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social determinants of health
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What term describes conditions in which we are born, live, learn, work, play, worship, and age
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social determinants of health
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What term describes the factors that influence the health of individuals and communities (Also affect functioning and quality-of-life outcomes)
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social determinants of health
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What affects the functioning and quality-of-life outcomes?
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False.
Social Determinants are MAJOR contributors to the health of communities
Social Determinants are MAJOR contributors to the health of communities
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True or False:
Social Determinants are minor contributors to the health of communities
Social Determinants are minor contributors to the health of communities
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Social and economic factors (40%)
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Which factor had the highest percentage in terms of affecting the length and quality of life to US individuals?
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Education, employments, income, family and social support, and community safety
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What comprises social and economic factors?
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social and economic factors; physical environment
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What social determinants are under policies and programs?
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health behaviors and clinical care
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What social determinants are under health factors?
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False.
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True or False: Access to healthcare is what guarantees health
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physical environment (air and water quality; housing and transit)
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10% of health behaviors is shaped by?
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access to care and quality of services received
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20% of what creates health in communities is ?
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individual, community, and environment and society at large
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Health can be created at what levels?
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Disparities occur
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If health is lacking in any one of the individual, community, and environment levels, what happens?
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FALSE.
Gains in health are NOT shared equally by those in society
Gains in health are NOT shared equally by those in society
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True or False:
Gains in health are shared equally
by those in society
Gains in health are shared equally
by those in society
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(EEHNS)
1. economic stability
2. education
3. health and health care
4. neighborhood and built environment
5. social and community context
1. economic stability
2. education
3. health and health care
4. neighborhood and built environment
5. social and community context
answer
What are the 5 domains of social determinants of health?
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economic stability
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What social determinant of health is the connection between a
person's financial resources
and their health?
person's financial resources
and their health?
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income, cost of living, poverty, employment
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Name examples of economic stability domain of social determinants of health
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Education
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What social determinant of health is the connection between aspects of a person's education and their health and well-being
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hs graduation, enrollment in higher ed, language and literacy, Early Childhood education and development
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Name examples of the Education domain of social determinants of health.
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Health & Health Care
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What social determinant of health is the Connection between a person's access to and understanding of health services and their health?
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access to care, primary care, and health literacy
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Name examples of the Health & Health Care domain of social determinants of health.
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Neighborhood and built environment
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What social determinant of health is the Connection between where
a person lives and their health and well-being?
a person lives and their health and well-being?
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housing, neighborhood and environment, healthy foods, crime and violence, environmental conditions
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Name examples of the Neighborhood and built environment domain of social determinants of health.
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social & community context
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What social determinant of health is the Connection between aspects of a person's social
environment and their health and well-being?
environment and their health and well-being?
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social support, family circumstances, community engagement
social cohesions, civic participation, discrimination
social cohesions, civic participation, discrimination
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Name examples of the social & community context domain of social determinants of health.
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Income is tied to health.
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In the study of the prevalence of heart disease per 1,000 persons among persons aged 18+ years by family income, what was the main takeaway?
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True.
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True or false:
Occurrence of heart disease is highest when one has low income
Occurrence of heart disease is highest when one has low income
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Those in high income
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In the study about "Trends in 10-Year Predicted Absolute CVD Risk, Mean
Systolic Blood Pressure, and Smoking by Income Strata," who had the lowest absolute risk of CVD over time?- some even got healthier
Systolic Blood Pressure, and Smoking by Income Strata," who had the lowest absolute risk of CVD over time?- some even got healthier
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cardiovascular (CVD)
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Change in income is linked to time to develop _________?
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True
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True or False:
In the study about change in income being linked to time to incident CVD Those with income drop had higher risk of CVD in comparison to those whose income was relatively unchanged.
Those with high income had incident CV.
In the study about change in income being linked to time to incident CVD Those with income drop had higher risk of CVD in comparison to those whose income was relatively unchanged.
Those with high income had incident CV.
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longer
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In a study, it revealed that the more education you have the (shorter/longer) you live?
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Females
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In a study that indicated the more education, the longer one lives, who had a greater life expectancy (males or females)?
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Lowest educational attainment
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What educational attainment had highest incidence of CVD?
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greater education
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What educational attainment had lowest incidence of CVD?
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False.
There is still the effect of education regardless of income
There is still the effect of education regardless of income
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True or False:
There is no effect of education when considering the categories of family income, income
change, occupation, or parental educational level.
There is no effect of education when considering the categories of family income, income
change, occupation, or parental educational level.
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True
answer
True or False:
US residents with higher education live longer and have better health.
US residents with higher education live longer and have better health.
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Greater education could link with greater cognitive skills, problem solving, learning effectiveness, sense of personal control-- all which help with decreasing risk of CVD
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How can greater education link with greater health outcomes?
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health literacy
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What is the Degree to which individuals have the capacity to obtain, process, and understand basic health information needed to make appropriate health decisions?
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Being able to:
- Read and comprehend essential health-related materials
- May increase a person's capacity to take responsibility for
their health and their family's health
- Read and comprehend essential health-related materials
- May increase a person's capacity to take responsibility for
their health and their family's health
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Give examples of health literacy.
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FALSE.
Low literacy may impact health literacy, but relationship is COMPLEX.
Low literacy may impact health literacy, but relationship is COMPLEX.
answer
True or False:
The relationship between literacy and how it affects health literacy is simple.
The relationship between literacy and how it affects health literacy is simple.
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TRUE.
answer
True or False:
An individual may have high overall literacy and still have low health literacy.
An individual may have high overall literacy and still have low health literacy.
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- Poor treatment regimen adherence (not taking medications as described)
- Greater emergency department usage (using the ER more)
- Greater emergency department usage (using the ER more)
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What 2 things is two health literacy linked to?
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- Poverty
- Racial and ethnic minorities
- Non-English speakers
- Adults age 65+
- Racial and ethnic minorities
- Non-English speakers
- Adults age 65+
answer
Where is low health literacy more common in? (4 areas)
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Health and Health Care
answer
What social determinant is health literacy under?
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FALSE.
Your life expectancy could vary by up to 15 years based on where you live.
Your life expectancy could vary by up to 15 years based on where you live.
answer
True or False:
Your life expectancy does not vary based on where you live.
Your life expectancy does not vary based on where you live.
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82.1 years
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What is the Average life expectancy for a baby born in LA county in 2014:?
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FALSE.
In the class example of Walnut Park and Cudahy (both areas within the same state), you could be two miles away and be 11 years apart in terms of life expectancy.
In the class example of Walnut Park and Cudahy (both areas within the same state), you could be two miles away and be 11 years apart in terms of life expectancy.
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True or False:
If you live in the same state as someone else, you both have the same life expectancies.
If you live in the same state as someone else, you both have the same life expectancies.
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ENVIRONMENT
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____________ affects the lifespan.
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health outcomes
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Two areas can have different ___________________.
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A higher poverty rate
resident is more likely to rent
- which contributes to lower community cohesion and lower stability
- the area may also more exposure to pollution which can lead to poorer health outcomes
resident is more likely to rent
- which contributes to lower community cohesion and lower stability
- the area may also more exposure to pollution which can lead to poorer health outcomes
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Give an example of how an environment affects lifespan.
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"Healthy food priority area"
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What is a more appropriate term for food desert?
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Mapping of food deserts shows
connection with obesity and diet-
related diseases, including
diabetes and CVD
connection with obesity and diet-
related diseases, including
diabetes and CVD
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What is the significant of food deserts?
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reduction in mortality (higher life expectancy).
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Increase in greenery near one's home is associated with a ____________?
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FALSE.
The greater amount of green space you're surrounded by, the lower your likelihood of mortality, EVEN when accounting for other determinants of health
The greater amount of green space you're surrounded by, the lower your likelihood of mortality, EVEN when accounting for other determinants of health
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True or False:
If you have other determinants of health, the greater amount of green space does not lower your likelihood of mortality.
If you have other determinants of health, the greater amount of green space does not lower your likelihood of mortality.
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It could increase likelihood of going outside for physical activity, can attenuate for pollution in air, help with stress reduction, and improve relaxation
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Explain how more green space can increase mortality rates.
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FALSE.
A food desert is an urban OR rural area where the availability of affordable healthy, fresh food is limited.
A food desert is an urban OR rural area where the availability of affordable healthy, fresh food is limited.
answer
True or False:
Food deserts only occur in rural areas.
Food deserts only occur in rural areas.
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Food desert
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What is an A food an urban OR rural area where the availability of affordable healthy, fresh food is limited.
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FALSE,
Food Access is Multidimensional
Food Access is Multidimensional
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True or False:
Food access is one dimensional.
Food access is one dimensional.
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- Closeness to grocery store
- Money to purchase food
- Fair prices
- Time for shopping , transportation, and cooking
- Knowledge about healthy eating
- Appreciation of the advantages of high-quality nutrition
- Money to purchase food
- Fair prices
- Time for shopping , transportation, and cooking
- Knowledge about healthy eating
- Appreciation of the advantages of high-quality nutrition
answer
Describe some ways in which Food Access is Multidimensional.
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FALSE.
To promote food access and healthy eating behaviors, you need MORE than just putting a grocery store nearby.
To promote food access and healthy eating behaviors, you need MORE than just putting a grocery store nearby.
answer
To promote food access and healthy eating behaviors, you only need a healthy grocery store nearby.
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Targeting issues related to:
1) Retail access
2) Purchasing power
3) Culture and built environment
1) Retail access
2) Purchasing power
3) Culture and built environment
answer
How do mobile markets help dismantle barriers to healthier local food.
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Social & Community Context
answer
What social determinant of health is the factor of discrimination under?
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Discrimination
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What is a Socially structured action that is unfair or unjustified and harms individuals and groups?
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Structural and individual
answer
What types of discrimination are there?
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- Residential segregation
- Disparities in access to quality education or in incarceration
(affecting a community at large)
- Disparities in access to quality education or in incarceration
(affecting a community at large)
answer
Describe structural discrimination.
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Structural discrimination
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Refers to societal structures and policies that reduce access of less privileged groups to desirable opportunities/resources
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- Being treated with less courtesy than others
- Unfair dismissal from a job
- Microaggressions (everyay slights, putdowns, and insults)
(Affecting a specific one person)
- Unfair dismissal from a job
- Microaggressions (everyay slights, putdowns, and insults)
(Affecting a specific one person)
answer
Describe individual discrimination.
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Individual discrimination
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What refers to Discrimination directed at an individual by another individual?
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Micro-aggressions
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What is the term for Overt discrimination or implicit bias
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Blacks and LGBTQ
There were also reports among Latinos, women, and Asian Americans.
There were also reports among Latinos, women, and Asian Americans.
answer
Of the survey taken by men and women about about structural and individual discrimination, which group reported the most experienced discrimination?
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Males and whites.
answer
In the survey about discrimination in America, which groups experienced the least discrimination?
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Discrimination
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_____________ has been linked to adverse mental and physical health outcomes
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- Mental health symptoms and
disorders
- Poor general physical health
- Chronic disease conditions (like obesity, CVD)
- Early indicators of chronic disease risk (like shorter telomeres and inflammation)
disorders
- Poor general physical health
- Chronic disease conditions (like obesity, CVD)
- Early indicators of chronic disease risk (like shorter telomeres and inflammation)
answer
List some examples of adverse mental and physical health outcomes that arise because of discrimination.
question
appraised.
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experiences of discrimination and how it is ____________ can adversely affect psychological well-being, symptoms of distress, and increase risk of psychiatric disorders,
question
FALSE.
The health outcome depends on how one appraised the discrimination.
Negative emotions can lead to biological dis-regulation of HPA Axis and contribute clinical disease and illness; increases in risky health behaviors like declines in use of health care services
The health outcome depends on how one appraised the discrimination.
Negative emotions can lead to biological dis-regulation of HPA Axis and contribute clinical disease and illness; increases in risky health behaviors like declines in use of health care services
answer
True or False:
A certain type of discrimination everyone experiences leads to the same health outcome.
A certain type of discrimination everyone experiences leads to the same health outcome.
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FALSE.
Those who experience discrimination can also neutralize responses that may occur, like emotional support from close relationships, religion etc.
Those who experience discrimination can also neutralize responses that may occur, like emotional support from close relationships, religion etc.
answer
True or False:
Those who experience discrimination have no control over neutralizing their responses.
Those who experience discrimination have no control over neutralizing their responses.
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We need to think about factors in our environment where we spend most of our time, and the barriers.
Examples: Grocery store, crime rates, access to green spaces, etc.
Income class and health
Examples: Grocery store, crime rates, access to green spaces, etc.
Income class and health
answer
Since our environment has more to do with our health, how do we promote health? Give examples.
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TRUE.
answer
True or False:
Gaps in health in US by income and education are LARGER than gaps in health by race.
Gaps in health in US by income and education are LARGER than gaps in health by race.
question
FALSE.
RACE STILL MATTERS:
- race often determines your access to resources even at high levels of education.
- inclusivity and discrimination have long term negative consequences on health
- Racism linked to higher outcomes in inflammation and processes of development heart disease
RACE STILL MATTERS:
- race often determines your access to resources even at high levels of education.
- inclusivity and discrimination have long term negative consequences on health
- Racism linked to higher outcomes in inflammation and processes of development heart disease
answer
True or False:
Since Gaps in health in US by income and education are LARGER than gaps in health by race, race does NOT matter.
Explain.
Since Gaps in health in US by income and education are LARGER than gaps in health by race, race does NOT matter.
Explain.
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race and socioeconomic status
answer
There's a need to look at intersections of inequalities-- looking at _________ and ___________ together and the joint effect of those variables.
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factors outside
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To improve healthcare, its not about more medical care but about _______________ and improving quality of life where Americans spend most of their time.
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Black people
answer
Who as a group have lower levels of education and home ownership and higher rates of poverty and unemployment?
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Black women
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Who may experience discrimination differently-- may experience preterm and low birthweight outcomes.
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worse
answer
When inequities are high and community assets are low, health outcomes are (worse or best)?
question
Best
answer
Where inequities are low and community assets are high, health outcomes are (worst or best)?
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FALSE.
Health equity means increasing opportunities for EVERYONE to live the healthiest life possible, no matter who we are, where we live, or how much money we make.
Health equity means increasing opportunities for EVERYONE to live the healthiest life possible, no matter who we are, where we live, or how much money we make.
answer
True or False:
Health equity means increasing opportunities
for certain people, to live the healthiest life
possible.
Health equity means increasing opportunities
for certain people, to live the healthiest life
possible.
question
Community driven solutions:
- community power, leadership to foster health equity
- thoughtful evidence informed policy making
- community-based solutions that are multi-sectoral; he more the better
- community power, leadership to foster health equity
- thoughtful evidence informed policy making
- community-based solutions that are multi-sectoral; he more the better
answer
What can be done to promote health equity?
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social institutional inequities and living conditions
instead of risk behaviors or disease and injury and mortality
instead of risk behaviors or disease and injury and mortality
answer
most focus has been placed on up stream (_____________).
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