Acculturation - PSM Exam Notes

Definition

Ways by Which Culture Contact (Acculturation) Takes Place

Classic example from Park: "The British brought their culture into India through conquest. An Indian is said to be the next best Englishman."

Effects of Acculturation (Both Good and Bad)

• Introduction of scientific medicine (medicine came to India through culture contact)
• Spread of modern education and technology

• Changes in food habits (e.g., orthodox Brahmins eating meat)
• Widespread use of tobacco all over the world is because of culture contact
• Altered cultural-behaviour patterns via radio, television, and cinema

Relationship to Culture

"Learned behaviour which has been socially acquired."

• Culture is transmitted from one generation to another through learning (formal and informal)
• Cultural factors deeply influence: personal hygiene, nutrition, immunization, family planning, health-seeking behaviour, and the entire way of life
• Examples of cultural influence on disease:
  • Smoking (lung cancer) in developed countries
  • Alcohol (cirrhosis) in developed countries
  • Pan chewing (oral cancer) in India

Contextual Placement in Park's Sociology Chapter

High-Yield Exam Points

1. Definition: Acculturation = culture contact = diffusion of culture both ways between two groups
2. 5 ways it occurs: Trade, Industrialization, Religion, Education, Conquest
3. Culture is defined as "learned behaviour which has been socially acquired"
4. Acculturation has both good and bad aspects
5. Tobacco use spreading globally is a classic bad effect of acculturation
6. Introduction of scientific medicine is a classic good effect
7. The concept appears under Sociology in Park's PSM (not anthropology or psychology chapters)
8. Socialization = acquiring culture as an individual; Acculturation = culture contact between groups - know the difference

Types and Functions of Family - PSM Exam Notes

Definition of Family

Factors that have affected family structure: Industrialization, urbanization, democratization, and acculturation.

Types of Families

1. Nuclear Family (Elementary Family)

• Universal in all human societies
• Consists of the married couple + their dependent children
• They occupy the same dwelling space
• Husband usually plays the dominant role
• Absence of grandparents/relatives places greater burden on the couple for child rearing
• Husband-wife relationship is more intimate than in joint family
• "New families": term applied to families under 10 years duration (parents + children) - important in family planning studies

2. Joint Family (Extended Family)

• Common in India, Africa, Far East, Middle East
• More common in agricultural areas than urban areas
• Classic example: orthodox Hindu family in India
• Urbanization and industrialization are causing its decline

• Greater economic and social security
• Protects the old, helpless, and unemployed
• Pools income for education, marriage, and business ventures

3. Three Generation Family

• Often confused with the joint family but is different
• Fairly common in the West
• Household with representatives of three generations related by direct descent
• Occurs when young couples cannot find separate housing and continue living with parents

Comparison Table

Functions of the Family

1. Residence

• Provides a clean and decent home to members
• Two types of residence:
  • Patrilocal: wife goes to husband's house (common among Hindus in India)
  • Matrilocal: husband goes to wife's house

2. Division of Labour

• In primitive societies: male = earner; female = child care and household
• In industrialized/urbanized communities: less distinction between male and female roles
• Modern trend is towards a "communal family" - all members share in management
• The modern Indian wife now brings professional education and seeks a career

3. Reproduction and Bringing Up of Children

• Very important function
• Mother: absolute care of infant and young children
• Father: provides for education and teaches social traditions and customs

4. Socialization

• Family is a bridge between generations
• It is the transfer point of civilization
• Cultural patterns of eating, cleanliness, dress, speech, language, behaviour, and attitudes are all transmitted through the family

5. Economic Functions

• Family implies economic partnership
• Inheritance of property and ownership/control (farm, shop, dwelling) controlled by family
• Property handed down to children

6. Social Care

• (a) Giving status in society to its members (family names, sense of kinship)
• (b) Protecting members from insult and defamation
• (c) Regulating marital activities of its members
• (d) Regulating political, religious, and general social activities
• (e) Regulating sex relations through incest-taboos

Family in Health and Disease (Health-Relevant Functions)

"Anyone who is concerned with medical practice or community health activities will come to know that family is ultimately the unit with which one has to deal." - Park

High-Yield Exam Points

1. 3 types of family: Nuclear, Joint, Three Generation
2. Nuclear family is universal in all human societies
3. Joint family - property held in common; authority with senior male member
4. Three generation family = 3 generations by direct descent (NOT the same as joint family)
5. 6 functions: Residence, Division of labour, Reproduction, Socialization, Economic, Social care
6. Two types of residence: Patrilocal (wife to husband's house) and Matrilocal (husband to wife's house)
7. Family = "transfer point of civilization" (socialization function)
8. Joint family motto: "Union is strength"
9. Factors disrupting family structure: Industrialization, Urbanization, Democratization, Acculturation

Social Stigma - PSM Exam Notes

Definition

Types of Stigma

1. Public Stigma

• Negative attitudes held by the general public toward a stigmatized group
• Involves stereotyping, prejudice, and discrimination at the societal level
• Example: believing people with mental illness are "dangerous" or "lazy"

2. Self-Stigma (Internalized Stigma)

• When a stigmatized individual internalizes society's negative attitudes
• Leads to shame, low self-esteem, and reduced help-seeking behaviour
• A major barrier to treatment in mental illness, leprosy, HIV/AIDS, TB

3. Structural/Institutional Stigma

• Policies and practices of institutions that restrict opportunities for stigmatized groups
• Example: mental illness being excluded from disability benefits or insurance schemes

4. Courtesy Stigma (Associative Stigma)

• Stigma extended to family members or caregivers of the stigmatized person

Goffman's Concept of Stigma (Sociological Basis)

Stigma in Specific Diseases (PSM Context)

Leprosy

• Major source of social stigma in India
• Causes social isolation, abandonment, loss of livelihood
• Park: IEC campaigns under "Towards Leprosy Free India" aim specifically at stigma reduction
• National Strategic Plan target: 50% reduction in stigma over baseline (NSS 2010-11)
• SPARSH Leprosy Awareness Campaign (2017-18): aimed to generate awareness, reduce stigma, and improve self-reporting; conducted in 60% of total villages across India

HIV/AIDS

• Severe stigma and discrimination remain key barriers to testing, treatment, and disclosure
• National AIDS Control Programme (NACP) vision: "HIV/AIDS will be perceived as a chronic manageable disease with no stigma and discrimination attached to it"
• Stigma drives patients away from healthcare and perpetuates the epidemic

Mental Illness

• Stigmatizing attitudes widespread even among mental health professionals
• WPA Stigma Programme study in India (4 cities, 463 persons with schizophrenia + 651 family members):
  • Two-thirds of respondents experienced discrimination
  • Women and urban residents most stigmatized
  • Men: more discrimination in job area
  • Women: more problems in family and social areas
• People with mental disorders perceived as "in control" of their illness - blamed for "weakness" or "lack of willpower"
• Shame is one of the main barriers to seeking help in both developed and developing countries

Burns

• Non-fatal burns cause disfigurement and disability, often resulting in stigma and social rejection

Consequences of Social Stigma

Stigma as a Barrier to Healthcare (PSM Importance)

• Delayed diagnosis: people avoid testing and healthcare due to fear of stigma
• Treatment non-adherence: fear of being seen taking medications (e.g., ART for HIV)
• Under-reporting: cases not reported, affecting surveillance data
• Social exclusion: stigmatized patients lose family and community support
• Nationally - stigma interferes with programme outcomes for Leprosy, TB, HIV, and Mental Health programmes

Strategies to Address Stigma

1. Protest

• Campaigns challenging stigmatizing portrayals in media and public discourse
• Some evidence of reducing stigmatizing behaviours

2. Education

• Promotes better understanding of illness
• Educated people are less likely to endorse stigma and discrimination
• IEC/BCC campaigns (India): e.g., SPARSH campaign for leprosy, NACP for HIV

3. Contact

• Inverse relationship between personal contact with stigmatized individuals and endorsing stigma
• Direct interaction with affected persons is the most effective anti-stigma strategy
• Park: recovered individuals sharing positive experiences through community leaders, social media, religious leaders - used in COVID-19 response

Additional Measures (Park's Programme Context)

• Community-based self-help groups
• Civil society organizations
• Legislative reforms (anti-discrimination laws)
• Involvement of opinion leaders and religious leaders
• Social activism and advocacy
• National Mental Health Programme (NMHP) - IEC activities specifically for stigma removal

Social Pathology and Stigma (Park's Sociology Chapter)

High-Yield Exam Points

1. Stigma = mark of disgrace/shame leading to discrimination and social exclusion
2. 3 core types: Public, Self (internalized), Structural
3. Goffman's 3 categories: Body abominations, Character blemishes, Tribal stigma
4. 3 anti-stigma strategies: Protest, Education, Contact (most effective)
5. In India - stigma is a major issue in Leprosy, HIV/AIDS, Mental illness, TB
6. SPARSH campaign = leprosy stigma reduction (60% villages, 2017-18)
7. NACP goal: HIV perceived as "chronic manageable disease with no stigma"
8. WPA India study: 2/3 of schizophrenia patients experienced discrimination
9. Shame is the main barrier to help-seeking in mental illness
10. Self-stigma leads to reduced help-seeking - a critical public health consequence
11. Inverse relationship: more contact with mentally ill persons = less stigma endorsed

Social Security - PSM (Simple Version)

What is Social Security?

"Security that society furnishes through appropriate organization, against certain risks to which its members are exposed."

Risks Covered by Social Security

Simple memory trick: SIMOD - Sickness, Invalidity, Maternity, Old age, Death

Two Main Components

Social Security in India - 3 Groups

1. Industrial Workers

2. Civil Servants (Government Employees)

• Pension - regular income after retirement
• Gratuity - lump sum on retirement/death
• Provident Fund - savings scheme (both contribute)
• Family Pension - pension to family after employee's death
• Central Government Health Scheme (CGHS) - comprehensive medical care to central govt employees in Delhi and other cities

3. General Public

• Life Insurance Corporation (LIC) schemes - cover death, accident, fire
• Public Provident Fund (PPF) - savings + tax benefit
• ESI schemes - for eligible workers

Key Points to Remember

1. Definition: Society's protection against sickness, invalidity, maternity, old age, death
2. Two components: Social Insurance (contributory) + Social Assistance (non-contributory)
3. Most important Act for workers: ESI Act, 1948
4. Oldest Act: Workmen's Compensation Act, 1923
5. CGHS = health scheme for central government employees
6. Social security is part of the Sociology and Medicine chapter in Park's