Exposing the Determinants: Keynote

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Exposing the Determinants: Keynote to 5th Annual Gay Men's Health Summit held in Vancouver, BC on November 9th and 10th 2009.

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Exposing the Determinants: Keynote

  1. 1. 5 th Exposing the Determinants 10 th
  2. 2. What’s so gay about…? <ul><li>Income and Social Status </li></ul><ul><li>Social Support Networks </li></ul><ul><li>Education and Literacy </li></ul><ul><li>Employment/Working Conditions </li></ul><ul><li>Social Environments </li></ul><ul><li>Physical Environments </li></ul><ul><li>Personal Health Practices and Coping Skills </li></ul><ul><li>Healthy Child Development </li></ul><ul><li>Biology and Genetic Endowment </li></ul><ul><li>Health Services </li></ul><ul><li>Gender </li></ul><ul><li>Culture </li></ul>
  3. 3. A decade of surveys… 2000 Gay Health Vancouver, n=550 2001 Rapid Assessment 2002 Pride, n=1,900 2003 Pilot, n=250 2004 Pride, n=2,800, 2005 Pilot, n=440 2006 Online, n=1,300 2007 Online, n=1,500 2008 Online, n=1,450
  4. 5. Income & Social Status No observed risk gradient Exposing the Determinants
  5. 6. Social Support Networks 62% “starved for company” at times 28% often Exposing the Determinants
  6. 7. Education & Literacy 72% tertiary education 75% < $70K Exposing the Determinants
  7. 8. Employment & Working Conditions 24% career affected 55% < $50K Exposing the Determinants
  8. 9. Physical Environments 71% dissatisfied with gay spaces Exposing the Determinants
  9. 10. Social Environments Exposing the Determinants internet community
  10. 11. Personal Health Practices Exposing the Determinants HIV risk untested
  11. 12. Exposing the Determinants Child Development 30% unwanted sex prior to 18
  12. 13. Exposing the Determinants Biological Endowment 71% feel oppressed at times 30% often
  13. 14. Exposing the Determinants Health Services 50% satisfaction with gay prevention
  14. 15. Exposing the Determinants Gender 50% single 26% man-partnered 6% man-married 16% woman-married/partnered
  15. 16. Exposing the Determinants Culture 51% exposed to anti-gay opression
  16. 17. Common cause <ul><li>homonegativity, heterosexism , homophobia, heteronormativity, moral panic, erasure , denialism, exclusion, institutional neglect , oppression, homonegativity , heterosexism, homophobia, heteronormativity, moral panic , erasure, denialism , exclusion , institutional neglect, oppression , homonegativity, heterosexism, homophobia, heteronormativity , moral panic, erasure , denialism…. </li></ul>
  17. 18. A missing determinant? <ul><li>Income and Social Status </li></ul><ul><li>Social Support Networks </li></ul><ul><li>Education and Literacy </li></ul><ul><li>Employment/Working Conditions </li></ul><ul><li>Social Environments </li></ul><ul><li>Physical Environments </li></ul><ul><li>Personal Health Practices and Coping Skills </li></ul><ul><li>Healthy Child Development </li></ul><ul><li>Biology and Genetic Endowment </li></ul><ul><li>Health Services </li></ul><ul><li>Gender </li></ul><ul><li>Culture </li></ul>
  18. 19. Jonathan Mann Proximate cause ≠ Root cause
  19. 20. Jonathan Mann “ HIV follows a path of least resistance through society’s most marginalized.” * International Conference on Health & Human Rights, Harvard 1994
  20. 21. Social conditions <ul><li>inclusion practices, awards committees , employment opportunity, review panels, policy decisions , staff composition, institutional behaviour , social equity, working environment , moral agendas, stigma, grants committees , employment practices, promotion, policy decisions , staff composition, institutional neglect , social equity, working conditions , moral agendas, stigma …. </li></ul>
  21. 23. Elizabeth Pisani
  22. 24. <ul><li>“ HIV is very good at exploiting the diversity of </li></ul><ul><li>human nature.” </li></ul><ul><li>* The Wisdom of Whores, 2009 </li></ul>Elizabeth Pisani
  23. 25. <ul><li>“ New HIV-infections among gay men are rising </li></ul><ul><li>everywhere they are measured .” </li></ul><ul><li>* The Wisdom of Whores Blog, 2009 </li></ul>Elizabeth Pisani
  24. 26. Gary Dowsett “ Homosexuality is the fundament of all suspicion about sex beyond the normative, and even casts doubt on the normative itself.” * The gay plague revisited: AIDS and its enduring moral panic, 2009
  25. 27. <ul><li>“ Not that others affected by HIV are not </li></ul><ul><li>marginalized, stigmatized or persecuted. They are </li></ul><ul><li>But I would argue they can only be so mistreated </li></ul><ul><li>because of the ease with which the homosexual can be </li></ul><ul><li>mistreated first. ” </li></ul><ul><li>* The Gay Plague Revisited: AIDS an its enduring moral panic, 2009 </li></ul>Gary Dowsett
  26. 28. <ul><li>“ Everything from child sexual abuse, to being </li></ul><ul><li>bullied in school, the ways dominant culture is negative </li></ul><ul><li>to homosexuality has a relationship to adult behaviours </li></ul><ul><li>that lead to HIV risk. ” </li></ul><ul><li>Australasian Sexual Health and HIV Conference, 2009 </li></ul>Judith Auerbach
  27. 29. Michel Foucault “ One day we will look back on sexuality and wonder why we gave it so much importance.” * The History of Sexuality, 1980
  28. 30. Exposing the Determinants… Are we asking the right questions? 10 th
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