101

Now that I've relearned the first term of hlth 101, I must know the other half...

The GREB stands for the General Research Ethics Board. It states that, if you are carrying out any research project involving humans, it must meet the standards and guidelines of the board.

The 5 fundamental values are honesty, trust, fairness, responsibility, respect.

Plagiarism is when you submit someone else’s work without giving them credit for it.

Academic integrity is the freedom to inquiry about and exchange ideas.

Social determinants of health are factors that influence people’s chances for living long, healthy lives.

Health is a normative discipline, which indicates that when studying health, you study how health should be (improved), rather than just how it is at the time.

Allan G. Johnson: Sociology is the study of individuals, society, and the intersection between the two. The “one thing” is to understand what you are participating in, and how you are. For example, if you are a male, you are fulfilling a “gender role.” Also, if you are speaking English, you are carrying out a tradition. Moreover, with racism, you realize that it is something you alone cannot abolish, but you can decide how you will participate in it; by being apart of the solution, not the problem.

David Butler Jones is the chief officer for public health in Canada. He issues annual reports on the status of the public’s health that year. These reports began in 2003 to prevent SARS from spreading.

“Health” is a word that comes from the Greek word “holos,” which means “whole” in English.

Negative health is the absence of diseases and illnesses; you are at a neutral/normal state of being.

Positive health is the absence of diseases and illnesses, but also the presence of other things; optimism, confidence, happiness, biological wellness, etc.

4 Understandings of Health:

WHO (World Health Organization): physical, mental, and social wellness.

“Lay” (ordinary people): being healthy, being able to do things, being active

Robert Crawford: control (of diet, exercise, etc.) and release (expression, enjoyment, relaxation, etc.)

Aboriginal: emotional, spiritual, intellectual wellness

Public Health (1948 origin): what we do as a collective society to ensure that everyone in the society has good health. The goal of public health is to improve it. Public Health is also seen as a law, a policy, a practice, and research. With public health, you need a combination of the government and the individual to improve the health of the public.

Robert Virchow was the founder of “social medicine” (social determinants). He concluded that poverty caused diseases. He recommended increasing wages to reduce poverty to better people’s health.

Edwin Chadwick was apart of the first public health act in 1948. He concluded that in order to have good health, you need clean water (for drinking, sanitation, etc.)

1. Socialism/Collectivism (Rob Baggott): positive liberty; freedom to do things with the help of the government’s assistance (ie. with government, you have health care; health care makes you healthy and gives you freedom to play sports, for example)

2. Neoliberalism/Individualism (Mike Harris): negative liberty; freedom from government interference (ie. without government, there would be no taxes)

3. Environmentalism/Green: the focus is on the interconnectedness of humans and how we interact with the environment (this is more local and community-based than the other 2 viewpoints)

Broad Model of Public Health: the focus is on prevention, rather than immediate treatment; in the river analogy, we are to “swim upstream” in order to find the causes of diseases to prevent them from spreading and reoccurring (with this model, there is no benefit to the individual; the only benefit is to the population as a whole) - exemplified by Daniel Goldberg

Narrow Model of Public Health: the focus is on acute care (immediate treatments); in the river analogy, we are to “swim downstream” to pull those out of the river who have fallen in (help those who are already sick) (with this model, there is no benefit to the population, but instead only to the individual) - exemplified by Mark Rothstein

Geoffrey Rose is the founder/creator of the river analogy, also known as the “prevention paradox.”

Friedrich Engels was an advocate for workers rights. He noticed how workers working under capitalism suffered early deaths and wanted to put an end to it.

Social justice, a Canadian term, is ensuring everyone in a society has access to society’s benefits (such as health care, education, sanitation, etc.) If we had this, Aboriginals would not be dying sooner than Caucasians, for example.

The LaLonde report concluded that health is not just about health. It is also about healthy environments and choices. It is also about “adding life to your years, and not just years to your life.”

The (Jake) Epp Report concluded that disadvantaged groups are sicker and therefore need a collectivist approach by swimming upstream.

The Ottawa Charter for Health Promotion concluded that we need peace, happiness and social justice for good health.

Population Health, a Canadian term, concerns the health of the population. The goal of population health was to improve the health of the population by reducing inequities among a population.

Health Promotion is about supporting healthy choices and environments, enabling people to meet their full potentials, and meditating between two competing interests (a compromise).

The PHAC (Public Health Agency of Canada) is about promoting and protecting the health of Canadians. It was created in 2003 to help prevent Canadians from getting SARS, along with David Butler Jones’ annual reports on the status of Canadians’ health.

Life Under Mike film: It is a film of one person’s point of view (and therefore it is biased) of the time when neoliberalist/individualist Mike Harris came into power in Ontario. It shows that Mike Harris cut welfare and increased taxes. With this, workers were laid off and some were left in poverty. Some of the workers began to create individual businesses of their own (such as carpet cleaning); some got fired for this in the first place. When workers were fired, they were replaced by “scavs,” so the workers went on strike to get more money/their jobs back. Those who were left with jobs were underpaid and were working in poor conditions under capitalism (this is what Friedrich Engels was talking about). Finally came a law that claimed it was illegal to be poor; the rich kept on getting richer, and they no longer wanted to even see the poor. Little do they know, they cannot survive without the poor. [Expand?]

Whitehall Studies: longitudinal (over time), epidemiological (concerning the spreading and tracking of diseases) studies of British civil servants in the UK. Studies were done by Michael Marmot.

Whitehall I: examined 4 different kinds of workers. The result was that the lower you are on the hierarchy, the less healthier you are. This is the “status syndrome” (Michael Marmot’s term): the richer you are, the healthier you are.

Whitehall II: measured personalities. The result was that there was a gradient between mortality (death rate) and morbidity (the rate at which you get sick). The gradient represents how if you go from upper to lower class, or lower to upper class, your mortality increases due to the stress.

John Snow was the founder of epidemiology (the study and spread of diseases using maps, stats, charts, etc). He was the founder of “germs.” He also used statistics and mapping to track the cholera epidemic.

Income Inequality (Richard Wilkinson: professor of epidemiology): inequality of income among populations (countries).

Disease: objectively diagnosed (medically assessed)

Illness: subjective feelings of discomfort (self assessed)

Public Health in the 20th Century: more local

Food (inspection and circulation)

Immunization (vaccinations)

Sanitation (clean water, sewers, etc.)

Health Education (especially for mothers and children)

Poverty in Ontario:

As unemployment increases, poverty increases (this is to be expected).

Being poor = unable to afford medicine, dentistry, education, etc.

OW (Ontario Works)

ODSP (Ontario Disability Support Programs)

These are 2 programs provided to people without an adequate income to provide for themselves.

Social Exclusion is not being able to do the things people usually do in your society for entertainment (ie. going to the movies, buying new shoes, etc.)

Economics: the work we do to produce the goods and services we need for survival and want for leisure.

Work: what we do and how we do it

Production: what we produce

Distribution: who gets what

End use: how we use what we produce

Environment: how our work relates to nature

Production:

Goods - material things (ie. cars, houses, etc.)

Services - functions performed for others (hair cuts, health care, education, etc.)

Micro economics: individual firms and consumers.

Macro economics: how individuals behave in a group environment.

Economists: study how the economy should be, versus just how it is (normative discipline)

Kinds of Economy:

Post-Industrial: the focus is on services rather than goods, especially when people’s incomes are increasing

Information: the information world has created an economy of its own (information over commodity)

3. Shared: capitalism is fair because everyone has their own shares (focus is on pension plans, retirement funds, etc.)

Measuring the Economy:

GDP (Gross Domestic Product): the sum of all goods and services performed for money (this does not include the goods and services not for money such as taking care of your kids, where daycares perform the same job and get paid for it); therefore this is an inaccurate way to measure the economy in regards to the amount of work done

Real GDP: GDP adjusted for inflation

GDP per capita: GDP divided by population

Evaluation the Economy:

Prosperity

Security

Innovation

Choice

Equality

Sustainability

Democracy

Capitalism (reading by Jim Stanford):

Most production is controlled by private company owners looking to make a profit off other people’s labour.

Most work is done by workers looking to earn money for themselves (this is called wage labour, or “employment”)

Types of Capitalism:

Anglo-saxon: least equal

Continental: more equal

Asian: even more equal

Scandinavian: most equal and regulated

Welfare (AKA “Social Security System” or “Social Safety Net”):

The goal of welfare was to civilize capitalism, not replace it.

Who needs welfare?

Seniors: are retired/too old to work (physically)

Children: if their parents lose their jobs, it isn’t their fault

Disabled: physically cannot work

Working aged adults: cannot get jobs and therefore do not have incomes

Causes of Welfare:

The Great Depression (1930s):

With the stock market crash came an economic downturn.
2. WWII (1939-1945):
There was a collectivist spirit in the air once Hitler was defeated. The mentality was “If we can defeat Hitler, we can defeat poverty too!” (The people’s first goal was to create/improve health care systems)

Universalist Welfare State:

The government plays a key role in distributing welfare funds. The assistance was for food, water, shelter, education, and health care, as well as income security; welfare supported good workers so they could continue to earn, buy, and sell, thus stimulating the economy. People also thought that personal misfortunes should be looked after too, such as post-traumatic stress of the death of a loved one.

Social Insurance Programs:

1. Employment Insurance

2. Canadian Pension Plan (CPP): must be 65+/retired to apply
3. Worker’s compensation (for accidents; not the workers’ faults)

Universal Programs: Everyone is eligible based on a certain criteria

Income-tested Programs: There was only one amount of money to be given out if you meet the criteria

Needs-tested Programs: This relied on a social worker’s assessment (very subjective, and punitive, and invasive)

Welfare into Employment:

This was difficult because it was expensive (transportation, appearance, daycare). Also, people were lacking the education and skills they needed to transition back into the workforce after a certain amount of time; everything is updating/advancing (theories, techniques, practices, etc). Also, if a job was granted, there are no benefits with minimum wage jobs, and it may be an insecure position. Welfare rates, however, have dropped 40% since 1995.

The “Working Poor:” people who are working but are below the poverty line.

Low-paid worker: Someone working minimum wage, for example (a teenager)

Low-income worker: Someone living in a low-income house

Only 24% of low-paid workers are living in low-income houses.

Recommendations to cut poverty (provincial and federal government):
Provincial: minimum wage increases
Federal: employment insurance and affordable child care

Race: a socially constructed category based on one’s access to resources and power in their society (race is not biological whatsoever).

Racism: discrimination based on the belief that one’s differences (ie. skin colour) produce superiority over another (ie. white privilege: the invisible/unearned privilege that comes with having white skin; it can be unintentional/institutionalized: ie. there are more white and black people in Parliament, but it is not intended to be racist)

Racism and health:
Direct effect: racism causes stress and hypertension

Indirect effect: racism doesn’t cause poverty; racism caused stress which causes poverty

Madeline Drexler and Racism:

Indirect effect: racism physically hurts the body; racism causes stress that causes heart disease

Allan G. Johnson and Racism:

We are to realize that we can’t abolish racism, but we can change how we will participate in it (being apart of the solution rather than the problem). Individuals are not responsible for the world they were born into, but are responsible for how they participate in it/attempt to change/improve it.

Race and Health (Aboriginals): descendants of the original people (natives, Indians, first nations)

“Indian:”
Status Indian: registered Indian (has access to rights/benefits)
Non-Status Indian: a non-registered Indian (ie. if a European man marries a status-Indian woman, her status is lost; until 1980)

Treaty Indian: affiliated with the treaty band

First Nations: replaced the term “Indian;” there was conflict of who was to call who what

2. Metis: French for “mixed blood” (ie. if a First Nations woman has a child with a European man = their baby is a Metis)
3. Inuit: Inuktitut for “people” (people living in Northern Canada)

Residential Schools: Aboriginal children were forced to go to residential schools and to be separated from their families and friends. The alleged purpose was to educate the Aboriginals, but in reality, the whole thing was a deliberate attempt to “kill the Indian in the child” and to teach the Aboriginals how to be like white people.

Canada’s Indian Policy wanted to protect the Aboriginals because the assumption was that they were inferior.

Post residential schools, survivors were emotionally/physically/sexually abusive to the people in their lives because abuse was all they knew (they were bad parents, husbands, wives, etc). Their traditions, cultures, believes and apart of their person was thrown out.

IRSSA (Indian Residential School Settlement Agreement):
CEP: Common Experience Payment - survivors received payments

IAP: Independent Assistance Program - survivors who were abused received extra money

TRC: Truth and Reconciliation Commission - a commission set up for relief for survivors of the schools (sharing stories, shedding free their guilts, etc.)

SDOH of Aboriginals: the numbers are appalling (low: university degree numbers, housing numbers, income numbers)

Naomi Adelson: an advocate for Aboriginal people’s rights since Aboriginals have little say in what they deserve. She discussed the disparities between Aboriginals and the government.

Cultural Continuity: preserving the culture
Self government
Land control
Schooling control

Health control

Policy and fire control

Cultural facility control