Chapter 4 book notes
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This 7 page Class Notes was uploaded by Gabriela Saint-Louis on Monday February 9, 2015. The Class Notes belongs to 1101 at George Washington University taught by Tamara Henry in Spring2015. Since its upload, it has received 275 views.
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Date Created: 02/09/15
Chapter 4 Social and Behavioral Sciences in Public Health How is Public Health related to the social and behavioral Sciences Social justice implies a society that provides fair treatment and a fair share of the rewards of society to individuals and groups of individuals Early public health reformers advocated for social justice and saw public health as an integral aspect of it How are Social Systems related to health Complex Interactions relationship between individuals and social systems is reciprocal meaning we in uence our social systems and our social systems in uence us due to constant interaction with our surroundings efforts aimed at improving population health require an understanding of the complex relationship between social systems and health Understanding levels of in uence within the social system Individual lifestyle factors characteristics of the indviidual including knowledge attitudes beliefs and personality traits age sex and hereditary factors Social and community networks points at which interaction with other individuals occurs can be divided into these levels interpersonal family friends and peers who shape social identity support and roles institutionalorganizational rules and regulations of institutions such as schools and places of employment that may limit or promote healthy behavior Community comprises informal and formal social networks and norms formed among individuals groups and organizations including cultural and religious practices General socioeconomic cultural and environmental conditions components of he surroundings external to individuals that comprise living and working conditions such as education housing work environment and healthcare services These conditions are shaped by public policy and laws at the local state and federal levels In uencing Behavior Berkman and Kawachi argue that social systems in uence behavior by shaping norms enforcing patterns of social control providing or not providing opportunities to engage in certain behaviors Reducing or producing stress for which certain behaviors may be an effective coping strategy at least in the short term ex college students may cope with stress around exam time by binge drinking to going for a run each choice having an effect on health Three key components of the social system and their relationship to health socioeconomic status culture and religion Socioeconomic Status 18005 social scientists developed the concept of socioeconomic status and elaborate systems to operationalize the de nition of quotsocioeconomic status and classify individuals in the US de nition included measures that are primarily economic family income 0 educational level or parents39 educational level 0 professional status or parents39 professional status In developed countries health status at least as measured by LE is strongly associated with socioeconomic status 0 Greater longevity is associated with higher social status Greater economic wealth usually implies access to healthier living conditions Education is also strongly associated with better health Higher education levels coupled with the increased resources that greater wealth can provide may increase access to better medical care and provide greater ability to protect against health hazards Individuals of lower socioeconomic status are more likely to be exposed to health hazards at work and in the physical environment air drinking water food social control and social participation control over individual and group decision making is much greater among individuals of higher socioeconomic status theory holds that the ability to control one s life may be associated with biological changes that affect health and disease Culture culture de nes what is good or bad and what is healthy or unhealthy Lifestyle patterns beliefs about risk and beliefs about body type ex in some cultures a large body type symbolizes health and wellbeing not overweight or other negative conditions 0 culture directly affects daily habits in life culture is also related to an individual39s response to symptoms and acceptance of interventions cultural differences should not be viewed as problems to be addressed but rather as practices to be understood Religion can have a major impact on health particularly for speci c practices that are encouraged or condemned by a particular religious group 0 ex circumcision reduce susceptibility to HIVAIDS Religious attitudes that condone or condemn the use of condoms alcohol and tobacco have direct and indirect impacts on health as well on exam social determinants of health refers to the conditions in which people are born grow up live learn work play worship and age as well as the systems put in place to deal with illnesses that affect health and quality of life shaped by economics social policies etc 10 key categories of Social determinants of Health 1 Social status 2 social support or Alienation 3 Food 0 quotfood desertquot term used to describe geographic areas that lack grocery stroes and other establishments in which lowincome individuals are able to purchase nutritious food due to high prices or inaccessibility housing educann work stress transportation place 10 access to health services 000 how do social determinants affect health recent increased attention on social determinants of health driven by connection with health disparities 0 Health disparities a type of difference in health that is closely linked with social or economic disadvantage Disparities occur in a wide range of health conditions including communicable and noncommunicable diseases and environmental health and safety 0 social determinants affect both physical and mental health mental health a state of successful performance of mental functioning resulting in productive activities ful lling relationships with other people and the ability to adapt to change and to cope with challenges mental disorders leading cause of disability in US mental health can impact physical health Can health behavior be changed behavioral change is possible for the better and for the worse some behaviors are easier to change than others why are some individual health behaviors easier to change than others along with knowledge incentivessuch as reduced cost increased availability or improvements in ease of use can encourage rapid acceptance and motivate behavioral change the most difficult behaviors to change are those that have a physiological component such as obesity r an addictive element such as smoking physical social and economic barriers can stand in the way of behavior change even if individual is motivated How can individual behavior be changed the forces at work to mold individual behaviors are sometimes referred to as downstream factors mainstream factors and upstream factors downstream factors factors that directly involve an individual and can potentially be altered by individual interventions such as addiction to nicotine Mainstream factors factors that result from the relationship of an individual with a larger group or population such as peer pressure to smoke or level of taxation on cigarettes Upstream factors are often grounded in social structures and policies such as governmentsponsored programs that encourage tobacco production how can health behavior be explained and predicted theory a set of interrelated concepts that presents a systematic view of relationships among variables in order to explain and predict events and situations Model a combination of ideas and concepts taken from multiple theories and applied to speci c problems in particular settings both are used by health researchers and health practitioners to gain insight into why people behave in healthy or unhealthy ways and to guide the development and evaluations of interventions aimed at changing behavior to improve health theories provide a useful framework to study health problems develop appropriate interventions and evaluate the impact of the interventions What are some key theories and models used to address health behavior Transtheoretical model Stages of Change the underlying assumption of this model is that people go through a set of incremental stages when changing behavior rather than making signi cant changes all at once very linear Stages of change Action Precontemplation Assessing readiness for change Individual not considering change Contemplation Motivate change Individual thinks actively about the Establish baseline to assess severity health risk and action required to of the problem focus attention on reduce that risk the problem and provide basis for comparison Preparation Set speci c measurable and Prepare for action including obtainable goals with deadlines developing a plan and setting a Recognizing habitual nature of timetable existing behavior and remove associated activities Action Reinforce change Observable changes in behavior Providesuggest tangible rewards with potential for relapse Positive feedback and encouragement of new behavior Maintenance Maintain change New behavior needs to be Practicereinforce methods for consolidated as part of permanent maintaining new behavior lifestyle change Relapse Restart process Goes back to behavior Theories and models are categorized according to three levels of in uence 1 intrapersonal focusing on characteristics of the individual including knowledge attitudes beliefs motivation selfconcept past experiences and skills Interpersonal Focusing on relationships between people acknowledging that other people in uence behavior by sharing their thoughts advice feelings emotional support and other assistance population and community focusing on factors within social structures such as norms rules regulations policies and laws How can theories be applied in Practice Choosing a theorvmodel gtUUl 39 U39l identify the health issue or problem and the population affected gather information about the issue population or both identify possible reasons or causes for the problem identify the level of interaction intrapersonal interpersonal or community under which the reasons or causes most logically t identify the theory or theories that best match the level and the reasons or causes Planning Frameworks a variety of approaches can be undertaken to app9y theory to practice Two useful approaches social marketing and the PRECEDE PROCEED framework social marketing a use and extension of traditional product marketing has become a key component of a public health approach to behavioral change social marketing is the use of marketing theory skills and practice to achieve social change eg health promotion 0 example include the National Youth AntiDrug campaign uses social marketing efforts direct at young people including the quotParents The antiDrug Campaign The VERB campaignfocused on 913 year olds with a goal of making exercise fun and quotcoolquot for everyone not just competitive athletes Social marketing incorporates which are widely used to structure traditional marketing efforts 0 Product identifying the behavior or innovation that is being marketed 0 Price identifying the bene ts the barriers and the nancial costs Place identifying the target audiences and how to reach them 0 Promotion organizing a campaign or program to reach the target audiences social marketing often relies on branding branding includes words and symbols that help the target audience identify with the service can be seen as a method of implementing the fourth quotp or promotion also builds upon the rst three quotPsquot requires a clear understanding of the product or the behavior to be changed product 0 successful branding puts forth strategies for reducing the nancial and psychological costs price 0 identi es the audience and segments of the audience and asks how each segment can be reached place Branding is the public face of social marketing but also needs ot be integrated into the core of the marketing plan
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