Final Flashcards

Question

Racialization

Answer 1

The social process of assigning people to racial categories. Whiteness treated as the standard and yields privileges, not disadvantages (being white doesn't become a signif. part of one's identity)

Answer 2

the way that society is organized in such a way to systemically discriminate against racialized groups

Answer 3

A system of categorization based upon presumed cultural characteristics such as culture, history, language, religion or regional affiliation

Answer 4

- Thought to challenge biological reductionism of race by focusing on cultural/social aspects of disease and ways of dealing with disease - Can be self-identified and empowering, but can also be ascribed by others - Often conflated with race, immigration and visibile minority in health research

Answer 5

New immigrants in Canada have an overall higher level of health than the average in Canada because the standards for immigration are so high. Over time spent in Canada this levels out with the rest of the population.

Answer 6

Epstein. Has 2 main aims: 1) Inclusion of women and children and 2) Inclusion of people of colour who are underrepresented in clinical studies

Answer 7

1993. Came with the inclusion-and-difference paradigm. Meant well but... -Encouraged biological reductionism - Overestimates biological incommensurability between races. -Encourages racial profiling in clinical settings (assumptions on race are used to choose treatment) - Obscured differences within racialized groups - Diverts attention from structural/social disparities - Rise of recruitmentology/contract research organizations and more overseas research

Answer 8

A new field of study about gaining access to research participants by finding the best ways to convince them to join trials. Researchers compete for a scarce number of racialized groups to participate in their studies. Lot's of studies in foreign countries where participants are 'pharmacologically naive', research is cheaper to conduct and there is a comparative absence of highly demanding research participants.

Answer 9

1. ALready marginalized groups come to bear more of the brunt of research and its risks 2. Their supposedly biological differences from the 'standard' (white) male human are reified 3. The social causes of inequality still aren't much addressed

Answer 10

Fixed, homogeneous cultural 'traits/, values and beliefs that strongly influence or determine clinically relevant behaviour.

Answer 11

Flexible, ongoing process of transmitting and using knowledge conditioned by dynamics both within communities and between communities and social institutions

Answer 12

- Culture seen as determining behaviour - Emphasizes difference from the dominant group - Emphasizes differences in the minority group - Diverts attention from structural inequality and racism - Justifies discrimination on basis of supposedly rational/progressive values, but it is essentially racism. People belong or don't belong to the dominant group. - Victim-blaming: minorities dangerous to their own health - Pathologization of minority culture

Answer 13

Arose out of recognition that cultural differences between care providers and users affect immigrant health care Having the knowledge, understanding and skills about a diverse cultural group that allows the health-care-provider to provide acceptable care.

Answer 14

1. Culture is a matter of ethnicity and race 2. Culture is possessed by the other; the other is/has the problem. 3. The problem of cultural incompetence lies in the practitioners' lack of familiarity with the Other 4. The problem of cultural incompetence lies in the practitioner's discriminatory attitudes toward the Other 5. Cross-cultural health care involves white practitioners working with ethnic or racialized minority groups 6. Cultural competence is about being confident in oneself and comfortable with others

Answer 15

Tries to address the role of racism and the power dynamics of interactions between users and the system. - Requires doctor to view everyone, including themself, as bearers of culture that can affect care and responses to it. - Service provider is responsible for addressing power relat bt user and provider; Service user must be a part in the decision making. They determine if the care is culturally safe or not and their way of knowing must be seen as valid.

Answer 16

statistical study of patterns of disease in the population

Answer 17

Armstrong: 1. Quarantine Regime 2. Sanitary Regime 3. Social Medicine Regime 4. New Public Health Regime

Answer 18

14th to mid-19th century Threat to health: Sick places Response: Quarantine - prevent traffic bt sick and healthy places (pest houses) Responsibility: State (police power) - police and military enforcement. Force used where necessary

Answer 19

- Mid 19th to early 20th century - Modern epidemiology and public health are born - Chadwick's Sanitary Idea - charting disease and poverty - Class Ideology - poor in a 'troubling' state. Poor just don't know how to be sanitary. Still a problem today. - Ill health is connected to the interaction bt bodies and environments. The contaminate each other. Threat: Squalor Response: Sanitation Responsibility: State (with help from the individual) - Beginning of disciplinary power. Surveillance builds/cajoling people to help/Responsibilization

Answer 20

- Early to late 20th century - personal hygiene and self-discipline - Ill health is due to interaction bt bodies (Germ Theory, Children) Threat: Germs - human to human contact Response: Good Hygience - moral responsibility, target children and educate using established public education. Gendered. Responsibility: Individual (with advice from the state) - disciplinary power apex. Responsibility of the ind to learn the rules and stop the spread of disease by following them.

Answer 21

-1970s to present - New focus on Risk (Ill health due to lifestyle, identity, industrialization, technology) -Skepticism - growing dependence on and mistrust of expert authority. Too much conflict in opinions, too much info. Epidemiology has conservative and radical potential (can contribute to individual risk and social foundations of risk) Threat: Human Action - but individual or collective? Response: Lifestyle changes or political action? Responsibility: Individual? State? Corporation?

Answer 22

Move to surveillance medicine. Focus on risk and entire population. So many risks to everyone, even healthy people. You can always be healthier, so keep working at it.

Answer 23

Transition from dangerousness to risk. Dangers beyond control, but risks give us impression that we you can insure yourself against risk by regulating your behaviour)

Answer 24

The Risk Society. Risk conversation is ironic because modern society has created the risks that we are also trying to protect ourselves from (industrialization, environment pollution)

Answer 25

Framing. Symbolic Interactionism - how people make meaning of social like and use that to decide what to do. Dramaturgic Model - social life is like a play. People behave differently when they are onstage.

Answer 26

Culturally share, socially specific schemata. Organize experience Provide context and meaning Multiple frames for the same action.

Answer 27

To mobilize support. Rhetoric used contributes to the way we perceive the cause. Frame as unjust, worth or sympathy, something that affects us all;

Answer 28

- Promotes a fight, strength ec - Reinforce traditional femininity, status quo (makes it feel less threatening) - Framing of the ideal breast cancer patient: positive, volunteer, feminine. Those who don't conform are ostracized.

Answer 29

An alleged situation that is incompatible with the values of a significant number of people who agree that action is needed to alter the situation.

Answer 30

Framing is used to decide what is and isn't a social problem. For there to be a problem, there has to be a moral judgement. Has to be seen as a problem by a number of people who social power.

Answer 31

The process we go through that decided that something is a problem

Answer 32

Pain journals were covering OxyContin as an addicting substance before addictions journals were. Addictions journals picked up coverage following high profile media coverage of the drug with addiction of crime, so the media set the AGENDA for the addictions journal.

Answer 33

``` Criminals Addicts/Dealers Overprescribing physicians Purdue Users Youth ```

Answer 34

``` Newspaper/media Law Enforcement Government Criminals Medical Colleges Prescribers/doctors Set-Up of Health Care Culture of opiphobia Anti-Oxy activists Purdue ```

Answer 35

- Greater threat of regulation from colleges (Physicians fear criminal prosecution) - Fewer willing prescribers who then face more demand - More research for alternative drugs - More press - More self-regulation, standardization, risk management and patient monitoring.

Answer 36

- Consistently negative - Less access to one major line of treatment - Longer waits - Increasing health insurance costs - Fear of Crine - Fear of labeling

Answer 37

The replacement for OxyContin made by purdue that is tamper resistant and patent protected, but very expensive

Answer 38

Expenditure on drugs in Canada are rising and this lines up with increase in medical spending (now on par with cost of doctors)

Answer 39

1. Funding Medical Research (Ghostwriting, bias, ties to major medical and research organizations, who else will fund) 2. Funding conferences and continuing medical education 3. Educational materials for doctors and patients (Direct mailing, detailing, CPS) 4. Advertising (medical journals, direct-to-consumer advertising)

Answer 40

By the Health Protection Branch - responsible for approving drugs for prescription. Troubling relat with pharma

Answer 41

The fact and/or perception that nations, businesses and people are becoming more connected and interdependent across the globe. Affects health by enhancing spread of disease.

Answer 42

- Increased spread of disease - Reduced public health funding - Reduced ability of governments to enforce public health measures or resist corporate actions.

Answer 43

Agreement for patent protection on brand name drugs. Give monopoly; Generic power drops and health care costs rise;

Answer 44

Integrating individual clinical expertise with the best available external clinical evidence from research.

Answer 45

Randomized controlled trial systematic review observational studies unsystematic clinical observation

Answer 46

Effects of treatment therapies are studied between groups of patients where the clinician has not randomly selected them

Answer 47

Our experiments in treatment are accepted but wouldn't be accepted by science standards - scientism. Questioning medical authority - moral judgement, do different things Reform of medical education

Answer 48

Sudnow showed that pronouncing dead depended entirely on the doctor's moral perception of the patient; Wennberg and Gittelsohn showed regional variations; Fletcher, Fletcher, Wagner published first text for med students questioning the knowledge of their teachers;

Answer 49

We need to fuse traditional methodologies of clinical medicine and epidemiology so we need to teach epidemiology and biostatistics in med student training. Reorganization of the hospital.

Answer 50

Weisz said that they changed the method of regulating the quality of medical care; Changes in governance and professional norms as well as in the conventions of medical practice; Different colleges endorse different guidelines;

Answer 51

Judgments of individual clinicians must be externalized through guidelines that can be successfully regulated; Physicians need not assess evidence, just guidelines; Colleges use guidelines to make judgements when complaints are made; Undermines EBM;

Answer 52

Prolematization of various medical uncertainties in clinical practice led tot he reform of medical education, rendering medical judgements amenable to intervention;

Answer 53

Means for the preservation of social order; Customs, mores, values; Use shame, guilt, exclusion, criticism to regulate people; How people respond to unacceptable behaviour; How people try to manage, prevent or reduce unacceptable behaviour; Surveillance;

Answer 54

Two common definitions in the West: 1) A medical agent 2) Substance that exerts physiological and psychological effects;

Answer 55

1. Gov revenue 2. Ensure purity 3. Symbolic control - class distinction 4. Cultural/religious virtues 5. Protection of public order (there are rules) 6. Improve public health (minimize harm)

Answer 56

1. The product (eg size) 2. The seller 3. The condition of sale (opening hours) Of the consumer (age)

Answer 57

1850 - early 1900s Lead up to prohibition; Many substances illicit today were widely consumed; Drug use predominantly by white, middle-class early settlers;

Answer 58

1900-1950: Legislation of the morality of health Start putting out acts to control the consumption of narcotics in USA and opium in Canada; Forces shaping drug control come in; Anti-immigration sentiment and reefer madness;

Answer 59

Second phase of drug control (1900-1950) 1. Moral Reform Movement - pure society due to wars 2. Child saving - keep them pure and good 3. International Pressures (Britain) 4. Anti-immigration sentiment 5. Drug Ideology - Reefer Madness

Answer 60

Write the Black Candle. Strong political campaigner and moral crusader; First female judge in British empire; Linked minority populations with demeaning cartoons; Themes of degradation of women;

Answer 61

1960s and 1970s Drug law reform because; Rise of middle class and youth consumption / white hippies; LeDain Commission (1972) Convictions go down, but use goes up and heroine convictions go up;

Answer 62

1972 Politicians get together to change drug laws. Agree to decriminalize drugs because it's costing too much money and not working. Focus on harm instead. Very progressive but nothing happened.

Answer 63

1980s - War on Drugs Indruduction of Crack Cocaine pushed the war War rhetoric used. Us vs Them. Ronald Regan in power. Affected Mulroney. 8:1 crack to cocaine possession law.

Answer 64

Pharma Industry | White coats, black hats. Ghostwriting, masking flaws, ghostwritten articles that have led to drug crises;

Answer 65

Pharma is Profit First. State handed over the right to say drugs are okay for the market to the pharma companies because it was too expensive, so now we don't know what drugs are safe. New drugs not made for rare diseases

Answer 66

Global health and social development of Alma Malta. WHO and Unicef use neo liberal ideals; There have been some gains but the health of the poor has gone down since globalization;

Answer 67

Health is an individual responsibility and if you aren't taking responsibility for your health you are a burden on the rest of the community and the state; Credit society;

Answer 68

Health is a community responsibility. We are making it so only the rich have access to services and yet again excluding the poor from health and access. No more church to help us deal with sickness so now we are trying not to get sick. Health is secular morality.

Answer 69

History of non-medical opiate use and control policies in canada; Narcotics policy has little to do with the physiological effects of the drug but rather political and moral factors;

Answer 70

Use and misuse of culture in medical education; Just like lecture. Wanted to get ride of disparities but instead they reinforce stereotypes and racial bias; Cultural competence used to address all non-culture related disparities in care as well. Tells has that other social issues are issues of culture and not in need of attention on their own; As long as poor don't have health care access, bridging culture isn't the most important way to alleviate health care disparities;

Answer 71

Diabetes in first nations people; Control of self=control of diabetes; First nations face the constraints of purchasing the right food;

Answer 72

Cancerland; Pink culture; Writing a cheque would be better; Surgery and mammography make an industry out of the disease. Mammography doesn't mean you won't get cancer;

Answer 73

Relationships between health consumer groups and pharam; Refusers, acceptors and non-disclosers; Some groups argue that a relationship is inevitable and can be beneficial to patient and all relationships come with problems;

Answer 74

Clinical Practice Guidelines; Credentials of the doctor no longer taken as sufficient; Doctors can't do all lit on their own; Protect against legal action; Health care is publicly funded so standardization and transparency is important.

Answer 75

Moral regulation and responsibilisation. Foucaultian; Moral projects in health regulation - how you change peoples' ethical subjectivity;

Answer 76

Study showed that being pronounced dead on arrive depended on the doctor's moral perception of the patient

Answer 77

Rsearch documented the regional variations in health care. Differences bt two hospitals in the same city.

Final Flashcards

(101 cards)