Social and Cultural Factors that Impact the SLT

Question 1

What are health inequalities?

Answer 1

“Health inequalities are avoidable, unfair systematic differences in health between different groups of people” (The King’s Fund, 2020)

Question 2

Who is vulnerable to health inequalities?

Answer 2

Some groups of people may be more vulnerable to health inequalities, because they are under-served by the health, social, education or othersystem due to:
Socio-economic factors
Geography
Specific characteristics including those protected in law, such as sex, ethnicity or disability.
Socially disadvantaged groups, eg people experiencing homelessness. (The King’s Fund, 2020)

Question 3

How can SLTs address health inequalities?

Answer 3

An SLT must be able to provide personalised and equitable care to all service users who require it, thus understanding each individual’s preferred language, culture, religion, family setup, attitudes toward their health status, beliefs on approaches to play, language or rehabilitation is imperative.

Having well-planned, accessible, equitable, and appropriate care pathways, resources, assessment materials and workforce are all essential to mitigating health inequalities.

Help service user

with health literacy
to overcome a language barrier
overcome digital poverty
understand health risks and choices through reasonable adjustments to their communication needs
support early years development in their awareness of diverse cultural and social communication environments
use general health campaigns e.g., refer to smoking cessation
access groups
overcome economic poverty
ensuring equal access to information e.g., brail or easy read for aphasia

SLTs recognise that adherence to expert dietary guidelines will vary due to food beliefs and practices which will impact on dysphagia management.

At a personal level the service users’ preference, taste, psychological state is considered.

At an interpersonal level, the patterns of the household, food preparation and habits of significant others are investigated.

At a community level the food availability and prices which could influence the accessibility of modified food and food choices are also taken into account.

Question 4

What is implicit or unconscious bias?

Answer 4

“associations outside conscious awareness that lead to a negative evaluation of a person on the basis of irrelevant characteristics such as race or gender.” (FitzGerald and Hurst, 2017).

Question 5

What did Hall et al (2015) find?

Fitzgerald & Hurst (2017) - gender

Answer 5

Implicit bias is present among healthcare professionals

Mixed evidence for impact of implicit bias on health outcomes

Seems to be a relationship between racial/ethnic bias and the interactions between clients and clinicians

Gender differences in implicit bias and experience of biased interactions

Question 6

Cooperative learning

Answer 6

Cooperative learning lessons are engineered so that students must teach and learn from one another

Expected outcomes include interpersonal attraction, perspective taking, social support, and constructive management of conflict

Result in a positive impact of cooperation on outcomes such as positive peer relationships and helpfulness (Johnson and Johnson, 1989)

Question 7

Examples of reducing prejudice through entertainment

Answer 7

Stories are channels for communicating social norms, descriptions of what peers are doing (and therefore, what the reader or listener should do) Bandura (1986).

Narratives encourage perspective taking (Strange, 2002) and empathy (Zillmann, 1991)

Question 8

Contact hypothesis

Outward bound camping expedition (Green and Wong, 2008)

Answer 8

Outward Bound Camping expedition

54 randomly assigned white teenagers to racial homogeneous groups or heterogeneous groups (Green and Wong, 2008)

Survival techniques taught under Allport’s (1954) conditions for ideal inter group contact: equal status, a common goal, authority sanction and intimate contact

One month after the 2/3 week trip
White teens that were in the heterogeneous group reported less aversion to black people and homosexuals and described themselves as less prejudiced compared to the teens in the homogeneous group.

However, this has not been proven in a real life setting

Question 9

Rokeach (1971) Value confrontation technique

Answer 9

Lecture to college students about fictitious research findings that people who value equality are more likely to be sympathetic towards black Americans’ civil rights
17 months later students in the lecture and the no lecture conditions increased their support for black civil rights

This could be explained in terms of exposure to the more liberal college atmosphere