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Health :star:, Irregular practitioners, Canada's Health Care System,…

- - - - social construction
    - - group of people born at a particular time and place
    - - social change occurs in historical time
  - - - stable gaps with age/across the life course
    - - narrowing gaps with age/across the life course
    - - widening gaps with age/across the life course
- - - - focuses on individual's ability to shape social structures through their actions
      - focus more on economic and institutional structures
    - - emphasizes the ways which social structures shape individual's actions through habits
      - places a greater emphasis on symbolic power and cultural practices
    - - focus more on economic and institutional structures
      - specifically applies the agency/structure debate to the context of health and healthcare
- - - - Parson's Sick role
        
        Onset of Symptoms
        
        Sick Role
        
        Patient Role
        
        Recovery
        
        linear pathway
        
        chronic health problems do not fit this model
        
        illness relapse does not fir this model
        
        contested illnesses get overlooked
        
        obligation to be sick
        
        Illness Career
    - - Rise in commodification of medical care: 3rd party!
        
        aka Countervailing Powers
      - Rise of "Managed Care" companies
        
        a. Efficiency & fair health care
        
        b. Utilization Review: control rising health care costs
      - Negative implication for doctor-patient relationship
        
        M.D. have to balance patient wellbeing & financial considerations
  - - - patient self-diagnose
      - service bought by patients and sold by physicians
        
        Inqeuality :!!:
        
        not all posess Cultural Health Capital
        
        care captating
        
        care enthrusting
        
        distrust, apathy, antagonism towards health providers
        
        foregone care
        
        not listened to when seeking care
        
        medical complications and death
      - advocation for specific treatment
      - social movements
        
        contested illness
        
        illness reification; normalization
      - patient proactive role
      - search for cheapest price
    - - neither M.D. or patient is automatically in charge
      - tension between professional expertise and patient experience
        
        COVID-19 M.D. ER burnout
  - - - emotional support
      - education of choices of diagnose and treatment
      - treatment options
  - - - companies of health apps might send info to police
    - - too much drug prescription
      - overmedicalization
      - patients still misinformed
- - - - Stress process model
        
        Social characteristics
        
        Social + personal resources
        
        Health
        
        Stress exposure
        
        Stress exposure + coping resources are socially patterned
        
        Discrimination-related stress
      - Biopsychosocial model
        
        Exposure to stress
        
        Hypervigilance in the brain (sympathetic nervous system, hypothalamic-pituitary-adrenal axis stimulated)
        
        Chronic exposure to glucocorticoids, inflammation
        
        Higher allostatic load
        
        Chronic disease prevalence (e.g. diabetes, cardiovascular disease)
    - - Discrete vs continuous
      - Micro, meso, macro
    - - Colourism affects psychosocial wellbeing: social gradient in skin colour affects mattering, length of telomere differs :(
    - - Definition: how social experiences are embodied biologically, affecting health + wellbeing, an active process written into DNA
        Nurture>nature
        
        Biomarkers in social science research as objective measures of stress embodiment
        Metabolic, CV, immune
      - 3 claims of embodiment
        
        Bodies tell stories about the conditions: stress process model
        
        Bodies tell stories that match person's accounts: people are aware of their conditions, the perception of circumstances and social standing affect how they tell stories
        
        Bodies tell stories that might not be told
        e.g. historial and intergenerational trauma, especially in Indigenous and Jewish communities
        
        Multilevel pathways: social hierarchies, behavioural + psychosocial, epigenetic
      - Consequences of stress embodiment:
        Stress is a robust pathway in how population health is shaped
- - - - Medical Care Act of 1966: Canada’s 1st National Health Care System
        
        4 principles:
        
        universal access
        
        publicly administered
        
        comprehensive coverage
        
        portable
      - Royal Commission on Health Service (led by Emmett Hall), 1961-1965: Recommended Saskatchewan Model be adopted across all of Canada
    - - Justice Emmett Hall chairs 2nd commission, 1979
        
        The Canada Health Act, 1984
        
        Retrenchment (mid 1990s):LOSS OF CONFIDENCE IN HEALTH CARE SYSTEM + ALIENATED HEALTH CARE
        WORKERS