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Specific Social Factors Affecting Health

Specific Social Factors Affecting Health. Age Sex Race SES Marital Status. Age. Machine analogy Spencer and organismic theory “wall” of longevity Chronic vs. acute disease. Gender. Women uniformly live longer than men Male fetuses are aborted more often than female

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Specific Social Factors Affecting Health

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  1. Specific Social Factors Affecting Health • Age • Sex • Race • SES • Marital Status

  2. Age • Machine analogy • Spencer and organismic theory • “wall” of longevity • Chronic vs. acute disease

  3. Gender • Women uniformly live longer than men • Male fetuses are aborted more often than female • Males have a higher risk of death under age 5 than females • Women use care more than men and believe they are sicker

  4. Gender • Women exhibit less stress than men • Women have more cancers except lung and prostate • Men have more coronary disease, injuries, ulcers because of risk behaviors, social expectations • Type of morbidity therefore differs as well as type of cause of death

  5. Race • Effect of race modulated through SES usually • Article on reserve (Hayward et.al.) shows that absent effects of SES there is still a difference in morbidity and mortality that can be shown to vary by race and ethnicity

  6. Marital Status • There is a salutary effect of being married to health of participants • Social Isolation—Durkheim • Social networks defined • Social integration • What is a social network and can we standardize it?

  7. Social Networks • Research design is affected by how social networks are defined • Experimental vs. quasi-experimental designs • Is this ethical? • Self-reports of health status vs. objective measures • Outcome measures

  8. Social Class • Classic Whitehall studies in UK • Now divide effects into SES= education+ income+ occupation

  9. SES • SES defined • In general, improved SES=improved health and less morbidity and mortality • This was not always the case • Factors interact • Examples

  10. Key Idea—Link and Phelan • Again, social determinants are more important to health, by any measure of outcome used, than genetic or etiologic causes • Fundamental causes—who we are in society • Proximate causes—behaviors • Behaviors are controlled by social conditions • Social causes are fundamental • SocialBehaviors/RisksOutcomes

  11. Religiosity • Religious people have better health than non-religious • May be modulated by improved social networks and decreased stress

  12. Diet • Modulated by SES • Cultural and social differences • Vegan and “Meat Eaters”

  13. Genes • See lecture from last week • May have modulation from maternal diet and stress, fetal alcohol and smoking affect birth weight and maturity, neural development • DM, HTN, CAD

  14. Proximate Causes • Stressed in our culture • Better controlled behaviors are socially modulated • Examples—drugs, alcohol, smoking, sex, violence and guns • Machines • Technology

  15. Global example--Bangladesh • Poor SES • Poor access • Women, religion and bias • Acute vs. chronic • Mortality and morbidity

  16. Summary • Social causes are fundamental to health, proximate (behavioral) causes are less important but easier to change • Many social factors affect levels of health and illness, including social views on justice and rights • Health status measurement complex

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