It is a paradox of recent epidemiology that as material inequalities grow, so
the pursuit of non-material explanations for health outcomes proliferates. At
one level, a greater recognition of psycho-social factors has deepened the
understanding of the societal determinants of health, the links between mental
and physical health and the social nature of human need. Too often however,
psycho-social factors are abstracted from the material realities of people
’
s lives
and function as an alternative to addressing questions of economic power and
privilege and their relationship to the distribution of health. The growing in
fl
u-
ence of salutogenesis and asset-based approaches is one example of this trend.
This paper re
fl
ects on the theories of public health that lie behind the dis-
course of assets, together with some of the reasons for, and consequences of,
its popularity and in
fl
uence, notably in Scotland.
Social Science & Medicine Dependency Denied Peacock, Bissell, Owen PDF_August...Paul Bissell
This document summarizes a study exploring how neoliberal discourses shape experiences of inequality in Salford, England. The study found evidence that supports Wilkinson and Pickett's hypothesis from The Spirit Level that inequality generates health damages by lowering social status and increasing stress. However, a more prominent finding was the articulation of a "no legitimate dependency" discourse, where participants disavowed any form of dependency and assumed sole responsibility for their situations. The authors argue that internalizing neoliberal discourses of individual responsibility, combined with the destruction of protective resources, increases strain and helps explain health damages from living in an unequal society. Integrating understandings of neoliberalism can enrich perspectives on the relationship between inequality and health
This document summarizes the findings of six studies that examined the relationship between economic insecurity and physical pain. The studies found:
1) Household unemployment level predicted increased consumption of over-the-counter painkillers, based on analysis of consumer panel data.
2) Both individual employment status and the economic prospects of participants' state of residence predicted higher self-reported physical pain. Those in states with higher unemployment reported more pain.
3) Experiments found that inducing feelings of economic insecurity, either by informing participants about high unemployment in their state or having them contemplate their own past or future insecurity, increased self-reported pain and reduced pain tolerance.
4) Mediation analyses established that
Medical Professionalism Expectations ObligationsJ L
The document discusses the concept of medicine's "social contract" with society. It describes how the social contract originated in philosophy to define the relationship between citizens and the state, and how more recently it has been applied to describe medicine's relationship with society. The social contract involves reciprocal expectations and obligations - society grants medicine autonomy and rewards in exchange for medicine prioritizing patient interests, ensuring competence, and addressing public health issues. The document analyzes the different parties involved in medicine's social contract, including individual physicians, professional organizations, patients and the public, government, and commercial sector. It provides a framework for understanding the complex relationships and expectations between these groups.
Peacock M Bissell P Owen JM. Shaming encounters, reflections on social inequa...Paul Bissell
This document summarizes an article from the journal Sociology that examines arguments about the relationship between social inequality and health. It critiques Wilkinson and Pickett's argument in The Spirit Level that social comparisons and the shame they produce contribute to poorer health in more unequal societies. The summary extends their framework by incorporating sociological perspectives on agency, resistance, and how people make sense of social position. It argues this provides a more nuanced understanding of how shame may operate and interact with contemporary forces like neoliberalism.
This document discusses the concepts of "care" and "dependency" and how they have traditionally been viewed separately in research and policy. It argues that care and dependency are interrelated and should be viewed as different aspects of the same phenomenon. The document outlines how the concept of "care" emerged from feminist scholarship to highlight the unpaid labor of women. It also discusses how "dependency" is a contested term with different meanings. The paper proposes that integrating perspectives on care and dependency can lead to a better understanding of their relationship and the social contexts involved.
Health has gained recognition as a foreign policy concern in recent years. Political leaders increasingly address global health problems within their international relations agendas. The confluence of health and foreign policy has opened these issues to analysis that helps clarify the tenets and determinants of this linkage, offering a new framework for international health policy. Yet as health remains profoundly bound to altruistic values, caution is required before generalizing about the positive outcomes of merging international health and foreign policy principles. In particular, the possible side-effects of this framework deserve further consideration. This paper examines the interaction of health and foreign policy in humanitarian action, where public health and foreign policy are often in direct conflict. Using a case-based approach, this analysis shows that health and foreign policy need not be at odds in this context, although there are situations where altruistic and interest-based values compete. The hierarchy of foreign policy functions must be challenged to avoid misuse of national authority where health interventions do not coincide with national security and domestic interests
This week we will begin by reviewing the course content and evaluation procedures. The opening remarks will include an examination of the biomedical and social models of health.
Thesis - Urbanism: A Trend in Hyper-Stimulation and Its Effects on the Human ...Nelson Rozo
Taking into consideration both the mind and its environment by examining the place of dwelling and its various characteristics. My undergraduate work has aimed to further understand the mechanisms underlying human behavior and perception by taking an interdisciplinary approach that combines the social sciences with cognitive neuroscience for a more holistic approach. In this thesis I examine some of the factors associated with urban living and their possible side effects on the human brain.
Social Science & Medicine Dependency Denied Peacock, Bissell, Owen PDF_August...Paul Bissell
This document summarizes a study exploring how neoliberal discourses shape experiences of inequality in Salford, England. The study found evidence that supports Wilkinson and Pickett's hypothesis from The Spirit Level that inequality generates health damages by lowering social status and increasing stress. However, a more prominent finding was the articulation of a "no legitimate dependency" discourse, where participants disavowed any form of dependency and assumed sole responsibility for their situations. The authors argue that internalizing neoliberal discourses of individual responsibility, combined with the destruction of protective resources, increases strain and helps explain health damages from living in an unequal society. Integrating understandings of neoliberalism can enrich perspectives on the relationship between inequality and health
This document summarizes the findings of six studies that examined the relationship between economic insecurity and physical pain. The studies found:
1) Household unemployment level predicted increased consumption of over-the-counter painkillers, based on analysis of consumer panel data.
2) Both individual employment status and the economic prospects of participants' state of residence predicted higher self-reported physical pain. Those in states with higher unemployment reported more pain.
3) Experiments found that inducing feelings of economic insecurity, either by informing participants about high unemployment in their state or having them contemplate their own past or future insecurity, increased self-reported pain and reduced pain tolerance.
4) Mediation analyses established that
Medical Professionalism Expectations ObligationsJ L
The document discusses the concept of medicine's "social contract" with society. It describes how the social contract originated in philosophy to define the relationship between citizens and the state, and how more recently it has been applied to describe medicine's relationship with society. The social contract involves reciprocal expectations and obligations - society grants medicine autonomy and rewards in exchange for medicine prioritizing patient interests, ensuring competence, and addressing public health issues. The document analyzes the different parties involved in medicine's social contract, including individual physicians, professional organizations, patients and the public, government, and commercial sector. It provides a framework for understanding the complex relationships and expectations between these groups.
Peacock M Bissell P Owen JM. Shaming encounters, reflections on social inequa...Paul Bissell
This document summarizes an article from the journal Sociology that examines arguments about the relationship between social inequality and health. It critiques Wilkinson and Pickett's argument in The Spirit Level that social comparisons and the shame they produce contribute to poorer health in more unequal societies. The summary extends their framework by incorporating sociological perspectives on agency, resistance, and how people make sense of social position. It argues this provides a more nuanced understanding of how shame may operate and interact with contemporary forces like neoliberalism.
This document discusses the concepts of "care" and "dependency" and how they have traditionally been viewed separately in research and policy. It argues that care and dependency are interrelated and should be viewed as different aspects of the same phenomenon. The document outlines how the concept of "care" emerged from feminist scholarship to highlight the unpaid labor of women. It also discusses how "dependency" is a contested term with different meanings. The paper proposes that integrating perspectives on care and dependency can lead to a better understanding of their relationship and the social contexts involved.
Health has gained recognition as a foreign policy concern in recent years. Political leaders increasingly address global health problems within their international relations agendas. The confluence of health and foreign policy has opened these issues to analysis that helps clarify the tenets and determinants of this linkage, offering a new framework for international health policy. Yet as health remains profoundly bound to altruistic values, caution is required before generalizing about the positive outcomes of merging international health and foreign policy principles. In particular, the possible side-effects of this framework deserve further consideration. This paper examines the interaction of health and foreign policy in humanitarian action, where public health and foreign policy are often in direct conflict. Using a case-based approach, this analysis shows that health and foreign policy need not be at odds in this context, although there are situations where altruistic and interest-based values compete. The hierarchy of foreign policy functions must be challenged to avoid misuse of national authority where health interventions do not coincide with national security and domestic interests
This week we will begin by reviewing the course content and evaluation procedures. The opening remarks will include an examination of the biomedical and social models of health.
Thesis - Urbanism: A Trend in Hyper-Stimulation and Its Effects on the Human ...Nelson Rozo
Taking into consideration both the mind and its environment by examining the place of dwelling and its various characteristics. My undergraduate work has aimed to further understand the mechanisms underlying human behavior and perception by taking an interdisciplinary approach that combines the social sciences with cognitive neuroscience for a more holistic approach. In this thesis I examine some of the factors associated with urban living and their possible side effects on the human brain.
HOW THE PANDEMIC DESTROYED OUR ‘SOCIAL CAPITAL’? A HOLISTIC REVIEWIAEME Publication
The COVID-19 pandemic shacked up our ability to work physically together, to solve complex problems in the field, and form initiatives that make up the new developments of our communities. This paper reviews how our social capital is being threatened, especially in unprecedented times. The research explores what challenges the pandemic and the new normal brought to our social capital, social mobility, social behaviours, while created an appreciation for our spiritual- and social being. The researcher investigates how our social capital values, and beliefs, besides our attitudes, have been affected by the changes in the social interactions that became more virtual since the outbreak. The implication of the paper carries early notes for mitigation against loss or destruction of social capital, which usually plays a puffer against collective social cognitive impairment. The paper concludes with recommendations and a scope for future framework that could help to bring initiatives that focus on citizens engagement, and optimising multidisciplinary thinking that targets the enhancement of future generations social networks capacity; taking in consideration the rise of aging populations.
This document discusses the role of social and environmental accounting research in times of sustainability crisis. It argues that lack of humanity, short-term thinking, and misuse of concepts like sustainable development have contributed to the current crisis. Researchers are urged to critically reflect on sustainability and corporate social responsibility reporting to help transform attitudes and behaviors. The document also notes tensions between sustainability and CSR, with CSR potentially co-opting the sustainability agenda. It calls on academics to enhance sustainability education and explore ways to improve organizational accountability and transparency.
Global Mental Health - Chair's Message to the GMH Caucus - Sept 2016Université de Montréal
1. The chair of the APA Caucus on Global Mental Health & Psychiatry discusses how mental health must now be understood globally due to increased globalization and the flow of information, goods, services, and people worldwide.
2. He argues that mental health issues are still often viewed in local and static terms rather than as global processes influenced by communities and cultures. The caucus aims to build bridges across medical specialties and perspectives to advance global mental health.
3. The caucus is entering its third year with over 300 members. It addresses the global aspects of psychiatry and aims to encourage cross-fertilization of ideas between stakeholders in global health.
This document discusses how political psychology could pay more attention to social and psychological processes involved in responses to innovative laws, particularly those related to sustainability and environmental protection. It argues that different types of legal innovation exist and mobilize different acceptance and resistance processes. The document outlines conceptual tools for examining how people and groups receive legal innovation, drawing on social representation theory and environmental psychology. It proposes a typology of legal innovation based on three criteria: whether the law directly binds individuals or governments, its target (behaviors or intergroup relations), and whether it regulates private or public spheres. Examples are provided from sustainability laws to illustrate differences in acceptance and resistance processes for different types of legal innovation.
This document summarizes Matthias Zick Varul's article analyzing Talcott Parsons' concept of the sick role and how it relates to chronic illness. The key points are:
1) Parsons' sick role concept is based on acute illnesses and becoming problematic with the rise of chronic illnesses which do not conform to the sick role's expectations of a temporary deviation from social roles and recovery.
2) Parsons viewed illness as a disruption of social and economic contributions in capitalist societies where health underlies economic productivity. The sick role provides legitimacy and social support during illness by exempting patients from normal roles and obligations in exchange for seeking treatment.
3) For chronic illnesses, the sick role's expectations of
SOCIAL CAPITAL ROLE IN ADDRESSING AGING PARENTS LONELINESSIAEME Publication
The challenges of caring for aging parents have different inputs and outputs; however, the one common factor that appears in both ends is the challenge of maintaining their social capital, regardless of their condition. In this paper, the social capital relevant to loneliness is addressed. The author, as a close carer, reviews the work that helped in addressing social capital maintenance, besides the mitigation mechanisms of both loneliness and its impact on cognitive decline. Based on the strategic framework that is synthesized from the literature, a communication model is proposed for close carers and the concerned stakeholders. The framework and the communication model mitigate the risks of loneliness by optimizing the social capital of the aging parents, and raising the best approaches for quality of life.
“The Experimental Child”: Mental and Social Consequences for Children and Fam...Université de Montréal
Abstract
Not only is the coronavirus crisis a natural laboratory of stress offering social psychiatrists a unique historical opportunity to observe its impact on entire populations around the world, but the responses to the crisis by international health authorities, such as the WHO, along with national and local educational institutions and health care and social services, are creating an unprecedented and unpredictable environment for children and youth. This hostile new environment for growth and development is marked by the sudden and unpredictable imposition of confinement and social isolation, cutting off or limiting opportunities for the development of cognitive abilities, peer relationships, and social skills, while exposing vulnerable children and youth to depriving, negligent, or even abusive home environments.
For this reason, this crisis has been renamed a syndemic, encompassing two different categories of disease—an infectious disease (SARS-CoV-2) and an array of non-communicable diseases (NCDs). Together, these conditions cluster within specific populations following deeply-embedded patterns of inequality and vulnerability (Horton, 2020). And children are the most vulnerable population around the world. The impact on children is part of a cascade of consequences affecting societies at large, smaller communities, and the multigenerational family, all of which impinge on children and youth as the lowest common denominator (Di Nicola & Daly, 2020).
This exceptional set of circumstances—in response not only to the biomedical and populational health aspects but also in constructing policies for entire societies—is creating an “experimental childhood” for billions of children and youth around the world. With its commitment to the social determinants of health and mental health, notably in light of the monumental Adverse Childhood Events (ACE) studies (Felitti & Anda, 2010), social psychiatry and global mental health in partner with child and family psychiatry and allied professions must now consider their roles for the future of these “experimental children” around the world. The parameters for observing the conditions of this coronavirus-induced syndemic in the family and in society, along with recommendations for social psychiatric interventions, and prospective paediatric, psychological, and social studies will be outlined.
Keywords: children & families, coronavirus syndemic, ACE Study, confinement, social isolation
People and Green Spaces: Promoting Public Health And Mental Well-Being Throug...KlausGroenholm
This document discusses how contact with nature and green spaces can promote both individual and public health outcomes. It reviews research showing the mental health benefits of ecotherapy and being in nature. The research found that, in addition to individual benefits, activities in green spaces can achieve unexpected social and community outcomes by building social connections and natural resources. This adds value for public health that has been overlooked. The document argues for more strategic and collaborative public health policies that incorporate access to nature to improve health and well-being.
Social Unrest and Mental Health
World Association of Social Psychiatry (WASP) Symposium
at the American Psychiatric Association Annual Meeting 2021
Vincenzo Di Nicola, MPhil, MD, PhD, DFAPA, FCPA President, CASP; President-Elect, WASP Professor of Psychiatry, University of Montreal, QC
Learning objectives
To understand the association between social unrest and mental health …
Specifically, to:
Identify the social determinants of unrest
Offer case examples of social unrest
Review WHO prevalence estimates and overall mental health impacts of social unrest
Discuss special considerations for children, youth & families
Plan for presentation
Social unrest and mental health: 30-45 minutes – V Di Nicola Social determinants: Triggers, aggravators & attenuators, circularity
Case examples (evidence-based studies)
Hong Kong Protests Black Lives Matter
WHO Prevalence Estimates (data)
Protests, Riots & Revolutions: A systematic review
Children, Youth & Families: Special considerations
Child and Family Impacts of the Coronavirus Syndemic: Developmental, Family, ...Université de Montréal
My presentation is part of the WASP-WPA Interorganizational Symposium for the WPA 21st Virtual World Congress of Psychiatry, Catragena, Colombia, October 16-21, 2021
Session Description
At this time, the death toll from COVID-19 is approaching 3 million people worldwide. The full toll of COVID-19 far exceeds
even this sobering number. Beyond the direct biological impacts of an infectious disease, the global impact of COVID-19 is
revealing and magnifying pre-existing fractures in our social structures. COVID-19 has led to significant differential impacts
among groups across age, health and socio-cultural variables, whether through increased direct illness morbidity and
mortality in the elderly or those with mental illness, or through indirect impacts associated with widespread societal and
health system changes, including youth impacted by confinement and social isolation impinging on development of prosocial
skills, increased caregiver and family stresses ranging from financial distress to violence, and further disenfranchisement of
already marginalized and vulnerable groups. At the same time, heightened public awareness and outcry about such
disparities has the potential to fuel new alliances, challenging and perhaps dismantling some historical stereotypes of race,
ethnicity, gender, sexual orientation, age, disability and illness. Rather than a pandemic, the global impacts reveal a
syndemic – multiple pandemics along different lines, both the viral/biological pandemic, plus a social pandemic superimposed
on pre-existing fault lines of inequity, poverty, mental illness, racism, sexism, ableism, ageism and other forms of stigma and
discrimination. This session will include discussion of the varied impacts of COVID-19 and exploration of their root causes
from a social psychiatry perspective.
Theories for social epidemiology in the 21st century.desbloqueadoPapa Torres Barrios
This document summarizes the emergence and development of social epidemiology as a field. It discusses:
1) How social epidemiology gained its name in the mid-20th century through works examining relationships between health and factors like residential segregation.
2) The three main theories currently used in social epidemiology - psychosocial theory, social production of disease theory, and ecosocial theory - which seek to explain social inequalities in health.
3) How while theories are key to shaping research and debates, literature explicitly discussing theoretical frameworks in social epidemiology remains limited. There is still room for developing more useful theories for the 21st century.
Theories for social epidemiologu in the 21st century an ecosocial perspectiveJorge Pacheco
This document discusses the history and development of theories in social epidemiology. It notes that while disparities in health have long been observed between social groups, explaining the causes has involved ongoing debates between individual-level versus societal-level factors. The term "social epidemiology" began to be used in the mid-20th century to describe the study of social determinants of health and disease. Early theories focused on host-agent-environment models but lacked accounting for social agency and distinctions between the natural and social environment. The document argues for advancing theories in the 21st century that can better explain social inequalities in health and hold social institutions accountable.
This document discusses definitions of health from different perspectives and models over time. It outlines four main schools of thought on defining health: the medical model from the 1920s which defines health as anatomical, physiological and psychological integrity; the holistic model from 1946 by the WHO defining health as physical, mental and social well-being; the wellness model from 1984 promoting health as realizing aspirations and needs; and the ecological model from the 1990s defining health as humans and living creatures coexisting indefinitely. The document then discusses parameters and factors that influence health, as well as the evolution of digital health from quantified self to anticipatory mobile health and personalized digital twins. It proposes applications of digital twins for health and explores challenges and solutions in implementing Health 4
Analysis of editorial discourse on environmental challenges in nigerian newsp...Alexander Decker
This document summarizes a study that analyzed editorial discourse in Nigerian newspapers regarding the 2012 flooding in Nigeria. The study examined how editorials attributed sources, assigned responsibility, advocated for behavior change, and proposed solutions in their coverage of the flooding issue. It reviewed literature on editorial discourse strategies and analyzed a sample of editorials from four Nigerian newspapers. The study found that editorials largely used expert sources for attribution and advocated for systemic, policy-based solutions. The document provides background on flooding in Nigeria and the role of editorials in influencing public policy debates.
This document discusses social capital and resilience as they relate to research on Aboriginal youth. It defines social capital and resilience at both the individual and community levels. The document presents a conceptual framework showing the four dimensions of this relationship: community resilience and social capital, community resilience and individual social capital, individual resilience and community social capital, and individual resilience and individual social capital. It reviews literature on the different types of social capital (individual vs. community/ecological) and the subdivisions within community social capital, such as bonding, bridging, and linking social capital.
Porque determinantes sociales oct 2010 okRoger Zapata
This document summarizes evidence that social factors profoundly influence children's health. It notes that children are especially sensitive to social determinants, particularly in early years. Adverse early social exposures can become biologically programmed, setting off chains of risk that lead to chronic illness later in life. However, positive influences can promote better long-term health trajectories. Effectively addressing social determinants requires both direct social policies to reduce poverty and inequality, and indirect strategies that disrupt links between social risks and poor health, such as transforming child health systems to promote collaboration.
Ulrich Beck is a German sociologist who developed the theory of the "risk society". According to Beck, modern societies have become preoccupied with future risks created by industrialization and globalization, such as pollution, pandemics, and other unintended consequences. The COVID-19 pandemic exemplifies many aspects of the risk society, as the virus spread globally through increased social connectivity and its risks were invisibly produced by modernization itself. Beck's theory helps explain how COVID-19 risks have been unequally managed and distributed according to social inequalities.
After the information revolution produced a global village, the economic revolution with its global flows of goods and services, finance and people, produces globalization of life. While research on social determinants of health means mental health must be understood globally, we talk about mental health in local and static terms, confining mental health to the margins. Health problems are seen as entities rather processes, solutions aimed at individuals instead of communities, and we overvalue biological explanations and undervalue family, social and cultural contexts for mental and relational problems. As the WHO/World Bank conference declared, “it’s time to move mental health from the margins to the mainstream of the global development agenda.”
This symposium by the Global Mental Health (GMH) Caucus addresses key developments in the GMH movement, integrating social determinants of health, primary care, school mental health, bio-ethics and cultural psychiatry, and emerging themes in medicine and the humanities on migrants, refugees and borders. Presentations by senior physicians address: (1) global initiatives in primary mental health to deal with health disparities, complexity and co-morbidity; (2) ethical dimensions of cultural sensitivity, ethical sustainability and culture-fair guidelines; (3) a pilot study for school mental health in several school settings in Kenya; and (4) needs of migrants and refugees in the light of changing definitions of borders and belonging. Two international fellows and residents provide the perspectives of psychiatrists-in-training on GMH.
Tackling health inequities by focusing on structural determinantsJim Bloyd
This document discusses structural determinants of health inequities in Cook County, Illinois. It provides examples of structural inequities like inequities in the labor market, education system, and safety net that lead to inequities in social position and intermediate factors, and ultimately inequities in health outcomes. It emphasizes that public health departments should address the fundamental social and political causes of inequities rather than just proximal causes, and notes the link between lack of power and greater health inequities.
Policy Development to Tackle Structural Origins of Health Inequities: Thought...Jim Bloyd
A plenary presentation by Jim Bloyd, MPH, Regional Health officer at the Cook County (Illinois, USA) Department of Public Health, was made Tuesday April 12, 2016, at the National Leadership Academy, "Strengthening the Capacity of Public Health Departments to Advance Health Equity," at the CDC Tom Harkin Global Communications Center, Atlanta, Georgia. The presentation describes the Chicago-area context in which policy is considered, the importance of adopting a causal framework for policy action to eliminate health inequities, actions taken by the Cook County Department of Public Health through its planning and assessment process, and the role of the Collaborative for Health Equity Cook County. The plenary topic, "Best Practices for Developing Policies to Address Social Determinants of Health," was addressed by a panel moderated by Leandris Liburd, Director, Office of Minority Health and Health Equity at the Centers for Disease Control and Prevention. The CDC hosted the National Leadership Academy on Health Equity, a two-day meeting April 11-12, 2016. The Association of State and Territorial Health Officials (ASTHO), the National Association of State Offices of Minority Health (NASOMH), and the National Association of County and City Health Officials (NACCHO) invited participants. At the conclusion of the National Leadership Academy on Health Equity a final report will be developed highlighting action steps, opportunities, challenges and lessons learned fro participants at the leadership academy. Participants' input during breakout sessions will play a critical role in defining the substance of the report. A twitter hashtag #CDCHealthEquity was created by participants during the meeting.
HOW THE PANDEMIC DESTROYED OUR ‘SOCIAL CAPITAL’? A HOLISTIC REVIEWIAEME Publication
The COVID-19 pandemic shacked up our ability to work physically together, to solve complex problems in the field, and form initiatives that make up the new developments of our communities. This paper reviews how our social capital is being threatened, especially in unprecedented times. The research explores what challenges the pandemic and the new normal brought to our social capital, social mobility, social behaviours, while created an appreciation for our spiritual- and social being. The researcher investigates how our social capital values, and beliefs, besides our attitudes, have been affected by the changes in the social interactions that became more virtual since the outbreak. The implication of the paper carries early notes for mitigation against loss or destruction of social capital, which usually plays a puffer against collective social cognitive impairment. The paper concludes with recommendations and a scope for future framework that could help to bring initiatives that focus on citizens engagement, and optimising multidisciplinary thinking that targets the enhancement of future generations social networks capacity; taking in consideration the rise of aging populations.
This document discusses the role of social and environmental accounting research in times of sustainability crisis. It argues that lack of humanity, short-term thinking, and misuse of concepts like sustainable development have contributed to the current crisis. Researchers are urged to critically reflect on sustainability and corporate social responsibility reporting to help transform attitudes and behaviors. The document also notes tensions between sustainability and CSR, with CSR potentially co-opting the sustainability agenda. It calls on academics to enhance sustainability education and explore ways to improve organizational accountability and transparency.
Global Mental Health - Chair's Message to the GMH Caucus - Sept 2016Université de Montréal
1. The chair of the APA Caucus on Global Mental Health & Psychiatry discusses how mental health must now be understood globally due to increased globalization and the flow of information, goods, services, and people worldwide.
2. He argues that mental health issues are still often viewed in local and static terms rather than as global processes influenced by communities and cultures. The caucus aims to build bridges across medical specialties and perspectives to advance global mental health.
3. The caucus is entering its third year with over 300 members. It addresses the global aspects of psychiatry and aims to encourage cross-fertilization of ideas between stakeholders in global health.
This document discusses how political psychology could pay more attention to social and psychological processes involved in responses to innovative laws, particularly those related to sustainability and environmental protection. It argues that different types of legal innovation exist and mobilize different acceptance and resistance processes. The document outlines conceptual tools for examining how people and groups receive legal innovation, drawing on social representation theory and environmental psychology. It proposes a typology of legal innovation based on three criteria: whether the law directly binds individuals or governments, its target (behaviors or intergroup relations), and whether it regulates private or public spheres. Examples are provided from sustainability laws to illustrate differences in acceptance and resistance processes for different types of legal innovation.
This document summarizes Matthias Zick Varul's article analyzing Talcott Parsons' concept of the sick role and how it relates to chronic illness. The key points are:
1) Parsons' sick role concept is based on acute illnesses and becoming problematic with the rise of chronic illnesses which do not conform to the sick role's expectations of a temporary deviation from social roles and recovery.
2) Parsons viewed illness as a disruption of social and economic contributions in capitalist societies where health underlies economic productivity. The sick role provides legitimacy and social support during illness by exempting patients from normal roles and obligations in exchange for seeking treatment.
3) For chronic illnesses, the sick role's expectations of
SOCIAL CAPITAL ROLE IN ADDRESSING AGING PARENTS LONELINESSIAEME Publication
The challenges of caring for aging parents have different inputs and outputs; however, the one common factor that appears in both ends is the challenge of maintaining their social capital, regardless of their condition. In this paper, the social capital relevant to loneliness is addressed. The author, as a close carer, reviews the work that helped in addressing social capital maintenance, besides the mitigation mechanisms of both loneliness and its impact on cognitive decline. Based on the strategic framework that is synthesized from the literature, a communication model is proposed for close carers and the concerned stakeholders. The framework and the communication model mitigate the risks of loneliness by optimizing the social capital of the aging parents, and raising the best approaches for quality of life.
“The Experimental Child”: Mental and Social Consequences for Children and Fam...Université de Montréal
Abstract
Not only is the coronavirus crisis a natural laboratory of stress offering social psychiatrists a unique historical opportunity to observe its impact on entire populations around the world, but the responses to the crisis by international health authorities, such as the WHO, along with national and local educational institutions and health care and social services, are creating an unprecedented and unpredictable environment for children and youth. This hostile new environment for growth and development is marked by the sudden and unpredictable imposition of confinement and social isolation, cutting off or limiting opportunities for the development of cognitive abilities, peer relationships, and social skills, while exposing vulnerable children and youth to depriving, negligent, or even abusive home environments.
For this reason, this crisis has been renamed a syndemic, encompassing two different categories of disease—an infectious disease (SARS-CoV-2) and an array of non-communicable diseases (NCDs). Together, these conditions cluster within specific populations following deeply-embedded patterns of inequality and vulnerability (Horton, 2020). And children are the most vulnerable population around the world. The impact on children is part of a cascade of consequences affecting societies at large, smaller communities, and the multigenerational family, all of which impinge on children and youth as the lowest common denominator (Di Nicola & Daly, 2020).
This exceptional set of circumstances—in response not only to the biomedical and populational health aspects but also in constructing policies for entire societies—is creating an “experimental childhood” for billions of children and youth around the world. With its commitment to the social determinants of health and mental health, notably in light of the monumental Adverse Childhood Events (ACE) studies (Felitti & Anda, 2010), social psychiatry and global mental health in partner with child and family psychiatry and allied professions must now consider their roles for the future of these “experimental children” around the world. The parameters for observing the conditions of this coronavirus-induced syndemic in the family and in society, along with recommendations for social psychiatric interventions, and prospective paediatric, psychological, and social studies will be outlined.
Keywords: children & families, coronavirus syndemic, ACE Study, confinement, social isolation
People and Green Spaces: Promoting Public Health And Mental Well-Being Throug...KlausGroenholm
This document discusses how contact with nature and green spaces can promote both individual and public health outcomes. It reviews research showing the mental health benefits of ecotherapy and being in nature. The research found that, in addition to individual benefits, activities in green spaces can achieve unexpected social and community outcomes by building social connections and natural resources. This adds value for public health that has been overlooked. The document argues for more strategic and collaborative public health policies that incorporate access to nature to improve health and well-being.
Social Unrest and Mental Health
World Association of Social Psychiatry (WASP) Symposium
at the American Psychiatric Association Annual Meeting 2021
Vincenzo Di Nicola, MPhil, MD, PhD, DFAPA, FCPA President, CASP; President-Elect, WASP Professor of Psychiatry, University of Montreal, QC
Learning objectives
To understand the association between social unrest and mental health …
Specifically, to:
Identify the social determinants of unrest
Offer case examples of social unrest
Review WHO prevalence estimates and overall mental health impacts of social unrest
Discuss special considerations for children, youth & families
Plan for presentation
Social unrest and mental health: 30-45 minutes – V Di Nicola Social determinants: Triggers, aggravators & attenuators, circularity
Case examples (evidence-based studies)
Hong Kong Protests Black Lives Matter
WHO Prevalence Estimates (data)
Protests, Riots & Revolutions: A systematic review
Children, Youth & Families: Special considerations
Child and Family Impacts of the Coronavirus Syndemic: Developmental, Family, ...Université de Montréal
My presentation is part of the WASP-WPA Interorganizational Symposium for the WPA 21st Virtual World Congress of Psychiatry, Catragena, Colombia, October 16-21, 2021
Session Description
At this time, the death toll from COVID-19 is approaching 3 million people worldwide. The full toll of COVID-19 far exceeds
even this sobering number. Beyond the direct biological impacts of an infectious disease, the global impact of COVID-19 is
revealing and magnifying pre-existing fractures in our social structures. COVID-19 has led to significant differential impacts
among groups across age, health and socio-cultural variables, whether through increased direct illness morbidity and
mortality in the elderly or those with mental illness, or through indirect impacts associated with widespread societal and
health system changes, including youth impacted by confinement and social isolation impinging on development of prosocial
skills, increased caregiver and family stresses ranging from financial distress to violence, and further disenfranchisement of
already marginalized and vulnerable groups. At the same time, heightened public awareness and outcry about such
disparities has the potential to fuel new alliances, challenging and perhaps dismantling some historical stereotypes of race,
ethnicity, gender, sexual orientation, age, disability and illness. Rather than a pandemic, the global impacts reveal a
syndemic – multiple pandemics along different lines, both the viral/biological pandemic, plus a social pandemic superimposed
on pre-existing fault lines of inequity, poverty, mental illness, racism, sexism, ableism, ageism and other forms of stigma and
discrimination. This session will include discussion of the varied impacts of COVID-19 and exploration of their root causes
from a social psychiatry perspective.
Theories for social epidemiology in the 21st century.desbloqueadoPapa Torres Barrios
This document summarizes the emergence and development of social epidemiology as a field. It discusses:
1) How social epidemiology gained its name in the mid-20th century through works examining relationships between health and factors like residential segregation.
2) The three main theories currently used in social epidemiology - psychosocial theory, social production of disease theory, and ecosocial theory - which seek to explain social inequalities in health.
3) How while theories are key to shaping research and debates, literature explicitly discussing theoretical frameworks in social epidemiology remains limited. There is still room for developing more useful theories for the 21st century.
Theories for social epidemiologu in the 21st century an ecosocial perspectiveJorge Pacheco
This document discusses the history and development of theories in social epidemiology. It notes that while disparities in health have long been observed between social groups, explaining the causes has involved ongoing debates between individual-level versus societal-level factors. The term "social epidemiology" began to be used in the mid-20th century to describe the study of social determinants of health and disease. Early theories focused on host-agent-environment models but lacked accounting for social agency and distinctions between the natural and social environment. The document argues for advancing theories in the 21st century that can better explain social inequalities in health and hold social institutions accountable.
This document discusses definitions of health from different perspectives and models over time. It outlines four main schools of thought on defining health: the medical model from the 1920s which defines health as anatomical, physiological and psychological integrity; the holistic model from 1946 by the WHO defining health as physical, mental and social well-being; the wellness model from 1984 promoting health as realizing aspirations and needs; and the ecological model from the 1990s defining health as humans and living creatures coexisting indefinitely. The document then discusses parameters and factors that influence health, as well as the evolution of digital health from quantified self to anticipatory mobile health and personalized digital twins. It proposes applications of digital twins for health and explores challenges and solutions in implementing Health 4
Analysis of editorial discourse on environmental challenges in nigerian newsp...Alexander Decker
This document summarizes a study that analyzed editorial discourse in Nigerian newspapers regarding the 2012 flooding in Nigeria. The study examined how editorials attributed sources, assigned responsibility, advocated for behavior change, and proposed solutions in their coverage of the flooding issue. It reviewed literature on editorial discourse strategies and analyzed a sample of editorials from four Nigerian newspapers. The study found that editorials largely used expert sources for attribution and advocated for systemic, policy-based solutions. The document provides background on flooding in Nigeria and the role of editorials in influencing public policy debates.
This document discusses social capital and resilience as they relate to research on Aboriginal youth. It defines social capital and resilience at both the individual and community levels. The document presents a conceptual framework showing the four dimensions of this relationship: community resilience and social capital, community resilience and individual social capital, individual resilience and community social capital, and individual resilience and individual social capital. It reviews literature on the different types of social capital (individual vs. community/ecological) and the subdivisions within community social capital, such as bonding, bridging, and linking social capital.
Porque determinantes sociales oct 2010 okRoger Zapata
This document summarizes evidence that social factors profoundly influence children's health. It notes that children are especially sensitive to social determinants, particularly in early years. Adverse early social exposures can become biologically programmed, setting off chains of risk that lead to chronic illness later in life. However, positive influences can promote better long-term health trajectories. Effectively addressing social determinants requires both direct social policies to reduce poverty and inequality, and indirect strategies that disrupt links between social risks and poor health, such as transforming child health systems to promote collaboration.
Ulrich Beck is a German sociologist who developed the theory of the "risk society". According to Beck, modern societies have become preoccupied with future risks created by industrialization and globalization, such as pollution, pandemics, and other unintended consequences. The COVID-19 pandemic exemplifies many aspects of the risk society, as the virus spread globally through increased social connectivity and its risks were invisibly produced by modernization itself. Beck's theory helps explain how COVID-19 risks have been unequally managed and distributed according to social inequalities.
After the information revolution produced a global village, the economic revolution with its global flows of goods and services, finance and people, produces globalization of life. While research on social determinants of health means mental health must be understood globally, we talk about mental health in local and static terms, confining mental health to the margins. Health problems are seen as entities rather processes, solutions aimed at individuals instead of communities, and we overvalue biological explanations and undervalue family, social and cultural contexts for mental and relational problems. As the WHO/World Bank conference declared, “it’s time to move mental health from the margins to the mainstream of the global development agenda.”
This symposium by the Global Mental Health (GMH) Caucus addresses key developments in the GMH movement, integrating social determinants of health, primary care, school mental health, bio-ethics and cultural psychiatry, and emerging themes in medicine and the humanities on migrants, refugees and borders. Presentations by senior physicians address: (1) global initiatives in primary mental health to deal with health disparities, complexity and co-morbidity; (2) ethical dimensions of cultural sensitivity, ethical sustainability and culture-fair guidelines; (3) a pilot study for school mental health in several school settings in Kenya; and (4) needs of migrants and refugees in the light of changing definitions of borders and belonging. Two international fellows and residents provide the perspectives of psychiatrists-in-training on GMH.
Tackling health inequities by focusing on structural determinantsJim Bloyd
This document discusses structural determinants of health inequities in Cook County, Illinois. It provides examples of structural inequities like inequities in the labor market, education system, and safety net that lead to inequities in social position and intermediate factors, and ultimately inequities in health outcomes. It emphasizes that public health departments should address the fundamental social and political causes of inequities rather than just proximal causes, and notes the link between lack of power and greater health inequities.
Policy Development to Tackle Structural Origins of Health Inequities: Thought...Jim Bloyd
A plenary presentation by Jim Bloyd, MPH, Regional Health officer at the Cook County (Illinois, USA) Department of Public Health, was made Tuesday April 12, 2016, at the National Leadership Academy, "Strengthening the Capacity of Public Health Departments to Advance Health Equity," at the CDC Tom Harkin Global Communications Center, Atlanta, Georgia. The presentation describes the Chicago-area context in which policy is considered, the importance of adopting a causal framework for policy action to eliminate health inequities, actions taken by the Cook County Department of Public Health through its planning and assessment process, and the role of the Collaborative for Health Equity Cook County. The plenary topic, "Best Practices for Developing Policies to Address Social Determinants of Health," was addressed by a panel moderated by Leandris Liburd, Director, Office of Minority Health and Health Equity at the Centers for Disease Control and Prevention. The CDC hosted the National Leadership Academy on Health Equity, a two-day meeting April 11-12, 2016. The Association of State and Territorial Health Officials (ASTHO), the National Association of State Offices of Minority Health (NASOMH), and the National Association of County and City Health Officials (NACCHO) invited participants. At the conclusion of the National Leadership Academy on Health Equity a final report will be developed highlighting action steps, opportunities, challenges and lessons learned fro participants at the leadership academy. Participants' input during breakout sessions will play a critical role in defining the substance of the report. A twitter hashtag #CDCHealthEquity was created by participants during the meeting.
LinkedIn is a professional networking platform that allows users to connect with colleagues and find job opportunities. It was founded in 2003 by Reid Hoffman and has over 48 million members worldwide. LinkedIn targets affluent professionals globally, including job seekers and those wanting to maintain business connections. The platform is free for basic use, but offers paid business accounts with additional features and advertising options.
Keynote address (Feb, 2016) to the educators in the Fort Nelson school district. We all know that we cannot teach a child without a concection... without a relationship. In the hustle and bustle of our jobs as educators, we often forget our why, the reason we got into education, of trying to make a difference with kids. In this talk, 6 Keys to Connecting are shared and discussed with the challenge of creating a more positive climate and better connections with kids in our classrooms, schools, and organizations.
Affect of Social Capital on Mental Health OutcomesRuby Med Plus
This research Paper discuss affect of social capital on Mental Health. Psycho social Processes and Social Capital, Empowerment and Social Capital, Social Networks and Social Capital, Measurement of social capital, The Mental Health Index indicators integration, The Social and Mental Well Being Index integration, Health-related Behaviors and Social Capital, Access to Mental Health Services and Amenities, Stressed Problems in Communities affecting social capital and mental health, Model of Overlapping Clusters of Problems, Suicide, Anti-social Behaviour and Social Capital.
Espousal of social capital in Oral Health CareRuby Med Plus
Oral health is projected to be affected by the environment; to provide an understanding to this, the concept of social capital can be used. Social networking appears to be the rational in social capital in which there is ‘connections’ among individuals, a social network guided by a set of values and norms of trustworthiness and reciprocity among peoples’, groups, communities etc of the network. Putnam (1995) defines social capital as “coordination and co- operation for mutual benefit”. Hence it is not only a way of describing social relationships within a group or society, but also adds a social dimension to traditional structural explanations of disease by viewing communities not just as contextual environments, but also as connected groups of individuals.
The theory of social capital emphasizes multiple dimensions inside the concept. For example, social capital can be divided into a behavioral/activity component (for example, participation) and a cognitive/perceptual component (for example, trust). These are respectively being referred to as structural and cognitive social capital. . Structural and cognitive social capital can therefore refer to linkages and perceptions in relation to people who are akin to each other; such as people in one’s own community or people of alike socioeconomic status (referred to as bonding social capital), or to people who are poles apart; such as people outside one’s community or with a different social identity (known as bridging social capital). Social capital relations can also occur in ceremonial institutions such as between community and local government structures (termed linking social capital) .
Social capital is not a magic pill for improving society’s oral health but, it is a useful concept which focuses our attention on an important set of resources, inhering in relationships, networks and associations, which have previously been given insufficient attention in the social sciences and Dental literature. This is probably partly because they are not easy to categories, study and measure their effects quickly. The social capital perspective therefore broadcast us that if we normatively approve of the goal of enhancing population oral health, we cannot achieve this through material inputs alone, or simply through “technological fixes”, whether “forced” or magnanimously “approved” by those with superior resources. Social capital can contribute towards health promotion, in the extent to which it can be used for its strategic value; the concept can be carefully employed within wider health promotion practices which explicitly draw upon social justice, equity and empowerment principles . Social capital draws on solidarity within groups, communities, societies as well.
From diagnosis to social diagnosisAuthor Phil Brown Mercedes Lys.docxshericehewat
From diagnosis to social diagnosis
Author Phil Brown Mercedes Lyson, Tania Jenkins
Abstract
In the past two decades, research on the sociology of diagnosis has attained considerable influence within medical sociology. Analyzing the process and factors that contribute to making a diagnosis amidst uncertainty and contestation, as well as the diagnostic encounter itself, are topics rich for sociological investigation. This paper provides a reformulation of the sociology of diagnosis by proposing the concept of ‘social diagnosis’ which helps us recognize the interplay between larger social structures and individual or community illness manifestations. By outlining a conceptual frame, exploring how social scientists, medical professionals and laypeople contribute to social diagnosis, and providing a case study of how the North American Mohawk Akwesasne reservation dealt with rising obesity prevalence to further illustrate the social diagnosis idea, we embark on developing a cohesive and updated framework for a sociology of diagnosis. This approach is useful not just for sociological research, but has direct implications for the fields of medicine and public health. Approaching diagnosis from this integrated perspective potentially provides a broader context for practitioners and researchers to understand extra-medical factors, which in turn has consequences for patient care and health outcomes.
Highlights
► “Social diagnosis” recognizes interplay between social structures and illness manifestations. ► Case study shows how Mohawk Akwesasne dealt with rising obesity. ► Provides broad context for practitioners and researchers to understand extra-medical factors.
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Keywords
Diagnosis
Risk
Social movements
Environment
Public health
USA
Canada
Reservations
Introduction
Sociological analysis of diagnosis has achieved considerable influence in the last two decades, providing important insight into how we understand health, disease, and illness. It has also expanded how we view the social and cultural influences that shape our knowledge and practice on health and illness. This includes studies of diagnosis that have gone beyond the interaction between physician and patient, to take into account the larger social, structural, and temporal forces that shape diagnosis (see, for example, the categorization of homosexuality as a mental disorder and the role of gay rights activists in the American Psychiatric Association’s deliberations) (Cooksey & Brown, 1998).
Recently we have also seen the emergence of diseases whose etiologies, symptoms, and, therefore, diagnoses, are often contested or uncertain. This combination of medical and social uncertainty leads us to propose a reformulation of the concept social diagnosis as a new way of thinking about the sociology of diagnosis. This paper explores social diagnosis by first, outlining a conceptual framework of social diagnosis; second, discussing the different acto ...
Shreejeet Shrestha provides an overview of sociology and its application in public health. Sociology developed from 19th century theoretical writings and emphasizes social structures and processes over individuals. Key concepts in sociology like social fabric, conflict, and social systems are highly relevant to public health. While psychology has traditionally dominated social sciences in public health, sociology is increasingly important for understanding large-scale social determinants of health like inequality, social capital, and health systems. Sociological methods involving both quantitative and qualitative data are valuable tools for public health research and evaluation.
Today, you are introduced to the Social Determinant of Health (SDOH) perspective. This assignment responds to two questions, firstly “What is a SDOH perspective?” which will be explored in detail providing two examples of a Social Worker role. The second question requiring a critical discussion surrounding SDOH including “What benefits does a social determinants of health perspective provide, and what are its limits?”.
EDITORIALTHE ETHICAL IMPLICATIONS OF THESOCIAL DETERMINA.docxtidwellveronique
EDITORIAL
THE ETHICAL IMPLICATIONS OF THE
SOCIAL DETERMINANTS OF HEALTH:
A GLOBAL RENAISSANCE FOR
BIOETHICS
In this special issue, Bioethics explores the ethical issues
that relate to the social determinants of health. As the
articles demonstrate, the recognition that social factors
help to determine a population’s health offers bioethics
new challenges and new opportunities. With this recog-
nition, fundamental bioethical concepts, such as cau-
sation, autonomy, rights, and justice, take on new
meanings. Likewise, mainstay bioethical issues, including
the equitable distribution of resources, the duties of pro-
fessionals, and the conflict between paternalism and
autonomy, become amenable to new perspectives.
The realization that social forces help to determine
health is hardly new. For millennia people have recog-
nized a relationship between the social environment
and disease. In the 19th century, sanitarians blamed the
rampant filth of growing cities for the incessant outbreaks
of disease. Later progressive reformers lambasted both
poverty and poor working conditions for disease and
premature death. The pioneers of epidemiology docu-
mented these relationships.
The field of bioethics has never been closed to such
concerns. Since its inception in the 1960s and 1970s,
however, bioethics has deployed much of its intellectual
energy on the moral issues that relate to the development,
distribution, and delivery of health care services. In so
doing, the field reflected medicine’s eclipse of public
health in the 20th century. As medicine became predomi-
nant and illness became more and more amenable to
individualized medical treatment, ethical discourse came
to emphasize clinical encounters. At the same time, as
disease and health increasingly came to be seen as result-
ing from individual factors, individuals began to be
viewed as morally culpable for both their illnesses and the
impact of those illnesses on others.
Not surprisingly, given the importance that bioethics
placed upon individual patients and providers, autonomy
surfaced as a key concern. In the early years bioethicists
focused on the autonomy of patients. Following the lead
of John Stuart Mill, bioethicists revealed the dangers of
medical paternalism and explained why and how patient
autonomy should be respected. In this they were highly
successful, as informed consent became both widely
regarded and legally established.
Individual autonomy remained of paramount interest
in the 1990s. By then, however, the concern widened to
include the autonomy of physicians. At least within the
USA, physicians criticized managed care for interfering
with their ability to make decisions for their patients
and infringing upon their professional autonomy. And
throughout the developed world, as health care costs rose,
market solutions were debated. Patients began to be
viewed as ‘consumers’ of medical care instead of as
patients in need of treatment and care. Not surprisingly,
once patients were.
Social Psychiatry Perspectives - Di Nicola & Marussi - CPA Toronto - 29.10.2...Université de Montréal
CASP Workshop on Social Psychiatry
Canadian Psychiatric Association 72nd Annual Conference
Toronto, Ontario
October 27 – 29, 2022
Title:
Social Psychiatry Perspectives on the Health of Canadians:
A Social Psychiatry Manifesto & Intimate Partner Violence
Symposium Panel:
1. Vincenzo Di Nicola (Chair & Presenter, Montreal, QC)
2. Daphne Marussi (Presenter, Sherbrooke, QC)
Abstract:
This workshop sponsored by the Canadian Association of Social Psychiatry (CASP) reviews two contemporary Canadian psychiatric issues from a social psychiatry perspective:
1. Vincenzo Di Nicola (Montreal, QC) presents a social psychiatry manifesto with an overview of Social Psychiatry in the 21st century by surveying three main branches of Social Psychiatry: (1) psychiatric epidemiological studies and public health; (2) community psychiatry; and (3) relational and social therapies such as couple, family and community therapies. Implications for research, practice, and teaching in social psychiatry will be outlined.
2. Daphne Marussi (Sherbrooke, QC) explores Intimate Partner Violence (IPV) which describes an alarming aspect of relational violence with major social psychiatric consequences: the physical, sexual, or psychological harm by a current/former partner that is associated with many mental disorders from anxiety and depression to eating and substance abuse disorders. This presentation discusses different forms of psychological abuse and coercive control in IPV, the abused/abuser bond and their impacts and consequences.
References:
1. Di Nicola, V. Review article—“A person is a person through other persons”: A Social Psychiatry manifesto for the 21st century. World Social Psychiatry, 2019, 1(1): 8-21.
2. Snyder, R.L. No Visible Bruises - What We Don’t Know About Domestic Violence Can Kill Us. New York, NY, Bloomsbury Publishing, 2019.
Learning Objectives:
1. Redefine Social Psychiatry, name and describe its main branches: psychiatric epidemiology, community psychiatry, and relational therapies.
2. Describe Intimate Partner Violence (IPV) mainly against women, with examples of its mental health impacts, and its importance in Canadian society.
DOI: 10.13140/RG.2.2.32952.62728
This document summarizes an article on assets-based approaches to public health. It discusses how health is influenced by complex systems at multiple levels, from individual to social and environmental. Traditional public health often focuses on individual behaviors, while assets-based approaches emphasize strengthening communities and environments to promote health and reduce inequalities. The document provides examples of initiatives that engage communities and utilize local knowledge and strengths to improve health outcomes.
Health Complete Advanced Clinical Disc.pdfBrian712019
Spirituality is an important part of holistic care for the elderly. Addressing spirituality allows social workers to better understand issues like illness, disability, and end of life. One effective spiritually based intervention is life reviews, which help elderly clients find meaning and purpose by reflecting on their lives. Research shows that incorporating spirituality and life reviews into interventions can aid the elderly in coping with challenges. Social workers must consider clients' spiritual beliefs and traditions when providing holistic care.
Health Complete Advanced Clinical Disc.pdfBrian712019
Spirituality is an important part of holistic care for the elderly. Addressing spirituality can help with understanding illness, disability, and end-of-life issues. One effective spiritually based intervention is life reviews, which allow elderly clients to reflect on their lives and make meaning of their experiences. Research shows that incorporating spirituality and life reviews into interventions can aid elderly clients and is an important part of biopsychosocial assessment and treatment.
Health Complete Advanced Clinical Disc.pdfBrian712019
Spirituality is an important aspect of holistic care for the elderly. Addressing spirituality allows social workers to better understand clients' experiences with illness, disability, and end of life. One effective spiritually based intervention is life reviews, which help elderly clients find meaning and purpose by reflecting on their lives. Research shows that incorporating clients' spiritual beliefs into interventions can improve well-being and quality of life for the aging population.
Factors That Impact Population HealthIn this Discussion, ydepoerossie
Factors That Impact Population Health
In this Discussion, you bring together the concepts that have been presented throughout this course by analyzing a current population health topic from an epidemiological approach. Consider the cultural, ethical, regulatory, and legal factors that may influence your selected topic.
To prepare:
Review the case study, presented on page 411 of your course text,
Population Health: Creating a Culture of Wellness
. Consider the cultural, ethical, and legal factors presented in the case study and how they influence the Michigan Primary Care Transformation Project.
With these thoughts in mind, select a current public health initiative that has been discussed in the popular press or available at the CDC website or your state’s health department website.
Consider this initiative through the lens of an epidemiologist and identify what you think are the three most important issues related to culture, ethics, regulatory, or legal aspects of the public health initiative.
Consider how current health care legislation might impact your selected public health initiative. Conduct additional research as necessary.
By tomorrow 05/09/2018 12 pm, write a minimum of 550 words in APA format with at least 3 scholarly references from the list of required readings below. Include the level one headings as numbered below”
Post
a cohesive response that addresses the following:
1) Provide a summary of your selected public health initiative and include a reference to the article
(and URL to the article).
2) Analyze the cultural, ethical, regulatory, and legal factors that influence your specified population health topic.
3) Evaluate how current health care legislation may positively or negatively impact your selected public health initiative.
Required Readings
Nash, D. B., Fabius, R. J., Skoufalos, A., Clarke, J.
L. & Horowitz, M. R. (2016). Population health: Creating a culture of wellness (2nd ed). Burlington, MA: Jones & Bartlett Learning.
Chapter 15
, “Risk Management and Law”
This chapter discusses the role of the U.S. legal system to foster the health of populations with emphasis on the U.S. Supreme Court’s decision on the Patient Protection and Affordable Care Act.
Chapter 16
, “Making the Case for Population Health Management: The Business Value of Better Health”
This chapter explores why good health is good business, the cost of good health and the potential provide to be realized when workforce health is improved.
Chapter 3
,
“Policy Implications for Population Health: Health Promotion and Wellness”
The chapter provides an overview of the intricacies of federal policy making and the key policy components necessary to advance the health of populations.
Chapter 5,
“The Political Landscape in Relation to the Health and Wealth of Nations”
The chapter describes the relationship between national health and population health and ...
Abstract—Theories of sociology of health and illness defy the biomedical model of disease as many of them are ‘concerned with the social origins and influence on disease’ rather than pathological reasons only. There are five sociological perspectives of health and illness: Social Constructionism, Marxism, Feminism, Foucaulian analysis, and Functionalism. These different sociological perspectives were critically analyzed through this article as for better understanding of conceptualize management of health services Social Constructionism is a sociological perspective focus on the sociology of knowledge and reality. Marxism focuses on equity between social classes and emphasizes inequality in capitalist society. According to Marxism inequality of distribution healthcare services in capitalist society arise from the marginalization of some categories of the population who do not contribute to economic system. Feminist theory is to understand and explore the multiple and various reasons for inequalities between the genders. In the healthcare sector, feminists believe that healthcare organizations are hierarchical systems, where doctors (usually men) are at the top level while nurses (usually women) have a lower level of importance. Main areas that Foucault theory emphasizes are power, knowledge and discourse. Foucault believes that there is a relationship between power and knowledge. This relationship appears clearly in the health field, as medical professionals comprise a group of people who have special knowledge (medical knowledge) and they gain the power from this knowledge. Finally, functionalism is a sociological perspective that describes society as a system made up of ‘interconnected and interrelated parts’ and it highlights the relationships between different parts of society In conclusion, the five sociological perspectives provide holistic picture about conceptualization of healthcare systems.
*************** resources************************8
Course Text:
Coreil, J. (Ed.). (2010).
Social and behavioral foundations of public health
(2nd ed.). Thousand Oaks, CA: Sage.
Chapter 1, "Why Study Social and Behavioral Factors in Public Health?"
The first chapter in the text describes the importance of studying culture and behavior. It provides a historical perspective of the field of behavioral and social sciences and sets the stage for the course with its overarching framework, the social ecology of health model. This chapter also explores the levels of social influence on health issues.
Chapter 2, "Historical Perspectives on Population and Disease"
This chapter delves deeper into the history of health, from the perspectives of disease and the cultural evolution. It also touches upon the health problems that generally occur at different stages of life.
Chapter 5, "Health and Illness Behavior"
Chapter 5 reviews the levels of prevention covered in the first course in the program (primary, secondary, and tertiary) and lays the groundwork for the course by reviewing the relationship between health and illness behavior.
Chapter 7, "Social Reactions to Disease" (pp. 134–136)
In this section of Chapter 7, you will study the concepts of medicalization and hygienization with respect to disease behavior.
Chapter 8, "Comparative Health Cultures" (pp. 145–154)
The authors introduce the concepts of ethnomedicine as well as the various "sectors" of medicine in this section of Chapter 8. The authors also explore cultural models of illness.
Article:
Healthy People. (2010). Healthy People 2020: The Road Ahead! Retrieved from
http://healthypeople.gov/2020/
You will become familiar with the Healthy People 2020 Campaign during this course. Healthy People 2020 is a national effort designed to solve unequal and unjust health treatment of populations. This website will be used for the In the News assignment as well as many other assignments in the course.
Article:
Robert Wood Johnson Foundation. (2009).
Beyond Health Care: New Directions to a Healthier America.
Retrieved from
http://www.rwjf.org/content/dam/farm/reports/reports/2009/rwjf40483
This article presents several carefully coined recommendations to build healthier society. The recommendations are based on research and statistics on the health status of adults and children.
Optional
Resources
Media
Documentary:
Moore, M. (Director). (2007).
Sicko
[Motion picture]. United States: Dog Eat Dog Films.
You may want to rent
Sicko
. It provides a fascinating and controversial view of the health care system in the United States today. The documentary also compares the American health care system with other nations, illustrating the differences in reactions to disease based on the health care system of other countries.
Readings
Course Text:
Social and Behavioral Foundations of Public Health
Chapter 10, "Reproductive Health"
Chapter 11, "Adolescent Health"
Chapter 12, "Public ...
This document provides a literature review and environmental scan on population-based health communication and social determinants of health. It discusses research showing that targeting specific audiences, framing messages based on political ideology, and increasing public support for policies addressing social and environmental factors can help reduce health disparities. The review examines topics like equity, investing in prevention outside of medical care, communicating about shifting investments, and how social circumstances impact behaviors and health outcomes. It provides examples of communication strategies and considerations for population health advocates in messaging around social determinants.
Medical sociology and health service research - Journal of Health and social ...Jorge Pacheco
This document summarizes key findings from medical sociology research on health services and systems over the past 50 years. It discusses three main findings: 1) Health services in the US are unequally distributed based on gender, socioeconomic status, and race, contributing to health inequalities. 2) Social institutions reproduce these inequalities by enabling or constraining actions of providers and consumers. 3) The structure and dynamics of health care organizations shape quality, effectiveness and outcomes for different groups in communities. The authors conclude by discussing implications for future health policy and reform efforts.
Similar to COMMENTARY ‘ What we ’ ve tried, hasn ’ t worked ’ : the politics of assets based public health (20)
Qualitative Research and Family Psychology by Jane F. GilgunJim Bloyd
Abstract: Qualitative approaches have much to offer family psychology. Among the uses for qualitative methods are theory building, model and hypothesis testing, descriptions of lived experiences, typologies, items for surveys and measurement tools, and case examples that answer ques- tions that surveys cannot. Despite the usefulness of these products, issues related to gener- alizability, subjectivity, and language, among others, block some researchers from appreci- ating the contributions that qualitative methods can make. This article provides descriptions of procedures that lead to these useful products and discusses alternative ways of under- standing aspects of qualitative approaches that some researchers view as problematic.
Gilgun, J. (2005). Qualitative Research and Family Psychology. Journal of Family Psychology, 19(1), 40-50. doi:10.1037/0893-3200.19.1.40
APHA for New Attendees Webinar: Notes Social Media & Electronic Meeting ToolsJim Bloyd
This is an incomplete list of suggested online resources and social media blogs, twitter accounts and list serves that may provide new attendees at the 2017 Annual Meeting of the American Public Health Associatiion with some ideas for getting the most out of the conference. These notes were used at the Chicago webinar of September 22, 2017, 1:00 pm CST.
This document summarizes a presentation given by Jim Bloyd on confronting the politics of health inequity and escaping the "fantasy world" often created in public health. Some key points made in the presentation include:
- Public health often focuses on downstream behavioral factors and medical care rather than upstream social and economic determinants of health inequity.
- Health inequities are influenced by political and economic forces like neoliberalism that make it difficult for governments to address root causes like inequality.
- The views and policy preferences of wealthy Americans have a disproportionate influence on policymaking compared to the general public.
- Addressing health inequities requires confronting issues of power, politics, and social injustice rather
Cook County Department of Public Health 2016 WePLAN 2020 Forces of Change Ass...Jim Bloyd
The Forces of Change Assessment identified several factors affecting public health in Cook County, Illinois, based on focus groups with knowledgeable individuals. The Affordable Care Act was seen as both an opportunity and threat by increasing access but also having limitations. State budget cuts limited resources. Climate change and marriage equality presented threats and opportunities. Incarceration and lack of economic opportunity disproportionately affected minorities and women. Large corporations were seen as prioritizing profits over communities. Focus group members felt average citizens had less power than wealthy individuals and corporations to influence policies impacting health.
2016 Foundational Practices for Health Equity State Self Assessment DRAFT Aug...Jim Bloyd
This document presents a learning and action tool to help state health departments advance health equity. It introduces key concepts like health equity, health disparities, social determinants of health, and structural inequities. It also presents a framework showing how social and economic conditions can impact health by influencing stress levels. The tool is intended to help organizations assess their capacity to address social determinants of health and transform practices to promote health equity.
This document outlines a presentation on achieving health equity in Will County, Illinois. It discusses frameworks for understanding health equity from the World Health Organization and others. Data is presented showing health disadvantages in the US compared to peer countries. Structural racism and inequities are discussed as root causes of inequities in health outcomes. A Child Opportunity Index is used to examine educational, health, and social opportunities for children across neighborhoods in Will County by race/ethnicity. The presentation concludes by emphasizing the need to address root social and economic causes through multisector partnerships and provides examples of health equity tools and resources.
This document summarizes Jim Bloyd's presentation on developing public health policies to address structural health inequities. It discusses the context of health inequities in Cook County, Illinois and presents conceptual frameworks for understanding their root causes. It also outlines Cook County Department of Public Health's assessment of the social and economic forces influencing community health, and principles of social justice and ethics that should guide policy responses. The goal is to confront systems of privilege and develop strategies to achieve health equity.
Phyisicans, health reform, and health equity: When we fight, we win!Jim Bloyd
Invited presentation at the Health Advocacy and Policy Forum, Urban Medical Program, University of Illinois at Chicago College of Medicine, February 15, 2016. Chicago, Illinois (USA)
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
COMMENTARY ‘ What we ’ ve tried, hasn ’ t worked ’ : the politics of assets based public health
1. COMMENTARY
‘What we’ve tried, hasn’t worked’: the politics of assets based public
health1
Lynne Friedli
Freelance researcher, London, UK
(Received 25 June 2012; final version received 29 October 2012)
Like you we suffer the relentless erosion of our livelihoods, like you we are afflicted by an
unending vandalism wrought upon even the vaguest dream for a future not dictated by
those who would keep us precarious. We too are facing a brave new world of austerity,
shock economics and class war.
Solidarity with Classe, student protest of Quebec, University for Strategic Optimism 20122
It is a paradox of recent epidemiology that as material inequalities grow, so
the pursuit of non-material explanations for health outcomes proliferates. At
one level, a greater recognition of psycho-social factors has deepened the
understanding of the societal determinants of health, the links between mental
and physical health and the social nature of human need. Too often however,
psycho-social factors are abstracted from the material realities of people’s lives
and function as an alternative to addressing questions of economic power and
privilege and their relationship to the distribution of health. The growing influ-
ence of salutogenesis and asset-based approaches is one example of this trend.
This paper reflects on the theories of public health that lie behind the dis-
course of assets, together with some of the reasons for, and consequences of,
its popularity and influence, notably in Scotland.
Keywords: assets; public health; politics; inequalities; mental health;
well-being; Scotland
Introduction
An asset-based approach is about focusing on the positive capacity of individuals and com-
munities, rather than solely on their needs, deficits and problems. This is linked to the the-
ory of salutogenesis, which highlights the factors that create and support human health,
rather than those that cause disease. (NHS Health Scotland 2012, 2)
The emergence of asset-based approaches to improving health is generating a level
of evangelism not seen since the days when social capital, a not unrelated construct,
inspired a similar fervour. However, while the research literature on social capital
included a very significant level of academic debate (Kawachi, Subramanian, and
Almeida Filco 2000; Lynch, David Smith, and Kaplan 2000; Wilkinson 2000; Krieger
2001; Muntaner 2004; McKenzie and Harpham 2006; Baum 2010), there has been little
critical analysis of asset-based approaches and their application to public health (Friedli
*Email: lynne.friedli@btopenworld.com
Critical Public Health, 2013
Vol. 23, No. 2, 131–145, http://dx.doi.org/10.1080/09581596.2012.748882
Ó 2013 Taylor & Francis
2. 2011, 2012a, 2012b). This is surprising, because the language of assets now permeates
the literature on health and health inequalities (Harrison et al. 2004; Foot and Hopkins
2010; Foot 2012; Lindstrom and Eriksson 2010; Morgan and Ziglio 2010; McLean and
McNeice 2012; Scottish Government and HAPI 2012), and also has a strong presence
in UK policy on public sector reform, as well as in wider debates on social protection
and public service entitlement (O’Sullivan et al. 2009; Christie 2011; Mair, Zdeb, and
Markie 2011; Scottish Government Social Research 2011).
Public health is responsible for understanding and acting upon the ‘distribution and
causes of population patterns of health, disease and wellbeing’ (Krieger 2011, vii). This
means paying special attention to how ideas that influence public health policy and prac-
tice both explain the fact of health inequalities and account for ‘who and what is respon-
sible’ (Birn 2009). These questions are always important. They assume a greater urgency
at this time of major political debate about the role and responsibilities of the state in
relation to health, and in the face of a renewed neo-liberal attack on the existing rem-
nants of market regulation and the social rights of citizenship (Beckfield and Krieger
2009, 153). As Beckfield and Krieger have observed: ‘Power, after all, is the heart of the
matter – and the science of health inequities can no more shy away from this question
than can physicists ignore gravity or physicians ignore pain’ (Beckfield and Krieger
2009, 170). Constructs like asset-based approaches emerge and gain currency in specific
social, economic and political contexts and are pressed into service as part of wider ideo-
logical conflicts. This paper reflects on the theories of public health that lie behind the
discourse of assets, and asks why the assets movement has joined the attack on public
sector provision, rather than addressing the health impact of corporate power. It also con-
siders some of the reasons for, and consequences of, its growing popularity and
influence, notably in Scotland, where asset approaches enjoy strong support from the
chief medical officer (Scottish Government 2010, 2011a, 2011b; McLean 2011; SCDC
2011).
Definitions of assets
Asset based approaches are concerned with identifying the protective factors that support
health and wellbeing. They offer the potential to enhance both the quality and longevity of
life through focusing on the resources that promote the self-esteem and coping abilities of
individuals and communities. (McLean 2011, 2)
Asset-based approaches are essentially about recognising and making the most of peo-
ple’s strengths, to ‘redress the balance between meeting needs and nurturing the
strengths and resources of people and communities’ (McLean 2011, 2), with a corre-
sponding shift in focus from the determinants of illness to the determinants of health
(salutogenesis). Although assets can include material resources – land, buildings and
income (Aradon 2007; Cooke 2010; Scottish Government 2012) – in public health,
more typically, the primary focus is on valuing individual and collective psycho-social
attributes. These include the familiar roll-call of self esteem, aspiration, confidence,
optimism, sense of coherence (SOC), meaning and purpose, the so-called intangible
assets such as knowledge, skills, wisdom and culture, and key features of social capital:
social networks, reciprocity, mutual aid and collective efficacy (O’Leary 2006, 2011;
Foot and Hopkins 2010; Lindstrom and Eriksson 2010).
Asset-based approaches draw on positive psychology and the work of Antonovsky on
SOC (Antonovsky 1987; Seligman 2003), as well as on traditions of community develop-
132 L. Friedli
3. ment (McKnight 1995, 2010; O’Leary 2006) and health activism, notably in the disability
rights, user/survivor and recovery movements (Duffy 2010a, 2011; Boardman and Friedli
in press). Although Antonovsky’s analysis acknowledges that psychological attributes are
strongly influenced by material and social factors (described as generalised resistance
resources), it is the concept of sense of coherence that dominates in the assets literature.
Based on empirical studies of psychological resilience in the face of profound adver-
sity, Antonovsky argues that the presence or absence of SOC – the belief that life is
comprehensible, manageable and meaningful – is fundamental to understanding healthy
life outcomes, notwithstanding the experience of trauma. Individuals who experience life
as structured, predictable and explicable, who are confident that they have the resources
to meet demands and who believe that such demands are challenges worthy of invest-
ment and engagement are thus said to be consistently more likely to have positive life
outcomes (Antonovsky 1987; Lindstrom and Eriksson 2010). Any correlation between
SOC and better health is unsurprising. The marked social gradient in both mental illness
(e.g. post natal depression, anxiety and psychosis) and levels of mental well-being (e.g.
Warwick–Edinburgh Mental Well-being Scale) suggests that psychological attributes like
SOC are strongly linked to social position (McManus et al. 2009). What is more, which
attributes attract social value and economic reward is highly ideological: hence, capital-
ism in crisis prefers aspiration to sufficiency and independence above solidarity (Bauman
2007). However, it is not clear that SOC is fixed: one five-year follow-up study found
that SOC is not stable, and that the level significantly decreases after a negative life
event (Volanen et al. 2007; Volanen 2011). Even a strong SOC decreased during the
follow-up period and was no more stable than a mediocre or weak SOC. The author sug-
gests: ‘in the light of the present study, it seems that SOC is determined not only by
socio-economic factors but also by close and successful social relationships during both
childhood and adulthood’ (Volanen 2011, 3, emphasis added).
Antonovsky’s work is part of a broader literature on well-being and resilience, and
typifies the growing influence of psychological and cultural explanations for health (for
reviews of competing theories see McCartney et al. 2011; Mackenbach 2012). Much of
the support for assets approaches is predicated on the view that confidence and self-
esteem are determinants of health and other outcomes. Marmot asserts that ‘taking an
asset-based approach at a local level fosters greater local confidence and self-esteem for
people and communities’ (Foot 2012, 3) although evidence to this effect is entirely
anecdotal. As is widely acknowledged, there is no ‘published evidence that use of a
broad assets based approach can successfully prevent or reverse the main avoidable
causes of ill-health’ (NHS Health Scotland 2012, 3; see also MacKinnon, Reid, and
Kearns 2006; McLean 2011). What are available are collections of ‘case studies’ that in
many cases have been retrospectively labelled ‘asset based’ (McLean and McNeice
2012). As the authors make clear, these examples cannot answer questions about effec-
tiveness one way or the other, although they do illustrate how quickly local projects
will adopt a label when it has powerful support. Nevertheless, lack of evidence has not
prevented advocates from stating that ‘it is justified to be very optimistic about the
potential of the asset based approach’ (Hills, Carroll, and Desjardins 2010, 97).
Asset approaches reflect and reinforce the view that the psychological attributes of
individuals can be extrapolated to explain what is happening to health at a population
or systemic level. In other words, an analysis of psycho-social factors can function as
an alternative to addressing questions of power and privilege and their relationship to
the distribution of health and the political production of social inequalities (Muntaner
2004; Phelan, Link, and Tehranifar 2010; Friedli 2012c). Like the wider well-being
Critical Public Health 133
4. debates (Friedli 2009; ONS 2011; Stoll, Michaelson, and Seaford 2012), asset
approaches are strongly associated with a non-materialist position – money does not
matter as much as relationships, sense of meaning and belonging, opportunities to con-
tribute and autonomy: there’s a difference between starving and fasting (Sen 1992).
The importance of the psycho-social domain is also central to critiques of consum-
erism, materialism and the dominance of marketised solutions to health and social
problems (Michaelson et al. 2009). The Stiglitz Report calls for measures of social
progress that include non-market activities, sustainability and quality of life, as does
the OECD Global Project on Measuring the Progress of Societies (ONS 2011;
Stiglitz, Sen, and Fitoussi 2009). These critiques come together in calls to value the
contribution of those outside the money economy: the core economy of friends, family,
neighbours and civil society (Cahn 2004). It is notable that the assets literature places
a high value on volunteering, for example, and on alternative currencies like Time
Banks.
A greater focus on psycho-social factors is part of a wider acknowledgement of
the non material dimensions of deprivation, perhaps most famously in Amartya Sen’s
call for ‘the ability to go about without shame’ to be recognised as a basic human
freedom (Zaveleta 2007). People living in poverty, as well as other vulnerable or
excluded groups, consistently describe the pain of being made to feel of no account,
which is often experienced as more damaging than material hardship (Nussbaum
2011). From this perspective, inequalities (the lived experience of injustice) greatly
exacerbate the stress of coping with material deprivation (Wilkinson and Pickett 2006,
2009). What is at stake is the social, emotional and spiritual impact of poverty and
inequality, as well as the belief that ‘wellbeing does not depend solely upon economic
assets’ (Sen 1992).
In their resistance to ‘deficit models’ and their insistence on recognising and valu-
ing strengths, asset-based approaches also draw on radical traditions in community
development: ‘They speak to the resistance of deprived communities to being
pathologised, criminalised, ostracised; to being described in public health reports in
terms of multiple deficits and disorders: ‘chaotic, unengaged, and disaffected’ (Friedli
2011, 2). These themes are an important element of work on assets-based community
development by Kretzmann and McKnight (1993), which argues that by defining
communities in terms of deficits, services exploit need and produce clients, whereas
communities produce citizens (McKnight 1995, 2010). Strengths based approaches are
also central to the recovery and disability rights movements and the principles of
respect for people’s self determination, choice, control and potential, as well as for
support that does not undermine citizenship – themes that find expression in debates
about personalisation (Duffy 2010b, 2011).
The social values associated with asset-based approaches – celebration of the
power of the human spirit, recognition of people’s strengths, resourcefulness and
creativity and the empowering nature of collective action – have a long history and
are common features of social movements and traditions of struggle for social justice
(Freire 1972). From a public health perspective, these values have been given added
impetus by growing evidence that social indicators are consistently emerging as more
significant to population health than ‘health behaviours’ (Holt-Lundstadt, Smith, and
Layton 2010; Jutte et al. 2010; Hertzman and Siddiqi 2009). The problem with the
assets literature is that respect for people’s capacity for resistance (generally described
as ‘resilience’) is abstracted from any analysis of social injustice or the causes of
inequalities: ‘naming who and what are the forces and institutions creating and
134 L. Friedli
5. perpetuating inequitable conditions in the first place’ (Birn 2009). So what emerges is
an attempt to reproduce, in poorer communities, psycho-social assets that are in fact
tied to material advantage, while leaving power and privilege intact (Bourdieu 1977).
The silence about political struggle, and the marked absence of either trades unions or
street protests from public health’s iteration of asset approaches, precludes any consid-
eration of how SOC, for example, might be forged through the expression of class
solidarity. One explanation for this failure by omission is the asset movement’s
disproportionate focus on the operation of the welfare state, as opposed to the
operations of the market. This is evident in their central proposition that public
services generate need and produce dependency.
Rationale for assets based approaches
With strong support from the Chief Medical Officer, the asset based approach is now being
endorsed across Scottish Government and is being promoted for use across all sectors and
across the national framework … (NHS Health Scotland 2012, 1)
The rationale for adopting assets-based approaches includes three core principles – (1)
focus on the determinants of health (rather than illness); (2) start with what people have
(not what they lack); and (3) emphasise the contribution of psycho-social factors to
health outcomes. In Scotland, the central arguments are broadly as follows:
• public health approaches to reducing health inequalities have failed – “what
we’ve tried, hasn’t worked” (Scottish Government 2010)
• public services are inefficient and unaffordable, requiring a “radical change in
design and delivery” (Christie 2011, 26)
• deficit approaches, by focusing on people’s needs, rather than their strengths, pro-
duce dependency (SCDC 2011)
The persistence and widening of health inequalities in the UK, notwithstanding
an ostensibly favourable policy environment under the New Labour government,
(Mackenbach 2011; Blakeley and Carter 2011) have been frequently cited to support
the case for asset-based approaches. Morgan and Ziglio suggest ‘The asset model may
help to further explain the persistence of inequities despite the increased efforts by gov-
ernments internationally to do something about them’ (Morgan and Ziglio 2010, 4), a
point echoed by Foot, who argues that current approaches to improving health have not
made the impact on health inequalities that had been anticipated (2012, 9), and by
Scotland’s CMO (Scottish Government 2010). This view has a particular resonance in
Scotland, where a strong body of research suggests that neither deprivation nor levels
of material inequality can fully account for Scotland’s poor health. As has been widely
commented upon, the rise in mortality in Glasgow since 1980 is greater than in Man-
chester and Liverpool, the other most deprived cities in the UK and it remains unclear
what explains Glasgow’s recent excess mortality from drugs, alcohol, suicide and vio-
lence, largely among working age adults (McCartney et al. 2011). At the same time, the
assertion: ‘what we have tried to date, (although well meaning), has not worked’ (Scot-
tish Government 2010, 7) raises important questions about what it is, exactly, that pub-
lic health has tried and in what context.
Critical Public Health 135
6. Assets and inequalities
Assets approaches invite individuals and communities to take control of managing positive
changes to their circumstances by co-producing the interventions by which they can be
supported out of poverty. (Scottish Government 2011a, 9)
While it is true that there have been many efforts to address health inequalities, there
has been a marked failure to acknowledge that these efforts have occurred in the
context of rising material inequalities (Mackenbach 2012) – with income inequalities
largely driven by wage inequalities. Although these trends occur across Europe, income
inequality has risen faster in the UK than in any other OECD country since 1975, over-
taking the USA in the 1990s and again in 2000. In the decade up to 2010, income
inequalities in the UK widened significantly, driven by a sharp increase in the incomes
of the richest (OECD 2011; Cribb, Joyce, and Phillips 2012). The same pattern,
although slightly less marked, is evident in Scotland, where income inequality has wid-
ened since devolution (McKendrick et al. 2011). This means the sharp inequalities of
the Thatcher years – and the problems associated with them – remain, exacerbated by
even greater inequalities at the top of the distribution. Although relative poverty (before
housing costs) fell slightly during the 1990s and largely continued to fall up to 2009–
2010, rates are still well above the 1979 figure of 13.4% of the population living in
poverty (Cribb, Joyce, and Phillips 2012).
It is difficult to predict future income inequality trends because much of the impact
of cuts in welfare benefits is still to come (Cribb, Joyce, and Phillips 2012), but income
inequality in the UK is well above the OECD average – the Gini co-efficient is cur-
rently close to its highest point since 1961 (OECD 2011). This is not accidental but has
been driven by neo-liberal policy (Scambler 2007). Since the mid 1980s, UK transfers
and taxes have become less redistributive, benefits have become less redistributive,
benefit amounts are declining, eligibility is more restrictive and more people are work-
ing at low-wage jobs: Britain has one of the highest proportions of low-paid workers in
the developed world and the share of low-paid work in the British labour market has
grown steadily over the past three decades. (OECD 2011; Cribb, Joyce, and Phillips
2012; Pennycook and Whittaker 2012). Britain also has some of the lowest social
mobility in the developed world, with earnings in the UK more likely to reflect those of
our fathers than in any other country (Crawford and Machin 2011). Against a back-
ground of the growing gap between rich and poor, growing wage inequality, a decline
in the living standards of low- and middle-income households that long predates the
current recession and increasing levels of insecurity and precariousness for households
below median income (Hirsch, Plunkett, and Beckhelling 2011; Pennycook and Whit-
taker 2012; Whittaker and Bailey 2012), it is not difficult to identify plausible reasons
why inequalities in health have also increased.
Of course, income inequality is not the only driver of health and other inequalities, but
the silence of the assets movement on the impact of major economic shifts on people’s
lives is a serious shortcoming. The focus on welfare obscures what is happening in the
market. For example, the failure to analyse the health impact of the following trends:
• sharp inequalities in the distribution of the benefits from previous periods of eco-
nomic growth
• growing wage inequality
• the shift from wages to profits
136 L. Friedli
7. • falls in real earnings
• the rise in commodity prices
• the rise in women’s employment, which has helped to sustain household incomes
for low- and middle-income households, (while income from men’s employment
fell significantly)
• reduced opportunities for organised resistance to poor pay and working conditions
(Cribb, Joyce, and Phillips 2012; Pennycook and Whittaker 2012; Whittaker and
Bailey 2012).
In the case of Scotland, for all the talk of a culture of dependency, ‘labour supply is
outstripping demand as there are currently more people than jobs. There are more peo-
ple with qualifications than there are jobs that demand those qualifications for entry’
(Scottish Government Social Research 2011, 58). Other factors implicated in increasing
or reinforcing health inequalities include the rise in spatial inequalities – gentrification,
the disproportionate impact of motor vehicle traffic on the poorest communities, the
psycho-social effects of geographical segregation and the privatisation of public space
(Smith 2002; Minton 2009; Dorling 2010; Slater in press).
The relative contribution of psycho-social vs. material factors to health inequalities
is a long-standing and ongoing debate. The Commission on the social seterminants of
health has argued that health inequalities are a symptom, an outcome, and of inequali-
ties in power, money and resources (CSDH 2008; Solar and Irwin 2011). These struc-
tural and material inequalities result in unequal exposure, by social position, to a range
of health risks and health advantages. An important emerging literature has also called
for a greater focus on political analysis – going beyond social processes and the biolog-
ical impact of status hierarchies to consider underlying political and economic systems.
In other words, inequalities are not accidental (Beckfield and Krieger 2009; Collins and
McCartney 2011; Krieger 2011). Central to these accounts is an acknowledgement of
class power, vested and competing interests and their expression in struggles around
employment, pay, income, social protection and housing, or what Birn describes as
societal determinants: how health is shaped by the political and economic interests of
those with power and privilege (Birn 2009). These issues are completely absent from
assets discourse: perhaps because encouraging communities to reflect on ‘inner and
innate resources’ and ‘starting from what they have, rather than what they lack’ tends
to preclude questions about the distribution of wealth and the production of poverty, in
Scotland and elsewhere. Nevertheless, thinking about political determinants raises ques-
tions about why the primary focus of asset approaches is on public services, rather than
on corporate power and the health consequences of the UK’s especially unfettered free
market (MacKay 2011).
Attacks on state provision
Assets based approaches are being used both to highlight the failings of the public sec-
tor and to reinforce the view that the way in which poor people make use of welfare
benefits (income and services) is morally flawed (Friedli 2011).
Our three social frameworks (Equally Well, Achieving our Potential and the Early Years
Framework) promote an assets, rather than a deficits, approach, to tackling poverty and
inequality. This means building the capacity of individuals, families and communities to
manage better in the longer term, ‘moving from welfare to wellbeing and from dependency
to self determination’. (Scottish Government 2011b, 7)
Critical Public Health 137
8. There are two main strands: firstly, the argument that public services have focussed on
deficits ‘the problems, needs and deficiencies within communities’ (McLean 2011, 5)
and secondly, that this focus has engendered ‘a culture of dependency that stimulates
demand’ (Scottish Government 2010; SCDC 2011, 2).
Implicit in this discourse are beliefs dating back to the Poor Laws, namely that social
protection results in moral and spiritual decline and that take up of welfare is driven
not by market failure, but by certain character traits – dependency and coping style.
(Friedli 2011, 11)
The move from ‘welfare to well-being’ also signals that assets based approaches are
part of efforts to reduce ‘unaffordable demand’, to achieve public spending cuts and
to promote a DIY response to loss of services and loss of benefits: ‘a focus on posi-
tive ability, capability and capacity leading to less reliance on professional services
and reductions in the demand for scarce resources’ (McLean 2011, 9). As the Scottish
Government notes in its child poverty strategy, ‘We believe that sustainable improve-
ments in people’s life chances are most likely to be achieved by identifying and sup-
porting the development of their own capabilities to manage their way out of
poverty’ (Scottish Government 2011a, 9). In this way, not only is poverty seen as an
individual misfortune, (rather than the systemic outcome of a particular economic
model), but the debate about public services and the public sector is framed in terms
that stigmatise need – dependency as moral failing, not as a fact of the human condi-
tion or even a reminder of what it means to be human. The recurring leitmotif of the
dependent poor also serves to disguise the nature and extent of state benefits enjoyed
by the rich: fiscal and economic policies that support the privileges of wealth: land,
property, inheritance and capital gains. For example, the tax exemption on private
education enjoyed by the 7% of children in the UK who go on to become 70% of
high court judges, one third of MPs, 50% of FTSE 100 Chief Executives and 50% of
medical consultants (Guardian Datablog 2012). The point is, of course, that both rich
and poor depend on the prevailing economic system, but with rather different conse-
quences – for health and other outcomes.
The extent to which the public sector is implicated, as the assets literature sug-
gests, in the failure to reduce health and other inequalities, raises important issues.
There is now growing evidence that health services influence public health and that
public health systems are under-acknowledged as a determinant of health (Rasanathan,
Villar Montesinos, and Matheson 2011; Solar and Irwin 2011). At the same time, to
attribute health inequalities largely to the shortcomings of the public sector serves to
minimise the importance of the market and the highly differential impact of wider glo-
bal economic trends. When problems are framed in terms of the ‘deficit approach’ of
professionals and a ‘culture of dependency’ among the poor, hard questions about cor-
porate power are avoided and the neo-liberal attack on the values of collective respon-
sibility, pooled risk and universal services goes unchallenged. Blaming the public
sector – the public services that are both picking up the pieces and picking up the tab
– provides ideological support for the retreat of state provision and let unregulated
free market capitalism off the hook. It also appears to be unsupported by the evidence.
OECD figures show that public services reduce inequalities in the UK more than
almost anywhere else, and this impact increased over the 2000s (OECD 2011).
Against all the odds, public services have improved their impact on reducing inequali-
ties. While there is always a case for improving services, it is not a ‘radical change in
138 L. Friedli
9. the design and delivery of public services’ (Christie 2011, 26) that is required so
much as a radical change in economic and fiscal policies that in Scotland, as else-
where, ‘sanction gross inequalities and obscene greed’ (Rio de Janeiro Declaration
2011).
Conclusions
Asset models tend to accentuate positive capability within individuals and support them to
identify problems and activate their own solutions to problems … they focus on promoting
health generating resources that promote the self esteem and coping abilities of individuals
and communities, eventually leading to less dependency on professional services. (Scottish
Government 2010, 7)
The radical agenda that perhaps originally inspired commitment to asset based
approaches still needs addressing. This includes the relationship between public sector
professionals and the communities they serve, the democratic deficit and abandonment
of areas of deprivation by both the market and the state, steep income hierarchies within
the NHS and the social, material and emotional distance between those who design
public health interventions and those who experience them. International comparative
studies suggest that status (the respect we receive from others), control (influence over
the things that affect our lives) and affiliation (sense of belonging) are universal deter-
minants of wellbeing (Kenny and Kenny 2006; Samman 2007). Public health needs to
pay more attention to the factors that injure these needs and the health impact of inju-
ries to these needs, undermining what Sen has called the freedom to live a valued life
(Nussbaum 2011). But in these efforts to address the missing dimensions of poverty
and deprivation (Samman 2007), the distribution of economic assets is still of funda-
mental importance. There is a link between living conditions and dignity. The idea of
justice is paramount (Nussbaum 2011).
The assets literature includes a wide range of case studies describing what commu-
nities have achieved, in the face of considerable adversity, through focusing on assets
and adopting strengths based, glass half full approaches (Foot and Hopkins 2010; Mor-
gan and Ziglio 2010; SCDC 2011; Foot 2012; McLean and McNeice 2012). The emo-
tional impact of stories of transformation like the widely cited Beacon and Old Hill
estate in Cornwall is powerful (Durie, Wyatt, and Stuteley undated; Friedli 2011). A
reminder, where that is needed, that materially deprived communities are rich in rela-
tionships, resourcefulness and creativity. That coming together to change things for the
better is inspiring and empowering. Many such projects provide an urgently needed
sanctuary, a refuge from grim circumstances and respite from class disadvantage. But, it
is the responsibility of public health to distinguish between providing ‘escape for some’,
while leaving the system that produces the need for escape intact, and providing leader-
ship on addressing the determinants of health.3
As John McKnight, founding father of
asset-based community development recently observed:
We must emphasise again that the local economic capacity for choice and sustenance is the
threshold policy issue. For we have economically abandoned far too many communities and
left at sea those citizens who have remained. It is these fellow citizens and their economic
dilemma that is the first policy issue of the twenty-first century. (McKnight 2010, 76)
Critical Public Health 139
10. As has been noted, asset-based approaches also draw on the language of recovery, which
traditionally adopted a strengths-based lexicon as a form of resistance to the imposition
of psychiatric labels and diagnostic categories (Campbell 2005). By contrast, the asset
movement employs psychological constructs that validate a very specific and narrow
range of attributes: self efficacy, aspiration, confidence, optimism, positive thinking,
agency, self reliance, resilience. These characteristics are frequently described in terms
of mental ‘well-being’, and are used to explain ‘health behaviours’ and to reinforce
behaviourist approaches. The discourse of assets makes no acknowledgement of the con-
tested nature of what constitutes mental health and mental illness, or the relationship
between multiple expressions of alienation, despair and self harm, and experiences of
oppression and exploitation (Survivors’ History Group).4
While public health rallies to
the cry that ‘focusing on the positive is a public health intervention in its own right’
(Stewart-Brown cited in Foot 2012), complex questions are avoided; for example,
questions about the social gradient in mental illness and in recovery from mental illness
(Lorant et al. 2003; Hauck and Rice 2004; McManus et al. 2009) and about the wider
structural factors that influence individual mental illness journeys: individual and collec-
tive experiences of pain, anger and demoralisation. Instead, therapies that aim to change
how people think are enthusiastically commissioned: it is more important to be positive
than to have an accurate perception of reality. Symptoms are reclassified as causes:
‘something within the spirit of individuals living within deprived communities that needs
healed’ (SCDC 2011, 3).
Perhaps, the major problem with public health’s uncritical adoption of asset-based
approaches is that it fails to distinguish between a radical critique of welfare, one that
is firmly linked to an analysis of neo-liberal economics and the neo-liberal attack on
welfare, which by contrast, supports the further de-regulation of markets and withdrawal
of the social rights of citizens. If the strength of the assets movement is that it has
generated discussion about re-dressing the balance of power between the public sector,
public services and local communities, its fatal weakness has been the failure to ques-
tion the balance of power between public services, communities and corporate interests.
As such, asset-based approaches sound the drum beat for the retreat of statutory, state
provision of both public services and public health.
Acknowledgements
My thanks to Margaret Carlin for the politics of working class enlightenment, for her very
considerable contribution to the ideas expressed in this paper and for her commentary and critical
input. This paper is dedicated to the memory of my brother Christian Friedli.
Notes
1. Early versions of this paper were presented at the Poverty Alliance Understanding Poverty
Seminar Series: Community Assets and Poverty (http://www.youtube.com/watch?v=dHC-
SiZkjJk) and the Socialist Health Association Health Inequality in Scotland and England
(http://www.sochealth.co.uk/events/inequality/) and appear in the Scottish Anti Poverty
Review Winter 2011/12.
2. http://universityforstrategicoptimism.wordpress.com/2012/06/10/london-plan-c-support-night-
for-classe-quebec/.
3. Margaret Carlin personal communication.
4. The Survivors’ History Group Pageant of Survivor History http://studymore.org.uk/mpu.htm.
140 L. Friedli
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