1
Q
Social Influence
A
any process whereby a person’s attitudes, opinions, beliefs, or behaviour are affected by others
- includes conformity, compliance, group polarisation, minority social influence, peer pressure, obedience, persuasion, and the influence of social norms
- ranges from explicit to implicit
3 Types:
- structural: quantity & quality of your social ties
- functional: emotional, instrumental (financial), or informational support
- normative: social norms provide a context in which individuals make decisions about their behaviour
2
Q
Structural Social Influence (on health work)
A
- generally more friends: better mental & physical health
- amount of social group membership, the larger buffer against pain
- but also satisfaction from social interactions related to self-reported health
3
Q
Functional Social Influence (on health work)
A
- social connection influences via lifestyle choices, psychological mechanisms & medical adherence
4
Q
Normative Social Influence (on health work)
A
- normative & behavioural guidance through comparisons with others (similarity & closeness)
- usually via peers
Umberson (2010): influences via meaning of life, social norms (descriptive & injunctive) and control
5
Q
Social ties
A
social ties influence our (health) behaviour through norms
- multiple layers (e.g. friendship, family, membership in sports etc.)
6
Q
Social Ties & health
A
- social relationships directly (positively) affect out physical 6 mental health
- act as buffer against stress (thereby indirectly affect health)
- health is improved by informal social networks, social activities, participation in organisation
7
Q
Social Ties & psychology
A
social networks can provide - - - social support
- self-esteem
- identity
- perception of control
8
Q
Levels of closeness
A
Primary group: significant others
- persons to whom er are emotionally tied & whom we view as important or influential
- e.g. souse, family, close friends
Secondary Group
- larger groups, more formal
- rules regulations, hierarchy
- less personal knowledge about other members
- voluntarily chosen individuals: similar others
- e.g. fellow students, colleagues, sports teams
9
Q
Quality & quantity (Social Ties)
A
both are positively & causally related to physical & mental health
- research shoed, the larger one’s social network for friends, family, club etc. the better one’s mental health
- satisfaction derived from interaction with friends (i.e. quality of interaction) positively related to self-reported health
- married individuals live longer (esp men benefit from being married)
10
Q
Social Isolation & Loneliness
A
harmful for one’s health
- loneliness was found to double the risk of developing alzeimers
11
Q
Mechanisms by which Social Relationships influence our health
A
- social facilitation - implicit
- modeling - implicit, some extent
- impression management - explicit
- norms - explicit
12
Q
Social Facilitation
A
improvement in individual performance when working with other people rather than alone
- the mere presence of others does the trick
- influence us largely outside awareness
- e.g. children eat more & faster in larger compared to smaller groups (healthy & unhealthy snacks)
- social facilitation doesn’t seem to occur when in company of strangers (may only hold for overweight individuals)
- quality of one’s peer relationship also matter
> perceived support from fam. facilitates exercise, bullying criticism from peers reduces
13
Q
Social Facilitation & risk taking
A
- susceptibility to social facilitation effects, particularly among males (often aren’t aware that they take risks)
- demonstrations if in-group characteristics, like risk-taking, may bolster self-esteem by winning admiration and praise from peers
- presence of male passenger in car doubles death rate der 1000 car crashes
14
Q
Modeling
A
individuals form beliefs & attitudes about the behaviours they see in others, which in turn shapes their own behaviour
- includes behavioural mimicry
- more direct/explicit form of influence on our behaviour than facilitation
- starts early in childhood
peers have influence on our levels of physical activity through modelling & socialisation processes
- given the prong influence of peers on behaviour, peer education is used more and more asa form of health education/health promotion
15
Q
Impression Management
A
wanting to convey a certain image of yourself to the outside world
- is natural behaviour but can be bad for your health
- attempts to consciously or unconsciously control impressions other form of us
How
- by regulation information we provide to them
- by strategic self-presentations
- it also inhibits healthy behaviour or even promotes unhealthy behaviour
(not wanted to be seen buying condoms)
e. g. occasional smoking used as impression management
- not wanting to appear as regular smoker while feeling immune to health risks of smoking
- pretending to have perfect life & show that to others
- peers provide normative contexts (college hazing)
16
Q
Norms
A
Descriptive: what I think others do
Injunctive: what I think others will approve or disapprove of me doing
subjective: what I think significant others expect me to do
ppl obtain normative & behavioural guidance through comparison with others
- who are similar to us
- who are close to us
17
Q
Norms & social influence & health
A
depending on which group or individuals are considered important to an individual, and which (health) norms are salient in that group
- such social influence can be demanding or encouraging for one’s health behaviour
18
Q
Thomas Theorem (Norms)
A
if a person perceives norm as real, then its consequences fir the person are real
19
Q
Norms & Misperceptions
A
often we have misperceptions about other pals attitudes (peer injunctive norms) or their behaviour (peer descriptive norms), which in turn influence our own behaviours
20
Q
Peer influence vs peer pressure
A
Peer influence:
- ability to influence individual behaviour among members of a group based on group norms
- groups send of that is the right thing or way to do things, and the need to be valued and accepted by the group
Peer pressure:
- really want to be accepted
- high normative social influence
- -> feels like pressure, otherwise feels like will be outsider
21
Q
Social Determinants of Health (SDH)
A
the conditions in which ppl are born, grow, work, live, age and the wider set of forces & systems shaping the conditions of daily life
- these forces & systems include economic policies, systems, development agendas, social norms, social policies, political systems
they lead to:
- unstable housing, low income, unsafe neighbourhoods, substandard education
- creates inequities between (groups of) individuals
22
Q
10 SDH according to WHO
A
- social gradient (lower SES also lower health)
- stress
- early life (stress, parents, environment)
- social exclusion
- work
- unemployment
- social support
- addiction
- food
- transport
23
Q
other determinants
A
- segregation
- social surroundings
- social inequality
- stigmatised reputation of area/people (isolation, restriction of info floe between residents & block development of trust & culture)
- individual (parental steps, child stress mental emotional, behavioural)
- relational (parental investment)
- institutional (schools, neighbourhood conditions, work of parents, stability
24
Q
Mediators between structural determinants of health & impact on equity in health
A
- social cohesion & social capital
- behaviour & biological factors
- psychosocial factors
25
Starting Points for interventions
changing the influence on these determinants, and ultimately reducing the inequalities/inequities requires structural solutions
E.g:
- provide basic income
- provide good infrastructure
- provide education for all children & adults
- provide accessible healthcare
- dual pay for both genders
BUT changing the influence of social determinants can also happen by focusing on the intermediate factors
- reserve capacity model
- focus on individual's psychological & social strengths (hope, self-efficacy, optimism)
structural changes in society are necessary
- psychologist can help with interventions focusing on more intermediary determinants of health
26
Where can Psychologists intervene?
focus on individuals' psychological & social strengths
| look at reserve capacity model
27
Reserve Capacity Model
framework to understand the mechanisms that underlie the well-established relationship between poverty/low SES and poor health
- explains how positive & negative consequences of SES can impact health
- suggests that stress depleted the resources from which ppl can draw in times of need & that over time low resources elicit the experience of negative emotions
> negative emotions affect physical health outcomes through poor health habits & chronic physiological arousal
- psychological & social reserves as mediators for multitude consequences
- we can intervene on anything in this model
> need to strengthen resources
Psychological Capital: hope, optimism, efficacy, resilience
28
Health Disparity/Inequality
particular type of difference in health or in the most important influences on health that could potentially be shaped by policies
- difference in which disadvantages social groups' systematically experience worse health or greater health risks than more advantaged groups
29
disadvantaged social groups
- poor
- racial/ethnic minorities
- women
etc
30
Health equity
pursuing the elimination of disparities
horizontal equity: equal treatment for equal need
vertical equity: different treatment for different need
31
Inequity
unfair, avoidable differences arising from poor governance, corruption or cultural exclusion
- if you refer to inequity of something, you are criticising it because it is unfair or unjust
32
Inequality
unfair situation in society when some people have more opportunities, money, etc than other people
- uneven distribution of health or health resources asa result go genetic or other factors or lack of resources
33
equity equality difference
equity:
if one needs more than someone else, the they get more treatment
equality:
all get the same treatment
first wen need equity to get equality
34
Methods to explore Inequalities
- mortality data
> includes social demographics & economic status
- self-report questions assessing educational level & details about demographic level
- relative index of inequality
> ration between estimated mortality, morbidity, or risk factors prevalence among individuals at rank 1 (lowest education, occupation and income level) and at rank 0 (highest level)
35
Determinants of Inequalities in Health
Immediate:
smoking, obesity, excessive drinking
more general:
lifestyle choices, use of healthcare, general living conditions as structured by political, economic, social & cultural factors
36
neighbourhood resources
people who are together in a group can outbalance each other by combining their resources
37
Social Belonging
a sense of heaving positive relationship with others
- seeing oneself as socially connected
- direct & indirect buffer against stress
- basic/fundamental human need
38
Belonging uncertainty
members of socially stigmatised groups are more uncertain of the quality of the social bonds & thus more sensitive to issues of social belonging
- global concern about the quality of one's social ties
- stigmatisation can give rise to belonging uncertainty
- may contribute to racial disparities in achievement
39
attributional ambiguity
- mistrust of the motives behind other people's treatment of them
- experienced by people targeted by negative stereotypes
40
Stereotype threat
- the fear of confirming a negative stereotype about the (intelligence of) the group
- experienced in evaluative contexts
41
perception of not fitting in
can increase stress & dissatisfaction
42
perceived availability of social support
buffers mental & physical health
43
social exclusion
keeping an individual or group out of social situations
- typically occurs in context, that the individual or group is believed to possess undesirable characteristics or characteristics deemed unworthy of attention
often based on
- ethnicity
- religion
- sexual preference
- gender
44
Social exclusion & health
- racial discrimination causes stress
> high blood pressure & more alcohol intake
- ppl. with more restricted networks (e.g. socially excluded networks) have more negative health outcomes, tend to feel anxious, depressed, suffered from headaches and stomach complaints
- socially excluded people also tend to feel fatalistic and hopeless or politically cynical
- -> social exclusion affects living & working conditions, ans as a result, one's psychological and physical health
- -> psychological consequences range from prejudice, stigma, to severe mental health problems
45
Feeling of belonging
can lead to upward spiral of increasingly better physical &psychological health
--> try to increase these feelings
46
Role of Socioeconomic Status
```
social standing or class of individual or group
- often measured in educaition, income and occupation
```
47
SES & obesity
- related (esp. childhood obeisity)
- SES affects access to food & patterns of physical activity
- SES with increased access to energy-dense food are at great risk but varies by county (Industrial low ses, developing high SES)
- obesity affects SES: limits educational & employment opportunities
48
SES & health care
lower SES more likely to die prevalent causes
| --> access to quality healthcare can cause this
49
SES & health
Clear association between SE & health
- individuals higher SES tend to have better health
- hold not only for individual but also community level
- persons living in poor neighbourhoods, even after accounting for their socio-economic characteristics, tend to have worse health outcomes
- dis-advantaged neighbourhoods are also exposed ti greater health hazards, including tobacco & alcohol advertisements, toxic waste incinerators, & air pollution
50
SES & HIV
effect of low SES on survival of ppl receiving care for HIV in US
- during study period, 20 % of sample had died, those with low education had 53% greater risk of death
51
Health differences between Better & worse-off Economic groups
- educational attainment
- occupational characteristics
- prestige, control/power
- income/expenditures
- accumulated wealth
- living conditions
- health insurance
52
Poverty
lack of means of providing material needs or comforts (also can be categorised as absolute, relative, subjective, asset)
associated with
- physical health
- language/cogntive development
- academic achievement
- mental, emotional, behavioural health
- children who grow up in poverty more likely to be poor when older
How can change: target mediating mechanisms or directly reduce poverty
53
Mediators of effect of poverty on health
Individual (quality of nutrition)
Relational (quality of family relationship)
Institutional (school, childcare)
54
Relational level (mediating mechanism of poverty)
- target features of parenting (e.g. responsiveness, cognitive stimulation, attachment)
- target parental mental health (e.g. intervention for parenting & coping for families --> experimental reduction in child & parent anxiety & depressive symptoms)
- target the parents (parental education, parenting intervention (how raise children & cope)) --> reduction in anxiety
55
Institutional level (mediating mechanism of poverty)
Target social-emotional learning (SEL) in:
- elementary, middle & high-school
> meta-analysis found improved SE skills &> academic performance, reduced conduct problems & emotional distress
- preschool: target child development, parenting quality, staff development, community development
> short term in SEL development
56
other (mediating mechanism of poverty)
education
- rewarded attendance or improvement of grades health domain
- rewarded if have health insurance
adult human capital interventions
- not effective without reward system
57
Childhood allowances
| directly tackling poverty
for new parents (transition to parenthood expensive), flexible funds so parents can decide to stay home or return to work
58
Tax credits
| directly tackling poverty
later in childhood (e.g. college savings plans, tax deduction for school loans)
59
Income supplement programs (Directly Tackle Poverty
- Reward full time with cash
- child care subsidies
- health insurance subsidises alongside supportive case management
--> reduced family poverty rates, increased childhood academic achievement
60
Considerations in Interventions
| Poverty
1. timing and intensity/magnitude of intervention matter - stronger impacts on children's MEB health with
- interventions early in childhood
- strategies that substantially increase the economic resources available to low-income families
2. many of the interventions describes here primarily target 1 risk factor
- may require more intensive intervention in that ares (or addition of efforts targeting other risks) to bring about greater & more sustained change
61
Education
across Europe
- mortality higher among those with less education
- smoking (more common in men) & obesity (women) are more common in people wit low education level
62
Stress
psychosocial stress
- can lead to acute & chronic changes in the functioning of body systems (e.g. immune system) & also lead directly to illness
63
Race & Environmental Hazards
Psychosocial distress: stressors Amy have direct influence on health
Gee: ethnic minority neighbourhoods tend to have higher rates of morbidity, mortality, health risk factors compared to white neighbourhoods (even after accounting for economic & other characteristics)
64
Exposure-Disease-Stress Model
- conceptual framework for relationship between race, environmental conditions & health
- shows how environmental toxicants might cause disease-continuum that includes emission of a contaminant from a source through human exposure to the occurrence of health effect
- susceptibility/vulnerabllity intersects the continuum, increasing or decreasing resistance to absorption and/or effect from toxicants
