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INTRODUCTION TO CULTURE DIVERSITY AND HEALTH (WK 1)REFLECT ON THE MEANING OF CULTURE culture is the evolved human capacity to classify and represent experiences with symbols and to act imaginatively and creatively culture is the distinct way that people who live differently classify and represent th...

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INTRODUCTION TO CULTURE DIVERSITY AND HEALTH (WK 1) REFLECT ON THE MEANING OF CULTURE -

culture is the evolved human capacity to classify and represent experiences with symbols and to act imaginatively and creatively

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culture is the distinct way that people who live differently classify and represent their experiences

EXPLORE ONE'S OWN IDENTITY AND HOW OTHER PERCEIVE YOU CONFRONT ONE'S OWN PERCEPTIONS OF THEIR OWN IDENTITY AND THAT OF OTHERS UNDERSTAND THE MEANING OF DIVERSITY AND IDENTITY -

diversity is the degree of variation of cultures, identities and other social and economic. factors within a given society

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identity is a person’s conception and expression of their individuality or group affiliations. what people thinks of themselves and what society dictates or understands of that person

REVIEW THE ROLE OF SOCIAL CONSTRUCTIONS IN HOW WE PERCEIVE OURSELVES AND OTHERS -

social construction: is a perception of an individual group or idea that is constructed through cultural or social practice

CONFRONT THE CONCEPT OF RACE AND WHAT THAT MIGHT MEAN FOR HEALTH AND WELLBEING -

no such things as race: gould 1997 (racist arguments and iq) the expression of any trait represents a complex interaction of heredity and environment

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social determinants race = phenotype (visible characteristics), genotype is the genetic makeup even tho the genotype is the same, there is a tendency to emphasise the phenotype because of the convenience it provides for creating hierarches among humans with power imbalances

WEEK 2 : INDIGENOUS AUSTRALIANS -

multicultural health by the National Health Medical research council: All Australians have the right to access health care that meets their needs. In our culturally and linguistically diverse society, this right can only be upheld if cultural issues are core business at every level of the health system – systemic, organisational, professional and individual. o based on human rights

IDENTIFY THE VARIOUS ASPECTS CONTRIBUTING TO AN INDIVIDUAL’S IDENTITY -

culture is dynamic and constantly changing. they can adapt and clash. cultural shock can be uneasy

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culture Totality of a group’s behaviours, values and beliefs, as well as its art, language, tools, world views, symbols

ethnocentrism: is the tendency to view the world through one’s own cultural filters which can create negative dynamics with and perceptions of those we deem to be the ‘other’. categorising by prejudice - aboriginals are categorised at part of the flora and fauna - prejudice is based on limited information and overgeneralised discrimination: is us acting out of prejudice - direct: say or do something that is based of prejudice with the outcome an action -

indirect

UNDERSTAND THE CULTURAL IDENTITY, PRACTICES, AND TRADITIONS OF INDIGENOUS AUSTRALIANS -

indigenous wellbeing: prior to colonisation in 1788, ASTI people had control over all aspect of their life (sovereignty, economy land), able to exercise self-determination, determine their well-being (psychological fulfilment) and incorporated the culture, social and spiritual sense (NAHS) o shows holistic nature and specific self determination

clashes of cultures: experiences and impacts - land: important for ASTI as they believe there are custodians // terra nullius -

lore: folklore, history language: links to ethic or cultural group

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law: the rules make up our understanding of culture and society what makes someone indigenous ? An Aboriginal or Torres Strait Islander is a person of: o

1) Aboriginal or Torres Strait Islander descent

o

2) Who identifies as an Aboriginal or Torres Strait Islander and

o

3) Is accepted as such by the community in which he [or she] lives.[

RECOGNISE THE NECESSITY FOR CULTURALLY APPROPRIATE HEALTH CARE -

In contemporary terms, Aboriginal people are more concerned about the quality of life. Traditional social systems include three-dimensional model that provides a blue-print for living. Such a social system is based on inter-relationships….

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Crucially it must be understood that when the harmony of this inter-relation is disrupted. Aboriginal and Torres Strait Islander health deteriorates persistently

IDENTIFY THE KEY FACTORS THAT HAVE DISADVANTAGED INDIGENOUS POPULATIONS -

stolen generation. the removal of indigenous children under the stolen generation policies ceased in 1969

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xenophobia: deep rooted, irrational hatred towards foreigners based on an unreasonable fear or hatred of the unfamiliar

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systemic racism: includes policies and practices entrenched in established institutions. institutional racism: own racist assumptions or beliefs that stems from conscious or unconscious personal prejudice

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colonisation consequences o people may not know if they are aboriginal: genetic based. based on cultural acceptability and heritage o

lowered self-esteem

o o

distrust and scepticism or government and public services employment opportunities

o

poverty and limited education prospects

o

housing availability and assistance

o

poor health outcomes and life expectancy

SOURCE EDUCATIONAL MATERIAL RELATED TO A CORE ISSUE IN AUSTRALIA: CLOSING THE GAP IN HEALTH CARE PRACTICES AND OPPORTUNITIES ASTI population: -

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The Australian Bureau of Statistics estimates that: o

669,736 Indigenous people living in Australia in 2011.

o o

NSW had the largest number but NT had the highest percentage Indigenous people made up 3.0% of the total Australian population

o

90% Aboriginal, 6% Torres Strait, 4% both

o

One-third of Indigenous people lived in major cities

The Aboriginal and Torres Strait Islander population has a younger age distribution than the non-Indigenous population o

Average age of 21 years compared with 38 years for non-Indigenous people.

o

The average age for Aboriginal and Torres Strait Islander males and females was 20 years and 22 years respectively.

Children under the age of 15 years made up 36% of the Aboriginal and Torres Strait Islander population o Compared with 19% of the non-Indigenous population The proportion of Aboriginal and Torres Strait Islander people aged 65 years and over was considerably smaller than for non-Indigenous people (4% compared with 14%). 2x more infant deaths o babies born 200grams less than non-Indigenous babies and 2x more likely to have a low birth weight

o -

-

o

Low birth weight = later health problems

o

Indigenous women are 5x more likely to become teen moms

primary causes of death: o CVD: smoking tobacco, not eating well, and having diabetes. one-in-eight Indigenous people reported having a long-term heart or related condition (National Aboriginal and Torres Strait Islander Health Survey, 2005) o

diabetes

o

cancer: lung, liver, cervical, pancreas // breast, bowel, prostate, skin and immune

o o

injury: traffic, suicide violence disability: 20% in 55+, 10%- 45+, 7% in everything lower

o

physical activity: 50% in sedentary, 20 in low

WEEK 3: THE CULTURES OF HEALTH AND HEA LTHCARE UNDERSTAND THE VARIOUS DEFINITIONS AND COMPONENTS OF HEALTH ACROSS CULTURES cultural norms have profound influence on health behaviour and ultimate health outcomes

Culture and healing are intermixed, emphasising that health practices are linked to the social and cultural relations within differing cultural groups.’ -

The definition of disease found in societies that emphasise the biomedical healing model is at odds with the cultural understanding of disease found in many non-Western societal groups

health continuum: Dis-ease -> absence of disease -> Health

RECOGNISE THE BENEFITS OF HAVING A VARIETY OF CULTURAL PERSPECTIVES culture is central to perception of biomedicine - Cultural perceptions and the social interactions surrounding them influence: o whether or not individuals will access health service o

acceptance or rejection of offered treatment

o

compliance to treatment

o

success of prevention strategies

o

the clients’ perception of standard of care

o

the clients’ view of health care providers and personnel

DESCRIBE THE DOMINANT HEALTH CULTURE IN AUSTRALIA AND ITS EFFECTS ON A MULTICULTURAL APPROACH TO HEALTH biomedical model of health: very strict model of health particularly the absence of disease - the biomedical model appears monolithic and objective - Australian health services and programs derive from Eurocentric forms and practices -

westerner healthcare providers are seen to be the norm and the recipient of services are believed to be deficient in knowledge and practice o

indigenous Australians: westerners believed they need to be helped (paternalize)

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target groups are need as needing help from the mainstream: implications of a hierarchy: race or cultural

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Eurocentric structures and programs marginalise non-western cultural practise –

EVALUATE THE WESTERN AND TRADITIONAL MODELS OF HEALTH The biomedical model -

a money-making venture in a capitalist society/ approach. Social Darwinism, socially better off are going to be better doesn’t consider the social determinants of health evidence: Forbes 2000 list. in 2017 first three are pharmaceuticals and then food. o people are promoted to be sick – more money is made from being sick lifestyle issues causes are not addressed o o

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e.g. disadvantaged children are most likely to be overweight or obese: at age of 4: 15% overweight and 5% obese socio-economically pattern: the poorest and marginalised population are more likely to experience this

limitations of the model: feeds into itself. disease treatment -> disease creation cycle

- biomechanical is effective: when you get hit by a car you wait surgery. e.g. vaccinations Traditional models: changed from capitalist society – from colonisation infiltrated communities and developed a hierarchy approach and changed traditional communities’ engagement of health - colonisation in Australia has resulted in lower life expectancy, higher infant mortality and increased morbidity (diabetes, renal failure, infectious, nutritional deficits, disability -

cultures and lifestyles: accumulating evidnece suggest that humans have lived longer and fuller lives in the past due to better lifestyle e.g okinawa

Traditional health care - Weston a price conducted international study to look at health practices on diet on everyone o

idea that western culture is better

Traditional models of health i.e. traditional Chinese medicine -

in western settings are a lifestyle choice

IDENTIFY THE SOCIAL DETERMINANTS OF HEALTH

IDENTIFY THE IMPORTANCE AND RELEVANCE OF WELLNESS CONCEPTS ACROSS CULTURES OF HEALTH awareness of cultural influenced behaviours - it may be out intention to try to modify the behaviours of other people in ways that we consider beneficial. Such effort are unlikely to result in change as why don’t understand why these conditions are as they are Exploring health beliefs and practices -

folk healing: set of health beliefs and practices derived from ethnic and historical traditions that have amelioration or use of psych, spiritual and physical problems o

health beliefs: based on idea that healing is an art, including culturally appropriate methods of treatment delivered by recognised healers in the community that capitalism on faith and belief systems in treatment process

o

diverse non static models have a distinctive role of healer + geography and cultural variation

o

e.g. Mexican folk medicine: blend of American religions and Roman catholic ideas about healing and illness as gods will

o o

e.g. Asian: complex and well-established therapeutic tradition often used in combination with diet, western med or supernatural healing . Classify food, illness and medication as hot or cool. e.g. pacific islander: mana: balance

o

indigenous people connect with other aspects of life: land, each other and cultural rituals and practices

Recognition & Engagement of Cultural Sensitivity in Health Service Practice - will improve the performance of both the individual and the organisation and offers opportunities to: o

improve quality

o

improve outcomes

o

reduce costs

o

enhance effectiveness and efficacy, and

o improve customer satisfaction. cultural competence in health care: -

Be sensitive to the role that folk or traditional medicine may play in a patient’s health strategy. Show tolerance of and respect for diversity in order to elicit and fully understand the patient’s story and provide appropriate treatment.

WEEK 4 : AUSTRALIA OF CULTURALLY AND LINGUISTICALLY DIVERSE BACKGROUNDS DEFINING CULTURAL AND LINGUISTIC DIVERSITY -

CALD communities are those which comprise people for whom English is not their primary language, or who were born into a culture significantly different to the dominant Australian culture (philanthropy Australia) o

very subjective of what diverse is from what or whom

o

centred around Anglo Australian culture: outside are ATSI, Non-English-speaking migrant

o

race: is a social construct

CRITIQUING CULTURAL AND LINGUISTICS DIVERSITY -

it is easier to talk about large group of people without being specific like race and religion

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“identification always relies upon a difference that it seeks to overcome, and that its aim is accomplished only by reintroducing the difference it claims to have vanquished. The one with whom I identify is not me, and that 'not being me' is the condition of the identification. o

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central group of people (Anglo-Saxon) is the threshold is being different. but align with the norm. it is hard to identify, what is the threshold? particular ethnic pattern

the Australia Bureau of Stats 2009, CALD status has been divided into four categories: o

Born in Australia, mainly speaks English at home

o

Born in Australia, mainly speaks a language other than English at home

o

Born overseas, mainly speaks English at home

o

Born overseas, mainly speaks a language other than English at home

UNDERSTANDING ASSIMILATION -

there are ethnic, racial, cultural hierarchies

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cultural assimilation is the process in which a minority group or culture comes to resemble those of a dominant group

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o

people try to become as similar to the centred group,

o

assimilation usually is a gradual change, new members become indistinguishable from old member

completed assimilation: ends at the moment when out language culture and ethnicity become of our country migration

MEASURING ASSIMILATOIN -

socioeconomic status (education attainment, occupation and income) o

education: Migrants, 20-24yo, who spoke another language at home were more educated than those who spoke English

o

English proficiency: less likely to complete or study a bachelor degree or above

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spatial concentration (residential concentration and geographical location) – higher prevalence of non-white background that are poorer

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language attainment (name changing) – loss of mother tongue, use an Anglo name

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intermarriage (mixed ethicality children) – race and ethnically: being social integrated into the mainstream group

Stats and info for CALD -

Among 15-64 year olds, 68% were born in Australia and mainly spoke English at home

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14% were born overseas and mainly spoke English at home

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14% were born overseas and mainly spoke some other language at home

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4% were born in Australia and mainly spoke a language other than English at home

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Demographics o

In NSW – 50% from Culturally and Linguistically Diverse (CALD) backgrounds

o

One third of marriages are between people from different countries of birth

o

150+ languages spoken in Western Sydney

o

40%+ Christian, ~2% Muslim

INEQUITIES AND BARRIERS TO HEALTH -

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basis of health inequality o income + standard of living = population health o

Residential segregation diminishes the opportunities for social cohesion

o o

Indigenous populations are experiencing poor health Migrants (especially those with low English proficiency) are experiencing poor health

societal repercussion

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-

o

increased crime and violence

o o

impeded productivity and economic growth: if running around doing things, very hard to move forward overall impaired functioning: health functioning, mental health

is Australia racially or ethically impartial o A recent study by the Public Religion Research Institute found 52 percent of whites agreed, "Today discrimination against whites has become as big a problem as discrimination against blacks and other minorities.  2011 study/ racism against Blacks has been slowly declining, but white people think racism against whites is growing at a fast rate o should focus on multiculturalism  being blind to difference: treat everyone equally  recognition of difference: away with the language barriers: o language barriers o differing cultures of health o transport o o

not enough money knowledge of ones rights

o

humility : embarrassed

o o

undertrained workforce general ignorance

WEEK 5: ETHIC DISPARITIES IN HEALTH -

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harm related appraisals: process that we think it is an attack : oppress or depress beliefs rationalising the appraisals negative emotions defensive coping action: avoiding discussion

RECOGNISE THE INFLUENCE OF LOCATION ON HEALTH AND LIFE EXPECTANCIES -

place and space : impact of life expectancies o access to treatment centres o socioeconomic o

access to services

mosman v mt druitt -

Mosman: Anglo Keltic. mt Druitt western area: more diversity

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green space improves health: limited in mt druitt fast food outlets: McDonalds Glasgow train lines

IDENTIFY THE SOCIAL DETERMINANTS OF HEALTH AND WELL-BEING social determinants: a system theory that impacts on a life span

DEFINE SEGREGATION AND HIGHLIGHT ITS IMPACT OF HEALTH -

people from certain areas in Sydney because of segregation: culturally concentrated + ethnic o b...