Social Sciences for Healthcare Professionals

Dr Chris Allen is Principal Teaching Fellow and Programme Lead for the Master of Nursing Programme at the University of Southampton, UK. With extensive experience in healthcare education and curriculum development, he specialises in integrating social science concepts into clinical training, ensuring students are equipped to deliver evidence-based, person-centred care.

• List of Contributors xiPreface xiiiAcknowledgements xv1 An Introduction to Social Sciences for Healthcare Professionals 1Chris AllenHow to Use This Book 1What Are the Social Sciences? 1Sociology and Medical Sociology 1Psychology and Health Psychology 1Economics and Health Economics 2So Why the Social Sciences? 2A Patient’s Journey: The Social Sciences in Action 2Completing Barry’s Story 3References 5Part 1 Understanding Health, Healthcare Systems, and the Healthcare Workforce 92 Social Theory, Social Research Methods and Health in the Context of Society and Care 11Chris Allen and Assaf GivatiIntroduction 11What Is a Theory? 12Understanding Theories Through Levels of Abstraction 13Why Is This Needed? 13Grand Theories 13Mid- Range Theories 13Programme Theories 13How Grand, Mid- Range and Programme Theories Work Together 14Macro, Meso and Micro Levels 15Macro Approaches: How Does Society Work? 16Functionalism 16Talcott Parsons: The Sick Role 17Conflict Theory 18Micro Approaches: How Does Society Work? 18Symbolic Interactionism 18Social Research Methods 19Positivism (Quantitative Methods) 20Interpretivism (Qualitative Methods) 20Conclusion 21References 213 What Is Health and Disease Why Do Definitions and Classifications of It Matter? 25Chris AllenIntroduction 25What Is Health and Well- Being? 26Shifting Perspectives on Health 26Health as a ‘Resource’ 27The Biopsychosocial Model 27Salutogenesis and Positive Health 28Salutogenesis 28Capability Approaches 28So How Should Health Be Seen and Understood? 29Disease Classifications 29The International Classification of Diseases (ICD) 30Classifying Mental Health and the DSM 30International Classification of Functioning, Disability and Health (ICF) 30Medicalisation, Over Medicalisation and Overdiagnosis 31Does Medicine Want to Be Dominant Through Medicalisation? 32Medicalisation and Overdiagnosis 32Invisible Illness: Felt but Not Seen 33Health, Disability and Personal Independence Payments 33Conclusion 34References 344 The Social Science of Mental Health and Illness 39Samuel Woodnutt, Simon Hall, and Chris AllenIntroduction 39Stress, Vulnerability and Mental Health 39Mental Health, Social Deviance and the Law 40How Does Society Care for Those Who Are Mentally Unwell? 42Mental Health, the Illness Framework and Psychiatry 42A Brief History of Mental Healthcare as a Social Paradigm 43Early Psychology Within Modern Society and Cognitive Behavioural Therapy 44Psychoanalysis 44Behaviourism 46Critical Views on Psychiatry and Mental Health Treatment 47Power Threat Meaning Framework 47The Birth of the Recovery Movement 47Modern (Integrated) Approaches in Current Health Contexts (4Ps Formulation) 48Conclusion 51References 515 Understanding the Organisation of Health Systems and Health Economics 55Chris Allen, Robert Slinn, and Sam WoodnuttIntroduction 55What Is Health Economics? 56How Are Decisions Made About Who Gets What? 56What Is the Political Economy and How Does It Relate to Health? 58What Is a ‘Health System’ and What Health Systems Are There? 60Out- of- Pocket Healthcare Expenditure 62How Do We Measure Success and Why Should We? 64Conclusion 67References 676 The Global Healthcare Workforce and the Social Science of HealthCare Professions 71Assaf Givati and Chris AllenIntroduction 71The Global Healthcare Workforce 72Globalisation and Brain Drain Amongst Healthcare Professionals 73Gender Inequalities and Healthcare Professionals 74The Global Healthcare Professional Workforce Crisis 74Who Are Healthcare Professionals? 75New Healthcare Professionals 76Sociological Explanations in the Study of Healthcare Professionals 77The Functionalist Perspective and the Traits Approach 78Neo- Weberian Perspectives: The Monopoly and Power of the Professions 78Occupational Closure and the Medical Profession 79Deprofessionalisation 80Conclusion 82References 82Part 2 Meeting Population Health Needs and Health Inequalities 857 Population Health Needs: Understanding the Care Transition 87Chris Allen, Lindsay Welch, and Lynn CalmanIntroduction 87A Changing Society, with Changing Health Needs 88Demographic Transition 89What Can a Bath Tell Us About Population Health? 91Demographic and Epidemiological Transitions: Why Increasing Chronic Illness, Multi- morbidity and Complexity Necessitates a Change in Care Paradigm 93Not a Bath, but an Ocean 94Increased Responsibilities and the Burden of Treatment and Disease 95Self- Management to Support Individuals 95Conclusion 96References 978 Social Determinants of Health and Inequality 101Chris Allen and Lindsay WelchIntroduction 101What Determines Health? 102Models of Health Determinants 102Constitutional Factors – Modifiable or Unmodifiable? 103Individual Lifestyle Factors 104Social and Community Networks 105Living and Working Conditions 105Housing 105Work Environment and Unemployment 105Education 106Health Services 106Social Position, Social Class and Social Status 107Intersectionality 108What Are Health Inequalities? 108Explanations for Health Inequalities 110Material Explanations 110Psycho- social Explanations 111Cultural Explanations 111Life Course Explanations 112How Are Health Inequalities Experienced? 112Conclusion 112References 1139 Stereotyping, Bias and Health- Related Stigma 119Chris AllenIntroduction 119Understanding Our Bias: Stereotyping and Unconscious Bias 119What Is a Stereotype? 120What Is Stigma? 121Implicit and Unconscious Bias 123Health- Related Stigma 124Mental Health- Related Stigma 124Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) 125Addressing Stigma and Reducing Implicit Bias in Healthcare 125Addressing Stigma 125Addressing Unconscious Bias 126Conclusion 127References 12710 Meeting the Needs of Those Experiencing Social Exclusion and Significant Inequality 133Lindsay Welch, Jasmine Snowden, and Chris AllenIntroduction 133What Is Social Exclusion and Marginalisation? 134Inclusion Health 135Forced Displacement, Migration and Health 136Place- Based Marginalisation, Nested Deprivation and Homelessness 139Racial Inequalities in Cancer Care 141Inclusive Healthcare Design and Research 143Conclusion 143References 14411 Disability, Society and Health 149Chris Allen, Simon Hall, Erica Goddard, and Neil SummersIntroduction 149Embodiment 149What Is Disability? 150Attitudes Towards Disability 151How Is Disability Understood? 151The Medical Model 152The Social Model of Disability 152Disability and Discrimination 154Children and Young People with Disabilities 154Learning Disability 156Inclusive Healthcare Provision for Those with a Learning Disability 157Mental Distress 158Conclusion 159References 159Part 3 Understanding Health Behaviours, Health Behaviour Change, and Public Health 16512 Understanding Unhealthy Behaviour 167Chris Allen, Sam Woodnutt, and Gilly ManczIntroduction 167What Are Unhealthy Behaviours? 167Diet 168Activity Levels 168Alcohol Consumption 168Smoking 169Why Do We Engage in Unhealthy Behaviour? 170Structure and Agency 170Social Structure 171Habitus and People’s Cultural and Social Environments 171The Commercial Determinants of Health 172Personal and Individual Level Factors 172Addiction and Habits 172Hedonism and Affective Responses 173Personality and Behaviour 174Theoretical Models of Health Behaviour 174Health Belief Model 176Social Cognitive Theory 176The Social Ecological Model 176Conclusion 178References 17813 Evidence- Based Behaviour Change Approaches 183Chris Allen and Gilly ManczIntroduction 183A Science of Behaviour Change 183Healthcare Professionals Roles in Promoting Behaviour Change 184Models and Theories of Behaviour Change 184Transtheoretical/Stages of Change Model 185Social Cognitive Theory 185COM- B and The Behaviour Change Wheel (BCW) 186Behaviour Change Techniques 188Behaviour Change Interventions 188Motivational Interviewing 189Making Every Contact Count (MECC) and Healthy Conversation Skills 191Digital Behaviour Change Interventions 193The Limits of Individual Approaches to Behaviour Change 194Conclusion 194References 19414 Public Health Interventions through the Lens of the Social Sciences 199Chris AllenIntroduction 199Upstream Prevention 200What Is Public Health? 200What Is a Public Health Intervention? 201The Political Philosophy, and (Bio)ethics of Public Health 201The Harm Principle 201Nanny or Nurture? 202The Stewardship Model 202The Nuffield Ladder of Interventions 202Healthy Cities 204Active Living 204Greenspace and Active Transport 204Parkrun, Free Exercise Classes and Gym Memberships 205Diet 206Calorie Information 206Sugar Tax and Levies 206Smoking 206Swap to Stop 206Smoking Bans and Smoke- Free Generations 206Drinking 207Minimum Unit Pricing (MUP) of Alcohol 207Getting Rid of the Pint! 208Nudging and Liberal Paternalism 208A Whole Systems Approach to Public Health 210Population and Planetary Health 210Conclusion 212References 212Part 4 Social and Community Networks, Loneliness, and Social Prescribing 21715 Understanding Support Networks and Influence Across the Life Course 219Chris Allen, Jasmine Snowden, Janine Hall, and Ellen Kitson- ReynoldsIntroduction 219The Life Course Perspective 220‘Linked Lives’: What Are Personal Networks and Why Are They Relevant to Health? 221Preconception and Maternity 222The First 1,000 Days and Childhood 223Adolescence and Emerging Adulthood 225Working Age Adult Life 226Retirement and Later Life 227Conclusion 228References 22916 Social Isolation and Loneliness in Contemporary Society 237Chris AllenIntroduction 237Social Isolation and Loneliness 237Who Is Affected, Where and Why? 239Global Loneliness Trends 239Personal Characteristics of Loneliness 240Loneliness and Age 240Loneliness and Inequality 240Loneliness and the Lived Environment 241Digital Communication Technology and Loneliness 241How Is Loneliness Measured? 241What Are the Health Impacts of Loneliness? 241Physical Health 242Unhealthy Behaviours 242Mental Health 242Reduced Social Contact 243What Interventions Have Been Considered? 244Conclusion 244References 24517 Social Prescribing and Health and Well- Being 251Louise Baxter and Chris AllenIntroduction 251Creative Health and Health Inequalities 252Heritage and Museum- Based Activities 252Physical Activity – Football Fans in Training (FFIT) 253Nature – Blue Care Interventions 254What Is Social Prescribing? 254What Is a Social Prescribing Link Worker? 255Does Social Prescribing Work? 255The Role of the ‘Social Prescribing Link Worker’ 256The Role of the Voluntary and Community Sector 256How Social Prescribing Is Experienced by Those Accessing Support 257Conclusion 257References 258Part 5 Leading Safe and Effective Care in Increasingly Changing Healthcare Systems 26118 Leading Safe and Effective Healthcare Teams: Leadership, Management and Complexity 263Matt Flynn and Chris AllenIntroduction 263Complexity and Contemporary Healthcare 263Complex Systems: When Things Go Wrong 264Human Factors and Ergonomics 264Reasons Swiss Cheese Model (Theory of Active and Latent Failures) 265The Systems Engineering Initiative of Patient Safety (SEIPS) Models 265What Is Leadership and How Is It Different to Management? 267What Makes a Leader? 269Self- Leadership and Emotional Intelligence 269The Evolution of Leadership Theories and Approaches 270Traits Approaches to Leadership 271Leadership Behaviours and Styles 271Situational Leadership 271Transformational Leadership 272Leader- Member Exchange Theory 273Authentic Leadership 273Servant Leadership 273Distributive and Shared Leadership 274Team Leadership 274Taking One Last SEIP 274Conclusion 274References 27519 Healthcare Teams, Team Effectiveness and Team Training 279Chris Allen and Matt FlynnIntroduction 279What Is a Team, and Why Do We Work in Them? 279Healthcare Teams 281Team Effectiveness: Inputs, Processes, Outcomes 283Team Inputs 284Team Member Characteristics 284Diversity 284Social Categorisation Perspective and ‘Fault lines’ 284Teamwork Processes 285Communication 285Psychological Safety and Conflict 286Incivility 286Group Think 287Reflexivity 287Understanding Team Performance (Outputs) 287Teamwork Training and Teamwork Interventions 288‘Huddle Up’ – Team Huddles 288Teamwork and Innovation 288Conclusion 289References 28920 Digital and Technological Innovation in Complex Healthcare Systems 293Chris Allen, Eloise Monger, and Cheryl MetcalfIntroduction 293The Social Sciences, Technology, Innovation and Digital Health 294The Case for Innovation in Health 294What Is a Health Technology? 294What Is a Digital Health Technology? 295Understanding What Makes Us Unwell 296A Helping Hand: Decision Support, Artificial Intelligence (AI) and Machine Learning (ML) 296Health and Self- Management Tools 296Remote Access, Video Consultations and Virtual Wards 297Preparing Healthcare Professionals for the Digital Future 298What Does Success Look Like? Needs Led and Responsible Innovation 299Intended User and Stakeholder Engagement 300Adoption: Moving Beyond Creation 301Healthcare Systems Readiness for Innovations 302Contingency Planning 302Interoperability 303Security 303Technologies, Inequality and Their Impact on Health 303Conclusion 305References 305Index 309