Week 4: Social Change
Systemic Oppression: how different forms of oppression play out within policies and programs across sectors
Approaches to address systemic oppression
Social Determinants of Health: health is determined not only by individual behaviour (38%), but also the physical environment (7%), medical care (11%), genetics and biology (21%), and social circumstances (23%)
Structural theory: socioeconomic circumstances of social groups cause differences in health outcomes - people with more resources in any setting or country are always healthiest
Gardener's Tale: an allegory that illustrates the impacts of racism on health and wellbeing. In rich, nutrient soil, even weak seeds will manage to grow. In rocky, nutrient-poor soil, even strong seeds will struggle.
Institutional racism: differential access to the goods, services, and opportunities of society, by "race"
Evaluating Systems
Social Systems: Examples of Systemic Inequities
Employment: systemic differences across industries and aspects of employment
Health Care: Aboriginal and Torres Strait Islander people have 2.3 times the disease burden of non-Indigenous people
Racial gap consistent across occupations, industries, and employer size - illustrated by studies showing white names/photos received 50% more interview call-backs, and ethnic minority candidates needed to apply for more jobs to be called back for an interview
Gender gap: WGEA study showed increased focus within organisations on gender equity - addressing the pay gap
What might be happening across all areas of SDH and within systems, and not just for an individual patient and provider?
Diversity Training: important for addressing systematic differences and gaps - typically evaluated as post-program changes in attitudes and knowledge
Organisational Factors
Organisation-level prevalence of discrimination
Numbers of ethnic minority employees
Organisation-level prevalence of diversity training
Individual factors
Minority status
Personal experiences of discrimination
Diversity training
Related to a decrease in experiences of discrimination for minority employees
Significant large effect of experiencing job discrimination on job satisfaction (lower)
Short-term Outcomes: changes in knowledge, attitudes, skills, etc.
Intermediate Outcomes: Changes in behaviour, practice, policies, etc.
Long-term Outcomes: Greater reach of services, increased funding for services, more cost-effective programs, etc
Reading
Q1: Diversity training programs are educational or developmental initiatives that address issues related to variability in employee social identities. The goal of diversity training is to decrease discrimination within the workplace and the improvement of the experiences of individuals from disadvantaged social identity groups.
Q2: Organisational ethnic discrimination is discrimination that occurs within organisations against people belonging to ethnic minorities
Q3: The research found that there was a significant, large and negative relationship between experiencing discrimination and job satisfaction
Q4: The research concluded that the negative effect of discrimination is attenuated when the prevalence of discrimination in the organisation is higher (when discrimination is more common, there is less of a negative effect. In settings where there are more ethnic minority employees, there is a greater negative effect of individually experienced ethnic discrimination on job satisfaction