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N382:Disparities and Determinants
Transcript of N382:Disparities and Determinants
The most important and driving force in poverty is relationships.
Relationships are more important than anything.
To create change, we must create relationships.
Through our relationships, we help others write a future story.
Health Disparities and Determinants of Health
"A particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage." (Healthy People 2020)
Health Care Disparity
A difference in the quality of health care received
Socioeconomic Status (SES) is the major determinant of health.
Within each SES, racial/ethnic disparities exist
Barriers to Health Care Access
Prevent individuals and populations from getting health care
"The ability to leave poverty is more dependent upon other resources than it is financial resources." (p. 11)
AA and Hispanics receive less evidence based care for many diagnoses.
Cultural Differences (i.e. customs, language)
Lack of insurance is the most significant barrier for minorities
Social Determinants of Health
Environmental toxins (e.g. lead)
Stress connected with poverty
There is a strong correlation between health and income and children are the most vulnerable
7 fold increase in poor health for children
5 fold increase in poor health in adults
Quality of Health
<Federal Poverty Level
>400% of Federal Poverty Level
More nutritious food
Impact on mood, mental health and sense of well-being.
Lower income women more likely to have low birth weight babies
decreased cognitive ability
increased behavioral problems
increased risk for chronic diseases
Decreased income and socioeconomic status
Poorer outcomes including health status
Emotional, Mental, Spiritual, Physical, Support System, Relationships/Role Models, Knowledge of Hidden Rules, Coping Strategies
Need to act
Overwhelms ability to learn
Prevents ability to see the future
Loss of Job
Loss of Home
You'll never have enough to get out of the hole so spend it before someone comes and borrows it.
Hidden Rule of Money
$22,113 for family of 4
Chronic Stress Effects
Heavier Health Burden
Chronic Physical Disorders
•Alcoholism and other substance addictions
•Peripheral vascular disorders
•Human immunodeficiency virus infection/acquired immunodeficiency syndrome
Problems Associated with Pregnancy
•Lack of prenatal care
(Maurer and Smith., 2013)
Acute Physical Disorders
•Upper respiratory tract conditions
•Trauma, including major and minor injuries
•Minor skin ailments
•Infestations (mites and lice)
Health Problems in Children
•Incomplete or no immunizations
•Speech and language problems
•Upper respiratory tract illnesses and asthma
•Minor skin ailments
•Lice infestations (Smith 537)
Mental Health Problems
•Borderline personality disorder
•Antisocial personality disorder
Awareness of all family members
Looking for community partners
Data collection and analysis
We all are vulnerable!!
"the learned and shared beliefs, values, and life ways of a group that are generally transmitted from one generation to the next and influence peoples' thoughts and actions" (Mauer&Smith, p. 268)
"Non-compliance" OR cultural behavior?
Race Vs. Ethnicity
Share common biological features
Share culture and a way of life
ASK THE CLIENT!!
Remember your transcultural nursing!
Role of Food
Cultural assessment tool in Table 10-4 on page 287.
History, traditions, communication
Incorporate culture into program design
Nurse cultural awareness on community level
Tami Bland, DNP, CPNP
Start by doing what's necessary; then do what's possible; and suddenly you are doing the impossible.
Francis of Assisi