Samenvatting
Summary Key Concept List - Health & Society (7332A005AY)
- Instelling
- Universiteit Van Amsterdam (UvA)
Key concept list of the course Health & Society, given at UvA by Dr. L. Leopold.
[Meer zien]Voorbeeld 4 van de 33 pagina's
Voorbeeld 4 van de 33 pagina's
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Voorbeeld van de inhoud
Health and Society: Key ConceptsWeek 1:
Research question:
Summarise what the researchers want to find out, and why they want to find
that out.
Analytic research strategy / analytic approach:
How do the researchers answer the research question? What is their general
idea and what are the important steps?
The research strategy is the overall plan, to help the researcher choose the
right data collection and analysis procedure (considering time and resources
available).
Example: “Compared particular countries in order to learn about the effects of
context on health decisions.”
Research design:
How was the analytic strategy implemented?
Examples: Regression analysis, experiment, GWAS study, twin study,
qualitative study, etc.
Example: “Experimental design completed in two countries where you ask
participants to make health decisions.”
The research design is technical, not analytical.
Data:
Mention the specific data source, and whether the data is representative /
non-representative, and of which population.
Representative data are necessary for an accurate description, but non-
representative data are often large enough to answer the question of how one
thing is related.
Examples: Qualitative, quantitative, cross-sectional, longitudinal, etc.
Measurements:
How are health and the main analytic constructs measured? And are those
measures adequate for the purpose of the study?
Do not forget the control variables used.
Results:
, Provide a summary of the findings without an interpretation.
Conclusion:
Interpretation of the findings in the context of the specific research question,
analytic strategy, and in the context of specific strengths and limitations of the
strategy, design, data quality, and measurements of the key constructs.
Limitations:
Was the research question answered sufficiently or are there aspects that are
not covered well?
Week 2:
The definition of health (WHO, 1948):
“Health is a state of complete physical, mental, and social well-being, and not
merely the absence of disease and infirmity.”
‘Well-being’ in this definition connotes ‘soundness’ and ‘vitality’.
‘Absence of disease and infirmity' in this definition ‘completeness’ and ‘proper
functions’.
The WHO definition aims at summarising all those important connotations
and facets of health.
John E. Ware’s (1987) definition of health:
“Health connotes completeness, proper functions, and long life.”
This is a definition that aims to describe the idea of health that is similar
across cultures.
The distinction between mental and physical health is important for people.
Quantity of life (Ware, 1987):
Length of life expressed in terms of average life expectancy, mortality rates,
deaths due to specific causes, and numerous other indicators (matters more
for developing countries).
For developed countries – quality of life ≠ health (but health status is one
element).
The difference between illness and disease:
Definition disease (Idler, 1979): “Disease is an abstract, biological-medical
conception of pathological abnormalities in peoples’ bodies. Diseases are
indicated by certain abnormal signs and symptoms which can be observed,
, measured, recorded, classified and analysed according to clinical standards
of normality.”
Idler states that “Biomedical disease presents no data for sociological
analysis; it reveals no social facts.”
Definition illness (Idler, 1979): “the human experiencing of disease, is an
explicitly social phenomenon with both an objective and subjective reality. A
person’s experience of ill health includes both behavioural changes and
feelings of being sick, each of which are intimately related to the person's
social context.”
It is important to note that the absence of disease does not mean the absence
of illness, and vice versa.
Absence of illness is more important for individuals and for social policy than
the absence of disease. For example, it is more important that people can live
well with high blood pressure, than that people do not have high blood
pressure.
Why measure health?
The policy aim of WHO and governments world-wide is to improve health as
measured by WHO. To achieve this goal, monitoring health is important. We
need to be able to identify populations at risk and how their health changes
over time.
To monitor health we need measures of health that reflect the broad definition
of health, but also measures that are comparable between populations.
Health inequalities:
Health inequalities definition (Chat GPT): “Health inequalities refer to
differences in health outcomes or access to healthcare between different
groups of people or populations. These differences are often unjust and stem
from various social, economic, environmental, and structural factors. Health
inequalities can manifest in various ways, including disparities in health
outcomes, access to healthcare services, and exposure to health risks.”
Population health:
Population health definition (Chat GPT): “Population health refers to the
health outcomes of a group of individuals within a population, including the
distribution of health outcomes within the group. It encompasses the health
status of the entire population and the factors that influence health outcomes
at both the individual and collective levels. Population health focuses on
improving the overall health and well-being of communities, reducing health
disparities, and addressing the underlying determinants of health.”
Mortality rate:
, Calculated as number of death divided in the size of the population in a
specific age group.
Either standardised to cases of death per 100.000 or 1.000, but can also be
expressed in percentages.
The reason why mortality is used so widely to measure population health, is
because it is a helpful tool to measure development in countries. And also
because vital statics – such as mortality – are widely available.
Infant mortality rate (IMR):
The number of deaths of infants under the age of 1 per 1.000 live births.
Child and infant mortality rates still differ between world-regions.
Data quality differences:
From 1955 onwards, vital statistics are almost complete in high-income
countries. From the 1980s onwards, also in Central and Eastern Europe,
Central Asia, and Latin America. In Africa, South-, and Southeast Asia the
quality of data is improving, but worse than in other parts of the world. This is
why the WHO focuses on these areas with surveys to arrive at higher quality
data.
This is important to keep in mind when reading studies about country
differences in life expectancy (LE).
Life expectancy (LE):
Life expectancy (LE) is basically a summary of age-specific mortality rates,
this measure is more often used than the mortality rate because it measures
both the risk of dying and the length of life.
From an historical perspective, population health world-wide has improved
and population differences in health became smaller (but still remain very
large).
Life expectancy is calculated from birth.
The spikes in mortality between the 18th and 20th century that Johan P.
Mackenback shows, are caused by (a) large famines, (b) large-scale
epidemics, and (c) wars (these are however less visible due to the
interruption of data collection during war time).
Cohort life expectancy (CLE):
Cohort life expectancy (CLE) is an average age at mortality in a birth cohort.
To calculate the CLE, all members of the cohort must have died.
For now, we know CLE from those who were born approximately in 1920 and
earlier.
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