Understanding Health Determinants: Explanatory Theories for Social Epidemiology

Description

This book assembles a wide range of explanatory perspectives on social inequalities in health. Everywhere in the world, those with less advantage die younger and suffer more illness than the wealthy. Decades of research have documented this reality and yet we lack a comprehensive understanding of the mechanisms through which social circumstances ultimately influence the biological processes that lead to disease. Explanations have been proposed from various disciplines – economics, psychology, behavioral science, geography, and neuroscience – and each sheds light on parts of the overall process. But very few texts assemble these insights into an overall explanatory paradigm. Through a review of concepts and theories from a wide range of disciplines, the author outlines how these may be woven together to offer a more complete picture of how social influences 'get under the skin' to affect health and disease. As well as understanding individual health, the book assembles explanations for social disparities in health. It concludes with a proposal for a set of explanatory models that cross disciplinary boundaries. Topics explored include: Social Inequalities in HealthExplanation and Causal Models for Social EpidemiologySocial and Economic Theories to Explain Patterns of DiseaseBiological Pathways Linking Social Determinants to HealthTheoretical Models of Health BehaviorWork Environment and HealthSocial Networks, Social Support and HealthPositive Influences on Health: Coping and ControlThe Relationship Between Personality and Health Understanding Health Determinants: Explanatory Theories for Social Epidemiology is a textbook for graduate students in epidemiology, health sciences, health policy, and psychology, as well as social science students who are studying health. It will also be of interest to general readers, and can serve as a reference for researchers in epidemiology and the health sciences who are planning studies of the social determinants of health. The book reviews theories that could be tested in such studies.   Preface References Acknowledgments Contents List of Figures List of Tables About the Author Chapter 1: Social Inequalities in Health Introduction: Background Concepts Conceptions of Health Population Health Conceptions of Social Position Health Inequalities Measuring Social Inequalities Scales of Analysis Social Mobility Global Patterns of Health (1): Rising Life Expectancy Historical Perspective: Epidemiologic Transitions International Patterns of Health (2): Health Contrasts Between Nations The Uneven Gains in Life Expectancy National Patterns of Health (3): Health Inequalities Within Nations Social Class and Health Trends in Social Disparities in Health Socioeconomic Status and Health: The Whitehall Studies Income Inequality and Health Further Investigations of the Income Inequality Hypothesis Critiques of the Income Inequality Hypothesis Conclusion Discussion Points References Chapter 2: Explanation and Causal Models for Social Epidemiology The Challenge of Explanation Explanation and Understanding Theories and Concepts Scales of Explanation Top-Down and Bottom-Up Explanations Idiographic and Nomothetic Science Systems Thinking Explanatory Models in Epidemiology The Epidemiologic Triad Explanation, Prediction and the Role of Time Binary Thinking Causality and Explanation Conceptions of Cause Causes and Determinants Counterfactuals, Potential Outcomes, and Causal Dilemmas Quantifying and Graphing Causal Influences Social Determinants The Limits to Explanation: Entropy The Limits to Explanation: The Role of Chance Traditional Explanatory Approaches in Epidemiology Causal Chains Causal Webs INUS Rothman’s Pies The Need for a Modified Conceptual Model Potentially Useful Analytic Tools for Social Epidemiology Complexity and Emergent Phenomena Emergence Agent-Based Modeling Adaptive Systems Applying Complexity Thinking Autocatalytic Sets Chaos Theory Catastrophe Theory Sensitivity to Initial Conditions Fractals Attractors Interacting Causes Conclusion Discussion Points References Chapter 3: Social and Economic Theories to Explain Patterns of Disease Explaining Patterns of Health and Longevity The Main Categories of Explanations for Social Disparities in Health An Economic Perspective: Concavity and the Absolute Income Hypothesis Historical Perspectives on the Interaction Between Wealth and Health The Links to Health The Scale of Analysis Social Mobility and Social Selection Government Policies and Political Influences on Health Political Ideologies and Health Neo-materialism, Neoliberalism, and Health Inequalities Neoliberalism Globalization Critiques of Neoliberalism Poverty and Lack of Material Resources as Explanations for Social Inequalities in Health Theories of Poverty Structural Theories of Poverty Poverty Traps Culture of Poverty Poverty and Family Structure Migration The Geography of Health Methodological Problems in Geographic Analyses The Modifiable Area Unit Problem Context and Composition Concepts of Space and Place Access to Nature Causal Direction and Interactions Between Health and Place Access to Care and Socioeconomic Status A Health Literacy Gradient Relative Income and Psychosocial Explanations for Health Inequalities Theories Concerning Community Structures and Health Social Cohesion Social Capital Socioeconomic Status and Social Capital Social Capital and Health Critiques of Social Capital Collective Efficacy Community Empowerment Community Resilience Theories Relating to Psychosocial Processes Within the Community Motivation and Self-Determination Theory Person–Environment Fit Variants of the P-E Fit Model Relative Deprivation Social Exclusion Discrimination and Social Dominance Theory Ethnic Diversity Racial Inequalities Critical Race Theory Social Policy Interventions How Effective Are Policies That Address Income Inequalities? Discussion Points References Chapter 4: Biological Pathways Linking Social Determinants to Health Introduction Brain Structure Limbic System The Neocortex The Nervous System Polyvagal Theory System Integrity The Endocrine System Types of Hormones Steroid Hormones Peptides and Oxytocin Hormones and the Brain Reward System Information Pathways The Stress Response The SAM and HPA Systems The Immune System Inflammation The Microbiome and Immunity Psychological States and Immune Function Socioeconomic Status and Chronic Inflammation Allostasis and Allostatic Load Biphasic Reactions and Hormesis Genetics and Epigenetics Genes Epigenetic Influences and Gene Regulation Telomere Length Conceptions of Environmental Influence Plasticity Multiple, Interacting Systems Case Study: Differential Male and Female Longevity Conclusion: Embodiment Discussion Points References Chapter 5: Health Determinants Cumulate Over the Life Course The Life Course Perspective Socioeconomic Status and the Life Course Barker’s Fetal Origins Hypothesis Developmental Origins of Health and Disease (DOHaD) Programming Mechanisms in Sensitive Periods Adverse Childhood Experiences Health Effects of Adverse Child Events Prospective Evidence Socioeconomic Status and Childhood Adversities Mechanisms for the Influence of Life Course Experiences on Health Pathway I: Cognitive Development Pathway II: Psychological Reactions Personality Reactions Self-Confidence Attachment Theory Resilience Successful Aging Pathway III: Adverse Child Experiences and Social Relationships The Role of Family Stability Parenting Delay of Gratification: The Experiments of Walter Mischel Socioeconomic Status and Parenting Styles Reproductive Strategies Pathway IV: Behavioral Mechanisms Pathway V: Biological Processes Brain Development Genetics and Epigenetic Processes Endocrine Pathways Immune Pathways Telomere Length Potential Life Course Interventions Discussion Points References Chapter 6: Theoretical Models of Health Behavior Health and Illness Behaviors Lifestyle Patterns and Social Class Risk Attributable to Behaviors Conceptual Approaches to Explaining Health Behavior Behavior as Choice Psychological Models: The Role of Cognition Subjective Expected Utility Theory Behavioral Economics Path Dependence and Health Behavior Prospect Theory and Risk-Taking Behavior Behavior as Constrained by Circumstance and Life Chances Collective Behavior Cognitive Models of Behavior: Continuum and Stage Continuum Models of Health Behavior Health Belief Model Rogers Protection Motivation Theory Theory of Reasoned Action Theory of Planned Behavior Albert Bandura: Social Cognitive Theory and Self-Efficacy Limitations of the Cognitive Analyses of Behavior and Behavior Change Heuristics and Judging Probabilities A Dual Processing Behavioral Model Stage Models of Health Behavior Stages of Change and the Transtheoretical Model Precaution Adoption Process Model Health Action Process Approach (HAPA) Model The Precede-Proceed Framework Taxonomies of Intervention Models: Changing Health Behaviors The Theoretical Domains Framework (TDF) The Behavior Change Wheel Discussion Points References Chapter 7: Work Environment and Health Work as a Health Determinant Evolving Patterns of Work Through Time Job Security The Benefits of Work Work-Life Balance Job Characteristics and Health Job Demand and Control Model The Employment Strain Model Effort-Reward Imbalance The Job Demands-Resources Model The RIASEC Theory of Vocational Choice Unemployment and Health Who Will Suffer Adverse Effects of Unemployment? Latent Deprivation Theory Fryer’s Agency Restriction Model of Unemployment Warr’s Vitamin Model of Unemployment Paul and Moser’s Incongruence Theory Ezzy’s Status Passage Model Unemployment and Socioeconomic Status Discussion Points References Chapter 8: Stress and Health Introduction: Stress and Health The Adverse Health Effects of Chronic Stress Conceptual Models of Stress Stimulus Models: Stressful Life Events Critiques of the Stimulus Model Response Models Harold Wolff Hans Selye Antonovsky’s Resistance Resources Critiques of the Response Model Interactional and Systems Models of Stress Lazarus and Folkman Vulnerability, Resiliency, and Stress Diathesis Toxic Stress Modeling the Time Dimension Weathering Problems with the Interactional Model Measurement Challenges Applying Interactional Stress Models to Disease Risk Stress and Socioeconomic Status Interventions Discussion Points References Chapter 9: Social Networks, Social Support, and Health Introduction Social Networks Social Support Evidence for the Impact of Social Relationships on Health Marriage Divorce Bereavement Paternal Absence Loneliness and Health Pets and Health Mechanisms of Influence: Theories Relating to Social Networks Network Analysis Scale-Free Networks Network Density and Redundancy Information Networks Network Reciprocity Network Pressure Space, Place, and Networks Social Networks and Social Support Social Supports: Conceptual Approaches Mechanisms of Influence: Theories Relating to Social Supports Perceived Versus Received Support Attachment Theory Disordered Attachment Unconditional Benefits of Support Interpersonal Theory Appraisal Function of Support Measuring Supportiveness The Potential for Negative Influences of Social Relationships Disrespect Rejection Mechanisms of Influence: Biological Mediators Summary: The Benefits of Social Connections Discussion Points References Chapter 10: Positive Influences on Health: Coping and Control Conceptions of Coping Physiological Responses and Allostasis Taxonomies of Coping Responses Personal Coping Repertoires A Conceptual Model of the Coping Process Two Major Coping Strategies and Their Effectiveness Sense of Humor and Laughter Physiological Effects of Laughter and Humor Aphorisms Religious and Spiritual Beliefs The Impact of Religion on Health Mechanisms of Influence Physiological Pathways Meaning and Purpose in Life Theories to Explain Coping Capacity Psychosocial Resources Mastery and the Sense of Control Conservation of Resources Theory Salutogenesis and the Sense of Coherence Positive Emotions: Broaden and Build Theory Community Coping and Resiliency Discussion Points References Chapter 11: Mental Processes and Health: The Mind-Body Connection Introduction Conceptions of Mind and of the Mind-Body Connection Cognition and the Mind Embodiment in Epidemiology Cognitive Embodiment Emotional Embodiment Social Embodiment The Placebo Response How May Placebos Work? How Powerful Is the Placebo Response? Which Types of Person Respond to a Placebo? Additional Theoretical Perspectives on the Mind-Body Link Psychoneuroimmunology Psychosomatics Psychoanalysts Intelligence Discussion Points References Chapter 12: The Relationship Between Personality and Health Personality Personality and Health Fundamental Attribution Error Theories of Personality The Big Five Model Two and Three Trait Models The HEXACO Personality Model The Hot and Cool Framework of Emotions The Alphabet Soup of Personality: Types A, B, C, and D Type A Personality and Behavior Anger, Hostility, and Aggression Type C, or Cancer-Prone Personality The Type D, Distressed Personality Culture, or the Personality of Groups Conceptual Links Between Personality and Health Positive Personality Traits and Health Happiness and Positive Well-Being Hopefulness and Optimism Personality and Coping Styles Self-Concept, Self-Esteem, and Self-Efficacy Locus of Control Mastery Resilience and Vulnerability Hardiness Mental Toughness Reserve Capacity Negative Personality Concepts Linked to Health Powerlessness and Learned Helplessness Denial Personality and Socioeconomic Status Discussion Points References Chapter 13: Overall Models for the Influence of Social Determinants on Health Introduction Models Income Inequalities Political Influences The Work Environment The Role of Education Intergenerational Transmission of Adversity Life Course Influences Conclusion References Index