Chapter 3: Social Justice Flashcards
Define socio-economic class and its relation to health - What does it account for?
An economic and sociological combined total measure of a person’s work experience and of an individual’s or family’s economic and social position in relation to others, based on income, education, and occupation
- Low = illness
- High = health
*Accounts for multiple aspects of economic and social disadvantage
Define Health Gradient
- 2 Factors
A gradient such that those one step down the ladder are unhealthier than those above
- Higher SES = better health
- Lower SES = worse health
- Psychological Factors = self-efficacy, self-esteem, perceived control, etc.
- Behavioural Factors = diet, exercise, etc.
Define Death gradient
When mortality is a measure more appropriate to term health gradient “death gradient”
What is equality and equity - what is the difference between the two?
Equality: State of being equal in status, rights, opportunity, health…
- Thought that giving everyone the same thing = everything will be ok
Equity: State or quality of being fair
- Acknowledges people start from different places and have different history; we don’t all have the same reality
- Just because people are all given the same thing, doesn’t mean they are all equal; we all need different things to achieve the same goal
What is social justice?
The equity of distribution of wealth, opportunities, and privileges within a society
Define Human rights
Fundamental moral and legal social norms necessary for people to live a minimally good life
What is the problem with the health gradient?
Our ability to approach health matters where we start
- Where we are born into, financially stable vs. facing hardships from the get-go
What did Louis-René Villermé discover?
Concluded there was a relationship between wealth of neighborhood (SES) and health of residence
- Poorer neighborhoods = higher death rates; illness;
disabilities; childhood suffering
- Was a social determinant of health (SDOOH approach to understanding health disparities.
Describe the poverty map
Wealth in the middle and poverty pushed to outskirts
- white flight = when white people move further as different races move into their areas
What is the germ theory and social darwinism?
- controlling pathogens = health
- innate inferiority of certain people = ill health
What are the four levels of the Bronfenbrenner’s model?
1) micro - family, school, neighbourhood
2) meso - peer groups
3) exo - parental support systems, parental workplace
4) macro - political & social philosophy
What are the factors the Bronfenbrenner’s model take into account?
1) Physical - smoking, violence…
2) Material - poor housing, insufficient school supplies…
3) Social - bullying, overcrowding…
4) Psychological - stress, lack of control…
What is the psychosocial explanation of the health gradient?
Focuses upon the:
1) Micro level (individual)
- argues that when those with lower SES compare themselves to others and see that they have less, this causes stress, which contributes to ill health
2) Macro level (social)
- focuses on how income inequality impairs social bonds and limits participation in civic benefits (e.g., good schools, safe housing, etc), resulting in unhealthy conditions
What is the neo-material explanation of the health gradient?
Focuses on importance of income and living conditions overall
1) Micro-level
- Unequal societies low SES = fewer economic resources vulnerability to threats ill-health
2) Macro-level
- Income inequality less investment unhealthy conditions ill-health
Define social capital
the networks of relationships among people who live and work in a particular society, enabling that society to function effectively
*The degree of civic engagement, levels of interpersonal trust and norms of reciprocity. E.g. community belonging
How does one reduce inequalities?
- Strengthen individual
- Strengthen community
- Improve access to facilities and education
- Encourage macro-level and cultural change
Discuss bridging social capital
Links with diverse groups and provides an opportunity community members to access power and resources outside their community
Discuss bonding social capital
refers to inward-looking social ties that bond the community together.
Social capital case studies
1) Gilbert et. Al (2003) – meta analysis demonstrated that social capital can increase the odds of good health by 27%.
2) Cramm et al. (2010) – social capital leads to social wellbeing in all income groups
3) Campbel et al. (2013) – community membership yields decreased hiv incidence and stigma
The Ottawa Charter of Health Promotion
“Health is a positive concept emphasizing social and personal resources, as well as physical capacities. Therefore, health promotion is not just the responsibility of the health sector, but goes beyond healthy life-styles to well-being”
- In the charter well-being relates to the idea of holistic health. More than just lack of illness symptoms
What are the pre-reqs for the Ottawa Charter?
The Charter identified 9 pre-requisites for health – these fundamental conditions and resources for health must be secure to provide a foundation for improvements in health
- Peace – safety from conflict; growth and development
- Shelter – safe, clean, secure, and adequate housing; protection from the elements
- Education – literacy, opportunities for training
- Food – secure access to nutritious food and clean water
- Income – adequate income to satisfy one’s needs and to cope with changes
- Stable ecosystem – predictable weather, healthy flora and fauna, and other environmental factors
- Sustainable resources – careful use of resources to preserve their supply
- Social justice – decision making power, access to resources, freedom to pursue well-being, freedom from violence etc.
What are the Ottawa Charters 8 Approaches to promote health
The resulting charter had 8 main approaches to promote health
- Strengthen community action
- Develop personal skills
- Enable
- Mediate
- Advocate
- Build healthy public policy
- Create supportive environments
- Reorient health services
