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Study guide: Determinants of health

In order to prepare for exams, it is important to prepare a "tailor-made" study guide.  A study guide should reflect your own learning and not just what someone tells you is the "best" research to use on an exam.

For the topic "Determinants of health", you will find an attached study guide.  I recommend that you attempt to fill it in before looking at the responses below.  There is both a paper and a digital copy available.

Determinants of health study guide

Digital Determinants of health study guide

A note on "determinants of health"

Although this topic is a "stand-alone" topic, research may be used from any of the health problems in order to answer the question.  You will reduce the number of studies you need to learn if you respond to the question by using research grounded in a specific health issue, rather than taking a more generic approach.  Below you will find examples from the smoking, obesity, and stress research.

Question 1: Discuss the biopsychosocial model of health and well-being.

Terms/theories: biomedical model, interactionist approach, holistic vs reductionist

Research: Any research could be used here from any of the health issues.  The goal of the response would be to show why the biopsychosocial model may be better than a biomedical approach to health problems.  Research could be used that shows both a psychological (cognitive and/or sociocultural) and a biological approach. For example, Steptoe and Marmot (2003) on the interaction of physical, cognitive, and social factors in stress; Farooqi and O'Rahilly (2006) on the gene-environment interaction in obesity; Kendler & Prescott (1998) on genetic vulnerability and social factors in drug use and addiction.

Critical thinking: Advantages and disadvantages of a biomedical vs a biopsychosocial model of health; difficulties in measuring the interaction of factors; implications of a solely biomedical model (eg. focus on treatment rather than prevention).

Different command terms: Evaluate, evaluate research...

Question 2: Discuss dispositional factors as determinants of health.

The IB has clarified that "dispositional factors" includes genetics.  Listed below is genetic research relevant to each of the health problems.

Terms/theories: Genetic vulnerability; type A personality.

Research: Personality: Roseman et al (1976); Ingledew and Ferguson (2006);  Genetics: Addiction: Kendler & Prescott (1998), Tsuang (1998), Ponce et al (2008); Obesity: Sorensen et al (1998); Stunkard et al (1990); Farooqi and O'Rahilly (2006)

Critical thinking: Genetics research has not yet been able to isolate the genes responsible for obesity.  The interaction between genetics and the environment is complex. Dispositional arguments are deterministic. Research is correlational and does not establish causation. Operationalization of health problems is problematic (e.g. the use of BMI to measure obesity); dispositional arguments are reductionist - which may be a good or a bad thing.

Different command terms: Evaluate research

Question 3: Discuss health beliefs as determinants of health.

Terms/theories: Optimism, health belief, self-efficacy, risk perception

Research: Optimism bias: Weinstein (1983), Hoppe and Ogden (1996); Health beliefs about sun-bathing; Self-efficacy: Neupert et al (2009); Lee el al (2012) Self-efficacy and pedometers

Critical thinking: Beliefs can only be obtained through self-reported data; use of cross-sectional vs. longitudinal research designs; demand characteristics; the research is correlational in nature, not showing a cause and effect; impossible to isolate beliefs as a factor in explaining behaviour.

Different command terms: Evaluate research

Question 4: Discuss risk and/or protective factors as determinants of health.

Terms/theories: Risk factors, protective factors, vulnerability models, adverse childhood experiences (ACE's)

Research: ACE's: Felitti (1998); Addiction: Park et al (2011); obesity: Currie et al (2010);  Joseph (2015)Koch (2008)Martinez-Gonzales (1999); Vandelanotte (2009); Østbye on moms and childhood obesity  stress: Curran and Hill (2017); lack of social support (Breslow and Breslow, 1993); levels of optimism (Jobin et al, 2014); life events (Evans and Kim, 2007), Marginalization (Kemeny, 2004).

Critical thinking: difficulties of isolating variables and controlling for extraneous variables; the importance of identifying risk and protective factors; methodological considerations of relying on self-reported data; problems with operationalization (e.g. BMI or "high stress.").

Different command terms: Evaluate research

Question 5: Discuss one or more research methods used in the study of determinants of health.

Terms/theories: research methods = interviews, observations, experiments, correlational studies, and case studies.

Research: Experiments: Lee et al (2012); Roseman et al (1976) Interviews/questionnaires: Joseph (2015), Koch (2008), Martinez-Gonzales (1999); Vandelanotte (2009). Correlational studies: Neupert et al (2009), Ingledew and Ferguson (2006) Case study: Marmot et al (1997)  

Critical thinking: Limitations of research methods.  Problems of operationalization.  The ability to draw conclusions about cause and effect.

Different command terms: Evaluate, contrast

Question 6: Discuss ethical considerations in the study of determinants of health.

Terms/theories: Ethical considerations include: informed consent, anonymity, right to withdraw, deception, undue stress or harm, and debriefing.

Research: Any research could be used to discuss ethical considerations.

Critical thinking: Issues of informed consent with minors (Joseph et al); undue stress and harm (stigmatization, feelings of embarrassment when assigned to the "obese" condition); the importance of debriefing (Østbye when discussing the role of moms in childhood obesity).

Different command terms: This question may only be asked as a "discuss" question.