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37588 results in Cambridge Textbooks

Page 1464 of 1880

  • 6 - Indigeneity and health

  • Toni Schofield, University of Sydney
  • Book:
    A Sociological Approach to Health Determinants
    Published online:
    06 August 2018
    Print publication:
    03 February 2015, pp 99-122

  • Summary

    Overview

  • What are the main health effects of indigeneity?

  • How might ‘indigeneity’ refer to a social process? How is ‘coercive alienation’ central to understanding it?

  • What is the relationship between colonisation and global division in relation to indigeneity? How does it work?

  • How do the health experiences of Indigenous Australians illuminate the dynamics of indigeneity?

    • Northern Queensland, Australia, 1870s

    This morning in the predawn dark, his eyes accustomed to darkness, Bidiggi could see the white men’s own totemic circle of saddles and packs stacked to make a bora ring. Behind that little wall he knew, and his father and uncles and brothers knew, the white man lay in wait…

    [H]e raced forward with his spear . . . Then the shouting sticks began to bark . . .

    His brother crumpled like a broken tree . . .

    [H]e could see as the dark thinned that more and more of his tribe had fallen . . . He shook with fear . . .

    The remnants of the tribe were in l ight . . .The world was a madness of shouts and the drumming of the animals, the screams of the running men.

    Two old men . . . had been left behind, and their wives. The other women had been shot as they l ed. The old women wailed and were silenced . .

    Bidiggi was only twelve, and although he didn’t measure by white time but by black, he knew he was a man. There had been the ceremony. His father was dead. His brother. His uncles . . . His head i lled with pictures of the men on the big animals beating the tribe like wild pigs along the reedy rim of the water where they fished and swam. The pictures were blotted with blood and he could still hear the men screaming back when the shouting sticks spoke to them and see the running women and children trampled into the morning grass. ( Astley 1987 : 39–41 )

  • 5 - Ethnicity and health

  • Toni Schofield, University of Sydney
  • Book:
    A Sociological Approach to Health Determinants
    Published online:
    06 August 2018
    Print publication:
    03 February 2015, pp 83-98

  • Summary

    Overview

  • What does the evidence tell us about ethnic disparities in health on a global basis?

  • What is ‘race’? What does a racist explanation of, or approach to, ethnic disparities in health involve?

  • What does it mean to say that ethnicity and ethnic division are social processes? What role does institutional racism play in these?

  • How does ethnicity work in the production of ethnic disparities in health?

    • New York City, approximately 1890

    The homes of the Hebrew quarter are its workshops also … You are made fully aware of it before you have travelled the length of a single block in any of these East Side streets, by the whir of a thousand sewing-machines, worked at high pressure from earliest dawn till mind and muscle give out together. Every member of the family, from the youngest to the oldest, bears a hand, shut in the qualmy rooms, where meals are cooked and clothing washed and dried besides, the livelong day. It is not unusual to find a dozen persons – men, women, and children – at work in a single small room … Typhus fever and smallpox are bred here … Filthy diseases both, they sprout naturally among the hordes that bring the germs with them from across the sea … The health officers are on constant and sharp lookout for hidden fever-nests. Considering that half of the ready-made clothes that are sold in the big stores, if not a good deal more than half, are made in these tenement rooms, this is not excessive caution. It has happened more than once that a child recovering from small-pox, and in the most contagious stage of the disease, has been found crawling among heaps of half-finished clothing that the next day would be offered for sale on the counter of a Broadway store; or that a typhus fever patient has been discovered in a room whence perhaps a hundred coats had been sent home that week, each one with the wearer’s death-warrant, unseen and unsuspected, basted in the lining (Riis 1890).

  • 8 - Health care and health

  • Toni Schofield, University of Sydney
  • Book:
    A Sociological Approach to Health Determinants
    Published online:
    06 August 2018
    Print publication:
    03 February 2015, pp 148-176

  • Summary

    Overview

  • What is the globally dominant form of health care organisation? How does it work?

  • What is the most effective form of health care in terms of advancing the health of most of the world’s peoples? How does it work?

  • What are the major social dynamics responsible for the prevailing patterns of health care both within and between countries globally?

    • Iraq, 1950s

    In the 1950s, archaeologists found a traumatised Neanderthal skeleton in northern Iraq in the Shanidar caves. Their examination of the remains showed that it was the skeleton of a man who had lived between 40 000 and 115 000 years ago and who had begun life with a stunted arm, a large part of it which he had lost some time later. It is likely that without the use of both arms the man had used his mouth for some tasks, such as scraping or cutting – because his teeth were very severely ground down. He had also lost two front teeth, probably in another accident. At some point in this life from thousands of millennia ago, something or somebody had delivered a sharp blow to the top of the man’s head … This was accompanied by another, harder blow that had caused the left side of his face to be shattered, most probably destroying his sight on this side as well. Somehow, he had struggled on long enough to develop severe and crippling arthritis. ‘[A]round his fortieth birthday the roof over his cave hearth collapsed, ending his saga and his troubles.’ (Wood: 1979: 22)

  • 7 - The state and health

  • Toni Schofield, University of Sydney
  • Book:
    A Sociological Approach to Health Determinants
    Published online:
    06 August 2018
    Print publication:
    03 February 2015, pp 123-147

  • Summary

    Overview

  • What is ‘the state’?

  • How did rationalised rule and governance differ from their predecessors? What role did they play in the development of democratic states?

  • What is neo-liberalism and what are the main processes by which it is played out in contemporary rule and governance? How do these affect health inequity?

  • What is the relationship between the state and other major processes of social division?

  • How do contemporary rule and governance establish barriers to and opportunities for the advancement of health equity?

    • Timor-Leste (East Timor)

    To the north of Australia lies the 21st century’s first nation state – Timor-Leste, or East Timor. After a period of brutal control by Indonesia, which had taken over the former Portuguese colony in 1975, Timor-Leste formally gained its independence in 2002. Today, Timor-Leste is one of Asia’s poorest countries, with more than 80 per cent of its 1.2 million people resident in rural areas. Yet, it has become one of the fastest-growing countries in the world, with a national budget of over US $1 billion per year. Its newfound wealth derives from vast stores of oil and gas in the Timor Sea that have been used to establish a government fund estimated to be worth close to US $12 billion dollars. Along with this wealth has emerged a major rift about what the government should spend this money on.

  • 3 - Class and health

  • Toni Schofield, University of Sydney
  • Book:
    A Sociological Approach to Health Determinants
    Published online:
    06 August 2018
    Print publication:
    03 February 2015, pp 33-59

  • Summary

    Overview

  • What is the social gradient in health? What are some of the key indicators of socio-economic status (SES) used to identify it?

  • What is the relationship between SES and social resources? What kinds of health disparities can it explain?

  • What is specific to class as a domain of social practice? What does it seek to explain in relation to health?

  • What is the division of labour and what role does it play in producing class?

  • How does the ownership and control of the resources needed for producing and distributing goods and services generate class?

  • What are representational practices and discourses? What role do they play in class dynamics?

  • How does class get into peoples’ bodies as health and illness?

    • California, United States, 2013

    As one of this year’s memorable episodes of the television program ‘Keeping Up With the Kardashians’ showed, Kim Kardashian’s pregnancy and baby appeared to be in crisis. Less than a week later, Kardashian and partner Kanye West had their first child, delivering a very happy ending to the medical drama.

    On a l ight during which Kardashian experienced unexpected distress, the reality star reported that she had ‘never experienced pain like this in her life’, and was rushed to her doctor. ‘The episode offered a behind-the-scenes look at her personal anxieties and fears for what has been a very public pregnancy’.

  • 4 - Gender and health

  • Toni Schofield, University of Sydney
  • Book:
    A Sociological Approach to Health Determinants
    Published online:
    06 August 2018
    Print publication:
    03 February 2015, pp 60-82

  • Summary

    Overview

  • What distinguishes gender from other processes of social division? What does it mean to say that gender dynamics are historically and socially variable?

  • How does a sex-differences approach to health characterise the health of men and women? What are the limitations of this approach?

  • What is a gender order and what does it mean to say that it is patriarchal?

  • What evidence is there to say that gender inequality prevails on a global scale?

  • What is gendered health? What are examples of gender dynamics involved in it?

  • What is the relationship between gender dynamics, intersectionality and health disparity?

  • How are gender inequality and patriarchy evident in health disparity?

    • China 1911

    ‘My grandmother’s feet had been bound when she was two years old. Her mother … first wound a piece of white cloth about twenty feet long round her feet, bending all the toes except the big toe inward and under the sole. Then she placed a large stone on top to crush the arch’ (Chang 1991:31). As Jung Chang (1991: 31–2) recounts in her acclaimed personal history about her life in China, the pain from footbinding had been so agonising that her grandmother had screamed in agony, fainting over and over. The procedure had been repeated over several years, with the feet bound day and night to stop them from recovering. Though there had been no reprieve from the pain throughout the process and Jung’s grandmother had pleaded with her mother to stop, the mother could only weep, telling her daughter her life would be ruined without bound feet and that her future happiness depended on it. As Jung explains, such a practice had prevailed in China for about a thousand years. It was only in bed at night that the binding could be relaxed – rarely ever removed and rarely ever witnessed by men. Removal of the binding usually revealed rotting, stinking flesh.

  • 2 - Understanding the social

  • Toni Schofield, University of Sydney
  • Book:
    A Sociological Approach to Health Determinants
    Published online:
    06 August 2018
    Print publication:
    03 February 2015, pp 16-32

  • Summary

    Overview

  • What does it mean to say that the individual is a ‘modern’ invention?

  • In what ways were modernist ideas about the individual central to the development of 18th and 19th-century European thinking about the social?

  • What is ‘social structure’ and what contribution does it make to understanding human being and action?

    • The Atlantic Ocean, somewhere between West Africa and South Carolina, 1756

    The contractions began rolling hard and long and often, and I left it to Fanta (a slave woman) to decide when to push …

    She pushed for a long time, and then she lay back and rested . . . ‘Now,’ Fanta said. She pushed three more times. I saw hairs on a head starting to part her, but the baby wouldn’t come yet. She pushed once more, and the head came all the way out, blue and purplish and light coloured and specked with bits of whiteness and blood. Fanta pushed again, and out came the shoulders. The rest slid out quickly . . . I . . . slice[d] the cord, then I wrapped the baby and gave him to Fanta. The baby cried, and Fanta let it howl good and long before allowing it to root for her nipple. She was not a proud mother, but an angry one. I tried to settle Fanta comfortably on the bed, but she pushed me away. (Hill 2007 : 86–7)

  • 1 - The social determinants of health approach

  • Toni Schofield, University of Sydney
  • Book:
    A Sociological Approach to Health Determinants
    Published online:
    06 August 2018
    Print publication:
    03 February 2015, pp 1-15

  • Summary

    Overview

  • What are health inequities according to a social determinants of health (SDOH) approach?

  • What causes health inequities and how can they be abolished using this approach?

  • What are the limitations of the SDOH approach in addressing and redressing health inequities?

    • Nigeria, around 1970

    Jonathan Iwegbu counted himself extraordinarily lucky. ‘Happy survival!’ meant so much more to him than a current fashion of greeting old friends in the first hazy days of peace … He had come out of the war with five inestimable blessings – his head, his wife Maria’s head and the heads of three out of their four children. As a bonus he also had his old bicycle – a miracle too but naturally not to be compared to the safety of five human heads …

    … [Jonathan] made the journey to Enugu and found another miracle waiting for him. It was unbelievable . . . This newest miracle was his little house in Ogui Overside . . . Only two houses away a huge concrete edifice some wealthy contractor had put up just before the war was a mountain of rubble. And here was Jonathan’s little zinc house of no regrets built with mud blocks quite intact! Of course the doors and windows were missing and five sheets off the roof. But what was that? And anyhow he had returned to Enugu early enough to pick up bits of old zinc and wood and soggy sheets of cardboard lying around the neighbourhood before thousands more came out of their forest holes looking for the same thing. He got a destitute carpenter with one old hammer, a blunt plane and a few bent and rusty nails in his tool bag to turn this assortment of wood, paper and metal into door and window shutters for five Nigerian shillings . . .

  • Foreword

  • Toni Schofield, University of Sydney
  • Book:
    A Sociological Approach to Health Determinants
    Published online:
    06 August 2018
    Print publication:
    03 February 2015, pp v-vi

  • Summary

    ‘To good health!’ we say when sharing a drink. Sadly, all too often that good health is not shared. Many people do not enjoy the conditions needed to live healthy lives.

    Health authorities around the world now recognise the social determinants of health as a major concern. That is an important advance. Recognising a problem, however, and understanding it, are different things. And doing something effective about it is another matter again.

    In this book Toni Schoi eld and her colleagues move us towards understanding and action. They give the facts about health and society, mapping the realities of class, gender, ethnicity, indigeneity, the state and health care. The facts are tough. There is grim evidence here about violence, abuse and exclusion; and about the less-dramatic, grinding effects of poverty and stress.

    The book does much more. It takes us beyond describing the social dimensions of health to the ‘causes of the causes’ – the social dynamics of health. The chapters consider carefully the major structures of inequality in contemporary societies, explaining how they operate and how they have changed. They place health in the context of economic change, colonisation, migration and changing reproductive practices.

    How do social inequalities get under the skin and become health effects? That’s a key question, and in this book we see the multiple answers. They range from socially caused malnutrition, to social pathways of viral infection, to physical injury in the workplace, to genetic damage and environmental pollution. All are bound up in the operations of social power. All have an impact on bodies, but unequally so.

  • Epilogue

  • Toni Schofield, University of Sydney
  • Book:
    A Sociological Approach to Health Determinants
    Published online:
    06 August 2018
    Print publication:
    03 February 2015, pp 177-182

  • Summary

    A common response to sociology is: ‘What do I do with this?’ (Russell and Schofield 1986 : 203). Physical scientists’ research can often be taken up for ‘practical’ purposes, such as providing cures and treatments for disease and injury. A sociological approach offers no comparable technical solution – no ‘magic bullet’. Not that sociology has a singular mission. In its comparatively short history, it has had many purposes. In this book, its ‘project’ has been inspired and shaped by international policy and research development in health: the social determinants of health. As Chapter 1 explained, the ‘social determinants of health’ has become a globally inl uential approach to understanding and responding to social inequalities and health disparities, both within countries and globally. Pioneered by the WHO, it has entered the lexicon of health policy makers, health practitioners, researchers and social movements. It has generated a seismic shift in global awareness of the inter-connectedness of the differentiated health fates of the planet’s peoples, and of the injustices that accompany them. Its central ‘take-home’ message is that health disparities are of our making and, therefore, can be un-made. What’s more, the problem does not lie with insufi cient global resources. Rather, the problem and its solution are located squarely within the realm of human society; in particular, ‘social factors’ associated with how we live, work and grow.

  • Africa

  • Paul G. Yock, Stanford University, California, Stefanos Zenios, Stanford University, California, Josh Makower, Stanford University, California, Todd J. Brinton, Stanford University, California, Uday N. Kumar, Stanford University, California, F. T. Jay Watkins, Lyn Denend, Stanford University, California, Thomas M. Krummel, Stanford University School of Medicine, California, Christine Q. Kurihara, Stanford University, California
  • Book:
    Biodesign
    Published online:
    11 May 2018
    Print publication:
    02 February 2015, pp 10-13

  • Summary

    Background

    Africa is on the rise. The twenty-first century has been called the “African Century” due to the continent's potential for increased economic development in the coming decades. From 2000–2012, economic growth averaged more than 5 percent per year, driven by the recovery of commodity prices, government economic and policy reforms, and restoration of international donor confidence and aid. Africa's collective gross domestic product (GDP) topped US$1.7 trillion in 2012 (making it nearly comparable to Russia or Brazil), and its middle class expanded to more than 34 percent of the continent's 1 billion people.

    Poverty is declining, yet Africa still has the highest poverty rate in the world with 47.5 percent of the population living on less than US$1.25 a day. The continent also accounts for 25 percent of the global disease burden. Maternal health, child health, HIV, tuberculosis, and malaria continue to be the continent's greatest health challenges. What may be surprising is that over the next 10 years, Africa will experience the largest increase in deaths from cardiovascular disease, cancer, respiratory disease, and diabetes of any continent in the world. For instance, the World Health Organization estimated that in 2008 the prevalence of hypertension was highest in its Africa region, with nearly half of the population affected, and this figure is on the rise.

    Generalities are difficult to apply across this diverse continent. It is a massive, highly fragmented mosaic of more than 50 countries, with an estimated 2,000 languages spoken and thousands of distinct ethnic groups. The continent's diverse population is expected to double by 2050, from 1 billion to more than 2 billion. Africa is endowed with more than 30 million square miles of varied geography and could fit China, India, the United States, and most of Europe within its physical boundaries. Across this great expanse, the continent's health-care infrastructure is evolving. African governments are working to expand healthcare delivery systems through public and private investment, but in the meantime, millions of people must travel vast distances to receive basic medical care.

  • Focus on Value

  • Paul G. Yock, Stanford University, California, Stefanos Zenios, Stanford University, California, Josh Makower, Stanford University, California, Todd J. Brinton, Stanford University, California, Uday N. Kumar, Stanford University, California, F. T. Jay Watkins, Lyn Denend, Stanford University, California, Thomas M. Krummel, Stanford University School of Medicine, California, Christine Q. Kurihara, Stanford University, California
  • Book:
    Biodesign
    Published online:
    11 May 2018
    Print publication:
    02 February 2015, pp 1-6

  • Summary

    What do we mean by “value” and why is it so important?

    The escalation of healthcare costs is one of the major economic and political issues of our time. The problem is most apparent in the United States, where healthcare as a share of the economy has more than doubled over the past 35 years. Spending on health accounted for 7.2 percent of the nation's gross domestic product (GDP) in 1970, expanded to 16 percent in 2005, and is projected to be as high as 20 percent of GDP by 2015.

    Simply put, the US economy cannot sustain this spending trajectory, which has outpaced GDP growth for years (see Figure V1). The problem is not just straining the federal budget: state and local governments have been forced to reduce support for education, infrastructure, and other critical expenditures as they struggle to fund Medicaid and other health programs. In the private sector, the cost of employment-based health insurance is one of the main reasons workers have seen their wages stagnate.

    Despite the fact that the US spends two-and-a-half times more per capita on health than most developed countries, it does not necessarily provide the best care to its citizens. In 2000, when the World Health Organization ranked the health systems of its 191 member states for the first time ever, the US found itself in 37th position. In a more recent study that compared the US to Australia, Canada, Germany, the Netherlands, New Zealand, and the United Kingdom on measures of quality, efficiency, access to care, equity, and the ability of citizens to lead long, healthy lives, America occupied last place. As the report pointed out, “While there is room for improvement in every country, the US stands out for not getting good value for its healthcare dollars.”

    Against this backdrop, economists, researchers, and policy makers alike have pointed to medical technology as a dominant factor driving increased health expenditures in the US.

  • China

  • Paul G. Yock, Stanford University, California, Stefanos Zenios, Stanford University, California, Josh Makower, Stanford University, California, Todd J. Brinton, Stanford University, California, Uday N. Kumar, Stanford University, California, F. T. Jay Watkins, Lyn Denend, Stanford University, California, Thomas M. Krummel, Stanford University School of Medicine, California, Christine Q. Kurihara, Stanford University, California
  • Book:
    Biodesign
    Published online:
    11 May 2018
    Print publication:
    02 February 2015, pp 14-17

  • Summary

    Background

    China is perhaps the most impressive economic development story in modern history. Sustaining annual growth rates upwards of 9 percent for more than two decades, the country's gross domestic product (GDP) reached US$8 trillion in 2012 (second only to the United States at US$16 trillion). This remarkable expansion has lifted hundreds of millions of Chinese out of poverty and created a new middle class that is larger than the entire US population.

    With more than 1.35 billion people, China has the largest citizenry in the world. In 2011, the country's urban population surpassed its rural population for the first time, with close to 700 million people living in China's cities. Population growth in China has decreased steadily over the last 20 years due to the controversial one-child policy (from approximately 1.2 percent to less than half of one percent) and is expected to continue to decline. The country's median age is just 35 years, compared to nearly 40 years in more developed countries. However, as a whole, the population is aging rapidly; senior citizens will account for as much as 35 percent of the Chinese people by 2053.

    One of the most important challenges facing China in the twenty-first century is how to allocate healthcare resources for its massive population. Despite progress in the country's economic transformation, China significantly lags the developed world in its ability to provide even basic health services to the vast majority of its people. The Chinese government spent approximately 5 percent of GDP on healthcare in 2011, compared to roughly 18 percent spent in the US and 9 percent on average in the OECD countries. Per capita spending on medical technologies is just US$ in China versus US$399 in the US.

    China's centrally planned economy provides health insurance coverage to approximately 90 percent of the population under three primary programs (an employer-based system, one for urban residents, and another covering the rural population). These insurance schemes are largely inadequate to cover basic care but rather focus on protecting patients from catastrophic health events. As a result, the Chinese typically pay for basic health services out-of-pocket, causing many individuals to delay diagnosis and treatment until they are critically ill.

Page 1464 of 1880