education, educational achievement and employment outcomes

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government response to the social inclusion agenda

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The Social Inclusion Agenda is about a socially inclusive society where all Australians feel valued and have the opportunity to participate fully in society. Achieving this through …Learning by participating in education and training;Working by participating in employment, in voluntary work and in family and caring;Engaging by connecting with people and using their local community’s resources; andHave a voice so that they can influence decisions that affect them.

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what is reflective practice?

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The ability to reflect on action to engage in a process of continuous learningCharacteristic of professional practiceFormal or informal process – journaling, group debrief or personal reflection

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what are the four components of the sociological imagination template?

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structural, cultural, critical, historical

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social construction

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Refers to the socially created characteristics of human life based on the idea that people actively construct reality (Keleher & MacDougall, 2011).A theory exploring how knowledge and interpretation of meaning results from social interaction, exercise of power and the broader social environment (Willis & Elmer, 2011).`

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biomedical model of health

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Western society’s focus on illness as a malfunction of the body’s biological mechanisms;Focus on treating individuals;Ignores social origins and prevention of illness;

Focus on illness as a malfunction of the body’s biological mechanisms;

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health and medicine

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“Many would be surprised to learn that the greatest contribution to the health of the nation over the past 150 years was made, not by doctors or hospitals, but by local government.”

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illness

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a highly personal state in which the person’s physical, emotional, intellectual, social, developmental or spiritual functioning is thought to be diminished. not synonymous with disease and may or may not be related to disease. highly subjective; only the individual person can say he or she is ill (Stanley, 2012, p. 351).
Illness is an outlook that understands a specific malady, whatever it’s particular causes, as created in the convergences between biology and culture

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parsons sick role theory

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Represents illness as a ‘failure’ to maintain normal social roles [Gerhardt, 1989, in Gray, 2006];Characterised by passivity, helplessness and emotional disturbance – seen as failure in society that values activity, competency and emotional self-control;

Critiqued for limited application to chronic, terminally ill and permanent disabling conditions;Uncritical acceptance of the role of medical profession;

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social determinants of heath

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The economic, social and cultural factors that directly and indirectly influence individual and population health

are the conditions in which people are born, grow, live, work and age, including the health system.

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WHO social determinants of health

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Early years’ experiencesEducation Economic statusEmployment or lack ofEmployment typesHousingEnvironmentEffective systems of preventing and treating ill health

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global health promotion

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1986 WHO Ottawa Charter for Health Promotion1988 WHO Adelaide Recommendations on Healthy Public Policy1991 WHO Sundsvall Statement on Supportive Environments for Health1997 WHO Jakarta Declaration on Leading Health Promotion into the Twenty-first Century

2000 WHO Mexico Ministerial Statement for the Promotion of Health: From Ideas to Action; Framework for Countrywide Plans of Action for Health Promotion

2005 WHO Bangkok Charter for Health Promotion in a Globalized World [Richmond & Germov, 2009, p. 479]

2011 WHO Rio Political Declaration on Social Determinants of Health, Rio de Janiero, Brazil

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Ottowa charter

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Move towards a new public healthBuilding healthy public policyCreating supportive environmentsStrengthening community actionDeveloping personal skillsReorientating health servicesOttawa Charter goals = social /holistic model of health

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ottowa charter: pre-requisites of health

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peace shelter educationfoodincomea stable eco-systemsustainable resourcessocial justiceequity

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primary health care

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Based on practical, scientifically sound and socially acceptable methodsTechnology made universally accessible to individual and familiesIncorporates the spirit of self reliance and self-determinationIntegral part of the health systemFocus on social and economic developmentFirst level of contact is the individual and familyBring health care as close as possible to where people live and workFirst element of a continuing health care process

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Canadian Public Health Association Statements on Social Determinants of Health

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Policies shape how money, power and material resources flow through society and therefore affect the determinants of health. Advocating healthy public policies is the most important strategy we can use to act on the determinants of health. Current policies that emphasize deficit reduction and private sector economic growth can be unhealthy for people.These policies may increase economic inequalities, environmental degradation, social intolerance and violence.

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social model of health

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Focus on social factors: life, work, love, right relationshipHealth & illness are social constructionsIndividual and community responsibility for health is assumed Health alterations (illness) determined by social inequality (see social determinants of health) Public policy and broad health promotion Goals: promote health, reduce inequalities & prevent illness

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the income gap

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the top 20% and the bottom 20% of weekly incomes1994/5 - 1999/2000 the mean weekly income of the bottom 20% of Australiansincreased from $96 to $136 an increase of $40 over 5 yearssame 5 years the mean income of the top 20% of incomes rosefrom $1407 to $1765an increase of $359

1994 to 2003, two million Australians, or 10% of the households, increase of $26 a week“That miserable $26 will not enable a household to go to a footy match, to half-fill a petrol tank for a day out, or to repair a broken appliance” St V de PaulCompare that with the top 10% of income earners who got an increase of $762 a week,