Presentation on theme: "Maslow’s Hierarchy of Human Needs Abraham Maslow 1908 - 1970."— Presentation transcript:
Maslow’s Hierarchy of Human Needs Abraham Maslow 1908 - 1970
Understanding the principles of social obligation in oral health service delivery * Principles Supply & Demand Demand for health care will always outstrip supply Capacity for health to absorb funds is almost unlimited Rationing is a reality Macro-level % GDP to public dentistry Micro-level range of services offered to an individual “Need” imposes a moral obligation; “wants/desires/ demands” are discretionary Often there is an “over-provision” of services to certain groups and “under-provision” to others Danger that supply will be determined by demand and not by need * Wayne Richards, Dental needs and priorities in dental care. British Journal of Heath Care Management 2004: 10:178-181.
Social Construction of Reality is a treatise written by Peter Berger and Thomas Lucknow in 1966. The central concept of the social construction of reality is that individuals and groups “interacting in a social system” create, over time, concepts and interpretations of the each other's actions, that eventually become habituated into their beliefs. When these concepts and actions roles are disseminated through to other members of the broader society they are said to be institutionalized. In the process of this institutionalization, meaning is embedded in society. Knowledge and people's conception (and belief) of what reality is becomes embedded in the institutional fabric of society. Reality is therefore said to be socially constructed.
Doctor Patient Application of Medical science Human Interaction Application of Medical science Human Interaction Doctor Patient MedicalProfession Family The Sociocultural matrix From: Samuel W. Bloom The Doctor and His Patient: a Sociological Interpretation. New York. Russell Sage Foundation, 1963 Fig 1. As an Interactive Model Fig 2. As a Social System Provider – Patient Relationships
So what underpins social inequalities? Capacity to Respond to Stress, Crisis, Change Material Resources – poverty & material resources Social Supports - networks Appropriate Skills – adaptive skills & coping repertoires (migrants). Training drills Sustained Motivation – willingness & commitment Effective personal defenses - alienation Capacity to Adapt to Stress, Crisis, Change Search for Meaning – especially in ambiguous situations Attribution – locus of responsibility Social Comparison – look to others in community/group Dependence & Power - relationships
What we “see” IS Important: Nature of the diseases Foundation Areas – strategies & indicators, systems and alignments Priority groups But what we don’t “see” – the social constructs of a civil society - are possibly More Important. Beliefs, Values, Ideologies/ Vested Interests Emotions Trust. Mixing Metaphors
The Life Course Life Phases &... Getting a Life! Don’t Blame Me... You Sort it Out!
Many more older people will be out & about Many more teeth at risk Many more health co-morbidities which overlap with oral health Less financial resources to access dental services Less physical and neurological capacity to manage sophisticated technical dentistry Greater political power and potential to embarrass politicians, the professions and bureaucrats Why should we care about the oral health of older people?
Slade G et al (eds) 2004- 2006 National Survey of Adult Oral Health. Australia’s dental generations 14,123 people aged 15 – 97 yrs Comparison with previous survey in 1987-88 % people who had no natural teeth halved (14.4 % to 6.4%) almost all of the reduction occurred because of the passing of the older generations that had experienced the ‘epidemic’ of dental extractions similar reductions in dentate populations with ‘inadequate’ dentitions (< 21 teeth) Page 54 - Priority Groups Underpinning Eco- system processes
Australia 2012Australia 2050 Age Pyramid in Australia 2012 - 2050
Total no. teeth (millions) 1989308 1999375 2009441 2019497 Total number of teeth - Australians 1989-2019 Courtesy: Professor AJ Spencer, 2011
Dr Patricia Edgar, Ambassador to the National Ageing Research Institute, author of “In Praise of Ageing”. “...contribution of older people through volunteering is massive and the economy just couldn’t work without them” “...contribution of older people through volunteering is massive and the economy just couldn’t work without them” “The biggest obstacle is discrimination...” “The biggest obstacle is discrimination...” “There’s a whole attitude that old people are irrelevant...” “There’s a whole attitude that old people are irrelevant...”