A Medical Sociologist Looks at Health Promotion - Assignment Example

Question Health promotion programs have altered people’s behavior, perhaps because almost everyone desires for longer healthy life. Though health promotion programs claimed they improved people’s health and well-being, Becker (1993) has noted otherwise. According to him, the premature exhortations to the public of health promotion resulting from conflicting scientific findings has instead created an ‘epidemic of apprehension’ which confused rather than cleared people’s understanding of healthy behaviors. As such, Becker emphasizes that in designing health promotion programs, like the community health promotion and primary or secondary disease prevention programs, it is important that these truly addressed the target population and disease. a. One factor to be considered is the influence of gender roles in utilizing preventive health services. Gender stereotyping remains until today, affecting all aspects of people’s lives including health. Specifically, these have formed the long-held beliefs on men’s and women’s health needs, risks and behaviors (Bird and Rieker, 1999). The effect of which, Kemper (2006) notes, is the worsening of gender bias in the provision and utilization of health care. Her study shows the effect of pharmaceutical companies’ gendered marketing of migraine to have misrepresented it as a ‘women’s disorder’. But the fact is migraine ranks among the world’s top 20 disabling disorders. Although the 1998 US population survey shows a greater portion of women (41%) than men (29%) suffering from migraine, this does not negate but rather confirms the fact that both women and men can suffer from migraine. Worst, portraying migraine to be a ‘women’s disorder’ due to hegemonic femininity has consequently inhibited men-migraine sufferers from seeking help. Resultantly, a greater number of migraine sufferers do not seek treatment. (p. 1986-1987) Similarly, Bird and Rieker’s (1999) study explains how the lack of understanding on the effect of socially constructed gendered roles has exacerbated health problems on men and women and how this has created incorrect assumptions regarding men and women’s health resulting to their non-cognizance of their need for preventive health behaviors. For example, women are believed to be at lower risk of heart disease; whereas men’s fertility health risks are underestimated, both resulting to unequal medical treatment, hence exacerbating their health risk. Added to this are behaviors society expects from their gendered roles. For example, men are believed to seek medical help lesser than women. As such, Bird and Rieker emphasize the need to understand sex and gender differences and their interrelationship, integrating biological and sociological studies in order to equally address the health of both men and women. (p. 751) b. Furthermore, given the positive impact of marriage on health, the promotion of healthy marriage is a positive factor in protecting population health. Idler et al.’s (2012) study findings revealed that unmarried persons are 1.90 times at greater risk of postsurgical mortality than married persons. Key to this is the reinforcing roles of spouses in care giving and in controlling health related behaviors. These findings are no longer new. Early studies in social science had long established the association of marriage with greater survival. Not only does marriage provide needed emotional support during health crisis, but more importantly it provides cognitive and marital support. In fact, marital relationship alone provides various types of resources enabling married persons surpass life-and-death situations. (p. 33-36) This is true even among homo and bisexuals. Wight, LeBlanc, and Badgett (2013) study has provided an empirical evidence on the positive impact of same sex-marriage on the psychological and mental well-being of gays, lesbians, and bisexuals. This could be due to the heightened sense of social acceptance inherent in the social institution of marriage. c. Given the social and structural inequalities causing the unequal provision and utilization of health care, designing programs to promote healthy choices by individuals (as a strategy of achieving maximum impact with maximum public support) is necessary. Not doing so leaves any health promotion programs futile. A case in point is the significant impact of a micro-finance based intervention on women’s empowerment in South Africa. Kim et al.’s study (2007) has shown that the combined Intervention with Microfinance for AIDS and Gender Equity (IMAGE) and microfinance program with participatory training on understanding HIV infection, gender norms, domestic violence, and sexuality can economically and socially empower women which resultantly can reduce the incidence of intimate partner violence (IPV). The strength of this combined intervention is its attempt to address the social and structural cause of IPV. By economically empowering women, their subordinate status in society is also improved and their struggle for equality becomes more acceptable. Question # 2 Inspired by past achievements and committed to attaining unmet targets, the Healthy People 2020 reasserts its focused on reducing health disparities (morbidity and mortality) by race/ethnicity and social class (Koh, 2010). To do so, the role that various factors play in the optimal use of primary health care services by the most vulnerable populations must be seriously considered. a. One factor is the attitude of low income African Americans in seeking medicine and medical care. The importance of this is derived from the century-long substantial disparities in racial and ethnic morbidity and mortality, which previous assumptions suggestively blame on African Americans’ negative attitude regarding seeking medicine and medical care (Schnittker, Pescosolido, & Croghan, 2005). As Green, Yawn, Lanier, and Dovey (2001) state: “The interactions between people and the health care system are driven by preferences and needs that persist despite changes in the organization of health care” (p. 2023). However, the 2000 General Social Survey showed otherwise. “African Americans report greater willingness to seek treatment for some symptoms and greater optimism regarding some treatment outcomes” (Schnittker et al., 2005, p. 255). This attitude almost defines this racial group regardless of education or income status. More importantly, this implies the selective treatment seeking attitude of African Americans. Therefore, it is important to note the kinds of symptoms that make them seek and not seek treatment and why. This knowledge could help make health care more responsive to this target population. b. Understanding the reasons that drive low income minority populations (LIMP) to prefer seeking health care in emergency rooms rather than from primary care physicians is similarly important. The importance of which lies not only on the harm this can effect on LIMP, but also on the exacerbation of health disparities and on its additional cost to the health care system. Actually, hospitalization of ambulatory care-sensitive conditions is costing the health care system approximately $30.8 billion annually. Yet, this problem that further burdens the health care system and widens health disparities is actually driven by the system itself. LIMPs prefer going to hospitals than in ambulatory care because they find the former more accessible and more efficient over the latter in terms of time, cost, process and result. Hence given the primary role of the ambulatory care in reducing health disparities, much focus should be given in making it a ‘one-stop-shop’ experience for patients. (Kangovi et al., 2013) Unless ambulatory care does not become accessible to LIMPs health disparity remains. c. Similarly, understanding the possible reasons that may lead lower income populations (LIP) to utilize ‘alternative care’ [non--‐medical] services and treatments for health problems is also important. It is highly surprising that a greater portion of American adults (62.1%) prefer using the complementary and alternative medicine (CAM) over conventional medical care (CMC). For this to occur at a time when CMC has been generally believed to be more effective is more surprising. But, CMC is more expensive. The per capita cost of health care is greater than the Americans’ personal income with 30% of American workers uninsured in 2009. Although data do not reflect specific group preference, cost concerns put LIP, especially those suffering from chronic health conditions necessitating continuous health care treatment, to logically end up using CAM. As such, making CMC more accessible to LIP is imperative to reduce health disparity. Besides, the safety and efficacy of CAM has yet to be established. (Pagán & Pauly, 2005) The significant number of Mexican American population in the US makes it important to understand why this population despite having access to US health services prefers seeking care from clinics in Mexican border cities in order to address the group’s specific need. Although various studies have tackled this health issue using different methodologies, common elements can be noted from their varying findings such as cost, convenience, and style of medical practice like “rapidity of services, personalized attention, effective medication, emphasis on clinical discretion [as opposed] to the frequent referrals and tests, impersonal doctor-patient relationship, uniform treatment protocols and reliance on surgeries” features of the US health care system (Horton & Cole, 2011, p. 1846). However, Horton and Cole note that these do not necessarily characterize a ‘Mexican medical culture’. Rather these appear to be characteristics unique to private clinic and hospitals in Mexican border cities which US Mexican immigrants can now afford. Essentially, this only confirms two important elements patients seek in healthcare: accessibility (including affordability, availability, and open schedule) and quality (including doctor-patient relationship, intervention, and outcome). References Becker, M. H. (1993). A medical sociologist looks at health promotion. Journal of Health and Social Behavior 34 (March): 1-6. Bird, C. E. & Rieker, P. P. (1999). Gender matters: An integrated model for understanding men’s and women’s health. Social Science & Medicine 48, 745-755. Green, L. A., Yawn, B. P., Lanier, D., & Dovey, S. M. (2001). Occasional notes: The ecology of medical care revisited. New England Journal of Medicine 344 (26), 2021-2025. Horton, S. & Cole, S. (2011). Medical returns: Seeking health care in Mexico. Social Science & Medicine 72, 1846-1852. Idler, E. L., Boulifard, D. A., & Contrada, R. J. (2012). Mending broken hearts: Marriage and survival following cardiac surgery. Journal of Health and Social Behavior 53, 33-49. Kangovi, S., Barg, F. K., Carter, T., Long, J. A., Shannon, R., & Grande, D. (2013). Understanding why patients of low socioeconomic status prefer hospitals over ambulatory care. Health Affairs 32 (7), 1196-1203. Kempner, J. (2006). Gendering the migraine market: Do representations of illness matter? Social Science & Medicine 63, 1986-1997. Kim, Julia C., Watts, Charlotte H., Hargreaves, James R., Ndhlovu, Luceth X., Phetla, Godfrey, Morison, Linda A., Busza, Joanna, Porter, John D. H., & Pronyk, Paul. (2007). Understanding the impact of a microfinance-based intervention on women’s empowerment and the reduction of intimate partner violence in South Africa. American Journal of Public Health 97 (10), 1794-1802. Koh, H. K. (2010). Perspective: A 2020 vision for healthy people. The New England Journal of Medicine 362 (18), 1653-1656. Pagán, J. A. & Pauly, M. V. (2005). Access to conventional medical care and the use of complementary and alternative medicine. Health Affairs 24 (1), 255-262. Schnittker, J., Pescosolido, B. A., & Croghan, T. W. (2005). Are African Americans really less willing to use health care? Social Problems 52 (2), 255-271. Wight, R. G., LeBlanc, A. J., & Badgett, M.V.L. (2013). Same-sex legal marriage and psychological well-being: Findings from the California health interview survey. American Journal of Public Health 103 (2), 339-346. Read More