1. The study of the development, structure, and functioning of human society.
2. The study of social problems.

How does society work, who has power and why, changes in society- how are people's lives affected by the wider world around them?

Structual approaches.

Karl Marx- conflict theory

Talcott Pasons- structual functionalism.

Argue that social structures (eg: economical, legal, healthcare, government and educatioal systems) shape human behavior, or determine how we think. Also affects individual chances at health, wealth etc.

Karl Marx- conflict theory:

Communistic. Anti-capitalist approach. Focus on class conflict, power inbalances, social inequalities. Argued that improved living and working conditions will improve health.

Talcott Parsons- Functionalism:

Everyone has a role to play in society. Sickness as a deviation from the norm- deviance in the sense that it prevents people from performing designated social roles...illness disrupts the normal function of society.  Dr as the gate-keeper, patient plays the sick role- obligation is to comply with orders and recover.

Interactionist Theory- Agency

Erving Goffman.

Interactionist/Agency approcahes argue that the individual creates society. Society is a product of individuals acting socially or collectively to create a society in which they live.

Focus on small scale interactions (micro perspective). 

Goffman:

Focus on labels, stigma and negative connotations. How individual abd small group interactions construct social meaning in every day situations, to create and change social patterns of behavior.
provides explanation for how/why some behaviors aee seen as deviant, as well as the bias/stigmatization of those groups so classed.

Biomedical approach: A state of complete physical, mental and social wellbeing and not mereky the absence of disease or infirmity

Social model approach: Physical, social, emotional, cultural wellbeing of the whole community.

Describe the biomedical model

Conventional western approach to medicine.

Based on diagnosis & explanation of sickness/disease of the body's biological mechanisms and medically defined pathology.

Cartesian dualism: Mind and body seperate identities.

Health determined by absence of disease.

All illness has a cause/reason and is therefore curable. Focus on problem only. 

Science that is rational, objective and value free.

Describe the Social Model of Health

Focus on social determinants of health- emphasis on social causes of disease transmission etc.

Social distribution of health and illness are the outcome of living/working conditions.

Takes account of the social construction of health and illness- definition of health varies between culture, time and place.

Looks at the social organization of health care (funding, oranization and utilization).

Focus on prevention and health promotion

Includes physical aspects of the environment- economic, behavioral, social factors etc which can affect health.

Economy

society

culture

SES

Access to health care

Life chances

Inequalities

Tyranny of distance

Employment

Education

The alma-Ata Declaration- 1978

Ottawa Charter (1986)

Alma- Ata: Called for an end to health inequality in and between countries.
"Health for all the people of the world by the year 2000".

Ottawa Charter: Reaffirmed the "health for all" target. Consists of 5 key action areas:

*build healthy public policy
*Create supportive environments

*Strengthen community action

*Develop personal skills

*Reorientate health services

Social class is the position in a system of structures inequality based on enequal distribution of wealth, power, income and status.

SES= Combined measure of income, education and occupation.

The most significant predictor of health status

Low family income = poorer health, less liklihood of accessing preventative health services.

Upper: 15%- ownership/control over economic resources

Middle: 47%- Ownership of marketable skills & qualifications

Working class: 38%- wage labour, unskilled manual & non-manual work

Cultural practices and attitudes that characterise a given group or people and distinguish them from others.

Ethic differences are learned- the result of socialization, not heredity.

A concept that uses skin colour and facial features to describe what are alleged to be biologically distinct groups of humans.

Assumes bioological and genetic differences in people.

Socially constructed and used to categorise people, implies assumed (and incorrect) intellectual superiority or inferiority.

Define gender

Socially constructed idea of the characteristics, roles & responsibilities of men, women, boys and girls.

Biological differences are interpreted and translated into social expectations and experiences. Society prescribes different roles to men and women in different social contexts.

Also influences the way we are percieved, and expected to think and acct because of the way society is organized- NOT becaue of biological differences.

*Recognition of cultural differences and similarities

*Nurses need to identify and learn about cultural differences

*Preserve and maintain cultural care

*Accommodate people's cultural care

*Recognition that appropriate cultural care is beneficial for all.

The basis of providing culturally safe health care environments.


Recognises the differences that are present across society/community, and works to adapt to take these differences into account in a way that is respectful and acceptable to both clients and carers.

Allows for the culturally safe and relevant health care.

What is cultural competence?

What are the 7 principles of cultural competence?

A set of behaviors, attitudes and startegies whereby a health professional is expected to respect individual needs/vulnerability/culture/values.

1) Reflection on self

2)Effective communication skills (competence, use of translators etc)

3) Undertand the influence of power imbalance on others

4) Develop trust

5) Negotiation/sharing of knowledge

6) Negotiation/sharing of outcomes

7) Understand cultre shock.

What is culture shock?

What are the 5 major stressors?

The feeling of disorientation experienced by someone who is suddenly subjected to an unfamiliar culture, way of life, or set of attitudes.

5 major stressors:

1) mechanical differences (routine, technology, personal space etc)

2) Isolation(fear, segregation, withdrawal)

3) Customs (new roles, routines, loss of identity, institutional organization)

4) Attitudes/beliefs (fear/anxiety, professional authority)

5) Communication (language/jargon, level of understanding, fear, acceptance of professional knowledge).

Cultural awareness: Understanding and identifying differences.

Sultural sensitivity: Legitimacy of differences- cross cultural understanding.

Cultural safety: Action which promotes and empowers the cultural identity and wellbeing of the individual.

When one or more cultures are integrated into one environment, causing disruption and challenging contemporary traditions.

Systemic bias

Steroetypes

Prejudices

Discrimination

Stages in Aboriginal history

Traditional, transitional and contemporary

*Traditional (pre 1788)

Traditional systems of kinship/society, the Dreaming etc.

Colonization occured in 1788.

*Transitional (post 1788- 1967)

Genocide, dispossesion, white Australia policy, disease, frontier conflict, culture clash, assimilation, stolen generation. 

*Contemporary (1967- current)

Referendum 1967.

1788: Colonization

1900: Constitution Act exclused Aboriginals from being counted as citizens

1905: Aboriginal Act- protection policy. Survivors moved to missions etc.

1937: Assimilation Policy- those not of 'full blood" were to be assimilated into the wider population.

1967: Referendum

1975: Self-determination policy- Aboriginal communities able to decide the pace and nature of future development as significant components within a diverse Australia. Right to be involved in decision making about their lives.

1992: Mabo (High Court determined that Aust. should never have been deemed Terra Nullius. Native Title established.

2008: Apology to the Indigenous people by Prime Minister Kevin Rudd

Within a generation:

Halve the gap in mortality rates for indig. children under 5 within 10 years.

Access to early childhood education for all Indig 4 year olds in remote communities within 5 years.

Halve the gap in literacy & numeracy skills for children within 10 years. 

Halve the gap for Indig students in yr 12 attainment by 2020.

Halve the gap in employment between Indig and non-Indig Aussies within 10 years.

Cardiovascular disease

cancer

diabetes

renal disease/failure

respiratory disease

eye, ear, oral and skin infections and infestations

Communicable disease

social/emotional wellbeing (psychological distress)

substance misuse

smoking

injury

Social factors- disposession, dislocation, depopulation and discrimination

Educational factors- poorer levels of schooling

Economic factors- low SES, employment

Physcial/environmental factors- housing, nutrition etc.

Historical factors- disposession etc.

Economical factors- employement, SES.

Psychosocial/cultural factors- racism, family violence, stress, transgenerational trauma.

Healthcare system access- affordability, availability, approriateness.

Risk behaviors- physical inactivity, poor nutrition, smoking, substance misuse.

Evironmental- housing, unsafe environment, isolation, lack of transport, poor food supply.

Non-modifiable risk factors- age, gender, genetics

Biomedical risk factors- obesity, hypertension, hyperlipidemia, low birth weights,

1) The honeymon phase- fascination, enthusiasm, excitement.

2) Disenchantment phase- frustration, anxiety, anger, isolation.

3) Recovery: crisis resolution, cultural learning.

4) Effetive functioning phase: adjustment, functional competence, enjoyment of new environment.