L4 Flashcards
Health disparities
inequalities or gaps in health or health care between group that affects the differences in morbidity and mortality rates between them
Health disparities in indigenous peoples
lower life expectancies, higher infant mortality rates, lower self-reported health, higher rates of illness, up to 4x more likely to experience various kinds of stress and trauma, 5x more likely to commit suicide (11x for Inuits)
2 possible mechanisms linking poverty and diabetes in Indigenous peoples
lower income and education result in (1) fewer healthy dietary options, less consumption of traditional foods, and (2) elevated cortisol levels, which increase blood glucose levels
What traumatic stressors were caused by European colonization?
new diseases, loss of land, criminalization and loss of culture, genocide, and forced assimilation
What is the most significant social determinant of Indigenous health according to WHO?
colonization
Intergenerational trauma
trauma passed down to subsequent generations
What are some direct and indirect mechanisms involved in intergenerational trauma?
direct experiences with trauma, vicarious trauma, lack of culture or culture identity, ongoing marginalization and discrimination, genetic and biological vulnerabilities, loss of ability to cope and parent effectively due to PTSD
Epigenetics
the study of changes in organisms caused by changes in gene expression (not DNA) due to environmental influences
Intergenerational epigenetic effects
epigenetic changes can be heritable via various processes and can affect multiple generations (at least 2)
How does the attendance of parents in residential schools affect their adult children?
For adult children with whose mother and father both attended residential schools, they have higher self-reported childhood adversity (e.g. family conflict and level of stress at home); Maternal attendance has a direct (possibly epigenetic) effect on allostatic load of adult children
Cultural identity clarity
a sense of confidence in knowing, expressing, and belonging to one’s culture
Benefits of making efforts to reclaim one’s culture
decrease in youth suicide, improved education, and fewer children being placed in foster care
Which types of Canadian neighborhoods had the highest COVID-19 death rates?
those with lower income, people who are a visible minority, recent immigrants, born outside of Canada, or who speak neither english nor french (especially men)
What is a common behavior between high- and low-ranking baboons?
displacement aggression, leading to chronically elevated stress hormones and high levels of obesity in low-ranking baboons
How is status related to health?
low status leads to the experience of stress, which results in increased morbidity and mortality
Impact of low-SES on the experience of stress
low-SES individuals experience more frequent and chronic stressors, have a tendency to interpret stressors as more threatening, and cope less effectively (increased allostatic load)
What are 2 of the most potent stressors in terms of SES?
social ordering and dominance hierarchies
Biological embedding model
childhood adversity gets programmed into the immune system through multiple mechanisms like epigenetics (e.g. immune cells develop pro-inflammatory tendencies that manifest throughout life and contribute to increased chronic disease)
Shift-and-persist approach to overcoming low-SES adversities
(1) shifting one’s perspective on stress with acceptance and adapting through reappraisals; (2) persisting by maintaining meaning and optimism
Key factors in the link between income and health
social status, individual income, reverse association, social cohesion (affected by level of inequality), social disinvestment in health-promoting resources
Reverse association
poor health interferes with an individual’s ability to secure and maintain employment
2 factors that cause the negative impacts of social inequality
heightened levels of competition and social evaluation anxiety
Social evaluation anxiety
increased stress due to greater threats to self-esteem, social status, and fear of judgement
Stigma
negative attitudes and behaviors based on group membership or affiliation
Marginalization
treatment of person or group as less important
Minority stress model
stigma, prejudice, and discrimination create a hostile social environment, leading to increased stress for minorities and increased incidence of disease and illness
Illnesses common among African Americans
stroke, diabetes, perinatal disease, some cancers, depression, substance abuse
Illnesses common among LGBTQ+ individuals
immune dysfunction, some cancers, substance abuse, depression, anxiety, attempted suicide
Specific sources of stress among minorities
direct experiences of discrimination, prejudice, and harassment; social stigma; internalized bias and stigma; rejection and expectations of rejection (in hiring, applying, social situations); having to hide or conceal identity
What 4 factors are associated with greater resilience to poor health outcomes among racialized groups?
subjective social status, perceived social support, racial socialization and identity
What 3 factors are associated with psychological well-being and lower risk of suicidality among trans people?
personal mastery or control, support-seeking and social support, emotional coping (especially positive reappraisal)
