Tuesday, December 3, 2013

Week 11: Social Justice

What is social justice? Equity? Equality? How is social justice related to nursing? 

According to Braveman & Gruskin (2003), social justice is often used interchangeably with equity. Equity is defined as "the absence of socially unjust or unfair health disparities", social justice, and fairness. (p. 254). The definition of fairness varies with every individual; thus, what I believe to be fair may or may not be fair to another person. 

Health is promoted and seen as an inequity, not an inequality. Similar to fairness, the meaning of health is different for everyone. Some people may associate being healthy as the absence of disease or illness, while others may think being healthy means exercising and avoiding chips and soda. Health inequity is present due to the social determinants of health that affects each individual. Geographically speaking, some individuals are more prone to certain diseases than others because they live in certain areas where the atmosphere and water are more polluted. Biologically speaking, some individuals may grow up free of diseases or illnesses while others develop diseases because of their genetic makeup. In addition, education and health practices can also affect peoples' health. These are some of the social determinants that cause health inequity. 

Furthermore, employment, social status, and income are factors that cause health inequity. These factors were played out during class facilitation where we were divided into three groups ranging from higher social class status, middle social class status, and lower social class status/poverty. The activity demonstrated that if the middle and lower social classes wanted to achieve their goal and obtain what they wanted, then they would need to make wise decisions such as purchasing a hard copy of the scholarly articles. On the other hand, it was noted that the higher social class was able to obtain their goal while spending the most money and having the most money left over. In addition, the higher class outbid the middle class for the fight to answer one question. The activity demonstrated inequity in the social environment because even though everyone was offered the same resources, not everyone was able to take them to their advantage because they did not have the income to do so.   

Equity is, however, not used interchangeably with equality. Equality is something that is fair and evenly distributed. 

For example, if Jacky buys Lizzy one scoop of strawberry flavoured ice cream and Belle one scoop of chocolate flavoured ice cream, then that is fair. However, if Jacky buys Lizzy one scoop of strawberry flavoured ice cream and Belle two scoops of chocolate flavoured ice cream, then that is unfair because Jacky did not buy equal numbers of ice cream scoops for the girls.  

The above case scenario demonstrated inequality because the girls did not receive the same amount of ice cream scoops. However, if we were told that Lizzy is 4 years old and Belle is 16 years old, then it is understandable that Belle has received one more scoop of ice cream than Lizzy. In this case, Lizzy may understand that Belle is older and eats more than her, therefore she gets two scoops of ice cream. Thus, this second case scenario demonstrates equity because Belle is older and can eat more.  

Below is another example of equality vs equity. Equality is based upon fair distribution between all members of a party, though it does signify that everyone gains equal benefits to it. The photo on the left shows how the three boys are treated equally because they are each given one box to stand on. Though, because the three boys are not the same height, one boy benefits from the box more than the other because the shortest one cannot see the game. In contrary, the photo on the right shows how the three boys are treated with equity because they are all able to benefit from the box since they can all view the game. 


Figure 1. Equality vs Equity. Adopted from "The problem with 'Equality'" by the City of Portland, Oregon, 2013. Retrieved from http://www.portlandoregon.gov/oehr/article/449547?

Another topic that was discussed in class is information poverty. Information poverty is a growing issue that is said by Britz (2004) to have a "negative effect on the economic, cultural, and socio-political development of the Third World nations" (p. 192). The author also mentions that people do not have the knowledge to obtain complete information needs because they lack the resources and materials to do so. There are three factors to information poverty: connectivity approach, content approach, and human approach (Britz, 2004). 
  
The connectivity approach in information poverty focuses on those who lack the access to information and communication technologies (ICT) due to digital barriers. Individuals who do not have access to the Internet or have a computer to connect to the Internet are affected by this approach. 

There are solutions to the connectivity approach. The community or public libraries can offer free internet access to those who want to use ICT. In addition, public libraries can set up workshops or groups for individuals to come in and learn how to operate a computer and to improve their literacy level.  

The content approach in information poverty is affected by a person's budget to afford the access to ICT. This approach plays an economic factor to individuals who do not have the income to purchase digitized formats of information. In addition, this approach also affects those with lower educational levels since they are unable to operate digital technologies with limited literacy. 

There are solutions to the content approach in information poverty. Similarly to the solutions to the connectivity approach, individuals can access ICT at public libraries or other institutions. 

Lastly, the human approach is determined by the individual's level of literacy to understand, read, write, and communicate the information that they are presented with. If an individual has access to ICT but does not have the literacy to understand how to operate it, then the individual is dealing with information poverty. 

Communities can promote and teach individuals how to operate computers and improve their literacy levels through training and education. For example, public libraries can form information groups or set up workshops for those who are willing to learn more about ICT. 

Information poverty is caused by three underlying factors which include the fundamental causes, socio-economic causes, and contextual causes

The fundamental cause of information poverty is due to the fact that the individual does not have the skill to access ICT or operate one that is up-to-date. For example, even if an individual has the capability to work an older version of ICT, it does not mean that the same individual will be capable of operating the newer version of ICT. 

In order for individuals to overcome the fundamental cause of information poverty, they will need to keep up-to-date with the ever-growing ICT. One such method can include attending workshops to improve one's ICT skill or obtaining a more recent version of ICT. 

Socio-economic cause of information poverty is affected by "globalization and integration of the world's socio-economic life" (Britz, 2004, p. 195). Since socio-economic is a huge factor that affects many people, the solution may involve authorized individuals to advocate for the vulnerable individuals for better resources. 

Lastly, the contextual causes of information poverty is often seen in comparison with two groups of individuals who share the same physical context, but differs in their level of literacy to understanding how to properly access ICT (Britz, 2004). For example, Audrey and Lydia are both international students from England and Korea who have come to Canada to study. Even though Audrey and Lydia are now within the same environmental and physical contexts, their levels of literacy differ because of where they came from. Audrey may have an easier time adjusting to ICT in Canada because she is fluent with English while Lydia may have a harder time adjusting since English may not be her native language. In this case, Audrey may be classified as information rich since she is able to access ICT with minimal issues and Lydia is information poor because she is having difficulties understanding English to an extent.  

To minimize or eliminate the contextual causes of information poverty, one must understand and learn another person's culture and beliefs in order to recognize the differences in both cultures. When the person is culturally aware, he/she can educate others easier as the person will be free of assumptions which can cause an unhealthy relationship. 

Overall, the three approaches in information poverty can be easily dealt with if individuals have equal access to public libraries. Public libraries provide basic literacy training and an open area for group discussions. They also contain "welcome desk, information provider, information producer, referral agent, and authority controller" to guide individuals and promote education (Ogunsola, 2009, p. 67). Public libraries also offer programs to alleviate those who are affected by poverty by encouraging them to learn basic adult literacy, health literacy, and information literacy (Ogunsola, 2009).  

In class, we also discussed how social media is used as a tool to include the vulnerable population to overcome exclusion and isolation. The vulnerable population include the aboriginal, refugee, older adults, homeless, and disabled. Though I will not touch upon all groups of the vulnerable population, I will be specifically looking at the disabled population since that is what my group focused on. 

For starters, taken from a census in 2006, the disability rate of Ottawa's population is 18% (Taylor, 2011). The majority of the disabled population is of people between the ages of 20-64. 
Social media attempts to include people affected by disability by creating and updating software that can assist their needs (mobility, vision, hearing, etc..) The population spend an average of six hours a week working on school assignments on social media and twelve hours a week on social media for leisure time (Taylor, 2011). Individuals use the Internet to go on social networking sites such as FaceBook, YouTube, or Skype. 

The advantages of including the disabled population via social media include eliminating the physical and geographical barriers that prevent them from interacting with friends or relatives. Social media also makes individuals feel more welcomed and accepted into society. 

However, there are factors that prevent some of the disabled population from accessing the Internet such as education and income. Education plays as a barrier to accessing the Internet where individuals cannot communicate with other people because they have a lower level of literacy. Income is another barrier since the lack of income can prevent an individual from obtaining Internet access, let alone enough money to buy a computer. In addition, income can also have an effect on the Internet speed, connectivity, and the amount of data that one can use. One last barrier that can inhibit or even prevent an individual from interacting or using the Internet is a physical barrier. The physical barrier includes assistive technological devices installed into the computer. If the assistive devices are not kept up to date, then they would not be running properly or operate at all. Without the use of assistive devices, the disabled population may not be able to enjoy using the Internet effectively as there is a barrier that prevents them from showcasing their abilities to interact with others. 

In conclusion, the issue of health inequity still remains in society as the social determinants of health play a negative impact towards a consumer's health. We are to be reminded that inequities are factors that are different in each individual and can only be prevented when there is an absence of health disparities. In order to rid the inequities of health, one must learn to advocate for necessities and educate those who are in need of health improvements. 


Braveman, P., & Gruskin, S. (2003). Defining equity in health. Journal of Epidemiology and Community Health, 57(4), 254-258
Britz, J.J. (2004). To know or not to know: a Moral reflection on information poverty. Journal of Information Science, 30(3), 192-204. 
City of Portland, Oregon. (2013). The problem with "Equality". Retrieved from http://www.portlandoregon.gov/oehr/article/449547?
Ogunsola, L.A. (2009). Health information literacy: a Road map for poverty alleviation in the developing countries. Journal of Hospital Librarianship, 9, 59-72
Taylor, A. (2011). Social media as a tool for inclusion. Final Report for the Horizontal Policy Integration Division (HPID) of HRSDC. Retrieved from http://www.homelesshub.ca/ResourceFiles/Taylor_Social%20Media_feb2011%20(1)_1_2.pdf

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