HLSC 120 2015 eModule 5 Page 1 HLSC 120: Society, Culture and Health eModule 5 eModule 5: Vulnerable People in Marginalised Groups and Health Related Issues Introduction eModule 5 is corresponding to Lecture content for Weeks 5 and 6. As explained in the very first eModule, the purpose of the online module content and learning activities in this unit is to extend the content of your weekly two hour lecture, to create knowledge links to the unit learning outcomes, graduate attributes, and seminar topics/questions and to help you enrich your learning as you further develop your reflective writing skills. In this eModule, the content is focused upon vulnerable people in marginalised groups and their health related issues. By attending the lecture, completing the eModule learning activities, readings reflections you will be well on the way towards having a deeper understanding of this important area and find that you are prepared to facilitate or be involved in the seminars. I would encourage you to keep up‐to‐date with your self‐directed eModule work, rather than leave it all until the last minute. This will help you to adequately reflect on the content, and to clarify any questions that arise during your reflections. It will also assist you with your exam preparation as any of the questions in the reflective learning and writing sections in any of the six eModules may appear in the exam. Learning Outcomes, Graduate Attributes In this Module the following Unit Learning Outcomes (LO) and ACU Graduate Attributes (GA) are most relevant. LO 5. Differentiate the health issues of vulnerable people in marginalised social groups in Australia. The graduate attributes aligned to this module are as follows: GA 1. Demonstrate respect for the dignity of each individual and for human diversity. GA 2. Recognize their responsibility to the common good, the environment and society GA 4. Think critically and reflectivelyHLSC 120 2015 eModule 5 Page 2 In the lecture, we identified and explored health issues related to a number of issues that lead to groups in society becoming marginalised, vulnerable and socially excluded. To further enhance your understanding of the issues affecting vulnerable groups, this eModule will explore issues related specifically to poverty, restrictions to education and health services, hence employment, and the detrimental effect the barriers have on specific communities, Thinking about what you have learnt in lectures, in your reading so far, through the media and previous experiences, consider what it is that constitutes a vulnerable group of people? What leads groups to being vulnerable? The South Australian Council for Social Services (2008) discussion paper identified vulnerable groups and the social determinants that impacted upon or lead to disadvantage and inequity. Look at Figure 1 below now to become familiar with these determinants and groups. Are there other groups that you believe to be vulnerable – refugees, for example? If so, who are these groups and what leads you to believe they are vulnerable? The South Australian Council for Social Services (2008)HLSC 120 2015 eModule 5 Page 3 Germov (2014) suggests that one of the key indicators of inequality is the distribution of wealth within a country; this is more complex than simply how wealthy a nation is. Statistics from the Australian Bureau of Statistics (as cited in Germov, 2014, p. 88) suggest that the top 20 per cent of the Australian population own 61.1 per cent of the nation’s wealth and the top 40 per cent of the Australian population owns 81.1 per cent of the nation’s wealth. 6.7 per cent of the nation’s wealth is shared amongst the lowest 40 per cent of the population. In discussing poverty, marginalisation and social exclusion, it is also important to investigate the difference between equity and equality. Do you know the difference? Equality in health care refers to the differences in the use, access, availability or quality of health care by different groups (Ward, 2009). Equity in health care is about the ability to access health services using concepts and approaches involving social justice and therefore requires a judgement about what is fair and just. This may involve assistance to enhance accessibility. The social determinants of health were introduced earlier in this unit. In 2008 the South Australian Council of Social Services released a discussion paper on the social determinants of health and their effects on vulnerable groups. Figure 1 (above) comes from that document and lists vulnerable and marginalised groups and determinants that affect these groups. In order to begin to understand why vulnerable groups exist, it is important to investigate and begin to understand the theories that sociology uses to attempt to explain the world. Read Chapter 5 in your textbook Second Opinion: An Introduction to Health Sociology. John Germov (2014) investigates the concept of class and how this has attempted to explain health inequality and inequity. Reading 5.1HLSC 120 2015 eModule 5 Page 4 The resources below are not compulsory but are suggested for students to help to deepen your knowledge and understanding. Michael Marmot has worked for many years researching and writing about the social determinants of health. In the clips below he talks about the social determinants of health generally and in relation to Australia. http://www.youtube.com/watch?v=ea4nEXzdGFM http://www.youtube.com/watch?v=GmuzM9IPDL0&feature=related In his paper ‘The dust of fact: a view from the ground’, Falzon (2010) highlights the effects of poverty and how it can lead to vulnerability and marginalisation as well as the way that a cycle of poverty and social exclusion can occur because of poverty. You might be interested to read his paper, which can be found by following this link. http://www.vinnies.org.au/icms_docs/179097_The_cost_of_poverty_is_more_expensive_than _the_dole.pdf There are many other reports and articles here that you might like to investigate. Ask yourself, who might be affected by poverty? What might be the results? By now you should be very familiar with Willis’ sociological template Germov, 2014) and applying it to analyse a sociological issue. Use the template to consider poverty and how it might lead to marginalisation and social exclusion. You might also want to look back at Figure 1 and think about how this might intertwine with the template. Figure 2: Sociological imagination template [Willis, cited in Germov, 2014, p.8) Historical Structural Sociological Analysis Cultural Critical Resources 5.1HLSC 120 2015 eModule 5 Page 5 What do you understand by the term “stigma” and what role does it play in marginalisation? Germov (2014) defines “stigma” as “a physical or social trait, such as a disability or a criminal record that results in negative social reactions such as discrimination and exclusion”. People with disabilities often experience inequity and are stigmatized in their community. It may also affect their ability to access health care and other services. Take a moment to reflect on your own beliefs/perceptions about people with disabilities. Where did you acquire these beliefs /perceptions? You may want to use the following questions to also help guide your reflections:  What do you know about the health needs of people with disabilities?  What do you know about the availability and accessibility of services?  What role do health professionals play in working with people with disabilities? You might like to investigate the Ramp Up website. This is a site for people living with a disability, for those working in the area or caring for a person with a disability. It provides a wealth of information. It can be found by following this link http://www.abc.net.au/rampup/ Stigma and disability exist within most communities around the world. They often manifest in different ways and for different reasons according to context. In developing countries, something that we in western countries may see as easily preventable can become a basis for stigma and social isolation. Watch Harris’ story at http://www.onamercyship.com/harris/video.html and respond to the questions below. Transcript at http://www.onamercyship.com/harris/harris.html 1. What are the challenges that Harris is likely to face? 2. Use the sociological imagination template to investigate some of the factors that influence Harris’ situation. 3. What is likely to happen for someone in the same circumstances in Australia? 4. Comment on the role and function of organisations that provide aid. Learning Activity 5.1 Learning Activity 5.2HLSC 120 2015 eModule 5 Page 6 Reflective Learning and Writing 5.1 Using the proforma reflect on the following questions. What do you know and what do you need to research further? 1. How do socio‐economic factors and indices (e.g., education, employment, housing, race, and gender) influence the health of an individual, family and community? 2. Globalisation has led to an increasing focus on international “corporate dominance” in health care which can lead to an increasing “assembly line” character in health care and provision of medical services (Wainwright, 2008, p. 154). Explain how this phenomenon can influence the quality of health care for families and communities in Australia. 3. How can stigma influence the living conditions and health care of marginalised people and groups in Australian society, such as migrants/refugees, homeless people, and racial and ethnic minorities? 4. Why has the self‐help movement developed in Western cultures, and what are its benefits and disadvantages for Australians who are socially and economically disadvantaged? It is important that you reflect on all the questions above, as this will assist you in preparing for the final examination. Remember that any of the questions in the Reflective Learning and Writing sections of the six eModules may appear in the examination paper.HLSC 120 2015 eModule 5 Page 7 References British Medical Journal Media. (2011). Interview with Prof. Sir Michael Marmot [Video file] Retrieved from http://www.youtube.com/watch?v=GmuzM9IPDL0&feature=related Falzon, J. (2010) The dust of fact: A view from the ground. Paper prepared for Intergovernmental Relations Conference Canberra, 13 April 2010. Retrieved from http://www.vinnies.org.au/articles‐reports‐and‐speeches‐national Germov, J. (2014). Second opinion: An introduction to health sociology (5th ed.). Melbourne: Oxford. Harrison, S. (2004 – 2006). Mercy, mercy ships and Scott Harrison. Retrieved from Mercy website: http://mercyglobal.com/home.htm Keleher, H., & MacDougall, C. (Eds.). (2009). Understanding health: A determinants approach (2nd ed.). Melbourne: Oxford. Marmott, M. (2008). Prof. Sir Michael Marmot ‐ Fulbright Symposium Australia 2008 [Video file]. Retrieved from http://www.youtube.com/watch?v=ea4nEXzdGFM South Australian Council of Social Service. (2008). The social determinants of health. Unley, SA: South Australian Council of Social Service. Retrieved from SACOSS website: http://www.sacoss.org.au/online_docs/081210%20Social%20Determinants%20of%20Hea lth%20Report.pdf The Australian Broadcasting Commission. (2011). Ramp up disability, discussion, debate. Retrieved form Australian Broadcasting Commission Ramp Up website: http://www.abc.net.au/rampup/ Wainwright, D. (Ed.). (2008). A sociology of health. Los Angeles: Sage Publications. Ward, P. (2009) Equity of access to health care services. In H. Keleher & C. MacDougall (Eds.). Understanding health: A determinants approach (2nd ed.). Melbourne: Oxford. Willis, E. (2004). The sociological quest (4th ed.). Sydney: Allen and Unwin.