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BPH 206 Exam 3 Questions And Accurate Answers
Disabiltiy a physical or mental condition that interferes with the ability to participate equally in society Disability Statistics 19% of US population live with a disability 22% of floridians have a disability 26% of miami dade county residents have disability A chronic disease is a Secondary disability U.S Census bureau disability data International classification of functioning, disability and health (ICF)
- created by WHO A universal classification system using standardized language that perceives health from a holistic perspective ICF key aims Provide a scientific base Provide a universal language to enhance communication Allow comparison of data Provide a uniform coding system ICF Dimensions of disability: -impairment -activity limitations -participation restriction People-First Language
emphasizes the person and not the perceived limitations of disability Ableism prejudice and/or discrimination against individuals with disabilities
- used to justify unethical, inhumane treatment of persons with disabilities: sterilization, experiments, institutionalization,, neglect
Ex: eugenics, Willowbrooks State school
United Nations on rights of PWD
- Respect for inherent dignity & individual autonomy
- Nondiscrimination
- Full & effective participation & inclusion in society
- Respect for difference & acceptance of PWD as part of human diversity & humanity
- Equality of opportunity for PWD
- Accessibility for PWD
- Gender equality among PWD
- Respect for evolving capacities of children with disabilities & the right of children with disabilities to preserve their identities
Healthy people 2030 objectifies on PWD
- Increase surveillance of disability; more health promotion programs for PWD
- Reduce cost-related delays in receiving preventive care; Increase use of assistive devices -Reduce physical barriers & PWD living in congregate care
- Increase access to regular education programs; Reduce serious psychological distress
Universal design intentional design of products & environments to be usable by all people, to the greatest
program discrimination
2017 senate hearing Reports: People with intellectual & developmental disabilities being paid: 33 cents/hour 48 cents/hour $2/day
Legal protection:1938/1966 Fair Labor Standards Laws = certified businesses allowed to pay subminimum wages for work performed by PIDD
Current barriers result in under-realized legal protections § Confusion about who is protected under the ADA, who is obligated to provide accommodations, what constitutes necessary accommodations § Lack of funding to implement legislation § Lack of coherent & unifying national strategies § Filing ADA complaints can be complicated
NATIONAL COUNCIL ON DISABILITY
- federal agency NCD makes recommendations to the President, the U.S. Congress, & other federal agencies about issues facing Americans with disabilities
Private orgs Protect & promote rights (advocacy & policy) + Monitor the government Facilitate active participation of PWD Provide resources: education, referrals, employment, financial support, assistive technology Research
Experiences of PWD with healthcare workers
Disempowering, negative, & hostile attitudes from HCPs Inadequate communication from HCPs Basic healthcare needs neglected Diagnostic & medication errors/delays Medical procedures that weren't necessary Missed opportunities for care Unwelcoming physical environments HCPs = healthcare providers Less than ½ of parents & carers of children with physical or learning disabilities felt that staff knew how to care for their child's individual needs." alot disease; preventative health services : Interaction of Social Identities Social identities intersect and cross over Everyone has their unique lived experiences based on social identities We must understand the ways these intersections serve to enhance discrimination and privilege
Medical professionals refer to a lack of disability-specific knowledge & experience in treating PWD
Common Misconceptions of PWD They all have poor health or may have chronic pain PWD should be treated as different & special Public Health activities need to focus only on preventing Disability Environment does not play a sig role in the Disability process
W/o appropriate training, Healthcare providers may. Underestimate the abilities of patients with Disabilities Underestimating the quality of life of patients with disabilities Minimize the patient's ability to participate in their care Minimize the extent & value of the patient's experience in own disease.
Traditional Reductionist Thinking in Public Health Aids In Establishing Causality Cause -> effect Sedentary lifestyle -> heart disease
Reductionalist thinking is:
. One intervention at a time - Straight -line or linear projects - Static analysis . A piece of the bigger ouzzle
Problem with traditional reductionalist thinking in public health Doesn't reflect real-world risk
systems approach looks at the multiple factors at play in the occurrence & addressing of poor health outcomes
What is a system?
. Interconnected parts that form a whole interacting **- Dynamic
- Organized in a specific form to generate outputs** . The performance of the system is with regard to its general structure
System thinking:
- Multiple concurrent interventions
- Measurement of complex interactions
- The outlook on constantly changing or dynamic model of analysis
Objective: To explain how system parts integrate into one interconnected whole to yield intended results
Systems Analysis steps:
- Identification of crucial influences or an outcome
- Specify the relative magnitude of the effect of each influence or intervention
- Describe interactions among these influences or interventions
- Describe feedback loops showing dynamic changes that may occur
- Describe bottlenecks limiting the effectiveness of the system & leverage points offering opportunities for improving outcomes
Reductionist thinking yields data about what kind of influences & interventions impact an outcome & their relative magnitude steps 1 & 2 -Determinants of health Impact of singular interventions
In systems thinking we also look at how these _____ and _____ interact step 3 Influences; interventions
Why do we need systems thing and analysis? In order to understand the dynamic nature of complex problems and their solutions
Feedback loops FL Shows how the system changes overtime
Positive FL
Collective impact The commitment of a group of important actors from different sectors to a common agenda for solving a specific social problem
Is about means to effectively work and address the complex problems through a collaborative, systems approach ING means thinking & acting outside of box traditional strategies. No solitary, siloed efforts• No agendas or outcomes focused on individuals• No duplication or obstruction of efforts Greater ability to tackle complex challenges A collective, systematic process
Principles of Practice for Collective Impact
5 conditions of collective impact
A Shared Vision Is Captured in A theory of Change
Community action plan 8 step framework
Collective Impact can frame collaborative work around pursuing systems change
Backbone Organizations Serve 6 Core Functions to Support the Functioning of the Collective Impact
Guide vision and strategy Support aligned activities Establish shared measurement via practices Advance policy Mobilize resources
5 phases of collective impact
Planned change process Asses the situation: problem & cause?
- recognize symptoms
- diagnose need
Form a plan:
- analyze alternative solutions
- select a change
- plan the change
Make it happen:
- implement the change
- evaluate the change
- stabilize the change
Force field analysis A technique for determining which forces drive a proposed change and which forces restrain it. Driving forces -> positive; favor change
(aka Stages of Change Readiness for change occurs in stages -> We must meet people where they are at & change happens incrementally
Behavioural change is most effective if content & messaging is tailored to their stage -> Processes of Change are the 'tools' or strategies that we can use
Relapse can occur at any time -> That's ok! Start over again, but with more knowledge about what works and what does
Processes of change used strategically to provide tailored messaging that will aid ingraduation to the next level
Theory of Planned Behavior intrapersonal model that focuses on attitudes, subjective norms, & perceived control
social cognitive theory interpersonal model acknowledging the interaction between individuals and their social systems
Reciprocal determinism -> the dynamic interplay among personal factors, the environment, & behavior
Diffusion of innovation theory A population and community level model focusing on how a new idea, product, or social practice is disseminated and adopted in a population
Diffusion and adoption/rejection are influenced by personal attributes of the innovation ->
Relative advantage• Compatibility• Complexity• Trialability• Observability
Process: knowledge->persuasion->decision->implementation-> confirmation
PRECEDE/PROCEED Model provides a framework for planning & evaluation of health education & promotion programs
Precede, proceed model
Critical Race Theory (CRT). Approach that assist us to understand how racial and structural inequities persist even when laws are in place to prevent them
**- Racism is baked into our laws
- Does not blame, vilify, or victimize any group
- Designed to have greater care for communities that are vulnerable, excluded, and** negate
Intersectional Advantage Hypothesis
. Race and gender are not discrete variables explaining health
positions
- Sojourner Truth's "Ain't I a Woman?" The concept of her gender as a woman was not enough to account for the unfair treatment she endured outside of its relation to her race
Social Power Racism, sexism, classism, etc.
Create social divisions unlikely to be exclusively understood in isolation
Concerned with how power/privilege is variably situated:
**- At various or particular intersections
- Through different domains of power (e.g., structural, disciplinary, cultural,** interpersonal
Social Inequality Concerned with the intersectional identities of individuals from historically oppressed and marginalised groups
Key areas of concern: Social inequality, oppression, marginalization
Social Context What particular contexts within which privilege and disadvantage operate for example, healthcare settings, schools? Which points in space and time are intersections most formative?
Complexity
- How race, class, gender, sexuality, ability status, etc are mutually constituted
- How intersections of categories operate at different domains of power, for example,
structural, cultural, institutional, interpersonal, etc.
- People/Groups are not always advantaged or always disadvantaged
The Intersectionality Paradox
- Intersectionality does not presume that all interlocking identities are equally disadvantaged. - low, e.g., racial minority, LGBT persons and high, e.g., upperor middle -class SES status social identities intersect to yield disparity and advantage
The intersectionality paradox describes the result of adverse health outcomes at the intersection of a "high status" identity, e.g., middle-class SES with race and gender for Black middle-class women and men.
- Disproportionate rates of infant mortality are seen among highly educated Black women
Social justice Seeks to destroy structures that perpetuate inequity
Intersectionality as an Analytical Tool
- Most statistical models base many analyses on assumptions of linearity, unidimensionality of measures and uncorrelated error components
- Examining "multiple social groups within and across analytical categories and noton complexities within single groups, single categories or both" is often difficult and convoluted
Intersectionality as a Critical Praxis for Public Health
. Check Your Privilege **- Apply intersectionality frameworks to research and practice
- Representation and inclusion
- Listen and Learn**
