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Week 5 - Coggle Diagram
Week 5
- Without interpreting health inequities as a function of the economy, government, or public discourse, approaches to addressing health inequalities may fall short, though they can still enact important changes for our health systems and services and provide the evidence that is required more upstream work.
Addressing modifiable and behavioural risk factors will take a healthy lifestyles approach by assuming the individual is capable of making healthy choices and places the responsibility on them (though this will only benefit those who are likely to make those healthy choices anyways)
Addressing differences in material living conditions such as neighbourhood characteristics, community development, and participatory or action research will identify and promote necessary changes to promote health in a community but assumes cooperation from authorities and governments who would be needed to see this through.
Improving access to and the quality of health care and social services can reduce health barriers but are insufficient in addressing the role of living and working conditions in health inequities
Example: Providing services to the folks in the Downtown Eastside is crucial as they would be much worse off without them but this will not prevent them from ending up there in the first place.
Addressing differences in material living conditions as a function of group membership (race, sex, class, etc) by focusing development and research on and with vulnerable and marginalized groups will enable these groups to take control of their health and provide evidence to support health promotion, but again this assumes cooperation from those higher up.
- Explicit and concentrated action is required to address drivers of health inequities in Canada such as structural racism and decolonization because such drivers cannot be assumed to be accounted for through equity and social justice.
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Forefront Indigenous self-determination in health promotion and question conventional knowledge systems that fail to align with Indigenous ways of knowing.
Increasing engagement of racialized and Indigenous faculty in academic and foregrounding competencies regarding structural racism and decolonialism in health promotion/public health programs will provide the field of practice with individuals who are properly equipped to address these drivers of health inequities.
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- Structural analysis is required to address the roles of the economic system, government apparatus, and public/social discourse that perpetuates health inequities and viewing health inequalities in this light will result in approaches that can work upstream to address the root causes.
Addressing differences in material living conditions by performing Health Impact Assesments (HIA) in public policy can promote health through policy and prevent harmful health outcomes, however, this approach is rarely seen in Canada!
Pluralism: the belief that public policy decsiions are made by weighing the pros and cons of policy advice contributed by a wide range of societal structures
Requires health promotion knowledge production, dissemination, transfer and exchange.
Analyzing how our government makes decisions on the basis of economic and political structures of power and influence can unveil areas for social and political action
The notion that a strong economy will be the solution to a healthy society ignores the inequalities resulting from the processes to strengthen that economy (for the rich) and is justifed by the idea that health is individually managed (as in "our economy is strong, if you are sick it is your fault")
Analyzing how health inequities are a product of actions performed by those with power and who benefit from them (Tax lobbyists, those pushing for less public expenditure, those controlling wages and employment benefits, etc.)
- A shift in the practice of health promoters away from health behaviouralism is required to accelerate change where it is truly needed (upstream with economic and political powers) rather than providing bandaid solutions to health inequities
Professional associations and agency networks can support professionals (who may be paid by the government) to speak out against economic and political influences on health inequities
Voting power and engagement in the electoral process is critical for electing people into power who are more likely to make meaningful changes reducing the health inequities in Canada
Provide support for policy action by telling solid facts and stories about health inequities and performing community-based action and needs assesments that can provide evidence for policy changes.
- In Canada, income has become the primary identifier for health inequities such that the health of individuals within the population can be predicted on along gradient from high to low income, where the top 20% of income earners will have a much better health outlook than those lower.
Currently the focus of most programs doesn't address the root causes of health inequities (income gaps/inequality, racism, sexism, etc) and instead work on improving health services, resiliency in the population, individualism, and social capacity.
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