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Lectures Comparative Health Problems And Policies - CHL32306

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Week 1 Q&A (preparation)
1. Putting problems in hierarchy
Health problems (how many people are affected by it / urgency):
1. Lonineless
2. Obesity
3. Alcohol abuse
4. Domestic violence
5. Suicide
Social problems
- What are the most important health problems?
- What is the yardstick/argument to determine importance?
- Are we worrying about the wrong problems?
- Are there problems on the list that have become more/less important over
time? Why?
2. Reading
a. Look at 1.1, page 19. Choose a health problem and try to fill in the
social problem process for this particular problem. Reflect on the
exercise: What do you notice? Is it easy or difficult? Why?

Claimsmaki Media Public Policy Social Policy
ng reaction making problems outcomes
work

Who are How are What is the Was policy Who is How is
the the issues societal implement addressing policy and
claimsmak covered in response? ed? the issue in work
ers? media? practice? evaluated?

For example: obesity, one of the main issues in health. However, it is difficult to
answer those questions.
b. Watch the following video. What are resources and rhetoric
employed by the people behind or in this video? How influential do
you think they are in shaping the public understanding of the
COVID-19 epidemic?
You see a video of Femke Louise who says she isn’t participating in helping to
reduce COVID-19 in the Netherlands. She has a lot of people watching her on
YouTube and Instagram, and the media is following her moves. So, she has the
resources to be influential (like having a platform, more status, more money,
more social contacts). She will be heard because she has more resources than
other people, it is easier to get your claims heard.
She is also using rhetoric strategies (how do they make a convincing claim, the
means you use to convince people, kinds of strategies you use), because she
tries to appeal to reason: the government is the problem, not COVID-19. The
government is taking away the freedom of people. Not as if it is protecting them
(making it emotional).
3. Watch knowledge clips




1

,Knowledge clip: Introduction to social problems
Objectives
- Recognize the difference between objectivist and constructivist
perspectives on social problems
- Understand what it means to see health problems as social problems
Introduction: Health problems
BRAVO topics
- Bewegen, Roken, Alcohol, Voeding/gewicht en Ontspanning
- (exercise, smoking, alcohol, food/weight, relaxation/stress)
- Other problems: ZIKA-virus, face mask (COVID-19), burn-out, lachgas, air
pollution, climate change (and related problems like asthma), sedentary
behavior,
Introduction: health problems and policy
Policy:
- Setting priorities under the condition of limited means (where are you
giving funds and energy to)
- Responding to numerous stakeholders (people advocate for certain
problems)
Health problems as social problems
- How do health problems become understood as topics of concern for
societies?
- How do they become social problems?
- What are the consequences if they do or don’t?
- How to ‘measure’ the problem?
- What are the different perspectives on the problem?
- How are health problems positioned in a hierarchy of importance?
Health problems as social problems
- Some health problems previously believed to be individual become social
problems (epidemic, like it is spreading)
- Almost any social problem is related to health (and vice versa)
- Criminal behaviour
- School abandonment
- Poverty
- Drugs
- Pollution
- Message: No a priori distinction between ‘health’ and ‘non health’
problems
Health problems as social problems
Sometimes former social problems become redefined as health problems (i.e.
the case of ADHD, first it wasn’t a health problem, only a social problem because
teenagers should learn to behave)
Health problems as social problems
- Objectivist
- What are the objective, measurable characteristics of health
conditions?
- However, does not explain ‘social problem’ status
- Constructivist
- Why do people think of certain conditions as social problems?




2

, Knowledge clip: Constructivist and critical public health
perspective
Objective
- Understand the constructivist and critical public health perspectives and
how they overlap.
Perspectives on social problems
- Objectivist: What is the objective, measurable characteristics of problems?
- Constructivist: Why do people think of certain issues as social problems?
Constructivist perspective
- Critical assessment of data and their use
- Flaws (looking at flaws in data, how do they shape our
interpretation)
- Contribution to a perspective (only partial view of an issue)
- Acknowledgement of multiple perspectives on problems (different in time,
space, and social groups)
- Comparative
- Time (i.e. perspectives change over time)
- Space (i.e. abortion is seen different in the Netherlands and the US)
- Social groups (i.e. between people affected and people not affected)
- Keen interest in power dynamics (i.e. who benefits, who is dominant)
- Denaturalizing policy and policy assumptions (i.e. how people deal with
policies, is taken for granted, you want to look more critical)
Constructivist perspective on social problems
How and why particular conditions come to be constructed as social problems
(and others less so)
- Power and resources
- Rhetoric
Coming back to… Critical Public Health perspective
‘Critical Public Health is an approach that challenges the status quo in public
health, questions what have come to be defined as problems, and breaks down
fundamental assumptions by considering them within the context of the social
systems in which they are created.’


Week 2 Q&A (preparation)
During this week you will learn about Disability Studies as a Critical Public Health
perspective. Disability Studies consists of a specific approach to research
practice, research questions and activism.
1. The structure of social problem claims
Knowledge clip: What is the ‘problem’ of disability?
Objectives
- Understand the structure of social problem claims
- Understand that ‘the problem’ of disability is constructed in multiple ways
Defining the social problem
- What is disability?
- What causes disability?
- Why is it a problem?
- Who is disabled?


3

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