HSCI 130 Lecture - Racism, Discrimination & Ethnic Differences in Health Pt 2

Concern: An individual reflects on their experience with a guessing game in a rural hospital where staff would estimate Indigenous patients' alcohol levels based on bias rather than medical assessment.
- Context: Indigenous patients often receive care while intoxicated, typically referred by police or paramedics.
- Cultural Acceptance: The departmental culture normalized harmful behaviors, including complacent attitudes towards racism.
- Change Catalyst: The ongoing investigation and its transparency sparked change in the healthcare system, acknowledging and confronting racism within healthcare.
- Quote: "This could not have been possible without the overwhelming participation from patients, family members, communities, and healthcare providers."
- Speaker: Dr. Kate Elliott, various ministerial roles in health and gender equity.

Widespread stereotyping and racism reported during healthcare interactions leading to discrimination.
Specific negative experiences highlighted by respondents:
1. Assumptions of Intoxication: Many respondents faced presumption of being drunk or questioned about substance use.
2. Treatment Acquiescence: Respondents often treated as immoral or dishonest—26% felt routinely insulted or harassed.
3. Cultural Invisibility: Indigenous patients reported that their cultural traditions were not acknowledged in their care.
4. Poor Experience Ratings: Patients noted receiving consistently poorer services compared to non-Indigenous counterparts.

Feelings of Safety: 31%-32% of respondents felt unsafe interacting with various healthcare workers.
Service Quality: 20%-31% felt they could never fully trust healthcare providers.
Exclusion: 59% reported feeling like token Indigenous persons in committees.

Discrimination affects healthcare access:
- Patients reported feeling unsafe in various healthcare settings including emergency and home care services.
- Lack of trust in healthcare providers was common, with 19% expressing neglect in service quality.
- Indigenous respondents reported being generally discharged without consideration for their unique circumstances, including returning to inadequate living conditions.
- Analysis revealed lower expectations of service among Indigenous populations, contributing to health inequity.

Authors: Martin Cooke and Tasha Shields from the University of Waterloo.
Research Scope: Examined over 2250 articles on anti-Indigenous racism published post-2000, focusing on patient experiences.
Survey Methodology: Majority of studies employed qualitative interviews, predominantly conducted in urban areas of Ontario and British Columbia, indicating a significant overlap with the Indigenous populations therein.

Covert Racism: Notable experiences included differential treatment and stereotyping correlating with substance abuse or poor parenting.
Overt Racism: Instances of overtly racist behavior were less frequently documented.
Racial Stereotypes: Common stereotypes included beliefs that Indigenous people are less responsible or more prone to substance abuse.
Gender Intersectionality: Studies indicated that Indigenous women and girls faced heightened stereotypes, experiencing compounded discrimination.

Health Inequities: Experiences of racism correlate with increased reluctance to seek healthcare, potentially leading to higher unmet healthcare needs.
Cultural Dismissiveness: Healthcare providers often dismissed traditional Indigenous medical practices.
Impacts on Patient Care: Instances were documented of patients receiving inadequate care based on assumptions about their cultural background.

Patient experiences include neglect in emergency care leading to severe health issues (e.g., ruptured ectopic pregnancies)
Instances where healthcare providers misinterpret Native patients seeking medication as illegitimate requests.

Definition: Immigrants to Canada typically arrive in better health than native-born Canadians, showing less chronic disease and disability within the first few years of arrival.
Health Deterioration Over Time: The initial health advantage tends to diminish after 10 years of residency in Canada, with immigrants adopting health patterns similar to native-born Canadians.

3-wave panel study findings with deteriorating self-rated health among immigrants over periods of 6 months, 2 years, and 4 years:
- Wave 1 (Immediate Arrival): 43% of immigrants rated their health as excellent.
- Wave 3 (4 Years Later): Only 23% rated health as excellent, showing significant health decline as immigrants acclimatize.

Converging Lifestyles: Immigrants adapting Western lifestyle choices leading to unhealthy habits.
Resettlement Stress: Increasing stressors with integration affecting physical health.
Differential Access: Language and cultural barriers hindering access to healthcare upon integration.

Cohesiveness and Health: Research revealed lower incidence of coronary heart disease (CHD) within Italian immigrant families in Roseto, suggesting community ties and religious practices influenced well-being.
Cultural Dilution Impact: Increased rates of heart disease coincided with declining social cohesion and traditional practices, demonstrating the health consequences of cultural assimilation.

Definition: The degree of adherence to and active participation in a religious community or practices.
Multidimensional Nature: The complexities involved in determining how religious beliefs can negatively or positively influence health outcomes.
Social Support: Religious organizations often provide communal support mechanisms beneficial for mental and physical health.
Potential for Harm: Conflicts may arise for individuals whose religious values contradict necessary medical treatments, potentially exacerbating health challenges.