Priority Populations Flashcards
Describe 3 core tenants of the UN Declaration on the Rights of Indigenous Peoples
- Recognise equality, right to be free from discrimination, and promote inherent rights of Indigenous peoples
- Autonomy and self-determination
- The need to respect treaties
List and describe 3 articles from the UN Declaration on the Rights of Indigenous Peoples directly related to health.
Article 17: protect Indigenous children from work that is likely to harm their health or development
Article 21: the right to economic and social conditions including housing, sanitation, health and social security
Article 23: the right to development and determining health, housing, and other economic and social programs affecting them
Article 29: States shall take effective measures to ensure programs are in place for monitoring, maintaining an restoring health, developed in collaboration with people affected
Define the following terms as outlined in the Indian Act (1876):
Registered Indian
Treaty Indian
Non-status Indian
Indian Reserve
Registered Indian: registered under the Indian Act with status, entitling the person to receive rights and benefits as outlined in the Indian Act
Treaty Indian: a person belonging to a, Indian band that signed a treaty, entitling them to treaty benefits
Non-status Indian: a person who self-identifies as First Nations but not entitled to registration under the Act
Indian Reserve: tract of land set aside under the Act or treaty agreement for exclusive use of the band
List 5 calls to action related to health from the Truth and Reconciliation Commission (2015)
- Acknowledge that the current state of Indigenous health is a result of prior government policies
- Close health gaps and publish annual reports (health status assessment)
- Address distinct health needs of FNI&M people and off-reserve Indigenous people
- Funding for Indigenous health centres with a priority on Northwest Territories and Nunavut
- Recognize the value of Indigenous healing practices
- Increase the number of Indigenous healthcare workers
- Education and cultural competency in medical and nursing schools
What is OCAP? List and describe each of the 4 principles.
OCAP stands for Ownership, Control, Access, and Possession. It is the standard for managing data for research conducted with First Nations communities, developed by the First Nations Information Governance Centre.
Ownership - the FN community collectively owns the data
Control - FN community controls the information collected for research and dissemination
Access - the right to manage and make decisions regarding access to their collective information. This may be achieved, in practice, through standardized, formal protocols.
Possession: possession or stewardship is more concrete: it refers to the physical control of data. Possession is the mechanism by which ownership can be asserted and protected.
E.g. data storage
List 8 priority topics to cover in a health status assessment for First Nations populations in Canada.
- Life expectancy
- Infant death rate
- Unintentional injury incidence and mortality
- Cancer incidence and mortality
- Cardiovascular disease prevalence and mortality
- Type 2 diabetes prevalence
- Tuberculosis prevalence and mortality
- HIV prevalence and mortality
List 4 elements of trauma-informed care
From the Royal College Indigenous Health Primer
1. Patientcentered communication and care
2. Understanding of the health effects of trauama
3. Interprofessional collaboration
4. Understanding your own history and reactions
5. Screening
Describe 4 parts of the cultural safety continuum and 3 elements of culturally safe care.
From the Royal College Indigenous Health Primer
4 parts of the cultural safety continuum:
1. Cultural awareness
2. Cultural sensitivity
3. Cultural competency
4. Cultural safety
3 Elements of culturally safe care
1. Building trust
2. Recognising the impact of social determinants and politics on health
3. Ensuring the patient is a partner in decision-making
The infant mortality rate is significantly higher in the Inuit population compared to non-Indigenous Canadians. List 3 possible explanations for this.
Using the determinants of health framework.
- Poor access to prenatal care in rural and remote Northern communities (proximal determinant)
- Low cultural competency amongst healthcare providers due to inadequate cultural competency curricula in medical training. (intermediate determinant), leading to culturally unsafe healthcare environments for Inuit patients.
- Systematic devaluing of Inuit communities leading to inadequate funding and health Human Resources in Northern communities (distal determinant)
List 3 positive social determinants of health in First Nations populations that are protective for health and wellbeing.
- Connection to land
- Connection to food
- Connection to community
Define the following terms: power, privilege, stereotyping, prejudice, discrimination, anti-oppressive practice, and stigma
Power: the ability to influence the course of events or the behaviour of others
Privilege: benefits not available to everyone
Stereotyping: viewing someone based on generalisations we make about their group (how we think)
Prejudice: holding a judgemental attitude and negative feelings toward a person, based solely on their membership to a group (how we feel)
Discrimination: treating someone differently because of their membership to a given group (how we act)
Anti-oppressive practice: acknowledging power differentials that arise through social differences
Stigma: the negative association between a person or group of people who share certain characteristics and a specific disease (WHO)
Describe 3 ways in which racism impacts health.
- Delayed medical diagnosis and treatment due to healthcare providers stereotyping a patient. E.g. delayed diagnosis of sepsis due to assumption that an Indigenous patient with altered mental status is intoxicated. (Interpersonal level)
- Overcrowded housing on reserve due to inadequate funding and supports, leading to higher secondary transmission of communicable diseases such as tuberculosis. (System level)
- Internalised racism and self-hatred as a result of cultural genocide from residential schools and subsequent intergenerational trauma leading to poor mental wellness, mental illness, and substance use disorders (Internalised; system and structural level)
Define the healthy immigrant effect
A phenomenon where foreign-born status is associated with better health outcomes due to the immigration process that selects for healthy, well-educated adults with healthy lifestyles (applies to economic migrants).
According to new immigrant and refugee screening guidelines, list 3 communicable diseases, 3 vaccines, and 3 chronic diseases that should be screened for.
From Pottie et al, 2011 CMAJ
- CDs: HIV, Hep B, Hep C, intestinal parasites (schistosomiasis, strongyloides), TB, Malaria
- Vaccines: MMR, Varicella, dTap, Hep B
- Chronic diseases: diabetes, dental diseases, visual acuity, iron deficiency anemia
Others
4. Psychosocial: depression, PTSD, child abuse, intimate partner violence
5. Women’s health: contraception, cervical cancer, pregnancy
Define homelessness
lack of stable, permanent, appropriate housing, or the immediate prospect, means and ability of acquiring it
