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1 The Chinese Welfare Association's Carer Support Project, Belfast

This audio unit features a project that was set up in Northern Ireland specifically to support Chinese carers. It is one of several projects being run by the Chinese Welfare Association in Belfast at that time.

The Chinese Welfare Association

The Chinese Welfare Association is a voluntary orga
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Introduction

This unit will help you understand how it is possible to meet the needs of a particular minority community – the Chinese who live in Northern Ireland. The audio clips will give you an opportunity to listen to some first hand experiences and discover some of the problems that this community are facing. You will also hear about the needs of the community in terms of care and support, particularly in terms of meeting the needs of older Chinese inhabitants.

The audio file was recorded in
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Acknowledgements

Acknowlegements

The material acknowledged below is Proprietary and used under licence (not subject to Creative Commons licence). See Terms and conditions.

Grateful acknowledgement is made to the following sources for permission to use material in this unit:

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References

Airhihenbuwa, C.O. (1995) Health and Culture: Beyond the Western paradigm, London, Sage.
Antonovsky, A. (1984) ‘The sense of coherence as a determinant of health’, in Matarazzo, J.D. (ed.) Behavioural Health, New York, Wiley, pp. 114–29.
Antonovsky, A. (1987) Unravelling the Mystery of Health: How people manage stress and stay well, California, Jos
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8 Summary and key themes

In this unit you have been introduced to a diverse range of ideas about health. To recap, the themes and ideas you have met in this unit are:

  • The diversity of accounts of health. An important theme of this unit is that there is a great diversity in what people mean when they talk of health; sometimes these meanings conflict and sometimes they can coexist but health is a creative and multifaceted concept.

  • The importance of
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7 Moving to a positive paradigm

Aaron Antonovsky (1984) has called the emphasis on illness and disease the pathogenic paradigm and has stated that this disease-focused paradigm has dominated our healthcare system. He claims that there are five important consequences of this domination:

  1. ‘We have come to think dichotomously about people, classifying them as either healthy or diseased’ (p. 115). Those categorised as ‘healthy’ are normal, those categorised as non-healthy or ‘d
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6.3 Responsibility for health and illness

In Activity 6 you explored factors which influence people's experience of health and we noted that inequalities in health are clearly related to the conditions of people's lives, such as their housing, income and education. On the other hand, health education messages have tended to focus on behaviour – what we
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6.2 Concepts of Illness

Sontag (1979) wrote about the metaphors we use to describe illness. Metaphors are ways of speaking about something as if it were something else which is imaginatively but not literally applicable, for instance calling a new moon a sickle. Sontag was mainly concerned with life-threatening illnesses such as cancer and AIDS, and how the metaphors we use can serve to stigmatise the sufferers, for instance referring to AIDS as a gay plague. But people use metaphors to explain illness to themselves
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6.1 Introduction

Although clearly related, the concepts of illness and disease are distinct. People have illness and physicians diagnose and treat disease. Disease is an objective term which implies a malfunctioning of the body or part of the body. Disease is pathological and is diagnosed on the basis of recognisable signs and symptoms. Illness is the subjective experience of pain, discomfort or disorder. Although it is mostly safe to say that illness is the subjective experience of disease, it is possible to
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5 Quality of life

‘Quality of life’ is beginning to be seen as significant by health policy makers. But this raises all kinds of problems about evaluating initiatives to promote wellbeing and quality of life.

If health is difficult to define then quality of life is even harder. You will have difficulty finding a tight definition. As George and Bearon state:

On the whole, social scientists have failed to provide consistent
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4.2 People knowledge

Stacey (1994) has made a passionate plea to understand the ‘power of lay knowledge’ which she prefers to call ‘people knowledge’. Stacey claims that two fundamental assumptions underline the importance of listening to lay voices. One is that all people are of equal worth and so their views should be heard. The other is that people are health producers as much as they are health consumers. She maintains that patients do a great deal of hard work, whether it is direct as with labouring
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4.1 Introduction

As we said at the beginning of the last section, much of the impetus in earlier work on lay perspectives was to examine how far they deviated from the ‘true’ knowledge of experts. Now the emphasis has changed and there is a move to try to understand lay knowledge in order to inform expert knowledge, and in the process the distinction is increasingly being questioned. As Bury notes, the ‘opposition between the world of patients and doctors has been a major theme in medical sociology’ (
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3.5 People's views on health

Health accounts, as well as being based in the experience of health, also relate to health behaviour. People's accounts of health are likely to be different at different stages in their lives. Two health promotion researchers, Backett and Davison (1992), have investigated the perceptions of health at different stages of life. Their work is based on two qualitative studies conducted in Edinburgh and South Wales. In these studies, health was also linked to health behaviours. The stage of life w
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3.3 Health and ethnicity

Clearly ethnicity, religion and culture have a great deal of influence on the way people view health. It was noted in the introduction to Section 2 that most of the early work was on health beliefs and that it was anthropological, focusing on ‘other’ cultures. Britain is a multicultural, multiracial society, yet attention
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3.2 Health and the middle class

In contrast, a study which focused on white, middle-class men and women between the ages of 35 and 55 (Saltonstall, 1993) found that respondents' views of health were closely connected to wellbeing, and this condition of being was related to ‘capacity, performance and function’ (p. 8). Saltonstall reports that the respondents, both male and female, catalogued what he called a ‘health inventory’ which included things they felt they had and things they thought they were expected to do t
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3.1 Health and low income

Health is a very personal matter, but people's health is very much situated in their life experiences and so their perceptions of health are likely to reflect their social situation.

Bostock (1998), a health researcher, interviewed mothers who were managing on low incomes to find out about their perceptions of their health. She was struck by the difference between her respondents' self-assessed health status compared to that found by the British Household Panel Survey (BHPS) which relat
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2 Accounting for health

Until relatively recently most of the information available to us about how people think about health and illness was concerned with non-Western societies. There was a time when a search in a good anthropological library in Britain would reveal more about the everyday health beliefs of the peoples of, say, African, Asian or South American countries than could be discovered about the everyday health beliefs of the people of the British Isles. Good (1994), in his book Medicine, Rationality a
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1.4 A community resource centre in action

It is clear that the well-being of communities and the well-being of the individuals within them are intrinsically linked. The Orchard Centre is a community resource centre for people with mental health problems in Bonnyrigg in Midlothian, Scotland.

Figure 1
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1.2 Boundaries between mental health and illness

Activity 1: What is mental ‘health’?

0 hours 20 minutes

What do you think it means if someone is described as ‘mentally healthy’? Think of all the different ways of describing ‘mental he
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1.6.2 Treating alcohol-related liver disorders

Although considerable progress has been made in the treatment of many other chronic medical conditions, scant progress has been made in the treatment of cirrhosis. In over 8000 people admitted to hospitals in the Oxford region of the UK with liver cirrhosis during a 30-year observation period, 34 per cent had died one year after their admission and this death rate remained more or less constant (Roberts et al., 2005).

The largely pessimistic view of the failure of treatment of liver dam
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