overview Flashcards

Question

HEALING CENTERED: What are the 4 key elements of HCE

Answer 1

1. Political not clinical – communities involved, not just individuals. Social and political actions – sense of purpose, power and control; all ingredients for well-being & healing. 2. Culturally grounded – shared culture & identities give us meaning, self- perception, belonging & purpose; shared rituals; spiritual. Healing circles. 3. Asset/Strengths-based - Those exposed to trauma as active participants, not victims, in their own healing. Value existing skills, experience, knowledge & curiosity. Lift these up! What do we want, not just where we’ve been. Salutogenic–what contributes to healing & well-being? 4. On-going Process - With Adults/Community – ‘wounded healers’ – those who have experienced trauma, can be healers while also working on themselves. Former addicts, best drug counselors.

Answer 2

Argues that health can be impacted by social and physical spaces and places It treats individuals different from the traditional public health and medical approaches Promotes positive exposures to reverse past adverse experiences The experiences and exposures experienced today will determine tomorrow’s health

Answer 3

-Build trust through shared experiences -Acknowledge existing/historical traumas -Adapt & adjust the process & content as community defines its own healing needs. -Always obtain informed consent & give participants the choice to participate -Aim to de-escalate stress by building social connections that can support healing

Answer 4

The social determinants of health (SDoH) are mostly responsible for health inequities - the unfair and avoidable differences in health status seen within and between countries.” -the conditions in which people are born, grow, live, work and age -Your social position in any given society is the fundamental determinant of if you will get sick, suffer unnecessarily & die early. -Social position = typically a combination & intersections among income, educational attainment, gender, (ethnicity, religion, tribe & caste) & occupational status (dominant but not only factors).

Answer 5

1). Living conditions – where you live & the physical environments (i.e., residential and work), including pollution, safety, distance to services (i.e., food access). 2). Institutional Decisions – whether or not society’s rules & laws serve your group – adequate schooling, economic opportunities, corporate hiring, policing, immigration agencies, & public participation in decisions (democracy). 3). Power-the social determinants are shape by who has the power to shape access to wealth & opportunities? (i.e., is wealth concentrated in hands of a few billionaires, who use that to influence government decisions?)

Answer 6

In simple terms (SDOH) what are the social determinants of the non-medical factors that influence health outcomes -they are conditions in which people are born, grow, work, live and age and the wider set of force and system shaping the conditions of daily life. -these forces and systems include economic policies and systems, development, agendas, social norms, social policies, racism, climate change and political systems -this includes social and structural conditions (policy & law, data & surveillance, infrastructure & capicty, community engagement, partnerships & collaboration, evaluation and evidence, building, data surveillance)

Answer 7

-In a biomedical model: the primary reason people get sick is due to molecular-level pathogens brought about by individual behavior, heredity biology or genetics -compared to the ecologic model - the primary reason for sickness is the living & working conditions, distribution of wealth, and social status in society; all these combine to produce exposures, like stress & environmental pollution, that lead to illness & premature death Interventions for the medical model: See you Dr. often; change personal ‘risk factors’ (e.g., smoking, diet & exercise); be educated about risks & case management when sick. interventions for the ecological model: Change policy, law & institutions to improve living/working opportunities & conditions, eliminate discrimination, others

Answer 8

UPSTREAM: Social Inequities (like class race/ethnicity, immigration status, gender, sexual orientation ) UPSTREAM: Institutional Inequities: the corporation business, government agencies schools, law & regulations, not-for-profit organizations UPSTREAM: Living conditions: 1. physical environment (land use, transportation, housing, residential segregation, exposure to toxins) 2. Social environment: experience of class racism, gender, immigration, culture-ads-media-violence 3. Economic & Work Environment employment, income, retail business, occupational hazards 4. service environment: health care, education, social services The ecological model is the new emerging public health practice that is focuses on policy -is the community capacity building, community organizing and civic engagement

Answer 9

DOWNSTREAM : Risk behaviors ( such as smoking, poor nutrition, low physical activity, violence, alcohol others drug, sexual behavior) -disease & injury (communicable disease, chronic disease, injury intentional & unintentional ) -mortality (infant mortality, life expectancy) The biomedical model si the current public health practice which focuses on individual health education, and health care

Answer 10

- Social & Cultural Values - Community Organizing

Answer 11

Land Use Social Services Experiences of Racism

Answer 12

Structural racism is defined as racial bias across institutions It is a product of the cumulative and compounded effects of factors that systematically privilege White people and disadvantage people of color.

Answer 13

-Internalized (belief within individuals ex. stereotype threat ) -interpersonal (bigotry between individuals racial anxiety ) -institutional (bias within an agency, school) -structural (cumulative among institutions, durable, multigenerational)

Answer 14

- Structural Racism in the U.S. is the normalization and legitimization of an array of dynamics –historical, cultural, institutional and interpersonal –that routinely advantage whites while producing cumulative & chronic adverse outcomes for people of color. -It is a System of hierarchy and inequity, Primarily characterized by white supremacy –the preferential treatment, privilege and power for white people at the expense of people of color mutually reinforcing systems of housing, education, employment, credit, media, health care, criminal justice, other

Answer 15

OVERT hate crimes; poor treatment which is easy observable \ Under the water line is discrimination that difficult to observe CONVERT/ SYMBOLIC implicit attitudes (such as behaviors think British racism, subtle ) Structural Segregation, racial ideology, institutional l policies ex. redlining

Answer 16

Institutionalized discrimination

Answer 17

-Portrays Asians/Asian Americans as having overcome the barriers of minority status in the US. -Incorrectly generalizes about all Asians/Asian-Americans as having the same experiences and/or opportunities and ignores the heterogeneity among AAPI populations. - Ignores the socioeconomic difficulties faced by many Asians/Asian Americans. -Assumes all Asians/Asian-Americans are healthy, one result being that medical and public health research frequently fails to include AAPI subgroups and/or measure things like mental health.

Answer 18

-Hate crimes and other overt acts of racial bias sit at the tip of the iceberg. In 2006, the Federal Bureau of Investigation recorded 239 anti-Asian hate crimes, representing about 4.8% of all race-related hate crimes (15). -These overt actions, however, are far less prevalent than more subtle, symbolic, and mundane types of discrimination, such as being treated with less respect. Although less dramatic, these mundane actions may be as damaging as more overt ones. -The base of the iceberg, however, is often more hazardous than the tip. What lies below the surface determines the direction and velocity of the iceberg and, when unrecognized, can cause catastrophes. - The bottom of the iceberg represents institutionalized discrimination, which may be considered a fundamental cause of health and health disparities. -Addressing the tip of the iceberg through protective legislation and cultural competency efforts is important -chronic exposure to stress may lead to the dysregulation of the body’s homeostasis and the accumulation of allostatic load, the “wear and tear” of body systems due to stress. -Direct pathways include mortality and morbidity from hate crimes. Indirect pathways include mediation through socioeconomic position, neighborhoods, or social evaluation. For instance, discrimination may diminish educational achievement or the accumulation of wealth.

Answer 19

differences in health status between population groups, such as disease rates - Two examples of a disparity - differences between groups that likely AREN'T the result of unfair social, economic, and/or environmental policies and practices that create barriers to opportunity - could be: a) worse health among the elderly compared with young adults; b) a higher rate of arm injuries among professional tennis players than in the general population.

Answer 20

Disparities in health status & mortality rates THAT ARE a result of systemic, avoidable and unfair social and economic policies & practices that create barriers to opportunity. (i.e., is it acceptable to you? Value judgment)

Answer 21

actions to eliminate inequities in health, both determinants & outcomes, to ensure all groups & places have the opportunities & resources to attain the highest possible level of health

Answer 22

-fundamentally, health disparities are differences in health status that ARE NOT related to socioeconomic and racial discrimination -While Health Inequity IS THE result of verbal and social, economic problems that foster barriers

Answer 23

because of the inequality, black has the highest maternal mortality rate during pregnancy & up to 12 months after birth,

Answer 24

-According to Unnatural Causes, a lack of health care is the primary cause of illness and disease. -According to one of the experiments described in Unnatural Causes, when exposed to a cold virus, those who were already under more stress were more likely to get sick because of a weaker immune system -The film Unnatural Causes references Sir Michael Marmot's Whitehall study, which found that health is directly correlated with social class across multiple variables (e.g., as one's social class worsens, so does one's health). This is known as the 'health gradient'. -When ‘stress response’ is chronic, as described by Dr. McEwen and others in Unnatural Causes, it can influence our health by... -promoting an unregulated release of cortisol that can impair immune function. -disrupting glucose & insulin regulation, increasing the risk of diabetes. -accelerating cellular aging. -prolonging the activation of stress hormones, which can inhibit memory.

Answer 25

- he was the chief commissioner of the commission on the Poor Law System in England -questioned why the poor remain poor and unhealthy, wanted to reduce the cost of caring of the poor and eliminate child labor

Answer 26

-english doctor who questioned the theories of disease distribution of diseases like miasma -oroginally people believed that cholera was an air-borne disease but in 1849 he hypothesized that it was transmitted in London by dirty water

Answer 27

New building codes * NYC Tenement House Law of 1867- Ventilation, sewerage connections, fire escapes, & indoor toilets * New drinking water & sewer systems infrastructure * New government institutions to manage street cleaning, inspect buildings, water, sewer, etc.

Answer 28

preservationist- criticize exploitation of nature, esp. mining, timber harvesting, damming rivers, & grazing. conservationist-wise use of natural resources. The country’s treatment of its land & wildlife is a measure of its character. romanticism: transcendental “enlightenment’ in nature; John Muir: wilderness – “sublime, transcendent & clean

Answer 29

-there was a new movement that challenged the idea that parks were just for fun but could serve as lungs for the poor, new movements such as the cleaning of parks, close to schools women leadership, no longer working on weekends or 40 laws -changed focus of urban & environmental health to working, living, educating & recreating conditions -In this movement, white educated women live w/poor immigrants, and offered immigrants services -moreover, they focuses on the social determinats of health -like public baths, daycare, college extension, music school art gallery -research impacts sweating system workplace conditions mapped disease

Answer 30

- founded Atlanta Neighborhood Union – black-led settlement house -Worked at Hull House; left frustrated not committed to Black Chicago. -nursing, hygiene, sanitation programs, field epidemiology investigations, political action committee for policy change -Partnered with Morehouse & Spelman College students -Detailed map-making, surveying & co creating intervention w/Black community

Answer 31

-miasma it was the belief that filth and foul air was from rotting from the organic matter and dirt causing disease -the proposed solution was to address urban congestion and sanitation like the H2o sewerage, ventilation, street cleaning & paving waste removal slaighterr houses -however the challenge that it not explain Not explain why not all filthy neighborhoods experienced epidemics; costly construction across the region; public policy/private action; controversial role for State. -2) contagion it was that disease passed form the sick to the healthy -a solution was that the Military enforced quarantines/cordons sanitaire; “Health Officer”. State intervention in economy/labor - a challenged : failed to explain why some people did not get sick removing people did not stop new epidemics 3). moral environmentalism disease was due to ocial pathologies,’ such as violence, intemperance, and idleness. Individual characteristics a solution was the civilizing of immigrants and people of color however, this was racist 4. germ theory -the emerging science of f bacteriology; microbes caused disease; specific germ for specific disease however, a challenge was that it ignored social conditions, racism that shaped why some exposed

Answer 32

race equals genetics; "races" are natural populations, meaning that they are defined by innate genetic differences, rather than socially created demarcations; and -Eugenics – was a racist interpretation of Darwin’s ‘natural selection

Answer 33

segregate land according to its use: industrial, residential, agricultural. -Nuisance control, smoke regulations, fire protection & protect human health Yet, also helped stabilize land values b/c brought consistency to land uses

Answer 34

-NEW federal housing agency construction standards GI BILL -helped returning white veterans -racial discrimination -FHA refused to insure mortgages for African Americans -whites restricted who could live in neighborhoods

Answer 35

Federal, Home Owners' Loan Corporation (HOLC) created a security of real estate investments, high risk or red areas were defined as comprised where a majority of people of color used to live -banks refused to offer them loans and marked this areas with red -only allowed loans to areas that were blue or green and only where whites lived

Answer 36

Remove urban ‘blight’. Entire neighborhoods demolished; and replaced with highways & buildings. Limited relocation programs or replacement housing

Answer 37

Nearly 70 years later, the legacy of urban renewal has not lived up to these optimistic goals. Far more housing units were destroyed than were created to replace those that displaced families lost, thereby disproportionately affecting black and low-income residents; 78% of relocated families were nonwhite. -justifies that urbal removal was an excused to displace black people from their homes in the promise so of better housing however businesses would then rent and sell the buildings at a high cost

Answer 38

The time may have come when the issue of race could benefit from a period of ‘benign neglect.” an attitude or policy of ignoring an often delicate or undesirable situation that one is held to be responsible for dealing with -ignored needs black & brown communities

Answer 39

actively removed fire, garbage, health care & other essential services in poor neighborhoods. Removed life-supporting services

Answer 40

Operated almost 30 community clinics around the country - Free breakfast programs for kids -screening for sickle cell anemia -Housing affordability & police brutality, as health issue -Campaigned against medical discrimination -“Survival programs” opened schools/community classes in economics, first aid & self defense; gave away groceries and clothing

Answer 41

-Building community drinking-water wells - Construction of sanitation sites, including outhouses -Conducting repairs on the homes of expectant mothers

Answer 42

The development of the Farm Cooperative All decisions around the Cooperative, which is entirely Black-run and Black-employed, are made by the people, for the people. This Cooperative allows for local residents to stay in their homes, and not have to migrate elsewhere in search of economic opportunity. Offering training for Health Center staff member positions (e.g., nurse aids) Local residents can train as nurse aids, medical assistants and other technical positions in order to secure a well-paying, community-centered job

Answer 43

- Integrating multiple issues to address inequities -Redefining health expertise as residents & workers engaged in science & action -Crossing racial & ethnic alliances & intersectional alliances for health equity

Answer 44

-Ran a free breakfast program -Campaigned against medical discrimination -ran “survival programs” which operated their own schools, conducted community classes in economics, first aid & self defense

Answer 45

-Community-based participatory research (CBPR) answers the call for more patient-centered, community-driven research approaches to address growing health disparities. CBPR is a collaborative research approach that equitably involves community members, researchers, and other stakeholders in the research process and recognizes the unique strengths that each bring. The aim of CBPR is to combine knowledge and action to create positive and lasting social change.

Answer 46

-Science cannot tell us whom to hold responsible for protecting the poor from climate change? -'real world' problems, science offers only part of the picture? -Science fixes our attention on the knowable, leading to an over-dependence on fact-finding. -uncertainty is seen as a threat to collective action?

Answer 47

1. physical natural environment like quality of air and water 2. availability of a healthy environment lie secure housing, emplymnet, safe areas for children 3. service environment. The presence or absence of adequate schools, transportation, police and fire protection, water and sewer systems, healthcare facilities, & social welfare services, 4. Socio-cultural features of a neighbourhood (Social environment). political, economic, ethnic and religious history of a community: norms and values, the degree of community 5. reputation of an area: How areas are perceived, by their residents, by service or amenity planners and providers, by banks and investors, may influence the infrastructure of the area, the self-esteem and morale of the residents, and who moves in and out of the area

Answer 48

The 2 neighborhoods were North Lawndale and South Lawndale, also called "Little Village." were the neighborhoods compared -that your neighborhood context matters for health -The more vulnerable your place, the more likely you were to die during a heat wave -Being elderly, lacking an air conditioner, access to transportation and social contacts (friends/family) nearby, made you vulnerable to death -That your neighborhood context matters for health -Living alone and having a per-existing medical condition made you vulnerable during a heat wave -

Answer 49

It directed public health agencies to identify individuals who are vulnerable but not the places where vulnerability is often concentrated? -they did not address the spatial patterns of death/health risks. -It failed to consider how one's neighborhood context could influence group vulnerability and health outcomes? -it only looked at individual vulnerability?

Answer 50

They are the only group segregated in ghettos with high levels of abandoned housing stock, empty lots, depleted commercial infrastructure, population decline, degraded sidewalks, parks, and streets, and impoverished institutions. the had violent crime & active street level drug markets, which exacerbated the difficulties of using public space and organizing effective support networks.

overview Flashcards

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