interprofessional: global health midterm notes

vulnerable population

populations that are wounded by social forces that place them at a disadvantage with respect to their health

social groups being compared are differentiated by

their underlying social position including but not limited to demographics, identity, orientation, wealth, power, and/or prestige

health disparities

denotes a specific kind of health difference between more and less privileged groups

health equity

the attainment of the highest level of health for all people

healthcare disparities

systematic differences in health care received by people based on these same social characteristics

a reduction in health disparities is…

evidence of making progress toward greater health equity

what shows a strong association with health and longevity

social class

higher ____ provides individuals with more material, psychological, and social resources, which can benefit their health

socioeconomic status (SES)

analyses of the SES gradient generally reveal

a sharp drop in mortality as income increases

in contrast to the relationship between income and health, which demonstrates a continued drop in mortality as income increases, the association between mortality and education is more…

discontinuous

the concept of race as commonly used tends to evoke differences in skin color and other superficial secondary charcateristics, whereas ethnicity…

incorporates the concept of culture

the concept of race is

a predominantly social construct

it is important to recognize that the forces producing health disparities function in a more ____, involving interactions and feedback loops among all the elements displayed

dynamic, multidirectional manner

genetic endowment and epigenetic processes

offers relative protection against, or vulnerability to certain conditions

epigenetics describe

physical environment, social environment, behavior and lifestyle, chronic stress, healthcare

for health professionals to successfully attend to the health needs of vulnerable populations, they must recognize…

how vulnerability manifests itself

a public health perspective compels health professionals to not only heal the wounds of vulnerability but also…

eradicate the primary causes of those wounds

list the contexts for effective intervention

• assessing vulnerabilities and strengths

• eliciting the pt’s story

• building the therapeutic alliance

what is therapeutic alliance?

when pt and clinician develop mutual trusting, caring, and respectful bonds that allow collaboration in care and treatment

what are the four main components of successful therapeutic alliance

empathy, trust, respect, agreement/collaboration

what is direct vulnerability?

the vulnerability in and of itself which leads to poor health

what is indirect vulnerability

vulnerability which affects components of the clinician/patient relationship or the therapeutic alliance

what is effect modification vulnerability

vulnerability which weakens or impedes the benefits of medical treatment on coexisting medical conditions

what are the results of the absence of a therapeutic alliance

mistrust, poor care, disrespect, and poor collaboration

what are the goals of a therapeutic alliance

• set a climate of interest, concern, and calm

• empathetic communication

• allow for the humanity of the patient and clinician to emerge

what does CAPTURES stand for

• C = curiosity/ interest

• A = appreciate/admire

• P = point of view

• TU = timing/use of body language

• RE = react

• S = support

what is inequality?

the condition of being unequal

what is inequity?

a disparity due to differences in social, economic, environmental, or healthcare resources

how is health equity achieved?

when every person has the opportunity to “attain his or her full potential” and no one is “disadvantaged from achiving this potential because of social position or other social determined circumstances”

what are common causes of inequity

income, education, access, environment

what is health policy?

decisions, plans, and actions that are undertaken to achieve specific health care goals within a society

an explicit health policy…

• defines a vision for the future

• establishes targets and points of reference for the short and medium term

• outline priorities and the expected roles of different groups

• builds consensus and informs people

what are the five steps of CDC policy process

problem identification, policy analysis, strategy and policy development, policy enactment, policy implementation

what is problem identification?

clarify and frame the public health problem to determine where to go in your policy journey

what is policy analysis?

use quantitative and qualitative methods to identify effective and efficient policy solutions

what is strategy and policy development?

identify and strategize for getting the policy adopted and how the policy will operate

what is policy enactment?

following internal or external procedures for getting a policy enacted or passed

what is policy implementation?

translating the enacted policy into action, monitoring uptake, and ensuring full implementation

what was true of public perceptions?

• impacts that are less tangible and more narrow had less support

T/F: equity down resolves underlying issues of inequities

false

what is true of inequity up

outcomes get better but inequity remains

policies that exacerbate inequity do not:

• define a vision for the future

• establish targets and points of reference for the short and medium terms term

• outline priorities and expected roles of different groups

• builds consensus and informs people

what are luxury beliefs?

ideas and opinions that confer status on the rich at very little cost, while taking a toll on the lower class

describe the healthy people 2030 initiative

• plans on building a healthier nation for all

• data-driven national, measurable objectives

• 359 core objectives as well as developmental and research objectives

• started in 1979, every 10 years

what are the social determinants of health

economic stability, education access and quality, health care access and quality, neighborhood and built environment, social and community context

according to the united nations universal declaration of human rights says…

health and medical care is a human right t

according to the WHO regarding universal health coverage policies

universal coverage means that all people can use health services, while being protected against financial hardship associated with paying for them

poverty and health have what type os association

bidirectional

what are causes of medical vulnerability worldwide?

1. poverty

2. malnutrition and food insecurity

3. environmental risk

4. fragile states and destabilized societies

5. displacement and homelessness

6. violation of human rights

countries with greater relative income inequality….

have worse measures of health and social problems

what is food insecurity?

the absence of enough, safe, nutritious, and socially acceptable food

may be chronic, seasonal, or temporary and may occur at the household, regional, or national level

high food security

household had no problems, or anxiety about consistently accessing adequate food

marginal food security

households had problems at times, or anxiety about, accessing adequate food, but the quality, variety, and quantity of their food intake were not substantially reduced

low food security

households reduced the quality, variety, and desirability of their diets, but the quantity of food intake and normal eating patterns were not substantially disrupted

very low food security

at times during the year, eating patterns of one or more household members were disrupted and food intake reduced because the household lacked money and other resources for food

what are some health system challenges

• lack of documentation

• workforce shortages

• unaffordability of care

lack of documentation is termed in literature as ?

scandal of invisibility

what are some health system solutions

• building primary care systems

• improving healthcare accessibility and affordability

• caring for displaced populations

• educating health professionals