Chapter 2 – Inclusive Approaches to Health Assessment
Oppression can be defined as the unjustified use of power and privilege to stagnate others socially, politically, and psychologically. Oppression is imposed through demoralizing interactions, discriminatory and exclusive policies/practices, deprivations in access to resources, and publicly propagated stereotyping that create barriers to opportunities, growth, acceptance, and recognition for some groups in society (Banks & Stephens, 2018).
Oppression is often framed in opposition to privilege, which can be defined as the unearned, unobstructed access to resources, respect, acceptance, and opportunities awarded to others.
Both oppression and privilege are unscripted laws of society that, whether exercised knowingly and unknowingly, govern how we think about and interact with those considered “different.”
Oppression is both experienced and felt. Social oppression is structural, meaning it operates at all levels and systems in society, but it is experienced at the individual/group level in the form of powerlessness, trauma, feelings of unworthiness, and an indefensible struggle for recognition and acceptance. This struggle has yielded a legacy of resilience and resistance in Canada, especially among racialized and Indigenous populations, but the persistent navigation of structural barriers and personal biases has had consequences for these groups, including trauma and illness (Matheson et al., 2019).
Anti-Black racism rooted in slavery and anti-Indigenous racism rooted in colonization are known to be illness-inducing forms of oppression. Experiences of anti-Black and anti-Indigenous racism often translate to less educational and job opportunities, increased rates of incarceration, and more exposure to violence. Black and Indigenous children are more likely to be in the child welfare system (Matheson et al., 2019). These experiences increase the possibility of these individuals coming into contact with the healthcare system.
As you engage with clients in the health and healing process, try to focus on restorative practices. Try to recognize and interrupt the negative consequences of discrimination, racism, colonization, and social injustice. As a nurse, you should operate from a position of cultural sensitivity, cultural competence, cultural humility, and cultural safety, with an overarching professional responsibility to anti-oppressive practices.
An anti-oppressive framework of practice is an all-encompassing commitment to social justice and the flourishing of human dignity.
When you apply an anti-oppressive perspective to a health assessment, you will be acutely aware of the many ways that health inequities can negatively transform the health of clients, their worldviews, and their responses and interactions. This kind of understanding will help ensure that you do not stagnate the client’s healing process, and prompt you to take action to confront discriminatory and exclusive practices within the healthcare system that might hinder the client’s access to equitable care.
For example, Black youth in Toronto are disproportionately affected by gun violence deaths and injuries. The social stigma of experiences with gun violence often has negative effects on the care they receive from healthcare providers (Khenti, 2018). When assessing a young Black man with an injury, a nurse who is aware of the concepts of culture will understand that race puts the client at risk for this type of injury. From an anti-oppressive perspective, the nurse further understands that racial inequities and social stigma associated with this type of injury may affect healthcare workers’ views and interactions with this young man and put him at risk for discriminatory care. Awareness of this possibility might prompt the nurse to obtain information needed to help advocate for health resources for the client, and also to support all members of the healthcare team in providing accessible and empathetic care.
Activity: Check Your Understanding
Banks, K. H., & Stephens, J. (2018). Reframing internalized racial oppression and charting a way forward. Social Issues and Policy Review, 12(1), 91-111. https://doi.org/10.1111/sipr.12041
Khenti, A. A. (2018). Three decades of epidemic black gun homicide victimization in Toronto: Analyzing causes and consequences of criminological approach. (Doctoral dissertation). https://yorkspace.library.yorku.ca/xmlui/handle/10315/34979
Matheson, K., Foster, M. D., Bombay, A., McQuaid, R. J., & Anisman, H. (2019). Traumatic experiences, perceived discrimination, and psychological distress among members of various socially marginalized groups. Frontiers in Psychology, 10, 416. https://doi.org/10.3389/fpsyg.2019.00416
refers to barriers that affect certain groups disproportionately and perpetuate disparities in outcomes. These structures can include practices, policies, and norms that privilege advantaged groups while systematically disadvantaging oppressed and marginalized groups.
is when an oppressed person/group internalizes the beliefs of the advantaged group or the group in power, making them feel like they have no power.