Professionalism and Ethics Exam 2

Colorism

the belief that one type of skin tone is superior or inferior to another within a racial group

Discrimination

the unjust or prejudicial treatment of different categories of people or things, especially on the grounds of race, age, or sex; actions

prejudice

making assumptions and decisions based on inaccurate or faulty information and assumptions; thoughts and feelings

racial steering

the act of real estate agents directing prospective homeowners toward or away from certain neighborhoods based on their race

Racism

a set of attitudes, beliefs, and practices that are used to justify the belief that one racial category is somehow superior or inferior to others; Sometimes Overt, Sometimes Subtle, Continues to Plague U.S. Health Care

Redlining

the practice of routinely refusing mortgages for households and business located in predominately minority communities

sedimentation of racial inequality

the intergenerational impact of de facto and de jure racism that limits the abilities of black people to accumulate wealth

stereotypes

oversimplified ideas about groups of people, a statement, action, or incident regarded as an instance of indirect, subtle, or unintentional discrimination against members of a marginalized groups.

When/Where was the Convention of the Medical Committee for Human Rights Held?

Chicago in 1966

What country/when was the concept of race developed?

The Portuguese in the 15th century

Tuskegee Experiment

experiment carried out from 1932 to 1972 by US public health service in which over 600 Alabama Black men were used as guinea pigs to determine what would happen to the body if syphilis were left untreated

What is the most growing race in the United States?

Hispanic

Equality vs. Equity

equality = sameness; equity = fairness

Racial Justice =

Equity

differentiate discrimination, prejudice, and racism

discrimination is actions; prejudice is thoughts and feelings; racism is beliefs

Representational Racism

racism expressed in how racial groups are represented within popular culture

Ideological Racism

world views, beliefs, and common sense ideas that are rooted in racial stereotypes and biases

eg. many people in American society, regardless of their race, believe that white and light skinned people are more intelligent than dark-skinned people and superior in a variety of other ways

Discursive Racism

racial slurs and hate speech, but also as code words that have racialized meanings embedded in them, like "ghetto," "thug," or "gangsta."

Interactional Racism

racism expressed in how we interact with each other

eg. white or Asian woman walking on a sidewalk may cross the street to avoid passing closely by a black or Latino man because she is implicitly biased to see these men as potential threats

Institutional Racism

institutions and social dynamics that may seem race-neutral but actually disadvantage minority groups

eg. decades-long set of policing and legal policies known as "The War on Drugs," which has disproportionately targeted neighborhoods and communities that are composed predominantly of people of color

Structural Racism

the ongoing, historical, and long-term reproduction of the racialized structure of our society through a combination of all other forms of racism

Systemic Racism

racism was built into the very foundation of our society, and because of this, it has influenced the development of social institutions, laws, policies, beliefs, media representations, and behaviors and interactions, among many other things; the system itself is racist, so effectively addressing racism requires a system-wide approach that leaves nothing unexamined

Power

The ability to decide who will access to resources; the capacity to direct or influence the behavior of others, oneself, and/or the course of events.

Sexual Orientation

One's natural emotional and physical preference in sexual and/or romantic partners.

Gender

A social identity used interchangeably with biological sex in a system that presumes if one has male characteristics, one is male, and if one has female characteristics, one is female

Identity

sense of self, providing sameness and continuity in personality over time the condition of being oneself and not another.

Privilege

Unearned access to resources only readily available to some people as a result of their advantaged social group membership.

Oppression

A system that maintains advantage and disadvantage based on social group memberships and operates, intentionally and unintentionally, on individual, institutional, and cultural levels.

Class

The system of ordering a society in which people are divided into sets based on perceived social or economic status.

Race

A socio-historical category used to divide people into populations or groups based on physical appearance, such as skin color, eye color, hair color, etc

Ethnicity

A category that describes membership to a group based on real or presumed common ancestry, shared languages and/or religious beliefs, cultural heritage and group history.

Microaggressions

statement, action, or incident regarded as an instance of indirect, subtle, or unintentional discrimination against members of a marginalized group such as a racial or ethnic minority.

Who and when was the term microaggressions made?

Dr. Chester Pierce in the 1970's

Examples of microaggressions?

- Where are you REALLY from?
- You're not like the other muslims.
- You don't act like a normal black person

Why is determining who has privilege complex?

cultural, social, and historical changes affect which groups are privileged and which groups are not

Class privilege

privilege based on someone's social class

eg. I do not fear being hungry or homeless

White Privilege

societal privilege that benefits white people over non-white people in some societies, particularly if they are otherwise under the same social, political, or economic circumstances

eg. I Have the Privilege of Having a Positive Relationship with the Police, Generally

Heterosexual Privilege

Unearned, often unconscious or taken for granted benefits afforded to heterosexuals in a heterosexist society based on their sexual orientation.

eg. My sexual orientation (if known to others) is not used to exclude me from any profession or organization (teaching, coaching, the military, Boy Scouts).

Able-bodied Privilege

an advantage people gain simply because they are not limited by physical or mental impairments

eg. If I need to move, I can easily be assured of purchasing housing I can get access to easily - accessibility is one thing I do not need to make a special point of looking for.

Religious Privilege

an advantage people gain simply by their spiritual affiliation

eg. I can expect to have time off work to celebrate religious holidays.

Citizenship Privilege

an advantage people gain simply by being a citizen of a certain state or country

Health Literacy

the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.

Food deserts

Areas where it is difficult to find affordable, healthy food options. More common in highly populated low-income urban neighborhoods where there are fewer grocery stores/transportation options to seek out other food choices. Contribute to obesity in these areas bc people resort to buying cheap, highly caloric foods

Ways to increase health equity among all

Culturally-Sensitive Education, Listening and Adaptation, Representation, Accessibility, and Means and Ends

Where do racial and ethnic disparities originate?

discrimination in health care, genetics, unequal educational opportunity, income gaps, health care access disparities, cultural beliefs, and community systems

cultural and linguistic competence

a set of congruent behaviors, knowledge, attitudes, and policies that come together in a system, organization, or among professionals that enables effective work in cross-cultural situations

Cultural competency in healthcare

the ability of healthcare providers and organizations to meet the cultural, social, and linguistic needs of their patients.

Culture

encompasses a person's learned beliefs, thoughts, and behaviors, their values, customs, and traditions, their communication style, their views on relationships, and the different ways they interact with others

What is culture shaped by?

race, ethnicity, nationality, heritage, socioeconomic status, education, and other factors

Diversity

Distinct qualities, backgrounds, characteristics and beliefs which make us different from each other either as individuals or as groups.

minority

An identified group of individuals which has little power or representation in a given society.

why is the idea of gender controversial?

one's assigned sex at birth may not be what they identify as

by 2050, what percentage of the American population will identify as a "minority?"

52%

Health Disparity

a higher burden of illness, injury, disability, or mortality experienced by one group relative to another.

health care disparity

differences between groups in health insurance coverage, access to and use of care, and quality of care.

more than half of new HIV infections in US each year come from whom?

gay and bisexual men

HIV prevalence in transgender females

25%

percent of LGBT youth who report physical abuse by family

approx. 30%

which race has the highest death rates of diabetes, cancer, and heart disease?

African Americans

Percent of whites diagnosed with COVID in South Carolina

> 50%

Who is dying the most from COVID and what percent of reported deaths?

African Americans; 56%

percent of blacks diagnosed with COVID in SC

41%

Percent of whites in SC who died of COVID?

44%

Why are poorer people twice as likely to be obese?

less $ is correlated with more calories consumed

Why are wealthy individuals more likely to live healthier lives?

access to exercise and eating well

what percent of US population have a disability?

18.7%

Health disparities in Appalachia

higher rates of cervical cancer, heart disease, premature infant mortality, and lung disease; poor access to health care, poverty, uneducated.

complex causes of healthcare disparities

social determinants of health, racial or ethnic bias, healthcare infrastructure, cultural and language barriers, number of providers*, health coverage, lack of diversity within health care, quality of care, lack of communication

examples of social determinants

Socioeconomic status, education, physical environment, social support, access, employment

Racial or ethnic bias in medicine

clinical uncertainty when interacting with patients of another racial or ethnic group

Gender Identity

An individual's INTERNAL SENSE OF GENDER, which may or may not be the same as one's gender assigned at birth

Gender Expression

Way in which an individual OUTWARDLY presents their gender, through how they choose to speak, dress, or generally conduct themselves socially; not always indicative of their gender identity

What does LGBTQ+ mean?

Lesbian, Gay, Bisexual, Transgender, Queer, Inclusive of all identities

Queer

individuals who don't identify as straight or who have non-binary gender identity

cisgender

having a gender identity that matches one's assigned sex

intersex

A general term used for a variety of conditions in which a person is born with reproductive or sexual anatomy that doesn't seem to fit the typical definitions of female or male.

gender non-conforming

Anyone who does not fit neatly into a gender role. Sometimes this is used to suggest that there is something wrong with people who do not fit gender roles. There is not.

Trans*

An umbrella term derived from a contraction of "transgender" or "transsexual". The asterisk is a "wildcard" that stands for the multitude of ways that trans people identify. The prefix "trans" can mean beyond, across, between, through, transcending, or changing. Many trans people have a gender identity that is different from the one they were assigned at birth. Some people identify as trans* if their gender expression is different than what is expected for their gender

MTF

"Male to female"; a person who was assigned male at birth and identifies as a woman.

FTM

"Female to male"; a person who was assigned female at birth and identifies as a man.

Binary

Having two parts. Some societies such as ours tend recognize just 2 genders, male and female

Non-Binary

person whose gender identity does not fit the strict man/woman dichotomy.

Two-Spirit

A term for LGBTQ members of the Native American community, first coined in 1990 by a Native American group in Winnipeg. The term references a tradition common to several tribes, where some individuals possessed and manifested a balance of both feminine and masculine energies, making them inherently sacred people.

How can stigma and discrimination effect LGBTQ+ members in health care directly?

Bias by health care professionals, violence fueled by hatred of LGBTQ+ people, and policies that deny health insurance coverage to same-sex partners

How can stigma and discrimination effect LGBTQ+ members in health care indirectly?

•Discriminatory actions toward LGBTQ+ people around the world creating a negative environment for LGBTQ+ individuals wherever they may reside.

Health Disparities for LGBTQ

Increased risk for depression, anxiety, SI, and substance use; Delayed or refusal of healthcare

prevalence of suicide attempts in LGBTQ+ youth compared to non-LGBTQ

4 times more likely to attempt suicide

what percent of transgender individuals have been refused care?

19%

4 conceptual frameworks in understanding LGBTQ+ Health-Related Challenges

1. Life Course
2. Social Ecology
3. Minority Stress
4. Intersectionality

Life Course Framework

People have different health care needs at different life stages.

Social Ecology Framework

Characteristics of the social environment, including family, other relationships, the community, culture, and general society, can affect an individual's behavior and well-being. How does the social context of people's lives influence their health?

Minority Stress Framework

Sexual and gender minorities (like other minority groups) experience chronic stress arising from social stigmatization and manifested in both external and internal processes. Lack of social tolerance of homosexual behavior may result in stress-related disorders, such as depression, for LGBTQ+ people, especially in those who feel the need to be covert about their sexual orientation or gender identity.

Intersectionality Framework

Social, racial/ethnic, religious, economic, cultural and other factors-in addition to sexual orientation and gender minority status-influence the identities, health, and lived experiences of LGBTQ+ people. Clinicians may need to explore and understand the role and intersection of different identities and other factors in their patient's lives.

Who and when was the term intersectionality coined?

Kimberle Crenshaw in 1980s

What does intersectionality inform us of?

we cannot just discuss separate categories of diversity and not address that they are also interdependent.

what does HEI stand for?

healthcare equality index

In order for health care organizations to achieve HEI leadership status, what 4 metrics must be demonstrated?

pt nondiscrimination policies, equal visitation policies, employment nondiscrimination policies, and training in LGBT Patient-Centered Care

same-sex couples were present in what percent of counties nationwide?

93%

percent of LGBT raising children

18-32%

percent of adults that identify as transgender

0.3%