Nufs 377 Midterm 1

• Health inequity is the unfair disparity in health status between groups due to avoidable or remediable differences in social, economic, or healthcare resources between different groups of people.

  •Some examples of groups that experience health inequities are lower socioeconomic status individuals(e.g., low income), some racialized groups (that is, persons, other than Indigenous peoples, who are non-Caucasian in race or nonwhite in colour), Indigenous peoples, and those living in rural and remote areas who lack access to healthcare services.
• Health Equity

  Health equity is the absence of avoidable or remediable differences in health among groups of people.

  Achieving health equity requires creating fair opportunities for health. It involves giving people who have experienced social or economic disadvantage what they need to enjoy full, healthy lives.
• Public health nutritionists try to create the conditions for health equity

  Public health dietitians can work with many sectors, communities, groups, and health professionals to try to create fair opportunities for health for people who experience health inequities.
• privilege

  The experience of unearned freedoms, rights, benefits, advantages, access and/or some people because of their group membership or social context and opportunities afforded it.
• White Privilege: The inherent advantages possessed by a white person based on their race in a society characterized by racial inequality and injustice. This concept does not imply that a white person has not worked for their accomplishments but rather, that they have not faced barriers encountered by others.
• “Most of us fall on different parts of the privilege spectrum depending on the scenario we find ourselves in, whether we are white or people of colour.”

  •Not everyone likes to think about having privilege “because if we admit we have privilege, we confirm that systemic racism exists —that we live, work and play within institutions that hold biases and a hierarchy system.”
• Attitudinal Terms:

  1. Personal bias
  2. Stereotype
  3. Prejudice
• Personal bias refers tobeliefs, opinions, or attitudes that people have that often reinforce stereotypes.
• A stereotype is a belief or assumption (positive or negative) about an individual based solely on their membership in a group, regardless of their individual characteristics.
• Prejudice is an unjustified negative attitude towards an individual based solely on their membership in a particular group which may lead to discrimination.
• Terms related to unjust treatment because of attitudinal beliefs

  1. Discrimination
  2. Racism
• Discrimination is the unjust negative treatment of a person based on characteristics such as race, gender, age, or sexual orientation whichis the result of negative beliefs about a particular group and prejudices against them.
• Racism is discrimination against an individual based solely on their membership in a specific racialized or ethnic group.
• Attitudinal terms

  •Stigmatizing is when a trait, characteristic, or activity is considered worthy of disgrace or disapproval. •Some people who experience social or economic disadvantage are more likely to have health conditions (e.g., obesity) or health behaviours(e.g., unhealthy diets) that have stigmatizing beliefs attached to them.
• Accept: Understand that engaging in equity-related discussions may generate discomfort, as it often calls for addressing personal biases, presumptions, and areas of privilege.

  Learn and Listen: Embrace the insights from those with different life experiences.

  Engage: Stay in the conversation, even when unsure about the correct terms to use. Ask questions in good faith where you are truly looking to listen to the other person and to learn from them.
• Apologize if mistakes are made: If you offend someone, even unintentionally, then apologize. Mistakes are a part of being human, and normalizing apologies fosters a safe environment for difficult conversations about equity.
• Seek Education: Find learning opportunities about equitable terminology, social determinants of health, and historical and systemic causes of behavioral health disparities. This information provides context and informs our word choice.

  Be careful with words: Avoid discriminatory, prejudicial, offensive, and stigmatizing words which create negative associations and devalue individuals, families, and their communities.
• Strengths-Based Approaches

  •Highlighting the inherent strengths and assets in all communities, strengths based approaches seek to depict communities in terms of their strengths and assets rather than exclusively describing their vulnerabilities and weaknesses through a deficit lens.

  •For example, an emphasis on recognizing and respecting the interrelations between all aspects of the person, the community, and the environment is found at the heart of Indigenous knowledge and values in many different Indigenous cultures and communities.
• Public Health Core Areas

  1. Protection
  2. Prevention
  3. Promotion
• Prevention

  1. Screening
  2. Vaccination
• Promotion

  1. Individual promoting health behaviours
  2. Improving the social determinants of health
• Protection

  1. Environmental hazards
  2. healthy workplaces
  3. control of infectious diseases
  4. managing health emergencies
• Public Health Enablers

  1. Governance
  2. advocacy
  3. capaciy
  4. information
• Advocacy: Influence and obtain support for action on a public health goal.
• Capacity: Public health nutritionists
• Information: Surveillance, research, monitor, evaluate
• WHO health definition: Health is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.
• Social well-being is a sense of belonging to a community and contributing to society through having positive interactions with other people and with local communities and social institutions (inclusion in society). It gives people a sense of meaning and purpose.
• Public health is ‘organised efforts of society to keep people healthy and prevent injury, illness and premature death’

  • Public health practice places health promotion, health protection, and the prevention of death, disease, injury and disability as the central tenets of all related initiatives.

  • It aims to prevent disease by reducing risk factors that are related to disease and altering unhealthy behaviours that can lead to disease.
• Health promotion aims to enhance health in terms of developing healthy public policies, healthy environments and personal resiliency.

  • It is the process of enabling people to increase control over, and to improve, their health.

  • Health promotion is the process of empowering people to increase control over their health and its determinants.
• Policy: rules around what actions are taking Strengthen community action is important for health
• Partners in Public Health

  1. Media
  2. Employers and businesses
  3. government agencies
  4. academia
• Public Health Approach

  1. Surveillance
  2. risk factor identification
  3. prevention
  4. Implementation
• What is the problem: surveillance
• Surveillance

  • Public health surveillance is the ongoing, systematic collection, analysis and interpretation of health related data essential to planning, implementation and evaluation of public health practice.
• Surveillance can be used to identify the problem, the risk factors for the problem, and what works to prevent the problem.

  – Estimate magnitude of nutrition-related health problems

  –Know about prevalence of risk factors

  –Provide information that can be used for health action by public health personnel, government leaders, and the public to guide public health policy and programs

  –Assess effectiveness of policies and programs

  –Monitor changes over time (has the health problem, health behaviour, risk factor or health determinants changed over time?)
• Canadian Community Health Survey

  • The CCHS is a cross-sectional survey that collects information related to health status, health care utilization and health determinants for the Canadian population.

  • It is designed to provide reliable estimates at the health region level every 2 years.

  – Can be used to monitor differences in the prevalence of nutrition-related diseases across socioeconomic groups

  – This information can be used to inform programs, policies, and research.

  • High-income individuals do not have the same need for type 2 diabetes interventions as low-income individuals.
• Must be able to use data collected, since questions are long and expensive to deliver There’s a clear gradient in money when looking at prevelance of disease

  • target lower income individuals, higher income have the resources to get treatment on their own
• What is the cause: Risk factor identification
• Life conditions and circumstances

  • An individual’s lifestyle ‘choices’ (e.g., diet, activity levels, alcohol and tobacco use) are heavily structured by conditions and circumstances in their life.