Socio-psychological and sociological models for the understanding Understanding Decision-making Capacity and Legal Competence of disease and health bring into focus Focus Area of enhancement measuring < 5 mm in diameter Imaging of the Breast influencing factors created by the social action of human beings. What are the social influences on health preservation, the development, and the social stratification of disease? How do social inequality and social stratification influence health? What role do occupation and unemployment play? What social-demographic determinants are important in medicine? We offer you all this information in the following article—along with all the facts pertinent to exams.
Last updated: 19 May, 2022
Behavioral models and psychological models bring the person to the forefront to explain disease and health. Sociological models focus Focus Area of enhancement measuring < 5 mm in diameter Imaging of the Breast on the influence of social structures on health and disease. The structure of society, the economic system, and the organization of health assurance (e.g., the introduction of health insurance structures) all play an important role. Thus, you cannot be healthier without involving society and interaction with others and the environment. The most common association of sociological influence on health is the direct effect of poor socio-economic background on morbidity Morbidity The proportion of patients with a particular disease during a given year per given unit of population. Measures of Health Status and mortality Mortality All deaths reported in a given population. Measures of Health Status. Poor people in every society are associated with multiple diseases and limited access to healthcare.
Norms are a society’s system of rules, which relate to the behavior of its members. Behavior that complies with the norms is reinforced and rewarded; behavior that deviates from the norms is sanctioned. Society places on the person a wide range of expectations relating to behavioral norms. If the behavior that deviates from the norms (e.g., quitting a job) is punished, this can harm a person’s physical and psychological state of health.
A social class is explained as a group of people having similar or equal circumstances, i.e., their living and working conditions are on the same level. Almost all members of society classify their fellow men into specific categories. This 1st assessment occurs based on outer appearance, language, clothing, and occupation. Social classes behave hierarchically with each other and enjoy different reputations within society.
The concept of social classes is a keyword in sociology. Class-related terms and models are based on education, income, and occupational class. This social class index (or meritocratic triad) is seen as an important resource concerning life chances.
Person is given an attributed status based on his or her origin. Acquired status describes the status, which a person can achieve by their performance, skill, and effort.
The meritocratic principle says that positions and rewards should only be distributed based on the performance of the person—not on the basis of their attributed status (e.g., gender Gender Gender Dysphoria, origin, parental home or ethnic affiliation).
The openness of a society can be perceived by studying the possibility of social mobility Mobility Examination of the Breast.
Under the prevailing circumstances, to what degree can a person influence his or her social position using his or her skill and effort?
The medieval estate-based society can be seen as an example of extremely low social mobility Mobility Examination of the Breast. Currently, due to the recession, there is a decrease in social mobility Mobility Examination of the Breast in industrial countries.
Poverty, unemployment, homelessness, and belonging to a social fringe group can mean Mean Mean is the sum of all measurements in a data set divided by the number of measurements in that data set. Measures of Central Tendency and Dispersion exclusion from society, i.e. social deprivation. Social deprivation harms health, independent of a person’s level of education and occupation.
| In lower social classes | In higher social classes |
|---|---|
| Generally an instrumental attitude towards the body: “As long as everything works, I do not need to see a doctor.” | The body has symbolic value; health is seen as a value in and of itself. |
| Higher tolerance Tolerance Pharmacokinetics and Pharmacodynamics of symptoms and more frequent non- compliance Compliance Distensibility measure of a chamber such as the lungs (lung compliance) or bladder. Compliance is expressed as a change in volume per unit change in pressure. Veins: Histology | Better access to health-related information |
| Workers make less frequent use of cancer screening Screening Preoperative Care and have a higher risk of early disability Disability Determination of the degree of a physical, mental, or emotional handicap. The diagnosis is applied to legal qualification for benefits and income under disability insurance and to eligibility for social security and workman’s compensation benefits. ABCDE Assessment as employees. | Population groups with a higher status more frequently experience allergic and atopic diseases. |
| People in socially weaker classes make less frequent use of prenatal care Prenatal care Prenatal care is a systematic and periodic assessment of pregnant women during gestation to assure the best health outcome for the mother and her fetus. Prenatal care prevents and identifies maternal and fetal problems that adversely affect the pregnancy outcome. Prenatal Care and screening Screening Preoperative Care for diseases. | Anorexia Anorexia The lack or loss of appetite accompanied by an aversion to food and the inability to eat. It is the defining characteristic of the disorder anorexia nervosa. Anorexia Nervosa nervosa is a disease of the middle and high classes. |
Social class gradients describe the reduced levels of, e.g., obesity Obesity Obesity is a condition associated with excess body weight, specifically with the deposition of excessive adipose tissue. Obesity is considered a global epidemic. Major influences come from the western diet and sedentary lifestyles, but the exact mechanisms likely include a mixture of genetic and environmental factors. Obesity, alcohol, and nicotine Nicotine Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. Stimulants abuse. Another factor is the prevalence Prevalence The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. Measures of Disease Frequency of mental disorders when it comes to higher classes within a population. Two theories offer explanations for the origin of these social class gradients: the social causation hypothesis Hypothesis A hypothesis is a preliminary answer to a research question (i.e., a “guess” about what the results will be). There are 2 types of hypotheses: the null hypothesis and the alternative hypothesis. Statistical Tests and Data Representation and the social drift hypothesis Hypothesis A hypothesis is a preliminary answer to a research question (i.e., a “guess” about what the results will be). There are 2 types of hypotheses: the null hypothesis and the alternative hypothesis. Statistical Tests and Data Representation. The social causation hypothesis Hypothesis A hypothesis is a preliminary answer to a research question (i.e., a “guess” about what the results will be). There are 2 types of hypotheses: the null hypothesis and the alternative hypothesis. Statistical Tests and Data Representation has received a greater degree of proof than the drift hypothesis Hypothesis A hypothesis is a preliminary answer to a research question (i.e., a “guess” about what the results will be). There are 2 types of hypotheses: the null hypothesis and the alternative hypothesis. Statistical Tests and Data Representation. The latter could primarily be observed in the area of mental disorders, especially in schizophrenic people.
The social causation hypothesis Hypothesis A hypothesis is a preliminary answer to a research question (i.e., a “guess” about what the results will be). There are 2 types of hypotheses: the null hypothesis and the alternative hypothesis. Statistical Tests and Data Representation (cause hypothesis Hypothesis A hypothesis is a preliminary answer to a research question (i.e., a “guess” about what the results will be). There are 2 types of hypotheses: the null hypothesis and the alternative hypothesis. Statistical Tests and Data Representation)
This hypothesis Hypothesis A hypothesis is a preliminary answer to a research question (i.e., a “guess” about what the results will be). There are 2 types of hypotheses: the null hypothesis and the alternative hypothesis. Statistical Tests and Data Representation states that being in a lower class in society is a cause/risk for developing certain diseases. The cause of the unequal distribution of health and disease is greater exposure Exposure ABCDE Assessment to factors that endanger health (higher environmental pollution Pollution The presence of contaminants or pollutant substances in the air (air pollutants) that interfere with human health or welfare, or produce other harmful environmental effects. The substances may include gases; particulate matter; or volatile organic chemicals. Asthma, worse working conditions, etc ETC The electron transport chain (ETC) sends electrons through a series of proteins, which generate an electrochemical proton gradient that produces energy in the form of adenosine triphosphate (ATP). Electron Transport Chain (ETC).) and risk behavior (nutrition, substance abuse, movement behavior, etc ETC The electron transport chain (ETC) sends electrons through a series of proteins, which generate an electrochemical proton gradient that produces energy in the form of adenosine triphosphate (ATP). Electron Transport Chain (ETC).), which is accompanied by affiliation to the respective social class.
The social drift hypothesis Hypothesis A hypothesis is a preliminary answer to a research question (i.e., a “guess” about what the results will be). There are 2 types of hypotheses: the null hypothesis and the alternative hypothesis. Statistical Tests and Data Representation ( selection Selection Lymphocyte activation by a specific antigen thus triggering clonal expansion of lymphocytes already capable of mounting an immune response to the antigen. B cells: Types and Functions hypothesis Hypothesis A hypothesis is a preliminary answer to a research question (i.e., a “guess” about what the results will be). There are 2 types of hypotheses: the null hypothesis and the alternative hypothesis. Statistical Tests and Data Representation)
The social drift hypothesis Hypothesis A hypothesis is a preliminary answer to a research question (i.e., a “guess” about what the results will be). There are 2 types of hypotheses: the null hypothesis and the alternative hypothesis. Statistical Tests and Data Representation argues in the opposite direction. It states that the unequal distribution of health and disease exists because disease forces social relegation or does not allow social advancement. This social drifting away is thus considered a consequence of a disease. The hypothesis Hypothesis A hypothesis is a preliminary answer to a research question (i.e., a “guess” about what the results will be). There are 2 types of hypotheses: the null hypothesis and the alternative hypothesis. Statistical Tests and Data Representation states that mental illness causes one to drift further downwards of the social class.
Tip: both hypotheses often come up in preliminary examinations!
Age is a common characteristic that we use to differentiate or sub-group a population. Age cohort is a group of subjects who have shared a particular event during a particular period.
‘Baby-boomer’ age cohort:
Consider the elderly – those over the age of 65 as they typically retire and are not contributing to the workforce. Resultant shift occurs in their quality Quality Activities and programs intended to assure or improve the quality of care in either a defined medical setting or a program. The concept includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps. Quality Measurement and Improvement of life as their reliance on social support increases. In the United States, 10% of people live below the poverty line. ‘Silent generation’ and ‘G.I. generation’ was born during the Great depression and WW 2. By 2025, it is estimated that over 25% of the population will be over the age of 65.
The dependency ratio Dependency ratio Ratio between dependents and the working group. Population Pyramids examines the proportion of elderly vs. non-elderly and the need for social support.
Age-related decline of physical health can impact:
The social significance of aging includes:
Life-course theory of aging is a process mediated by:
Life-course theory of aging
Image by Lecturio.There is a shift in age-related expectations with increased life expectancy Life expectancy Based on known statistical data, the number of years which any person of a given age may reasonably expected to live. Population Pyramids.
Other theories of aging include:
Gender Gender Gender Dysphoria is the range of characteristics regarding and differentiating between and from masculinity and femininity.
Considerations for determining the gender Gender Gender Dysphoria of an individual include:
| Sex Sex The totality of characteristics of reproductive structure, functions, phenotype, and genotype, differentiating the male from the female organism. Gender Dysphoria | Biological factors | The sex Sex The totality of characteristics of reproductive structure, functions, phenotype, and genotype, differentiating the male from the female organism. Gender Dysphoria someone was born with | |
| i.e. chromosomes Chromosomes In a prokaryotic cell or in the nucleus of a eukaryotic cell, a structure consisting of or containing DNA which carries the genetic information essential to the cell. DNA Types and Structure XX vs. XY vs. intersex ( genotype Genotype The genetic constitution of the individual, comprising the alleles present at each genetic locus. Basic Terms of Genetics does not align with phenotype Phenotype The complete genetic complement contained in the DNA of a set of chromosomes in a human. The length of the human genome is about 3 billion base pairs. Basic Terms of Genetics) | |||
| Gender Gender Gender Dysphoria | Identity | The gender you “identify” with | |
| Woman | Man | ||
| Expression | The gender you “express” to the outside world | ||
| Trans- gender Gender Gender Dysphoria | Cis CIS Multiple Sclerosis– gender Gender Gender Dysphoria | ||
Genderqueer, also referred to as non-binary, is when an individual is not exclusively masculine or feminine.
This is a catch-all category which can include:
Sexual orientation Orientation Awareness of oneself in relation to time, place and person. Psychiatric Assessment:
Sexual orientation Orientation Awareness of oneself in relation to time, place and person. Psychiatric Assessment refers to a person’s sense of identity-based on attractions, related behaviors, and membership in a community of others who share those attractions.
Sexual orientation Orientation Awareness of oneself in relation to time, place and person. Psychiatric Assessment is composed of:
Sexual orientation Orientation Awareness of oneself in relation to time, place and person. Psychiatric Assessment is traditionally defined as including:
The social construct of gender Gender Gender Dysphoria refers to social norms, expectations, and roles assigned to each gender Gender Gender Dysphoria many times even before they are born. The gender Gender Gender Dysphoria roles can shape the expectations of ‘proper’ behavior.
Society tends to redefine the characteristics of each gender Gender Gender Dysphoria:
These predefinitions are propagated by media and society and disapproved upon when broken. Societal views are more biased towards men than women (i.e. men shouldn’t have feminine roles). The roles for men are perceived as having more value (i.e. home-maker vs. professional).
Society also assigns unequal value to jobs and education based on gender Gender Gender Dysphoria:
There is a social difference in biological vs. psychological differences in health.
Gender Gender Gender Dysphoria segregation:
Gender Gender Gender Dysphoria segregation is the separation of people according to the social constructs of gender Gender Gender Dysphoria.
The race is a socially defined category that is based on physical differences between groups of people. The racial formation theory looks at race as a socially constructed identity, where the content and importance of racial categories are determined by social, economic, and political factors. Many times the racial difference may be perceived or based on a historical perspective (i.e. the color of your skin Skin The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue. Skin: Structure and Functions vs. the color of your hair or eyes).
Ethnicity is a category of people who identify with each other based on cultural differences:
Ethnicity is a dynamic process and can change across generations.
Social constructs of race and ethnicity can impact:
Racialization or ethnicization is the process of assigning ethnic or racial identities to a group that did not identify itself as such:
Immigration status:
Immigration is the movement of people into a country of which they are not natives, to settle or reside there. Immigrants tend to move to more industrialized, economically sound, and politically stable countries. Immigration can have both positive and negative effects for the donor and recipient countries:
In the long term, high workloads have a negative influence on health. Workers are more often affected by physically hard labor Labor Labor is the normal physiologic process defined as uterine contractions resulting in dilatation and effacement of the cervix, which culminates in expulsion of the fetus and the products of conception. Normal and Abnormal Labor and shift work, which fosters physical diseases. Doctors, e.g., are exposed to very high psychological loads, in terms of high responsibility, high level of time pressure, and high expectations from many sides (e.g., from patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship, relatives, colleagues, family, etc ETC The electron transport chain (ETC) sends electrons through a series of proteins, which generate an electrochemical proton gradient that produces energy in the form of adenosine triphosphate (ATP). Electron Transport Chain (ETC).).
Person’s subjective impression of job insecurity is a stress factor!
Two models have been developed concerning the influence of stress in professional life. They describe the connection between stress factors in professional life and the risk of cardiovascular diseases.
A person’s workload can be described in the demand-control model in terms of 2 dimensions:
Strong social support can serve as a stress buffer and compensate for high workloads.
High amounts of demand + low controllability = high workload (e.g., assembly Assembly The assembly of viral structural proteins and nucleic acid (viral DNA or viral RNA) to form a virus particle. Virology line work)
As the name suggests, the model of occupational gratification crisis brings into focus Focus Area of enhancement measuring < 5 mm in diameter Imaging of the Breast the relationship Relationship A connection, association, or involvement between 2 or more parties. Clinician–Patient Relationship between occupational exertion and earned rewards (e.g., payment, social recognition, etc ETC The electron transport chain (ETC) sends electrons through a series of proteins, which generate an electrochemical proton gradient that produces energy in the form of adenosine triphosphate (ATP). Electron Transport Chain (ETC).). Social support and attitude (goals in life, psychological stability, etc ETC The electron transport chain (ETC) sends electrons through a series of proteins, which generate an electrochemical proton gradient that produces energy in the form of adenosine triphosphate (ATP). Electron Transport Chain (ETC).) are buffers Buffers A chemical system that functions to control the levels of specific ions in solution. When the level of hydrogen ion in solution is controlled the system is called a ph buffer. Acid-Base Balance.
High personal commitment + low gratification = high workload (e.g., single mothers)
| Social | Work situation, social class, family relations, housing situation, and social network |
| Cultural | The cultural understanding Understanding Decision-making Capacity and Legal Competence of health and disease play an important role, which has to be taken into consideration when dealing with foreign patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship! Symbolism, religion, and moral concepts have a great influence on the understanding Understanding Decision-making Capacity and Legal Competence of health and disease and their progress. |
| Natural | Biological, chemical, and physical circumstances are basic influencing factors on health and disease, especially if diseases accumulate following a long period of latency (e.g., radioactivity, chemical poisoning). |
| Technical | Risks and injuries, which result from technical devices, e.g., car accidents, electric smog, etc ETC The electron transport chain (ETC) sends electrons through a series of proteins, which generate an electrochemical proton gradient that produces energy in the form of adenosine triphosphate (ATP). Electron Transport Chain (ETC). On the other hand Hand The hand constitutes the distal part of the upper limb and provides the fine, precise movements needed in activities of daily living. It consists of 5 metacarpal bones and 14 phalanges, as well as numerous muscles innervated by the median and ulnar nerves. Hand: Anatomy, many technical achievements impact the progress of the disease (e.g., modern medical devices). |
The economic and financial situation of a country has a great impact on the health of an individual. The structure of the health system is also very important: statutory or private? In the United States, e.g., a lot of people in lower social classes have no access to medical care Medical care Conflict of Interest. The enormous impact of economic factors on health can be seen in terms of life expectancy Life expectancy Based on known statistical data, the number of years which any person of a given age may reasonably expected to live. Population Pyramids as seen when comparing highly-industrialized countries and threshold Threshold Minimum voltage necessary to generate an action potential (an all-or-none response) Skeletal Muscle Contraction countries.
Average life expectancy Life expectancy Based on known statistical data, the number of years which any person of a given age may reasonably expected to live. Population Pyramids for men 2005–2010:
Demography: The science of population combines elements from sociology, geography, medicine, and economics, and it examines the life, growth, and decay of human populations.
These are some terms you should memorize:
Population pyramids Population pyramids A population pyramid graphically illustrates the age and gender distribution of a given population. The shape of the pyramid conveys details about life expectancy, birth, fertility, and mortality rates. Population Pyramids illustrate all age groups within a given population at a given time, in graphic form. Note the following when it comes to the interpretation of a population pyramid:
The ideal basic forms are presented in the following graphic:
Structure of age:
a. Linear or classic pyramid shape (isosceles triangular shape)
b. Widened or modified pyramid shape (pagoda shape)
c. Beehive shape
d. Bell shape
e. Onion or urn (exaggerated onion)-shape
f. Christmas tree or droplet shape
During nation-wide industrialization, shifts in the generative structure of the population occur. Although this theory originates from the 1920s, it still influences epidemiological thinking. The 5 stages describe the transformation Transformation Change brought about to an organism’s genetic composition by unidirectional transfer (transfection; transduction, genetic; conjugation, genetic, etc.) and incorporation of foreign DNA into prokaryotic or eukaryotic cells by recombination of part or all of that DNA into the cell’s genome. Bacteriology of aspiring societies: initially, high birth and death rates dominate. In the course of industrialization and modernization, the birth rates stagnate, the population shrinks, and life expectancy Life expectancy Based on known statistical data, the number of years which any person of a given age may reasonably expected to live. Population Pyramids increases. Germany and most other industrial countries are in stage 5.
The 5 phases of demographic transformation Transformation Change brought about to an organism’s genetic composition by unidirectional transfer (transfection; transduction, genetic; conjugation, genetic, etc.) and incorporation of foreign DNA into prokaryotic or eukaryotic cells by recombination of part or all of that DNA into the cell’s genome. Bacteriology
The epidemiological transition describes the changes in the frequency of diseases and the causes of death. In modern societies, chronic-degenerative diseases rather than infectious Infectious Febrile Infant diseases tend to dominate.
This has (had) the following consequences for medical practice:
Primarily, medical treatment no longer aims to cure the patient, but rather to preserve the quality Quality Activities and programs intended to assure or improve the quality of care in either a defined medical setting or a program. The concept includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps. Quality Measurement and Improvement of life. This entails implementing rehabilitative measures rather than curative practice. Demographic aging impacts both health and social politics. One of the goals is compression Compression Blunt Chest Trauma of morbidity Morbidity The proportion of patients with a particular disease during a given year per given unit of population. Measures of Health Status, i.e. seeking to ‘compress’ diseases and disabilities into the shortest possible period immediately before death. Thus, good health should be preserved during old age, to keep the enormous costs of chronic diseases at the lowest possible level.
The law of contraction describes the historical tendency towards smaller families, with the consequence that solidarity between individuals only relates to smaller groups of people.
This sociological thesis was developed in the context of a background where the state is taking over more and more tasks relating to social security, thereby taking over the function of the family nucleus Nucleus Within a eukaryotic cell, a membrane-limited body which contains chromosomes and one or more nucleoli (cell nucleolus). The nuclear membrane consists of a double unit-type membrane which is perforated by a number of pores; the outermost membrane is continuous with the endoplasmic reticulum. A cell may contain more than one nucleus. The Cell: Organelles. Certain changes can indeed be explained by the law of contraction, however, in most cases, the nuclear family still forms the most important social and financial network.
Yet, it is an undeniable fact that the number of 1 and 2-person households are continuously increasing in Germany and very few multi-generational households now exist. Furthermore, both partners within a family work. One consequence of the health system is the changing way that things are being organized for sick and elderly people. There is an increasing need for hospital beds, nursing, and retirement homes as well need for the provision of childcare.
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