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mind map #6 - Coggle Diagram

- - - - Improve measurement
      - Unmeasured, indicators, such as wealth, access to bank credit, occupational or economic returns to education, & purchasing power, that aren’t usually included in socioeconomic measures
  - - - Family networks, barter exchange systems, use of social welfare programs, membership in communities of faith, & alternative economic enterprises
  - - - Location - first to know / social position - didn’t have access to lifeboat, etc /
    - - Only white people were allowed on
  - - - Socioeconomic status (SES) & health
        
        Titanic
        
        Higher survival rate of the first & second class passengers v.s. The second & third class passengers
  - - - Inferior social status & resultant poor health are characterized as essentially their own fault
    - - Whiteness is a prerequisite for membership
  - - - Lower levels are worse off
    - - May mask heterogeneity, overestimate the benefits of material resources, underestimate psychosocial & physical health costs of resource acquisition for some groups, & overlook the value of alternative socio cultural orientations
- - - - Interrogating health disparities experienced by marginalized pop. & their relationship to quality of health care
        
        Deconstruction of patterns & norms -- delivery space supports the elucidation of how such practices are often products of historical, political, & social factors -- traumatize patients in the margins of society
  - - - Focus on health care experiences of either African Americans of African immigrants or both groups
      - Focus on communication experiences of either/both groups
      - Focus on the role of nursing in providing quality care for Black immigrants or African Americans
  - - - Quality of communication during a health care encounter has been specifically cited as a critical factor influencing health disparities based on the patient’s experiences & engagement with the health care provider
        
        Black individuals are more likely to report negative experiences & discrimination when accessing health care services & experience poorer health outcomes
        
        Patient experiences with communication have been found to influence their overall health outcomes, adherence to health care providers' recommendation & trust
    - - Still persist
      - Disproportionate burden of disease, disability, & mortality across several health indicators
    - - Explore themes identities through our literature review, which include -- discimination, mistrust, low health literacy, & the impact of culture & language barriers on health literacy
        
        African Americans v.s. African immigrants
  - - - Historical ex:
        
        Tuskegee Syphilis study
        
        Contributed to the lower rates of African American participation in health research compared with other racial groups
      - African immigrant mistrust has received little research attention
        
        They do not feel accepted in U.S. based on how they speak, dress, & color of their skin
      - Represents the extent patients have confidence in the quality & genuineness of their provider’s care & their clinical competency
        
        Mistrust of the genuineness of care provided opposed to a lack of trust in their clinical competency or abilities
        
        Feelings of being treated like a “guinea pig” & being experimented on by health care providers
    - - Health literacy - the degree to which an individual has the capacity to obtain, communicate, process, & understand basic health information & services to make appropriate health decisions
        
        Greatest disproportions -- those who do not speak English as a first language
        
        Historical practices -- suppression of reading & writing for enslaved people, residential segregation, & the subsequent disinvestment in urban communities, have had lasting implications of African American literacy levels for generations
    - - Discimination - a process in which a member or members of a socially defined group are treated differently due to their membership in the group
      - African Americans had a significantly longer wait time to a treatment area
        
        Experienced serious health issues, such as a stroke, medical intervention was delayed, compared with Whites
        
        African American mortality rates were 1.2 times greater than Whites
        
        More likely to develop chronic conditions in earlier adulthood & have increased death rates in midlife from alcohol-realted liver disease, chronic, lower repiratory tract disease, suicides, diabetes, pancreatic disease, overdoses, homicides, hypertensive disease, obersity, & live cancer than Whites
        
        African immigrants’ ability to successfully access health care & navigate the healthcare system
        
        Overt racial, cultural, & religious discimination they endure, which further burdens them with chronic conditions & poor health outcomes
        
        “Double jeopardy”
        
        Treated differently based on their accents & cultural mode of dressing
        
        1 more item...
    - - Some many countries that not all are the same
      - Language -- embarrassment or minimize of symptoms
      - African immigrants -- may have relied on religious & traditional medicine more so than western medicine
        
        Issues of reproductive health are considered very private
        
        Different-gender health care providers may be challenging
  - - - Intercultural competence trainings should be central to ensure the effective delivery of health care services to minorities & marginalized pop, especially in medical & nursing schools
        
        Include self-reflection & awareness, knowledge of cultural issues, & developing skills in clinical settings that lend to understanding the unique needs of people of African descent
      - Aware of the societal mistrust & the history that surrounds it in order to avoid contributing to it further
        
        Empathic communication, communication immediacy, warmth, & most importantly, the practice of self-reflection & reflexivity to minimize personal, implicit biases
      - Institutionalized racism & discrimination within health care system
      - Language barrier
        
        Use simple words, hand out printed materials, & speaking slowly
        
        So act like their either children or dumb?
      - Cultural safety framework - emphasizes the need to address health outcomes for marginalized pop.
      - Prioritize genuine interpersonal relationships with their patients