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