What is a social ecological or multi-systemic approach to health, and why does Health Psychology (HP Key Concepts text) and Health Promotion/Public Health (Prilleltensky, Theory at a Glance (Natl Cancer Institute, Kickbusch) favor this approach? Please use at least two specific examples, use one only from the people in Unnatural Causes, and one other from your own experience, other readings.
A social-ecological approach to health is a method used in health promotion which includes a combination of efforts to change behavior of individuals, policies, physical and social environment to improve the health of the community (Albery and Munafo 2). The approach is favored by psychologists because it focuses on preventive rather than therapeutic measures. Thus, it not only focuses on alleviating illness but also health promotion among individuals in the community.
The clinical health psychology focuses on an individual with the aim of dealing with the illness. On the other hand, the public health psychology entails improving the general health of the public through health promotion. The community health psychology is almost similar to the public health psychology, but its interventions are limited at the individual and organizational levels, whereas the critical health psychology focuses on improving healthcare by aligning the interplay of politics, economics and other governance structures for an efficient healthcare system. (Antonio and Kerry 20). It is important to understand the role power plays in healthcare as suggested by critical health psychology, because that is only when one can be in a position to fight for equality and justice in the delivery of health services and distribution of resources to promote health.
It is important to analyze the effect of stressors at different developmental phases because studies indicate that health status of people improves with an increase in wealth and advancement in education. The reason is that allostatic loads of individuals in the same development stage are likely to be the same because they undergo almost similar challenges and other encounters in life. (Braveman and Gottlieb 21).
For example, in Unnatural Causes, by assessing the lives of an unemployed mother, a janitor, a lab supervisor, and a CEO the first episode proves that health is a product of several factors . Another example is the fact that infections are more prevalent in developing countries where there is poverty, political instability, and illiteracy among other factors.
Health promotion is the process of enhancing the ability of people in a community to exercise control over their health and its factors with the aim of improving their health. Health promotion implies preventing diseases from occurring, stopping the progress of an existing disease or preventing consequences of an existent disease. It does not target a single illness or risk factor (Prilleltensky 5). Instead, it enhances the ability of members of a community to promote their health which is achieved through the creation of environments that support well-being. Besides, health promotion seeks to create a situation where there is a natural evolution of health (Prilleltensky 8). The promotion is only possible through supporting communities in assuming the influence of such factors as food choices, physical activities, and programs for taking care of the elderly on their health among others.
What are the he advantages of the the multi-systemic approach?
One of the advantages of the the multi-systemic approach is that it shifts societal attention from blaming victims of health malpractices to controlling the abuses (Glouberman and Millar 388). Secondly, it makes everyone realize the importance of every determinant of health even if it is the responsibility of someone else hence, enhancing a sense of accountability. Also, it achieves a population-level impact which is not the case in individualized health promotion and programs targeting specific illnesses. Furthermore, it engages the community in health promotion activities compared to a technocratic approach which leaves the responsibility of better health to healthcare professionals alone. Besides, the multilevel ecological models employed in holistic approaches to health promotion provide frameworks that are essential for dealing with health issues facing the community (Davis-Floyd 75). For example, HIV prevention programs would not achieve the effectiveness they have attained if healthcare strategies targeted the infected individuals alone.
Can the US healthcare system be considered the best in the world? Does it experience any problems?
Despite the challenges facing the US healthcare system, it can be considered the best in the world because the last century has seen it improve on health indicators. It has witnessed an increased life expectancy at birth and a significant decrease in the mortality rate caused by heart disease which is the number one cause of death in the United States (Starfield 484). Some people think that it is because of the USA's improved standards of medical training, enhanced regulation of healthcare professions and informing clinical practice through scientific research. Others believe it is due to the investment in promoting public health systems and avoiding epidemics (Starfield 485).
Despite the huge strides the US has made, it experiences some problems in healthcare. First, primary care is not yet institutionalized in policy- making. Therefore, despite the emphasis on primary care, it remains marginalized in the reform agenda in the US healthcare system. As a result, it has not grown into a major component of healthcare delivery. Furthermore, the number of US citizens who die due to medical errors remains high. Moreover, a significant number of Americans are not satisfied with the care given to people with chronic conditions due to a minimal accommodation of needs and demands of patients (Berwick et al. 764).
The US has a variety of possible solutions that it can employ to develop an ideal healthcare system. First, the country should increase the quality of healthcare, although this might be more costly due to the greater demand for health services. It can also come up with policies to reduce the cost of accessing health care by introducing a single payer system. Policies to institutionalize health promotion should also be put in place and implemented. I think a multi-systemic approach, as suggested by Davis Foyd, can make technocratic healthcare better since the general health of the public is improved thus, only a few cases will go to specialists for treatment.
How does inequality burden health and how does social justice promote wellness?
There are different factors which affect a persons health stability. Health of a group of people can be classified according to their socioeconomic status which is derived from either their income or level of education. Poor people with the smallest income and also the lowest level of education happen to suffer earlier mortality and also worse health complications as compared to the middle class with a fair amount of income and a level of education. Generally, their health is better if compared to poor. Then comes in the wealthy. Their health is above the charts as compared to the middle class and the poor since the levels of income are higher and much better as well as their education, which is far better (Bruce 106). Apart from the three different classifications affecting health, there are also other causes of poor health and these include environments, work, relationships, knowledge or health damaging factors.
Stress levels differ depending on different situations as seen above, starting with different inequalities. Low income, for instance, comes along with a couple of stress-causing factors. The brain perceives the experiences and tries to give the appropriate response which leads to allostasis and adaptation. Over time as the allostatic load accumulates as the person adapts to the stress situations and the over exposure to immune stress, mediators affects the body organ system of the person exposing them to diseases (Bruce 106). When there are less the situations leading to stress as experienced by a group, for example, the wealthy class, there is also less piling up of allostatic load hence, less exposure to sicknesses (Antonia and Chamberlain 26).
Social justice promotes more equality among people. Governance determines the equality experienced by the people being governed (Isaac, 18). The health records in poorly developed areas happen to be worse as compared to developed areas in many countries. Since social justice does not act appropriately in relation to to all citizens, it fails to support wellness among the community at large.
How do you understand racism at each level identified by Camara Jones ?
Camara Jones divides racism into three various categories as a way to break down the concept of racism in the health sector so as to help fight racism in the sector. She clearly paints the picture to us on how we perceive racism and why fighting the problem in the medical field has not been effective. Jones divides racism into institutionalized racism, personally-mediated racism, and internalized racism. Looking at racism at these levels we are able to figure out how racism can be impactingdifferent players in the health sector and understand how to intervene so as to control or eliminate the issue.
Institutionalized racism can be defined as differential access to goods, services and opportunities existent in the society by race (Jones 1212). This type of racism is more of an inherited norm that is carried on from one point to the other and mostly happens to be invisible. Institutionalized racism implies differential access to such things as sound housing, job opportunities, healthcare services. This level of racism explains that there is an association between race and social economic status.
The other level of racism is mediated racism. It can be defined as differential assumptions about the abilities of other people in connection to the race which results in differential actions based on those assumptions. A good example is the brutality of the police which impacts different peoples health depending on their race.
The other level of racism is internalized racism. This can be defined as acceptance by members of the stigmatized races of the negative messages about their own intrinsic worth. This level of racism can lead to such things as self-doubt, self-devaluation and low self-confidence. This is the feeling that you cannot do a particular thing. A good example of this is when, for instance, when one chooses a specific race of a physician since they feel the other race is incompetent to help.
Albery, Ian, Munafo, Marcus. Key Concepts in Health Psychology. Sage, 2008.
Berwick, Donald. M., Nolan, Thomas W., & Whittington, John. The Triple Aim: Care, Health, and Cost. Health Affairs, 27 (2008), 759-769.
Braveman, Paula, & Gottlieb, Laura. The Social Determinants of Health: It's Time to Consider the Causes of the Causes. Public Health Reports, 129(2014), 19-31.
Davis-Floyd, Robbie. The Technocratic, Humanistic, and Holistic Paradigms of Childbirth. International Journal of Gynecology & Obstetrics, 75 (2001).
Jones, Camara Phyllis. Levels of Racism: A Theoretic Framework and a Gardener's Tale. American Journal of Public Health 90.8 (2000).
Kickbusch, Ilona. "The Contribution of the World Health Organization to a New Public Health and Health Promotion." American Journal of Public Health 93.3 (2003): 383-388.
Lyons, Antonia C., Kerry Chamberlain. Health Psychology: A Critical Introduction. Cambridge University Press, 2006.
McEwen, Bruce S. "Allostasis and Allostatic Load: Implications for Neuropsychopharmacology." Neuropsychopharmacology 22.2 (2000): 108-124.
Prilleltensky, Isaac. "Wellness as Fairness." American Journal of Community Psychology 49.1-2 (2012): 1-21.
Starfield, Barbara. Is US Health Really the Best in the World? Jama, 2000.
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