Culture, Ethnicity, Nationality, and Race

• The term test covers material from weeks 8-13.
• The test includes 50 questions in True/False, Fill-in-the-Blank, Short Answer, and Select All That Apply formats.

Week 9 Definitions

• Culture is a broad concept encompassing language, communication, and community.
• Ethnicity refers to a shared language, culture, origin, and ancestry.
• Nationality describes where people live or their citizenship.
  • This includes current citizenship or former countries of residence.
• Race is used to categorize people but lacks scientific basis; it is a social construct used to justify racism.
• Religion is a faith-based system with rituals and beliefs centered on superhuman entities, spirituality, or faith.

Week 8

• Culture is both implicit (suggested but not directly communicated through gestures and feelings) and tacit (understood without direct communication, learned through experience).

• FNMI communities in Canada are projected to exceed 2.5 million in the next two decades.

• The healthy immigrant effect is observed when immigrants arrive in countries like Canada, New Zealand, and Australia with relatively good health that declines over time.

  • Foreign-born minority women are particularly vulnerable to this decline.

• Erosion of the healthy immigrant effect can be attributed to acculturation (adopting unhealthy lifestyles), stressors (discrimination, underemployment, social isolation), and barriers to healthcare (language, cost, unfamiliarity).

• New immigrants face challenges impacting healthcare access such as language barriers, racism affecting job attainment, episodic healthcare treatments hindering health promotion, social isolation, and experiences of refugee camps that increase PTSD risk.

  • New Canadians may need to wait up to three months for provincial health coverage.

• Race is a social construct without scientific basis that is used to justify racist notions.

• Culture is a broad concept including language, communication, relationships with the land, food, rituals, art, customs, beliefs and attitudes.

• Racialization in healthcare can lead to inaccurate assessments and negative profiling.

• The cycle of oppression helps to understand how stereotypes and prejudice cause societal and systemic oppression.

  • Discrimination results from actions or inactions based on prejudice.
  • Oppression is discrimination supported by systemic power, often unconsciously within health systems.

• Cultural competence allows nurses to plan effective, culturally specific healthcare interventions via a lifelong process.

• Cultural safety ensures effective nursing practice that addresses power dynamics and allows patients to feel safe when approaching healthcare services.

• Cultural humility enhances culturally safe care via self-reflection.

• Racism in nursing presents as barriers to health equity and social justice.

  • It is expressed in values, culture and their application to nursing.
  • It is present in education about race, settler privilege, systemic racism, white privilege, and nurse education.

• Ecological determinants of health are necessary to sustain all life forms on earth.

  • They comprise interacting ecosystems or the "natural goods and services" essential for life

• Indigenous traditional knowledge about ecosystems is linked to the land.

  • It reflects the diversity of Indigenous people around the world
  • Ancestral relations with land = Traditional Ecological Knowledge and Wisdom

• Segments of the population susceptible to weather and environmental extremes include children (due to pesticide exposure), older adults (vulnerable to heat waves), and First Nations (due to inadequate housing).

• Two-Eyed Seeing as a holistic concept, helps overcome the prevailing Western dualistic thinking and opens possibilities for the relationship with the environment

Week 9

• Neoliberalism is a policy model transferring control of economic factors from the public to the private sector.
  • An example of this would be group homes privately funded, but by the government.
• Neoliberal policies shift public services to private hands, reducing access for low-income communities, turning basic needs into profit-driven commodities, and undermining community control and accountability.
• Outcomes of Neoliberalism are reduced public spending, gentrification, and displacement.
  • Racialized populations are more likely to be poor
• Rural poverty is more isolated, less visible, with fewer safety net supports, unlike urban poverty, which are more populated.
• Low-income cut-off (LICO) is a relative measure based on income thresholds (before and after tax) where a family spends 20% more of its income than the average family on necessities.
• The Market Basket Measure determines the income needed for a family (two adults, two children) to afford basic goods and services.
• Upstream interventions to improve food security include advocating for increased minimum wage, increased social assistance, and affordable housing/childcare.
• Groups more likely to develop mental health challenges include chronic oppressed groups, women, Indigenous peoples, visible minorities, LGBTQ individuals, homeless individuals, refugees, and persons with disabilities.
• Bullying impacts mental health, addressed through trauma-informed approaches.
• Groups with higher suicide rates include First Nations, those aged 40-59, and LGBTQ individuals.

Week 10

• Aboriginal is a colonial term by the Canadian government for all First Nations, Métis, and Inuit peoples.
• “Colonial” refers to power exerted by the dominant culture of settlers over the Indigenous people to maintain authority to replace the original population
• Indigenous refers to original peoples of land/descendants, used by the UN to uphold Indigenous human rights.
• First Nations refers to original nations in modern Canada below the Arctic.
  • They are either status or non-status Indians; Arctic Indigenous people are the Inuit.
• Métis are mixed-race descendants of unions between First Nations and European settlers (18th-19th centuries), and who speak French as the first language.
• Cultural safety through reflective practices is needed for nurses when working with First Nations communities.
  • It is based on honoring Indigenous peoples and respecting their rights, health, well-being, and dignity of culture.
  • Nurses have a key role in stopping Colonial narratives perpetuated by stigmatization.
• FNMI populations access acute care services via systems interfacing with the Canadian health care system, as hospitals are a provincial responsibility.
  • First Nations and Inuit health branches provide care for those on reserves.
• Housing on FNMI reserves is often subpar, with high rates of TB compared to non-Indigenous populations.
• Significantly higher life expectancy can be found in urban areas due to the following: healthcare access, infrastructure, education, and public health programs.

Week 11

• Inmates in Canada have a right to the same level of healthcare as non-incarcerated people, but that is often not the reality.

• The five levels of prevention identified week 11 are primordial, primary, secondary, tertiary, and quaternary.

• Primordial prevention is the newest, primary aims to prevent disease onset, secondary is early disease detection, and tertiary aims to prevent worsening of existing diseases.

  • Correctional nurses typically deal with the three highlighted levels of prevention

• Quaternary prevention deals with overmedicalization.

• What factors contribute to the over-representation of certain visible minorities in the prison system?

• The John Howard Society supports neighborhoods, protects communities, and rebuilds lives.

• The John Howard Society provides programs/services for people affected by the justice system to develop key life skills/navigate issues of criminal justice.

• Report spousal abuse to police

• Factors associated with violence, power and control wheel

Week 12

• Commonly abused substances include marijuana, alcohol, prescription drugs, and nicotine.
• Smoking is a leading cause of death in Ontario.
• The four pillars of Canada’s drug and substance strategy are harm reduction, prevention, treatment and enforcement.
• Factors contributing to substance abuse: interpersonal violence, military service, incarceration, homelessness, and concurrent disorders.
• Public stigma involves negative attitudes/stereotypes labeling substance users as morally weak/dangerous, leading to discrimination/social exclusion.
• Self-stigma involves internalizing society's negative beliefs, causing shame/guilt/low self-worth, reducing motivation for treatment/fostering hopelessness.
• Structural stigma consists of policies/practices penalizing substance users, such as punitive drug laws/limited funding for addiction programs.
• Courtesy stigma extends to people associated with the substance user, which can reduce the support network/discourage open discussion about the problem.
• Goal of harm reduction is to reduce drug-related harms without requiring cessation.
• Medically supervised injection sites, street outreach, needle exchange, and methadone maintenance treatment programs are strategies for harm reduction.

Week 13

• Natural disasters occur unpredictably/quickly and examples include floods, droughts, earthquakes, tsunamis, and volcanoes.
• Human-made disasters involve mass civilian injuries and deaths including bioterrorism, bombings, and technical disasters.
• Epidemics occur when infectious diseases spread rapidly affect large numbers in a population
• Pandemics occur when the infection goes worldwide.
• Bioterrorism is a human-made disaster that uses the release of bacteria/viruses/other pathogens to cause harm.
• Agent Orange which was used by the US military in the 1960s in Vietnam as herbicides/tactics to deprive the opponent of its food supplies.
  • Tcdd is the toxic chemical in Agent Orange.
• The Public Health Agency of Canada provides leadership in promoting health and investigates/controls disease.
  • It also supports public health infrastructure and fosters collaboration between governments.
• The five phases of emergency management include prevention, mitigation, preparedness, response, and recovery.
  • Prevention focuses on stopping hazards from occurring.
  • Mitigation seeks to reduce the loss of life/property.
  • Preparedness involves planning/organizing/training/equipping/exercising/evaluating/taking corrective action.
  • Response is the reaction to a catastrophic disaster/emergency.
  • Recovery involves activities beyond the emergency, to restore critical functions/manage stabilization efforts.
• Ischemic heart disease is the top cause of death worldwide.
• Most maternal deaths can be prevented through healthcare access during pregnancy.