Week 4: Chapter 39 Health Equity

Week 4: Chapter 39 Health Equity Critical Thinking Questions: · Why are some people healthy and others not? Learning Outcomes: · differentiate between equality and equity · Explain how social position influences vulnerability to poor health · Explain what intersectionality is · explain what is meant by the social determinants of health & give examples · differentiate between upstream and downstream actions for health Equality: means each individual or group of people is given the same resources or opportunities Equity: recognizes that each person has different circumstances and allocates the exact resources and opportunities needed to reach an equal outcome Health inequalities: differences in health among groups of people in the population that may be positive or negative Health equity: refers to fair conditions in society that allow each person to achieve their potential for health Health inequities: those differences in health that can be deemed unfair or unjust because they are the product of social processes that can potentially be changed What is Vulnerability? “The risk of poor health is shaped by living conditions, and the risk of poor health is different for individuals and groups of people at various times in their life and in relation to their social position” · Vulnerability suggests that individuals or groups are in need, at risk of, or susceptible to harm because of their exposure to particular social conditions placing them at a greater risk of harm in comparison to others in a population Eg. There were medical (underlying health conditions) and social (social conditions of everyday life that made some people more susceptible) vulnerabilities during COVID Structural Vulnerability · the idea that we need to try to understand how “societies and systems are organized to create and maintain vulnerability for certain populations” · “a positionality that imposes physical/emotional suffering on specific population groups and individuals in patterned ways… which is a product of class-based economic exploitation and cultural, gender/sexual, and racialized discrimination, as well as complementary processes of depreciated subjectivity formation” Conditions that shape vulnerability: · living conditions such as: poverty, unsafe and inadequate housing, inadequate food · Stigma, discrimination, previous trauma, violence, abuse Individual VS Social Conditions: · Vulnerability can be understood as an individual problem and/or a product of social conditions · You must consider whether or not a situation is because of individual or societal/environmental/ systemic factors such as: student debt, student poverty, stress related to socially enforced performance expectations, racism, gender norms, etc. Intersectionality: an approach focusing on the multiple social circumstances that taken together shape the lives of individuals and thereby their chances to be healthy Social Determinants of Health: · “the conditions in society that impact the health of the population. This includes access to material factors, such as housing, income, social support, employment, and education, and access to health care as well as to non-material determinants such as respect, power, and decision making” · Materialistic explanations focus on how the social determinants of health, such as housing, employment, income, social support, education, and so on, influence health Health Inequities · Health inequities: differences in health that are unfair or unjust and created by social conditions that are potentially remedial (this is different from health inequalities b/c health inequalities can be positive or negative) Nurses Role in Addressing Health Inequalities · we can see the impacts of poor living conditions and how they contribute to poor health · Nurses can advocate for changes in health and social conditions through raising awareness of the importance of the SDOH. This advocacy can include: - political action - working directly with vulnerable populations - counter stigma and discrimination by promoting mutual understanding - engage peers and leaders in discussion Looking Upstream and Working Downstream · it is essential for nurses to understand the sources of vulnerability to poor health, particularly the sources that arise as result of the conditions in which people live, especially for those who experience poor health in society · Upstream actions for health: “strategies that dismantle & change the fundamental social & economic systems (structural determinants of health) that distribute the root causes of health inequities including wealth, power, and opportunities” · These changes generally happen at the provincial, territorial, national, and international levels. They are about changing the cause of health and health inequalities · Downstream actions for health: “strategies that seek to address immediate needs & mitigate the negative impacts of disadvantage on health at an individual of community level through the availability of health & social services.” · These changes generally occur at the service or access-to-service level. Downstream strategies are about changing the effects of the causes ⑧ ⑧ ·