Appendix D

Glossary

Accountable care organizations: Groups of health care providers who work together to coordinate care for their patients who are covered by Medicare.

Advanced practice registered nurses (APRNs): Hold at least a master’s degree in addition to the initial nursing education and licensing required for all RNs, and may continue in clinical practice or prepare for administrative and leadership positions.

Community resilience: “Community capabilities that buffer it from or support effective responses to disasters,” and is of growing importance in disaster preparedness, particularly in underresourced areas (Wells et al., 2013, p. 1172).

Compassion fatigue: “A health care practitioner’s diminished capacity to care as a consequence of repeated exposure to the suffering of patients, and from the knowledge of their patients’ traumatic experiences” (Cavanagh et al., 2020, p. 640).

COVID-19: The official name for the disease identified as the cause of the novel coronavirus outbreak first identified in Wuhan, China, in 2019; CO stands for corona(virus), VI for virus, and D for disease. COVID-19 is a variant of a group of coronaviruses that can infect humans and animals and cause respiratory illnesses (CDC, 2020).

Cultural competency: “A set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective

work in cross-cultural situations. Competence implies the capacity to function effectively as an individual and an organization within the context of the cultural beliefs, behaviors, and needs presented by consumers and their communities” (Cross et al., 1989, p. 17).

Cultural humility: In health care, cultural humility is a goal in training and education that informs providers’ relationships to patients and people and involves “developing mutually beneficial and non-paternalistic partnerships with communities on behalf of individuals and defined population” (Tervalon and Murray-Garcia, 1998, p. 118).

Cultural racism: “The ideology of inferiority in the values, language, imagery, symbols, and unstated assumptions of the larger society” (Williams et al., 2019, p. 110).

Cultural taxation: Refers to the phenomenon whereby faculty who are individuals of color are asked routinely to take on extra, uncompensated work to address a lack of diversity in their institutions.

Culture of health: The Robert Wood Johnson Foundation (RWJF, n.d.) defines a culture of health as “one in which good health and well-being flourish across geographic, demographic, and social sectors; fostering healthy equitable communities guides public and private decision making; and everyone has the opportunity to make choices that lead to healthy lifestyles.”

Disaster: Defined as a serious disruption of the functioning of a community or a society at any scale due to hazardous events interacting with conditions of exposure, vulnerability, and capacity, leading to one or more of the following: human, material, economic, and environmental losses and impacts (UNDRR, 2017).

Discrimination: Occurs when people or institutions treat racial groups differently, with or without intent, and this difference results in inequitable access to opportunities and resources (Williams et al., 2019).

Downstream intervention: “Interventions and strategies that aim to provide equitable access to care and services to individuals, groups and communities, in order to mitigate the negative impacts of adverse health effects” (NCCDH, 2020). These interventions occur at the individual and family level.

Grey literature: Literature, writing, and research that is produced at all levels of government, academia, and private industry in both print and electronic formats but is not controlled by or associated with commercial publishers (Farace et al., 2005; Schöpfel and Farace, 2010).

Health care equity: Ensuring that access to health care and high-quality care are available to all individuals and communities.

Health disparities: Health differences that “adversely affect groups of people who have systematically experienced greater social or economic obstacles to health based on their racial or ethnic group, religion, socioeconomic status, gender, mental health, cognitive, sensory, or physical disability, sexual orientation, geographic location, or other characteristics historically linked to discrimination or exclusion” (Carter-Pokras and Baquet, 2002; HHS, 2016).

Health equity: “The state in which everyone has the opportunity to attain full health potential and no one is disadvantaged from achieving this potential because of social position or any other socially defined circumstance” (NASEM, 2017).

Health inequities: “Systematic differences in the opportunities that groups have to achieve optimal health, leading to unfair and avoidable differences in health outcomes” (NASEM, 2017).

Implicit bias: “Refers to the attitudes or stereotypes that affect our understanding, actions, and decisions in an unconscious manner” (Staats, 2013, p. 6).

Intersectionality: Recognizing the complex factors that contribute to health inequities by stressing the importance of the intersection of multiple interdependent social determinants that shape the health and well-being of individuals and communities. More specifically, the theoretical framework considers the intersection of these social determinants at the “micro level of individual experience to reflect multiple interlocking systems of privilege and oppression at the macro, social-structural level” (Bowleg, 2012, p. 1267).

Licensed practical nurses (LPNs)/licensed vocational nurses (LVNs): Support the health care team and work primarily under the supervision of a registered nurse (RN), advanced practice registered nurse, or physician. They perform basic tasks, such as taking vital signs; administering medications; changing wound dressings; and ensuring that patients are comfortable and receive nutrition and hydration. LPNs/LVNs complete a 12- to 18-month education program at a vocational/technical school or community college, and are required to take a nationally standardized licensing exam in the state where they begin practice (IOM, 2011). In nursing homes, where they predominate, they supervise nurse aides to oversee care. LPNs/LVNs can become RNs through associate’s degree or baccalaureate in nursing bridge programs.

Microaggressions: “Brief and commonplace daily verbal, behavioral, or environmental indignities, whether intentional or unintentional, that communicate

hostile, derogatory, or negative racial slights and insults toward people of color” (Sue et al., 2007, p. 273).

Midstream interventions: “Seek to reduce exposure to hazards by improving material working and living conditions, or to reduce risk by promoting healthy behaviors” (NCCDH, 2020). These interventions occur at a level between upstream factors (e.g., policy) and downstream factors (e.g., chronic illness), and often include a mixture of population- and individual-level factors, such as access to quality health care.

Moral well-being: “The highest attainable development of innate capacities that enable humans to flourish as embodied, individuated but necessarily interdependent social organisms by managing the adaptive challenges of vulnerability, constraint, connection, and cooperation in an uncertain, risky environment” (Thompson, 2018, p. 4).

Nursing informatics: “The specialty that integrates nursing science with multiple information and analytical sciences to identify, define, manage and communicate data, information, knowledge and wisdom in nursing practice” (ANA, 2015).

Population health: “The health outcomes of a group of individuals, including the distribution of such outcomes within the group” (Kindig and Stoddart, 2003, p. 381).

Posttraumatic stress disorder (PTSD): A “psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, or rape or who have been threatened with death, sexual violence or serious injury” (APA, 2020).

Public health: “The art and science of preventing disease, prolonging life and promoting health through the organized efforts of society” (Acheson, 1988).

Racism: “An organized social system in which the dominant racial group, based on an ideology of inferiority, categorizes and ranks people into social groups called ‘races’ and uses its power to devalue, disempower, and differentially allocate valued societal resources and opportunities to groups defined as inferior” (Williams et al., 2019, p. 106).

Registered nurses (RNs): Provide preventive, primary, and acute care in collaboration with other health professionals. Their roles vary enormously by setting but can include such activities as conducting health assessments and taking health histories, looking for signs that health is deteriorating or improving, providing counseling and education to promote health and manage chronic disease, admin-

istering medications and other personalized interventions and treatments, and coordinating care. RNs are required to take a nationally standardized licensing exam after completing a program at a community college, diploma school, or 4-year college or university.

Relational ethics: Defined in health care as actions that take place within relationships and consider the existence of the other (i.e., patient, nurse) (Bergum and Dossetor, 2005). Core tenets include mutual respect, engagement, embodied knowledge, environment, and uncertainty; the most important tenet is mutual respect (Pollard, 2015).

Resilience: Refers to “the capacity of dynamic systems to withstand or recover from significant disturbances” (Masten, 2007, p. 923).

Resilience engineering: Focused on “understanding the nature of adaptations, learning from success and increasing adaptive capacity” (Anderson et al., 2016, p. 1).

Social determinants of health (SDOH): The conditions of the environments in which “people live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.” These conditions include education, employment, health systems and services, housing, income and wealth, the physical environment, public safety, the social environment (including structures, institutions, and policies), and transportation at the population level. SDOH are sometimes called social influences or social factors (HHS, 2020).

Social justice: The concept that everyone deserves equal rights and opportunities. In health care, it refers to the delivery of high-quality care to all individuals.

Social needs: A person-centered concept that incorporates a person’s perception of her or his own health-related needs. Nonmedical social needs that may affect health can include housing instability, food insecurity, and exposure to violence that drives health care utilization and may impact health outcomes (NASEM, 2019).

Structural inequities: The personal, interpersonal, institutional, and systemic drivers—such as racism, sexism, classism, ableism, xenophobia, and homophobia—that make those identities salient to the fair distribution of health opportunities and outcomes (NASEM, 2017, p. 99).

Structural racism: “The processes of racism that are embedded in laws, policies, and practices of society and its institutions that provide advantages to racial groups deemed as superior, while differentially oppressing, disadvantaging, or

otherwise neglecting racial groups viewed as inferior” (Williams et al., 2019, p. 107).

Systemic racism: According to The Aspen Institute, “In many ways ‘systemic racism’ and ‘structural racism’ are synonymous. If there is a difference between the terms, it can be said to exist in the fact that a structural racism analysis pays more attention to the historical, cultural and social psychological aspects of our currently racialized society” (The Aspen Institute, 2016).

Telehealth: “The use of electronic information and telecommunications technologies to support and promote long-distance clinical health care, patient and professional health-related education, and public health and health administration” (HHS, 2020).

Trauma-informed: “A program, organization, or system that is trauma-informed realizes the widespread impact of trauma and understands potential paths for recovery; recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system; and responds by fully integrating knowledge about trauma into policies, procedures, and practices, and seeks to actively resist re-traumatization” (SAMHSA, 2014, p. 13).

Upstream interventions: These “interventions and strategies focus on improving fundamental social and economic structures in order to decrease barriers and improve supports that allow people to achieve their full health potential” (NCCDH, 2020). These interventions occur at the community and population levels.

Well-being: An inherently complex concept, encompassing an individual’s appraisal of physical, social, and psychological resources needed to meet a particular psychological, physical, or social challenge (Dodge at al., 2012).

White privilege: Defined by The Aspen Institute (2016) as “whites’ historical and contemporary advantages in access to quality education, decent jobs and liveable wages, homeownership, retirement benefits, wealth, and so on.”

REFERENCES