16. ETHNICITY AND ILLNESS (PART 2)

Question 1

1. According to the case, what might be the reasons behind his condition?

Answer 1

• smoking
• occupational stress
• isolation
• low population density
  (fewer opportunities to be supported)
  (more opportunities to experience stigma)

Question 2

2. He feels that he lives in a racist country.
   Could racism influence his health?
   How?

Answer 2

• he feels excluded
• he feels devalued
• he feels a loss of control
• he feels a loss of predictability
• he feels stigmatised
• he feels abnormal

Question 3

3. How many dimensions does racism consist of?

Answer 3

• two

Question 4

4. What are the two dimensions of Racism?

Answer 4

1. Prejudice
2. Discrimination

Question 5

5. What is Prejudice?

Answer 5

• these are the negative attitudes towards a
  person/group

EG: name calling

Question 6

6. What is Discrimination?

Answer 6

• these are the actions based on prejudice

EG: preventing someone from an ethnic minority group to get a job

Question 7

7. What is racism associated with?
   Name 7 negative side effects.

Answer 7

1. social isolation
2. inactivity
3. unemployment
4. poor opportunities
5. low salaries
6. chronic stress
7. altered social relations

Question 8

8. Complete the sentence:
   Racism affects how people interact with their
   1.________, 2._________ and 3._________ 4.__________.

Answer 8

1. friends
2. family
3. wider
4. community

Question 9

9. What are four aspects of life that are problematic for victims of racism to access?

Answer 9

1. employment
2. education
3. housing
4. medical care

Question 10

10. Which kinds of areas are victims of Racism likely to live in?

Answer 10

• polluted areas
• cheaper areas

Question 11

11. What does the stress that racism victims experience impact?

Answer 11

• it has an impact on mental illnesses
• it has an impact on the cardiovascular system

Question 12

12. How do people tend to cope with chronic stress experienced as a result of racism?

Answer 12

• they are likely to develop unhealthy coping activities
• such as:
  - smoking
  - alcohol abuse
  - drug use
  - criminal activity
  (this is a form of reaction to oppression)

Question 13

13. What is Institutional Racism?

Answer 13

• it is the exclusionary practices which arise from a racist
  ideology
• this ideology either exists or existed
• it is when organisations exclude people from opportunities based on their ethnic background

Question 14

14. What are people who experience Institutionalised racism excluded from?

Answer 14

• goods
• services
• opportunities
• these are all integral to institutions

Question 15

15. When it comes to discrimination by the National Health Service (NHS), which services are lower among minority ethnic communities?

Answer 15

• preventative services are offered less to minority ethnic communities
• cervical cancer screening is an example of a preventative service

Question 16

16. What are Black and Asian patients less likely to receive?

Answer 16

• follow up services
• they are also less likely to be referred to a consultant if
  they have a serious illness
  (EG: heart disease)

Question 17

17. With regards to discrimination done by the National Health Service, which kinds of societies are many General Practitioners unwilling to work in?

Answer 17

• socially disadvantaged societies
• inner city areas
• societies were most minority ethnic groups live
• areas where there are language difficulties

Question 18

18. What does the National Health Service fail to do?

Answer 18

• they fail to reach out sufficiently to various minority
• cultural values and needs of ethnic minority groups are not well understood by nurses and health professionals
• they are lacking strategies to understand cultural and
  ethnic groups well
• the cultural competence of many medical practitioners is still lacking

Question 19

19. What are 4 methods that we can use to Reduce
    Institutional Racism and Health?

Answer 19

1. Improved Neighbourhood and Housing
2. Increased Household Income
3. Employment Opportunities
4. Racially Integrated Education

Question 20

20. How does Improved Neighbourhood and housing reduce institutional racism and health?

Answer 20

• it is associated with:
  - higher employment rates
  - lower use of welfare services
  - better health
  - less abuse

Question 21

21. How does increased household income reduce institutional racism and health?

Answer 21

• there is less stress prevalent
• it is associated with:
  - improved health
  - lower smoking

Question 22

22. How do Employment Opportunities reduce institutional racism and health?

Answer 22

• it is associated with:
  - better health outcomes
  - higher academic achievements

Question 23

23. How does racially integrated education reduce institutional racism and health?

Answer 23

• it is associated with:
  - higher education rates
  - higher incomes for minority
  - better socio economic status
  - more employment opportunities
  - improvement in social conditions
  - improvement in health status

Question 24

24. What other issues have been brought up?

Answer 24

• GP is not fulfilling his role in a fair way
• he feels devalued
• he wants to obtain Health as an Equilibrium
• no cultural competence

Question 25

25. What does Cultural Competence refer to?

Answer 25

• it refers to understanding the importance of social and cultural influences on patients health beliefs and behaviours
• it looks at how these factors interact at multiple levels of the health care delivery system
• it also focuses at devising interventions that take these issues into account
  (this assures quality health care delivery to diverse patient populations)

Question 26

26. What two factors are focused on in Cultural Competence?

Answer 26

• knowledge
• skills
• these are utilised as social and cultural knowledge
• this benefits the patients

Question 27

27. How is Cultural Competence acquired?

Answer 27

• it is acquired through:
  - a careful interview of patients
  - social sciences training
  - social sciences practice

Question 28

28. Which three factors are associated with Cultural
    Competence?

Answer 28

1. Patient Satisfaction
2. Improved doctor-patient relationship
3. improved adherence
   (the outcomes will be more positive)

Question 29

29. What are 6 skills for Cultural Competence?

Answer 29

1. Critically reflect on our own values and beliefs
   (this is a fundamental skill)
2. Communicate in a nondiscriminatory, non
   stereotypical way
   (regardless of cultural and ethnic background)
3. Empathy regardless of ethnic background
4. Knowledge of social determinants of health
5. Awareness of intersectionality
   (culture, social class, gender, disability etc.)
6. Awareness of cultural values
   (these have an impact on understanding diagnosis
   and management)

Question 30

30. What can Cultural Competence potentially reduce?

Answer 30

• it can reduce health inequalities among ethnic groups
• it can improve overall health care

Question 31

31. What are the social reasons the patient has fallen ill?

Answer 31

1. SOCIAL DISADVANTAGE AND POVERTY
   
   • poverty
   • social disadvantage
   • chronic stress
   • lifestyle
   • family size
2. LOW POPULATION DENSITY
   
   • he does not socialise with many people from his
     home country
   • this may lead to social isolation
3. RACISM
   
   • discrimination of other people on the basis of
     prejudice
4. INSTITUTIONAL RACISM
   
   • discrimination by organisations
   • institutions on the basis of ethnicity

Question 32

32. Read through this summary.
    Does everything make sense?

Answer 32

• yes