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A general definition of social influences on Health is that health is influenced by the social context on a personal level. The social context of behavior may be presented by how a person behaves with persons with whom he has frequent interactions or by how he behaves in the larger social environment such as the communal setting. The normative social context is how an individual perceives the societal norms concerning behavior such as smoking and prostitution. It may also be as a result of what an individual has gleaned from watching and listening to mass media such as movies and TV Programs. Theoretical models have included the conception of social influence and how it can be employed in the prediction of health related behavior and how it can be used as a preventive strategy. The conception of social influences on health has variations across the many models that are available. This ranges from conceptions of more tangible forms of influence in which there is pressure upon a person from other to the more intangible in which social perceptions are a unspoken influence for instance perceptions on drug abuse and drinking as cool or uncool may determine the use of these drugs by adolescents (Avendano, 2009). Even as all conceptualizations of influence have draw pragmatic support it is important to take into consideration the aspect of social influence that is most relevant in the context being observed.
Employment of the Concept in Behavioral Theories
Social Modeling Theory
Suggest that behavior is influenced by processes of modeling which posits that individuals usually observe the behavior of other persons which is then copied especially in instances of a special attachment between the model and the modeler. For instance children with parents who smoke are more likely to end up as smokers. If an improvement in healthy behavior is thus to be obtained the theory suggests an alteration in the modeling influences such as quitting of smoking or the change to healthier diets in cases of obesity.
Social Pressure Theory
This theory asserted that behavior is modeled upon the influence of peers who pressurized the individual into conforming and through mockery and taunts. Children who are for instance subjected to engage in premarital sexual relations may succumb due to this pressure. The theory suggest that in order to counter this pressure, models of resisting such pressure for instance movie heroes should be presented.
Social Norm Theory
This theory asserts the role played by an individual’s perception concerning social norms or about healthy behavior. These perceptions are usually obtained to their instance in the general population a observed by the individual who then gets a perspective on their acceptability. A good example is the overestimation of smoking prevalence among teens by other teens which leads to smoking. In order to use this method effectively true perceptions have to be employed to counter false perceptions (Alperovitz, 2005).
Social Perception Theory
This theory asserts that individual perceptions of people who indulge in unhealthy or healthy behavior may cause a motivating effect on them. For instance the perception of smoking as cool by an individual may make a teen to indulge in smoking in order to attain the prototype of being cool. This theory can be used in making up intervention programs which modify images towards more healthy directions.
Social Communication Theory
This theory makes it’s focus the communications between parents and children concerning norms and values of healthy behavior. The negative and positive portrayals by parents concerning these norms will play a great role in influencing this behavior. The use of this model involves the construction of interventions that encourage parental child communication concerning these norms and values.
Social determinants of health comprise the social and economic circumstances which determine people’s health. They are usually referred to as societal risk circumstances as opposed to individual risk circumstances. It used to be thought that health policy should include only the provision of medical care. This has now changed to include also the provision of social care as it is now widely acknowledged that social influences play a great part in determining of health. Social determinants play a role in determining the achievement of personal aspirations, satisfaction of needs and how they react to their environment (Bethune, 1997).
Improving Health Status
According to Bradshaw (2000) there has been a marked improvement in the health status of people in many of the industrialized countries in the last century. Scholars attribute this improvement in health and longevity to improved access to health care. Statistics however point out that this result in only about 15-20% improvement. It is a well documented fact that the improvement in behavior which has led to a decrease in tobacco use, diet changes to incorporate more healthy food and improved exercise lifestyles have played a role in improving health but the incidence of better social conditions such as better education, better food, housing and other social amenities is the major cause of improvements in health standards.
Inequities on the Global Scene
Evans et al., (1999), claims that there is a marked difference between the developed and the developing countries on the issue of health care. This has been attributed to the lack or insufficient provision of basic necessities in the developing world. There is however a difference among the developed countries on matters of health as countries such as Sweden as compared to the United States have healthier populations. A country such as the USA is noted for offering a laissez faire health care system. The Swedish government on the other hand offers its citizenry more in terms of security and services. Sweden especially focuses on policies to bring down unemployment, reduce wealth and income disparities and improve the diversity of social determinants. Nations such as the US place less emphasis on these resulting to a less healthy population.
Cultural and Structuralist Approaches
The cultural structuralist approaches usually take into consideration the individual choices and how they influence behavior. They posited that choices of poor diet and use of alcohol for instance were responsible for poor health in some people. Choices though are to a great extent influenced by the material conditions of the individuals on question (Fein, 1995). Some of these conditions include access to a good diet, housing, clean water, security among other things. The material structuralist concept has undergone changes into a variety of frameworks such as psychosocial, materialist and neo materialist. The materialist conception is concerned with the social determinants of health and living conditions determine health. The neo materialist concept is concerned with the incidence of these living conditions. The psychosocial conception on the other hand is concerned with how individuals make comparisons of their lives with others and the effect of this on health and wellbeing.
This argument posits that people are exposed to differential degrees of negative and positive experiences which are then exhibited in adulthood health outcomes. While the general wealth of a nation is a useful indicator of its health, socioeconomic status plays a big role in influencing individual health outcomes and development. This is because economic conditions determine the incidence of good diet, better growth and development, educational and social life. Materiality also has an influence on the psychosocial life of individuals due to differences in coping mechanisms which are played out in adulthood (Bandura, 1977). For instance the taking up of unhealthy behaviors such as drug abuse is considered by some to be a coping mechanism due to differences in socioeconomic conditions.
The neo Materialist Approach
This theory is concerned with the unequal distribution of wealth among people in different nations and the effect of this on the health of the people. In the USA for instance some jurisdictions have greater levels of inequality and these jurisdictions are usually associated with lesser investment in social programs for instance education and housing and as such they tend to have unhealthier populations. A country such as Canada has more equalitarian population and hence it tends to spend more on these social amenities leading to better health among its population (Donkin et.al, 2002). This theory therefore emphasizes the importance of ensuring more equitableness in the provision of the social determinants of health if a country is to have healthier populations.
The Social Comparison Theory
The main argument of this theory is that social determinants have a role to play in how citizens interpret their position in the social hierarchy. At the level of the individual the perceiving and experiencing of one’s status in societies which are unequal may result to poor health and even stress. The comparison of themselves with others may lead to feelings of worthlessness and shame which may lead to negative behavior such as taking extra jobs which are a threat to their health, overspending. Some people may even take up health threatening behavior such as drugs or alcoholism in order to cope (Claussen et.al, 2003). At the level of the community the increasing of the gap in the social ladder leads to a weakening of social cohesion. Individuals become more distrustful of others and this weakens support for communal programs such as education and health. This theory is more interested on the psychosocial impact of policies which lead to the weakening of social determinants.
The Life Course Theory
Conventional approaches usually focus on the present in interpreting health issues. People are usually warned of the dangers of engaging in unhealthy behavior at the present moment. The life course theory on the other hand places its emphasis on how accumulated experiences affect present health. Developmental issues have been found to have a great influence on adult health. According to Shcroedor (2007) the social economic conditions under which people live certainly have a cumulative impact on their adult lives. For example low birth weight may be a reliable precursor of the happening of adult diabetes or heart disease in adult life. The cumulative influences of the negative and positive experiences through time usually are manifested in later poor health. The life course perspective directs the focus to how socio economic health determinants operate at every stage of development in order to influence the health of an adult.
While most social research scholars tend to focus on the correlation between health status and the social determinants it is a fact that these determinants of health do not exist in a vacuum. Access and quality of social determinants of health are usually the function of public policy made by government officials at the various levels. For instance the access to good education or quality health care is a function of employment security of the parents, wages and housing policies. If for instance the government perceives early life as a function of the parents, it will enact policies to foster better parenting as opposed to offering better financial resources or health care to the family. As a matter of fact there is an individualized manifestation of each health determinant even as there is a lack of proof in showing the impact of such methods in improving health standards of the vulnerable without altering to some degree their poor living conditions.
Politics and Political Ideology
This concerns the concept of the welfare state and the degree to which governments are willing to go to offer better lives to their citizenry. There are three distinct welfare regimes; Social democratic countries show more governmental intervention while liberal show lesser degree of governmental intervention. The conservative welfare system is a balance between the two systems. Social democratic nations offer a diverse range of universal benefits mostly in social programs intended to benefit the less well off citizens. The social democratic nations generally have healthier populations due to their emphasis on social support systems (Lucey, 2007). Policies made by any country are made by politicians who are in government. Governments are usually controlled by parties which ascend to power with a certain ideology along which policy is formulated.
Individual Determinants of Health
There are also individual factors which also play a vital role in influencing the health of an individual. The definition of individual determinants of health is that these are factors which are particular to an individual which may be as a result of his own making or not, controllable or not. A variety of factors usually work together to determine the health status. The health of people is usually a function of the surroundings and in some instances genetic. Genetics and relationships with the people we live in though not considered as great influence as socio economic determinants play significant role in determining health status (Green, 1978).
Genetics play significant role in determining the general health of a population or an individual. For instance it has been established that people of African American ancestry are more likely to abuse drugs as they react more to drugs than people of other races. This then means that African Americans then will have a more likelihood of being alcoholics and drug addicts due to their genetic makeup (Tones et. al 1994). Genetics also plays a great role in how individuals acquire habits and behaviors and how they develop in later life. For instance it has been found that families with a history of mental illness are more likely to have a mentally ill member than families which do not have a history. Families which also adhered to healthy diets and healthy habits such as avoidance of drugs and alcohol are more likely to have healthier members who do not use drugs and live healthy lifestyles. As social relationship is a great factoring influencing health, familial social relations may play a big role in the determination of the future social relations of its members in and outside the family. Issues such as coping mechanisms have been found by scholars to be affected by genes. Families which have positive coping mechanisms tend to produce members who are of the same temperament.
Self care refers to the maintenance of personal health by an individual. It is anything done by the individual in order to improve, restore health, treat or prevent disease. Self care activities may include exercising in order to be physically fit, good dietary habits, practice of good hygiene and the avoidance of negative habits such as drug abuse. It also involves the attention to ailments by seeing a health practitioner. While support for self care is crucial, it has been found to be more effective in countries in which people are more enlightened or are more conscious of their health and play a role in keeping themselves healthy. The instance of personal health to a great extent is dependent on active participation as concerns their health. Information gleaned from personal observation is invaluable in self care (Daniel et. al 1999). For instance, if a person feels tired after nights sleep it may lead to a decision to change the mattress. A patient experiencing that their shoes are a little bit tighter than normal may share this with a health professional that may diagnose health problems of the heart and take remedial action before it is too late.
According to Mcleroy et al (1988) to an extent personal health is influenced by the interactions between them and other members of the community in which they live in. Strong and intimate social relations have been linked to good health, positivity and longevity among other things. Positive social interactions have been linked to increase in chemical and hormonal levels which are related to intelligence and personality. Activities such as volunteering have been found to increase social interaction while releasing feel good hormones which increase positive attitudes. Interpersonal relationships cultivated by an individual with another individual are also strong influences on individual health. These relationships are usually founded on the basis of some type of thing which the two people have in common for instance love, solidarity, business interaction. These interrelationships play a role in the development if feelings of belonging mutual respect and acceptance which scholars have proved to be influential in other areas such as self worth which also determines how an individual values himself and hence hi s health. The lack of building or the maintenance of interpersonal relationships may lead to the lack of development of these feel good feelings leading to even stress and a don’t care attitude towards one’s health. The development of social relations in most instances leads to feelings of dependence and obligatory commitments among the people involved (Tonin 1980). For instance, a father who has been diagnosed with lung cancer would be more persuaded to quit smoking if he has a stronger bond of love with his family.
Hygiene is defined as the practice of maintaining the cleanliness of the body so as to avoid illness and infection. It involves avoiding contact with infected disease causing agents. Such practices of hygiene include brushing of teeth, hand washing, and cooking and eating with clean utensils. The body also has to be kept clean from toxins by regular bathing. All these activities help in washing away infectious gents which may be present on the body hence preventing their entry into the body. Hygiene in most instances is usually a function of the individual as most of these activities have to be done by the individual. Lack of adherence to hygiene or adherence to hygiene standards is what determines the health status of an individual. Individuals who have generally poor hygiene are generally more prone to infectious diseases and vice versa (Milio, 1983).
Stress is one of the major causes of ill health as it leads to a variety of diseases such as ulcers, cardiovascular diseases, and stroke among others. Stress which has been unnecessarily prolonged is often cited as negatively impacting health by leading to cognitive impairment, depression and other expressions of disease. The management of stress is normally an issue to do with the individual as different people react differently to stress. Stress management therapy is one of the methods normally applied to reduce stress. Such therapy may include relaxation techniques, meditation, and positive attitude building. The improvement of relevant reactions end skills help a lot in reducing stress and the build up of confidence. The reduction of uncertainty is usually brought by the increasing of information and knowledge concerning the issue bringing about the stress. Different people however have different reactions as some may not be willing to learn about their stressful issue and hence may continue to wallow in their misery leading to poor health. Some people may react fearfully to their situation which does little to alleviate stress. Individuals who face up to stress and have positive attitudes usually have better health than those who do not (Wallerstein, 1992).
Health care refer to the diagnosis, preventing and treating of illness, infection, injury among other human impairments (Rifkin et al 1988). The services of health care are normally offered by qualified medical practitioners in either the private or public health systems. It is however the prerogative of the individual to present themselves to the health practitioners in instances of ill health. Some individuals usually do not present themselves to medical help when they need it until it is too late which leads to their illness progressing to critical levels. Perceptions concerning health care by the individual may thus be very influential in whether they seek it or not and hence this affects their health status.
Wellness and Wellbeing
In recent times programs of wellness and wellbeing have been all the rage with many employers recognizing their value in enhancing staff morale and productivity. Wellness programs usually include thing such as fitness centers, health training and programs such as counseling of staff. Some employers may even incorporate health screenings and health risk assessments. Some of these programs are sometimes offered as social programs in communities and neighborhoods to people who need them. Although these wellness and well being programs are for the most part free, they are also for the most part voluntary. Being voluntary also entails that some people may not feel like attending them due to individual choices. For instance some people may feel embarrassed to attend such programs for fear of being seen as struggling or some people may not believe in the value of such programs (Minkler, 1997). Research has shown that all people regardless of socioeconomic position need wellness and wellbeing programs as there are a variety of issues which affect all people in addition to common afflictions (Flynn et al 1994). Research has also shown that people who engage in programs of wellness and well being are likely to be healthier and better adjusted to life and their environment.
The health of nay person is a combination of the social and individual determinants of health. Although some of the social and individual determinants cannot be changed or controlled, a lot of these determinants can be modified by the individual or the policy makers in order to forge a healthier person ands a healthier population. A healthy population therefore is not only the function of the individual solely or the work of the policy makers solely. Health remains a function of a combination of factors in which both the individual and the community and the policy makers have a role to play in bettering it.