health disparities

equality

everyone having the same thing

equity

getting someone what they need in order to be equal

types of racism

systemic, interpersonal, internalized

systemic and structural racism

emphasizes the involved of the entire system and emphasizes structures themselves

interpersonal racism

defined as prejudice and discrimination where prejudice means differential assumptions about abilities, motives and intentions of others according their race, and discrimination means differential actions toward others according to their race, leads to conscious and unconscious bias

internalized racism

Defined as acceptance by members of the stigmatized races or negative messages about their own abilities and intrinsic worth

discrimination and health impact

Individuals are not doomed to disease because of their circumstances. Health and illness are the result of a complex interplay between genetics, behavior and environmental conditions 

epigenetics

effects that parents, grandparents have had and if triggered will get activated

overt behavior

hate crimes and poor treatment

cover/ symbolic behavior

stereotypes, anti asian treatment, implicit policy

money and wealth

asians have highest income, non hispanic whites have highest accumulated wealth

wealth

is not money but network, resources, parent’s upbringing

gender

women of color make less wealth compared to both men of the same racial group and with white women

racism

upstream cause of differences in environments and experiences that shape health and disease

good stress

tolerable stress with no health effects

toxic stress

more likely to occur when people experience chronic exposure to many stressors in everyday life with limited control

allostatic load

cumulative wear and tear on the body’s systems caused by endocrine and neural response to prolonged stress

allostasis

 the body’s natural process of achieving stability through physiology change

physiological dysregulation

measured by biomarkers reflecting chronic over or under activity of key systems

epigenetic effects

triggered through pervasive moments of stress, oppression or weathering

weathering

wear and tear one’s body that that one experiences through racism and oppression

weathering hypothesis

black americans health declines at an earlier age cause of cumulative impact of social and economic adversity they experience over their lifetimes

role of historical trauma

historical policies created conditions that cause poor health, exposure from trauma generations ago can influence current health disparities

Policy imperative

braveman advocates for upstream policy interventions that target social and economic foundations of stress

ultimate goal of policy implications

to reduce differential exposure to health damaging chronic stress to achieve greater health equity

resilience resources

focused on trying to buffer the harmful effects of stress on health rather than addressing its causes

education access

leads to economic resources, health literacy, and behavioral choices e

economic resources

high education leads to better income and wealth which leads to quality healthcare and food

health literacy

educated individuals are better at understanding and navigating the complex healthcare system

behavior choices

 formal education is linked to healthier lifestyle habits

mobility

the ability of person to move up or down social or economic status across their lifetime

upward mobility vs downward mobility

high income, more education vs loss of income, fewer opportunities

accumulated wealth

monetary value of assets

what are two commonly used factors used for socioeconomic status in us

income and education

status syndrome

populations with low ses are more than three times likely to die prematurely than those at the top

Ses and association with wealth

as income goes up, health status improves

health and race/ ethnicity

racial or ethnic diff in living and working conditions that affect health may be more important in determining who will be healthy or become sick in the first place

chronic stress related to experiences of racial or ethnic bias

may significantly contribute to disparities in health among racial or ethnic groups over and above diff in living and working conditions and diff in medical care