WEEK 4 Flashcards
What is the impact of widening access to medical education for under-represented socioeconomic groups?
Suggested that students who train in a demographically diverse medical school have educational and professional benefits
What are the educational and professional benefits from the widening access scheme?
Medical students gain greater understanding of others and their socioeconomic backgrounds
What is the view of the NHS Constitution and Plan & Care standards?
Incorporates the need to be responsive to different groups
What are the different population groups?
Ethnicities, religions, genders, race, sexuality, disability, class, geography
What are three examples of policy drivers in the past?
1) Sex Discrimination Act 1975
2) Human Rights Act 1998
3) Race Relations Amendment Act 2000
What are two examples of misleading beliefs?
1) ‘not racist, we treat everyone the same’/’All Lives Matter’
2) never experienced racism/discrimination
What does BaME stand for?
Black and Minority Ethnicities
What is one benefit of religions on health?
Most religious rules are salutogenic (healthy rules)
What is intersectionality?
The interaction of interlocking influences on health outcomes
Give an example of intersectionality in healthcare
Better maternity services located in hospitals in more affluent areas, women from poorer areas with higher ethic diversity find it harder to access these services
What are five factors affecting intersectionality?
1) Ethnicity
2) Location
3) Poverty
4) Access to services or education
5) Gender
What is Inverse Case Law?
The tendency for those with the greatest need and propensity to benefit to get the least
Give an example of the Inverse Case Law
non-white patients less likely to be given advice, have BP checked or wait longer for treatment (not necessarily discrimination)
What is the purpose of the 2017 ‘Race Audit’?
To identify the relative health risks of ethnicities compared to the White population
What was one thing identified by the 2017 ‘Race Audit’?
The general health of women is significantly worse than men in ethnic minorities
What is an ethnic disease?
A disease that disproportionately discriminates against a specific race/races
Give three examples of ethnic disease
1) Cystic fibrosis (disproportionately affects white ethnicities)
2) Tay Sachs (disproportionately affects Jewish population)
3) Sickle Cell Anaemia (disproportionately affects african ethnicities)
Give an example of ethnicity-specific risk threshold differences
WHO introduced differential risk for South Asians’ BMI overweight and obese brackets
What are the characteristics that define the three key parameters of difference?
Primary characteristic, origin and associated perceptions
What are the three key parameters of difference?
Race, culture and ethnicity/ethnic group
What is the primary characteristic of race?
Inherent, physical, natural
What is the origin of race?
Genetic
What is the associated perception of race?
Permanent
What is the primary characteristic of culture?
Behavioural expression of preferred lifestyle
What is the origin of culture?
Upbringing
What is the associated perception of culture?
Capable of being changed/optional
What is the primary characteristic of ethnicity/ethnic group?
Identity, multi-faceted, ‘political’
What is the origin of ethnicity/ethnic group?
Social construct, internal/external, legal
What is the associated perception of ethnicity/ethnic group?
Situational/negotiated
What makes up culture?
Religion Language Art Diet (food) Music Family Shared history (impact of racist experiences)
What are the three factors affecting access to and outcomes of healthcare?
‘Provider’, structural and ‘consumer’
Give three examples of factors influencing healthcare inequality due to the ‘provider’
1) Clinical practitioner competence
2) Referral patterns
3) Interpreter and translation provision
Give two examples of factors influencing healthcare inequality due to structure
1) Resources/provision
2) Geography
Give two examples of factors influencing healthcare inequality due to the ‘consumer’
1) Cultural differences and specificity
2) Genetic differences
What are communication methods to help with different groups?
Language support (interpreters)
Symbols (but these differ between places/cultures)
Signifiers and directions
Multi-lingual IT and web-based resources
How is death related to culture?
Preparing and dealing with death is linked to the fundamentals of any culture
What often provides the answer to preparing and dealing with death?
Religion
Define medicalised death?
Where medicine ‘takes over’ from religion/family (death taking place in hospital)
What are the 5 factors of medicalised death?
1) Professionals prepare body for funeral
2) Denial of death as failure of medical practice
3) Medical intervention interrupting ‘natural’ death
4) Negotiation between family and doctors on what’s desirable
5) Pt may express dying wishes to influence medical intervention
What are the concepts of palliative care?
built on openness/acceptance of being at the end of life, autonomy of the dying person, improving quality over quantity of life, at home/hospice rather than hospital
Give two examples of inequalities faced by BaME communities in palliative care
less likely to access palliative care services and undertake Advanced Care Planning
What is the problem with a factfile approach to cultural competence?
Too simplistic/overwhelming and causes individual preferences to be lost
What is the opposing approach to cultural competence that isn’t a factfile approach?
Openness and questioning
What is the ASKED model of cultural competence?
Awareness (of one’s background)
Skill (integrating knowledge in clinical practice)
Knowledge (about culturally diverse groups)
Encounters (engaging in and reflecting on transcultural interactions)
Desire (motivation and ‘wanting to’ engage)
What should also be incorporated into the ASKED model of cultural competence?
Acknowledgement and receptiveness to the vast differences in people’s lives
Why are funerals important?
Symbolic of beliefs
Important role for dead person’s family
Shaped by tradition (can be comforting)
Who may attend a funeral?
Group/neighbourhood
Roles/expectations for people involved
May be restrictive (public/private event)
Large scale collective mourning (celebrity/stately figure)
What are death rituals?
Symbolic actions performed at or after death, often religious
What are 5 general ritualistic functions?
Living say goodbye, progress with their lives
Living feel they have been able to respect the deceased person
Respectfully dealing with actual body
Alleviates guilt for survivors
May help grief/acceptance
What is a modern/new ritual stemming from social media?
memorial account-condolences
What are the three stages of life relating to religion even for people that may not be religious?
Hatching, matching and dispatching
Describe the usual process of a Muslim funeral
Buried, never cremated-ASAP
Body washed, Koran passages read and family prays
Body taken to mosque or graveside for prayers before actual burial
Not usually buried in a grave
Describe the usual process of a Sikh funeral
Cremation-ASAP
Coffin first goes to family home for people to pay last respects
Then taken to gurdwara/crematorium for service
Duty of heir of dead to light funeral pyre (push crematorium button in Britain)
Ashes taken and scattered
What are differences between death rituals to think about?
Involvement of family
Timing of funeral
Burial or cremation?
Symbolic clothing/items to accompany body
Who attends funeral and roles in service/ceremony?
