Health Sci 100 Exam Notes

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Health Sciences
Health Sciences 1001A/B
Shauna Burke

December 2008 Health Science Exam Notes Film: “Whoʼs Counting?” • Economics for the people • contrast between Cathy and Benʼs jobs • United Nations Systems of National Accounts - set of rules all countries have to abide by (environmental, market trade) • Subsistence Farming Race as a Determinant of Health: Racism and Health • Smedley Reading • Oprah show, African Americanʼs health compared to White Americanʼs Health • hypertension (high blood pressure), heart disease, diabetes, life expectancy, mortality and coronary heart disease • salt-retention hypothesis • health of new immigrants and their health over time. • Health follows a class ladder (income and education) • gender inequities • distinguish sex and gender • biological differences should not be socially significant (women being caretakers and not men) • gender inequities are produced by social hierarchies that divide division of resources unevenly between men and women • are reflected in economic policies • and are mutable (liable to change) Universal Child Care as a Public Health Policy • Canada has no universal child care policy (not Quebec) • percent of children (under 6 yrs) with access to publicly funded child care • Canada - 15% • Denmark - 65% • can be seen as an SDH • health inequality is a result of social inequality and social exclusion Racial Inequalities in Health • in US • African men die 5.1 years earlier (average) than White men • African women die 4.3 years earlier (average) than White men • 880,000 deaths could have been prevented from 1991-2000 if Black Americans had the same health level as White American (Airplane metaphor) • Aboriginal Peoples tend to have worse health (Metis, Northern Indians, Inuits) • Asian Americans tend to have the best health out of all the minority groups. Intersection of Race and Class as a Determinant of Health • race includes racism, that leads to poor health outcomes (share a history of oppression) • Vincent Navarro thinks that class is more important than race (classical marxist - neo marxist) • International Journal of Health Services • African Americans have the highest infant mortality rate no matter what social class they are in (education) • infant mortality rate decreases as motherʼs educational level increases • BUT African mothers with college degrees still have higher infant mortality rates than White mothers with a highschool diploma. • infant mortality related to race Race • social and political construct used to classify people based on their physical appearance • different from ethnicity • there is no biological basis to race. • What is racism? ideology, set of beliefs that is personal prejudice, take shape in governments, businesses, education, and institutions • affects health by social exclusion Segregation • Dissimilarity Index (New York had a dissimilarity index of 81) • effects of segregation on: • social exclusion • economic opportunity • healthy choices • environmental hazards • housing • schools • crime • incarceration • the “poverty tax” • racism is an unacknowledged privilege (invisible knapsack) • race as a social product and not a property of individuals First Nations People and their Health • leading causes of death: injury and circulatory disease • big gap for males and females aboriginals when it comes to injury and poisoning (way more aboriginal men die from injury and poisoning) • leading cause of death below the age of 45 is suicide • 3/4 of deaths from 1-9 years old come from injury from car accidents, drowning, fires • low suicide rates in areas with lots of community factors (name these community factors) • high suicide rates in BC • in Northwest Territories, Aboriginals have more likely to use drugs and alcohol excessively. • Life expectancy: man 7.4 years earlier, woman 5.2 years earlier • Infant Mortality Rates: 1.5X the national rate • TB Rates are 8-10X higher • Colonialism: involves oppression • reference (standard) group vs. inferior group • experience of inferiority and hopelessness • Internal colonization: attempt to assimilate a certain group into the mainstream culture • Cultural genocide • Residential schools in Canada (“Killing the Indian in the child”) • increase of aboriginal people living in urban areas (1% to 49%) after WW2 • fewer aboriginal people complete all levels of education • educational attainment improving • unemployment rate • Aboriginals on reserve have extremely low income ($2000 annually) • income gap in widening and worsening, leading to health disparities • Housing: • 90X more likely to have no piped water supply • 5X more likely to have no bathroom facilities • 2X more likely to be in need to major repair • Indian Act: • can be thought of racism as structuralism • built into institutions • Film: “Finding Dawn” • no sense of urgency when aboriginal people go missing Violence and Aboriginal Women • 3/4 of Aboriginal women have suffered violence • mortality rate : 3X higher • exposure to drugs and violence related to prostitution • aboriginal women affected by colonialism (disconnection) • experience of violence increases risk of HIV • experience of violence increases substance abuse • little knowledge about HIV and its risks • challenges with confidentiality (doctor being our neighbour) • aboriginal women are “DOUBLY OTHERD” (double disadvantaged) Globalization, Trade and Health • World Bank and IMF (differences) • World Bank - loans • IMF - economic assistance • SAPs (Structural Adjustments Programs) - loans given to countries, but countries have to follow their rules • World Trade Organization (WTO) - supra-national organization, free trade, 3 jobs • provides a forum (meeting place) for trade negotiations between countries • handles trade disputes (when countries disagree) • monitors national trade policies • Millennium Development Goals and Targets 1. eradicate extreme poverty and hunger 2. achieve universal primary education 3. promote gender equality and empower women 4. reduce child mortality 5. improve maternal health 6. combat HIV/AIDS, malaria, and other diseases 7. ensure environmental sustainability 8. develop a global partnership for development Globalization and Health • Impact on Poverty and Economic Inequality • increased debt and poverty • 1997-1999, rate of inequality has almost doubled • undermines local economies • life expectancy - decreased except for 20% of richest countries • economic growth - decline in poorest 20% of countries • rate and growth of public education • literacy rates (decreased in poorest 40%) • Deterioration of social welfare systems • impact on female caregivers • impact of low education • Lack of protection for labour rights • maquiladoras • Environmental Impact • unconsidered by WTO policies • globalization leading to greater pollution • Reduce power of national governments • pressure to privatize health care • creates inequalities in access to care (i.e. Brazil, more doctors for the rich people) • trade agreements “lock in” levels of privatization and have a direct bearing on public health •GATS, NAFTA- Chapter 11 • GATS - General Agreement on Trade in Services • one of the main pillars of WTO • Why is opening up essential services (i.e. health care) always appealing to foreign bu
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