Foundations in Health (Final) PDF

lOMoARcPSD|35249408 Foundations in Health (Final) Foundations in Health (MacEwan University) Studocu is not sponsored or endorsed by any college or university Downloaded by Megan nobert ([email protected]) lOMoARcPSD|35249408 HLST - 152 Foundations in Health (Lecture #11 - #19) ● Intersecti...

lOMoARcPSD|35249408 Foundations in Health (Final) Foundations in Health (MacEwan University) Studocu is not sponsored or endorsed by any college or university Downloaded by Megan nobert ([email protected]) lOMoARcPSD|35249408 HLST - 152 Foundations in Health (Lecture #11 - #19) ● Intersectionality Theory and Education & Literacy Multiple and intersecting factors influence health (No one factor is more important than another) ○ It is the intersection of many factors where an individual’s health experience is defined and created ○ Uncovers multiple forms of discrimination and oppression Health Benefits of Education ● “Better” jobs (e.g., higher earnings) ● More likely to learn about and practice healthy behaviours ● Social & psychological benefits (e.g., reduced stress, more social networks) ● More likely to live in healthier neighbourhoods ● Sets children off on a positive path ● Health Literacy - Definition ○ “The ability to access, comprehend, evaluate and communicate information as a way to promote, maintain and improve health in a variety of settings across the life-course” (Public Health Agency of Canada) Health Literacy - Definitions ● “The cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health” (WHO) ● “The degree to which individuals have the capacity to obtain, process and understand basic health information and services to make appropriate health decisions.” ● “A constellation of skills an individual needs to function effectively in the health care environment and act appropriately on health information.” “Health literacy is a resource for daily living in various settings (where we live, learn, work, worship and play)” ● ● ● “Functional literacy is a practice-based skill.” In Canada, what percentage of leisure activity is devoted to reading? - 14% Functional health literacy – ability to manage words (prose and document literacy) and numbers (numeric literacy) in a medical context The Extent & Distribution of Health Literacy in Canada ● Age Group ● Education ● Gender ● Language Downloaded by Megan nobert ([email protected]) lOMoARcPSD|35249408 ● Province and Territory ● Persons with Disabilities ● Immigrants Significance of Health Literacy ● Expected to understand sophisticated information about health issues and the health care system (Stats Canada, 2000) ● Increased knowledge demands that coincide with increase in chronic diseases ● Greater involvement in self-managing chronic diseases is required Health Literacy Framework (Nutbeam, 2000) ● Social Determinant of Health - Income and Income Distribution Underlying Premises ○ Health status improves at each step up the income and social hierarchy ○ High income determines living conditions ○ The healthiest populations are those in societies which are prosperous and have an equitable distribution of wealth Social Determinant of Health - Income and Income Distribution Downloaded by Megan nobert ([email protected]) lOMoARcPSD|35249408 ● ● ● Socioeconomic status or social class is the strongest and most consistent predictor of a person’s health and life expectancy throughout the world (Cockerham, 2016) Some scholars use the term social class interchangeably with socio-economic status Socioeconomic Status (SES) Different Models of Class Structure ● Basic 3-class scheme (upper, middle, and lower) ● 5-class model (upper, upper-middle, lower-middle, working class, lower) ● Britain – focus on occupation to determine class standing; location in a class hierarchy Components of Social Class Class Inequality in Canada... 1. Inequality in income distribution “The gap between the rich and the poor continues to increase” 2. Inequality in Wealth 3. Inequality in Economic Power 4. Inequality in Health Downloaded by Megan nobert ([email protected]) lOMoARcPSD|35249408 Explaining Health Inequalities ● Individual Explanations ● Materialist/Structural Explanations ● Psychosocial Explanations Explaining Health Inequalities (Individual Level Explanations) ● The “artifact” explanation/statistical anomalies ● The Social Darwinist explanation ● Cultural/behavioural explanations Explaining Health Inequalities (Materialist/Structural Explanations) ● Role of social, economic, and political factors in determining the social distribution of health and illness ● Focuses on the basic class structure of society Explaining Health Inequalities (Psychosocial Explanations) ● Social justice ● Social cohesion ● Social capital Neighbourhood Astle, B. & Duggleby, W. (Eds.) & Potter, A., Perry, A.G., Stockert, P. & Hall, A. (US 9th ed. Eds.). (2019), p9 8-11. ● Physical Environment (p.8) ○ Includes factors in the built environment, such as housing, food security, and community planning, as well as factors in the natural environment (geography, quality of the environment, and climate change) ○ Includes geographic conditions that contribute to isolation and limit access to health care, as well as environmental quality ○ Children from low income families often live in neighbourhoods located near highways and industrial areas – areas that are likely exposed to air, water, food and soil ● Social Environment (pp.10-11) ○ Includes social safety net, social exclusion, and disability ○ “The array of values and norms of a society that influence the health and well-being of populations” ○ Includes a sense of community belonging Downloaded by Megan nobert ([email protected]) lOMoARcPSD|35249408 ○ Includes safety – violence both in the home and the community ○ Healthy social environments include freedom from discrimination and prejudce ● Built Environment ○ “The external physical environment where we live, work, study and play. It includes buildings, roads, public transit systems, parks, and other types of infrastructure. It is linked to how we design, plan and build our communities.” Neighborhood ● Where you live influences your health ● Strong associations have been demonstrated between area of residence, health behaviour, and self rated health ● Neighborhoods differ in the degree of personal security and sense of safety, access to social services and health care, proximity and character of green spaces, etc. ● Some neighbourhoods have food deserts ● People “do better” when residing in “mixed” neighborhoods (poor and rich together) ● “Disordered neighbourhoods” ● Social Determinant of Health - Culture “Culture and ethnic factors influence people’s interactions with the health care system, their participation in prevention and health promotion programs, their access to health information, their health related lifestyle choices, and their understanding of health and illness” Health Canada, 2006 Immigration & Ethnocultural Diversity ● More than 200 ethnic origins were reported in the 2011 National Household Survey (NHS) ● One out of every 5 people in Canada’s population is foreign born (20.6% of the total population) ● Ethnic Diversity Survey (2003) reveals that one-half of the Canadian population feels a strong sense of belonging to ethnic or cultural groups Immigration & Ethnocultural Diversity ● One in every 4 (25%) children in Canada is either an immigrant or the child of immigrant parents ● Newcomers bring strengths, but also often experience challenges ● Statistics Canada, 2007d, report that the most significant difficulties after living in Canada for four years relate to finding appropriate and adequate income and learning a new language. “Indeed, the health transition of immigrants may be a key signal of the importance of the social determinants of health, or factors outside the formal health care system that influence patterns of morbidity and mortality throughout the life course.” Ethnic Differences in Health ● Aboriginal peoples have poorer health outcomes due to social exclusion ● There is a ‘healthy immigrant effect’ that deteriorates over time ● There are ethnic differences in perception and understanding of symptoms ● There are ethnic differences in health-care behaviour Downloaded by Megan nobert ([email protected]) lOMoARcPSD|35249408 ● There are ethnic differences in the social determinants of health Culture and Health ● Cultural beliefs and values play an important role in an individual’s understanding of health and illness ● Different ethnic groups have different expectations of what constitutes appropriate treatment, which will, in part, reflect understandings of causes of health and illness Immigrants and Mental Health ● Some immigrant groups are significantly less likely to use primary-care mental health services or to seek out mental health care. Components of Culturally Competent Care ● Delivering services in the appropriate language ● Overcoming linguistic barriers ● Providing culturally appropriate services ● Reducing economic barriers to obtaining health care (Medicare has reduced some of these barriers in Canada) Early Child Development and Health Early Childhood ● “The period from prenatal development to eight years of age” ● Healthy early childhood development includes the physical, social/emotional and language/cognitive domains of development, each equally important What are current trends? ● The nurturant qualities of the environments where children grow up, live and learn—parents, caregivers, family and community - will have the most significant impact on their development. Significance: Early Childhood Development ● Early experiences have a lifelong influence on brain and body development including learning and coping abilities (National Forum on Health, cited in CPHI) ● Healthy childhood development is critical for long-term health and well being ● Successful early childhood development depends on: health (both parent and child), nutrition, parenting, strong social supports and stimulating interaction with others Factors that Contribute to Positive Child Outcomes Downloaded by Megan nobert ([email protected]) lOMoARcPSD|35249408 “Long-term-exposure-to-expression relationships cluster into three generic patterns” Hertzman & Power, 2003 Pathway Effects ● Early life environment sets individuals onto life trajectories that in turn affect health status over time Cumulative Effects ● Multiple exposures over the life course, whose health effects combine ● The longer the child lives under conditions of material and social deprivation, the more likely they are to show adverse health and developmental outcomes The Attachment Connection ● Infant attachment ○ “As babies are lovingly cared for, there is created a set of specific sensory stimuli which are translated into specific neural activations in areas of the developing brain destined to become responsible for socio-emotional communication and bonding” ○ Physical proximity ○ Emotional proximity Social Support & Social Networks Social Support ● “A network of interpersonal relationships that provide psychological and material resources intended to benefit an individual’s ability to cope” (Pender, Murdaugh & Parsons, 2015, p. 200). ● “The degree to which a person’s basic social needs are met through interaction with other people and describes the kind of networking that helps a person cope with stress” (Karen, Smith, & Gordon, 2014, p. 233.) Types of Social Support ● Emotional ● Instrumental ● Informational ● Appraisal Social Networks ● “The web of social relationships or social ties that surround an individual and the characteristics of those ties” (Pender, Murdaugh & Parsons, 2015, p. 199) Downloaded by Megan nobert ([email protected]) lOMoARcPSD|35249408 ● ● ● Organized religious support –similar values and beliefs Self-help groups including voluntary service groups and mutual help groups Computer-based support groups Social Support & Mutual Aid ● Collective activities in which people informally engage to exchange mutually beneficial or reciprocal forms of social support ● Reciprocity and balance Social Support versus Social Network… Social Support ● ● ● An interpersonal transaction involving emotional concern, aid, and affirmation Resources within the network that are sensed as being available and helpful (perceived support) or are actually provided (received support) Usually smaller than the social network Social Network ● ● The collective social relationships of a person Objective, structural components of support Social Integration ● The degree of involvement or participation in the social network ● The converse of social integration is social isolation ● People who are socially isolated are at an increased risk of death from a number of causes ● Social disconnectedness and perceived isolation in older adults has been associated with lower levels of self-rated health ● The act of confiding, disclosing our thoughts and feelings, is important to health ● Preventing loneliness is a better approach than treating loneliness and isolation once it has occurred ● Prevention includes: ○ Identifying high risk groups ○ Educational interventions Social Support and Health …. There’s more ● Helps people solve problems , deal with adversity, and maintain mastery and control over life circumstances ● Enhances self-worth ● Lack of social support may be as significant to health as not smoking, getting physical activity, reducing obesity, and high blood pressure. ● It is not the quantity of relations that matter but the quality Social support is a basic human need! Downloaded by Megan nobert ([email protected]) lOMoARcPSD|35249408 “Social support “decreases the occurrence of stressors, buffers the impact of stress, and decreases physiologic reactivity to stress” Social Support at a Societal Level ● Communities have better health if high levels of social cohesion exist ● Social relationships are also important for the health of communities ● “Strong communities provide a vital support to families with young children by encouraging opportunities for optimal early childhood development.” (Dr. Clyde Hertzman, Director, Human Early Learning Partnership) Social Support at a Societal Level ● Social Capital ○ “The social investments of individuals in society in terms of their membership in formal and informal groups, networks and institution” (Turner, 2004) ● Social Exclusion ○ “Social exclusion is an expression of unequal relations of power among groups in society, which then determine unequal access to economic, social, political, and cultural resources” (Galabuzi, 2009) The “Roseto Effect” ● “Researchers concluded that it was features of social support and social cohesion that accounted for the difference in health status between Roseto’s men and those of nearby communities” (Davidson, 2015, p. 127). 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