equity
treatment of individuals in their own social context and provide additional support based on the social context
equality
everyone has access to the same resources
health disparity
a statistically significant difference in health indicators that persists over time
health inequity
differences in health that are not only unnecessary and avoidable but, in addition, are considered unfair and unjust
what difference does a word make?
- because using health disparities can obfuscate the fundamental cause of health disparities as embedded in societal structures and policy decision
- health disparities mask the ethical principle of social justice which provides the moral imperative to address the causes
- the societal structures that underlie the unequal distribution of resources (and hence social inequalities) are economic, political, and ideological
what term most clearly reflects a value orientation of social justice and most explicitly exposes the cause of health disparities as rooted in societal structures?
health inequities
what are the most significant health disparities in Canada to socioeconomic status?
aboriginal identity, gender, and geographic location
four determinants for health inequities
- exposure to unhealthy, stressful living and working conditions
- inadequate access to essential health and other public services
- health-damaging behaviours (where choice is restricted-look at their behaviour and determine if it is their choice)
- health-related social mobility involving the tendency of sick people to move down the social scale
impacts of poor water quality
perception of water as being life-giving, pure, and medicinal was altered to a perception of it being toxic to physical, mental, and spiritual health
health equity
- reflects the principle of social justice
- is based on a human rights perspective
- determined by social, economic, material, cultural, political structures
- includes access to health care and they social determinants of health
- requires an intersectoral approach
emancipatory knowing
a critical approach to health that involves a “political economy perspective to emphasize historical, social, economic, and political factors that lead to social inequities and ultimately to health inequities
emic
within a group
etic
outside a group
barriers to addressing health inequities
-the ideology of neoliberalism affecting Western democracies including Canada
- policy silos
- funding of the health care system (focus on curative services rather than health promotion and population health)
- the ideology of individual responsibility for health
- the focus on biomedical/behavioural lifestyle discources
barriers to addressing health inequities
-the ideology of neoliberalism affecting Western democracies including Canada
- policy silos
- funding of the health care system (focus on curative services rather than health promotion and population health)
- the ideology of individual responsibility for health
- the focus on biomedical/behavioural lifestyle discources
- nurses education
- nurses working conditions
- fear of speaking the truth
what does achieving health equity require?
health professionals, politicians, civil society, and other organizations that work toward decreasing or eliminating disparities
what type of issue is health inequity?
social justice
views of justice
- distributive justice (equality principle)
- market justice (acceptance of inequity)
- social justice (justice as an ethical responsibility)
distributive justice
- refers to the equal distribution of goods and services in society
- a right of the citizen but not a moral responsibility
- focuses on giving the same access and resources to different groups in society
- major flaw: equality does not mean equity
market justice
- posits that people are entitled only to those goods and services that they acquire according to guidelines of entitlement
- entitlements and privileges enable and maintain inequities
- major flaw: injustice creates and perpetuates inequities in health
- ex. prescription drugs, routine dental care
social justice
is a concern for the equitable distribution of benefits and burdens in society
- dont want to place more burdens on one group than another
CNA code of ethics
- social justice is the fair distribution of society’s benefits, responsibilities, and their consequences. it focuses on the relative position of one social group in relation to others in society as well as the root causes of disparities and what can be done to eliminate them
social inclusion
- being acknowledged, respected, valued
- a sense of belonging as a person, a group, a community
- the foundation for human dignity
- privilege
privilege
legal and structural institutions maintain inclusion and power of the dominants group
