Your task for this assignment is to reflect on where you currently fall within Nieto’s Beyond Inclusion, Beyond Empowerment Framework in terms of the ranking system, and reflect on how this affects you and your patients in your clinical practice setting.
First, copy and paste the chart below into a word processing program, and fill in what your current relationship is to each of the rank categories.
If you feel confused about where you fall, read back through the Nieto reading. Remember that status is different than rank and that although you may have experienced low status treatment in one of your rank categories where you are an agent, this does not affect your agent rank.
For example, if a man is picked-on by a woman because he is a man, this is an example of low-status treatment; it does NOT change his position as Agent within the ranking system of gender. In another example, a White person may have experienced prejudice from a Person of Color, but this does not affect their position as Agent within the ranking system of Race.
Remember also to concentrate on each “channel” of the ranking system individually. For example, if you are disabled, you may not feel like you experience agency in terms of Age rank, but it is important to remember that Age is a different “channel” than Disability. If it helps, you can compare yourself with other people in the same rank–for example, ask yourself who has more access to structural power, who is given more authority in our culture? A disabled person who is 30, or a disabled person who is 6 or 80?
Also remember that in terms of Social Class, Nieto includes most of the middle class and even large numbers of the working class among the “agent” group. You can be considered an agent if you have access to higher education, which we all have as people who meet together in a college classroom.
Pay careful attention to Nieto’s discussion of Indigenous Heritage. If you are indigenous to land outside of the US and its territories, then you are an Agent in this rank category.
Fill in the chart as best you can. Some of you may find yourself having all Agent Ranks, and some of you may find yourselves having mostly Target ranks.
This is the part that needs to be done!
Below is the Rank Table
Rank Relationship to Rank
Age Agent
Disability Agent
Race Target
Religious Culture Target
Ethnicity Target
Social Class Culture Agent
Sexual Orientation Agent
Indigenous Heritage Agent
National Origin Target
Gender Target
Finally, write an essay of minimum 500 words (single space) where you reflect on two Rank categories, and how they affect you and your patients in your clinical practice setting (or student setting). First, use County Health Rankings (Links to an external site.) to identify and describe disparities faced by populations served in your clinical practice setting. Choose two ranks that you see are at play (Age, Disability, Ethnicity, Gender, etc), and give one specific example for each rank. How are you and your patients affected by the rank disparities you have chosen? Fewer points will be awarded for general answers.
In your paragraph, you must show that you completed the reading in Nieto by including a minimum of two quotes from Nieto (with page numbers) to support your statements. The quotes should be taken from pages 45-77 of the Nieto reading. (Nieto’s Beyond Inclusion, Beyond Empowerment Framework textbook)
