LEARNING OUTCOMES
.Understand health and social, cultural, environmental and structural factors which interact to influence health
. Examine health through the lens of intersectionality
. Evaluate sources of global health inequity using a social justice lens
RESOURCES
Required reading: From SOCIAL MEDICINE AND PUBLIC HEALTH), page 9 to page 18 (end of THE
THREE DIMENSIONS OF THE SOCIAL MODEL OF HEALTH)
Germov J. Health sociology and the
social model of health. 2014. In: Second opinion: An introduction to health
sociology [Internet]. Melbourne, AUSTRALIA: Oxford University Press; [5-22].
KEY CONCEPTs
UNRAVELING COMPLEXITY IN HEALTH
Medicine has made great strides in the last
100 years - from saving of lives in acute life-threatening emergencies, to
thoroughly improving health outcomes through preventive and curative
interventions and minimizing the deterioration in the quality of life related
to chronic disease. The advancement and
integration of technology including complex, computerized machines, has played
a monumental role in the study of the human body and its functioning,
diagnosis, and treatment of disease.
Disease and Social Context
Yet, today, besides emerging diseases we are witnessing the re-emergence of diseases that had declined dramatically but are again becoming a problem for a significant proportion of the world’s population. Tuberculosis and malaria are examples. Tuberculosis (TB) is preventable and curable. Yet, it is not without reason that TB is called a disease of poverty as it disproportionately affects the poor. While more than 95 per cent of TB deaths occur in low-and-middle income countries (LMICs), TB also affects the most poor and vulnerable populations such as the homeless, urban poor, HIV-infected persons, drug users, and immigrants in developed countries.
Poverty and disease are mutually reinforcing. Epidemics and chronic disease cluster, recur, and prevail amidst rampant poverty.
Beyond Medicine
Social Justice and Health
Even when biological risk is equal, those living in
deprivation are at greater risk of disease. It is this unfair and avoidable
disadvantage experienced by socially disadvantaged populations that contributes
to negative health outcomes which is called health inequity. Health inequity is
also significantly associated with healthcare inequities.
The concept of health/healthcare inequity or health equity,
therefore, embodies the notion of social justice because it is anchored within
principles of fairness and distributive justice.
In this unit, we will explore evidence-based approaches to
understand the importance of social justice and human rights in health, paying
considerable attention to health systems as an important determinant of health
equity.
UNRAVELLING HEALTH AND ITS COMPLEXITY
The Biomedical and Social Models of Health
Video 2 introduces the biomedical model and the social model of health, sketches how each developed, and clarifies their scope and limits.
The aim is to see when each lens is sufficient, when it falls short, and how they can be used together in complementarity in clinical work and public health.
STRUCTURAL DISCRIMINATION
Explore and analyze life expectancy trends in Malaysia using the Open DOSM Life Expectancy Dashboard and Statistics on Causes of Death, Malaysia to examine the most recent year available. Describe what the figures show without making causal claims.
First, identify the highest and lowest life expectancy values and state the absolute gap in years. Next, note the leading causes of death overall (and by sex or age where reported). Try to explain how these descriptive patterns might reflect differences in living conditions, service availability, or protection from risk, and state one policy that could plausibly narrow the observed gap.
1. Click every hotspot on the HIV image.
2. Read the explanation in each pop-up carefully.
3. Look for a pattern across the hotspots.
Intersectionality
In the next activity you will work through a maternity-care scenario involving two women, Amni and Fatima, who arrive at the same hospital to deliver their babies. They share the same clinical need, but their experiences can differ because their social circumstances differ.
As you work through the activity, focus on three ideas: social identity (how a person is socially recognized), social location (where that places them within social structures), and social power (what that position enables or constrains).
EQUALITY vs EQUITY
So that brings us to the final part of this topic, and to an important question. Answer the question, and check out the slide on the difference between equality and equity and the summary of Health and Medicine.
