Njiolenaka Ogbonnaya Jr Akpara

OGBONNAYA AKPARA

FUNDAMENTALS OF SOCIAL BEHAVIORAL HEALTH TOPICS

Naming and Addressing Racism: A Primer by Ogbonnaya Akpara

The webinar begins with webinar 1 talking about how racism continues to diminish the United

States of America. The definition of racism is a system of structuring opportunity and assigning

value based on the social interpretation of how one looks. Racism unfairly disadvantages some

individuals and communities. There are three types of racism. The three types of racism are: 1)

Internalized racism, 2) Personally-mediated racism, and 3) Institutional racism.

Internalized racism is the acceptance by the stigmatized races of negative treatment on our own

abilities and intrinsic worth. Examples are: 1) Self-devaluation, 2) White man's ice is colder and

3) Resignation,hopelessness, and helplessness. Personally-mediated racism is differential

assumptions about the abilities, motives and intents of others by race. It also has to do with

prejudice and discrimination for example: 1) Police brutality, 2) Physician disrespect, 3)

Shopkeeper vigilance, 4) Waiter indifference, and 5) Teacher devaluation. Institutional racism is

the differential access to the goods, services and opportunities of society, by "race". Example: 1)

Housing, education,employment, and income (A lack of these will lead to health disparities), 2)

Medical Facilities (Linguistic access), 3) Clean Environment, 4) Information ( Health

Information), resources (Knowing someone from the inside) and voice ( government and

media).

The leadingg cause of death in the United States are heart disease, cancer, diabetes, infant

mortality and suicide. Healthy People 2020 explains that health starts in our own homes, schools,

workplaces, neighborhoods and communities. A key social determinant is education. Social

determinants of health are conditions in the environment in which people are born, live, learn,

work, play, age, and worship that affects a wide range of health.

Webinar 2's title: No Safety, No Health: A Conversation about Race, Place and Preventing

Violence was a short webinar that talks about race, place and preventing violence. Neighborhood

violence is a preventable public health issue and it is shaped by many factors, including racism.

Violence impacts our health and well-being, and also prevents neighborhoods from realizing

their full potential.

Webinar3's title: Unequal Treatment: Disparities in Access, Quality and Care talks about the

Affordable Care Act and how it has led to the growth in health insurance coverage. Racial and

ethnic minorities lack access to quality care and have bad health outcomes. These health

disparities intimidate our country. Racism is within the healthcare system and we are addressing

discrimination to improve public health by creating incentives to better align health

care resources with community needs. Also, they are increasing diversity among providers and

monitoring health care access and quality discrimination.

Webinar4's title: Racism:The Silent Partner in High School Dropout and Health Disparities talks

about fifty million students attending high school this fall. Two-thirds of African AMerican and

three-fourths of Latino students will graduate on time. More than half of all students attending

public school live in poverty. Obstacles to high school graduation are key public health concern

because high school graduation is a leading indicator of healthy adult behavior and health status.

Mr. Troutman and Mr. Murphy analyzes how current policies and practices in educational

systems disproportionately impact students of color and contribute to disproportionate dropout

rates.The study Racism:The Silent Partner in High School Dropout and Health Disparities shows that

the prevalence of Asians and Blacks involving high school graduation rates are as follows:

93.1% of Asians are high school graduates and 66.1% of Blacks are high school graduates. This

means that there is a 27% gap between Asians and Blacks when it comes to percentage-wise. The

high school dropout rate for Blacks is 33.9%. This percentage is high because it is almost near

the half way percentage mark. The Asian high school dropout is 6.9%. This percentage is low

compared to the dropout rate of Blacks.

Roberts, a legal scholar and author of Roberts, a legal scholar and author of fatal invention: How

Science, Politics and Big Business Re-create Race in the Twenty first century

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The video clip begins with Mr. Tavis Smiley congratulating Mrs. Dorothy Roberts on her book

that is called "Fatal Intervention: How Science, Politics, and Big Business Recreate Race in the

Twenty-First Century. Mrs. Roberts is a professor of law at Northwestern and the chair of the

board of directors at the Black Women's Health Imperative. Mrs. Dorothy defines Fatal

Intervention as a race in the United States. She goes on to say that an intervention is a political

system that was created out of slavery and colonialism that continues to exist today to govern

people. Fatal means that it has caused devastating inequalities that continue to this day.

The FDA accepts a drug called BiDil and Mrs. Roberts explains that there was no evidence that

BiDil worked differently in African Americans than in people of other races. Mrs. Roberts

examines the political and commercial incentives for continuing the categorization of people by

race. C,ommercial incentives today to produce products by race is based on false assumptions,

that you can divide up the human species into biological groups called races says Mrs. Roberts.

She goes on to say that commercial incentives is like race-based medicine. Companies and

researchers are looking for race-based products that can replace individual drugs tailored to our

genotype.

Mrs. Roberts explains mass incarceration of African American women and men, increase in

poverty, and the poverty gap between Blacks and whites in this country. The health gap is high,

infant mortality among Blacks is three times that of whites and maternal mortality is four times

that of whites. Mrs. Roberts talks about health disparities and how it is still continuing in the US.

We are being told that race is not a factor anymore and Mrs. Roberts explains that we will never

achieve equality if we do not address that race is real.

"When the Bough Breaks" from the Unnatural Causes series

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In the video "When the Bough Breaks" from the Unnatural causes series, the video clip talks

about infant mortality in the United States. Infant mortality is greater in the United States than in

other countries in the world. United States ranks 34th in infant mortality. African Americans have

twice as high rates of infant mortality than White Americans. Educated African American women

have birth outcomes than White women.

Kim Anderson is an Atlanta lawyer and a mother who was pregnant with her first child in 1990.

She did a tremendous job in providing a healthy baby but Mr and Mrs. Anderson were

overwhelmed and traumatized because her newborn weighed less than three pounds. Mrs.

Anderson went into labor before her two and a half month due date. Mrs. Anderson did all the

right things the doctors told her such as: 1) Eating healthy, 2) Exercising, 3) Staying away from

drugs and alcohol, and 4) Receiving excellent parental care.

The elevated you are on the socioeconomic ladder, the lower you are to risk health disparities.

The advantages of wealth and status played a major contributing factor in Mrs. Anderson's health

as well as racism. According to Neonatologist Mr. James Collins and Mr. Richard David, "they

believed that African American women are at an elevated risk during pregnancy of racism as

they encounter it through their everyday life". Dr. Collins and Dr. David displayed that "African

immigrants to the US and US- born white women had the same birth outcomes, yet African

American women prefer to have babies that weigh less. They also displayed that the African-

born group declined or deteriorated within one generation.

Dr. Michael Lu believes that chronic stress is the perpetrator when racism affects pregnancy.

Racial inequity causes anxiety and the release of stress hormones that prompt or promotes

premature labor. Dr. Camara Jones of the Center for Disease Control (CDC) gives an explanation

that people of color experience racism and it is a stressor that is embedded into all the stressors in

a person's life.

Anthropologist Fleda Jackson, Sociologist Mona Phillips and Epidemiologist Carol Hogue are

collaborating to assist and better understand racism and racism's impact on African Americans.

Through groups and programs, Mrs.Jackson, Mrs. Phillips, and Mrs.Hogue are helping African

American women find resources they need to survive in a world surrounding negative impacts on

African American women and the dangerous conditions that remains to be a difficult challenge to

tackle.

In my opinion, I believe that we experience discrimination everywhere we go. For example: the

schools we go to, the jobs we work at, when we walk down the street, and when we go into a

store to buy or even look at something. Sometimes we do not see it openly because they do not

want to expose themselves which is overt racism. They usually do it secretly so that you can read

between the lines and that is covert racism. I experience both covert and overt racism throughout

my life which is very difficult for me to tackle and challenge on a day-to-day basis.

"Place Matters" from the nnatural causes series

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In the video "Place Matters" from the unnatural causes series, the video clip begins by talking

about the place you live is a good or excellent indicator of health complications or health

disparities. Latino and Southeast Asian immigrants Mr. and Mrs. Boonkeut moved into an

abandoned neighborhoods in Richmond, California, mainly a Black city in the San Francisco

Bay Area. Segregation, lack of jobs and nutritious foods, and affordable housing have been

dangerous to the health of African American residents. Richmond, California has greater than

average rates of asthma hospitalization, lower life expectancy and higher rates of diabetes. Mr.

Boonkeut's region or district has larger rates of poverty, lower income rates and lower

educational attainment. In low-income communities, tobacco, liquor and fast food restaurants are

everywhere while in affluent or wealthy communities, fresh produce or fresh foods are

everywhere.

White families took advantage of federally backed home loans to start fresh in a new district, but

prejudicial policies and practices excluded African American families from those similar

opportunities. Less than 2% of $120 billion in government-backed home loans went to non-white

residents between the years of 1934 and 1962. In Northern, California, 350,000 federally

guaranteed new home loans, went to white families and fewer than 100 went to African

American families. All across the United States, in cities like Richmond, California, African

Americans were left behind in increasingly abandoned neighborhoods. As social conditions

worsened, so did health. Studies have displayed that living in poverty leads to a 50-80% increase

in heart disease- the number one killer in the United States. Stressing over violence in the

communities were individuals live in, lousy schools parents put their children in, unpaid bills,

living in poverty, not having access to fresh foods, reliable transportation are all negative effects

on your health.

To conclude, the video clip ends with a quote from Harvard's David Williams. According to

David Williams, he states that "Housing policy is health policy. Neighborhood improvement

policies are health policies. Everything that we can do to improve the quality of life or

individuals in our society has an impact on their health and is a health policy." This means that

the place you stay or reside has a major impact on your health.

Six Reasons Why Parks Matter for Health

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This blog talks about the six reasons why parks matter for health. The National Park Service

celebrates its 100 year and has a best-ever achievement 307.2 million visits in 2015. The access

to natural scenery and park activities play a role in improving health. Research shows that public

parks contribute to health in a number of ways, from promoting physical activity to improving

mental health and reducing health care costs.The six reasons why parks matter for health are: 1)

parks foster mental, physical, and spiritual health, 2) parks encourage physical activity, 3) parks

advance health equity, 4) parks helps kids flourish, 5) we need parks to survive, and 6) parks are

powerful prescription to combat chronic disease.

Parks foster mental, physical and spiritual health through the provisions of clean air and water,

and also provides spaces for finding break from the stressors of everyday life. The national park

service has 400 parks, recreation areas that serve as "go-to" resources for people's health and

well-being. Parks encourage physical activity such as moderate exercise and access to outdoor

fitness equipments. Parks advance health equity by helping to restore people from the stress of

day-to-day challenges and struggles. That is especially essential for individuals who are more

likely to experience discrimination.

Parks help kids flourish by creating opportunities for kids to enjoy themselves and interact with

others in an environment where they are shielded from adversities in their daily lives. Parks are

powerful prescription to combat chronic disease by exposing themselves to sunlight which is a

healing process for medical and mental health reasons. We need parks to survive because it helps

biodiversity that we need as a species to survive. They also alleviate or reduce climate change

impact by having green infrastructure that contributes to our air and water quality.To conclude,

there are health disparities in this country and by preventing them through exercise and engaging

in outdoor activities, we can reduce the epidemic of diseases that are prevalent in this country.

Taking advantage of parks is very vital in controlling one's health.

Optional Reading- Robert Wood Johnson Workplace and Health 2016

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This article talks about Workplace and health based on the title that is presented to me. Where

people reside and work influences their health. According to Robert Wood Johnson Workplace

and Health 2016, scientists found that an individuals job affects their health for more than 4 in

10 working adults. Workers in minimum wage face treacherous or deadly work situations

(45%) compared to those in high-paying jobs (33%). Individuals who find work have a poor

impact on stress (51%) compared to those in medium and high-paying jobs (41%).

One in 5 employees (19%) are laborers, working 50 or more hours a week in their main job.

They do so because they say it is essential their career (56%); and that their workload makes it

difficult to take a vacation. African American employee adults give their organization fair or poor

ratings (37%) on providing a healthy work environment, compared to Hispanics (26%) and white

workers (21%). Women are more likely while employed to have cared for a family member who

was seriously sick, injured or disabled (33%), compared to men (24%); African American are

more likely (41%) to have done so than whites (28%) or Hispanics (20%).

A majority of employees (55%) go to work when ill; including medical employees (60%) and

restaurant employees (50%) who go to work when they have a cold or flu. For most employees,

the workplace provides a healthy work environment (75%) and offers formal wellbeing or health

advancement programs (51%).To conclude, where an individual lives and works strongly

impacts or control an individual's health and wellbeing.

RE: Rethinking Gender Differences in Health: Why We Need to Integrate Social and Biological

Perspectives

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In the article "Rethinking Gender Differences in Health: Why We Need to Integrate Social and

Biological Perspectives" by Reiker, PP and Bird, CE, the authors discuss the difficulty or

problem of sex-specific differentiation in an individual's health for example men's lower

longevity and a women's relative incidence of disease that continues past intuition of either social

or biological detriment. The division remains in comprehending the ancestry of such distinction

and the problem it arises regarding the similarities between social and biological movement. The

objective of the article is that sex-specific differentiation in health is essential and that

comprehending these distinctions requires interpretation of why individuals are not making

health a major concern in their daily lives. The authors also discuss constrained choice which is a

key element in this article that talks about Gender distinctions in Health and how we have to

incorporate social and biological views. Constrained choice is a very essential problem or

controversy that is lacking the comprehension of these sex-specific distinctions in health. It also

signals the social science neighborhoods to work with the scientist on collaborative work

required to direct the complicated or convoluted differences in men's and women's health.

In today's society, some physical factors that contribute to gender differences in health are as

follows: Women undergoing or encountering larger rates of depression and anxiety disorders

than men while men have larger rates of substance abuse, antisocial behavior and suicide than

women. According to the article, "there are three reference conditions that exhibit substantial

gender differences and they are: CVD, immune function and disorders and depression". The

authors also state that"men and women's physical health are very confusing. Women live longer

than men, yet they have higher morbidity rates".This means that women have a longer lifespan

than men even though they have a relative incidence of disease that often occurs.

According to the article, some of the social factors that contribute to gender differences in health

have not been used while scientists have investigated or reviewed some of the pathways through

which social factors might differentially affect men and women's health including positive and

negative health behaviors, exposure to stressors and coping lifestyles. In order for an individual

to lists some social factors that contribute to gender differences in health, the individual must

integrate social and biological procedures to preferably comprehend the distinction in men and

women's health.

The economic factors that contribute to gender differences in health is income. According to the

article, sex-specific differentiation in income may result from a variation and diversity of factors

over the life course including occupational choice, opportunities for employment and

advancement, work-related skills and experience, as well as job benefits including health

insurance, pension, and retirement income. Women are more than likely to be a single parent and

have reduced income per capita. The gain of income on health would be expected to be similar

for men and women, the levels of income may vary by sex-specific for a variety of reasons other

than the job one currently has. Welfare and income entitlements such as social security are tied to

both one's own employment and income history and that of one's spouse according to the article.

To conclude, gender differences in health is vital and we need to incorporate or integrate social

and biological perspectives. Constrained choice is a very crucial or key part that is lacking the

grasp or mastery of gender-specific distinctions in health. Constrained choice includes the gain

of governmental and workplace policies on men and women's health.

References

Rieker, P. P., & Bird, C. E. (2005). Rethinking gender differences in health: why we

need to integrate social and biological perspectives. The Journals of Gerontology

Series B: Psychological Sciences and Social Sciences, 60 (Special Issue 2), S40-S47.

Optional Viewing: The Health Belief Model History, Constructs and Applications by Andy

DeDomenic

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The video clip talks about the history of the health belief model, the constructs of the health

belief model and the applications of the health belief model. The health belief model

(HBM) began in the 1950s from the work of social psychologists in the US. public health

service. These pyschologists were faced with the problem that very few individuals were

partaking in and these individuals were participating in preventive and disease detection

programs. There were theories that assisted in helping to develop the health belief model and

they were: Atkinson's risk-taking model, Feather's decision making under uncertainty model,

Rotters Reinforcement Model, Edwards subjective expected utility model, and

Tolman's performance behavior theory.

The constructs of the health belief model are as follows: perceived susceptibility, perceived

severity, pereceived barriers, cues to action, perceived benefits, and self-efficacy. Perceived

susceptibility is the belief that an individual has with regard to obtaining or receiving a disease or

reaching a harmful state as a result of partaking in a behavior. Perceived severity is an

individual's instinctive or personal belief in the extent of harm that can result of a specific

behavior. Perceived benefits is the belief in the advantages of the methods suggested for

diminishing the risk or seriousness of the disease or harmful state resulting from a specific

behavior. Perceived barriers is the belief concerning the actual and imagined costs of the new

behavior. Cues to Action is the precipitating forces that make an individual feel the need to take

action. Self-efficacy is the confidence an individual has in his or her ability to pursue a behavior.

The applications of the health belief model has been used for behavioral research in: Modeling

for physical activity behavior, Predictors of health behaviors in college students, Socio-

psychological modeling for diabetes and many more. The health belief model is the first theory

that was developed exclusively for health related behaviors.

Optional Viewing: Introduction to the Theory of Planned Behavior

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The video clip's aim is to talk about the predictors of intentions to he theory of planned behavior

and how it affects real life. The three processes of planned behavior are: Behavioral attitudes,

subjective norms and perceived behavioral control. Behavioral attitudes refers to what an

individual thinks and feels about behavior. The behavioral attitude consists of affective attitude

and instrumental attitude. Affective attitude asks a question stating Is the behavior enjoyable or

not?

Instrumental attitude asks the question Is the behavior beneficial or harmful? Subjective norms

refers to support given by significant others example family and friends. Subjective norms

include injunctive norms and descriptive norms. Injunctive norms states how others encourage

the behavior while descriptive behavior states that others do the behavior. Perceived behavioral

control refers to if an individual is capable and confident, and can overcome barriers and

challenges.

When an individual recognizes or distinguishes an activity that is fun and have good benefits,

they are supported with other individuals which also does exercising and feels in control, and are

capable of doing behavior. They will form a tighter intentions and more likely engage in

behavior. The real life situation has to do with Sharron and how she is not execising, has low

control of behavior and lacks confidence in abilities.

Optional viewing: Trans-Theoretical Model of Behavior Change

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The video clip discusses trans- theoretical model and how it assists an individual to comprehend

the complex stages of process of not ready to change, thinking about change and persisting with

behavior. The aim of this model is to distinguish between the five stages of change. The 5 stages

of change are pre-contemplation, contemplation, preparation, action and maintenance. Pre-

contemplation refers to an individual not ready for a task, unlikely to engage in the near future,

encourages to think about positives and negatives, and very down and defensive. Contemplation

refers to an an individual getting ready for a task, intention to engage in the behavior, appreciates

the positives of change, may still try to avoid action, and has the thought but is unlikely to act.

Preparation refers to an individual ready for a task, gradual steps to fit into their life, and might

tell family and friends to change their behavior. Action refers to an individual doing the behavior,

refers to the need to keep working hard, and also mentions the usefulness to learn techniques to

enhance commitment (acknowledging the steps taking and avoiding people who encourage

unhealthy behaviors). Maintenance refers to the changed and substained behavior, sharing

experiences and seeks support when an individual behaves in a healthy way, and also is essential

or important to be self-aware, need to be challenged, feel competent to overcome barriers.

Optional Viewing: Introduction to the Theory of Planned Behavior

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The video clip's aim is to talk about the predictors of intentions to he theory of planned behavior

and how it affects real life. The three processes of planned behavior are: Behavioral attitudes,

subjective norms and perceived behavioral control. Behavioral attitudes refers to what an

individual thinks and feels about behavior. The behavioral attitude consists of affective attitude

and instrumental attitude. Affective attitude asks a question stating Is the behavior enjoyable or

not?

Instrumental attitude asks the question Is the behavior beneficial or harmful? Subjective norms

refers to support given by significant others example family and friends. Subjective norms

include injunctive norms and descriptive norms. Injunctive norms states how others encourage

the behavior while descriptive behavior states that others do the behavior. Perceived behavioral

control refers to if an individual is capable and confident, and can overcome barriers and

challenges.

When an individual recognizes or distinguishes an activity that is fun and have good benefits,

they are supported with other individuals which also does exercising and feels in control, and are

capable of doing behavior. They will form a tighter intentions and more likely engage in

behavior. The real life situation has to do with Sharron and how she is not execising, has low

control of behavior and lacks confidence in abilities.

RE: the role of behavioral science theory in development and implementation of public health

interventions

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In the article "The Role of Behavioral Science Theory in Development and Implementation of

Public Health Interventions" by Glanz, K and Bishop, DB, the authors explain the growing

verification that implies that public health and health-promotion interference are based on social

and behavioral science theory or propositions that are powerful or successful than those that are

non-existent in a theoretical base. Influential contemporary view stresses the multiple

determining factor or decisive factor of health and health behavior. The authors also states that

the most frequent used theories or propositions of health behaviors are social cognitive theory

(SCT), the trans-theoretical model (TTM) /stages of change, the health belief model (HBM) and

the theory of planned behavior (TPB). According to the article, social cognitive theory (SCT) is

the cognitive statement or expression of social learning theory. Trans-theoretical model (TTM) /

stages of change illustrates an individual's drive to modify a behavior. The health belief model

(HBM) was started to assist in comprehending why an individual did or didn't use preventive

services offered by the public health department. The theory of planned behavior (TPB)

identifies cognitive stages of readiness and decision to take action.

According to the article, the authors define theory as "a set of interrelated concepts, definitions

and propositions that explain or predict events or situations by specifying relations among

variables." Moreover, according to the article, the authors also define theory as "a systematic

way of understanding events, behaviors, and/or situations. The question asks how can one

combine theories to have a greater effect on a target population. The answer to that is when an

individual integrates or incorporates theories, it is essential or vital to precisely assume that the

unique contribution has different theories to the combined model according to the article. The

author also states that a developing or expanding body of information implies that interventions

are refined or advanced with an accurate or exact analytical foundation or foundations that are

more useful or adequate than those lacking a analytical base and that some strategies are

combined multiple theories according to the article.

To conclude, the analysis, survey or report of experimentation or investigation on modifying a

variety of health behaviors have shown that interventions are based on theory or theoretical

design that are more adequate or useful than those not using theory. However, the structure that

clarifies the greater effects have not been designed or examined by researchers or scientists.