Social Context of Health & Oral Health

• What are the 4 key components of health inequalities according to Link & Phelan?

  1. The cause (socioeconomic status) influences multiple disease outcomes

  2. The cause affects disease outcomes across multiple risk factors

  3. The cause involves access to resources that can assist in avoiding health risks or to minimise the impact of disease once it occurs

  4. The association between a fundamental cause & health is reproduced over time via the replacement of intervening mechanisms
• What did Link & Phelan suggest in 1995?

  Social conditions actually act as fundamental causes of disease & if you remove those social conditions, the disease would not occur
• what is the epidemiological triangle?

  it is the multicausal explanation that looks at the relationship between the agent, the host and the environment

  
  

  - the environment can either act as a buffer ( protecting the host from the agent= preventing disease) or can be the cause of the agent coming into contact with the host (encouraging disease)

  
• What are the 5 theories of disease causation?

  - Germ theory-

  monocausal (one germ causes each disease)

  
  

  - Epidemiological triangle-

  multicausal, disease = agent + host + environment

  
  

  - Web of causation-

  multicausal, complex interaction of factors

  
  

  - Theory of general susceptibility-

  explores why some groups more susceptible than others

  
  

  - Socio-environmental approach-

  based on risk factors from social & physical environment
• Variations in Disease Patterns

  
  

  describe health in the Modern Industrial Era (1850 AD onwards)

  There was a decline in death/disease due to:

  - improvements in nutrition, personal hygiene, public health measures and medical interventions

  - increase in amount of food available

  - real value to wages and general standard of living was rising

  - dramatic increase in caries and tooth loss. Also, big increase in sugar consumption
• Variations in Disease Patterns

  
  

  describe health in the Agricultural Era (2000 BC - 1850 AD)

  - there was the development of farming which led to changes in living patterns and population density, diet, and growth in social patterns of health and diseases

  - the major cause of death was infectious disease

  (plague was the most significant cause of death in Europe)

  - diets become more define so pit and fissue caries and decay increases
• Variations in Disease Patterns

  
  

  describe health in the Pre Agricultural Era (8000-10000 BC)


  - there was no settled agriculture and less communal living

  - diseases were passed to humans through animal vectors and included parasitic invasion, mites and malaria

  - malnutrition, starvation, and trauma were also common

  - most deaths were due to hunting accidents and exposure

  - minimal caries due to non-carcinogenic diet
• historical perspective

  
  

  what has happened in relation to health over the years?

  • Death rated halved over last 150 years

  • Life Expectancy Increased

  • Developing World Life Expectancy Still low
• What is the Department of Health definition of oral health?

  Oral health is the standard of health of the oral and related tissues which enables an individual to eat, speak & socialise without active disease, discomfort or embarrassment and which contributes to general wellbeing
• What are the 6 dimensions of health?

  Physical health- concerned with the functioning of the body

  Mental health- the ability to think clearly & coherently

  Emotional health- to recognise & express emotions such as fear, joy, grief

  Social health- to form & maintain relationships

  Spiritual health- concerned with either religious beliefs & practices or personal creeds & principles of behaviour

  Societal health- closely linked to the environments they live in
• What is the WHO (world health organisation) definition of health?

  A state of complete physical, mental, and social wellbeing and not merely the absence of disease or infirmity
• what are the disadvantages of the biomedical model?

  - ignores subjective reactions and meanings.

  This can lead to down playing the experiences of patients in relation to the results of (e.g.) physio-chemical tests

  
  

  - focuses on pathology

  (but it is possible to feel ill without having a disease)

  
  

  - makes non allowance for the fact that disease can be present with no symptoms
• What are the key characteristics of the biomedical model?


  - Scientific rationality

  (knowledge/methods that help understand disease and seek to eradicate it)

  
  

  - Objective numerical measures

  (normal parameters for the functioning body have been set and are used to make objective comparisons with data collected from the patient)

  
  

  - Physio-chemical data

  
  

  - Mind/body dualism

  
  

  - Views of disease as objective, concrete entities
• what is the biomedical model?

  The biomedical model understands health as the absence of disease, considering purely physical factors and excludes psychological, environmental, and social influences.
• how are diseases identified?

  via the biomedical model
• what is disease?

  a biomedically defined pathology which may or may not be apparent

  
  

  - only identified by doctor/dentist
• what is illness?


  a lay interpretation of bodily/mental symptom as normal/abnormal

  
  

  - relies on the subjective self analysis of what is/is not normal

  SOCIALLY CONSTRUCTED CATEGORY
• what is sociology?


  the term sociology is derived from the Latin socius which means social or being with others and the greek logos which means study.

  
  

  -> Sociology is the study of social life, social change, and the social causes and consequences of human behavior.