Week 9 Lecture on Social Determinants of Health PDF
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Uploaded by TransparentLemur
Brant Community Healthcare System
2023
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Summary
Week 9 lecture notes cover social determinants of health, focusing on gender and inequality in healthcare. The lecture discusses various aspects, including biological sex, gender identity, and intersectionality.
Full Transcript
Week 9 Lecture November 13, 2023 1:34 PM Week 9 Page 1 Ex. Male nurses mistaken for physicians Week 9 Page 2 - Sex - physiological make up - Gender - how an individual self-identifies - gender - has more diversity in how people identify - Sex: "othering" is further stereotyping, but can leav...
Week 9 Lecture November 13, 2023 1:34 PM Week 9 Page 1 Ex. Male nurses mistaken for physicians Week 9 Page 2 - Sex - physiological make up - Gender - how an individual self-identifies - gender - has more diversity in how people identify - Sex: "othering" is further stereotyping, but can leave the box blank on patient forms about sex (M/F..and can leave blank) Week 9 Page 3 - with sex, can respond differently to different medications, which is why it's important to know this information - Ex. females more likely to sleep-drive and get into accidents vs. males - Prior to 2016, haven't considered the use of male/female vs. gender Week 9 Page 4 - We do have objective and subjective screening ○ We need to be mindful how this may skew statistical results - Ex. Hysterectomy - was believed that women experienced "hysteria" and depressive symptoms b/c of uterus, thus if removed uterus, would remove sx of hysteria…one example of gender bias - Ex. Preference to work with certain genders over others - Ex. MI - women more likely to be sent home with an MI b/c they present with different symptoms than men-->have nausea, thus not initially flagged with MI. (atypical symptoms). ○ But, most studies have been on men, so nausea is PERCEIVED as atypical, so women present NORMALLY, and it's just that not enough research has been done on women with MI for it to be considered normal Week 9 Page 5 - Left political level - determines the distribution of resources, and these are the influences - Gender falls under the SE position, and has a greater variation in downstream effect ○ People can identify with different genders, which may impact their intersectionality in society ○ Ex. Female surgeon - can transition to male surgeon for greater opportunity - Sex falls more downstream, b/c can't change biology …so it's more downstream ○ Ex. Females - genetically have higher risk of high cholesterol, developing MI - Positionality - traits that you identify as having - Intersectionality - these traits interact with one another to determine DoH - Assessment done?? Week 9 Page 6 - We have a significant wage gap: ○ Males making more money than females ○ We're 23/27 in OECD in fair compensation between sex ○ Some decline in this wage gap, but still significant - UofT increased wages for all women faculty to dec wage gap - But for the most part, women less likely to ask for an inc…due to a gender gap, not sex gap Week 9 Page 7 - Prior to 1985, if male who is not indigenous married an indigenous women, that male would gain indigenous status ○ And woman could lose her rights and status as indigenous - If non indigenous woman married a indigenous male, she would not gain the status - Know there is a significant difference - Toronto star report - Persistent inequality: ○ Showing that we have gender and race based inequities Week 9 Page 8 - Men with bachelor's earn 45% more than men with a highschool diploma - Women earn 63% more - Education is more influential on women than it is on men--makes more of a different to women - We have more mood and anx in women than men - More DM and heart disease in men than women Week 9 Page 9 - GBA+ - govt of Can uses this term to promote policy to consider gender differences It's use to identify diversity between men and women, to promote less ineuite "+" = more than just biological sex, but more diversity in gender identities GBA+ used to assess the policies in the country - time: our bodies was one of the est nonfiction books Throughout hx we've have policies released that have negatively impacted women - GBA+ is an answer to help women in creating policy - In 1800s-1820s, women were advocating for equal human rights as men - 1960s - women seeking contraceptive rights, and having menopause and menstruation better care within healthcare - 1970s - women wanting to be seen in positions of power Week 9 Page 10 - Continue to remove barriers for more equitable opportunities Week 9 Page 11 - we have more gender bias for female researchers when accessing funds - Shows that men are more likely to have successful applications for research funds and advance their careers - Gives idea what mainstreaming gender in policy looks like - Gender meanstreaming platform that policymakers can use to assess if they are considering GPA+ in the policy cycle, to achieve gender equality Week 9 Page 12 CHIR - canadian insti for health research - they have extensive grants that promote rigorous research - Video: - As a health care provider, may make a mistake and misidentify a pt--need to apologize and move on - Be self-relflective and congizant of how language can influence - Website that gives more context to diff idnetities and expressions - It's agains Week 9 Page 13 - Against the ontario human rights commission to discriminate or harass ppl based on gender identity and gender expression - Various considerations for when providing care to pts Week 9 Page 14 - Representation of sDoH when there is discrimination and transphobia - Be mindful of intersectionalities that impact health - There is regression politically - transphobic media representation is rising - Ex. In U.S. don't allow for athletics to have youth based on gender identity, which is causing negative implications on those youth - Ex. 21 new bills passed that make puberty blockers illegal - Ex. Quebec bill 2 amendment proposal - if individual wants to change sex identity, they need to undergo surgery before changing sex - Thus need nurses in politics Week 9 Page 15 - Want to remember that we don't know everything about person's gender identity, use appropriate terms "partner", not assume - Use body terms "chest feeding" as opposed to breast feeding - "pelvic ca" as opposed to "gynecological ca" Week 9 Page 16 - Link to find out more about intersectionality -->reinforceing that women don't always start off with the same life changes - Some women have more barriers than others - b/c of diff intersectionalities, women will face different barriers and inequities - There is a lot of discrimination that ppl face beyond gender--so can be for many reasons they are facing discrimination - Viewing Greater systemic discrimination can help understand a woman's lack of opportunity Week 9 Page 17 - Looking at the frames in which we think - How we label people in different situations - Ex. Black man, black woman - ^ this may be due to access, health literacy (looking at intersectionality now), communities have different funding for available screening, cost of transportation Week 9 Page 18 Updated report on Hamilton code red People in this demographic are dying at a much higher rate-->boils does to SES Awareness and efforts in the last 10 years, but health outcomes still declining Inequalities between best and worst performing places has stayed the same or deteriorating 13 health indicators--10 worsened, only 3 improved Avg lifespan declined by 1.3 years over the last decade, of just over 65 years Canadian lifespan ER visits and hospital admissions are climbing Psych ER visits and resp emergencies rising In one day, there is enough hospital beds being billed by individuals to be moved (ALC), can make up an enter hospital - Code red further demonstrates the inequality between social and economic factors - Factor close to code red, may impact health outcomes, not a desirable place for families to live here - Week 9 Page 19 - Media portrays missing indigenous women - Indigenous and racialized women don't have the same media coverage as non-racialized women Week 9 Page 20 - Youth and older adults…? - Looking at professional designations (looking at people regulated within a professional body, not PSWs) - **Review this discussion in the required media files Week 9 Page 21 - there are systemic barriers that impact the intersectionality - Be mindful that women are disadvantaged, as well as immigrant population - Silo nature = on it's own Week 9 Page 22