Shared Flashcard Set


Race, Health, and Ethnicity
UC Berkeley PH131AC
Health Care
Undergraduate 3

Additional Health Care Flashcards




Hispanic Paradox
  • Foreign born Latinos have decreased health risks in the US, especially when living in foreign-born Latino neighborhoods
  • Possible expanations: they move to their birth country to die, only healthy people are able to successfully immigrate to the US, foreign born Latino communities positively affect the health of the individual residents
Fatalism and Prevention
  • Prevention subscribes to the upstream/downstream analogy.  Why are people jumping in the river in the first place, not how can we fish them out
  • Fatalism is the concept that disease and poor health are conditions of the environment.  The locus of control is external so individually taken medicine is useless.  (ex. "God's will")
Acculturation and Assimilation
  • Acculturation is the change of one's cultural patterns to those of the host society
  • Factors of acculturation for Latinos
  • Nutrition, less reliance on family, responding to stress, alcohol, faster pace of life, concepts of time (lateness), being bi-cultural
  • Assimilation refers to the process of complete conformation to the dominant culture
Key Values in Latino Culture Affecting Health
  • Health is based on luck
  • Good behavior is rewarded with good health
  • Prevention of illness through prayer
  • Individual 'balance' maintains good health and poor health, caused by an upset in this balance can be remedied by rebalancing (ex. hot and cold theory)
Migrant Farm Worker Health Issues
  • Very poor
  • Short term work contracts make it difficult to obtain insurance through employment
  • Poor living conditions and sanitation, exposure to pesticides, operation of dangerous machinery, overexposure to sun and heat
  • Tuberculosis, STDs, diabetes, hypertension common in migrant families
  • Administrative barriers to Medicaid
  • Disconnect (language, culture) between health care professionals and migrant workers.  Often workers seek care in Mexico or from indigenous medicine as a primary resort
Locus of Control
  • Belief in an external locus of control (popular among Latinos) may lead to disbelief in modern Western medicine.
  • Latinos and African Americans believe at least partially in an external locus of control as prayer is believed to aid health problems
Concept of Hot and Cold
  • Treatments based on balancing hot and cold, one example of human internal balance (see Latino health beliefs)
  • Example: lying on a cold linoleum floor to treat an asthma attack, rubbing vicks vapor rub for chest pain or breathing problems.  
  • Potentially dangerous as using these treatments may discourage visits to a health care professional, render prescriptions dangerous or useless, or be dangerous themselves
Potential Impact of Prop 187
  • The proposition would deny health care, social services, and education to illegal immigrants
  • Effects of the proposition include: nowhere for children to go during the day which may lead to increased crime, sedentary lifestyle (as in the video Fear and Learning at Hoover Elementary).  Refusing health care to undocumented residents additionally demonizes Western medicine, hospitals, doctors, etc.  as they would become an untrustworthy resource
Biomedical Definition of Health vs. Public Health Definition
  • Biomedical definition is "the absence of disease"
  • World Health Organization definition "the state of complete physical, mental, social, and spiritual well-being and not merely the absence of disease
Determinants of Health
  • Mental health, relationships, SES, race, nutrition, physical health, living conditions, environmental conditions (smog, etc), sanitation.
John Henryism
  • Stress caused by strong coping behaviors to deal with psychosocial and environmental stressors such as career issues, health problems, racism
  • John Henry is a folk hero who hammered nails in the railroad faster than a machine but then collapsed dead from exertion
  • The condition leads to increased heart rate and systolic blood pressure
  • Common especially in poor minorities as they face stresses from economic situation, racism, family situation (deadbeat parents?), administrative/governmental barriers.  
  • May also lead to internalized racism / hopelessness
Weathering Hypothesis
  • Health status of minorities deteriorates in young adulthood as a result of long-term exposure to financial and social stress
Resource Deprivation Theory
  • Minorities are more likely than whites to live in resource-lacking communities.  This may lead to poor nutrition, poor access to health care, and health information.  Crime and drug use may also be increased as a result of this as there is greater competition for resources
Risk Exposure Theory
  • High exposure to social and/or environmental risks leads to higher prevalence of disease and death, especially in minorities (as they are more often exposed to this type of risk)
Health Disparities
  • The differences in incidence, prevelance, mortality, and burden of disease and other adverse health conditions that exist among specific population groups in the US
  • Differences in health status and/or health risks.  Notabe between different groups of people based on race, SES, location (environmental pollution, crime rates, etc)
  • Contributing factors: SES, Racism/discrimination, Psychosocial factors (health behavior, stress, social support, etc), access to health care
Race as a Biological vs. Social Construct
  •  Definition of Race - a categorization of phenotypical external physical differences
  • Biological definition is based on genetic differences as a basis of race classification.  One study showed that while genetics has a role in race discussion, it is not genetic/biological differences that determine race.  Assumptions of this definition
  • Race groups are biologically discrete and exclusive
    • Each race has distinctive cultural behavior
    • Behaviors and physica features are innate and inherited
    • Racial differences are unalterable
    • Races naturally unequal
    • Racial classifications stipulated in legal and social systems (?)
  • From Goodman article  - human biological variation is continuous, often there is more genetic variation within a race group than between race groups.  So, to justify race groups in this way is discriminating against certain genetic aspects, not based on actual levels of variation.
  • Race as a social construct - determined by social status and politics
  • The US recognizes 5 race groups: white, back, Asian, native Hawaiian / Pacific Islander, American Indian / Alaskan Native.  2 ethnic groups are recognized: Hispanic, Latino

Black Hospitals in the African American community
  • Video A Jewel in History
  • These hospitals emerged out of post-slavery segregation and mistreatment of blacks.  Satisfactory care was not provided at white hospitals (to patients and professionals), so the Walter Phillips hospital was opened, partly due to philanthropic donations.  The hospital provided jobs for the black community (in the hospital itself, restaurants, surrounding schools).  
  • The Phillips hospital was eventually shut down by the city
  • Additional functions of black hospitals
  • Training opportunities in professional medicine for blacks
    • Source of pride
    • Culturally appropriate care
    • Response to oppression

Levels of Racism
  • Institutional racism - differential access to goods, services, and opportunities within a society, according to race.  Examples: quality, education, sound housing, information access, voting
  • Personally mediated racism - practice of prejudice and discrimination based on race, intentional or not.  Examples: lack of respect, suspicion, devaluation, dehumanization
  • Internalized racism - acceptance by members of a stigmatized race of negative messages about their own abilities and intrinsic worth.  Examples: embracing "whiteness", self-devaluation, hopelessness (dropping out of school, not voting, etc)
  • The gardener example (metaphor for institutionalized racism): two pots, one with good soil, the other with poor soil.  Then the gardener chooses which color/type of flower to plant in the good soil (access to better services)
Socio-economic Status (SES)
  • Measurements: income, poverty, education, occupation, occupational prestige, wealth
  • Health disparities based on SES do exist but cannot alone explain racial health disparities
  • Effects on health: access to good jobs with insurance plans, transportation, proper nutrition, information.  Physical effects may include overworking, economic stress, increase in violence/crime in low SES neighborhoods
  • Stats of contributing factors for Latinos
  • 50% over 25 have completed high school
    • 27% live below the poverty line
    • Highest dropout rate in California
  • Stats of contributing factors for African Americans
  • 22% live below the poverty line
    • 25% with incomes less than $50,000
    • Median family income of black families 87% that of whites, net worth median 10% that of whites

Family in African American culture
  • Structure, assets, medical history, resources, behaviors, parenting style
  • Extended family often included, and grandparents often the head of teh family which suggests potential low income for many families.  Family behaviors such as diet, exercise, acceptable weight, etc. can cause health risks
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