camara jones + access flashcards from cert

Define + Describe Availability

Definition:

• Measures the extent to which the provider has the requisite resources (such as personnel and technology) to meet the needs of the client → just means whether the volume and type of services needed by the community are available

• E.g. Do we have enough GP’s, do the GP’s have enough of this, of that? Do we have to go to another branch/service because the first place you went to didn’t have the provisions/resources on hand?

Define + Describe Acceptability

Definition:

• Cultural and social factors determining the possibility for people to accept the aspects of the service ( and for services to accept aspects of the patient) and the judged appropriateness for the persons to seek care → Emcompasses ethnic background, gender, class, culture

• E.g. is a woman is going in for a cervical screening, is there a female practitioner available? → are our identity, gender, sex etc. reflected in the health care services?

Define + Describe Affordability

Definition:

• The economic capacity for people to spend resources and time to use appropriate services

• When mentioning affordability: Always state whether it is a direct or indirect cost → Even if healthcare was “free,” it wouldn’t actually be free → we would be paying elsewhere

• E.g. won’t seek out services due to cost / won’t get their precription due to cost

Define + Describe Accommodation

Definition: T

• Measures the extent to which the provider has the requisite resources (such as personnel and technology) to meet the needs of the client → just means that the volume and type of services needed by the community are available

• Reflects the extent to which the provider’s operation is organised in ways that meet the constraints and precedences of the client → includes structural aspects(how the health system is built)

• E.g. Opening hours, Telephone services, How appointments are made

Define + Describe Accessibility (geographic)

Definition:

• Measures the extent to which the provider has the requisite resources (such as personnel and technology) to meet the needs of the client → just means that the volume and type of services needed by the community are available

• E.g. People residing in rural areas could travel for hours to access certain health services (e.g. specialised services)

Which of the 5 A’s does the following statement refer to?

The relationship of prices of services
and the client’s ability to pay

Affordability - Penchansky & Thomas (1981) (1981)

Which of the 5 A’s does the following statement refer to?

How the patient feels about the
characteristics of the provider (and vice
versa)

Acceptability - Penchansky & Thomas (1981) (1

Which of the 5 A’s does the following statement refer to?

The relationship between the manner in
which the supply or resources are
organised to accept the client and the
clients’ ability to accommodate to these
factors

Accommodation - Penchansky & Thomas (1981) (1

Which of the 5 A’s does the following statement refer to?

The relationship between the location of
supply and the location of the clients

Accessibility (geographic) - Penchansky & Thomas (1981) (1

Which of the 5 A’s does the following statement refer to?

Volume and type of services relative to
client need

Availability - Penchansky & Thomas (1981) (1

Describe the impact of the SDoH on health

They dictate health opportunities / the opportunity to obtain and maintain healthiness of social groups based on their placements within these within hierarchies of power, prestige and SES → where you sit in the hierarchy dictates what type of social determinants you have access to

SDoH dictate your health outcomes → they dictate how exposed we are to them → can be positive + negative → is it the distribution of the SDoH that determine whether we are healthy or not

Define Prejudice

differential assumptions about the abilities, motives, and intentions of others according to their ‘race’/ethnicity

What is Discrimination?

Differential action towards others according to race/ethnicity based on prejudicial assumptions

Includes acts of omission(excluding/leaving out someone or something) and commission (instruction/command given to a person).

How does Jones (2020) describe the Idea of Race?

• ^{Race (or ethnicity) is preceded by racism}

• ^{‘Race’ (or ethnicity) is not a biological construct that reflects innate differences, but rather, it is a social construct that captures the impacts of racism in a racialised-society}

• ^{‘Race’ was created to justify that actions of the European expansion and manifested in many different types of differences like oppression}

What does Racism entail?

• Differential access to goods and services of society

• Structures that favour one group over another group (inaction in the face of need)

• Discrimination (differential action towards others according to race/ethnicity based on prejudicial assumptions ) + Privilege

• Produces inequities that manifest as a disadvantage for some groups and privilege for others

What are the 3 levels of Racism as described by Jones (2020)?

• Institutional

• Personally-Mediated

• Internalised

Note: the levels are not equal → just like in the TKHM Modified Williams model, we want to intervene in the structural, basic causes (i.e. don’t target personally-mediated & internalised)

Define Institutional Racism

 differential access to the goods, services and opportunities of society by ethnicity

Describe Institutional Racism

aka structural/social/systemic racism

• Embedded in social norms, custom, laws (social)

• Manifests itself in material conditions and access to power (structural)

• Inaction in the face of need (systemic)

• Because it is structural →maintained by political and social institutions →  no identifiable perpetrator

• Drives differences in SES by ethnicity

• Manifests as inherited disadvantage

• “When an entire network of rules and practices disadvantages less empowered groups while serving at the same time to advantage the dominant group/s”

• Don’t provide equality or equity for all

Describe Personally-Mediated Racism

• Prejudice (differential assumptions) and discrimination (differential actions) → expressions of societal racism operating through individuals 

• Acts of commission (doing) / omission (not doing)

• Maintained by structural barriers + societal norms

Describe Internalised Racism

• Taking on / accepting messages about inferiority or superiority of social groups in racialised hierarchies

• Not believing in themselves or in others who look like them 

• Manifests as helplessness, hopelessness, self-devaluation

• Product of systemic/institutional racism

• Acepting limitations to one’s own full humanity, including one’s spectrum of dreams, one’s right to self-determinations, and one’s range of allowable self-expression

• Where people believe in the racial hierarchy → you internalise that racism you have been exposed to, and then you believe it

• Manifests as an embracing of “whiteness”

Describe Privilege

• A feature/product of racism where inequities manifest as a disadvantage for some and an advantage for others

• The flip side of oppression.

• Oppression confines and limits one’s opportunities, while privilege confers power, dominance, resources, and rewards”(Schaefer, 2008) 

• Unearned systematic and interpersonal advantage (Borrell et al, 2009)

True/False: If a group is being disadvantages, another is being privileged

True

True/False: We can’t have privilege in some areas of our lives, and be disadvantaged/oppressed in others

False

True/False: We can be unaware of our privilege, when it may be obvious to other people (we assume that everyone has the same as us)

True

“It is hard for any of us to recognise a system of inequity that privileges us” (Camara Jones)

What are 3 ways racism impact health outcomes?

• Differential exposure to the determinants of health (e.g. socioeconomic & environmental)

• Differential access to and quality of health services

• Direct effects of racism such as trauma and stress - intergenerational