Global health theories are a powerful tool in guiding public health professionals to design effective programs/interventions to address health inequalities. A core aspect of these theories requires an individual to analyse/assess the social determinants of health: “the nature and causes of poverty and inequity” (Farmer et al., 2103, p. 16). Nicole Berry, is an Assistant Professor in the Faculty of Health Sciences at Simon Fraser University, her research work will be studied to review a holistic approach on four social theory concepts.
One model utilized to examine the social determinants of health is Social Construction of Reality. The social construction of reality theory suggests that a person’s knowledge and beliefs about the world, including both science and human knowledge, “regardless of its ultimate validity or invalidity” – become justified in society, and this can be viewed as “socially constructed”. (Farmer et al., 2013, p. 18-19). An example of the social construction of reality theory can be seen in an argument between a physician and a gentleman named Diego.
Diego’s wife was pregnant and had been informed by their mid-wife that an x-ray was needed to determine the position of their child. Diego and his wife had formed a trusting relationship with a midwife. The physician made several attempts to inform Diego that an x-ray was unnecessary and possibly a danger because babies normally have a tendency of moving (Berry, 2008). The couple came to the hospital for one reason – for Diego’s wife to obtain an X-Ray. The treatment never occurred.
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The physician utilized a biomedical protocol that centralized a medical model of physician’s reasoning that dictated the physician’s decision on whether Juliana was going to receive an x-ray. In another words, the physician agrees to follow a set of conventional rules set forth by society. The utility of the x-ray was minimal and possibly dangerous to the patient and unborn child (Berry, 2008). The physician would not perform an x-ray, while a person is pregnant unless it was diagnostically required, and the risk outweighed the benefits.
Diego was highly upset with the physician because he was under the assumption that an x-ray should be performed. From Diego’s view, the quality of care that his wife is receiving did not meet his expectations. This interaction between Diego and the physician can be viewed as a theory known as unanticipated consequence of social action. Contrary to what was originally intended, the outcome did not occur, and this is referred to as “backfiring” and resulting in unanticipated consequence of social action (Merton, 1936).
The couple felt powerless because they did not feel involved in their health care. This powerless feeling results in another social theory referred to as social suffering. The concept of social suffering is a complex issue that encompasses several social forces including politics, culture, social relationships, social institutions, and economics. An indigenous group living in Guatemala are the Maya. The Maya have low levels of educational achievement, high poverty, poor health, and low socioeconomic status, compared to their Ladino counterparts, which are a distinct culture group of individuals with a mixture of Native American-African-Spanish.
The Maya community has a long history of being treated unfairly by Ladinos which resulted in seizure of the Maya’s community land, political, socioeconomic, and structural inequities, alongside new traditions of governance (Berry, 2008). This continuing tyranny and governmentality control resulted in violent acts against the Maya community. Further resulting in conspiracy theories, when the government could not explain these events. Consequently, the Maya’s distrust of strangers begins with the similarities between the “political-economic underpinnings of the distribution of power, wealth, and violence and of the circulation of public discourse”. (Briggs, 2004, p. 182).
Clearly, there is a lack of trust of outsider’s intentions within the Maya communities. The Maya’s feel that their community’s belief systems are neglected by government regulatory agencies. Several of these beliefs include family planning and pregnancy care. The social theory of Biopower, explains how political governance utilizes its effects by means of control of bodies and populations (Kleinman, 2010). There must be a disbanding of racist coercion from the Ladinos with their common respect, along with surmounting the language, social, and cultural barriers and biopower could positively influence the necessity of conformity and unify both culture groups.
