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Chapter 4

NSE 112 Chapter 4: NSE 112 - Week 11 OBJECTIVES: SOCIAL JUS..

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Ryerson University
NSE 112
Harvey Skolnick

April 6, 2017 NSE 112 – Week 11 Social Justice and Advocacy Readings: - Potter & Perry (2014), 44, 47-50. X - Mikkonen, J., & Raphael, D. (2010). Social Determinant of Health: The Canadian Facts. Toronto: York University School of Health Policy and Management. Retrieved from: http://www.thecanadianfacts.org/the_canadian_facts.pdf (read pp32-40) X - Vancouver advocacy guidelines. Retrieved from http://www.vch.ca/media/Population-Health_Advocacy-Guideline-and-Resources.pdf X - Zomorodi, M., & Foley, B. J. (2009). The nature of advocacy vs. paternalism in nursing: clarifying the ‘thin line’. Journal of Advanced Nursing, 56(8), 1746-1752. X Weekly Objectives: 1. Discuss the concept of social justice. - Promoting the Health of Populations and Community Groups o Population: collection of individuals who share environmental characteristics  i.e. Ghanaians, older adults, Aboriginal people o To determine health status of a population, consider: occurrence of illness, disability, death, lifespan, education and living conditions of individuals o Community: group of people sharing geographic location and social dimensions (individual relationships, interactions among groups, shared characteristics between members) i.e. neighbourhood, women’s health network  Health community has health members who are involved and work together to create healthy living environment  Able to solve problems, have good living conditions, safe environment, sustainable resources (employment, health care, education) - Community Health Nursing Practice o Population health promotion, protection, maintenance, restoration – community, family and individual o Coordinate care, plan services through collaboration o Social Justice: equitable/fair distribution of society’s benefits, responsibilities and their consequences, focus on relative position of social advantage of one individual or social group in relation to others in society as well as root causes and strategies for elimination – roots in notion of social responsibility and justice (fairness)  Encompasses: equity, human rights, democracy, civil rights, capacity building, just institutions, enabling environments, poverty reduction, ethical practice, advocacy and partnership o Community health nurses focus on subpopulations – health and direct effects 2. Discuss related terms including: vulnerable, marginalized and at-risk. o Vulnerable – likely to develop health problems due to excessive risks, barriers to health care services or dependant on others for care  in relation to determinants of health (SES, literacy and social inclusion)  poverty, homeless, i.e. women in IPV, chronic conditions, disabilities, stigma (substance abuse, unsafe sex)  may be in multiple groups  different vulture, beliefs, language barriers etc.  Nurse:  Comfortable with different groups and diversity  Communication and caring is crucial  Do not evaluate based on own culture  Typically have poorer health status 1) Poor and homeless  Even less resources than low-income families  Social condition, lifestyle, environment leads to vulnerability  May see health care as judgemental  High incidence of mental illness and substance abuse 2) Precarious circumstances  Women greater risk for low income, violence, stressors – unpaid caregiving  Physical, social, emotional and sexual abuse – high in older adults, women and children  Provide privacy and confidentiality during interview  Unintentional injury, unemployment, depression, suicide – high in young Aboriginal men  Consider environmental conditions – hazards, landfills, incinerators 3) Chronic conditions and disabilities  Physical and emotional aspects  More chronic conditions in older adults  Collaboration is key – family, community etc. 4) Those engaging in stigmatizing risk behaviors  Substance abuse – links to health and SES problems  Financial strain, employment loss, family problems  Harm reduction – controversial approach, use input of the user, do not follow pragmatics and offer alternatives, accept abstinence, reduce barriers – user friendly environment  i.e. needle exchange programs, o Nurses’ Role:  Communication, facilitation, leadership, advocacy, consultation, collaboration, build capacity etc. o Marginalized – WEEK 2 o At-Risk  Combination of vulnerability and marginalization  i.e. poor, frail, disabled, economic problems, homeless, racial/ethnic minorities, low literacy, abuse victims, social risk factors (i.e. isolation) 3. Review the social determinants of health. o Social exclusion – unequal relations of power among groups in society, which then determine unequal access to economic, social, political and cultural resources  Specific groups denied rights/opportunity to participate in Canadian life  More likely to be unemployed and earn lower wages  Less access to health and social services and furthering education  Separated into specific neighborhoods  Lack power = excluded from government/institution decisions  4 aspects of social exclusion: 1) Denial of participation in civil rights – due to legal sanction/ institutional mechanisms, systemic discrimination (i.e. race, gender, ethnicity
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