social significance of age

1. Sociocultural context
of health and
healthcare delivery
Age, disability, gender & social class and
stratification

2. The social significance of age
O As with biological traits, we observe a
person’s age when interacting with
him/her.
O Significant as it defines what is
appropriate and expected from people of
different ages.
O For this reason we are not surprised to
see a small child crying for sweets in a
shop.
O We also treat children different than we
would treat adults.

3. The social significance of age
O Age is defined in terms of the number of years
one has been alive. (chronological age).
O It is different from one’s functional age- refers
to observable individual attributes such as
physical appearance, mobility, strength and
mental capacity.
O We automatically look at how old people are in
our day-to-day lives and interaction. We look at
things like grey hair, wrinkles etc.
O Society decides thus what is considered as
‘old’.

4. The social significance of age
O Because life expectancy differs from country to
country, a 68 year old can be considered old in
a society where people live to an average of
about 45 years old.

5. The changing age structure of
society
O ‘Greying of nations’- the elderly who make
up a growing proportion of societies.
O Figure 3.2 illustrates that we can expect to
be faced with a growing number of elderly
people in society as the elderly make up a
growing % of the total population.
O It is estimated that by the year 202, almost
10% of the world population will be 65
years and older.

6. Problems in inter-age
interaction and how these
manifest in healthcare
O 1) Ageism
O is stereotyping and
discriminating
against individuals
or groups on the
basis of their age

7. O Often the elderly are seen as unattractive,
unemployable, mentally incompetent, slow,
caught up in the past, demanding, absent-
minded etc.
O As with all other forms of diversity, the
danger for the healthcare provider lies in the
fact that treatment of the elderly patient
might be based on stereotypical ideas.

8. O It manifests in the following ways:
O Marginalization.
O The use of dismissive and demeaning
language.
O Humour and mockery.
O Physical, sexual, emotional and financial
abuse.
O Economic disadvantage.
O Restricted opportunities.
O Psychological abuse.

9. O Financial exploitation typically involves the
theft or misuse of the elderly person’s
money.
O Medical abuse occurs when a person
withholds or improperly administers
medication or health aids.
O Neglect.
O Abuse ( difference)

10. 2) Ageism in nursing and how
to combat it
O Thompson points out that ageism in
healthcare involves dehumanisation,
depersonalisation (the action of divesting
someone or something of human
characteristics or individuality), ageist
language, elderly abuse and
infantilisation.

11. 2) Ageism in nursing and how
to combat it
O Nurses should act in an anti-ageist
manner:
O - personhood: ascribe value to all people
of all ages.
O - citizenship: the relationship between the
individual and society is acknowledge. It
emphasises the rights and responsibilities
of individuals in society.
O - celebration: age is to be celebrated and
an achievement.

12. 3) Senior status of the elderly
O Role conflict that nurses experience when
it comes to the elderly.
O Cultural backgrounds mostly enables
nurses to have respect for the elderly.
O Role conflict on ‘informing’ an older
person on what to do.
O In some cases elderly people may refuse
to do what is instructed.

13. Old age and health
O The older population usually has a lower
incidence of acute diseases than the younger
population.
O They suffer from more chronic conditions.
O The likelihood of having a chronic disease not
only increases in old age, but varies in sex.
O Women tend to have more arthritis and vision
problems.
O Men have a higher rate of life-threatening
chronic conditions such as heart disease.

14. Old age and health
O Whatever disease the elderly may be suffering
from, healthcare may not be always accessible.
The reasons being: the bad attitude of health
staff towards poor people, shortage of supplies,
lack of information, lack of funds and poor
implementation structures.
O In addition to this, the elderly have to wait until
someone is available to accompany them to the
health centres.
O The difficulty of getting to a doctor may result in
many of the elderly going without proper care.

15. Old age and health
O A primary care giver can thus be identified as a
person who attends to the elderly person’s
immediate needs.
O Usually a person within lose proximity. Often it is
a female.
O Primary caregivers suffer from emotional or
physical strain due to caring for the elderly
O Burden
O May have a negative effect on the quality of
care.
O Old age homes.

16. Old age and health
O The 2001 population census found that 7.3% of the total
population were 60 years or older.28 This proportion may
be perceived as low, or at least considerably lower than
the 2000 proportions of some developed nations, such as
Italy (24.1%), Greece (23.4%) and Japan (23.2%), but it is
higher than the proportions of almost all other African
nations in 2000, with the exception of the two island
populations of Mauritius (9%) and Reunion (9.9%). South
Africa’s 7.3% was noticeably higher than the 5.1% for the
African continent as a whole, but displayed similar levels of
ageing as those in such nations as Brazil (7.8%), India
(7.6%), Mexico (6.9%), Samoa (6.8%) and Vietnam
(7.5%). The average proportion for the Southern African
region in 2000 was 5.7%, and neighbouring countries’
proportions ranged from 4.5% in Angola and Botswana to
6.5% in Lesotho.

17. Old age and health
O Despite the demographic impact of HIV/AIDS,
the South African proportion is projected to
increase over the next two decades, and that by
2025 more than one person in ten will be 60
years or older.
O The demographic ageing of populations
throughout the world is directly related to
fundamental changes in the health and disease
patterns within that population, as
epidemiological change ensues with a change
from the predominance of infectious, parasitic
and nutritional disease to the growing weight of
chronic diseases of lifestyle (CDL)

18. Old age and health
O The individual ageing process, from a medical
perspective, is often associated with disease and
disability. This association has been challenged on
the grounds that there are many older persons who
do not suffer chronic illness or disability, and many
claiming to be in good health despite the presence of
chronic illness.
O However, this ‘medical myth’ is supported by
morbidity and cause of-death statistics showing that
diseases are usually more common among older
than younger people, and that the prevalence of
disability and chronic disease increases with
advanced age.

19. Old age and health
O As in many other countries, mortality statistics in
South Africa are an important and often-used
source of evidence on the health status of the
population, while it is difficult to find reliably
measured population-based information about
disease, disability and health risks. Given the
recent emphasis on reproductive, child,
adolescent and maternal health in the country, it
is likely to be even more difficult to find reliable
representative information about disease,
disability and health risks in the older population.

20. Selected risk and lifestyle
factors for chronic disease
O It is widely acknowledged that being
overweight or obese is associated with an
increased risk of disease. The adverse
metabolic effects include raised blood
pressure, altered blood lipid profiles and
the development of insulin resistance;
these, in turn, are related to a range of
chronic diseases.

21. Selected risk and lifestyle
factors for chronic disease
O In the population 65+ years old, 43% of
men and 60% of women had excess body
weight with a BMI ≥25 kg/m2.
O This implies that large proportions of this
population are at risk of a range of
associated chronic conditions – including
IHD, hypertensive disease, stroke, type 2
diabetes, osteoarthritis and several
cancers – and the associated limitations in
survivors.

23. Disability
O"Disability is the disadvantage
or restriction of activity caused
by a society that takes little or
no account of people who have
impairments and thus excludes
them from mainstream activity."

24. Disability
O It is estimated that half a billion people are
disabled, worldwide as a result of
physical, sensory or mental impairment.
O SA- 2 255 982.
O About 5% of the South African population.
O It is argued that disabilities increase yearly
as advances in medical science and
demographic changes result in more
people surviving life threatening
conditions, only to be left with chronic ill
health or impairments.

25. Disability
O Disability focusses on impairment: mental,
physical, emotional).

26. Approaches to defining
disabilities:
O Medical model of disability:
O The medical model is presented as viewing
disability as a problem of the person, directly
caused by disease, trauma, or other health
condition which therefore requires sustained
medical care provided in the form of individual
treatment by professionals. In the medical model,
management of the disability is aimed at a "cure,"
or the individual’s adjustment and behavioral
change that would lead to an "almost-cure" or
effective cure. In the medical model, medical care
is viewed as the main issue

27. Approaches to defining
disabilities:
O Impairment: the result of a biological or physical
abnormality.
O Disability: the resulting restrictions in activity due
to impairments.
O Handicap: a disadvantaged faced by people with
disabilities that arises due to impairments and
disabilities.

28. Approaches to defining
disabilities:
ICIDH Model of disabilities:
Impairment:
person with a
physical disability
Disability: cannot
walk up the stairs
Handicap:
cannot get a job
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