Structurally Vulnerable Populations

Question 1

Vulnerable Populations

Answer 1

Those living in poverty
The homeless
Disabled persons
Older adults
Children and youth in disadvantaged conditions
People with low literacy skills
Women
Gay, lesbian, bisexuals, and transgendered people
Immigrants
Refugees
Single Parent Families
Indigenous Communities

Question 2

Sex and Gender

Answer 2

Gender: expression of one’s sex in terms of masculinity and femininity as is rooted in culture and history
Gender identity: describes view of ourselves as women, men, neither, or both. affects our feelings and behaviours
Gender Roles: defined as social & cultural expectations
- Cisgender - gender identity matches their biological sex
- Transgender - gender identity is different from his or her biological sex and does not related directly to sexuality

Question 2

Sex and Gender

Answer 2

Gender: expression of one’s sex in terms of masculinity and femininity as is rooted in culture and history
Gender identity: describes view of ourselves as women, men, neither, or both. affects our feelings and behaviours
Gender Roles: defined as social & cultural expectations
- Cisgender - gender identity matches their biological sex
- Transgender - gender identity is different from his or her biological sex and does not related directly to sexuality

Question 3

Societal Attitudes and Current Stressors

Answer 3

Reluctance to disclose sexual orientation or gender identity or fear of the consequences of disclosure relates to several essential concepts:
- Homophobia (can appear as low self-esteem, reduced self-care)
- Heterosexism - assumption that heterosexuality is the norm and a lack of awareness that other orientations or genders exist along the spectrum of “normal”

Question 4

SDOH and LGBTQ2S

Answer 4

• Higher rates of mental health issues, self-harm, suicidal thoughts/attempts among tobacco, alcohol, and substance use
• Lesbian and bisexual adolescent girls have higher overweight and obese body-mass index (BMI)
• Gay and bisexual boys and men have lower BMI and increased risk of eating-disorders
• Higher risk for HIV/AIDS among men
• Disclosure of a non-heterosexual sexual orientation or transgender identity can be difficult

Question 5

Gender and Health

Answer 5

• LGBTQ2S: health inequities in Canada d/t health-related effects of societal stigma and discrimination
• face hate crimes and assault in the community, harassment or discrimination in the workplace, and rejection within their families
• Minority stress: the effect of stigma, prejudice, and discrimination on the LGBTQ2S community; contributes to higher risk for health problems and poorer self-rated health
• racialized ethnocultural backgrounds, and those with visible or invisible disabilities face additional challenges

Question 6

Community Health Needs

Answer 6

• Gov’ts / Agencies using gender-based analyses to ensure programs and policies are equitable
• Perceiving gender as a modifiable determinant of health:
• Empowers CHNs to identify, apply, and evaluate gender-sensitive strategies to promote an individual’s well-being
• Exploring how gender impacts health at various levels assists to identify how health outcomes are impacted by gender
• Gender bias is the root of gender inequities arising from 3 problems:
  Overgeneralization | Insensitivity | Double Standards

Question 7

Health Outcomes

Answer 7

• Sex and Gender – powerful determinants (influence health)
• Men and Women differ in development of diseases, symptoms, responses to treatments/Medications
• Gender ideals – mediate experiences and expressions of health /illness
• Little is currently known about the health outcomes of those people who identify themselves as transgendered

Question 8

Indigenous Notions of Gender

Answer 8

• Indigenous cultures have different definitions & expressions of gender than are found in Western cultures.
• Gender is a fluid notion than just being a man or a woman.
• Two Spirit refers to Indigenous people born with masculine and feminine spirits in one body

Question 9

Gender-Based Inequities: Institutionalized Gender

Answer 9

distribution of power between genders (political, educational, religious, media, medical & social institutions in society).

Question 10

Gender-based Inequities: Gender inequity

Answer 10

individuals not provided same opportunities due to gender or gender-identity

Question 11

Prevention and Advocacy

Answer 11

• reflect on the degree to which programs are gender-blind, aware, exploitative, accommodating, or transformative.
• Use a gender-appropriate and Intersectional approach
• CHNs require relational skills to assist individuals and groups to think critically about gender and health.
• Advocate for gender transformative public policies and ensure access to health and quality of life

Question 12

Gender - Levels of Prevention: Primordial & Primary prevention

Answer 12

eliminate assumptions and non-critical approaches
focus on structural environments of policies to prevent harassment and violence
strive to reduce and eliminate gender-based inequities
advocate for all CHNs to participate in GBA+ training
think upstream and question powerful gender role prescriptions that oppress
eliminate invisibility, experiences of harassment, transphobia, and societal exclusion
strive to ensure a gender-based lens in health promotion planning

Question 13

Community Health Nursing with LGBTQ2S Populations

Answer 13

Providing safe and inclusive care for LGBTQ2S people?
Consider own assumptions, beliefs, values, and attitudes about sexual orientation and gender diversity
Challenge attitudes/actions of co-workers, colleagues
Reflect whether you regularly use inclusive language (taking history from client / forms used
be clear about the level of confidentiality in the clinical and public health agency charting
Educational material (images of same-gender couples in illustration)

Question 14

Community Health Nursing with LGBTQ2S Populations

Answer 14

Providing safe and inclusive care for LGBTQ2S people?
Consider own assumptions, beliefs, values, and attitudes about sexual orientation and gender diversity
Challenge attitudes/actions of co-workers, colleagues
Reflect whether you regularly use inclusive language (taking history from client / forms used
be clear about the level of confidentiality in the clinical and public health agency charting
Educational material (images of same-gender couples in illustration)

Question 15

Primary Prevention

Answer 15

• groups to lear stress coping techniques; healthy nutrition and physical activity
• policies in order to prevent harassment and violence

Question 16

Secondary Prevention

Answer 16

• screening for hypertension
• provide counselling and testing for sexually transmitted infections

Question 17

Tertiary prevention

Answer 17

interventions for chronic health conditions
advocating for the development of programs appropriate to the LGBTQ2S community