Lecture 4 lay conceptions of health illness

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Information about Lecture 4 lay conceptions of health illness
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Published on March 1, 2008

Author: liamgr

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Lecture 4:  Lecture 4 Lay conceptions of health & illness The ‘enigma’ of health:  The ‘enigma’ of health Is it not an extraordinary thing that the lack of something, though we do not know exactly what it is that is lacking, can reveal the miraculous existence of health? Gadamer, 1996 Social Representations of Health (Herzlich 1968/1973) :  Social Representations of Health (Herzlich 1968/1973) Study of 80 Middle Class French adults Semi-structured/qualitative interviews Health defined in terms of social activity Health understood independently of illness Herzlich (1973) Lay Views of Health :  Herzlich (1973) Lay Views of Health Lay Conceptions of Health (Herzlich, 1973):  Lay Conceptions of Health (Herzlich, 1973) (1) Health-in-a-vacuum absence of illness one only knows one has good health when illness strikes independent of person (2) Reserve of Health Characteristic of individual individual felt capacity protection against illness (presence) (3) Equilibrium contingent upon events in a person’s life NOTE: 1. People’s ideas about health are not fixed 2. Health is independent of illness Reactions to Illness:  Reactions to Illness Illness as destructive: perceived as threat to social being since it excludes one from active social involvement Illness as liberator: perceived as release from social obligations Illness as occupation: accepted but must be struggled against Social Representations of Health:  Social Representations of Health When an individual talks about health and illness, he also talks about something else: The nature of his links with his environment, physical and social, as well as aspects of social organization.” Herzlich (1973) Health ‘registers’ (Pierret, 1995):  Health ‘registers’ (Pierret, 1995) Health-illness (Health as not being sick) Health-tool (Health as reserve/’savings’) Health-product (External factors: the search for pleasure vs control of risk) Health-institution (Health as societal/political ‘good) Cornwell (1984) Hard Earned Lives:  Cornwell (1984) Hard Earned Lives Illnesses as ‘morally problematic’ conditions implying a ‘right’ position Attempt to appear ‘basically healthy’ Self-definition of healthiness despite serious health problems …illness can incapacitate and prevent people from working. In doing so it can threaten not only the practical basis of their lives but also their moral reputation… (1984 p.127) Blaxter (1990) Health & Lifestyles:  Blaxter (1990) Health & Lifestyles Think of someone you know who is very healthy How old are they? Who are you thinking of ? What makes you call them healthy ? At times people are healthier than at other times. What is it like when you are healthy? Blaxter (1990) Health & Lifestyles:  Blaxter (1990) Health & Lifestyles 9000 respondents 10% of respondents unable to answer the question ‘What is it like when you’re healthy?’ 15% could not think of anyone healthy A typical response: I don’t really know. Sometimes I do feel less healthy, but I can’t say that I feel what it is like to be healthy at other times. Blaxter (1990) Health & Lifestyles:  Blaxter (1990) Health & Lifestyles Health as energy or vitality Paid work for men housework for women When I'm healthy l feel like tackling the housework Health as a social relationship Women more likely than men to define health in terms of relationships with others Health as function Ability to do hard work (Men) To do things (Women) Health as psycho-social well being Purely mental state It's good to be alive Blaxter (1990) Health & Lifestyles:  Blaxter (1990) Health & Lifestyles Health as not ill Not ill = no symptoms People in poor health less likely to define health in terms of illness Health as absence of disease/ health despite disease Never been in hospital Coping with disease or misfortune Health as reserve Recovers quickly, never gets a hangover Healthy stock Blaxter (1990) Health & Lifestyles:  Blaxter (1990) Health & Lifestyles Health as behaviour Virtuous life "She leads a proper respectable life so she's never ill Health as physical fitness Sport & Sportsmen (men) Outward appearance (women) 80% males & 57% females mentioned a man as the model of health Variations in conceptions of health :  Variations in conceptions of health Working class more likely to emphasise the ability to carry out work and family duties Middle class more likely to emphasise the broader, psychological aspects of energy, positive attitudes, control Variations also found amongst ethnic/religious groups Implications of lay representations of health:  Implications of lay representations of health Health professionals need to comprehend the ways in which people assess and understand health and messages about health If members of the public do not share professionals’ beliefs about key influences of health they are less likely to adopt professional guidelines for managing health or preventing illness. How people react to illness shapes the way they deal with it. People react to the ‘meaning’ of a symptom, not merely the symptom. Meaning is derived from their cultural and social milieu which in turn shapes their responses and help-seeking behaviours Further Reading:  Further Reading Blaxter M. (1990) Health and Lifestyles London: Tavistock/Routledge 1990 Blaxter M. (1997) Whose fault is it? People’s own conceptions of the reasons for health inequalities. Soc Sci Med 44 747–56. Cornwell J. (1984) Hard-Earned Lives: Accounts of Health and Illness from East London. London: Tavistock Furnham A (1994) Explaining health and illness: lay beliefs on the nature of health. Pers Individ Dif 17 455–66 Macfarlane A, Kelleher D. (2002 )Concepts of illness causation and attitudes to health care among older people in the Republic of Ireland. Soc Sci Med; 54 1389–400. MacIntyre et al (2006) Lay concepts of the relative importance of different influences on health; are there major socio-demographic variations? Health Education Research 21 731-739

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