Chapter 10: Community and Public Health and Racial/Ethnic Populations

Majority

those with characteristics that are found in more than 50% of a population

Minority Groups

subgroups of the population that consist of fewer than 50% of the population

Ethnicity

sub-cultural group within a multicultural society

Race

the categorization of parts of a population based on physical appearance due to particular historical and political forces

Operationalize

(operational definition) provide working definitions

Acculturated

cultural modification of an individual or group by adapting to or borrowing traits from another culture

Refugee

a person who flees one area or country to seek shelter or protection from danger in another

Immigrant

individuals who migrate from one country to another for the purpose of seeking permanent residence

Alien

a person born in and owing allegiance to a country other than the one in which he/she lives

Unauthorized Immigrant

an individual who entered this country without permission

Minority Health

refers to the morbidity and mortality of American Indians/Alaska natives, Americans of Hispanic origin, and black Americans in the United States

Health Disparities

differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups

Socioeconomic Status

relating to a combination of social and economic factors

Cultural and Linguistic Competence

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

Why is it said that the United States was built on diversity?

The strength and greatness of America lie in the diversity of its people. The US has been a safe haven for immigrants since it was founded. The US thrives on the differences in cultures and beliefs that make this country diverse.

What is the Office of Management and Budget's Directive 15?

It is titled "Race and Ethnic Standards for Federal Statistics and Administrative Reporting" and it presents brief rules for classifying persons into 4 racial categories (American Indian/Alaskan, Asian of pacific Islander, black, and white) and 2 ethnic categories (of Hispanic origin or not of Hispanic origin).

Why is it important for community health workers to be aware of the significant health disparities among various minority groups in the United States?

because the US population is and will continue to get more diverse. The impact of a more diverse population in relation to community health efforts will be important based on knowledge of past health issues and disparities. We must make sure that advances in health are reaching the minorities to help close the health gap.

What were the significant findings of the 1985 landmark report, " The Secretary's Task Force Report on Black and Minority Health"?

This report in 1985 first documented the health status disparities of minority groups in the US. It provided data documenting that minority populations, compared to the nation as a whole, experience higher rates of morbidity and mortality. It identified the 6 causes of death that counted for 80% of the excess mortality observed in minority groups:

1. infant mortality

2. cancer

3. cardiovascular disease

4. diabetes

5. homicide and accidents

6. chemical dependency

List and explain the six priority areas in the Race and Health Initiative.

Infant mortality: the death before age 1,

• Black Americans infant death rate more than two times that of white Americans

• Lack of prenatal care and low-birth-weight babies

o cancer: Incidence and death rates highest among black Americans for various types of cancer

• Many disparities attributed to lifestyle factors, late diagnosis, access to health care

• Less primary and secondary prevention in various minority groups

o cardiovascular disease: Death rates vary widely among racial and ethnic groups

• Black Americans have higher rates from CHD and stroke

• Hypertension prevalence as a risk factor varies according to race/ethnicity

• Black American tend to develop hypertension earlier in life than whites; unknown reason

o Diabetes: Overall prevalence has risen in U.S. in recent years

• Prevalence in those 20 and older varies in minority groups

• Increase in age-adjusted death rates in all racial and ethnic groups

• Significantly higher in minority groups

o HIV/AIDS: Proportional distribution of AIDS cases has increased in black Americans and Hispanics and decreased in white Americans

• Attributed to higher prevalence of unsafe or risky health behaviors, and lack of access to health care to provide early diagnosis and treatment

o Adult and child immunization: Early childhood immunizations do not vary significantly by race or ethnicity

o Older adult immunization rates are substantially lower in minority groups, even though an overall increase has occurred

What role does socioeconomic status play in health disparities among racial and ethnic minority groups?

Socioeconomic status (SES) considered the most influential single contributor to premature morbidity and mortality. The relationship between SES and health can be described as a gradient, the more the family income is above the poverty threshold, the more the health improves, and the greater the gap in income, the greater the gap in health. SES is not a direct factor of bad health, but things that are risk factors because of low SES can result in lower health, like less access to healthcare.

Why is it important for community health professionals and workers to be culturally sensitive and competent?

Culture is vital in how community health professionals deliver services and how community members respond to programs and interventions. Different minority groups each have unique cultural traditions that must be respected if the solutions are to be successful. Culturally competence includes appropriate services offered to different groups to improve satisfaction and outcomes. Culture is a vital factor in both how community health professionals deliver services and how community members respond to the community health programs and preventive interventions. It is important that health educations are able to communicate with different communities and understand how cultures influence health behaviors.

List each o the three kinds of power associated with empowerment. What is the importance of each in empowering individuals and communities?

1. Social Power: an increase in social power brings with it access to "bases" of production such as information, knowledge and skills, participation in social organizations, and financial resources

2. Political Power: more than just the right to vote; it is also the power of voice and collective action. A single voice does not effect change; it is the collective voice that can make things happen.

3. Psychological Power: best described as an individual sense of potency demonstrated in self-confident behavior. Often the result in success of the first 2.

What is diversity?

differences in gender, age groups, sexual orientation,socioeconomic status, language preference, religion, political views, and special needs as well as race and ethnicity

What percentage of Americans are white (majority)?

63.4%

Is race a biological construct or a social category?

social category

List the majority and minority groups in order according to which is largest.

1.White

2. Hispanics

3. African Americans

4.Asian Americans

5.American Indians and Alaskan Natives

What did the Snyder Act create?

the Bureau of Indian Affairs (BIA) which provided emphasis on providing health services to native Americans.

What is the IHS?

Indian Health Service, it is responsible for providing federal health services to the 566 federally reorganized Native Americans and Alaskan Native tribes.It wants to improve the health status of the Indians and Alaskan Natives

The increase of refugees to America does what to our culture?

enriches it

Cancer death is highest among what minority group?

African Americans

Cancer is the ___ leading cause of death in America.

Second

Secondary cancer prevention refers to ______.

early detection of cancer through screening tests

What type of cancer is the leading cause of cancer death among women?

breast

What is HIV infection?

a chronic condition that progessively damages the body's immune system

What two vaccinations should those 65 and older get?

influenza and pneumoccocal

Who often occupies the lowest socioeconomic rankings in the U.S.?

the minority groups

What does empowerment do?

it replaces hopelessness with a sense of being in control and a sense that one can make a difference