What behaviours are more common among less well off people?
Smoking, drinking, having multiple sexual partners, illicit drug use and speeding
What is the exception?
Extreme sports. More popular among wealthy people.
What is an example of how social determinants influence health?
Smoking prevalence goes down as income goes up.
What factors influence our health behaviours?
Income, education, gender and characteristics of surroundings
What does social influence mean?
Effects on personal choice arising from a wish to please others, fear of sanctions and peer pressures to conform
What does methodologically individualist mean?
Any approach that attempts to explain social phenomena by the choices and behaviours of discrete individuals
Who developed the Health Belief Model?
Rosenstock and his colleagues in the 1960s
What 4 variables impact the health belief model?
- Self perceived personal risk
- Self perceived severity of the outcomes associated with unhealthy behaviour
- Self perceived barriers to and costs of behavioural change
- Self perceived benefits of making the behavioural change
What issues are there with the health belief model?
Fails to consider social and contextual factors
What does social patterning of behaviour mean?
Usually unconscious determination of behaviour by contextual factors such as place in social network
Which thinkers are associated with the social patterning of behaviour?
Durkheim
Define brain plasticity
The capacity of the brain to reorganize itself in response to learning and experience
Define neural sculpting
Brain’s destructive process of pruning or removing connections that aren’t in use. Part of plasticity.
Define lifestyle
Way of living
Define nudge theory
Proposed alternative to regulation and health education that relies on providing cues to people through indirect suggestions that alter motivation and choice
What are the issues with the risk factor/behavioural model?
- Davidson believes that dialogues around personal choice are mistaken
- Behaviour is embedded in social context
- Health behaviours = wrong level of analysis
Addendum: Gender roles appear important, not so much sex
Describe human behaviour and its context
- Human behaviours cluster by social status
- Most risky behaviours happen among those less well off including smoking, sedentariness, multiple sexual partners, drug use, binge drinking, misuse of a vehicle
- Exception of extreme sports which affluent partake. Rare and don’t make a dent on pop. level.
Explain the health gradient from a social patterning of behaviour perspective
Durkheim and Demer believe that behaviour is socially determined/patterned
Healthy lifestyles cluster by social class, other variables
Connection via stress
Incentives to behave in certain ways pervades the social environment
- Advertising
- Behaviours of our social networks
- Sets of opportunities and constraints
Why is the health belief model wrong?
Only weakly predicts behavioural change
Self perception is key consideration
Describe incentives and choice
People often self sacrifice for others
Incentives work when they are large and people already want to change
Not so much when neither is true
May have unintended effects
Describe why taxes targeting unhealthy foods are problematic
Arbitrary
Punish poor people
Don’t help guide people toward healthier foods
Unintended effects
Cash grab for governments
Describe Denmark’s fat tax
Inelastic demand
Consequences for poor people
Substitution effects
Removal of policy in 2012
What problems exist with informed consent?
- More information makes medical decisions more difficult
- Most patients don’t have the expertise to use that information and want doctor to make choice
- We are affected by biases and attitudes that trump information
- Health information is notoriously unreliable
Describe the organic nature of choice
Our choices are often unconscious, automatic
Personal experiences become part of neural circuitry
Implication: Habits are ‘wired’ into us.
Good decisions are possible but not easy
