Social Construction of Health and Disparities

Social Construction of Health, Medicine, and Illness

• Health, illness, and medicine are not fixed, objective realities but are shaped by various cultural, social, historical, and economic forces.
• Definitions and understandings of these concepts vary across cultures and time periods.

Fundamental Cause Theory

• Societal factors (e.g., socioeconomic status, racism) are fundamental causes of health disparities.
• These disparities persist even when specific biological exposures are controlled.
• These factors influence multiple disease pathways.

Racial and Class Health Disparities

• Health disparities exist between racial and socioeconomic groups.
• These disparities include higher rates of illness, poorer health outcomes, and lower life expectancy for marginalized groups.
• They are rooted in systemic inequalities, historical injustices, and ongoing discrimination.

Healthcare Systems – US vs Other Wealthy Countries

• The US healthcare system differs significantly from those of other wealthy nations.
• Key differences include: financing models (e.g., universal vs. private insurance), access to care, cost structures, and resource allocation.
• The US system often faces challenges in terms of affordability, access, and quality compared to other systems.

Illness Narratives

• Illness experiences are often complex and multifaceted, involving personal stories of diagnosis, treatment, and recovery.
• These narratives shape perceptions of illness and influence decisions about treatment and management.
• Individual and social contexts greatly influence these narratives.

Framing Institutions

• Institutions (e.g., hospitals, clinics) frame illness through the lens of their own structures and priorities.
• This often involves standardized processes, medical classifications, and professional perspectives on health.
• These frames may impact patient experiences and disease management.

Good Deaths

• "Good deaths" are subjective and influenced by personal values, beliefs, and cultural norms.
• Factors contributing to perceived good deaths include a sense of control and dignity, a sense of peace, connection with loved ones, and absence of pain and suffering.
• End-of-life care practices can significantly shape the experience of death.

Empathy and Sympathy in End-of-Life Care

• Empathy and sympathy are crucial in end-of-life care.
• Empathy involves understanding and sharing the feelings of the dying person.
• Sympathy involves compassion and sorrow for the dying person's suffering.
• Both are essential for providing compassionate and holistic end-of-life care.