Race

Question 1

Positionally

Answer 1

Acknowledging where you stand as your identity, when speaking of a topic that you may or may not relate to. For example, when prof acknowledged her position as someone with a Chinese background and that although she is part of a racialized group, not all experiences of racism and inequities are the same

Question 2

Historical background of Race and Health - Structural Functionalism and Conflict Theory

Answer 2

• Dominated sociological inquiry in 1960s which siloed research into examining the ways macro-level forces modernized societies, institutions, and cultural values and class relations
• Consequently also meant that there were not many impacts in literature for race, gender, etc.

Question 3

Historical background of Race and Health - Symbolic Interactionism

Answer 3

Challenged the supposed objectivity and scientific neutrality of the biomedical model when we saw other factors come into play (although has been criticized for negating power structures and power/hierarchy influences)

Question 4

Historical background of Race and Health - Was there a complete absence of race in science

Answer 4

No, although we did not acknowledge race, did not mean we did not take race into research and there are early forms of systematic data available on race and health can be found as early as the 1800’s in North America

Question 5

Historical background of Race and Health - The Black Deficit

Answer 5

• Although in the 1800s life expectancy was low and morbidity rates high, people of colour in NA were still overrepresented in almost all categories of disease, illness & death helping create culture of biological determinism and scientific racism

Question 6

Historical background of Race and Health - Race’s variability w/in health research

Answer 6

• Major variable both in social and medical fields
• Globally, racially dominant groups are healthier and live longer than racially subordinate groups
• Definitions of race have shifted throughout the decades - now seen as a socially constructed category rather than a biological one, bringing out the history aspect of how we define and view things and how this impacts conducting research and resource allocation

Question 7

Historical background of Race and Health - Definition of Race

Answer 7

• Race is understood by most as a social categorization of groups ppl are based off physical attributes like skin colour

Question 8

Historical background of Race and Health - Ethnicity

Answer 8

Ethnicity often includes aspects such as language, history, religion and customs

Question 9

Historical background of Race and Health - Race vs Ethnicity

Answer 9

Race is inherited vs Ethnicity is learned (through schools, govt, economy, institutions, etc.

Question 10

Historical background of Race and Health - Stereotyping

Answer 10

• These beliefs may be less explained in terms of biological traits, but are often justified through flawed social & cultural values
• Weird mix between the biological/physical and morality, like the idea that skin colour leads to different moralities especially when compared to the dominant group
• Causes increases in institutionalized/structural racism (policies, Red Lining, Eugenics)

Question 11

Historical background of Race and Health - Impacts of stereotyping and racism

Answer 11

• Regardless of race being widely accepted as a social construction, the damaging impacts of stereotyping are still prevalent for POC
• Facing racism has been found to have (-) health impacts on POC, such as with economic mobility/SES, as it determines who and how certain services are accessed, cultural capital building, cultural norms surrounding health, wage gap, etc.

Question 12

Historical background of Race and Health - Social Stress Paradigm

Answer 12

• In health sociology, aligns with the stress from experiencing or the existential threat of experiencing racism
• Argues that when groups of people are at a social disadvantage (living in a society built on struc.rac.) they are more likely to be vulnerable to stress and stress induced health risks (mental illness, heart disease)
• Self-esteem, self-worth, and the sense of mastery over life have been pointed out as increasing factors for illness

Question 13

Historical background of Race and Health - Stressors included in Social Stress Paradigm

Answer 13

Strain/stress, institutionalized, structural, polite/nice racism

Question 14

Historical background of Race and Health - Racism

Answer 14

Chronic stressor for POC, especially Black and Indigenous people

Question 15

Historical background of Race and Health - Nice Racism

Answer 15

• A form of micro aggression
• Ignorant behaviour where ppl try to seem not ignorant & instead are racist
• Implicit, formulated under premise of not meaning to be racist, does not have to be malicious to be racist

Question 16

Historical background of Race and Medical Science - Origins

Answer 16

When Black slavery became more institutionalized, the theory that African Americans being innately inferior to white Europeans became more widely accepted and because of this it embedded itself in practice of health and medicine, resulting in high exploitation of black ppl for economic gain of white medicine

Question 17

Historical background of Race and Medical Science - In Medicine

Answer 17

• Black individuals were often compared to apes, therefore seen as less human, less intelligent and uncivilized
• Medical sciences at this time often justified this through pseudo-scientific theories, such as “the great chain of being”

Question 18

Historical background of Race and Medical Science - The Great Chain Of Being

Answer 18

Progression amongst human groups, with the lowest being simple and animal like and the most progressed being civilized beings, human and… white

Question 19

Historical background of Race and Medical Science - The Great Chain of Being’s biological “facts” about Black ppl

Answer 19

• Larger body parts
• Sexually Deviant
• Strong body odor
• High tolerance for pain
• As well as Chronic Leprosy, lockjaw and difficult parturition were known as Black disease

Question 20

Historical background of Race and Medical Science - The Great Chain of Being and Medicine

Answer 20

• This paradigm was widely accepted by physicians and medical science, formulating the idea that Black ppl were mentally and medically inferior
• During this time, medical theories based off of racist ideologies were prolific and were shared in a way that promoted slavery and Black inferiority
• Biological determinism was a central tenet of NA viewpoint at the time and was a cultural phenomenon/norm

Question 21

Historical background of Race and Medical Science - Medical Experiments

Answer 21

• Enslaved and freed African Americans (plus some poor white ppns) were used for medical experiments
• Slave owners often tested the efficiency of medical remedies on slaves
• Slaves were often used as medical demonstration and test subjects for surgery, which at the time were so underdeveloped that needing surgery was considered a death sentence
• Medical schools would dug up bodies from Black cemeteries without asking or getting permission

Question 22

Historical background of Race and Medical Science - J. Marion Sims

Answer 22

• Founding father of gynecology
• Was known for testing and ‘perfecting’ vaginal surgery techniques on Black enslaved women - often without anesthesia
• It has been documented that he had multiple cases where he performed 20-30 surgeries on a single patient

Question 23

Historical background of Race and Medical Science - Slavery abolishment

Answer 23

• In United States, after the civil war and after the 13th Amendment was adopted (Dec 18, 1884)
• In Canada, official August 1st 1884
• However, the impacts of slavery and ideological belief in biological determinism still prevailed

Question 24

Historical background of Race and Medical Science - impacts of slavery and biological determinism

Answer 24

• By late 19th Century, Black people faced higher rates of sickness than whites & significantly shorter life spans
• Following emancipation, lack of policies to aid former enslaved Black ppl created a crisis of health & mortality, exacerbated as afro-americas left rural & plantation areas
• It has devastating consequences as they were not seen as people and not given health rights, such as being forbidden to get vaccines, lower accessibility to clean living conditions, reduced access to clean birthing conditions and less access to nutritious food

Question 25

Differences in Health Outcomes - Race

Answer 25

- Influential variable when examining health and health outcomes, showing African Americans are twice as likely to rate their health as fair or poor compared to white Americans - These indivs are more likely to have higher rates of earlier morbidity and mortality when rating their health as fair-low, which shows the importance of perceived health - More prevalent in African families as they feel like illness is inevitable

Question 26

Differences in Health Outcomes - Health conditions

Answer 26

- Black women are 20x more likely to experience heart failure under age as compared to white women - Black men are at lower risks of getting diagnoses w CVD than white men, but have higher rates of mortality from this disease (can be tied back to male white centric research generalized to ppns it should not generalize to) - Black women are at lower risks of getting breast cancer but are 30 times more likely to die from it, which can be attributed to symptoms medicalized differently, accessibility for getting tested and the power and privilege that is needed to have agency or feel like you do in a doctor's office - In general, black ppl overrepresented in Type II Diabetes, high rates of mortality, hypertension, HIV Aids, etc.

Question 27

Cumulative disadvantage

Answer 27

Emphasized how early advantage or disadvantage (generationally) creates differential status and therefore, health outcomes over time; most research supports this when it comes to explaining the health deficit experienced by POC

Question 28

Cumulative disadvantage example

Answer 28

Organized sport is more important than physical activity, for every ages as it involves physical exercise and meeting people; increases social capital, social support, social network, social resource (impacting health longterm) and leads to learning how to interact with others, positive mental health outcomes, learning physical activity, gaining social capital, creating culmination of resources to make a change according to this hypothesis

Question 29

Universal Context of Fairness

Answer 29

Modern society as fundamentally fair and equitable; this is fueled by the access to opportunities, personal experiences, and the fundamental idea that people get what they deserved ideology (neoliberalism)

Question 30

Problems with Universal Context of Fairness

Answer 30

- Large proportion of white ppl have limited contacts w POC - Negates varying social factors - Does not mention equity - Intersectional approach ignored - History is important as it gives a "why" and generational factors, but it ignores intergenerational trauma - If we build a society in this theory, it negates the structural advantages & disadvantages a society is built on

Question 31

Decolonizing Health Canada: Indigenous people

Answer 31

- Due to diversity of Indigenous peoples in Canada, analyzing health outcomes can be challenging (incomplete diversity in data as data generalizes experiences of Indigenous people & disregards variations) - Despite this, it is clear that Indigenous peoples experience higher rates of chronic disease and higher risk factors to illness than non-indigenous Canadians

Question 32

Decolonizing Health Canada: Health outcomes

Answer 32

- Indigenous peoples experience lower life chances and have lower life expectancy than non-Indigenous Canadians - Indigenous peoples are more likely to experience violent deaths, death by suicide, and death by injury - These rates change w/in intergroup w addition of variables like ethnicity & geographical location

Question 33

Decolonizing Health Canada: Ex. of health disparity

Answer 33

- Overrepresentation of Indigenous in CVD & diabetes - Rates of cancer mortality escalating more than other groups, but Indigenous are less likely to be diagnosed, due to diagnosis issues, lack of trust, lack of cultural competence, feeling unsafe, generalizability

Question 34

Decolonizing Health Canada: Increasing factors

Answer 34

- Loss of language, cultural traditions, and traditional lands increase risk factors for illness and disease for Indigenous peoples in Canada - Income, education, living conditions and several Indigenous-specific determinants of (colonization, dispossession of land, and loss of traditional practices) are immediate indicators of vulnerability to illness and disease

Question 35

Decolonizing Health Canada: Risks through these factors

Answer 35

- Risks to diet, physical activity & tobacco use correlate with risks of specific chronic disease and all other determinants of health - Limited access, rural communities need food & water (fresh produce) need to be imported which costs a lot - Colonial mechanisms have replaced traditional diets of low-fat, high nutrient foods that required more energy expenditure to high fat, high sugar, & sedentary lifestyles w/in Indigenous ppns

Question 36

Decolonizing Health Canada: Data suggestions

Answer 36

- 58.3% Indigenous populations living off-reserve live inactive lifestyles - 41.3% of Indigenous youth living off-reserve are overweight or obesity

Question 37

Decolonizing Health Canada: Before residential schools

Answer 37

- The legacy of residential schools cannot be left out of conversation when talking about health outcomes - Historically, Indigenous peoples across NA lived out successful and dynamic societies, which included forms of education and learning, such a spirituality - These forms were secured and survived through passing down from gen to gen

Question 38

Decolonizing Health Canada: Residential Schools

Answer 38

- A joint project by the federal govt and christian and catholic religious groups, residential schools were used to facilitate the assimilation the assimilation of Indigenous peoples in Canada - Sir A John A. Macdonald authorized the creation of the first three residential schools in 1883. However, documentation of residential schools can be found as early as 1620 when missionaries from France started laying down the groundwork for assimilation w/in Canada

Question 39

Decolonizing Health Canada: The Davin Report

Answer 39

- Historically significant for residential schools - In 1879, the federal govt appointed Nicholas flood Davin, a Toronto-based journalist, lawyer and an unsuccessful conservative parliamentary candidate to investigate the boarding school system in the US - At the time, the US was launching industrial schools, with the goal to separate. children from their families and from multiple communities for several years to provide them skills to acclimate to the changing colonial environment (economically and socially) - Partnered with churches for school purposes (a moral based curriculum & cheaper labour)

Question 40

Decolonizing Health Canada: The Davin report resulted in recommendations

Answer 40

- Removing any Indigenous leaders from the character and/or management of the schools - Partnering w Canadian churches for operation purposes - Fast track the schools for economic benefit of Canada -> economically beneficial citizens participating in economy to produce more cultural capital

Question 41

Decolonizing Health Canada: "End" of residential schools

Answer 41

- By 1940s, the decline and failure of these schools was prevalent, as Academic achievement was low and only 3% of students had gone beyond grade 6 in 1930. - But, forced colonial schooling persisted - By 1950s, the federal govt began phasing out compulsory residential schools and forcing Indigenous children into provincial schools - Residential schools were kept open during the 1960s and used as boarding schools for children whose families were deemed unfit to care for them - Genocide, as we are phasing out but if we deem families as unfit to parents, we can continue this, as there is still an economic benefit ideal - Based off of race, who says what is or isn't fit, biological determinism (inequity, inequality & violence)

Question 42

Decolonizing Health Canada: Abuse in Residential schools

Answer 42

Psychological, spiritual, physical and sexual abuse were common

Question 43

Decolonizing Health Canada: Impacts of violence on survivors

Answer 43

- Heightened experiences of anxiety, depression, anger, low self esteem, and PTSD - High rates of suicide, suicide attempts and/or self-harm - Substance abuse - High rates unemployment, homelessness & incarceration/overrepresentation of Indigenous in Justice System - Impacted intergenerationally, which will take decades to regress (trauma)

Question 44

The Sixties Scoop

Answer 44

- Large scale removal of Indigenous children from their homes, communities & families often w/o consent or w coercion - Some children were adopted into predominantly non-Indigenous, middle-class, families across Canada and the US - some sent abroad to New Zealand - In the 60s federal policy, continued colonial mechanisms, and residential schools left devastating consequences on Indigenous communities - Taking children lasted from 196-s and into the 1980s, although there is no accurate number as to how many children were forcibly removed from their homes and communities, but recent dsts suggest over 20,000.

Question 45

Epigenetics

Answer 45

Conditions associated with racial discrimination can result in epigenetic alterations within a person's genome, increasing their risks to disease and aging

Question 46

What do epigenetics do

Answer 46

Epigenetics examines our genome and its effects on ppls's health and epigenetic events occur when people experience certain social conditions over time and/or with severity (like loneliness, known to increase resistance to bacterial infections, but decrease to viruses)

Question 47

Methylation

Answer 47

- A complex chemical process, which simply put is a chemical called methyl acts like a on and off switch for particular genes - Been known to be an epigenetic phenomenon - Increases risk to CV disorders, diabetes, autoimmune diseases, and canecr

Question 48

Telomere Length

Answer 48

- Third epigenetic phenomenon - DNA and protein structures located at the end of chromosomes that help protect them - Act as an indicator of aging (several studies show an increased level of anti-black discrimination with a faster shortening of telomeres

Question 49

Epigenetics and Race

Answer 49

A fairly new field of science, but current literature strongly supports the adverse effects of chronic exposure to racial discrimination to changing us on a microscopic biological level