New York Social Work Ebook Continuing Education

● LGBTQ Americans may have also experienced significant mental health issues that are related to the COVID-19 pandemic. Self-Assessment Quiz Question #4 All the following statements are accurate EXCEPT: a. In the U.S. 61 million adults live with a disability. b. The type of functional disability that has the highest percentage is that of cognition. c. More than half of LGBTQ Americans report hiding a personal relationship. d. Transgender individuals face unique obstacles to accessing healthcare. The complexity of individual diversity is inclusive of not just of racial and ethnic identity but also of variables such as socioeconomic class, disability, and LGBTQ status. While these facets of diversity are not exhaustive, they do represent some important categories of diversity.

Healthcare professionals must consider the unique array of diverse identities that are represented within each individual encountered in each therapeutic relationship. The complexity embodied within each patient affects the way that the patient understands and views the healthcare professional and the professional relationship, just as the complexity of the healthcare provider’s diversity dimensions affects the way that the healthcare professional understands and views each patient. It is impossible to provide information that allows healthcare professionals to gain knowledge about categories of people and how they behave or view the world, because not only is the variation within individual ethnicities and races endless, but the variation within each individual also is endless. Instead, healthcare professionals should aim to understand the societal landscape that privileges and oppresses individuals. The experiences of oppression experienced by various diverse groups are likely to provide them with a unique perspective on both the larger society and on the relationship with healthcare professionals.

OPPRESSION, PRIVILEGE, AND MARGINALIZATION

Understanding the concepts of oppression, privilege, and marginalization is essential for practicing with cultural humility. There are various aspects of individual identities that oppress or privilege people and their marginalization or empowerment. Oppression can be defined as “unjust or cruel exercise of authority or power” (Merriam-Webster, 2021). A person or group that knowingly or unknowingly abuses a specific group. Oppression is a pervasive system. It has its foundation in history and is maintained via individual and institutional systematic discrimination, personal bias, bigotry, and social prejudice. Oppression leads to a condition of privilege for the person or the group that is the oppressor(s). National Conference for Community and Justice (NCCJ; 2021). Privilege is a central concept within the healthcare professions. The concept of White privilege and male privilege was clearly articulated and widely disseminated through McIntosh’s work in the 1980s. McIntosh articulated White male privilege as “an invisible package of unearned assets which he can count on cashing in each day, but about which he was ‘meant’ to remain oblivious. White privilege is like an invisible weightless knapsack of special provisions, assurance, tools, maps, guides, codebooks, passports, visas, clothes, compass, emergency gear, and blank checks” (McIntosh, 1998, p. 1). Privileging is “a process where chances or odds of being offered an opportunity are altered or skewed to the advantage of members of certain groups” (Minarik, 2017, p. 55). Essentially, privilege functions by providing some groups of individuals (e.g., White, male, heterosexual, abled, middle class) with preferred treatment in the form of special opportunities and advantages, while withholding that preference from other individuals (e.g., African American, female, LGBTQ, disabled). Privilege can include many advantages including being given the benefit of the doubt and feeling a sense of belongingness (Minarik, 2017). Individuals who are not privileged experience the opposite – such as being an automatic suspect or having to prove belonging (Minarik, 2017). Privilege is not a guarantee of success for those groups who receive it; however, it is an advantage that other groups do not receive and allows for opportunities that others are denied (Minarik, 2017). A final key aspect regarding privilege is that it is not necessarily visible to those who receive it. The invisibility of privilege is the key component that allows it to continue. More simply, when those who receive privilege do not recognize it, they are unable to take actions to change it. Once people

become aware of privilege, they choose to use the benefits of privilege to advocate for marginalized populations. Self-Assessment Quiz Question #5 When discussing oppression and privilege, healthcare professionals should know that: a. Privilege is the commission of an unjust or cruel exercise of authority or power. b. Privilege is a guarantee of success for groups receiving it. c. Oppression’s foundation is in the “me too” movement. d. Oppression leads to a condition of privilege for the person or the group that is the oppressor(s). Marginalization is an important concept in the delivery of patient care. Marginalization is the “act of placing a person or group in positions of lesser importance, influence, or power” (Dictionary.com, 2021). Examples of groups that have been, and are being, marginalized include ethnic and racial minorities, immigrants, the LGBTQ population, persons who are disabled, and the economically disadvantaged. Some experts have identified the following three themes of marginalization (Baah et al., 2019): 1. Creation of margins : Margins act as barriers and connections between a person and the environment. Margins construct physical, emotional, and psychological boundaries that people experience during interactions with society. Enforcement and maintenance of boundaries divide the political and socioeconomic resources in an uneven fashion. This also facilitates the unbalanced distribution of critical resources such as healthcare (Baah et al., 2019). This illustrates the concept of social determinants of health (SDH), which is defined as “the circumstances in which people are born, live, work and age and the systems put in place to deal with illness” (World Health Organization [WHO], 2010). 2. Living between cultures : Living between cultures is another factor that links marginalization to SDH. Although the boundary or margin separates the dominant and peripheralized group, incomplete integration leads to a person or group that lives between cultures. Incomplete integration creates a situation where a person or group relinquishes characteristics of the marginalized group in order to bond with the dominant society, but is unable to do so. Examples of living between cultures are the ways of life of most

Book Code: SWNY1224

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