Race Final
native of Europe
European
heart disease is the leading cause of death and malignant tumors (cancer) is the second leading cause of death in which races
For whites, blacks, American Indians, Alaskan Natives, and Latinos,
Non-Hispanic black persons were more likely than ____ and _____ to have failed to obtain needed medical care due to cost.
Hispanic persons and non-Hispanic white persons
give an example of political power in the works?
Post neonatal mortality rates were lower where African Americans had higher levels of political power
what was the title of that report?
Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care
how do you measure obesity?
Use waist circumference to measure visceral and abdominal subcutaneous fat
"originating from western of European countries"
Western
african american infant mortality rates decrease as
education levels increase
"are resources that either facilitate or inhibit someone seeking health care services"
enabling factors
culturaly appropriate programs are also community specific rather than
ethnic group in general
"refers to a common heritage shared by a particular group"
ethnicity
In the last decades of the 20th century Hispanic/Latino...
expanded rapidly
the native indian group generally have a ____ death rate compared to other groups
higher
Low SES and high John Henryism =
highest blood pressure and vice versa
African American maternal mortality exceeds
hispanic and whites
"Communication is more than simply shared language it must also include a shared understanding and shared context as well"
huge issue
____ is the most prevalent health problem among blacks
hypertension
Indian and Alaska Native has experienced extreme health problems... they had little or no
immunity to the diseases brought by the Europeans
"Policies at the local, State, and Federal level affect individual and population health."
policymaking
many low come euro american mothers are single parents and employed but had
poorer health due to multiple stressors
____ is more prevalent among African American than among White Americans
poverty
no consistent racial groups emerge when
ppl are sorted by physical and biological characteristics
"are an individual's inclination to use health services, most notably one's attitudes toward using health care. These attitudes may be facilitating or inhibiting and are largely influences by cultural beliefs and prior experiences."
predisposing factors
"weathering hypothesis and John Henryism" immigration, acculturation, and racism
psychosocial/behavioral theories
"defined as a biological category as a way to label different groups according to a set of comon inborn biological markers"
race
"in many medical encounters race plays a role in communication"
racial discrimination aka sickle cell and mental illness treatment for african americans
_____says that racial/ethnic disparities in health status exist because minorities are more likely than whites to live in communities that are lacking in the necessary infrastructure to support a healthy lifestyle. Infrastructure includes road ways, food sources, safety, and health care services, to name a few.
resource deprivation
reference, control and comparison populations
standard population for comparison
American Indians and Alaskan Natives are at a heightened risk of ____ compared to whites
stroke
involve ____ ___ in decision making about health care needs and hire ___ ____ as workers
target community
The John Henry Hypothesis predicts
that individuals in lower SES categories who utilize active coping skills related to the excess stressors are more likely to suffer from hypertension due to their effort.
what is the operationally defined definition of cultural competence
the integration and transformation of knowledge about individuals and groups of people into a specific standards, policies, practice and attitudes used in appropriate cultural setting to increase the quality of health care; therby producing better health outcomes"
the robust association between SES position and health in general population is due
to their proficiency in enlighs? which leads to positive effects on health
hispanics have a higher prevalence of _____ and ___ than whites and blacks
metabolic syndrome and diabetes
API have a highly prevalence of...
metabolic syndrome than whites at each level of BMI
hispanics have the highest ____ rate
mortality
Hispanic population has increased over the years o 1980 Census: o 2000 Census: o 2010 Census:
o 1980 Census: 14.6 million o 2000 Census: 35.3 million people o 2010 Census: 50.4 million people
why address culture?
o Health disparities among racial/ethnic groups exist o Institute of medicine report on unequal treatment among racial/ethnic groups o America has a very diverse population and it is becoming more diverse
African American adolescents are disproportionately affects by
obesity
____ is a significant complicating factor in many medical and surgical techniques
obesity
"native of the west"
occidental
among latino boys and girls, acculturation affects their view
on gender roles and racial stereotypes
cultural competency has to be _____ no on ever masters a culture
on going
implement recommended national standard into
organizational health structures
The Bureau of Indian Affairs was developed to
oversee health care for the American Indian population
is one's belief that he/she does (or does NOT) need to utilize health care services for health issues.
perceived need for health care service
white women struggle to maintain healthy lifestyle due to...
personal and work responsibilities
"genetic differences among racial/ethnic populations"
physiological theories
hispanics are disproportionately affected by
type two diabetes -poverty prevents them from accessing healthy food
health care is ____ among the API
underutilized, caused by cultural factors
_____ seeks to explain the differences between African-Americans and Whites in pregnancy outcomes.
weathering hypothesis
when did the Alaska NAtives become eligible for IHS services?
when Alaska became part of the US
"races with a light complexion"
white
_____ were more likely than ___ to have failed to obtain needed medical care due to cost in the past 12 months. What this illustrates is there is a difference by both sex and age group.
women... men
in whites, body dissatisfiaction is most common in
young women
what are the eight guiding principles to how cultural competence works
• Define cultural broadly • Value clients cultural beliefs • Recognize complexity in language interpretation • Facilitate learning between providers and communities • Involve the community in defining and addressing service needs • Collaborate with other agencies • Professionalize staff hiring and training • Institutionalize cultural competence
what are some key concepts to recognize when providing culturally and linguistic appropriate health care
• Linguistic variation within a cultural group • Cultural variation within a language group • Variation in literacy levels in all language groups (translation and interpretation, medical interpretation)
reserach shows that more acculturation leads to... and less leads to...
• More accumulation leads to the worse health effects • Less acculturation leads to the better health effects
White Population: 1980 Census: 2000 Census: 2010 Census:
•1980 Census: 188 million ppl •2000 Census: 211 million ppl •2010 Census: 233 million ppl
why should the term Latino not be recognized as a nationality?
NOT a language or race
"who tends to have income below the federal poverty level and high unemployment rate"
Native Indians
what is the social message for white women
"take care of yourself for health of those you love"
Black families tend to leave weight loss programs early (____) due to...
(attrition) -distrust of mental health providers -work barriers
in 2010, there were about ____ APIs
-15.2 million -5.9% total poplation
a large portion of APIs are immigrants which leads to
high prevelance of mental health probs
what are the top three reasons why there is a high infant mortality rate within the african american population
-Black urban communities are highly toxic environments -Lack adequate medical services -Higher housing costs
name the four stressor factors
-Environmental Factors -Constitutional Factors -Sociodemographic Factors -Psychological and Behavioral Factors
what are the four specific reasons for leaving/staying
-Life problems -Worldview -Collaboration and Reinforcement of Therapy -Confidence levels
what are the top four major health risks and issues for African Americans?
-Poverty and low SES -HIV/AIDS -Homicide -Obesity -Smoking
what are the five group specific health risks for the American Indian and Native Alskans
-accidents -alcohol -mental illness -child obesity and early onset type 2 diabetes -adult obesity
AIAN deaths are equal or higher than ____ and compared to ___, the death rate is 1.7x higher for most age categories
-african americans -hispanics
what is the top five leading causes of deaths among API females
-cancer -heart disease -stroke -diabetes -unintentional injuries
what is the top five leading causes of deaths among API males
-cancer -heart disease -stroke -unintentional injuries -diabetes
APIs believe that ancestral spirits influences... and they emphasize collective over
-health exhibit respect for nature -individual needs
what are the leading causes of death in white women
-heart disease -cancer -stroke -chronic lower resp disease -alzheimers
what are the leading causes of death in white males
-heart disease -cancer -unintentional injuries -chronic lower resp disease -alzheimer's
currently in the US, the two leading causes of death are...
-heart diseases -malignant neoplasms (tumors) for all racial/ethnic groups
why is homicide 34% African Americans?
-high poverty -social disorganization
what are the five determinants of health?
-policymaking -social factors -health services -individual behavior -biology and genetics
African Americans representation is 3X greater than their proportion of the population... leading factors are
-poverty -stigmatization
what are the major health risk for the native indians
-poverty and low SES -language and cultural barriers
what are the three theories of health disparities
-socio environmental -pyschosocial/behavioral -physiological
what are two cultural factors to obesity
-standards of beauty (Media) -Perception of "normal" weight
what are some strategies to improve AIANs health?
-target obesity prevention -understand the role of caregiving and theirs traditional meds -decrease alcohol in youth
In 1999, congress requested an institute of medicine study to: -assess the extent of disparities in the types and quality of health services received by U.S. racial and ethnic minorities and non-minorities
-to explore factors that may contribute to inequities in care -to recommend policies and practices to eliminate these inequities.
The behavioral model of health care utilization consists of three factors:
1. Enabling Factors 2. Predisposing Factors 3. Need for Health Care Service
what are the top five leading causes of death for African American females?
1. heart disease 2. cancer 3. stroke 4. diabetes 5. kidney disease
what are the top five leading causes of death for African American males?
1. heart disease 2. cancer 3. unintentional injuries 4. homicide 5. stroke
____% of the African American population live in the Southern Region
55%
African Americans were ____ more likely to identify their usual sources of care as a facility rather than a person
1.6X
African Americans make up ___% of the US population (2016)
13.3
Native Indians are ____x more likely to have diabetes than general U.S. population
2.3
The largest death rate disparity between African Americans and Hispanics is...
2.4% for the 40-44 age groups
Over ___% African American live below the poverty line
22
according to the 2010 Census, there are more than ___ American Indians and Alaska Natives (AIAN)
3 million
nearly __% of hispanics DO NOT have a usual source of health care
31
there are ____ million Americans of African decent (2013)
38.9 million
___% of white males are not satisfied with their body image
43
___ of the native indian population is obese
50%
**at age 80, selective survival leads to a crossover in death rates where
AIANs have lower death rates than other racial groups
what race generally has a higher death rate compared to ALL other groups?
African Americans
considering death rates... the largest disparities are found with
Asians and Pacific Islanders the death rate is 50% higher than the Asian/Pacific Islanders
what are the two predisposing breast cancer genes
BRCA 1 and BRCA 2
"high probability of hereditary breast cancer and long term survival"
BRCA 1 carriers
patients with _______ carriers had better overall survival
BRCA 1 carriers
what is the difference between disparities and dissimilarities?
Disparities are those differences that are indicative of injustice or unfairness while Dissimilarities are the differences that are not attributed to injustice or unfairness.
Why can political power be used as a strategy for health?
Feelings of hopelessness and alienation from societal institutions leads to poorer health status among African Americans
what was formed in 1955
Indian Health Services HIS to oversee healthcare
How does segregation affect african american health?
Infant mortality rates segregate blacks and whites within the U.S and internationally
"a strong behavioral predisposition to cope actively with psychosocial environmental stressors"
John Henryism
_________ assumes that lower SES individuals in general, and African-Americans in particular, are routinely exposed to psychosocial stressors (e.g., chronic financial strain, job insecurity, and subtle or not so subtle social insults linked to race or social class) that require them to use considerable energy each day to manage the psychological stress generated by these conditions."
John Henryism hypothesis
"beliefs, attitudes, institutional arrangements and acts that tend to denigrate individuals or groups because of phenotypic characteristics or ethnic group affiliations"
Racism
in 2011 what races was the most % uninsured, 2nd most and third most
Therefore, Hispanic persons are the most likely to be uninsured, followed by non-Hispanic black persons, and then non-Hispanic white persons.
overwhelming evidence show that greater genetic variation occurs within a racial group than
across racial groups
what groups is known as the model minority?
asian pacific islanders -many have few health risks -diabetes is high in Hmong population
malignant tumors is the leading cause of death while heart disease is the close second in which races?
asians and pacific islanders
Health Care Utilization revolves around...
availability of health care resources
cultural competence is beyond
awareness and sensitivity
why do we need separate data for APIs
because disease like AIDS may be underreported or misclassified
which race has a higher prevalence of hypertension, diabetes, mellitus and left ventricular hypertrophy than whites
blacks
what is leading cause fo death in the asain pacific islanders?
cancer
what are the top five leading causes of death in AIAN females
cancer, heart disease, unintentional injuries, diabetes, stroke
"indo-european"
caucasion
what is the leading preventable cause of death for african americans
cigarette smoking, coping mechanism
partner with other agencies to
combine and expand culturally competent services
"refers to a group of skills, attitudes, and kowledge that allows a person, orginaization and systems to work effectively with diverse racial, ethnic, and social groups"
cultural competence
"Knowing that cultural differences as well as similarities exist, without assigning values to those cultural differences"
cultural sensitivty
"Understanding that ethnic and racial groups will have values that they hold that are specific to their culture"
cultural specificity
"broadly defined as a common heritage or set of beliefs norms and values"
culture
lack of data on indian and native... On of the most limiting issues is that
data systems within healthcare settings do not code patients race
the white population is ______ as compared to other races
decreasing
what is particularly high among the Hmong, Guamanian, and Chamorrow populations
diabetes
variations in health insurance coverage is likely due to
differences in legal status •Not as likely to obtain employment in companies that offer health benefits.
latina breast cancer survivors were generally
dissatissfied with their oncologist
what did that report tell us?
found that a consistent body of research demonstrates significant variation in the rates of medical procedures by race, even when insurance status, income, age, and severity of conditions are comparable. This research indicates that U.S. racial and ethnic minorities are less likely to receive even routine medical procedures and experience a lower quality of health services. The report says a large body of research underscores the existence of disparities.
everyone studied within a population
general population
Poverty and low SES are linked to living in communities with
greater exposure to physical environment
80% of the native indians...
have a BMI over average more health problems such as high blood pressure, high cholesterol, arthritis, and gall bladder disease
chinese american have a ___ SES due to bimodal education and income has led to
have positive health outcomes
what lead the native indians to mistrust the gov
having experienced severe oppression
African American patients with similar needs are half as likely to receive diagnostic and interventional treatments for
heart disease when compared to white patients
What are the leading causes of death for hispanic females?
heart disease, cancer, stroke, diabetes, unintentional injuries, Alzheimer's
what are the top five leading causes of death in AIAN males
heart disease, cancer, unintentional injuries, chronic liver disease, diabetes
What are the leading causes of death for hispanic males?
heart disease, cancer, unintentional injuries, stroke, diabetes, homicide
______ includes similar history, language, rituals and preferences for music and food
heritage
what three things do not include this concept
knowledge, sensitivity, awareness
what has led to mistrust with the gov with the AIANs
lack of respect for treaty provisions
_____ is a huge barrier for hispanics
language and many doctors do not understand their cultural belief
APIs have a different attitude towards suffering and some believe that
life is predetermined
"The capacity of an organization and its personnel to communicate effectively and convey information in a manner that is easily understood by diverse audiences including"
linguistic competence • Persons of limited English proficiency • Those who have low literacy skills or are not literate and individuals with disabilities
implement culturally and ______ appropriate services
linguistically
for blacks, there is an inverse relationship between hypertension and socioeconomic status. This hypothesis suggest
low socioeconomic are routinely exposed to psychosocial stressors
The world health orginization recommends... for this populaiton
lower BP
In most health research on race, ethnicity, and health, the comparison group has been
majority or white population
________ says that high prevalence of social or environmental health risks in predominantly minority communities lead to a higher prevalence of disease and death. Because the United States is a highly racial segregated country, different rates of health risk in different communities place different populations at different levels of risk in those communities.
risk exposure
The John Henryism theory was developed by
sherman james, a psychologist who was trying to understand why African Americans have such high rates of hypertension.
"determinants of health reflect social factors and the physical conditions in the environment in which people are born, live, learn, play, work and age."
social
the weathering hypothesis proposes that
social stress in the community, in the environment and the society, affects African Americans and other minorities negatively.
"risk exposure and resource deprivation" race and ethnic segregation
socio-environmental theories
______ ___ is an important risk factor for infant mortality
socioeconomic status