1RR3 Exam practice

What is sex?

Biological factors (XX, XY)

What is gender?

Socially constructed roles typically assigned at birth

What are the implications of sex?

Disease related to morality and morbidity (ex: cervical cancer/ testicular cancer)

Explain issues with women's health and drug testing

Most studies are conducted on men, under the false pretence that men and women need the same dosage of medication

Give an example of a dangerous outcome from men only drug testing

Sleeping medication zolpidem - women only need 1/2 a dose compared to men

Who tends to utilize health care services more?

Women tend to utilize health care services more than men

How do rates of depression and suicide compare between men and women?

Women have higher rates of depression, but men have higher rates of suicide

Define Gender Inequality (pertaining to health care)

Sex based differences are not recognized. Women will be cared for in the same way as men.

Define Gender Inequity (pertaining to health care)

Receiving unfair health care based on gender (typically women face this)

Explain the inextricable link between sex and gender in health

Sex = biological reasons for different presentations
Gender = women often seen as hysterical

How does gender relate to the other SDoH?

- Relates to socio-economic factors
- Intersects with social class and ethnicity
- Upstream to education, occupation and income

What is the difference in poverty rates for children of 2 parent homes, vs. children of lone-parent homes?

Much higher in lone-parent homes

What is needed to close the gender pay gap?

Eliminating forms of gender based discrimination

How does income differ for women with a bachelors degree vs. just a high school diploma

Women with Bachelor's degree earn ~ 63% more than women with a high school diploma

How does income differ for men with a bachelors degree vs. just a high school diploma?

Men with Bachelor's degree earn ~ 45% more than men with a high school diploma

What is the trend with the gender wage gap?

Declining, but still high

How does food insecurity effect mood and anxiety if men vs. women?

Food insecure women are more impacted by mood and anxiety than food insecure men.

What is the women's health movement?

Women fighting to "take back" their bodies from male dominated health care systems

What does goal 3 of the sustainable development goals address?

Health and wellbeing for all

What does goal 5 of the sustainable development goals address?

Gender equality

What does goal 10 of the sustainable development goals address?

Reduction of inequality within and among countries

What is the gender bias in grants for female scientists?

Female scientists receive less in grants from the government than men

What is gender identity?

Internal awareness of gender

What is gender expression?

Social expression of gender

What does it mean to be trans?

Incongruence with assigned gender (umbrella term for not Cis)

What does it mean to be cis?

Non-trans

What does it mean to be non-binary?

Does not identify exclusively with one gender

What does it mean to be 2-spirited?

Indigenous term referring to having both a masculine and feminine spirit

What does it mean to be gender non-confirming

Expression of gender that transcends masculine/feminine stereotypes

What is dysphoria?

Discomfort with the discrepancy between gender identity and (biological) sex

What does being a single mom intersect with?

Geography, and low income and core housing need

Do race and gender intersect?

Yes

What other SDoH intersect with gender?

Age and location (urban vs. rural)

Why are single mothers at higher risk for entering poverty?

Due to the high costs of childcare

What are women more prone to than men?

Long-term disability and chronic diseases

What are men more prone to than women?

Accidents and social exclusion

What percentage of prison population is men?

95%

How do contracts of masculinity affect health?

Can worsen mens health

Why are LGBTQ people more likely to experience adverse health effects?

Experience of discrimination can lead to adverse health effects

What is race?

Classifies humans into physical, biological, and genetically distinct groups. Assumes humanity is divided. It is a social, political, and historical construct.

What is racism?

A way of thinking that relates race to psychological factors, and views different races as superior or inferior

What is racialization?

Is the process (historical, social, political) of constructing/constituting racial identities and meanings

What in society racialized?

- Education
- Labour
- Professions
- Employments

What is individual racism?

Pre-judgement, bias, or discrimination by an individual based on race

What is institutionalized racism?

Policies, practises and procedures that work better for white people than people of colour

What is structural racism?

A history of current reality of institutional racism

What is the healthy immigrant effect?

An observed time path in which the health of immigrants just after migration is substantially better than that of comparable native-born people but worsens with additional years in the new country"

What health care conditions specifically affect racialized immigrants?

- Cardiovascular disease
- Cancers
- Occupational and environmental illness
- Diabetes
- Mental health
- HIV/AIDS
- Intimate partner violence
- Other health conditions and outcomes

How does racism effect health?

Racism harms health in many ways, and leads to inequities in health care.

How do Canadian physicians view racism?

They feel that they are immune to the kinds of racial bias seen in the US

What is one of the most racialized disease of modern medicine?

Sickle cell disease

What issue did aboriginal women face in Saskatoon, related to their health?

The were coerced into having tubal ligations, and not fully informed on the irreversible nature of this procedure

What injustice occurred to Brian Sincleir?

He was an indigenous man that died of a bladder infection, after being ignored for 34 hours in the emergency room

What are typical minimalistic responses to racism?

- Cultural competence training
- Implicit/ unconscious bias training
- "Data collection"

What is the problem with cultural competence as a response to racism?

It promotes a "colour blind" mentality, and an obsolete view of culture. It ignores structural and institutionalized racial issues.

What is unconscious bias training?

The trainings often begin with demonstrations of how the mind operates in ways that are outside of conscious awareness or control. Demonstrates how we often make snap judgements about people.

What is the problem with unconscious bias training?

Doesn't fully deal with all causes of discrimination, should be coupled with other types of training

What is the issue with data collection?

It needs to be coupled with data analysis, so that it's findings can be put to effective use.

What is eugenics?

the sterilization and institutionalization of the mentally disabled as well as laws restricting immigration and marriage would improve public health

Who fell under prohibited classes in the immigration act of 1910?

Persons mentally defective", "Diseased persons", "Persons physically defective", "Criminals", "Prostitutes or pimps", "Procurers", "Beggars and vagrants", "Charity immigrants" and "Persons not complying with regulations"

Who was Dr. Helen MacMurchy?

- She was Ontario's leading public health expert in 1914
- She promoted eugenics and advocated for segregation

How does Hamilton rank for hate crimes

- Second highest in Canada
- Highest for police reported hate crimes

How can we make change regarding racism?

Developing and Implementing approaches to racism that acknowledge our complex complicities in our disciplines, professions, practices, policies and institutions at:Individual, Institutional/Systemic and Policy Levels

What are socially excluded people more at risk for?

More likely to be unemployed, have less access to health services, and means of furthering their education

What are the 4 aspects of social exclusion?

- Denial of participation in civil affairs
- Denial of social goods
- Exclusion from social production
- Economic exclusion

What is detail of participation in civil affairs?

Results from legal sanction and other institutional mechanisms, systemic forms of discriminations

What is denial of social goods?

Includes lack of housing, income security, and language services

What is exclusion from social production?

Lack of opportunity to participate and contribute to social and cultural activities

What is economic exclusion?

When individuals cannot access economic resources and opportunities

What is social exclusion associated with?

Poor health, educational problems, and a sense of powerlessness, hopelessness and depression

What can is social exclusion a factor leading to?

Onset diabetes, as well as a range of other chronic diseases

Who are indigenous people?

The original inhabitants of Canada

What does section 35(1) of the constitution act of 1982

- Protects Aboriginal and treaty rights
- Recognizes that Aboriginal peoples include "...the Indian, Inuit and Métis people of Canada"
- FNIM peoples are not a cultural group to Canada, but rather a distinct Constitutionally recognized peoples with Aboriginal and Treaty Rights

How many indigenous people live in Canada?

1,673,785, accounting for 4.9% of the overall Canadian population

How do age populations differ in indigenous vs. non indigenous people?

Indigenous folk have many more people aged 0-14 than the do 65+, whereas in non-indigenous people, these populations are very similar in numbers

How many residents identify with a single aboriginal identity?

11,655

How does burden of disease compare to indigenous vs non-indigenous people?

Burden of disease is disproportionate

What does post truth and reconciliation equal?

Benevolence

What is colonization?

The action of trying to overtake indigenous people, or dissolve them into our culture. Closely tied to racism.

What is the issue with apprehension of indigenous children by child welfare agencies?

Disproportional to non-ingenious children being taken by child-welfare agencies

What is the issue with imprisonment and victimization of indigenous people?

Disproportionate to non-indigenous people

What are other issues surrounding ingenious health regarding colonization?

Denial of positive parenting, community leaders and a positive sense of identity and self-worth

How do infant mortality rates in indigenous children compare to non-indigenous children?

Infant mortality rate for First Nations & Inuit children ranging from 1.7 average to over 4 times the non- Indigenous

How do suicide rates compare in indigenous vs. non-indigenous populations?

Overall suicide rate among First Nations communities that is about twice that of the total Canadian population

What social determinants do indigenous people face inequity in?

- Income levels
- Employment
- Housing
- Health overall

What are some examples of structural inequity towards indigenous people?

- Canadian Institute of Health Research-Institute of Aboriginal Health (CIHR-funded: Governance re-instated)
- National Aboriginal Health Organization (funding terminated)
- National Collaborating Centre for Aboriginal Health (PHAC - funded)
- FNIGC - First Nations Information Governance Committee - OCAP

What are the intergenerational impacts of survivors of residential schools?

Partners, children, grandchildren, extended families, and communities are all impacted

What is systemic racism?

When acceptance of discriminatory and prejudicial practices is normalized across our society, in public services and institutions

What is the colonization process fuelled by?

Racist beliefs & ideas about Indigenous peoples; their ways of knowing & being, customs and practices

Why is current policy inadequate for positive indigenous health outcomes

- numbers do not serve the purposes or interests of indigenous people
- the policy has a limited scope, aggregate format, deficit focus, and decontextualized framework
- the policy narrative perpetuates inaccurate portions of the embodied realities of indigenous people.

What data is needed surrounding COVID-19?

- Need for race based data
- SDoH intersection
- Data governance

What is the first task in truth and reconciliation?

To understand historical and local truths

What does reconciliation involve?

- Develop partnerships that are based on reciprocity and equity
- Personal and professional journey

What are the calls to action regarding indigenous health?

1. Link between current state of FNIM health and government policies
2. Measurable goals to close gap
3. Address jurisdictional issues
4. Sustainable funding for healing centres
5. Recognize value of Indigenous healing practices
6. Increase the number of Indigenous health professionals & cultural competency for all healthcare professionals

What self determining efforts currently exist for indigenous people?

- UN Forum of Rights for Indigenous People
- United Nations Declaration on the Rights of Indigenous Peoples

What is a self determination?

Indigenous people having control over their institutions, resources, knowledge, and information systems

What is the Canadian Government's participation UNDRIP (United Nations Declaration on the Rights of Indigenous Peoples)?

Canadian Government pledged to respect and go adopt as reconciliation framework. "Nothing about us - without us"

How long has the Canadian Government participated in UNDRIP?

about 25 years

What are the rights of indigenous people?

Without discrimination ....
- Improvement of health
- To be actively involved in developing and determining health
- The right to their traditional medicines and to maintain their health practises
- The right to access all social and health services

Where are the indigenous rights to health stated?

UNDIP - Article #24