Lecture 1: introduction
Two important course topics:
Social problems
Critical public health perspective
Social problems
Health problems:
1. Mental health
2. Obesity
3. air pollution
4. Smoking
5. Substance abuse
Arguments
1. large part of the population is affected (scope of the problem)
2. it costs a lot of money
3. it is related to early mortality
4. it is linked to other health issues
5. it is unfair / inequality
6. Mental health 1, 2
7. Obesity 1, 2, 3, 4, 5
8. air pollution 1, 2, 3, 4, 5
9. Smoking
10. Substance abuse
We use different arguments to list problems and qualify them.
Introduction: health problems and policy
Why is hierarchy important?
Policy:
Setting priorities under the condition of limited means
Responding to numerous stakeholders, with different priorities and arguments
Why is it helpful o make a hierarchy of problems? Its been done even if we don’t like it., it relates to
fundamental tasks of policy making, it is abroad fields with many practices. Policy – you need to set
priorities under the conditions of limited means – It is about allocating money to certain issues. You
have to make priorities – if you are in that position you have to make choices base don arguments.
There are obviously there are organisations that want attention to their problems.
Health problems as social problems
How do health problems become understood as topics of concern for societies?
How do they become social problems?
It is about the question about how we perceive problems in out societies, how are these issues
understood in society? There are number of questions you can ask:
- How do we ‘measure’ this problem? – how many people are affected (many people have
headaches but it is not major concern in society but how it affects mortality)
- How are the different perspectives on the problem? and how are they in contradiction with
each other? People affected and people unaware of that?
- What are the consequences if they do or don’t? alcohol? What is the consequence of our
cultural norm to normalize it?
, - How are health problems positioned in a hierarchy of importance? How do we make
comparisons between problems? How do we as a society make a hierarchy? How different
people are categorizing problems and how do they see it? Different perspectives and people
trying to claim that their problem should be higher on the agenda
Are health problems individual, or social problems? Some health problems previously believed to be
individual become social problems
- ‘epidemic’
Common social problems: criminality, drug use, poverty, pollution and not all are health problems
Specifically health problems – major problem for somebody who is affected, when does your
personal problem something that society should be concerned about? When does you problem
become a social problem? It is dynamic, there are changes: depression is no longer an individual
problem but it has become a social problem, they become it so it changes.
When is something a health problem? What is the distinction between social problem and health
problem?
Many social problems have an health aspect to it, almost any social problem is related to health
- Criminal behaviour
- School abandonment etc
- Poverty
- Drugs
- pollution
There is no clear distinction
We also se trajectories where problems become seen (redefined) as health problems – redefining the
problem. Something that has to do with misbehaving of young boys to ADHD medical focus on it
So: no a priori distinction between health or non health , individual or social
Perspectives within this course
- Objectivist = what are the objective, measurable characteristics of health conditions
(however, does not explain ‘social problem’ status), most approaches take this approach:
what are the characteristics but it doesn’t explain why we find it a social problem, so we
think obesity is important so we measure it objectively
o What are the objective, measurable characteristics of health conditions?
However, does not explain social problem status
- Constructivist = how do people think of certain conditions, and why? Preceding question,
why do we consider certain issues important, how do we understand such issues? What are
the driving forces to understand an issue in a way? – linked to critical public health
perspective
o How do people think of certain conditions, and why?
Objectives
- Recognize the difference between objectivist and constructivist approaches to social
problems
- Understand what it means to see health problems as social problems
Critical public health – challenge of status quo (questioning hierarchy, what is behind the problems),
understanding what kind of problem it is? obesity – is it a personal problem or environmental
problem? Questioning our understanding of the problem, it is also important to look at the
understanding within a social context (it illustrates that problems are context dependent)
, ‘’critical public health is an approach that challenges the status quo in public health, questions what
have come to be defined as problems, and breaks down fundamental assumptions by considering
them within the context of the social systems in which they are created’’
Constructivist approach
- How and why particular conditions come to be constructed as social problems (and others
less so)
- Acknowledgement of multiple perspectives on problems
- Attempt to look for those perspectives (minority groups, patient groups)
- Comparative approach – it could be different, it can be different in another place, another
time and another social group, by acknowledging tha tit could be different it gives some
distance for understanding the problem; Comparative:
Time
Space
Social groups
- Critical assessment of data and their use. Critically look at the role of science and research,
critical assessment of data and how they are used, methodological choices highlight different
perspectives? Potential flaws – what was you sample? Contribution to perspective: how does
it contribute? Life narrative is different than a table
- Interest in power dynamics behind our understanding of problems, who has a certain stake?
Who has the power to stir the understanding of an issue
- Denaturalizing policy and policy assumptions – a lot of things are deemed peoples individual
responsibility (obesity for example – focus of individual used to be the focus but now it is
shift to environmental causes, intervene in people environment, material surroundings), so
changing it
- Rhetorics – persuasive techniques people use to make us look at a problem in certain way
Objective
Understand the constructivist approach and critical public health approaches and how they
overlap
Lecture 2: Disability studies and counterclaims
Try to be Critical of the data – misrepresent the issues, inconsistencies, id you see those, say it,
relevant to highlight
Disability studies
Technical aids – how they help people be part of society and what are the disadvantages of that
Objectives for this lectures:
- understand the structure of social problem claims
- understand that ‘the problem’ of disability is constructed in multiple ways
- this problem construction depends on the social and health policy context
(depends on the context, trained to understand problems within particular contexts)
Social problem claim around disability
Grounds – lots of people in wheelchairs, these people experience barriers in life, transport etc, ina
stigma
warrants – do something because they suffer form it, everybody should be equal
Conclusions – change policy and stigma, intervene in environment
