HHNP1 Module 12. Student PDF

Module 12 Population health, Global health, and Cultural safety Module 12: Learning Objectives Explain how population health strategies can be used to reduce health inequities among population groups Discuss the differences between global health, planetary health, communicable and non-commu...

Module 12 Population health, Global health, and Cultural safety Module 12: Learning Objectives Explain how population health strategies can be used to reduce health inequities among population groups Discuss the differences between global health, planetary health, communicable and non-communicable diseases Describe the historical development of the concept of culture, cultural competence, cultural safety, and cultural humility in relation to nursing practice. Describe the concepts of global citizenship and the professional roles of nursing in a global world. Describe the current impact of global and planetary health issues (climate change, immigration and migration trends) on society, healthcare and, population health in Canada Previous content: Population Health Promotion Model 3 Population Health Promotion Model Stakeholders must collaborate to address health determinants. Society is responsible for its members’ health status. Health status is a result of health practices and social and physical environments. Opportunities for healthy living are based on social justice, equity, and relationships of mutual trust and caring. Health care, health protection, and disease prevention complement health promotion. Active participation in policies and programs is essential. 4 Promoting the Health of Populations and Community Groups Population A collection of individuals who have in common one or more personal or environmental characteristics Community A group of people who share a geographic dimension and a social dimension 5 Community Health Nursing Practice Social justice “Social justice is the equitable, or fair, distribution of society’s benefits, responsibilities and their consequences” (CNA, 2010) Encompasses equity, human rights, democracy and civil rights, capacity building, just institutions, enabling environments, poverty reduction, ethical practice, advocacy, and partnerships 6 Community Health Nursing Practice Community health nursing Includes public health nursing, home health (community-based) nursing, community mental health nursing, street health, outpost nursing, and parish nursing Primary health care Education, rehabilitation, support services, health promotion, and disease prevention Empowerment-based models of community practice 7 Community Health Nursing Practice Empowerment: A process by which people, individually, and collectively in organizations and communities, exercise their ability to effect change to enhance control, quality of life, political effectiveness, and social justice Both an outcome and process 8 Public Health Nursing Improves the health of populations in the community Emphasis in public health is the health of the entire population e.g., improve food and water safety, ensure adequate sewage disposal Population health: “An approach to health that aims to improve the health of the entire population and to reduce health inequities among population groups” (PHAC, 2016) Action is directed primarily at community levels 9  Public Health Nursing 10 High-Priority Populations for Community Health Nursing High-Priority Populations: People Most Affected by Health Inequities People who live in poverty People who are homeless People who live in precarious circumstances People with chronic conditions and disabilities People who engage in stigmatizing risk behaviours Indigenous peoples New immigrants and refugees 2SLGBTQIA+ 11 High-Priority Populations for Community Health Nursing Working with high-risk populations requires: Culturally competent and safe care Understanding clients’ cultural beliefs, values, and practices Working together to determine needs and appropriate interventions Practising trauma-informed care 12 High-Priority Populations for Community Health Nursing Harm reduction Offers alternatives to reduce consequences of high-risk behaviour Accepts alternatives to abstinence Reduces barriers to treatment Provides user-friendly access 13  “The optimal well-being of all humans History of from the individual and collective perspective” (CNA, 2009) Global Encompasses prevention, treatment, and care, while focusing on the improvement Health of health for all and health equity (Koplan et al., 2009)  Brings together actors across different sectors to deliberate and guide mechanisms toward collaborative resolutions to complex global issues Millennium Development Goals Global United Nations General Assembly Health (2000) Address key health and Governanc development issues (e.g., reduce poverty) e Sustainable Development Goals United Nations General Assembly (2015) 17 universal goals  It is important to have access to reliable Global data. Global burden of disease (GBD) is a Health metric that quantifies the health of populations at regional or national levels. Examples: Indicators Morbidity and mortality Disability-adjusted life year Health Fundamental to understanding and Equity achieving global health for a population Health disparities and Health inequities Social and structural determinants of Health health Health equity Inequities Relational Theory and Ethics Support nurses’ considerations of the concepts of health equity and inequities, their situatedness in political economy, and its influences on the social and structural determinants of health Guide nurses to assume people, ideas, organizations, bodies of knowledge, and contexts are all interconnected Encourage nurses to listen for and amplify voices that are often excluded by the social and structural determinants of health Planetary Health The health of human civilization and the state of the natural systems on which it depends An intact and healthy ecosystem Environmental sustainability Disease prevented by healthy environment One Health: the interdependence of humans, plants, and animals Determinants of planetary health from an Indigenous perspective Climate Change Adverse changes in the environment directly impact the health and well-being of the population and the planet Considered a major public health threat to human health The Paris Agreement The need for action in the form of sustainability requires a key understanding that the desires of the present must not lead to environmental destruction in the future.  Communicable diseases Issues in Pandemics Global Noncommunicable diseases (NCDs) Gender equality Health Immigration and migration trends Ethnocultural diversity Communicable diseases and Pandemics Communicable diseases: infectious diseases that are transmissible (HIV, cholera, hepatitis, influenza, malaria, measles, TB, COVID-19 etc.) Low-income countries and marginalized populations disproportionately affected Threat to International health security Pandemic: worldwide spread of a new disease Non-communicable diseases Not contagious: not passed from person to person Cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes 74% of all deaths globally Each year, 17 million people die from a NCD before age 70; 86% of these premature deaths occur in low- and middle-income countries Tobacco use, physical inactivity, the harmful use of alcohol, unhealthy diets and air pollution all increase the risk of dying from an NCD Detection, screening and treatment of NCDs, as well as palliative care, are key components of the response to NCDs Gender Equality All people should be given equal treatment and not be discriminated against on the basis of their gender. Continued discrimination against women and girls in education, health, political participation, employment, the labour market etc. Direct discrimination Indirect discrimination Many experience multiple forms of discrimination (intersectionality)  Ethnocultural diversity According to the 2016 census, approximately one in five people (20%) in Canada were born outside of the country. Refugees, Immigrants, Asylum seekers, Migrants etc. Newcomers frequently experience language barriers, social isolation, separation from family, loss and grief, and a lack of information and access to available health care resources. Refugees may be relocated without having chosen their destination, while immigrants are able to choose where they wish to live. Refugees tend to experience greater dislocation and deprivation than do immigrants, who have the option of returning to their homelands. Global/Planetary Health Nursing Nurses have a key role to take the lead in advancing health equity towards climate justice. Global and planetary citizenship Investing in the Global Nursing Workforce Global Health Education National and international organizations for global health Reminder Module 3: 4.9% of population is Indigenous Diversity among Indigenous groups Indigenous History: white settled colonialism, cultural genocide, residential schools, History in reserve system, structural racism, MMIWG, sixties scoop etc. Canada Correlation between health and Indigenous identity and Nursing: respect, trust, spirituality, Indigenous strengths-based approach, trauma- informed care health Indigenou Indigenous peoples represent approximately 15% of the poorest people s Health globally, yet make up only about 5% of the population worldwide —The Indigenous peoples continue to suffer abuse and denial of human rights, Global including their right to health and to land. Recognizing the burden of disease for Perspecti Indigenous groups requires an understanding of the impact of ve colonialism  Connections between determinants of health and illness patterns and major Indigenou health concerns Lower life expectancy s Health Access to holistic and culturally appropriate health services remains —The challenging Nurses can advocate related to health Global inequities and social injustices. Assisting Indigenous peoples to build Perspecti capacity and work closely with systems of health care will be part of the next wave of ve radical reorientation that is urgently needed.  Culture and cultural competence Culture: patterns of human behaviour, norms, traditions and values that affect the thinking and behaviour of members of a particular group of people. Includes race, ethnicity, and ancestry, but also the beliefs, common experiences, and ways of being shared by groups of people (disabilities, 2SLGBTQIA+, faith and spiritual communities, socioeconomic classes, etc.) Cultural competence: our ability to effectively interact with people belonging to different cultures. It is a process, and learning occurs on a continuum and over a life-time. Reminder: Cultural Safety Cultural safety Involves considering the redistribution of power and resources in a relationship. Cultural humility A lifelong learning experience, value, or virtue that shapes character traits across the lifespan. Actions that demonstrate interpersonal respect and interpersonal reflection of one's cultural assumptions and biases. Culturally competent care Bridge cultural gaps in care, work with cultural differences, and enable patients and families to receive sensitivity, creative and meaningful care. Nurses need to exhibit specific ability, knowledge, sensitivity, openness, and flexibility toward the appreciation of cultural difference Will discuss more later in the course!  Culture and cultural competence People who identify as Black, Indigenous, People of Colour, or part of the LGBTQIA2S+ community experience many forms of hate and discrimination. Statistics Canada reports an increase in race and ethnicity-based discrimination in recent years (Statistics Canada, 2022a) Diversity, equity, inclusion, bias, and cultural sensitivity are fundamental terms for understanding how to become a culturally competent nurse.  Diversity: the variety of unique dimensions, qualities, and characteristics people possess. Race, ethnicity, age, gender, sexual orientation, religious beliefs, economic status, physical abilities, life experiences, and other perspectives can make up diversity. Equity: Where everyone is treated according to Cultural their diverse needs in a way that enables all people to participate, perform, and engage to the competen same extent. It is not the same as equality. Inclusion: creating a culture that embraces, respects, accepts, and values diversity. It is a ce mindful and equitable effort to meet individual needs so everyone feels valued, respected, and able to contribute to their fullest potential. Bias: A conscious (explicit) or unconscious (implicit) opinion, preference, prejudice, or inclination, formed without reasonable justification, that prevents a balanced or even- handed judgement. Practice Resources: Cultural Competence https://www.werpn.com/wp-content/uploads/2023/11/W eRPN-My-Commitment-to-Cultural-Safety-Workbook.pdf https://www.werpn.com/education/practice-resources/cu ltural-competency-resources-for-nurses/ https://www.cno.org/en/protect-public/code-of-conduct-f or-nurses/culturally-safe-care-resources/