Family & Community

National University

Faculty of Medicine

1st year- Semester 2

Behavioral Sciences (ME-BEHAV-119)

Dr. Osama Ahmed

0912368596

31-Mar-19 1

Community & Family: Definition of Community

• In the simplest terms, a community can be defined as a group of

people who have some common characteristics and are bound together

by “WE” feeling.

• This sense of ‘we’ feeling (i.e., shared togetherness) may be due to a

place where they all stay or due to some other common interest.

31-Mar-19 2

Community & Family: Definition of Community

• Community is a sociological unit of individuals who come together for the common

interest of satisfying their day-today needs.

• Accordingly, communities can be either “structural” or else, “functional”

communities.

• Functional communities are nongeographic aggregates which are bound together

by some common factor other than geographical place of residence or work; e.g.,

religion, occupation, special interest or need.

• Structural communities are organized by geographical or political boundaries.

31-Mar-19 3

Community & Family: Definition of Community

• Communities are differentiated on the basis of size of the population as Large and

Small, on the basis of economic function as Primary, Secondary and Tertiary and also

on the basis of whether they are rural and urban depending upon the nature of the

occupation of the majority of the population.

• In the rural community, the main occupation is the cultivation of plants and

maintenance of animals.

• A community is called an ‘Urban’ if:

• Its population is above 5,000

• At least 75 percent of male population is engaged in nonagricultural occupation

• Its population density is at least 400 persons per square kilometer.31-Mar-19 4

Community & Family: Culture

• It is a learned behavior, consisting of customs, beliefs, laws, religion,

moral percepts, arts, skills, etc. acquired through generations, which

has a profound influence on health and disease.

• It is a product of human societies.

• Such a culture differs from nation to nation (one geographic area to

the other) and from religion to religion.

31-Mar-19 5

Community & Family: Culture

• A culture denotes total way of life.

• It is recognized that cultural factors are deeply involved in all the affairs of

man including health and sickness.

• The cultural factors such as customs, beliefs, values and religious taboos

create an environment that helps in the spread or control of certain

diseases and affect health of the community.

31-Mar-19 6

Community & Family: Family Definition

• “The Family is a group defined by a sex relationship precise and enduring

to provide for the procreation and upbringing of children” (MacIver).

• The family is a primary unit of all societies.

• As a cultural unit, the family reflects the culture of wider society of which

it forms a part and determines the behavior and attitudes of its members.

31-Mar-19 7

Community & Family: Family

• Family differs from ‘Household’, in that all the members of the

household may not be biologically related, but live together and share

common kitchen.

• A family is a primary unit of society in many respects socially,

biologically, economically, culturally, epidemiologically and

operationally.

31-Mar-19 8

Community & Family: Family Types

• Nuclear Family (Elementary; Primary Family)

• It consists of a couple, with their dependent children, residing under same roof. It is a

conjugal arrangement. The relationship is more intimate.

• Extended Primary Family

• Apart from the couple with their children, it consists of sibling(s) of the husband or wife,

with their spouses and children. Thus, two or more primary families are joined

horizontally (Lateral extension of primary family).

• Three Generation Family

• This consists of couple with their children and parents. It consists of members of three

generations. Thus, there are two primary families, joined vertically (i.e. vertical extension

of primary family).31-Mar-19 9

Community & Family: Family Cycle

• Phase of formation: This phase starts with marriage and ends with the birth

of the first child.

• Phase of expansion: This starts with the birth of the first child and expands

with the birth of the successive children. Thus, it is the stage of growth.

• Phase of completion: This ends with the birth of last child.

31-Mar-19 10

Community & Family: Family Cycle

• Phase of contraction: This occurs when female children (daughters) get

married and go to husband’s house or sons leave the house in search of the job

or separate out eventually and repeat the family cycle. With this there will be

reduction in the size of the family.

• It is also called as ‘stage of retraction’.

• Phase of dissolution: This starts when one of the parental couple passes away

and total extinction occurs when the survivor also dies.

• This is also called ‘stage of disintegration’

31-Mar-19 11

Community & Family: Family Role

• Homely Life

• Economic Security

• Reproduction

• Education

• Socialization

• Emotional Support

• Social Care

• Support

• Bridging the Generation Gap

• Job Distribution

31-Mar-19 12

Community & Family: Cultural Factors in Health

• Health Perception

• Housing Condition• A poor housing condition with ill-ventilation and ill-lighted rooms, often associated

with over-crowding and with livestock (animals), predispose to airborne, and vehicle-borne infections.

• Personal Hygiene

• Child Rearing• The child rearing practices has a profound influence on the health of the growing

children, such as breastfeeding practices, eating habits, feeding habits, sleeping habits etc.

• The child care determined by tradition, varies, from society to society.31-Mar-19 13

Community & Family: Cultural Factors in Health

• Socialization• This is transfer of civilization including culture, beliefs, traditional practices,

general codes of conduct, healthy habits, etc. from parents to children, makes the children into future promising citizens of tomorrow.

• Personality Formation• Depending upon the set up of the family, cultural practices, behavior of the

parents and siblings, family environment, etc. all lay the foundation in promoting the development of personality and also promotes physical mental and social health of the growing children.

• Lifestyle

• Dietary Practices

31-Mar-19 14

Community & Family: Cultural Factors in Health

• Disposal Practices

• Reproductive Behaviour

• Care of the Sick and Injured

• Stabilization of Adult Personality

• The stress of modern life is associated with mental illness and behavior disorders.

• The stress could be injury, illness, births, deaths, tension, emotional stress, worries,

anxiety, economic insecurity, etc.

• The family acts as a good ‘Shock absorber’ to the stress and strains of life.31-Mar-19 15

Community & Family: Social Processes

• Socialization• It is a process of acquiring culture and norms of the family and becoming a member of the

society.

• Role• It is the behavior of an individual in an expected way when he/she is in a certain position.

• Roles are of two types.

• ‘Ascribed role’ is given to that individual by virtue of age, sex, birth, etc.

• ‘Achieved role’ is acquired by the individual by virtue of certain characteristics like education, qualification, experience.

• Acculturation• It means ‘culture contact’, when there is contact between two persons (or two groups of

persons) with different cultural background, there is diffusion (or exchange) of culture both ways, through the means of trade and commerce, education, industrialization, conquest, propagation of religion, etc.

31-Mar-19 16

Community & Family: Social Processes

• Social Controls

• Sociologists consider that social behavior should be subjected to certain constraints and

regulations.

• There are two types of social controls—formal and informal.

• Formal controls: Laws and enactments of the Parliament/ Assembly are examples of social

formal controls. Small institutions like hospitals also have their own formal controls.

• Informal controls: These are not in the form of laws but they serve as pressures exerted on

the individuals for desired behavior. Thus, there is no formal law which states that a

mother should take care of her child. 31-Mar-19 17

Community & Family: Social Processes

• Social Change

• It is a complex process that involves change in:

• Aggregate attributes of the population—such as changes in age-sex

composition, occupation, literacy, etc.

• Social behavior of the population—such as suicides, homicides, juvenile

delinquency, etc.

• Social structure of the population—such as changes in family structure, rise

and fall of institutions, changes in social control mechanisms, etc.

• Cultural patterns of the population—such as changes in customs, values,

knowledge, expressive symbols, etc.31-Mar-19 18

Community & Family: Social Processes

• Social Change

• Doctors can play an important part in bringing this change by the following roles:

• By providing impetus: Doctor can demonstrate why an epidemic has

occurred and how it can be prevented.

• By forming peer group: Doctor can mobilize the resources like nurses or

other professionals. He can also motivate the identified individuals in the

community for desired changes.

• By identifying the social controls: Doctor can handle a situation tactfully and

motivate the couple to accept contraceptive method, thus bringing a

desirable change.

31-Mar-19 19

Community & Family: Social Processes

• Social Stratification

• Social stratification means division of the society into various strata based on age, sex, marital status,

place of birth, citizenship, occupation, type of activity, language, income, religion, caste, literacy

level, etc.

• Sociologists study the processof stratification to find out its association with health and disease

• Education: ‘Any person, who is able to read and write with understanding in any language’ is

considered as literate.

• Occupation: Registrar General of England has grouped occupation into five classes Cl I-

Professionals; Cl II-Managerial; Cl III - Clerical and skilled; Cl IV—Semiskilled and Cl V—Unskilled.

Occupation not only determines the income but also the life-style of the individual.

• Income: This is the most important determinant of health and disease because it determines the

living condition, cleanliness, education, lifestyle, etc.31-Mar-19 20

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