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Health in society short summary including all chapters of The New Public Health (Baum), lectures, reading questions for discussion in seminars and main points$8.04
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Health in society short summary including all chapters of The New Public Health (Baum), lectures, reading questions for discussion in seminars and main points
Summary for health in society including:
Short summary of all chapters of The New Public Health (Baum),
Lectures given by John de Wit,
Reading questions with answers for discussion in seminars,
Main points to prepare for exam.
Important subjects are highlighted, including the subjects that wer...
College aantekeningen Health in society (201900017)
Health in Society Book Summary 2020
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Universiteit Utrecht (UU)
Algemene Sociale Wetenschappen
Health in Society
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Book: The New Public Health (Fran Baum)
Chapter 1. Understanding health (definitions and perspectives)
What is health? → complex outcome, results of genetic, environment, socially, political
and economic factors. In Western society unhealthy is seen as undesirable (cultural).
5 main perspectives on health:
- the clockwork model of medicine (biomedical perspective); health is seen as the
body that operates efficiently, with components that can breakdown (illness)
- illness → individual experience (cultural specific)
- disease → objective, with a set of signs/symptoms/medically abnormalities
- definition of health according to World Health Organization (WHO):
The complete state of physical, mental and social well-being, and not
merely the absence of disease or infirmity (including mental health)
- health as defined by ordinary people with three domains relating to the definition;
- health is not being ill; it is a necessary prerequisite for life's functions (a
resource); it is a sense of wellbeing express by physical and mental terms.
- health can fulfill different functions for different people:
- health seen as self-control (health to achieve through healthy
behaviour, with internalization of medical knowledge, middle-class)
- health as a release mechanism/freedom of control (health as a goal
to achieve through instrumental action by the working class)
- critical understanding of health; explanation of the purposes of defining health.
- health as an outcome; mechanisms and measures of the particular interventions.
- health as a characteristic place/environment; defining collective health → health
promotion with a broader view of health (social, physical, economic factors).
Public health is focussed on populations and changing risk factors to change population
health (prevention), rather than focussing on individuals risk.
Chapter 2. A history of public health
Health was seen as part of life, then it became, in colonial legacy, a public effort for
controlling disease and healthier living environments. There was control of infectious
disease/emphasis on sanitary measures. Intervention existed of provision of clean water
and sanitation. Mckeown thesis → decline in mortality as a result of improved living
standards. The nation-building era was focused on creating a pure race; maintaining
health was then the duty of citizens. Later there came state intervention
(housing/education), with a focus on improving daily life (clinical medicine, expanding
hospitals and health services). New public health era → focus on collective measures,
emphasis on poverty and social justice in public health policies. Development of healthy
public policy and policy support. Global new public health → recognition of public
health as global public good.
Chapter 3. The new public health evolves
Five strategies of the ottawa charter for health promotion (1986):
- development of healthy public policy;
- creation of supportive environments;
- the strengthening of community actions;
- the development of personal skills;
- reorientation of health services to interventions that are community based.
,It is about advocacy for health, enabling people to achieve their full health potential and
mediation between different interests in society for the pursuit of health.
Public health became the creation for healthy living through:
- closing the health gap between social groups and nations;
- broadening the choices of people to make healthy choices;
- ensuring supportive social environments.
→ public health reflects the social and economic climate.
The social determinants of health are the circumstances in which people are born, grow
up, live, work and age, and the systems put in place to deal with illness. These
circumstances are in turn shaped by a wider set of forces: economics, social policies, and
politics.
Chapter 4. Ethics, politics and ideologies: the invisible hands of public health
- democratic/undemocratic
- liberal/authoritarian
- egalitarian/inegalitarian
The new public: democratic, liberal and egalitair, with citizens that express their views
through institutions, it is not value-free, as it reflects a set of ideologies and values.
Consequentialism → The outcomes determines the good or the bad of that decision.
Deontological → ethical decision is based on moral principe. The process determines the
rightness of an action (human rights arguments are based on this → ´natural rights´).
Utilitarianism → the greatest good for the greatest number.
Victim blaming → consequent of individualism, blaming the victims for their ill health.
Victim blaming is simplistic and ignores the social, cultural and economic context.
Behavioral justice refers to the concept in which individuals should be held responsible
for maintaining a healthy lifestyle, but only when they have the resources to do so.
Even though there is an increasing evidence that illness and health are produced by
social, economic and environmental structures, policy solution are still focused on
behavior change.
Biomedical/psychosocial perspective → individual focus. Epidemiological perspective →
exposure to physical, economic, social and cultural factors. Social-structural perspective
→ societal factor.
Chapter 5. Neoliberalism, globalisation and health
Neoliberalism is about the reliance on economic factors, with the believe that the free
market should determine all economic transaction. Open competition is good for
efficiency. Intervention is then seen as supporting inefficient industry. The justification
for neo-liberal policies lies in the belief that policies that encourage economic growth will
be beneficial for human health and well-being. The argument is that wealth will trickle
down so that eventually everyone benefits from economic growth.
Neoliberalism is proving unhealthy for populations. It has a detrimental effect on health
and equity. There are equities that are social, political and economic in origin. From a
public health perspective, they can be tackled if we can create political, economic and
social arrangements that make trade fair, reduce inequities and improve health.
, Chapter 6. Research for new public health
The growing realisation that health/illness reflect the structure, culture, power
relationships, economy and politics of a society created that public health is seeking to
understand more about health and disease (not only immediate cause of disease)
Chapter 7. Epidemiology and public health
Epidemiology looks at describing the distribution and extent of disease in population;
identifying the cause of diseases; and assessing the effectiveness and efficacy of
intervention to prevent, control and treat disease.
Incidence refers to the number of new cases of disease occurring in a defined population
over a specified time period (expressed as a proportion of the total population, the
denominator). Prevalence refers to the number of cases of disease that exist in a defined
population at a particular point in time; rates will depend on the duration and incidence
of a disease.
Chapter 9. Qualitative research methods
Participatory action research (PAR) → seeks to understand and improve the world; it is
a different understanding of research and emphasis is put on collective participation, the
process and product of research. Researchers and participants focus on understanding
and improving the practice in which they participate and have a reflective process which
exists of understanding the history, culture, local context and social relationship.
Chapter 10. Planning and evaluation of community-based health promotion
Community based public health projects are based on social and environmental
understanding of health and the assessment of needs is based on physical and social
environments that help keep people healthy. Evaluation has to be flexible enough to
accommodate policy and community change, and encourage reflective practice.
Chapter 11. Changing health and illness profiles in the 21ste century
Social determinants of health → the conditions in which people are born, grow, work, live
and age (and the wider set of forces and systems shaping the conditions of daily life).
Data demonstrate that health is an extremely unequally divided resource globally.
Rich countries have longer life expectancy and less disease burden and more resources.
In Africa, life expectancy is declining in a significant number of countries. The challenge
is to ensure that health is evenly divided so that the gaps in life expectancy between rich
countries and others are reduced.
Chronic disease are the leading causes of illness, disability and death in Western
society. Because it is typical in rich countries, there is a recognition that has lead to
chronic diseases being viewed as a disease of wealth (affluence). However, chronic
diseases are also affecting middle- and low income countries.
Chapter 12. Patterns of health inequities in Australia
Poverty has a strong influence on health. Absolute poverty was used as a concept in
developed countries, until the rising living standards in the twentieth century and with
that a shift to relative poverty. Now a population can be said to be in poverty when
people can't cover essential living costs (basic living standard) or have a lack of
opportunity to participate fully in society.
Healthy migrant effect: those who opt to move country are likely to be healthier and
have less existing sickness and disability. Second, the government selection process
uses health status as one of the criteria for excluding potential migrants.
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