Social structural Determinants of Regional Variations in Fertility

2016 ◽  
Author(s):  
Samsik Lee ◽  
Hyojin Choi
Keyword(s):  
Structural Determinants ◽  
Regional Variations ◽  
Social Structural

Freidson Then and Now: An “Internalist” Critique of Freidson's Past and Present Views of the Medical Profession

1992 ◽  
Vol 22 (3) ◽  
pp. 497-512 ◽  
Author(s):  
David Coburn
Keyword(s):  
Health Care ◽  
Medical Profession ◽  
The United States ◽  
Professional Autonomy ◽  
Policy Recommendations ◽  
Structural Determinants ◽  
The Core ◽  
Social Structural ◽  
Core Elements ◽  
Medical Dominance

Freidson is a foremost analyst of the medical profession. Most recently Freidson attacks those who claim that medicine is declining in power. He insists that medicine has not lost the core elements that make it a powerful, indeed, the dominant, health profession. The author compares Freidson's early writings on medicine with his most recent ones, and shows that there are critical confusions in Freidson's central concepts of professional autonomy and dominance. This difficulty is illuminated by viewing dominance, autonomy, and subordination as on a continuum of control. Using this continuum, the author argues that Freidson implicitly admits what he set out to deny (that medicine has not declined in power) by shifting his focus from medical dominance to that of autonomy. Freidson also now rejects valid parts of his earlier work (that which emphasizes social structural determinants of behavior over socialization). In equating medicine in the United States with teaching in that country, Freidson's contention of “little change in medical power” meets its own refutation. Finally, despite his derogation of others, Freidson's lack of an adequate framework to explain the dynamics and not simply the structure of health care produces purely normative, Utopian (and unhelpful) policy recommendations.

The Myth of Gender Differences in Health: Social Structural Determinants across Adult Ages in Britain and Finland

2001 ◽  
Vol 49 (3) ◽  
pp. 31-54 ◽  
Author(s):  
Eero Lahelma ◽  
Sara Arber ◽  
Pekka Martikainen ◽  
Ossi Rahkonen ◽  
Karri Silventoinen
Keyword(s):  
Gender Differences ◽  
Structural Determinants ◽  
Social Structural

COVID-19 Cases Among Facility-Staff by Neighbourhood of Residence and Social and Structural Determinants: An Observational Study (Preprint)

2021 ◽  
Author(s):  
Huiting Ma ◽  
Kristy C.Y. Yiu ◽  
Stefan D. Baral ◽  
Christine Fahim ◽  
Gary Moloney ◽  
...  
Keyword(s):  
Observational Study ◽  
Census Data ◽  
Structural Determinants ◽  
Term Care ◽  
Lorenz Curves ◽  
Gini Coefficients ◽  
Greater Toronto Area ◽  
Social Structural ◽  
Neighbourhood Level ◽  
Facility Staff

BACKGROUND Disproportionate risks of COVID-19 in congregate settings including long-term care homes, retirement homes, and shelters both affect and are affected by SARS-CoV-2 infections among facility-staff. In cities across Canada, there has been a consistent trend of geographic clustering of COVID-19 cases. However, there remain limited data on how COVID-19 among facility-staff reflect urban neighbourhood disparities, particularly stratified by the social and structural determinants of community-level transmission. OBJECTIVE To compare the concentration of cumulative cases by geography and social/structural determinants across three mutually exclusive subgroups in the Greater Toronto Area (population 7.1 million): community, facility-staff, and healthcare workers (HCW) in other settings. METHODS We conducted a retrospective, observational study using surveillance data on laboratory-confirmed COVID-19 cases (January 23 to December 13, 2020; prior to vaccination roll-out). We derived neighbourhood-level social/structural determinants from census data, and generated Lorenz curves and Gini coefficients to visualize and quantify inequalities in cases. RESULTS The hardest-hit neighbourhoods (comprising 20% of the population) accounted for 53.4% of community cases, 48.6% of facility-staff cases, and 42.3% of other HCW cases. Compared with other HCW, cases in facility-staff more closely reflected the distribution of community cases. Cases in facility-staff reflected greater social and structural inequalities (larger Gini coefficients) than other HCW across all determinants. Facility-staff cases were also more likely than community cases to be concentrated in lower income neighbourhoods (Gini 0.24[0.15-0.38] vs 0.14[0.08-0.21] with lower household density (Gini 0.23[0.17-0.29] vs 0.17[0.12-0.22]) and with a greater proportion working in other essential services (Gini 0.29 [0.21-0.40], 0.22[0.17-0.28]). CONCLUSIONS COVID-19 cases among facility-staff largely reflects neighbourhood-level heterogeneity and disparities; even more so than cases in other HCW. Findings signal the importance of interventions prioritized and tailored to home geographies of facility-staff in addition to workplace measures, including prioritization and reach of vaccination at home (neighbourhood-level) and at work.

scholarly journals Understanding Open Defecation in the Age of Swachh Bharat Abhiyan: Agency, Accountability, and Anger in Rural Bihar

2020 ◽  
Vol 17 (4) ◽  
pp. 1384 ◽  
Author(s):  
Anoop Jain ◽  
Ashley Wagner ◽  
Claire Snell-Rood ◽  
Isha Ray
Keyword(s):  
Political Ecology ◽  
Rural Areas ◽  
Social Epidemiology ◽  
Structural Determinants ◽  
Open Defecation ◽  
Rural Residents ◽  
Social Structural ◽  
The Government ◽  
And Behavior ◽  
Latrine Use

Swachh Bharat Abhiyan, India’s flagship sanitation intervention, set out to end open defecation by October 2019. While the program improved toilet coverage nationally, large regional disparities in construction and use remain. Our study used ethnographic methods to explore perspectives on open defecation and latrine use, and the socio-economic and political reasons for these perspectives, in rural Bihar. We draw on insights from social epidemiology and political ecology to explore the structural determinants of latrine ownership and use. Though researchers have often pointed to rural residents’ preference for open defecation, we found that people were aware of its many risks. We also found that (i) while sanitation research and “behavior change” campaigns often conflate the reluctance to adopt latrines with a preference for open defecation, this is an erroneous conflation; (ii) a subsidy can help (some) households to construct latrines but the amount of the subsidy and the manner of its disbursement are key to its usefulness; and (iii) widespread resentment towards what many rural residents view as a development bias against rural areas reinforces distrust towards the government overall and its Swachh Bharat Abhiyan-funded latrines in particular. These social-structural explanations for the slow uptake of sanitation in rural Bihar (and potentially elsewhere) deserve more attention in sanitation research and promotion efforts.

scholarly journals Social and structural determinants of injecting-related bacterial and fungal infections among people who inject drugs: protocol for a mixed studies systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e049924
Author(s):  
Thomas D Brothers ◽  
Dan Lewer ◽  
Matthew Bonn ◽  
Duncan Webster ◽  
Magdalena Harris
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
People Who Inject Drugs ◽  
Fungal Infections ◽  
Risk Behaviours ◽  
Risk Environment ◽  
Structural Determinants ◽  
Individual Level ◽  
The Social ◽  
Social Structural

IntroductionInjecting-related bacterial and fungal infections are a common complication among people who inject drugs (PWID), associated with significant morbidity and mortality. Invasive infections, including infective endocarditis, appear to be increasing in incidence. To date, preventive efforts have focused on modifying individual-level risk behaviours (eg, hand-washing and skin-cleaning) without much success in reducing the population-level impact of these infections. Learning from successes in HIV prevention, there may be great value in looking beyond individual-level risk behaviours to the social determinants of health. Specifically, the risk environment conceptual framework identifies how social, physical, economic and political environmental factors facilitate and constrain individual behaviour, and therefore influence health outcomes. Understanding the social and structural determinants of injecting-related bacterial and fungal infections could help to identify new targets for prevention efforts in the face of increasing incidence of severe disease.Methods and analysisThis is a protocol for a systematic review. We will review studies of PWID and investigate associations between risk factors (both individual-level and social/structural-level) and the incidence of hospitalisation or death due to injecting-related bacterial infections (skin and soft-tissue infections, bacteraemia, infective endocarditis, osteomyelitis, septic arthritis, epidural abscess and others). We will include quantitative, qualitative and mixed methods studies. Using directed content analysis, we will code risk factors for these infection-related outcomes according to their contributions to the risk environment in type (social, physical, economic or political) and level (microenvironmental or macroenvironmental). We will also code and present risk factors at each stage in the process of drug acquisition, preparation, injection, superficial infection care, severe infection care or hospitalisation, and outcomes after infection or hospital discharge.Ethics and disseminationAs an analysis of the published literature, no ethics approval is required. The findings will inform a research agenda to develop and implement social/structural interventions aimed at reducing the burden of disease.PROSPERO registration numberCRD42021231411.

scholarly journals Subculture Theory and the Fetishism of Style

2009 ◽  
Vol 2 (1) ◽  
Author(s):  
Benjamin Woo
Keyword(s):  
Cultural Studies ◽  
Analytical Model ◽  
Cultural Reproduction ◽  
Structural Determinants ◽  
Social Structural ◽  
Cultural Formations

Subculture theory, a paradigm most closely associated with British cultural studies, promised to provide a Marxian sociology of the connections between social-structural determinants and their expression in the relatively autonomous sphere of culture. This promise has remained largely unfulfilled. The more recent, so-called “post-subcultures” literature has decisively demonstrated the limitations of the model elaborated by the scholars of the Birmingham School. However, in abandoning its class-based critique, they have tended to fall back upon a single-minded concern with the emancipatory potential of lifestyle and consumption. In neither of these “moments” is the issue of style itself opened up as an arena of social and cultural reproduction. That is to say, subculture theory has tended to fall prey to a fetishism of style. In this paper, I will briefly outline post-subculture critiques of “classical” subculture theory and, drawing on Jean Baudrillard’s theory of consummativity, point towards the need for a defetishizing study of subcultures as an integral part of a critical cultural studies project. I will also outline a typology of cultural formations as an analytical model for future subculture research.

Social Structure and Status of the Aged: Toward Some Valid Cross-Cultural Generalizations

1972 ◽  
Vol 3 (4) ◽  
pp. 297-306 ◽  
Author(s):  
Irwin Press ◽  
Mike McKool
Keyword(s):  
Social Structure ◽  
Cross Cultural ◽  
Structural Elements ◽  
Direct Control ◽  
Structural Determinants ◽  
Peasant Communities ◽  
Social Structural ◽  
Aged Individual

Through an examination of social structural elements in Meso-American peasant communities, six “structural determinants” of status of the aged are derived. These are almost identical with determinants proposed independently by Cowgill, derived from a number of cross-cultural sources. It is suggested that these determinants have universal validity, and that status of the aged in all societies is dependent upon them. It is further proposed that these determinants can be economically reduced to four basic “prestige generating” components: (1) advisory, reflected in the degree to which the advice or opinion of the aged individual is actually heeded; (2) contributory, reflected in the extent to which older society members still participate actively in various spheres; (3) control, reflecting the degree of direct control which the aged have over behavior or welfare of others; (4) residual, reflecting residual prestige from previous statuses. These four components of prestige may vary independently, and one or more must be operative for aged individuals to be viewed with, and accorded, prestige.

scholarly journals Integrating Intersectionality Into the Exposome Paradigm: A Novel Approach to Racial Inequities in Uterine Fibroids

2021 ◽  
Vol 111 (1) ◽  
pp. 104-109
Author(s):  
Ami R. Zota ◽  
Brianna N. VanNoy
Keyword(s):  
Environmental Health ◽  
Clinical Care ◽  
Uterine Fibroids ◽  
Health Inequities ◽  
Environmental Chemicals ◽  
Biological Complexity ◽  
Structural Determinants ◽  
Novel Approach ◽  
Social Structural ◽  
The Life Course

Intersectionality is a critical theoretical framework that emphasizes the influence of intersecting systems of oppression on the lived experiences of people marginalized by inequity. Although applications of intersectionality are increasing in public health, this framework is absent in environmental health, which has instead focused on the exposome, a paradigm that considers the totality of an individual’s environmental exposures across the life course. Despite advancements in the biological complexity of exposome models, they continue to fall short in addressing health inequities. Therefore, we highlight the need for integrating intersectionality into the exposome. We introduce key concepts and tools for environmental health scientists interested in operationalizing intersectionality in exposome studies and discuss examples of this innovative approach from our work on racial inequities in uterine fibroids. Our case studies illustrate how interlocking systems of racism and sexism may affect Black women’s exposure to environmental chemicals, their epigenetic regulation of uterine fibroids, and their clinical care. Because health relies on biological and social–structural determinants and varies across different intersectional positions, our proposed framework may be a promising approach for understanding environmental health inequities and furthering social justice.

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