Exam Flashcards
What are the two most commonly discussed factors for health in our society
Genetics and Behaviors
What are some common characteristics of social determinants of health
Social living conditions
Non-medical factors
Ways of thinking about social and living conditions and their causes beyond just genetics
What was life expectancy in Canada in 1800’s
Below 40
What was the life expectancy in 1921
57.1 years
What was the life expectancy in 1950
70 years
What is the life expectancy now
82 years
What are the top 10 caused of mortality in 1881
- Smallpox
- Typhus
- Cholera
- Diphtheria
- Dysentery
- Measles
- Tuberculosis
- Typhoid
- Scarlet Fever
- Meningitis
What are the top 10 causes of death in Canada today
- Cancer
- Heart disease
- Stroke
- Chronic lower respiratory diseases
- accidents
- Diabetes
- Alzheimer
- Influenza and pneumonia
- Suicide
- Kidney disease
What are the difference between the top 10 causes of death in Canada from 1881 to now?
Now they are chronic diseases that take longer to lead to death than infectious diseases. We don’t smoke have access to vaccines and know whats healthy.
Who is the father of modern pathology
Rudolf Virchow
Who said this quote “Disease is not something personal and special but only a manifestation of life under modified pathological conditions
Virchow
What are the 3 low income disease mechanisms
- Material and social deprivation
- Adoption of health-threatening behaviours
- Chronic stress
Why should we care about SDH
- Pragmatic (helps explain patterns in the distribution of health and disease rates, supports the development of sustainable solutions, life course perspective)
- Job creation
- Ethical is a social justice issue, everyone has a right to live the healthiest life possible
What is code red
Explores the impacts that social determinants of health have on people in Hamilton
When was code red started
2010
How many difference in life expectancy in Hamilton
21
How much of the difference in life expectancy in hamilton is due to SDH and what are the 3
42% due to 3 SDH
Poverty
Acess to health care
Education
What is mothers too soon and when was it published
It is an article that talks about teen pregnancy in two neighbourhoods and was published in 2011
What are some of the risks of teen pregnancy
- Judgment and stigma
Reduces income and opportunities in education
Risks to the child being born
Die during first year of life
learning diffculties
leave school before graduating
In mothers too soon how much percent have lower birth weights in some neigborhoods
15%
In mothers too soon in Sherman wentworth neighbourhood how many moms were teens
1 in 7
What are some facts about the sherman wentworth neighborhood
Average household 36,000
1 in 4 adults dont have a high school education
What are some facts about the Burlington the orchard neighbourhood in mother too soon
Not one teen pregnancy in same 4 years
Average household income 106 000
2 out of 3 adults have university
What were some of the patterns across the province that were noticed in the mothers too soon article
- correlates to poverty
- opportunity deficit
- Limited support for and success in school
neighbourhood and family norms and value
Perception of healthcare and system providers
What are the 14 social determinants
- Abrioginal staus
- Disability
- Early Life
- Education
- Employment and working conditions
- Food insecurity
- Health serviced
- Gender
- Housing
- Income and Income distrubution
- Race
- Social exlusion
- Social safety net
- Unemployment and job security
True or false Canada is one in the two wealthiest conturies that developed the greatest income inequality
True
What are some ways to decrease income inequality
Increase the minimum wage and boost assistance levels
Progressive taxation
Greater degree of unionized workplaces
Policy implications to reduce the effects of education
Tuition fees for uni and college must be controlled by the government
In the reading, if Canada should adopt a food stamp style program to help with food insecurity what was the coluncsion?
That we should not adopt it as it will do very little to help and might even increase further harm
What is food insecurity
A measure of inability to access food
What are the causes of food insecurity
Global and economic forces, war and displacement environmental disaster and inequality
What does being food secure mean
Having the right calories and the right type of food to lead a healthy life
What percentage of Canadians reported being food insecure in the past 30 days
14.6%
How many households are food insecure in Canada
2.1 million compared to 1.2 in 2011
Who uses food banks
33% are children
32% have a disability
4% are senior citzens
What are the stats about the uneven distribution of food insecurity across social groups
- 20% recent immigrants
28% racialized black minorities
28.2 being aboriginal people
34% of households that are food insecure are headed by single mothers
What province has the highest insecurity
Nunvut at 57%
What are some systemic factors of food insecurity in Nunavut
changes in tradation dependendent on imports and povery
What percentage on social assistance in Nunavut
41%
What amount o households have emplyoment income that are food insecure
2/3
What are the disease that come from food insufficient households in canada
Diabetes 80% more likely
70% more likely to develop food allergies
50% more likely to experience high or low blood pressure
What article states that everyone has a right to standard living adequate including food
25
The great depression how many people were out of work in 1930
25%
When was the food stamp program put in place
1939
What was the food stamp program
If you pruchased a $1 organe stamp you could get a 0.50 blue stamp for free and the blue food stamp would go to things that were in a slurplus that way they didn’t have a complete ecnomic downfall
Who was the first person to stand in line
Mrs Mabel Mcfiggan
What was the new food stamp program SNAP
It was in 2008 and a bank card based to get rid of stigmitzed stamps and there were 40 million participants
What were the qualifications for the SNAP program
Had to be living under the 30% poverty line and not if your a student without a disability 1 person houselhold would get 204 a month and a 4 person household would get a 604 month
What is a paternalistic police
Procetcting the people who are governed or employed by porviding them with what they need but not giving them any responsbility or choice
What is the ratio of people who use a food bank who are insecure
1 in 5
What is the capability approach
Poverty is a moral wrong and you need to ctually fix the problem jobs are too low paied
What are 3 system level solutions for food insecurity
- Food insecuriy cut in half once recive old age
- Maybe subsidizing food for norther and rual communities
3.Newfoundland and Labrador 2006 poverty reduction stratgey
What systems make food insecurity a health issue
Part of the CAN med and Canadian nurse practitioner core competent be able to advise them on certain opportunities.
What is the special diet allowance
- supports those that have a medical condition that costs more money such as gluten intolerance
What are disadvantages of food stamps
- says the problem is a lack of food
still stigma
food stamps dont eliminate f.i
bureacuracy
indignities
paternalism/dependency
What are 6 things that defines a job as good?
Job security
Safety
Adequate conditions/ intensity
Opportunities for self-expression and individual development at work
Feeling one is a valued participant
Work-life balance
What percentage of people work in gig economy
8%
What is intensification and what are the stats
Increased expectations that work be completed at a greater speed with greater effort and on a tight deadline
2/3 of Canadians are working more than 40 hours a week
What country has the highest stat minimum and who has the lowest
Australia
Japan
Who has the highest amount of public holidays and who has the lowest
Japan has the highest
and Australia has the lowest
How many amount of North Americans who had vacation time did not take it
70%
What are the impacts of objective conditions on emplyoment
Being unemployed objectively reduces one’s income and ability to secure resources
How many Canadians are eligible for employment insurance
1 in 2 worker
What are subjective impacts for unemployment
Different individuals experience the objective conditions of employment in different ways
How are objective and subjective impacts of work also contextual
The work that we accept or need to accept the working conditions we face are all socially determined
Also how we respond to these conditions can be the result of social circumstances and status
What are the 5 potential pathways of job insecurity
- Injury
- Stress-induced physiological changes
- Increased risky behaviour
- loss of social support
- Inadequacy of income
What ratio of injuries that need medical attention occur at work
1 in 6
What job has the highest amount of work injuries
Construction and manufacation at 40%
How many people said there disability was due to work
25%
How many Canadians find most work days stressful
1/3
What is allostatic overload
Wear and tear on the body due to sress
What is the long arm of the job
Work spills over and high affects home life
Rather then compensating they replace
What is the scarcity hypothesis
When we are being used to much at work we become tired and start to emotional distance and absence from home
What are some negative impacts on family life with jobs
Parents mental health
Increase irritability in interactions with kids
Impacts on marital satisfaction
What are the gendered differences observed in a work home life balance
Its hardest on children when the mother experiences a WFC
Children recover faster when the WFC is with the father then with the mother
What is the fourth industrial revolution
Increased opportunity for gig work off shoring services and those who are tech savy
What is gig work
They are self-employed freelancers (uber eats, contractors)
What are some negative impacts about gig work
Unstable flow of income
Job insecurity
Privitaized responsibility for safety
What is the problem with digital skills being increasingly needed
Not everyone has the same access to digital upskilling
What are the issues with AI facilitated job recruitment
Discriminate against people who are less tech savvy
May favour body language of certain genders or cultural groups
What is worker vulnerability
Groups of workers who are exposed to structural factors (racism, ableism sexism)
What happened to Joyce Echaquan?
She had suffered severe stomach pain they called her stupid and only good for sex this is not the only case she ended up dying because she didn’t receive treatment.
What act protection from discrimination as a right of all Canadians
The Canadian charter of rights and freedoms
What are acts of discrimination
- Actions within systems of power that adversely affect populations directly and indirectly
- Often normalized and nautralized
What is racism at a structural discrimination level
Macro level conditions that limit resources opportunities and the well of less privileged groups
It is institutionalized, widespread and normalized
What are the interlocking patterns that are examples of structural discrimination
Housing
Criminal Justice
Public Health
Education
Banking
How many people in Canada who self-identify as belonging to a visible minority have experienced discrimination
81%
How many women have experienced racism
1 in 5
How many people in poverty identify with a racial group
62%
How much do racialized Canadians earn in comparison to $1 by non-racialized groups
81.4 cents
What ammount of members of the black community of Torontos population and how many of that percentage faced police charges
8.8% are apart of Torontos population and 32.4% faced police charges
How does individual discrimination affects one health
Higher chronic disease risk: diabetes and cardiovascular disease, reduced health seeking, higher levels of unhappiness, loneliness and depression
True or false that every income bracket in Canada harbours slightly better outcomes than the one below it
True
What is social deprivation
Not able to get jobs or schooling or participate in normal extra curricular activities need to accept risker jobs
Where do racialized identity and income intersect for disadvantage
Material deprivation: cant buy healthy or sufficient food
Neighbourhood/ housing conditions
Access to green spaces/ nature/ recreation
How does racism have an impact on health as a psychosocial stressor
- People anticipate negative interactions
-Being hypervisible and being more noticed or judged - Stress of worrying about loved ones navigating risks of discrimination
What are some ways allostatic load can wear down the body
Chronic stress, anxiety, poor sleep, increased risk for cardiovascular, suppressed immune system, anxiety, depression, hypertension, insulin resistance, decreased digestive actvity
What is intersectionality
People simultaneously face bias along multiple identity dimensions
How much higher were covid-19 cases in racialized communities
1.5 to 5 times higher
How much higher were rates of infection in first nations communities
69%
What is the she-cession
Covid-19 disproportionately impact women as they have both paid roles and informal roles of caregiving
How did the pandemic disporportionatly affect first nations people?
Indigenous people in Canada face up to 50% of heart disease and 2X more likely to develop kidney disease than non-indigenous people therefore Covid-19 is more dangerous for people with chronic conditions.
What are the three forms Bias comes in
- Interpersonal Interactions ( diagnoses, pain management)
- Internal dynamics (communication, collaboration)
3.Costs/wastes
Who declared climate change to be the greatest threat of 21st century
LANEET
In what year did LANEET declare climate change to be the greatest threat of 21st century
2009
What is anthroprogenic
originating in human activities, so climate change is from human activities
What does overheating of the body do ?
- increases respiratory problems+ dehydration (shared risk with young children)
- increase risk of heart attack and dizziness, exhaustion, falls
What is UHI
Urban Heat Island Effect
In UHI, why are the microclimates created?
- due to construction materials
-lack of ventilation - lack of green spaces
- -5 higher in certain areas?
What are vector borne diseases patterns
- when more insects are bread faster due to increasing heat causing a high population of them to infect
- infections transmitted by the bite of an anthropoid species (eg, mosquitoes)
What is the stat about vector borne disease patterns
up to 10x increase with every 1 degree celsius increase
What are examples of vector borne diseases
malaria, dengue, tick-borne and encephalitis
What was BC’s fire season and what was the record of being worse
- in 2021
- 3rd worst on record
How many fires and what is the area of the burning
- 16.000 fires
- 87000 square km
Why were there forest fires in BC
due to drought and heat waves
Where do wild fires thrive?
-dry vegetation+ hot weather and wind to spread on initial spark
What is Manitoba’s relationship to drought?
exceptional drought conditions
What is the stat regarding lightning in Canada regarding wildfires and how much is burned
- lightning causes 50% of Canada’s wildfires
- responsible for 85% of areas burned
Smoke increases air pollution which releases…
- sulphur dioxide
- carbon dioxide
- fine particulate matter (PM)
Symptoms of smoke exposure are:
- headaches
- eyes/ears/nose/throat irritation
- chest pain
- severe cough
- wheezing
- irregular heartbeats
Who are more susceptible to wildfire smoke
- seniors
- people employed outdoors
- preggo women
- young children+ infants
- people with pre-exisiting heart conditions such as diabetes, lung/ heart conditons and cancer
What do climate change disasters cause?
- death
- worse chronic health conditions
- mental health trauma
- access to essentials medicine/loved ones/ water supply/ etc
Stat about climate change disaster
- more than 20 million people per year are forced from their homes by climate change
What structures are at a greater risk of being destroyed during a natural disaster
- precarious structures are at a greater risk
What is gender?
a culture specific system of power that defines certain values, norms, rules ‘natural’ for men and women
- also context and historically culturally specific
Stat about gender
men have more control and power over family and material resources (ex. land, income)
Drought meaning
- period of time when an area/region experience below normal precipitation
What was Zambia’s main concern? and stat about times and years
drought
- in 2019 they had the lowest rainfall since 1981
What does Zambia mainly survive on
subsistence farming
What is subsistence farming mean
relying on food/ livestock at the local and househould levels
What is qualitative research
a research aims to deepen understanding of a phenomenon and it produces detailed description of social phenomenon and human making, behaviour, meaning-making and interactions
The methods of qualitative research
- ethnography
- focus group discussions
- interviews
- observation
What is quantitative research
- measures a phenomenon and produces data that can be analyzed with statistical procedures
Addressing inequalities about maternal mortality stat
- 25x higher risk of death giving birth in Zambia compared to in Canada
Ways to address inequalities
- access to health care
- access to low interest loans
- fertilizers and short cycle crops
- incentives for keeping girls in school
What is climate justice
- the adverse impacts of climate change are not equally distributed
- adverse effects will be greater for socially and economically marginalized groups
- ethnically and practically, an intersectional approach is needed to reduce the interconnected social environmental impacts of climate change
What are the root cause of anthropogenic climate change around the world
green houses
What is morbidity vs mortality
morbidity: #of diseases
mortality: #of deaths
What did women in Zambia desire due to drought
smaller families
What happened as household incomes declined in Zambia?
- women and girl vulnerabilties increased
- young children increasingly entered the workforce
- young girls were married when families could not afford school fees and struggled to support them financially
What does WHO estimate in the Zambia article?
- between 2030- 2050 climate change will be responsible for 250 000 excessive deaths due to malnutrition, malaria, diarrhea, and heat stress
How much is it going to cost the US in direct health costs?
- 2-4 billion dollars by 2030
In Zambia article what are the trends for girls?
- reduced school attendance
- early marriage
- male out migration
- studies in south asia have shown increased risk of preterm birth and preclampsia to environmental changes
- sexual and gender based violence is frequently reported during forced migration events
- the agriculture sector supports 85% of the country’s population while employing 52% of the country’s working- age population
What did the drought do to Zambia people?
- pushed women into jobs with heightned manual labour
- men in sectors traditionally dominated by women
- reduced employment in agriculture
- lead to more alc usage among men and therefore household problems
- cant afford contraceptives
- food insecurity linked to heightened sexual risk among girls +women
- adolescent girls and unemployed women experience higher rate of intimate partner sexual +physical violence in drought related communities
How many people did July’s heatwave in Quebec kill?
- over 90 people in over a week
Was Montreal’s city allowing the homeless population to public areas during heat wave
no
What is benedict Lobre House
a day center for homeless people
What couldnt the benedict lobre house do?
secure a donated air conditioning until 5 days into the heatwave
How many Montreal Residents were killed due to the heatwave
54
What was the age group of the majority of the residents that died in montreal due to the heatwave
over 50 years old
How long were the bodies decaying for?
2 days before being found
Who suffered the most in the heat?
poor and isolated
Stat about US immigrants and heat
they are 3 times more likely to die from heat exposure than american citizens
Who are vulnerable to heat death in india
Slum dwellers
What do the hawaiian researchers project?
share of the worlds population exposed to deadly heat for atleast 20 days in a year will increase from 30% now to 74% by 2100 if greenhouse gas emissions grow
What happened in 2018 regarding heat?
- azerghijah or baku had te hottest temp of 43 degrees celsius
- low 30’s in scandinovia
- mercury did not dip below 38 degrees celcius for a week in tokyo japan
- in early july heatwave in LA, Chino, saw temps of 48.8 degrees celsius
Balck people, asians and hispanic stat in releation to heat risk
black people were 52% more likely to than white people to live in areas of unnatural “heat risk - related land cover” asians: 32% and hispanics are 21%
What did india do to help reduce heat related risks?
- unlocking the gates to public parks during the day
- distributing free water
- painting the roofs of slum communities white- knock off 5 degree celsius internal temps
What is a global health challenge
The challenge exists across many regions of the world
The causes and impacts transgress the national border
What are two examples of global health challenges presented in the lecture
The refugee crisis
Climate change
In 2018 how many people died from TB
1.5 million
What are the stats of TB in refrence to poverty and inequality
95% of cases in low and middle income conturies
What are the 4 countries that account for 2/3 of the cases for tubericolus
India Indonesia China Nigera
How many cases of TB were in India
27%
How many UN sustainable development goals are there
17
What year is TB targeted to end and under which goal
2030 goal number 3
What are the problems with trying to treat TB in Africia
Hard to find cases and symptoms can be because of lack of food
Hard to get to health care systems
People don’t seek healthcare early
What are the problems with non adherence
TB treatment takes 6 months
It’s hard on the body
Hard to get refills
Requires monitoring
What is the first pillar when trying to target TB
Integrated patient-centred care and prevention
( early detection treatment and make sure they have access to treatment and engage in it)
What is the second pillar when trying to target TB
Requires intense participation across government, communication and private stakeholders
What is the third pillar when trying to target TB
Intensified research and innovation (new technologies)
What are DrOTS
Drone observed therapy system that took place in Madagascar
How many people live in extreme poverty in Madgascar
79%
How far are people in Madagascar from a health center
60% liver over a 5km about a 12 hour walk away
What are the 4 innovations that were disscused in helping treat TB in madascgar
- Instructional videos shown on mobile phones
- Medication reminder/recorders (boxes that beep when to take your pill)
- Remote symptom monitoring
- Drones for transport
How did the drones work what were the steps
Health worker activates a GPS to call in the drone for the suspect case of TB
The drone is flow in from the treatment center
Health care worker takes a sputum sample and sends it back
The analysis is done and if positive MERM devices is given out and exchanged each month delivering new drugs
How many lives were saved through the TB diagnosis and treatment between 2000 2019
60 million
How many people die daily in the world because of TB and how many in total died in 2019
5000 die daily and 1.4 milion died in 2019
What is the charity model of disability
Common consequence of deinstitutionalization is the inability to access other built environmental at the neighbourhood scale, particularly due to the legacy of poor urban-scale design
- western cities are characterized and inscribed with the values of an able- bodied society
What is the medical model of disability
- normative model based on classifying levels of deviance or deficiency compared to a normative state
- a persons impairment can be diagnosed, cured or atleast rehabilitiated by modern medicine or medical technology and interventions will be provided by all-knowing professionals
- looks at u being the problem
What is the social model of disability
- disability arises from barriers within an oppressive and discrminantyl society rather than impairment
- recognizing that the built environment is a disabling instrument itself
- ***basucally places responsibility on society to get rid of barriers so as to accomodate and inlcude people w disabilities
What is the relational model of disability
-strong support of deinstitulization, recognition of the diversity of the human condition, and belief that people with disability and ‘normal’ (ordinary life) including access to the built environment are not mutually exclusive
- an emerging grand idea of social inclusion for people with disability
What is the diversity model of disability
- under representation of people with disability in employment, reduced educational attainment and the discriminatory nature of the existing built environment
- disablement is a human phenomenon rather than a minority one
What does disability as human variation mean under the diversity model of disabiltiy
- focus on how society’s systems respond to varition introduced disability
what is the human rights model of disability
- evolved within a continuum of rights-based approach thinking
- requires all built structures to be accessible for disabled people
What is assessing neighbourhood accesbility
- across anglophone countires, many people with disability find their everyday environment a daily overwhelming struggle
What is the disability model application
- unable to access local pedestrian environment, services and public transport
- children with disability and unaddressed community access careers
What are the two terms of dividing of social model (criticism)
- no place for impairment within the social model of disability
- the social model fails to take account of difference and presents disabled people as one unitary group whereas in reality our race, gender, sexuality and age mean that our needs and lives are more complex than that
what is the social model limiting
to what is happening to disabled people in the modern world
What distinction does the social model make
- between impairment and disability
What is disability vs impairment
impairment: persons condition
disability: social and political problem of society’s barriers
what model looks at themselves being the problem and tries to fix themselves for you?
social model
What is the affirmative model
- instead of seeing a problem, this model positions impairment as an ordinary aspect of the human experience
**embraces disability and sees impairment as part of an individual
What is the rights based model
uses rights framework (UNCRPD) to posit that all persons should have access to all aspects of community
**looks at the rights of individual to partake in community
What are the 4 main barriers accessing health care
- Physical barrier: stairs, narrow doorways
- Attitudinal barriers: unwillingless to accomodate
- Communication barrier: inadequate knowledge on how to communicate with individuals with diff forms of communication needs
- Systemic barriers: policies that systematically exclude, eg lack of homecare hours
What are economic barriers
due to high unemployment rates among people with disabilities, paying for medical services might be difficult
Examples of accessing information (barriers)
- medical forms are hard copy and is hard to read or other disabilities with just understanding the forms
- leads to lack of access to info
Solutions to information barriers
-e forms
- QR codes
- medical info written in plain text
- 14pt form
Trasportation barriers to access health care
- might require paratransit
- but u need advance booking
Stat about employment and disabilities
transit is costly, and 49% of canadians with disabilities are employed
Solutions to transport barriers
- services like red cross offer medical transportation
- tell patients about homecare and follow up to ensure services are being delivered
- uber medical transportation project
challenges in way finding in medical facilities
- signage often in print and difficult to locate
- assumptions that patients that require help will have someone to find
solutions to way finding in medical faciltiies
- install way finding tactic markers
- eg, bluetooth gps (indoor navigation)
- eg, blind square, near by explorer, aira (example of bluetooth gps)
Stat about people with disabilities
22% of canada’s population live with disabilities
What does community-based homecare promote
promotes independence and well being
what are the most common types of assistance required in community based homecare
- housework
- getting to appts
- meal prep
what are the max number of hours provided for agency based community care
4 hours
if u have direct funded care; what are thr max hours for agency based care
6 hours day
how many individuals live with a disability under age 65 in canada
18% live in long term care homes
why do these individuals in long term care homes
- due to long waiting list times for funding
- restrictions on type/required assistance needed
- accessible vs affordable housing
What ratio of people get assistance and what gender is more favoured?
- 2/3 individuals are amt that get assistance and women are more likely to get help than men
What is ableism in health care
- a belief system that favours able bodied experience
- perceives people with disability as less worthy
- can be conscious or unconscious in an individual, institution or a culture of a society
What can institutional ableism restrict?
it can restrict community engagement for people with disabilities
How to dismantle the ableism culutre in health care
- recognizing and valuing the experiences of users with disabilities
**and then these individuals can learn from others
What are the 6 CanMEd competencies
Professional
Scholar
Health Advocate
Leader
Collaborator
Communicator
What are the 4 strategies used to emphasize SDOH in medical education and medical practice?
- Partnerships between academic medical centers and community-based organizations
- Incorporating competency frameworks like the CanMED
- Utilizing non-clinical patient navigators
- Using electronic health record-based tools
How many physicians as of Janauray
86 092
How many jewish died in concentration camps
3.2 million
What was Thomas’s special technique for sales?
He was willing to be rejected
What has intertia
culture
What did thomas do to make the nursing home feel like home
2 dogs, 4 cats and 100 birds, lots of plants and children visiting
* every resident got plants and birds in their room
- also added a child daycare station
What was the impact of Thomas’s bringing in?
- reduced the number of prescriptions required per resident by 38% and the death falls went down by 15%
Why did thomas bring life back into the nursing home?
- so that the residents find a reason to live
- changed for the better by being holistic
What happens as people become old?
- they become more aware of their finite life and don’t ask for much
What are the 5 ways loneliness can hurt your health?
- elevated cortisol
- chronic inflammation
- poor diet
- too much bouze
- too little exercise
According to loneliness, what does elevated cortisol do?
- loneliness causes stress which the body interprets as danger and this will chronically elevate cortisol which contributes to heart disease, diabetes, cancer, etc
According to loneliness, what does chronic inflammation do?
- its a systemic release of blood proteins that prep the immune system to deal with danger or injury
what does health mean according to WHO
- a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity
What does pain mean?
- highly unpleasant physical sensation caused by illness or injury
- it can be measured
- its mental suffering and distress as well
What does suffering mean?
- the state of undergoing pain, distress or hardship
- it does NOT depend on physiological condition
Who is Bill Thomas?
- a nursing home abolitionist
What was the nursing home that bill thomas work on contain?
- 80 elderly residents
- 80% cognitivie disability or Alzheimers
- all ‘severely disabled’
What are the 3 plagues of nursing homes
- boredom
- loneliness
- helplessness
What SDHs does Chase Memorial (the nursing home) look at?
- neighbourhood and built environment
- health care and health
- social and community context
What is the 3 wishes project?
- took place in st joseph’s hospital in hamilton
- this was done bc over 60% of canadians are dying in hospitals where many are dying in ICUs
- and ICUs are not created for dying
- the death in ICUs is hard on the surviving family members bc it gives them a hospice setting vibe
What is the goal of the 3 wishes project?
- to bring peace to the final days of patients’ lives and ease the grieving process
How are the 3 wishes project being done?
the patient or from the dying patients’ family members the project will honour 3 wishes from the patient
What is culture?
- multidimensional
- shared, learned, dynamic (not static)
- cannot be exhaustively defined
- includes visible and non-visible aspects
What is the importance of culture in health care
- respect for culture= respect for persons and humanity
- denial of cultural difference can reinforce inequities and increase suffering
- culturally sensitive care is good as it is more high quality and more family centered care
What is death denying culturr
aging and dying viewed as pathological
What city has the largest INUIT population other than the north
ottawa
Why are there less resources for the inuit people in ottawa?
- the census data is inaccurate leading to less funding for organization that serve the community
In canada, what are the three indigenous groups recognized by the Constitution Act
- first nations
- metis
- inuit
How many first nations groups are there approaching a population of 1 million
663 first nation groups
What is the percentage of aboriginal people that represent canada
4%
How many inuit regions are there in canada
4 Inuit regions
In what year did the first nation gain the right to vote?
1960
What are the many layers of stressors
- racism
- poor education
- family instability
- poverty
- unemployment
- residential instability
all of these are linked with high rates of depression, alcoholism, suicide and violence
What is residential instability
associated with family instability and a high proportion of female love- parents families with low incomes
**individuals living with this experience great social difficulties, such as poor education attainment divorce, crime and suicide
What is the major challenge for URBAN indigenous people
1.to maintain social cohesion
2. made more complex bc of multinational and multitribal nature of urban indigenous populations which further reduces social cohesion and the ability to establish indigenous institutions
What did the Canadian Government suvery in 2001 show?
it showed that 2/3 of first nations reserves had water supplies that were at risk of contamination
What is an increasing disease due to environmental factors in indigenous populations
diabetes
What did Australia and Canada see in 2008 and for what ?
they saw apologies from the federal governments for their assimilationist policies
What constitution act protects aboriginal and treaty rights
section 35, 1982 of the constitution Act
What names were replaced instead of using “Indians”
-first nations
- aboriginals
**but they prefer to go by their reserve names
How many first nations communities are there in canada
634
how many first nations communities are there IN ONTARIO
133
What is the dominating groups in Ottawa and Toronto
Inuit
Why are a lot of Inuits in toronto and ottawa
- came for treatment and were either stranded there or just decided to stay which just increased the social capital
What is the average life expectancy for Indigenous, Inuit and Metis
- on average they are much lower to the common population of Canada
What is the infant mortality rate in high density inuit populations?
- 3.9 times higher
What are the leading causes in infant mortality in inuit populations?
- food insecurity
- unemployment
What is the most common cancer among first nations people?
- colon, rectum, kidney, cervix and liver cancer and it is diagnosed at a higher rate compared to non indigenous or general canadian population
What is the ratio of first nations being diagnosed of lung cancer?
1:7
Where is the most smoking done? and why?
- on reserve and bc they have easy access to tobacco as it is promoted
What is tobacco viewed as in the first nations cultures?
- sacred medicines
- medicine for healing or giving thanks to the creator
What are the 4 sacred medicines in first nations cultures
- cedar
- sage
- tobacco
- sweetgrass
What are the uses of tobacco?
- sales to provide an income for your family (on-reserve)
- smoking it as a coping strategy for salient issues
- loss of culture
When was the Indian Act made
1886
What is the Indian Act?
a person means an individual other than an Indian
- they had to wear a tag to differentiate them
When did residential schools start and by who?
- 1857
- by the church
When did the government of canada take over residential schools?
- 1880
What was bad at residential schools?
- decline of nutrition
- denied dental care
-1:25 children dying in schools
-the children died but experiments still continued
-experimental mix of pablum caused more anemia and more deaths
Who is Jordan Anderson
a guy that died in 2005, bc of federal and all governments on who to pay for him
When was the last residential school closed
1996
What is the jordan’s principle
- put in effect in 2017
- legal across all of canada
- ensures equality and no gaps in publicly funded health social and educational programs services and support for First Nations children between the ages of 0-17
- over 250 000 claim to this principle
What are the odds of dying for children in Indian residential schools
1 in 25
What are the odds of dying for canadians serving in WWII
1 in 26
Who are metis people
-mixed first nation and european
- great political body
- sometimes people say ur metis when you trace your ancestory back to red river (louis riel)
- large community in ontario
Who are Inuits people?
- inuit means it includes land, water and ice
- there is a growing population in ontario especially in ottawa and toronto
What are the 4 indigenous health disparities
- suicide mortality: higher in areas with higher concentrations of indigenous peoples especially amongst areas with a larger number of inuit men.
- mental health
- chronic illness: higher rates of asthma, arthritis, diabetes, and obesity typically higher amongst first nations adults
- tuberculosis: inuit in canada have a TB rate that is 300 times higher than that of the rest of the country
What is that stat of smoking on reserve and off reserve
- 50% of first nations living on reserve or in community and 43% off reserve reported smoking cigs daily (20 years and older)
- 22% dont
Who smokes the most and how many on reserve and off reserve
20 to 29 year olds
- 67% on reserve and 48%
A pattern of first nations with tobacco use
12-17 year olds 7 and 3 times higher in on reserve and off reserve youth
What is the medicine wheel
its used by the Ojibway people to how to be healthy. living a healthy means to have a balance between spiritual, physical, emotional and health
What is the infinity symbol and when was it invented?
- represents strength and continuity of the metis nation
- 1816
IQ is the tribe name lol
What does colonialism mean?
- a practice if domination which involves the subjugation of one people to another
What is the two row wampum?
- contract and treaties
- represents two distinct nations working together often the metaphor is the image of a canoe and a ship travelling side by side not interfering with each other but heading in the same direction
What does the ojibway creation story say
- the own people fight each other
- the creator decided to purify the earth
- made a flood killing everyone
- only nanabush survived
- turtle, hell driver, and loon tried to get land to make earth but failed
- the muskarat got earth but died and the turtle grew the the earth on his back and the island is now north america
Cree creation story
- two people walking on clouds saw a black speck and found the black hole
-the firt animal that goes down onto earth is the carbiou and the fisher helped him down - the bear teaches them everything they need to know in the world and thats why they call the bear the brother
Inuit creation story
- raven made the world in the waters with the beats of his wings and he had the powers of both a man and a bird and he couldd change by pulling a mask off
- he created land and water with peapod plants and 5 days later a peapod burst open and a fully grown man came out
- he supplied the man with raspberries and limited him to food so it doenst run out by planting things away
- raven built a figure out of a clay which was a woman and gave him to the man saying its your companion
What is the land
- the air the water the earth the plants the animals and all animate and non animate things as spirits that occupy the place
anishinabek means…
land
where are social relationships formed
land
what are direct disposession (environmental disposession)
mining and forestry
what are indirect disposession (environmental disposessions)
residential schools, which erodes connection to the land and sharing of indigenous knowledge
How many active physicians are there and what percent are male and female
86 092 43% female 57% male
How many physicans practice in rural areas
8%
How many of the medical school 2024 class is racialized and how many are first in family to attend medical school
55%
83%
