According to the lecture, committee recommendations for reducing racial and ethnic disparities in health care include which of the following: Show Increase awareness about disparities The definition of health disparity put forth by Health People 2020, includes
the following types of disadvantages, except: biological The 1966 Highway Safety Act is an example of which determinant of health: Policymaking Heart disease is the
leading cause of death for all of the following groups except: asian/pacific islanders Delaying medical treatment and not participating in preventative care are related to which determinant of health: health services Social determinants of health reflect political and physical conditions in the environment. false Non-Hispanic black person are the least likely to be insured when compared to white and Hispanics. false Health equity can be defined as the attainment of the average level of health for all people. false Sickle cell disease is developed when: both parents carry the gene An ecological approach focuses on which of the following: individual and population According to Williams (2010), which of the following group racial/ethnic group is becoming the model minority with some health indicators. black women According to the lecture, the number of deaths in a population at a given time refers to which key term: mortality According to the lecture, the number of ill individuals among a group of
people at risk for the illness at a given time refers to which key term: morbidity Gender differences in life expectancy are consistently larger than whites, for which group: asian and pacific islander Prevalence and incidence are equal most of the time. false Which mortality measures the death of an infant at 0-28 days old. neonatal Prevalence rates
when compared to incidence rates are generally larger. true he "weathering hypothesis" refers to all of the following except: climate changes affect levels of chronic disease When calculating the years of potential life lost, one must include the quality of life in the calculation. false The number of years that are lost due to untimely death are referred to as: YPLL Expressing one's desire to use a condom is an explicit way to express one's health belief. true If a health belief is explicit, that means it is understood though not directly expressed. false All of the following are examples of risk behaviors, except: taking prescribed medicine Illness behaviors are more closely linked to which type of preventative behavior: secondary Health behaviors are shaped by all of the following except: genetics Getting vaccinated is an example of which type of prevention: primary Risk behaviors are defined as any behavior that puts an individual at risk for negative consequences. true Health behaviors that have benefits to the person practicing the behavior can be described as all of the following except: risk behaviors Illness behaviors are weakly linked to socio-demographic factors, such as gender, ethnicity, and income levels. false According to the lecture, health behaviors are _______ reflections of a person's health beliefs. implicit and explicit Differential access to socioeconomic and political power contribute to disparities in health? true Apartheid played a role in the differential spread of HIV and in the legacy of inequalities in all of the following: all of the answer choices are correct The South African National Blood Service were found in political conflict after taking what actions: using race/ethnicity to classify blood safety Population profiling continues to be a tool for analysis/interventions in _____ research. epidemiological Which of the following categories was NOT added to the 2000 US Census from the 1990 US
Census? japanese An unsuccessful legislative proposal to abolish the collection of data on race/ethnicity by Californias public services is described by: proposition 54 Epidemiologist use race/ethnicity to operationalize which of the following: all of the answer choices are correct The Western Province Blood Transfusion Service faces the same political struggles as SANBS with using the terms
race/ethnicity measurements: false Brazil is home to one of the largest immigrant populations of Japanese people outside of the country of Japan? true All of the following are categories under SANBS four categories except: all are correct The Office of Management and Budget responded to the need to standardize data collection on race and ethnicity by developing: directive 14 The Secretarys Task Force Report on Black and Minority Health was released in 1985 by who: margerat heckler Which president was the
first to apologize for the Tuskegee Syphilis Study. clinton Which amendment paved the way for equal educational opportunities. 14 All of the following shaped the health status of Black in the late
1800s, except: immigration Which of the following cases endorsed the development of state and local Jim Crow laws? plessy v ferguson
How long did the Tuskegee Syphilis Study last? 40 years According to the Tuskegee lecture, which of the following is associated with the sentiments some may feel towards government research. mistrust According to the Tuskegee lecture, the government doctors felt betrayed by the governments failure to defend the study. true According to the Tuskegee lecture, the role of Nurse Rivers was important because: she gained the confidence of the participents and was credited by some for the success of the study Health disparities more closely relates to which of the following terms: inequalities The term "double disadvantage" is in reference to which social category: sexism and racism Race could be characterized by all of the following except: genitcally defined Scholars find black men to be more liberal than white men, regarding women employment outside the home. true Nontraditional gender roles
among Black women are fostered which of the following: prominent roles in the family High socioeconomic status (SES) correlates to:
healthier individuals and communities According to the lecture, health disparities have led to all the following circumstances except: higher routine medical care Socioeconomic status (SES) is the
measure of social and economic characteristics that typically include measures of income, poverty level, wealth, education, work status by occupation, and place of residence. true According to the lecture, all of the following countries exceed the US life expectancy, except: argentina Factors linked to changing trends in gender-role attitudes in the contemporary United States include all of the following except: changing household structure Race Social Category, Physical appearance due to particular historical social and political forces, Focused on physical characteristics Ethnicity Social category, Shared Cultural identity with distinct behavioral characteristics, Focused on Common cultural traits Nationality Membership to a Nation or sovereign state, citizenship, place of residency, sense of national identity Health Disparities incidence, prevalence, mortality, and burden of disease within a population Health Care Disparities differences in the presence of illness, health outcomes, or access to care, within a population Inequality in Health differences in both health experience and health status between countries, regions, states, and socioeconomic groups Inequity in Health systematic, unfair, or unjust, yet potentially avoidable differences in access to health services across defined population groups Determinants of health Factors which directly cause illness and disease or are risk factors that affect the health of a population, community, or individual Socio-environmental factors Mortality Number of deaths within a population Crude Mortality Rate total number of deaths within a time period Cause-specific Mortality attributed to a particular cause/disease/illness Age-specific Mortality specific age group Infant mortality rate •infants under the age of 1 Life Expectancy average years a person can expect to live a healthy/productive lifestyle that is determined at a particular age Morbidity •Number
of individuals with a disease, illness, injuries, and disabilities within a population Incidence number of persons contracting/new cases of a disease Prevalence number of persons who have/all cases a particular disease/condition Socioeconomic Status measure of social and economic characteristics that typically include measures of Plessy v. Ferguson •1896 W. E. B. Du Bois •published The Philadelphia Negro Booker T. Washington •founder and president of Tuskegee Institute in Alabama •became so successful that around 1932 it was adopted by the U.S. Public Health Service as part of the new federal Office of Negro Health Works •1951, however, the Office of Negro Health Works was decommissioned in the name of integration Slavery •African Americans arrived in 1619 Tuskegee •1932-1972, Macon County, Alabama •withheld adequate treatment from a group of poor black men who had the disease •told the men they were being treated for "bad Blood." Margaret Heckler •Secretary of U.S.Department of Health and Human Services •Secretary's Task Force Report on Black and Minority Health. Emancipation Proclamation After more than 240 years of slavery, President Abraham Lincoln issued the Emancipation Proclamation on January 1, 1863, announcing, "that all persons held as slaves" within the rebellious areas "are, and henceforward shall be free 13th Amendment ratified in 1865 outlawed slavery in the U.S. and all territories 14th Amendment paved the way equal educational opportunities with the Supreme Court's declaration in Brown v. Board of Education that racially segregated schools violate the equal protection of the laws guaranteed by the Fourteenth Amendment 15th Amendment Male Voting rights; (however, a plethora of insidious methodologies for preventing African Americans from exercising their voting rights were successfully implemented by racist whites who dominated the corridors leading to the voting booths. Civil rights act of 1964 Prohibited discrimination in public accommodations such as mass transportation, restaurants, and hotels on the basis of race, color, religion, or national origin; shifted government policy away from the support of racially discriminatory social norms Voting Rights Act 1965 Eliminated discriminatory election ( practices and suspended literacy tests and provided for the appointment of federal examiners (this and the CRA dismantled the most limiting components of the "Jim Crow Laws" and fulfilled the constitutional guarantees contained in the 14th and 15th amendments) 19th Amendment guaranteed all American women the right to vote Directive 15 Office of Management and Budget (OMB) issued in 1977 (the "Race and Ethnic Standards for Federal Statistics and Administrative Reporting" contained in Statistical Policy Directive No. 15.) Directive 15 is an attempt to standardize data collection so that comparisons of races could be made by creating categories to classify individuals. Importance of Studying Minority Health •The public cost of disparities •Direct Costs •Indirect Costs National Center on Minority Health and Health Disparities •lead, coordinate, support and assess the NIH effort to eliminate health disparities NeoNatal Mortality Rate •Number of deaths during the first 28 completed days of life per 1000 live births in a given year or other period Post NeoNatal Mortality Rate rate of newborns dying between 28 and 364 days of age Socio-economical Model •Intrapersonal Incidence Rates The rate a disease develops in a group of people over a certain period of time. Number of new cases. Divide the number of new cases by the number of people at risk and multiply Prevalence Rates Number of existing cases of a disease in a population at some designated time. Divide number of cases by total number in population at a given time Specific Rates Stratified rates Adjusted Rates Statistical procedures applied to make crude rates more comparable Mortality Crossover Mortality rates that illustrate two groups of individuals vary in one way for younger versus older individuals Comparative Mortality Crude mortality rates cannot be compared , Age adjusted and specific mortality rates can be compared more accurately Acute Short-Term Chronic Long-Term
Birth Rates •Number of live births at a given time YPLL Years of Potential Life Lost 3 Determinants of Health Behavior & Lifestyle : 80% Low SES and Health • Increased morbidity and mortality Closing the Gap on SES Disparities • Providing health coverage Implicit Health Behavior Implied or understood though not directly expressed, Contained in the nature of something though not readily apparent Explicit Health Behavior Clearly developed or formulated, Fully and clearly expressed or demonstrated Preventative behaviors - Primary Primary Illness behaviors Behaviors people engage in with the aim of relieving effects of illness Risk behaviors •Behaviors which are associated with increased risk/susceptibility to adverse health consequences (e.g., illness, injury). Healthy People 2020 address the relationship between focuses on both individual-level and population-level determinants of health and interventions Determinants of health Policy Making Policy Making Policies at the local, State, and Federal level affect individual and population health. (Increasing taxes on tobacco sales, for example, can improve population health by reducing the number of people using tobacco products) Social Factors reflect social factors and the physical conditions in the environment in which people are born, live, learn, play, work and age. Also known as social and physical determinants of health, they impact a wide range of health, functioning and quality of life outcomes. Poor health outcomes are often made worse by the interaction between individuals and their social and physical environment. Health Services Both access to health services and the quality of health services can impact health. Healthy People 2020 directly addresses access to health services as a topic area and incorporates quality of health services throughout a number of topic areas. Lack of access, or limited access, to health services greatly impacts an individual's health status. (For example, when individuals do not have health insurance, they are less likely to participate in preventive care and are more likely to delay medical treatment.) Individual Behavior plays a role in health outcomes. Biology and Genetics Some biological and genetic factors affect specific populations more than others. (For example, older adults are biologically prone to being in poorer health than adolescents due to the physical and cognitive effects of aging) Disparity those differences that are indicative of injustice or unfairness Dissimilarities differences that are not attributed to injustice or unfairness Health disparities "a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage. due to injustice Health care disparities refers to differences specifically within the healthcare system, access to health care, quality of health care, and utilization of health care services that are a result of injustice. Health care dissimilarities refers to the same differences within the health care system (access to health care, quality of health care, and utilization of health care services) that are NOT a result of injustice. Health equity attainment of the highest level of health for all people. Achieving health equity requires to focused on avoidable inequalities, historical and contemporary injustices, and the elimination of health and health care disparities." Health Care Utilization Enabling Factors Enabling Factors are resources that either facilitate or inhibit someone seeking health care services. (For example, having a car is a facilitating factor because it provides transportation, a useful resources for physically traveling to a health care provider.) ( Having no health insurance would be an inhibiting factor because it often deters one from seeking health care services). Predisposing Factors are an individual's inclination to use health services, most notably one's attitudes toward using health care. These attitudes may be facilitating or inhibiting and are largely influences by cultural beliefs and prior experiences. (For example, if someone distrusts the medical establishment, or has had negative experiences with the medical establishment, he/she may be less likely to seek health care services. Conversely, is one has a great relationship with a medical provider, he/she is more likely to continue visiting this provider in the future.) Perceived need for Health Care Service is one's belief that he/she does (or does NOT) need to utilize health care services for health issues. If one does not perceive a need for an action, including health behaviors, he/she is much less likely to engage in that behavior. Leading causes of death •For whites, blacks, American Indians, Alaskan Natives, and Latinos, heart disease is the leading cause of death and malignant tumors (cancer) is the second leading cause of death •For Asians and Pacific Islanders, malignant tumors is the leading cause of death while heart disease is the close second Theories of health disparities Socio- Environmental Theories Socio- Environmental Theories Risk Exposure Psychological/Behavioral theories Weathering Hypothesis Physiological Theories Genetic differences among racial/ethnic populations Risk Exposure theory says that high prevalence of social or environmental health risks in predominantly minority communities lead to a higher prevalence of disease and death. (Because the United States is a highly racial segregated country, different rates of health risk in different communities place different populations at different levels of risk in those communities.) Resource Deprevation says that racial/ethnic disparities in health status exist because minorities are more likely than whites to live in communities that are lacking in the necessary infrastructure to support a healthy lifestyle. (Infrastructure includes road ways, food sources, safety, and health care services, to name a few.) Weathering Hypothesis seeks to explain the differences between African-Americans and Whites in pregnancy outcomes. It proposes that social stress in the community, in the environment and the society, affects African Americans and other minorities negatively. Specifically, these populations are said to actually "weather" or age at accelerated rates because of increased exposure to stress. We know that excess stress has numerous health implications, including premature aging and associated conditions John Henryism developed by Sherman James, hypothesis assumes that lower SES individuals in general, and African-Americans in particular, are routinely exposed to psychosocial stressors ( that require them to use considerable energy each day to manage the psychological stress generated by these conditions. The hypothesis further assumes that individuals exposed to excess psychosocial stressors will respond differently, with varying degrees of success. The John Henry Hypothesis predicts that individuals in lower SES categories who utilize active coping skills related to the excess stressors are more likely to suffer from hypertension due to their effort Preventative behaviors -Secondary Early diagnosis and treatment of existing disease and/or health condition in order to avoid further debilitative
effects Preventative behaviors -Tertiary •Fighting the disease and/or health condition when signs/symptoms present to minimize complications Preventative behaviors -Quaternary •Avoidance of over-treatment Secretary's Task Force Report on Black and Minority Health. 10-volume •documented "excess"deaths from seven disease conditions (cancer, cardiovascular diseases, chemical dependency, diabetes, homicide, unintentional injuries,and infant mortality Minorities are more likely to Live in poverty relationship between SES and an increased risk of being affected by health disparities Income Future Directions using SES Lifestyles What are 3 health disparities?Examples of Health Disparities. Mortality.. Life expectancy.. Burden of disease.. Mental health.. Uninsured/underinsured.. Lack of access to care.. What are the 7 health disparities?Health and health care disparities are often viewed through the lens of race and ethnicity, but they occur across a broad range of dimensions. For example, disparities occur across socioeconomic status, age, geography, language, gender, disability status, citizenship status, and sexual identity and orientation.
What are considered health disparities?Health disparities are preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations. Despite significant progress in research, practice, and policy, disparities in youth health risk behaviors persist.
What are four factors that contribute to health disparities?Social determinants of health such as poverty, unequal access to health care, lack of education, stigma, and racism are underlying, contributing factors of health inequities.
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Health disparities include differences in all of the following except
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