Final Exam Prep Flashcards
gender Inequality
sex-based differences: femaile having a MI presenting with upper back pain/fatigue
gender inequity
female gets sent home with no MI-work up
-5.80%
child poverty rate for those living in couple families
-26.20%
child poverty rate for those living in female lone-parent families
While the wage gap is declining, it is still significant with men earning hourly wages on average $31.05 and women $26.92
-eliminating various forms of gender-based discrimination is needed to close the gap
- improve access to employment insurance and create policies that make it easier for workplaces to achieve collective agreements through unionization.
ways to eliminate various forms of gender
gender-based inequity
non-racialized women earn 69 cents for every dollar non-racialized men earn
race-based inequity
Racialized men earn 76 cents for every dollar non-racialized men earn, Racialized women earn 85 cents for every dollar non racialized women earn
gender based + race based inequity (intersectionality)
racialized women earn 58 cents for every dollar non-racialized men earn
~63%
how much do women with a bachelor’s degree earn more than women with a highschool diploma?
~45%
how much do men with a bachelor’s degree earn more than men with a highschool diploma?
gender bias in access to federal research dollars
reviewers selecting researchers is more at a disadvantage to women
gender identity
internal awareness of gender
gender expression
social expression of gender
Cis
non-trans
non-binary
does not identify exclusively with one gender
two-spirit
indigenous term referring to having both a masculine and feminine spirit
gender non-confirming
expression of gender that transcends masculine/feminine stereotypes
gender dysphoria
discomfort with the disrepancy between gender identity and biological sex
a women living in a high-income neighbourhood in Toronto is ___ more likely to have up-to-date screening than a recent immigrant of South Asian descent who is over 50 and doesn’t have a general practitioner
4x
race
term for the classification of human beings into physical, biologically and genetically distinct groups
racism
can be defined as: a way of thinking that considers a group’s unchangeable physical characteristics to be linked in a direct, causal way to psychological or intellectual characteristics, an which on this basis distinguishes between ‘superior’ and ‘inferior’ racial groups
racialization
-process of constructing/constituting racial identities and meanings
individual racism
-pre-judgment, bias, or discrimination by an individual based on race
institutional racism
-policies, practices and procedures that work better for white people than for people of colour, often unintentionally or inadvertently
structural racism
- a history and current reality of institutional racism across all institutions, combining to create a system that negatively impacts communities of colour
researchers have identified numerous pathways to health inequities related to racism
- the psychological stress of living in a racist environment
healthy immigrant effect
an observed time path in which the health of immigrants just after migration is susbtantially better than that of comparable native-born people but worsens with additional years in the new country
racialized immigrants and specific health conditions
-cardiovascular disease
structural problems from the report from Saskatoon Health Region about Aboriginal women being coerced into tubal ligation immediately after childbirth
- 16 Aboriginal women contacted the reviewers and seven interviews were completed
Brian Sinclair
- died of treatable bladder infection in 2008 after being ignored in the emergency department
typical minimalist responses for race
-cultural competence training
solution to inequities and disproportionate access issues or disproportionate pathologization and criminalization including methodological and political issues that make the project of cultural competence suspect for over:
- individualizing the solutions
cultural competence
-promotes a colour-blind mentality that eclipses the significance of institutionaled racism
unconscious bias
-popular approach to diversity education
eugenics
the study of the agencies under social control that may may improve or impair the racial qualities of future generations
eugenicists
the sterilization and institutionalization of the mentally disabled all well as laws restricting immigration and marriage would improve public health
house of commons debates revealed that early 20th century psychiatry propounded the belief that persons with mental disabilities
were undesirable immigrants because they were by nature degenerates, dangerous and dishonest in disposition
section 3 of the Immigration Act of 1910: prohibited classes
- persons mentally defective
Dr. Helen MacMurchy’s the Almosts: A study of the Feeble-Minded
promoted eugenic ideas that advocated for segregation and sterlization to eliminate the feeble-minded, their economic costs and their criminal threat to society
MacMurchy
declared that the problem defective children could only be solved if special education and medical inspection were complemented by restricted of immigration
According to the Immigration and Refugee Protection Act, a foreign national is inadmissible on health grounds if their health condition is:
a) likely to be a danger to public health
blood and racism - societies of sanguinities
key ideological term that held class, sexuality and race together was that of blood. Fostered the need to protect the purity of blood
CPHA commited to a series of reforms in the following actions:
-will review and amend its systems and processes to eliminate those processes that could lead to racist behaviour within the Association
social accountability
-refers to the obligation of family medicine to meet the priority health needs of Canada’s neighbourhoods, communities, regions, and provinces
The Constitution Act 1982
-protects Aboriginal and treaty rights
context of indigenous health
- pre-contact
contemporary reality
- disproportionate apprehension of Aboriginal children by child-welfare agencies
systemic racism
-when acceptance of discriminatory and prejudicial pratices is normalized across our society, in public services and institutions
colonization process
fuelled by racist beliefs & ideas about Indigenous peoples; their ways of knowing and being, customs and practices
truth & reconciliation
- first task - to understand the ‘truths’ (historically, locally)
calls to action: health
- link b/w current state of FNIM health and government policies
Self-determination
-indigenous people have been engaged in global self-determining efforts to have control over their institutions, resources, knowledge and information systems
UNDRIP
Canada ~25 years of participation
Indigenous Rights
without discrimination:
United Nations Declaration on the Rights of Indigenous Peoples:
- Indigenous peoples have the right to their traditional medicines and to maintain their health practices, including the conservation of their vital medicinal plants, animals and minerals. Indigenous individuals also have the right to access, without any discrimination to all social and health services
Indigenous knowledge
is a central to culturally relevant exchange of health information
Indigenous scholars
have articulated the complex nature and importance of IK towards the culturally safe services for Indigenous populations
In the two-eyed seeing: model (p. 496), the role of IPAH is entailed as:
- researcher-community engagement
close the gap
-level the gradient
complete the circle
- promote Indigenous-centered ways
interventions & training
- initiatives to increase the number of indigenous healthcare providers
reflexive allyship
-personal commitment
institutional allyship
-community engagement
dish with one spoon:
-maintaining peaceful relations
medicine wheel:
-recognition of interdependency among four races of the world
4 R’s of Downey Research
- reclamation
health equity
defined in ways that espouse values of social justice and benevolence and is held up as an ideal state achievable by all
public health stakeholders
aspire to close the gap and level of gradient to reudce inequities though the implementation of various health equity focused strategies
the path of shifting towards promoting health equity
first: improve the conditions of daily life
the historical denial of the rights of Indigenous peoples is directly linked to socioeconomic disparities, including poor health outcomes
in understanding the gap for health inequities towards indigenous people,
paydshiquin
completing the circle; how one sees the world around us; suggests a constant, completeness and a balance
race assumes:
-humanity is divided into unchanging natural types
race implies:
-some aspects can be related to racial origin
limitations of the traditional stigma reduction strategy for protest
-can increase stigmatizing attitudes
limitations of the traditional stigma reduction strategy for contact
-only effective when face to face
limitations of the traditional stigma reduction strategy for education
-less effective for individuals with greater prejudice
implicit bias
- our unconscious attitudes towards people or groups and associated stereotypes
upstream determinants of health
-governance
downstream determinants of health (impacted by socioeconomic and political context and socioeconomic position)
-material circumstances
average life expectancy in Canada
84.0 years for women
average life expectancy in BC
84.6 years for women
average life expectany in Nunavut
73.4 years for women
geography of specific vulnerabilities & health risks in both rural and urban areas
ie. public policies that create housing insecurity intersect with racial discrimination & urban ghettoization directed towards recent immigrants of colour
climate pressures
-increasing temperatures
exposure pathways
-extreme heat and heatwaves
health outcomes
-heat stress and heat stroke
extreme heat
- heat waves
natural disasters and variable rainfall
a) weather related natural disasters have tripled since 1960s - 60k deaths annually - mostly in low-income countries
patterns of infection
lengthens transmission seasons of important vector-borne disease and alters their geographic range (ie. malaria and dengue fever, malaria kills over 400K people annually- mostly children under five living in Africa)
association
-relationship between two random variables (statistically significant), without understanding the direction of the relationship (ie. ice cream and crime)
correlation
-measure of the strength of the relationship between two variables (change of one based on change of another)
traditional hazards
-associated with lack of development: drinking water, sanitation, plumbing, indoor cooking etc.
modern hazards
-associated with unsustainable development: water pollution, industry, intensive agriculture, urban air pollution, vehicular traffic, climate change, ozone changes etc.
61
how many long-term drinking water advisories are in effect?
441
how many projects are to repair, upgrade or build infrastructure
all long-term drinking water advisories on public systems on reserves
will be lifted by March 2021
microplastics
tiny particles of plastic measuring less than 5 mm in diameter
United Nations Collaborative Programme on Reducing Emissions from Deforestation and Forest Degredation
which program was the first joint UN global initiative on climate change?
inhalation of lead particles
-burning materials containing lead (recycling; stripping leaded paint)
ingestion of lead-contaminated dust
-water (leaded pipes)
globalization
processes by which nations, businesses, & people are becoming more connected & interdependent via increased economic integration & communication exchange, cultural diffusion & travel
united nations: paris climate agreement
aim: reduce greenhouse gases
Grassy Narrows First Nation
made an agreement with the federal government for an on-reserve care facility which serves people in the community suffering from the effects of mercury poisoning
societal factors vs. societal forces
(ie. income and employment) help shape health and explain health inequities
early period for social policy in canada: evolving ideology (1867 - 1930s)
-limited ‘state’
middle period for social policy in canada: evolving ideology (1945 - 1970s)
-supported for state being more involved
neo-liberal period for social policy in canada: evolving ideology (1975 - present)
-reduced state involved (and provinces/municipalities expected to foot more of the bill)
positivism in health sciences
-reliance on quantitative approaches
SDOH discourse: 1. identify those in need
-assumptions that service provision will improve health
SDOH discourse: 2. Identify modifiable risk factors
-assumptoms that behaviour change will improve health
SDOH discourse: 3. living conditions shape health
-identify SDoH pathways - strengthens evidence base
SDOH discourse: 4. material circumstances differ among groups
strengthens evidence base - forms basis for anti-discrimination efforts
SDOH discourse: 5. health determined by public policy
attention directed at public policy
SDOH discourse: 6. SDoH distribution determined by government/societal ideology
structures needing modification are identified
SDOH discourse: 7. SDoH distribution determined by who has power in society
focus on wealth redistribution
pluralism
governments adopt good policy ideas
political economy
policies serve the ‘economic elites’
disengaged citizenry
the privileged person looks at the lived reality of the less privileged and assumes that the world works for others the way it works for themselves
national housing strategy
-cut chronic homelessness by 50%
better to improve QoL for children in poverty
why affordable child care is important?
Housing policy recommendations according to Raphael et. al. suggest:
-increasing funding of social housing programs for low-income Canadians
Housing policy recommendations accoding to RNAO (2009) recommends:
-policy to reduce discrimination in rental housing
-implementation NOT impossible but requires members of society to demand policy changes in health and health equity
upstream: welfare & government
when nursing duties and loyalties conflict with societal power structures and nurses blindly adhere to policies rooted in structural racism, patients are not longers the center of care
allyship and patient-centered care
-engage with movements that confront oppression (ie. BLM)
becoming a formidable ally
knowledge is inextricably linked to power…nurses have the capacity to both exercise and resist power, making nursing care inherently a political activity
knowledge as power
- dissemination
St.Michael’s stages of health equity
-chronic disease
poverty is a risk factor for many health conditions:
-adoption of health-threatening coping behaviours
unemployment can lead to: