Nursing Health Inequalities

Nursing Health Inequalities

Factors such as income, transportation, cultural norms and preferences, language barriers, education, family dynamics, etc., all interplay with every health encounter and will help determine what is desirable and possible for a patient.

So often in practice, we come across patients not adhering to the treatment plan. Whether it’s the patient not following-up, showing up, taking medications as prescribed, completing labs, or not being disciplined enough to practice healthy habits, it’s far too easy to blame the patient and label him/her as “non-compliant.” However, is the patient really non-compliant? Is it fair and appropriate (or even ethical) for clinicians to make this judgment? There’s almost always a logical and more compassionate reason to explain the patient’s circumstance, and it’s often attributed to social determinants of health (SDOH) and inequities.

Your role as the provider is to listen to your patient and help determine what is desirable and what is possible.

If a patient is not interested in changing (no matter how much you perceive that they need to change), they will not change. This is true no matter how “urgent” the behavior change may be. If we make recommendations that don’t match our patient’s desires or are impractical for them to achieve, we are actually harming them by wasting their time and resources, diminishing the therapeutic relationship by not listening to them, and providing culturally unsafe care.

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Therefore, as providers, we need to train ourselves to become cognizant of how the social determinants of health impact our patients’ lives to make meaningful recommendations and provide the best care.

It is also important to remember that we provide care with our unique “lens” on, just as our patient comes to us with their unique “lens.” We will have “blind spots” when we consider how the social determinants of health impact our patients because our “lenses” are different since our life experiences are almost certainly different from theirs. Therefore, we will not even consider some primary things for our patients.

Nursing Health Inequalities

Ultimately, the point is that there are so many factors to consider, and we will be blind to key components of our patient’s lives and experiences because they are not visible to us and because our “lens” only shows us what we know.

Unless we make the effort to move beyond the limits of our lens, by being open-minded, respectful, and inquisitive.
Overview
Health inequities are the direct result of the impact of policies and actions that disempower and oppress communities and populations, leading to sub-standard social determinants of health (SDOH) inclusive of all categories: income, housing, access to employment and education, social structure, religious freedom, etc.

We can see how the two biggest systems that created the power and wealth of the United States were based on racist policies; chattel slavery and settler colonialism are the results of U.S. Government policies that benefited those in power. The disenfranchisement of African people who were brought here as slaves and their ancestors, and the Indigenous people who lived here prior to colonization and their ancestors, is now evident in multi-generational trauma, disparities in social determinants of health, and health inequities.

This article gives us a closer look at several of the significant policies in recent U.S. history that have impacted the health of Native Americans. This gives us a big-picture view of how policies impact social determinants of health which in turn impact health outcomes. It also zooms in and tells the story of the Day family – Dorene Waianuenue Day’s family in fact! Dorene is our guest instructor from the Introduction to Cultural Safety course. We get to learn about what it was like for her and her family to live through the experience created by the U.S. governmental relocation program and the aftermath.

Please note: We appreciate that it’s hard to learn and unlearn dark parts of our history and for those students who experience trauma, oppression, or marginalization, reading about this may be difficult or triggering. Please take care of yourselves in any and all ways you have available to you and reach out to your faculty if you have concerns about your experiences with this content. Assignment Instructions

Nursing Health Inequalities

Read this article about the American Indian Removal policies from the 1950s in the U.S.: Uprooted: The 1950s Plan to Erase Indian Country Links to an external site.
Disclaimer: The article includes a quotation using potentially sensitive and offensive language. Please know that this language does not reflect the perspective of FNU. The audio version of this article excludes this quotation.
Fill out this worksheet table Download worksheet table Open this document with Read Speaker docReaderbased on information in the article
Note: not every policy goes into great detail regarding the population implications, but you can infer some of the outcomes/inequities as you work through the table cumulatively
Please type your answers succinctly into the template provided. Calibri, Times New Roman, or Arial fonts are the easiest to read.
Answer the following questions:
Overall reflection from the article (free write).
What examples of Native American self-advocacy efforts (apart from the governmental policies) stood out to you from the article? Describe at least three.
https://www.apmreports.org/episode/2019/11/01/uprooted-the-1950s-plan-to-erase-indian-country