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Health resilience and sustainabilty
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LecturesLecture 1 31-9-2021
Objectives
• To understand the concept of the health gradient.
• To be familiarized with different models of health and disease from a sociological point of
view.
More generally, to answer the questions:
• Why would sociologists be interested in health?
• What is a sociological perspective on health?
• Why a sociological perspective on heath?
Health (illness) and sociology → Health (illness) does not randomly occur in the population but it
reflects general systemic inequalities.
The health gradient
• Materialist (structuralist) explanations.
• Psychosocial explanations.
• Cultural behavioural explanation.
Materialist (structuralist) explanations
Disease is shaped by society: who gets sick, how they experience the condition, how they will
diagnosed and treated, how they will recover, etc.
Health: between individual and societal responsibility.
Social, political and economic factors beyond the control of individuals adversely affect their health.
• Link the biological with the sociological.
• Large-scale physical organisation of the living spaces.
• Isolation (both socially and from health services), e.g., due to lack of access to transportation.
• Work related hazards and injuries.
• The content of the work itself (low autonomy, high workload).
• Structural changes in the labour market and the institutional makeup.
The default of the American lifestyle has three fundamentals:
1. Displacing human energy with mechanical energy.
2. Displacing household food production with industrial food production.
3. Displacing health maintenance with medical dependency.
Displacing human energy with mechanical energy.
• Before industrialisation physical activity was necessary as there were no machines;
• The number of jobs requiring moderate physical activity has decreased;
• The work-related physical activity has decreased in this period of time with more than a
hundred calories.
Labour market flexibility, cumulation of atypical jobs and health.
,Labour market positions:
• Typical employment (open-ended contract) – the golden standard, high security.
• Atypical employment (fix term contract, self-employment, etc.) – high insecurity.
• Looking for job – high insecurity.
Atypical employment for early career workers:
• Easier to enter the labour market.
• Try out different jobs, looking for the perfect match.
• Higher time flexibility (e.g., for self-employment).
• Similar legal protection as the employees with open ended contracts.
• But… gender differences for example?
It is not the contrast between secure and insecure jobs that impacts health but the cumulation of
insecure positions!
Health – a conclusion
Health is not exclusively the responsibility of individuals!
• Society shapes the life of individuals, creates and exposes them to conditions that influence
their health;
• Clearly seen in the persistent health inequalities that follow the usual dimensions of
stratification in society;
• The debate on who has responsibility for taking care of the ‘bad’ health outcomes depends on
the stance on the issue of responsibility (individual versus society).
Lecture 2, 7-9-2021
Objectives
• To be familiarized with different models of health and disease from a sociological point of
view. Cultural behavioural and psychosocial explanations.
• To understand the concept of different vulnerability.
Last week we talked about materialistic (structural)
explanations, this lecture is about the cultural
behavioural explanations.
In our life we have general socio-economic, cultural and
environmental conditions and we have our age and sex
as constitutional factors, but there is also something in
between and we call this life style factors.
, Life style factors are the things we as human being do and like. It is how we live, what we do, which
clothes we wear and how we act. Life style factors also conclude:
• Physical activity
• Smoking
• Drinking
• Diet
And therefore they influence our health.
In the end this model can be created:
Bourdieu’s theory of TASTE also argues life style as an important factor in health. TASTE as a way
to create distinction through embodied lifestyle (a system that posses a common thread).
The psychosocial model → link the biological with the sociological. It is a theory about how society
‘gets under the skin’ and makes people sick. Examples of this theory:
• Susceptibility (approachability) to common cold liked to the strength of social relationships
• High levels of job stress associated with high levels of morning cortisol
• Life course accumulation of risks related to higher allostatic load
• Neighbourhood characteristics and perceived neighbourhood environment related to allostatic
load
Allostatic load refers to the cumulative burden of chronic stress and life events. Allostatic load as a
measure of cumulative stress exposure. It is the:
• The price that the body pays when constantly being in a state of alertness due to objective or
perceived stressors;
• "The wear and tear on the body" which grows over time when the individual is exposed to
repeated or chronic stress;
• A dysregulation of various physiological systems;
‘Our perceptions and cognitive-emotional responses to
environmental stimuli can, and do, influence patterns of
physiological activity and reactivity
How stress works, the physiology of the acute stress response:
Step 1: primary mediators for example secretion of stress
hormones.
Step 2: secondary outcomes:
• Metabolic and cardiovascular systems increase activity in
order to mobilize energy.
• Activity of other systems is affected for example the
immune system, memory and reproduction.
Step 3: tertiary outcomes (basically bad health).
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