KNPE 335 Final Flashcards
Health Inequity
unjust or unfair differences between persons, often rooted in social, economic, environmental or systemic conditions that disadvantage certain groups
*preventable
examples of inequity
more infant mortality in lower income places, access to healthcare, race, gender etc
Health Inequaltiy
observable or measurable health differences in health status or outcomes among different population groups
*differences quantifiable
*natural result of diverse pop
examples of inequality
varying life expectancy, mortality rates, older adults are more susceptible to chronic illness
Diversity with aging
as people age, experiences of health, support andn well being vary based on social det. of health which can lead to inequalities naturally
Health inequality in aging
measurable differences in health outcomes among older adults
-often result from many factors
Health inequity in aging
often stem from lifelong disadvantages such as poverty, racism, limited access to healthcare, affecting adults late life
*preventable, reflects social injustice
ex. rich ppl get better healthcare
links with health outcomes
-physical and mental inequities
-socio-economic factors
-poverty and disadvantage
inequities and inequalities relates to survival from various health conditions are closely linked to
age, sex, ethnicity
risk factors for senior risk of isolation, health inequality & inequity
-age and gender
-ethnicity
-social relationships
-poverty/lack of resources
-sexual & gender identity
-geography
-life transitions
-health&disability
-knowledge & awareness
opposite of a risk factor
in some cases the opposite of a risk factor is a protective factor
Indigenous peoples in canada
-were in good health prior to colonization
-included nutritious diets, rich and diverse healing systems and active lifestyles
how did contact with european settlers greatly affect health outcomes and continues to affect their health
-poorer health outcomes
-suffer from more chronic illnesses and disabilities (heart disease and diabetes)
direct causes of poor health outcomes for indigenous people living in canada
embedded racism & loss of support system
*type 2 diabetes continues to be 5 times more common against indigenous due to historical trauma and land dispossession
example of systemic discrimination
residential school system; loss of cultural identity is a loss of health
which entho-racial groups have higher risks of developing dementia
Black, hispanic/Latino, Native Hawaiian/Pacific Islander
*differences persist despite similar rates of cognitive decline
risk and expression of dementia are influenced by
social determinants, discrimination and access to healthcare
disparities in dementia care
access, diagnosis and outcomes
influential factors of disparities of dementia:
socioeconomic status, cultural diversity and geographical location
how are 12 risk factors of dementia influenced by inequities
lower income ad minorities face more barriers to managing risk
Prescription drug access
-insurance generally does not cover this
-people w private insurance plans have better access
-many older adults, indigenous and immigrants struggle to afford meds leading to poor adherance and health outcomes
Oral health inequities
-affect older adult
-often based on income and private benefits not provincial plans
why do many older adults avoid dental care
high costs
how does poor oral health impact overall health for older adults
-lost/broken teeth affect nutritional status = additional health complications
-stigma around poor oral appearance can affect mental health leading to social isolation
older adults who are caregivers
-face additional inequalities
-increase burden, depression, stress, financial problems, poor health, loneliness & social isolation
spousal caregivers
-at greater risk of experincing loneliness and decreased social support
proportion of seniors who are also caregivers
almost 1/4 aged 65 and older
female caregiver inequity rates
female caregivers tend to feel more inequities than male counterparts
Caregiver interventions that are proven to reduce inequalities and inequities
-physical and financial support through informal assiatance
-respite services
-home care or related services
-income and tax relief programs
-education and skills training
-psychological support
-interavtive online activities and groups
population of older adults that are immigrants
3.3%
Older adult immigrants in canada
-immigrant older adults are significantly lonelier
-lower prevalence of successful aging
Healthy immigrant effect
immigrants are generally healthier than domestic-born Canadians when they first arrive
Hypothesis explaining healthy immigrant effect
only people who are healthy migrate
Inclusive healthy aging interventions for immigrant older adults in canada
-additonal data collection research on immigrant older adults
-culturally and linguistically appropriate programs and services
Older adults in rural/remote areas
-increased risk of social isolation, smaller support networks, greater loneliness and lower utilization rates of health and social services
-increased risk of morbidity, obesity, diabetes, heart disease, cancer, COVID and excess mortality
what percent of seniors live in rural areas
23%
what are rural populations considered
a health disparity group in part because these populations have higher rates of mental illness, chronic disease & worse general health
strageties for improving healthy aging in rural areas
-Reducing
-joining
-developing
-improving
-stimulating
Strageties for improving HA in rural areas: Reducing
reduce health inequalities by providing older people with better access to healthcare services (more centers/programs)
Strageties for improving HA in rural areas: Joining
joining transport, housing, healthcare services to improve cost-effective service provision and access to services (all services in one area)
Strageties for improving HA in rural areas: developing
-cost effective transportation solutions to afford accessability and better social integration
-developing volunteer/community based initiatives to improve social integration
Strageties for improving HA in rural areas: Stimulating
bottom up socal enterprises and collaborative ventures to improve economic diversity of rural areas to encourage FURTHER DEVELOPMENT
Low income older adults
-one of most financially vulnerable canadian populations (esp people who live alone)
-increased risk of loneliness, social isolation, poor health outcomes, lower QoL and premature mortality
rate of older canadians living in low income has increased from
12.1% to 14.1% in 2016
Higher income older adults
experience more years of good health and better QoL
Programs and Services to help low-income older adults
- Income assistance
- Provincal and teritorial programs
- Residental rehabilitation assistance program (RRAP)
- Avance life deferred annuities (ALDAs)
- Variable life payment annuities (VPLAs)
Healthcare professionals - increasing cultural competence in HA
Awareness, Knowledge and skills (learn about their own personal biases and prejudices)
4 characteristics of aiming for culturally sensitive healthcare
- Under-served needs
- Cultural targeting (not one size fits all)
- Patient care/ health literacy (patients have a voice)
- Cultural Competence
cultural competence in healthcare
culturally sensitive care is essential to address diverse needs and promote healthy aging among all older adults
Low income impact
financial vulnerability among older adults leads to worse health outcomes and lower QoL
most tolerated form of social discriminationin canada
ageism
what percent of canadians would treat someone differently because of their age
35
unfamilliar negative expectations of old age
-twilight years
-golden years
-autonomy
-smelly
age related stereotype
cognitive structures embedding beliefs and expectations that people hold about different age stages
stereotypes of aging are
assumptions and generalizations about how people at or over a certain age should behave
2 types of stereotypes
- Explicit attitudes
- Implicit Priming
Explicit attitudes
-previously learned info’
- What people consciously endorse or believe
-direct and deliberate
-can be adknowledged
Implicit Priming
-associations that are outside of the conscious awareness
-unconscious and effortless
-indirect and automatic
-involuntarily active
stereotype content model
-2002
-all group stereotypes and interpersonal impressions form along two dimensions: warmth and competence
warmth dimension SCM
based on notion that people are evolutionarily predisposed to first assess a strangers intent to either harm or help them
competence dimension (SCM)
judge capacity to act on percieved intention
Low Competence, High Warmth
Paternalistic Prejudice
low status, not competitive pity, sympathy
ex. elderly, disabled, housewives
High Competence, High Warmth
Admiration
high status, not competitive pride, admiration
ex. in group close allies
Low Competence, Low Warmth
Contemptous prejudice
low status, competitive contempt, disgust, anger, resentment
High Competence Low warmth
Envious prejudice
high status, competitive envy, jealous
eg, asians, jews, rich ppl, feminists
Stone & Baker 2017
-self-efficacy and biomechanics related to stair navigation in older adults
-primed older adults can navigate stairs with more confidence and efficency
Barber et al., 2020
-stereotype threat can impair older adults physical performance
-dependent on tasks objective difficulty an participants subjective evaluations of their own resources
what categories did older adults claim to be thriving more compared to younger persons
-social
-financial
-community
-physical
What is ageism
how we think (stereotypes, feel (prejudice) and act (discrimination) towards others or ourselves based on age
Everyday ageism
occurs in day-to-day lives through interpersonal interactions and exposure to ageist beliefs, assumptions and stereotypes
percentages of everyday ageism
82% experience one or more forms everyday
65% exposure to ageist messages
45% ageism in interpersonal interactions
36% internalized ageism
3 types of ageism
cognitive (stereotypes)
Emotional (prejudice)
Behavioural (discrimination)
Cogntive ageism
how we think about agining and older adults
emotional ageism
how we feel about getting old
behavioural ageism
how we act towards getting older
Ageism in the workplace
can affect financial security and mental health
rate of workplace ageism
78% of older workers experienced/witnessed age discrimination at work
ageism in healthcare
prevalent through communication, diagnosis and treatment decisions
ageism in the media
negative portrayls, underrepresentation, and framing aging as the program
ageism in the legal system
ageism language, age restrictions and accessability
how does ageism shorten older adults lives
-poor physical health
-delay in injury or illness recovery
-decreased mental health
-increased social isolation and loneliness
-lower QoL
ageist effects on society
-shortens lives
-costs society billions of dollars
-causes conflict between generations
-causes loss of productivity in the workplace
-causes elder abuse (directly and indirectly)
rates of portrayl of older adults in the media
-96% positive portrayl under 50
-72% positive portrayl adults over 50
-15% of images are of 50+
disney roles of older characters
-39% of older adults had a major role
-80% were male
-many portrayed as neagtive or villanous
aging in the beauty industry
normative aging is associated with a loss of beauty. there is a direct link between body concerns and ageism
Categories of everday ageism (3)
- Exposure to ageist messages
- Ageism in interpersonal interactions
- Internalized ageism
most popular form of everyday ageism
“I see, hear and read jokes about old people, aging etc”
age stereotypes affects individuals well being how?
via physical and mental health, autonomy & how they see themselves