Health Illness and Society - Case Study Example

Health illness and society Health may defined differently by doctors and their patient. Discuss this assertion in relation to the problems of defining health, illness and disease. Doctors adhere or should adhere to health science in defining health, illness and disease. However, laymen or people who do not belong to the medical profession have their own notions of the terms that may or may not correspond to what may be considered scientific. In other words, there are lay theories or concepts of health, illness, and disease. Lay notions, concepts, or theories on health refer to the people’s understanding of on the meaning and importance of health and how health in retained and lost (Hughner and Kleine 2004, p. 1688). Lay notions or theories on health are not limited to illnesses and symptoms but as to how people interpret and respond to symptoms as well (Hughner and Kleine 2004, p. 1688). For instance, Hughner and Kleine (2004, p. 1869) pointed out that a person who sees the role of a physician as someone who would fix his or her body would behave in a different way compared to a person who sees himself or herself as somebody who can control his or her own health. A person who sees pills as a magic substance that will cure his or her health will progress differently from a person who sees medicines as only one aspect of a comprehensive approach to health (Hughner and Kleine 2004, p. 1869). Blaxter pointed out in 2000 that the poorest sectors of society can attribute illnesses to purely behavioural causes or that the causes of ill health are beyond their control (Hodgins et al. 2006, p. 1986). Illnesses are always attributed to poverty and the idea that one can be socially unfortunate yet very healthy is intensely resisted (Hodgins et al. 2006, 1986). Hodgins et al. (2006, p. 1984) reported that a prevailing belief among Travellers, an ethnic minority in Ireland, is that a woman has to be very sick before seeing a doctor. The Travellers believe that the mother must be the one who must get well last from any illness and that the mother must take care of the family because husbands can leave the family but not the wife or the mother (Hodgins et al. 2004, p. 1983). Travellers also believe that smoking is not contraindicated for heart ailments but is even a way of relaxation (Hodgins et al. 2007). Norby (2008, p. 357) pointed out, “Patients tend to think they are entitled to understand lay health terms like ‘sickness’ and ‘illness’ in ways that do not necessarily correspond to health professionals’ understanding.” Further, Norby (2008, p. 357) argued that it is “easier for doctors to create a communicative platform of shared concepts by using and explaining special medical expressions than by using common lay expressions.” Norby (2008, p. 357) elaborated that the views mentioned are different from “the view that doctors and patients typically understand each other when they use lay vocabulary.” Norby (2008, p. 357) pointed out that “it is important that doctors have an awareness of how patients interpret” medical terms. For a successful communication with patients, doctors should use and explain health concepts in ways that patients are capable of understanding (Norby 2008, p. 358). In viewing a condition a bacterial infection, non-health professionals oftentimes view the fever as the illness and not as a response of the body to the infection and as an attempt of the body to the infection. Thus, a non-health professional especially those who are uneducated would try to treat the fever instead of the infection. In contrast, a health professional would try to find out the reason for the fever so that the appropriate antibiotics, dosage, and duration of treatment can be prescribed. Doctors and patients must reach a common understanding. Otherwise, given economic difficulties, a patient may stop taking the antibiotics after the fever has subsided even as the infection continues. It is important for health professionals to change the patients’ mind-set. Even if the doctor succeeds in treating a particular ailment and if the patient mind-set is not changed, the patient may continue to practice his or her notions come next infection. 2. How true is the sociological idea that people diagnosed, or at risk of being diagnosed, with socially stigmatised condition, find the stigma more fearful than the condition itself. Both the stigma and illness are both undesirables that must addressed in public health. We must stress that infectious illnesses like AIDS and SARS, and diseases associated with poverty, “inferior” social status, and illicit sexual behaviours are life threatening. They are by no mean less fearful than the stigma. Let us discuss the matter in the case of the AIDS. Acquired Immune Deficiency Syndrome or AIDS is easily transmittable via sexual intercourse. Illicit sex or relations, sex with prostitutes, promiscuity and unhealthy/unsanitary sexual interaction are associated with the spread of the disease. Having a sexual experience today is as easy as going to a bar or a grocery store. Yet, the stigma associated with promiscuity continues. More so, if one is suspected of having AIDS. Peter Piot, Executive Director of the United Nations program on AIDS, described AIDS as an exceptional threat to humanity that it needs an exceptional response (2005, p. 2). In a population when AIDS is not abated, the prevalence can reach up to 40% as in the case of Botswana, Swaziland, and still rising (Piot 2005, p. 4). Piot (2005, p. 4) described AIDS to be globalizing rapidly from “West Africa to Eastern Europe, from China and India to the Caribbean and Central America.” AIDS can also become generalized in a population so that it becomes no longer concentrated in centres of promiscuity or flesh trade but becomes a fact in all of the population (Piot 2005, p. 4). According to Piot (2005, p. 4), this has happened in many countries in West Africa, including Nigeria with a population of about 140 million. AIDS has emerged from just a circumscribed epidemic 25 years ago to a pandemic that affected 65 million people as of 2005 (Piot 2005, p. 4). Bongaarts et al. (2009, p. 2) of the United Nations Population Council estimated that about 24 million have died from AIDS between 1980and 2007 and by 2030 the total is projected to reach 75 million. The share of AIDS from all mortality figures have reached 3.9 percent worldwide and 15 percent in sub-Saharan Africa and the proportion is expected to remain at the current level for at least several years more (Bongaarts et al. 2009, p. 2). AIDS is now the fourth leading cause of mortality worldwide (USAID 2002, p. 1). Despite the UNODC assessment (2005, Section VII or page 5-6) that nobody can get AIDS from sleeping in the same room, kiss on the check hug, share the same towel, and breathe the same air with a person who has AIDS, it remains that people avoid people with AIDS precisely because people usually don’t know much about AIDS. Estimates place while AIDS cut around 21 years off the life expectancy in the United States, AIDS cut off around 13 years in the life expectancy of individuals in the United Kingdom based on research presented at the Tenth Congress on Drug Therapy in HIV Infection in Glasgow in November 2010 (Caims 2020, 2nd paragraph). The stigma that comes with HIV infection probably revolves on two points. First, infection with AIDS makes one a carrier of illness that can reduce one’s life expectancy from 13 to 21 years. Second, infection with AIDS makes one a suspect of having illicit sexual activities. This can range from having promiscuous behaviour to sexual intercourse with prostitutes. Of course, infection with AIDS does not necessarily make one promiscuous and transmission can easily be prevented. Nevertheless, the stigma can be enough to hide one’s infection with AIDS and could make the transmission faster. This is a real problem but this should not be enough to say that the stigma is more fearful than the condition itself. Unlike social stigma which can easily be addressed, infection with AIDS is not something easily addressed. 3. Why is it difficult to PROVE a causal relationship between social factors such as poor housing or unemployment and illness? It is difficult to prove a causal relationship between social factors such as poor housing or unemployment and illness. It may true that poor housing and unemployment makes one vulnerable to diseases that can be associated with low income groups: higher infection rates, higher morbidity rates and even higher mortality rates. However, association is not causation. Two variables, say A and B, for instance, may be associated but there can be a variable C that may be causing the two of them and, thus, it would be incorrect to say that A causes B or that B causes A because C may be causing both A and B. At the same time, there are several other possibilities. For instance, variable A may be associated with B because A is associated with C and it is C that is in fact that can cause B. Thus, A and B are only associated because A is associated with C that in turn causes B. At the same time, the relationship between A and C need not be strong. Another variable D can intervene. Variable A will only cause C if the value of D is 0 but not if the value of D is not zero. In our example, variable A can be one’s socio-economic status or poverty and B can be the variable ill health. Variable C in turn can be vulnerability to infectious diseases. However, vulnerability to infectious diseases can only result if there is the absence of adequate education or if the value of variable D is zero. However, the vulnerability to infectious diseases will not result if the value of variable D is not zero or the person has adequate education. At the same time, there can be a variable E that can be government policy that can make variable D not equal to zero. Still, there are other possibilities. For instance, the artificial association between illness and socio-economic status can take place because of a third variable F that can be location. The poor may be living in locations where the population may be exposed to vulnerabilities to infection. Thus, it is not the socio-economic status that is causing the vulnerability but the location of residences of the people belonging to lower socio-economic status. The association can be reduced to zero if the poor or those from the lower income groups are relocated to other residences. There can be also hereditary factors like history. Genetics can be an accident or a twist of history. For instance, the royal families may have been a product of good genes. Of course, this is both debatable and non-palatable but this remains one possibility. Another possibility can be lifestyle. The socio-economic status can imply certain lifestyles which if adequately imbibed by the lower income groups or vice versa can mean better health associated with the lifestyle. It may be possible that the poor are exposed to certain diseases because their occupations exposed them to health risks but the health risks can disappear if certain safety equipment or tools are used. The rich may be having sedentary lifestyle but the lifestyle can change as exercise is introduced and promoted within the income groups. One classic material that can guide us to produce better research that deals with competing hypothesis is the one by Donald Campbell and Julian Stanley (1963). Of course, there are several and newer materials on research designs since then. Another way to handle situations where there are competing hypothesis is to use regression techniques. Regression techniques provide a way for statistical controls. References Bongaarts, J., Pelletier, F., and Gerland, P., 2009. Global trends in AIDS mortality. New York: United Nations Population Council. Caims, G., 2010. HIV in the UK still cuts 13 year off life expectancy: late testing is the main reason. NAM AIDSMAP. Available in http://www.aidsmap.com/HIV-in-the-UK-still-cuts-13-years-off-life-expectancy-late-testing-is-the-main-reason/page/1558930/ [accessed 2 January 2010]. Campbell, D. and Stanley, J., 1963. Experimental and quasi-experimental designs for research. Chicago: Rand McNally College Publishing Company. Hodgins, M., Millar, M., and Barry, M., 2006. “…it’s all the same no matter how much fruit or vegetables or fresh air we get”: Traveller women’s perceptions of illness causation and health inequalities. Social Science & Medicine, 62, 1978-1990. Hughner, R. and Kleine, S., 2004. Variations in lay health theories: Implication for consumer health care decision making. Qualitative Health Research, 18, 1687-1703. Norby, H., 2008. Medical explanations and lay conceptions of disease and illness in doctor-patient interaction. Theory and Medicine Bioethics, 29, 357-370. Piot, P., 2005. Why AIDS is exceptional. Speech given at the London School of Economics. 8 February. USAID, 2002. USAID’s expanded response to HIV/AIDS. US Agency for International Development. UNODC (United Nations Office on Drugs and Crime), 2005. Module 5: Basics of HIV/AIDS. United Nations: Office on Drugs and Crime. Read More