Quiz L Study Guide Minority Health

What is Minority Stress Theory?

Created by Ilan Meyer, explains why people who belong to marginalized groups often have worse health outcomes than the general population: they experience extra social stress simply because they are part of a stigmatized group.

What are the components of the Minority Stress Theory?

1. General Stressors

2. Distal Stressors (External)

3. Proximal Stressors (Internal)

General Stressors

Normal daily stress that everyone experiences, like dealing with economic problems or environmental factors

Distal Stressors (External)

Stress that comes from the outside world due to minority status. This includes direct acts of prejudice, discrimination, rejection, and unfair laws or policies

Proximal Stressors (Internal)

Stress that comes from within the individual as a result of living in a biased world. This includes hiding one's identity (concealment), expecting rejection, or internalizing negative social messages

What are General Stressors examples for the Maternal and Adolescent Child Health population?

Stress that affects everyone, regardless of status (Example: ecomonic downturn or low income)

What are Distal Stressors examples for the Maternal and Adolescent Child Health population?

Direct hostility or systemic unfairness (Example: Bullying of lesbian, gay, or bisexual high school students. Experiences of biphobia (prejudice against bisexual people) when trying to access health services. Historical practice of forced sterilization of Latine/Hispanic, Black, and Indigenous women without consent)

What are Proximal Stressors examples for the Maternal and Adolescent Child Health population?

Internal struggles caused by stigma (Example: Hiding one’s sexual orientation from doctors (39% of bisexual men and 33% of bisexual women reported this). Continuous stress from assessing one's safety in different environments)

What are examples of health outcomes that result from General, Distal, and Proximal Stressors?

This excess stress can lead to serious health problems, including:

• Mental Health Issues: Increased rates of depression and elevated risk for suicidal thoughts and self-harming behaviors. Bisexual adults, for instance, report double the rate of depression compared to heterosexual adults.

• Physical Health Issues: Stress can lead to a compromised immune system, and is linked to chronic illnesses like diabetes, hypertension, and heart disease. Bisexual women specifically face higher rates of all cancers and heart disease compared to heterosexual women.

• Behavioral Issues: Increased rates of substance abuse (like smoking and alcohol use) often used as coping mechanisms. Bisexual youth are twice as likely as non-LGBT youth to experiment with drugs and alcohol.

What are the common reasons why minority communities are hesitant to utilize public health services?

Stems primarily from a breakdown of trust and the presence of deep-rooted barriers:

• Generational Mistrust and Exploitation: Minority groups have a long history of medical mistreatment and exploitation, such as the Tuskegee Syphilis Study, which makes trust-building efforts essential today. The history of forced sterilization also contributes to current fears and lack of trust in government and medical institutions.

• Structural and Legal Fears: Immigrant or undocumented populations may avoid formal healthcare due to fear of documentation checks or lack of legal status. Fear of judgment or retaliation from political groups can also discourage residents from seeking care.

• Cost and Access Barriers: The cost of formal healthcare services can be prohibitive.

• Cultural Discomfort: Negative personal experiences in healthcare settings, such as biphobia, can lead people to delay visits or avoid sharing their identity with providers.

What are common barriers to public health services experienced by Hispanic communities?

• Systemic Barriers: Experiences of systemic racial neglect, leading to limited access to healthcare and resources. Structural barriers can also limit access, safety, and trust during outreach efforts.

• Language and Health Literacy: Language barriers complicate health communication. Many individuals also have low health literacy and may lack knowledge on how to access preventive care.

• Cultural Influences: Decisions are often influenced by cultural beliefs and family dynamics (Familismo), where collective well-being guides choices. Outreach often fails when it overlooks these cultural nuances.

• Preference for Informal Care: Communities may rely on alternative, traditional medicine (like teas or herbal remedies) because they believe in their effectiveness, or because these methods are easier to access and less costly than formal healthcare.

What are the methods for building trust with minority communities?

1. Partner with Trusted Messengers: Utilize local advocates, church/faith leaders, or Community-Based Organizations (CBOs) to deliver messages, as they are credible within the community and are familiar with resident needs and routines.

2. Deliver Culturally Competent Information: Health messages must be provided with cultural sensitivity and resonate with the community’s values, experiences, and emotions. This may involve using clear, simplified language and relatable examples.

3. Promote Agency and Access: Public health efforts should support individual decision-making (Agency), helping people make plans and build confidence in seeking care. They must also improve Access by working with trusted spokespersons to reach communities effectively.

4. Embrace Empathy and Safety: Listen, validate, and understand people’s emotions and beliefs. Creating a safe space for community members to share thoughts and concerns is vital.

What is cultural competency?

Communicating health information with sensitivity so that the message resonates culturally and emotionally with the community's experiences and values.

What is agency?

Supporting the individual's ability to take ownership of their health journey and make informed decisions.

What is access?

The ability of people to reach health services or information; improving access often involves working with trusted local entities.

What is Community based organizaton (CBO)?

A local organization that acts as a trusted source and messenger to promote health efforts within the community, often helping to increase vaccine access.

What is trusted messenger?

A person or group who is seen as credible and reliable by the community (e.g., CBOs, local advocates, faith leaders).

What are common reasons why public health interventions fail when working with vulnerable communities?

• Lack of Trust: Historically, public health initiatives often overlook the long histories of medical mistreatment and distrust that marginalized groups harbor toward government or medical institutions.

• Ignoring Structural Barriers: Focusing only on health facts is not enough; interventions fail if they do not address the systemic barriers that limit access, safety, and trust (such as immigration fears or legal issues).

• Lack of Cultural Competence: Standard outreach often does not meet community needs and fails when it is not made meaningful, relatable, and culturally relevant.

What is the role of misinformation in marginalized communities?

(false or misleading information shared without intent to deceive) can greatly influence health decisions in marginalized communities, especially during crises like pandemics.

• Social Media Influence: Platforms like Facebook and YouTube are major sources of news and can shape how immigrant communities trust and respond to public health information, impacting crucial decisions like vaccine uptake.

• Exploitation of Trust: Social media algorithms reward content that is emotional and relatable, allowing misinformation to spread easily within tight-knit communities. Anti-vax pages deliberately use imagery related to family, religion, and fake authority to build false credibility and drive vaccine hesitancy.

• Vulnerability: Challenges related to digital literacy make marginalized communities more vulnerable to detecting inaccurate content, including AI-generated information.