HS 1002 FINAL flashcards

Week 1 to 11

What is a reductionist statement?

• Not analytical 

• Represent complex phenomenon as if they are simple 

• Proposes they are impossible to change

What are the 2 most commonly discussed factors for health in our society?

Genetics

Behaviors

WHO def.

Non medical factors that influence health outcomes

• conditions in which people are born, grow, work, live and age

What are the 2 types of social determinants

Attitudinal

• personal beliefs, perspectives, and perceptions 

Structural

• policies, healthcare systems, infrastructure

A policy of excluding dental care from universal healthcare and defining it as an “individual responsibility” is a —-determinant of health that is rooted in —- determinants

• Structural

• Attitudinal

• Basically, people who don’t have healthy teeth did it to themselves and must reap the consequences of their choices. 

Health inequalities

Some people are healthier for a multitude of reasons

• money

• choices

• access

Health Inequities

Some people have worse health due to not being given the same support/opportunities

The 14 determinants:

• Aboriginal status     

• gender disability    

•   housing early life    

•  income and income distribution

• education    

•   race employment and

• working conditions 

• social exclusion

• food insecurity    

• social safety net health services    

• unemployment

• job security

What ethnic group experiences higher prevalance of caries compared to any other group

Latino children

What causes difficulties in access to care (refering to latino oral health article)

1. Fluctuating eligibility for public health insurance

2. limited community infrastructure

3.  lack of public transportation

What is a low income disease mechanism?

Explains how living in poverty leads to disease in the body

ex.:

1. Chronic stress

2. adoption of health threatening behaviors

3. material deprivation

Definition of health capital

The accumulation of health resources (physical and psychosocial) over the early stages of life

T or F: Canada is a powerhouse in SDH scholarship

True

T or F: In 1800s, many didn’t make it past 40

True

Avg life expectancy 1921, 1950, 2021

• 1921: 57.1 was avg life expectancy 

• 1950: 70 was avg life expectancy 

• 2021: 73.3 years global average 

• 2021: 82.6 Canada avg

Basically, life expectancy increased

Top 3 causes of death in Canada - Recent 

1. Cancer 

2. Heart disease 

3. Covid 

Malawi life expectancy change

• Malawi changed their avg life expectancy from 44 to 62 within 14 yrs  

What did Madagascar rank on the multidimensional poverty rank

5th out of 110th

Who is the Father of Social Medicine and what does he state

Rudolf Virchow

“Disease is not something personal and special, but only a manifestation of life under modified (pathological) conditions”

Whitehall studies, what is it?

Principal investigator: Michael Marmot

10yr study pf 17500 male civil servants

Even though everyone had jobs,
social status still affected health

Whitehall 1 findings and Whitehall findings 2

• higher civil ranking = longer life

• Lowest grade (pay and status) civil servants had a 2.1x higher relative risk for cardiovascular disease mortality compared to highest grade civil servants 

• Clear relationship between social status, the behaviors and conditions of living typical of a particular status, and health 

Causality def

• Relationship between cause and effect 

Prevalence def

• Measure of disease that allows us to determine a person's likelihood of having a disease 

Socialization def

process by which individuals learn the norms, values, and behaviours of their society.

Population health

A way to understand health of populations and develop interventions to improve/protect it

Dose Impact

• The more exposure you have, the bigger the effect on your health.

Key drivers of health disparities is

1. Poverty

2. Access to healthcare

3. Education 

Opportunity deficit

1. Limited support for and success in school

2. No good jobs in sight

3. Limited sense of purpose and meaning 

How many young women experience postpartum depression in Canada and globally

• 20% in Canada

• 40% Globally

Children born into poverty are more likely to —- during first year of life

1. die

2. have learning difficulties

3. leave school before graduating

4. experience poor health

What do bigger income gaps lead to deteriorations in (3 things)

1. Social relations

2. Health

3. Human capital

Advantages and Risks

Risks can be defined as the “potential of probability of harmful outcome through an exposure” 

Physical

Biological

Chemical

Psychological

Vulnerability

how likely someone is to be harmed

Job security

• A sense of well being, control, fulfillment, and self esteem 

• Mutual trust and respect between employer and employee 

• Environment feels safe 

• Job stability 

What are characteristics of a precarious or non standard work

• No job security 

• Often multiple employers 

• Lacks comprehensive benefits of standard work 

non standard work: part time, contract work, freelancer

What is the Intensification of work 

• Increased expectation that work will be completed at greater speed with greater effort and better results on a tight deadline 

About — of injuries require medical attention in Canada

1/6th

Stress profileration, how many workers in Canada reported feeling exhausted and burnt out?

• A single problem can spread and create multiple new problems.

• can lead to injury, burnout, and ALLOSTATIC overload 

• Almost ¼ of workers in Canada reported feeling exhausted and burnt out most of all of the time in spring 2023.

Burnout and symptoms

• Psychological term 

• It is used in the employments health lit; refers to condition arising from chronic work related stress 

• Symptoms: Emotional exhaustion, disinterest in work, and lack of motivation 

Allostatic Load def

• Physiological wear and term on the body due to chronic stress and the repeated activation of the stress response system 

• Measurable through biomarkers such as cortisol levels, blood pressure, inflammation, and metabolic dysregulation 

What defines a public health challenge? 

• The burden of disease in a population 

• The number people at risk for disease 

• Evidence: likelihood of harmful consequences from exposure to that risk 

What does Work family conflict refer to

• “Refers to the strains (times based strains and attention-based strains) that arise for parents when work and family demands are incompatible” (Greenhaus and Beutell, 1995) 

Dinh and colleagues (what do they state):

• Workplaces are one of the most important social institutions families engage with, supplying critical resources to families

The Long Arm of the Job

• Q: “What impact does one's day to day experience at work have on what does and how one behaves when off work?” 

A: “The results of this paper suggest that the extent to which a man is used, as a resource in the organization of work, is  a burden– light or heavy– not easily dropped at the mill gates.” 

This basically means that:

• The impact of one's lived experience at work and how this relates to the ways in which people operate outside of work in the home sphere 

Scarcity Hypothesis 

• We have limited resources of time and energy, and when these become taxed to the point of overload, this results in tiredness, emotional distancing, and absence from home 

Dinh et al. 2017 – “Growing up in Australia" study 

1. What is it

2. Goal

3. Findings

1. Studied 2496 dual earning couples and children 

2. Goal of study: Study impact of various factors of children health and development by interviewing a national sample of parents twice a year, starting when their kids were in kindergarten.

3. Findings: 

   • Negative impact on parent mental health 

   • Increases irritability in interactions with kids 

   • Impacts marital satisfaction

T or F: Mothers work-family conflict experiences impacted children differently than fathers WFC

T

Healthy childhood development depends on 3 factors: 

1. Safe physical environment 

2. Access to adequate nutrition 

3. Quality supportive relationships 

Gender norms

Standards and expectations to which those socially identified as belonging to a gender generally conform within a range that defines a particular society

What is the Fourth Industrial Revolution

a time when advanced technologies like AI and robotics are changing how we live, work, and communicate.

Gig work

unincorporated self employed workers whose future business activity is uncertain or expected to be minor or occasional

Gig economy stats

• Growing internationally 

• 8-10% of Canadians engage in gig work 

• 871,000 Canadians reported gig work as main job 

Gig workers in canada more likely to be 

- women 

- 15-24

-immigrant men 

Worker vulnerability according to Jetha et al. 

• Vulnerable worker: Workers exposed to structural factors (ex. Racism, ableism, sexism) that may contribute to adverse work arrangements/environments 

Fragmentation in the Future of Work Reading

Goal of study

Results

Conclusion

• Goal of study: to understand how future of work could result in conditions which contribute to vulnerability for different groups of workers 

• Results: Nine trend categories were uncovered, which included digital transformation of economy, AI, climate change and the green economy. 

• Conclusion: Future of work represents an emerging public health concern

1. What are sources of risk to migrant workers’ health and well-being as they perform their daily tasks in the greenhouses?

• They work 10 hrs a day or more, 7x a week

• Cannot rest 

• Work on holidays, not paid extra or overtime 

• Not treated as humans (humiliated and abused) 

• Separation from family (stress)

2. What aspects of stress and gig worker vulnerability discussed in your required reading for week 3, the Fragmentation of Work, emerge in some form in the film?

• Decline in union representation 

• Discrimination at work 

• Wage depression 

• Increased exposure to health and safety risks

How do specific structural conditions and factors (meaning economic, political, legal, and social norms, forces, policies, and systems) contribute to poor working and living conditions faced by the migrant workers?

• Employers hire workers in desperate need for jobs and barely pay them (cheap labour) 

• They pay minimal for the labour and provide extremely cheap housing and utilities, causing the employees to be almost fully dependent on their job 

• Employers make it so that they have full power so that employees do not have a say - wage depression 

• This makes it difficult for an employee to have increase in pay or have any sort of power 

• Some immigrant workers are undocumented, so they fear reporting or speaking up 

• Employers have many ways of getting around certain labour laws as they are not enforced well enough (ex. Working overtime and crowded housing) 

The long-arm of the job theory proposes that “the extent to which a man is used, as a resource in the organization of work, is a burden— light or heavy—not easily dropped at the mill gates. “  How is this theory illustrated or countered in the film?

• The stress of not seeing family for 8 months (even more) while working in unsafe working condition and living conditions is extremely harmful 

• Working tiring, physical labour jobs can lead to body pain and cause mental stress

• Constant fear of employers and their unstable future (one small mistake can lead to getting fired)

What did Joyce Echaquan experience

• First nation

• Complained about severe stomach pain, in return was insulted by healthcare workers 

Canadian Charter of Rights and Freedoms Purpose

• Protection from discrimination as a right of all Canadians 

• Equality rights

Is racism an SDH

yes

Acts of discrimination 

• Actions within systems of power

• Socially structured 

• Normalized 

• Productive acts

• Occurs at structural and individual levels 

In Canada, —% of visible minority have experienced racial discrimination

81%

—- women in Canada have experienced racism when using the healthcare system

One in five

Poverty is racialized in Canada, —% of people living in poverty identify with a racial group in Toronto  

62%

Evidence of direct impacts on health 

• Higher chronic disease

• Reduced healthseeking 

• Higher levels of unhappiness 

• Higher levels of poverty

T or F: Every income bracket in Canada harbors slightly better health outcomes than the one below it 

T

— racialized families live in poverty in Canada as opposed to — non racialized families 

1 in 5

1 in 20

Intersectionality def

• How different parts of someone's identity creates unique experiences 

Structural discrimination vs Individual discrimination

SD:

• macro level conditions that limit resources, opportunities, and the well being of less privileged groups

ID:

• Negative interactions with another person (health care provider, salesperson, etc.) based on an individual's characteristics (race, gender, etc.)

In Ottawa and Toronto, in the middle of the pandemic, COVID-19 cases were——- higher within racialized communities as compared to nonracialized communities

1.5 to 5 times

within First Nations communities in February 2021 indicated that rates of infection were —-% higher as compared to non-First Nations communities

69%

The she session

• Women are more likely to be negatively affected than men, esp. in jobs and income

• recession triggered by COVID 19 disproportionately effects women

• women of colour are more likely to be effected

T or F: COVID-19 is not the only pandemic, racism and inequity are also pandemics

T

Does equity equal equality?

No, treating someone equitably leads to better outcomes than treating everyone the same way.

T or F: The Chief Public Health Officer’s 2020 report highlighted that inequity in health outcomes was only a problem during the COVID-19 pandemic.

FALSE: Inequity has always been a problem

What are three ways that implicit racial bias affects healthcare?

1. Interpersonal Interactions

2. Internal Dynamics

3. Cost and Waste

Jetha and colleagues (2021) examine the changing nature of work on workers experiences of vulnerabilities. What are the trend categories reported in this required reading to impact vulnerability? 

Focus- big, system-level trends shaping work, not individual outcomes

• Precarious employment (unstable, insecure jobs)

• Changing workforce composition (e.g., more gig workers, migrants)

• Technological changes (automation, digital work)

• Changing organization of work (outsourcing, subcontracting)

What is food insecurity, what does it mean to be food secure?

•  Not knowing if you will have enough food to eat today or in the future (if farmer, not knowing when food from harvest will run out) 

• If food secure: always have enough calories and right kinds of food for healthy life 

What is the most extreme form of food insecurity

Famine

What are causes of food insecurity

• Global + local economic forces 

• War and displacement 

• Environmental disaster 

• Poverty and non living wages

3 levels of food insecurity

Marginal: Worrying about running out of food or having limited selection 

Moderate: Compromising in quality/quantity of food 

Severe: Missing meals, reduced food intake, going without food 

Approx. —% of households are facing food insecurity at mod + sev. level

16%

— children are experiencing food insecurity in Canada 

1 in 5

— people who used food banks in 2023 used it for the first time

2 in 5

Food insecure stats

2017:

2020:

2022:

Food insecure households 

2017-2018: 1.2 mill

2020: 2.1 mill

2022: 8.7 mill

Who groups are the highest food insecurity among

• Low income/ on social assistance

• Female single headed households with children 

• Racialized groups 

• Recent immigrants (20%) 

• 33% First Nations living off reserve

Highest rates of food insecurity are in —— (-% to -% of households are food insecure) 

Nunavut

57 to 76%

Uneven distribution of food insecurity among social groups: 

• -% seniors 

• -% have a disability 

• -% children 

• 7.7% seniors 

• 32% have a disability 

• 33% children 

—% of Canadian food bank users are on ——- as their MAIN source of income 

42.4%

social assistance