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what is social justice in healthcare

This short podcast is about social justice and reflects a session that was recently presented at the 2018 International Rural Nursing Conference held in Nashville, Tennessee USA. Foster an open and honest dialogue within your agency (and ideally with your community partners) about historical injustices and present-day racism, bias and inequity and how they contribute to disparate health outcomes. Most people accept that premise, but differ in … He said during that time: “We are now faced with the fact that tomorrow is today. See Educator Profile. Dr Foster also serves on a variety of committees both within her college and across the University of Alabama campus including: Former Chair of the Medical School’s 50th Anniversary of the Integration of the University of Alabama, committee member of the Medical School’s Diversity Committee, Former University of Alabama Faculty Senator and Co-Chair of the Faculty Life Committee, and Past President of the Black Faculty and Staff Association (2016-18). I work in this area – I came to it actually because in this country HIV AIDS was mainly found in gay, white males in large metropolitan cities, and over the decades, 30 years later the epidemic is largely African American – both male and female – and not only in large cities but in small rural areas and in small communities and particularly has shifted from the east and west coast of the United States to now the South, the Deep South where I am now in Alabama. And if we look at the fact, there are 39 million blacks living in the US, 53% of them say they attend church regularly, thats a lot of people who have the power to end HIV AIDS, 20 million. And they said that the church is really the right place for action for the church to be involved. Why is their health outcome different, perhaps to those colonisers who came? In addition to her broad training experiences in population and public health and bioethics and preventive medicine, Dr Foster’s research interests include health disparities with a specific interest in HIV/AIDS related stigma in rural faith based settings in the Deep South. Dr Pamela Payne Foster is a Preventive Medicine/Public Health Physician and Professor in the Department of Community and Rural Medicine and Deputy Director, Institute for Rural Health Research, at The University of Alabama, Tuscaloosa Regional Campus. Social justice is the view that everyone deserves equal rights and opportunities —this includes the right to good health. Within social justice, healthcare is regarded as a social good that should be financed by all citizens regardless of the healthcare recipient’s ability to pay. 35-66). The new #LancetCountdown f… https://t.co/AR2IQdUos6, With #COVID19, people with chronic diseases get sicker and die sooner. In our next video series, we introduce social justice issues, including healthcare, immigration, eco-justice and ethic of life to explain the issues and … To assure that everyone has the opportunity to attain their highest level of health, we must address the social determinants of health AND equity. of social justice that is involved in developing and maintaining pro bono programs and projects, so they can see that their pro bono practice is grounded in a developed framework of social justice. Social justice examines how these rights are manifested in the lives of individuals. A2013studypublishedintheMaternalandChildHealth … Yet today, there are inequities in health that are avoidable, unnecessary and unjust. And this was very attractive to black churches. https://apha.org/news-and-…, In his book “Young Water Protectors: A Story About Standing Rock,” Aslan shares his inspiring experience of how, at just 8 years old, he and his family traveled…, RT @nationshealth: Our weekly public health news quiz takes you through some of the important headlines from the past week. So thats startling. These inequities are the result of established policies and practices that maintain an unequal concentration of money, power, resources, and perceived value within society … Work with these partners to ensure that health and equity are embedded in their decision-making process. Creating health equity requires targeted investment in marginalized and under-resourced communities. Fight against the trend of growing voter restrictions. Climate change does exactly the same thing,… https://t.co/pcjTm4vaWW, People used to think that climate change was something that would occur in the future, says Harvard's @DrHowardKoh.… https://t.co/s8IYmBMmRx, Let's use this countdown…to renew our efforts to get off of carbon-based fuels, to reduce air pollution and to make… https://t.co/MDXvxq1mYs, Research Assistant | UMKC School of Medicine, Assistant/Associate Professor, Social Work | University of Connecticut, Policy/Communications Support Administrator | Long and Associates, LLC, Clinician Investigator - General Internal Medicine | The Ohio State University Wexner Medical Center, Assistant Professor-9 month appointment, Public Health and Sports Medicine | Missouri State University, Research Faculty - General Internal Medicine | The Ohio State University Wexner Medical Center, Environmental Health Services Division Director | El Paso County, CO, Chief Medical Officer, Western Maryland Hospital Center | Maryland Department of Health, Assistant Professor of Social Epidemiology | SDSU, Director of Research Development | University of California, Irvine. Social justice is not merely a nice idea but a crucial part of our responsibility to promote health. Because of inequitable access to care and other health-promoting resources, these populations are often sicker when they do find a source of care and incur higher medical costs. Epub 2017 Aug 3. The WHO Commission on the Social Determinants of Health concluded that “the social conditions in which people are born, live and work are the single most important determinants of good health or ill health, of a long and productive life, or a short and miserable one”. Lipscomb’s article notes the renewed interested in social justice, a renaissance which he accounts for in terms of two main reasons. But we can't do it alone, says APHA President José Ramón Fernández-Peña https://you…, Today is #GivingTuesday, a global day of giving. Now, I’ll give one example that I use in my own research, but also let me just go, now, to talk about how we can overcome some of these barriers. You can advance your career in population health, social justice, and nursing with a Master’s of Science in Nursing from Goodwin College, and move towards enforcing social justice in the broader nursing field. So, thinking about even combining degrees for training or combining training programs to really get the kind of product we want. Name and address racism. Start a conversation about health equity within your agency or organization. Criminal justice — Thirty years of “tough on crime” and “war on drugs” public policies8 have resulted in mass incarceration of primarily black and Hispanic males. Same thing for women we make 12% of the female US population, but 64% of female HIV diagnosis, and really the one statistic they used to really bring this home was if black America were its own country, it would rank 16th in the world in the number of people with HIV, which is very very graphic. Social justice from a healthcare point of view means members of a population, regardless of social status, would have equal right and access to health care … Her main teaching areas of interest have been health disparities, bioethics and medical ethics, and diversity and cultural competency issues in health care. Varying levels of income can create a substantial gap in life expectancy for both men and women. For example, usually the minority groups have poorer health outcomes than the Caucasian majority group but in a place like South Africa, where native Africans might be the larger population, they might have worse health outcomes. We are confronted with the fierce urgency of now. So, it makes it very difficult for those of us who are trained as physicians or healthcare providers like nurses, Nurse Practitioners. Use tools such as the documentary “Unnatural Causes: Is Inequality Making Us Sick?” to jumpstart the conversation. Social justice principles refer to values "that favours measures that aim at decreasing or eliminating inequity; promoting inclusiveness of diversity; and establishing environments that are supportive of all people.” The social justice principles include: equity, diversity and supportive environments. NASW’s goal is twofold: encourage those who can vote to exercise their right and work to eliminate barriers to participation. Conceptual Foundations for Social Justice Education. Name racism as a determining force in the distribution of the social determinants of health and equity. In addition to her broad training experiences in population and public health and bioethics and preventive medicine, her research interests include health disparities with a specific interest in HIV/AIDS related stigma in rural faith based settings in the Deep South. Minority communities like African Americans, Latinos – but my boss was a retired cardiologist who went back to school to get a PhD degree in philosophy and that’s how he got into the area of bioethics. A social justice approach to population health challenges us to deal with these underlying concerns, to recognize that racism, socioeconomic inequality, gender discrimination, and hate, to name a few, have negative consequences for health, and that we simply cannot improve the health of populations without tackling these foundational causes, a point made repeatedly and eloquently in a large body of … So, for example, they looked at the black male population being 11% and the HIV diagnosis at 42% very disparate. New York: Routledge. Of course, that history of colonisation brings with it oppression, which leads to poverty… so all of these things are issues and really what we talk about with these health equalities is social issues. Whiteness Whiteness is a location of structural advantage, of race privilege. Social justice is the view that everyone deserves equal rights and opportunities —this includes the right to good health. “It also examines power, because those with power have control over resources and the ability to examine and determine access to these resources—in our case, healthcare. As I said, most of us are not comfortable dealing with social health issues because of our training: we haven’t been trained that way, of course. For example, she teaches a Special Topics course entitled: Cultural Competency in Health Care and she recently taught a special co-learning course entitled: Health Cultural Competency in Latinos. Multiple factors have an effect on life expectancy, including income, education, occupation, race and ethnicity, and health disparities. I got a Master’s of Public Health – I think the idea of training around population health rather than patient centred, to really think about people who are trained as population scientists as well as patient scientists, is great. So, back to my example of HIV AIDS. Read and share the repor… https://t.co/wOjmu4jWMd, Work at the federal level on climate change matters, but “grassroots people power is what it will take to get this… https://t.co/SPMXqSU1hc, It’s time for leaders to support healthy, equitable communities, says NHMA’s Elena Rios. Social justice, however, maintains that all people deserve and should have access to the same rights and resources. She has been involved in medical education and her main teaching areas of interest have been health disparities, bioethics and medical ethics, and diversity and cultural competency issues in health care. Everyone needs a voice in improving our communities, and such community participation is intrinsic to achieving health equity. My father is a native of rural Alabama, most of you have heard of a town called Selma, Selma Alabama is his birthplace, so I have just been proud to work in communities like Selma and others in the rural south – Alabama. So, more of a three-dimensional definition because it really incorporates the differences we see between the two groups but really trying to understand what is the root cause or what are the underlying causes that cause the differences between the two groups. ), Teaching for Diversity and Social Justice (2 ed., pp. But i’ll end on this quote from the Reverend Dr Martin Luther King Junior. I am currently a professor starting 8/16/18 at the University of Alabama school of medicine, Tuscaloosa campus. Hello, this is Dr Pamela Payne Foster, and I am doing a follow-up podcast from a presentation I did recently in Nashville Tennessee at the International Rural Nurses Association meeting. https://t.co/4F…, With COVID-19 surging and hospitals strained, it’s more important than ever to get vaccinated against the flu, says… https://t.co/SGgJrPudV9, New: CDC urges universal use of face masks indoors when not at home: https://t.co/liN3VKexPx, APHA is the voice of public health and we champion the health of all people. 2020 © American Public Health Association, APHA is the voice of public health and we champion the health of all people. But, the statistic for HIV is so much worse than those social justic issues but the one that really ranks in commanility with it is incarceration rates – which we know incarceration rates are extremely high in the United States compared to other Westernised or comparable countries, but the incarceration rate for 18 year olds or older is 1 in 15 in black men, which is extremely high, and they compared that to the HIV diagnosis rate over a lifetime 1 in 16 for black men will be diagnosed with HIV in his lifetime. Help us create the healthiest nation in one generation. So, many of us know the definition of health disparities as comparing two populations and looking at the differences in their health outcomes, usually in the context here in the United States we look at racial-ethnic groups like African Americans or Latinas and we compare them to the standard, larger group like the Caucasian here in the United States. So, I began to test an anti-stigma, a faith-based intervention, which was very effective but i used some of the curriculum developed by a civil rights organisation here in the United States, called the NAACP – National Association for the Advancement of Colour People – old civil rights organisation, they’ve retained the name – but what they began to do was say, ok we know HIV AIDS is a public health issue but in order for the church to embrace it maybe we need to think about a social justice issue. Health care as a social-justice issue is at the root of community health care. One is with training. So that’s one way, another way would be partnering with a social scientist, which I think is always a good way to deal with these very complex issues. Perhaps the time is now. It also aims to redress inequalities based on gender, race, religion, age, and other characteristics. “Social justice, as it is understood by the secular and religious thinkers, is concerned with the distribution and the use of resources,” she explained. Racism and other forms of structured inequity sap our potential to become the healthiest nation. Public health improves quality of life, extends life expectancy, reduces human suffering and saves resources over the long term. (Lipscomb, 2012, p. 1) Secondly, there is a theoretical emphasis on social justice in healthcare academic discourse. That 30 percent translates to more than $230 billion over a four-year period.5 In addition, studies have shown that clinicians tend to have more negative attitudes toward people of color, and unconscious racial bias among clinicians has been shown to lead to poorer communication and lower quality of care. The gap between men with disparate income levels is 15 years, and the gap between women is 10 years. Firstly, changing economic circumstances have led to this returned engagement with social justice. One thing I did was I started out with some definitions to really bring us into the mindset of how we can really frame social justice in our work with health disparities. Justice involves concepts of right and wrong and people receive positive or negative sanctions based on their past performance. APHA is a 501(c)(3) non-profit organization. She also completed her Internal Medicine internship and Preventive Medicine/Public Health residency from the State University of Stony Brook where she also received her MPH from Columbia School of Public Health. So, that’s our definition with health disparities – really comparing the health outcomes with two different populations on something like race or ethnicity. She has been involved in medical education through a variety of roles: as former Co-Clerkship Director for the Community Rural Medicine Clerkship, as a former Learning Community Leader, as a faculty member in the Community Rural Medicine Ambulatory Acting Internship, as a frequent Special Topics and Co-Enrolled Elective Instructor. The definition of social justice revolves around the concept of equality and human rights. Demand the fair allocation of community resources. Ensure representation of these groups in decision-making processes. Same thing for colonisation even in a country like Australia where you have natives there. Types of Social Justice Issues Social justice issues can be delineated into two categories, which are interrelated and often co-dependent: Inter-Social Treatment and Unequal Government Regulation. In this unfolding conundrum of life and history, there is such a thing as being too late.”. So, that’s one way. So that’s really the premise of the work I’ve been doing to try to get a little deeper into why we have to begin as healthcare providers to think in a different way. Exercising the right to vote is one of the social justice issues prioritized by the National Association of Social Workers. While discrimination affects social justice on a global level, many leaders strive for human righ… Identify the structures, policies, practices, norms and values in which racism may be operating. Dr Pamela Payne Foster from the University of Alabama initially defines social justice and then proceeds to talk about health disparities that affect various racial-ethnic groups. So that our prevention efforts were not as much advocacy around HIV, particularly around rural areas, and particularly as I began to do some research with the nursing league, we found that people living with HIV AIDS said that where they felt most stigmatised was the church, and as we know culturally in the South it’s very religious in that area of the country and that might actually be a barrier to effectively dealing with HIV AIDS in that part of the country. Dr Pamela Payne Foster can be contacted at: pfoster@ua.edu, Community Medicine and Population Health; The Institute for Rural Health Research 
The University of Alabama. Donate today and help APHA promote and protect the health of all people by creating the healthiest nation in one generation. A brief plea for social justice around the issue of healthcare, in these challenging times we are living in. Before coming to the University of Alabama, Dr Foster served on the faculty of a variety of institutions including Morehouse School of Medicine, George Washington University, SUNY Stony Brook, and the National Bioethics Center for Health Care and Research at Tuskegee University. On this day to take action and help others, public health needs our help more than ever. Racism is a system of structuring opportunity and assigning value to individuals and communities based on race that unfairly disadvantages some individuals and unfairly advantages others. This discrimination and inequity undermines the social and community fabric that is so vital to public health, narrowing opportunity, disrupting families and social cohesion, and preventing civic participation. Racism and other “isms” are forces that determine the distribution of the social determinants of health, including: Health care — More than 30 percent of direct medical costs faced by blacks, Hispanics and Asian-Americans can be tied to health inequities. NHS England Health and … If you see yourself as a change-making agent in the healthcare industry, this is the place to be, right now. The words or at least concepts of ‘social justice’ are used in contexts where people understand social justice to be Health equity is more than one intervention; it’s a lens through which all of your work should be viewed. I’m also Deputy Director of the Institute of Rural Health Research here at the campus. Social justice issues can occur in relation to practically any aspect of society where inequality can arise as a result of unjust prejudices or policies. We’re joining the COVID Collaborative — made up of leaders across public health, education,…, This Thanksgiving, the best way to keep family & friends safe is to celebrate at home with only your immediate household, says APHA. Justice is a complex ethical principle, with meanings that range from the fair treatment of individuals to the equitable allocation of healthcare dollars and resources. All of these sectors and many more have a role in creating the conditions that enable all people and communities to attain and sustain good health. It’s interesting, I’m a preventive medicine public health physician so I have public health training as a part of my residency training. 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