EM

1190B Week 1

Land Acknowledgement

  • Acknowledge Ancestors: Recognize the ancestors of the land we inhabit, as their legacy continues to shape our present and future.

  • Traditional Stories: Highlight the importance of traditional stories owned by First Nations families, particularly those of Southwestern Ontario, which hold deep cultural significance and insights into their histories.

  • Shared Traditional Lands: Acknowledge the Anishnaabe, Haudenoshaunee, and Lenni Lenape families as the original stewards of these lands and the ongoing relationships they maintain with the environment.

  • Building Relationships: Emphasize the necessity of establishing trust, humility, kindness, and respect when engaging with local Nations. This involves understanding their governance structures, traditions, and community needs.

  • Resource: The Baroness Von Sketch Show YouTube clip provides a comedic yet educational perspective on land acknowledgment practices and their impact.

  • Land Acknowledgment: Actions should be part of the acknowledgment to help with the reconciliation with the indigenous groups

Concepts of Health

  • Definition of Health:

    • Health is multifaceted, encompassing a Healthy Body, Healthy Mind, and Happy Human.

    • Recognizes that health is dynamic, deeply influenced by diverse environments and contexts.

    • Encompasses physical, emotional, social, and spiritual aspects integral to individual well-being.

    • Subjective nature: acknowledges that personal perceptions and cultural beliefs influence the definition of health for each individual.

  • Right to Health:

    • Entitlements include the right to clean water, sanitation, nutritious food, adequate housing, education, and healthy environments.

    • AAAQ Framework: Availability, Accessibility, Acceptability, and Quality are essential components of health rights as emphasized in General Comment No. 14.

    • Canada Health Act (1984): Guarantees equitable access to healthcare for all individuals, regardless of employment, income, or health status, reinforcing the principle of universal health coverage.

Health Defined

  • Medical Model:

    • Traditionally, health was defined predominantly as the absence of disease.

    • Critique: The medical model is recognized as limited, calling for more inclusive definitions that incorporate broader health determinants and holistic measures of well-being.

    • WHO Definition: "Health is a state of complete physical, mental, and social well-being..." however, this definition has faced critiques for being overly rigid and idealistic.

  • Socio-environmental Approach (1980s):

    • This approach views health as influenced by individual as well as social, economic, and environmental conditions, providing a more comprehensive understanding of health disparities.

    • Focuses on identifying and overcoming barriers to health access and equity.

  • The Ottawa Charter (1986):

    • Identifies the prerequisites necessary for health, including:

      • Peace

      • Shelter

      • Education

      • Food

      • Income

      • Stable ecosystem

      • Sustainable resources

      • Social justice

      • Equity

Critical Factors Contributing to Health

  • Key influences on health include:

    • Income & Income Distribution

    • Social Safety Net

    • Early Childhood Development

    • Education

    • Food Insecurity

    • Housing

    • Employment & Working Conditions

    • Indigenous Ancestry

    • Geography

    • Race and Social Exclusion

  • Reference: Social determinants of health by Raphael et al., which outlines the structural factors that influence health outcomes.

Access to Health in Canada

  • Examine personal control over housing, education, and health services

  • Promote discussions about the perceived quality of Canada's healthcare system, highlighting successes and areas needing improvement.

  • Conditions that are shaped by the quality of our communities are often out of our control

Diversity, Equity, and Inclusion (DEI)

  • DEI initiatives promote tailored support to enable equal opportunity for all individuals, considering their unique backgrounds and circumstances.

  • Reflection is required to understand the nuances between diversity, equity, equality, justice, and inclusion in the healthcare context.

  • Equity: Ensure the resources are shared based on needs

  • Diversity: Recognizing the differences between and among a population

  •  Inclusion: Valuing everyone with their differences, not in spite of them but because of them

  • Equal tools doesn’t equal equal opportunity because the privileged will still have a better chance of getting the opportunity presented to them

  • Although we could adjust our tools to be more equitable, the system in place would still be leaning toward the more privileged side

  • When we introduce justice into the equation, we focus on fixing the system that has been in place to help those with more privileges and give the underprivileged the same number of opportunities instead of simply giving them the tools to reach what they never had access to.

Equity in Health Care

  • Equitable access is related to the fair distribution of resources based on the needs of individuals and communities.

  • Highlighting persistent inequalities affecting Aboriginal people and fostering discussions on envisioning an equitable healthcare system.

Challenges of Inequality and Inclusion

  • Definitions of inclusion, exclusion, and integration in health contexts are critical for understanding systemic barriers.

Barriers to Health Access

  • Main barriers identified include:

    • Language barriers

    • Stigma and fear of judgment

    • Transportation issues

    • Wait times

    • Lack of medication coverage

    • Food deserts

    • Policy limitations surrounding identification for health services.

Current View of Health

  • Presented by D. Gordon: highlights the importance of holistic approaches in improving health outcomes, moving beyond traditional models to inclusive practices.

Structures and Systems Creating Inequities

  • A comprehensive analysis of the barriers individuals face, such as language, access to technology, and availability of community services, to better understand systemic inequities.

  • Inclusion involves everyone in the decision-making process, ensuring that diverse perspectives are considered and valued, ultimately leading to more effective and equitable health interventions.

  • Insurrection can arise when marginalized groups feel excluded from these processes, highlighting the need for genuine engagement and representation in policy-making. Another word for protesting within a society.

  • Exclusion can lead to feelings of resentment and disconnection, further perpetuating the cycle of inequity and hindering progress toward a more just society.

  • Segregation can create barriers that prevent individuals from accessing essential services and resources, exacerbating existing disparities and undermining the principles of social justice.

  • Integration brings a different group into society but does not yet include their ideas in the overall population

Nursing and Social Justice Mandate

  • Recognition of the significance of understanding how environments influence health behaviours, leading to strong advocacy for social justice within nursing practice.

  • An understanding that health-inhibiting behaviours may serve as coping strategies for addressing environmental stressors is essential for nurses working with diverse populations.

Foundation of Nursing Knowledge

  • A review of various ways of knowing is needed to support clients in nursing practice, integrating lived experiences alongside traditional knowledge systems.

  • Emphasizing the critical examination of dynamics beyond textbook learning to create holistic nursing care.

Ways of Knowing/Patterns of Knowing in Nursing

  • Informed by Carper’s framework, including:

    • Ethical: Addresses moral principles in nursing practice.

    • Empirical: Involves knowledge gained through observation and evidence-based practice.

    • Personal: Relates to the nurse's personal experiences and engagement with clients.

    • Aesthetics: Recognizes the art of nursing and the importance of creative expression in care.

    • Emancipatory Knowing:

      • Linked with advocating for social justice, demanding awareness of broader societal injustices, and raising consciousness about their impact on health.

Indigenous Ways of Knowing

  • Emphasizes relational, spiritual, and storytelling methodologies for knowledge transfer, highlighting the importance of learning from Indigenous cultures.

  • Recognizes the necessity for decolonizing nursing practices to create inclusive and respectful care frameworks.

The Role of the Nurse as Advocate

  • Introduction to nursing activism, exploring historical exemplars such as Harriet Tubman and Edith Anderson Monture, the first Registered Indigenous Nurse in Canada, to inspire future nurses to engage in social justice initiatives.