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Make it concise as per wbuhs exam oriented answers
Here are the concise WBUHS exam-oriented answers for Chapter 2 - Social and Behavioural Science and Health:
CHAPTER 2: SOCIAL AND BEHAVIOURAL SCIENCE AND HEALTH
Q.1. What is medical sociology? Discuss social determinants in health and disease. [BNMU 2013, ABKUB 2017]
Medical Sociology: Study of effects of social and cultural factors on health, illness, health care delivery, and social role of health establishments.
Social Determinants:
- Education - Higher education → better job → better health decisions
- Income - High income → better healthcare access; poverty → malnutrition, infections
- Gender - Women face discrimination, exploitation (rape, dowry, female feticide) affecting health
- Occupation - Professionals (doctors, engineers) have better health awareness and access
- Urbanisation & Industrialisation - Leads to: environmental sanitation problems, communicable diseases (TB, malaria), social problems (alcoholism, drug addiction), accidents, food-borne infections
- Migration - Rural migrants have poor access to healthcare → more disease
Q.2. Cultural factors in Health and Disease. [RGUHS 2010, SAMU 2012, TGMGRMU 2013]
1. Concept of Aetiology and Cure:
- Supernatural causes: Wrath of gods, taboo breach, past sins, spirit intrusion → delay in scientific treatment
- Physical causes: Weather effects, impure water, impure blood beliefs
2. Environmental Sanitation:
- Open field defecation → water pollution, fly breeding
- Cow dung on floors → soil contamination
- Ganga water worship → cholera, gastroenteritis
- Katcha housing → poor ventilation, disease risk
3. Food Habits: Influenced by religion (Muslims avoid pork, Hindus avoid beef)
4. Mother and Child Health:
- Good: Prolonged breastfeeding, oilbath, massage
- Bad: Restriction of eggs/meat/fish during pregnancy; dry food to mother postpartum; delivery by untrained dais; colostrum considered harmful
- Uncertain: Kajal application (may transmit trachoma)
5. Personal Hygiene:
- Tobacco/betel chewing → oral cancer
- Unsterilised barber instruments → skin infections
- Prohibition of bathing during menstruation → skin infections
- Purdah → higher TB incidence
- Barefoot walking → hookworm disease
- Circumcision → reduces cancer of glans penis
6. Sex and Marriage: Early marriage → large families, maternal ill-health, foetal loss
Q.3. What is a family? Types, Family Cycle, Role of family in health and disease. [WBUHS 2010, SMU 2011, 12, 14]
Definition: "A group of individuals related by blood, marriage or adoption, living under the same roof and sharing a common kitchen." It is the basic functional unit of a community.
Types:
- Nuclear family - Couple with dependent children
- Joint family - Two or more couples, patrilineal descent, property held jointly by male members
- Three-generation/Extended family - Couple + children + dependent parents
Family Cycle:
| No. | Phase | Begins | Ends |
|---|---|---|---|
| I | Formation | Marriage | Birth of 1st child |
| II | Extension | Birth of 1st child | Birth of last child |
| III | Completion | Birth of last child | 1st child leaves home |
| IV | Contraction | 1st child leaves home | Last child leaves home |
| V | Completed contraction | Last child leaves home | 1st spouse dies |
| VI | Dissolution | 1st spouse dies | Death of survivor |
Roles in Health and Disease:
- Child rearing - Breastfeeding, feeding habits influence child growth
- Socialisation - Transfer of culture and healthy habits to children
- Personality formation - Family environment shapes personality
- Care of dependents - Sick, pregnant, aged, handicapped
- Stabilisation of adult personality - Acts as shock absorber against stress (prevents psychosomatic diseases)
- Familial susceptibility - Shared genes → haemophilia, diabetes, colour blindness, schizophrenia
Q.4. Functions of Family. Family physician vs Clinician. Importance of FAP. [BNMU 2012, WBUHS 2018, 2024]
Functions of Family:
- Homely life - safety, security, social identity
- Economic security - income sharing, necessities of life
- Reproduction and child rearing
- Education - language, religion, morals, habits
- Socialisation - cultural practices, festivals
- Emotional support - buffer against stress
- Social care and social support for weaker members
- Bridging generation gap
Family Physician vs Clinician:
| Family Physician | Clinician | |
|---|---|---|
| Role | First contact point | Specialist/hospital-based |
| Qualification | MBBS/BAMS/BUMS/BHMS ± MD | Specialised qualification |
| Approach | Comprehensive, community-based | Disease/organ-specific |
| Function | Treats + refers + gate-keeper | Diagnosis and treatment |
Importance of FAP (Family Adoption Program) for UG Students:
- Exposes students to patients' socioeconomic background
- Teaches students how to help within community constraints
- Motivates spirit of service to society
- Identifies important community health problems
- Corrects misconceptions about health
- Better interaction at family level
Q.5. Community diagnosis vs Clinical diagnosis. Clinico-social diagnosis of 19-month female child with acute watery diarrhoea. [WBUHS 2023]
Community Diagnosis: Pattern of disease in a community described in terms of important influencing factors.
Difference:
| Procedures | Clinical Diagnosis | Community Diagnosis |
|---|---|---|
| Assessment | Patient/family | Community leaders |
| Detect illness | Examine patient | Community observation |
| Investigations | Lab tests | Primary/secondary data |
| Treatment | Medications, surgery | Action plan |
| Who controls | Doctor | Community |
| Follow up | Confirm/change diagnosis | Monitor, plan new health actions |
Clinico-social factors for 19-month female child with acute watery diarrhoea:
1. Individual factors:
- Age (19 months), sex (female)
- Immunisation status (Rotavirus)
- Feeding practices, nutritional status
2. Family factors:
- Type and composition of family
- Education, occupation, socioeconomic status
- Knowledge and practices regarding healthy lifestyle
- Water supply, housing, sewage disposal
- Food hygiene, nutrition
- Healthcare services available
3. Community factors:
- General attitude toward disease prevention
- Available healthcare facility
- Organised public health services
- Political will
Q.6. Barriers to good health and health seeking behaviour. [WBUHS 2023]
- Poverty - Cannot afford health services (economic barrier)
- Illiteracy - ~90% in India; prevents universal health coverage
- Cultural barriers - Wrong beliefs, attitudes, practices
- Lack of access - Distance, no transport, inaccessible services
- Poor quality of health services
- Unsuitable timing of services
- Gender bias and discrimination
- Stigma - associated with leprosy, TB, mental illness
- Lack of cooperation/poor communication by service providers
- Lack of faith and trust in the system
Q.7. Social Security - Definition, why essential, types. [WBUHS 2014]
Definition: Security/guarantee furnished by the State through appropriate organisations to members during crises (loss of working/earning capacity) due to sickness, invalidity, maternity, old age, death.
Why essential: Insecure individuals cause social pathology and total development lags behind. Social security is the basis of social welfare.
Types:
- For industrial workers: Workmen's Compensation Act 1923, Central Maternity Benefit Act 1961, ESI Act 1948, Family Pension Scheme 1971
- For civil servants: Pension, gratuity, provident fund, family pension
- For general public: Insurance schemes (LIC), PPF schemes
Q.8. Differences between Social Insurance and Social Assistance. [WBUHS 2023]
| Characteristics | Social Insurance | Social Assistance |
|---|---|---|
| Contribution | By employees + employers | Non-contributory |
| Benefit | Cash; matter of right | Cash or kind |
| Inferiority complex | Does not develop | May develop |
| Involvement | Actively involved in planning | Not actively involved |
| Suitability | For workers who can contribute | For workers who cannot contribute |
| Dependency | Not permanently dependent | May become permanently dependent |
| Legislation | Many legislations | Hardly any |
| Beneficiaries | Industrial workers, government employees | Unemployed, widows, orphans, handicapped |
| Examples | ESI, PPF, LIC, Group Insurance | Sanjay Gandhi Niradhar Yojana, SavithriBai Dattakpalak Yojana, Kannyashree Prakalpa |
SHORT NOTES
Q.B.1. Socialisation
- Process by which individual acquires culture and becomes a member of a social group
- Begins after birth; depends on reflexes, instincts, capabilities, genetic makeup
- Factors: Suggestions, imitations, identification, language
- Chief agencies: Family, school, playmates/friends, temple, state, environmental stimuli
Q.B.2. Acculturation
- "Culture contact" - exchange/diffusion of culture between two groups with different cultures; always reciprocal
- Factors: Trade/commerce, conquest, migration, industrialisation, education, religion
- Barriers: Resistance (mores, taboos, sense of superiority), poor adaptability, physical isolation
- Types: Direct diffusion (physical contact) and Indirect diffusion (via media - TV, cinema, radio)
- Has both good (scientific medicine) and bad effects (smoking, alcohol, drug abuse)
Q.B.3. Family Diagnosis
- Medical diagnosis for all family members + determinants influencing family health; also called medico-social diagnosis
- Determinants considered: (i) Demographic distribution (ii) Environmental status (housing, water, sewage) (iii) Socioeconomic status (iv) Socio-cultural background (v) Nutritional factors (vi) Individual health status (vii) Knowledge regarding common diseases (viii) Health care seeking behaviour
Q.B.4. Problem Family
- Standards of life below minimum; members unable to discharge family obligations
- Features: Constant quarrels, negligence of children, substandard housing, excessive hostility, unsatisfactory neighbourhood
- All broken families are problem families (associated with poverty)
- Children at risk: Prostitution, crime, vagrancy, psychopathic behaviour, subnormal intelligence, antisocial behaviour
Q.B.5. Socioeconomic Status (SES) Scales
1. B.G. Prasad's Method (1961):
- Indicator: Per capita family monthly income
- Used for social classification of families (not individuals)
- For rural areas; updated using Correction Factor (CF) = AICPI × 4.93%
2. Modified Kuppuswamy's Scale (1976):
- For urban areas
- Variables: Education + Occupation + Monthly family income (weighted scores)
- 5 classes: Upper (I), Upper middle (II), Lower middle (III), Upper lower (IV), Lower (V)
3. Pareek & Kulshrestha Scale:
- For rural areas; 9 characteristics: Caste, occupation, education, land holding, social participation, type of family, housing, farm power, material possession
- Graded into 5 SES categories
Q.B.6. Family Physician
- First contact point for patients
- Provides continuing and comprehensive medical care to all family members regardless of sex, age, or type of problem
- Qualification: MBBS/BAMS/BUMS/BHMS (with or without MD in Family Medicine)
- Acts as gate-keeper; refers to specialist when required
- Knowledge of all specialties at basic level
Tip for WBUHS exam: Always write answers in structured format with headings, subheadings, and tables where applicable. Questions marked with year tags (e.g., WBUHS 2023) are high-priority for revision.
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