Various determinants of health
Social determinants of health: health is a multifaceted issue that can also be a subject issue
1. Income: gives people the ability to have better health care, better nutrition, and higher sense of personal control
- Social environment: quality and number of social networks in a community, beneficial for health because having a positive one allows us to feel more supported
•ex: volunteering has benefits for both people volunteering and the people receiving help - Our physical environment: natural environment around us and the built environment
•natural: air quality (pollution level), water contamination
•built: buildings people find themselves in (especially homes), suffering from water damage, it is inviting lots of insects, home can mould, etc. - Culture: more important what people perceive your culture to be
•leads to employability and other kinds of opportunities/how other people interact with you
•ex: do you suffer discrimination/bullying, could put you at risk when being in certain physical environments
How culture impacts various aspects of health among indigenous people
Land Acknowledgment: UBC’s point grey campus is located on the traditional, ancestral, unceded terrify of the Musqueam people
•Traditional: this is territory where the people have engaged in traditional, cultural behaviours
•Ancestral: the musqueam people have been on this land since time immemorial
•Unseeded: this is not territory that passed hands due to treaties or consent
Indian Residential School System:
•Assimilationist education system designed to eradicate and replace indigenous culture with anglo canadian culture
•schools built far away from families and banned indigenous languages/practices among children in school
Timeline
1880s: first residential school established
1920s: all indigenous children must attend residential schools or parents would be arrested
1996: Last residential school closed (Saskatchewan)
Outcome:
•Abuse, disease, and poor sanitation led to high death tolls
*24% of indigenous children died in school and over 50% of children sent home died shortly after
•Lack of trust in education system among indigenous people
Role of determinants of health - social involvement
For Inuits in Canada, happiness means:
1. Family and Kinship: being around family, sharing food with family
•unhappiness is not being with parents
- Talking and communication: talking leads to positive emotional outcomes while not talking leads to negative emotional outcomes
•”healing is talking, and getting together with people” - Traditional knowledge and practice: traditional tools to hunt, going out on to the land
Role of determinants of health - income
•people on the reserve have very low income (under 15,000) while very few are making into $100,000 per year (only some metis and vary few inuits)
Employment and lack of education relationship
•employment patterns have shown to be lower amongst indigenous people
•unemployment attributable to discrimination, seasonal jobs, lack of education
•distrust in education system leads to lack of education leading to lower employability and less economic power
Role of determinants of health - physical environment
Kaschechewan diet: non perishable foods
•617 indigenous communities
•118 communities have “drinking water advisories”
•longest acting advisory - 23 years
•boil water advisories, do not consume advisories
•do not use - most serious kind, even toughing the water will make you unwell
Therapeutic landscapes •any physical environment that is associated with treatment and healing examples •bath, spas, hospitals •indigenous: hunting, sweat lodges
Association between cultural continuity and suicide risk
Indigenous youth who are given opportunity to connect with cultural heritage (cultural continuity) have lower suicide rates
•Graph 1: the more that you have, the better mental health of that community
•Graph 2: numbers are number of suicide (more factors of cultural continuity = lower suicide)
Relates to Arents-Toth and Van de Vijver’s model of acculturation
•heritage identification (related to cultural continuity) and mainstream identification (related to cultural competence, mainstream discrimination, and both related to psychological outcomes)
Define acculturation and different types of group level outcomes
def: consequences of people from different cultural groups being in continuous first handed contact
•change occurs in one or both of the groups (not just about the non-dominant group adjusting to dominant group)
•acculturation has always existed, but is now very fluid and much faster
•graph: immigrants in US take up almost half of the population (similar to Canada but has a slower rate)
Group levels of acculturation: not necessarily one getting absorbed by the other, but three possible outcomes
•none are considered positive or negative
1. Destructive: loss of culture through absorption or elimination from continuous contact with another cultural group
•ex: indigenous schools, foot binding
- Reactive: groups re-establish their original culture by revitalizing or reaffirming them in the face of another culture
•ex: language schools to reaffirm importance of their culture/indigenous initiatives to revitalize their language (places where you must speak Squamish) - Creative: new culture or cultural information emerges through interactions between the original cultures
•ex: metis people, food (spam musubi in hawaii), religion (protestantism in korea is slightly different because the focus is on the accumulating wealth aspect - more focus on current than afterlife)
•adopting to the cultural norm
Individual level outcomes of acculturation
Individual level outcomes of acculturation:
•main focus on immigrants acculturation strategies
•strategies reflect how people reconcile norms/values of cultural of origin and culture of dominant society, studied using different models:
- Unidementional model (mutually exclusion model)
You couldn’t identify with two cultures at once so you either develop:
•Assimilation: adopt norms and values of dominant culture while rejecting those of the culture origin or
•Separation: retain norms and values of culture of origin while rejecting those of dominant culture
•problem: assumes that adoption of dominant norms and values inversely related to retention of of original norms and values - Bidimensional model of acculturation
CHART
Graph: slide 16 and 17
Integration: postive attitudes towards host and heritage cultures
•participate in host culture while maintaining traditions of heritage culture
•most successful strategy (less prejudice and more social support)
Assimilation: positive attitudes towards host, negative attitude towards heritage culture
•participate in host culture, lives behind traditions of heritage culture
Separation: negative attitudes towards host/doesn’t identify but positive attitude towards heritage culture
•ignores host culture and maintains tradition of heritage culture
Marginalization: negative attitudes towards host and heritage culture
•doesn’t make effort to engage with host and heritage culture
•more rare, least successful strategy for wellbeing (confusion on cultural identity)
•ex: 3rd culture kids
Predictors of acculturation strategies
- people with different physical characteristics from host/dominant culture have more marginalization or separation
- host prejudice against one’s heritage culture have decreased motivation to fit in
- lower SES tend to have more marginalization/separation
- valuing cultural diversity and acceptance of multiculturalism has more integration or assimilation
Define global orientation and its different types of responses
Global orientation: individual differences in receptiveness to cultural globalization can be affective, cognitive, and behavioural
Proactive responses: receptive to acquiring new cultures
•appreciating diversity/having diverse knowledge of other cultures
•learning languages/norms of other cultures
•making social contact with other cultures
Results in
- Promotion orientation: motivation to try to achieve and approach positive outcomes (ex: learning new things)
- Higher cross-cultural efficacy: more confidence in one’s ability to engage in cross cultural interactions
- For those in mainstream culture: fosters more tolerance for other cultural groups, predicts more frequent and pleasant intercultural contact
- Migrants have better acculturation outcomes (psychological well being and cultural competence), and perceive less discrimination
Defensive responses: focus is on affirming ones ethnic culture
•felling uneasy about cultural interactions
•feeling superiority of one’s own culture
•insisting to sticking to norms of ethnic culture
•doesn’t try to make social contact with other cultures
Results in
- Prevention orientation: motivation to try to avoid losses and other negative outcomes (ex: avoiding potentially undesirable consequences of globalization)
- Lower cross-cultural efficacy: less confidence in one’s ability to engage in cross cultural interactions
- Greater acculturative stress for immigrants
How globalization impacts psychology in self identity, mental health, intergroup relations, and environment
- Self-identity
Traditional theories of the self
•Traditional characteristics of individuals: personality traits and individual traits
•characteristics of cultures (interdependence vs independence/ holistic vs analytic thinking)
•cultural fit: cultural context emphasizes some characteristics that a person has *difficult to adjust to environment when there isn’t a culture fit
Challenging when we consider third culture kids
•First culture: heritage
•Second culture: heritage plus another culture
•Third culture: describes people who have moved around so much and lived in so many places that label isn’t efficient because
1. Lack of rooted sense of belonging in a particular country (feel like outsiders - adjust everywhere but don’t belong anywhere)
2. More chameleon-like interactions (changing identities - adaptive)
•hard to find people who understand their experience/can affirm their identity
•some argue high levels or marginalization as acculturation strategy
- Quality of life: deterritorialization of information
•engagement in global and local information networks creates a sense of subjective overload (google - overwhelming)
•the absent present: physically present, psychologically disengaged in a virtual realm - Mental health: exporting western models of mental health
Western: PTSD
•Societal impact: councillors knew little about this demand of therapy, assumed that the experience was universal, and ignored establish cultural traditions regarding traumatic events
•Western response: centred around damage to individual psyche, associated with fear, anxiety, and other emotional/social consequences – helped through talking
Sri Lankan response to trauma
•entered around damage to social relationships, associated with physical elements (joint pain/muscle aches), negative social consequences as source of distress, cultural mechanisms were to talk using euphemisms
•hindu/buddhist beliefs helped promote resilience
- Intergroup relations
•increase in globalization = increase in intergroup contact and increased likelihood of intergroup conflict especially when groups see their culture as threatened
•more countries involved in conflicts and consequences affect more countries - Climate change
•less developed nations less complicit, but more impacted than developed nations
Impact: rising temp and aggression, natural disasters and trauma, increased inter group conflict over natural resources
Culture bound syndromes
- Sinbyeong (spirit sickness): found in Korea primarily among women
•seen as a spiritual calling to become a shaman
•symptoms: dizziness/heart palpitations, insomnia, loss of appetite, hallucination, dissociation and possession, communicating with sprits
•can only be alleviated with a ritual kut (become shaman)
•ritual involves accepting spiritual possessions and performing superhuman feasts
Essentialism and genetic essentialism and its association with other social phenomena
Essentialism: objects in the world exist in fundamentally different categories
•ex: a rock is a rock a dog is a dog
•some “essence” underlies fundamental differences (we don’t really know what makes a dog a dog, but its a dog)
•genes are what give rise to our identity
Genetic essentialism:
•genes are such fixed indicators of our essence (they give rise to everything you are and differentiate people)
*men, women, africans, asians, etc
•social dominance orientation: sexism, racism, etc.
