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Social Class


First, social class affects the incidence of mental illness. To be more specific, poor people exhibit more mental health problems than richer people: They are more likely to suffer from schizophrenia, serious depression, and other problems. A major reason for this link is the stress of living in poverty and the many living conditions associated with it. One interesting causal question here is whether poverty leads to mental illness or mental illness leads to poverty. Although there is evidence of both causal paths, most scholars believe that poverty contributes to mental illness more than the reverse (Warren, 2009).[38]

Race and Ethnicity


Second, there is no clear connection between race/ethnicity and mental illness, as evidence on this issue is mixed: Although many studies find higher rates of mental disorder among people of color, some studies find similar rates to whites’ rates (Mossakowski, 2008). [39] These mixed results are somewhat surprising because several racial/ethnic groups are poorer than whites and more likely to experience everyday discrimination, and for these reasons should exhibit more frequent symptoms of mental and emotional problems. Despite the mixed results, a fair conclusion from the most recent research is that African Americans and Latinos are more likely than whites to exhibit signs of mental distress (Jang, Chiriboga, Kim, & Phillips, 2008; Mossakowski, 2008). [40]

Gender


Third, gender is related to mental illness but in complex ways, as the nature of this relationship depends on the type of mental disorder. Women have higher rates of manic-depressive disorders than men and are more likely to be seriously depressed, but men have higher rates of antisocial personality disorders that lead them to be a threat to others (Kort-Butler, 2009). [41]Although some medical researchers trace these differences to sex-linked biological differences, sociologists attribute them to differences in gender socialization that lead women to keep problems inside themselves while encouraging men to express their problems outwardly, as through violence. To the extent that women have higher levels of depression and other mental health problems, the factors that account for their poorer physical health, including their higher rates of poverty and stress and rates of everyday discrimination, are thought to also account for their poorer mental health (Read & Gorman, 2010). [42]


KEY TAKEAWAYS


  • Social class, race and ethnicity, and gender all influence the quality of health in the United States. Health problems are more common among people from low-income backgrounds and among people of color. Women are more likely than men to have health problems that are not life threatening.

  • Although debate continues over whether mental illness is a social construction, many people do suffer mental health problems. The social epidemiology for mental health and illness resembles that for physical health and illness, with social class, race/ethnicity, and gender disparities existing.

  • The private insurance model in the United States incurs huge administrative costs and results in more than 50 million people lacking health insurance.



FOR YOUR REVIEW


  1. In thinking about the health problems of individuals from low-income backgrounds, some people blame lack of access to adequate health care for these problems, while other people blame unhealthy lifestyles practiced by low-income individuals. Where do you stand on this debate? Explain your answer.

  2. Write a brief essay in which you present a sociological explanation of the higher rate of depression found among women than among men.

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[3] Coleman-Jensen, A., Nord, M., Andrews, M., & Carlson, S. (2011). Household food security in the United States in 2010. Washington, DC: US Department of Agriculture.

[4] National Center for Health Statistics. (2011). Health, United States, 2010. Hyattsville, MD: Centers for Disease Control and Prevention.

[5] Van Cleave, J., Gortmaker, S. L., & Perrin, J. M. (2010). Dynamics of obesity and chronic health conditions among children and youth. JAMA, 303(7), 623–630.

[6] Centers for Disease Control and Prevention. (2011). CDC health disparities and inequalities report—United States, 2011. Morbidity and Mortality Weekly Report, 60, 1–114.

[7] National Center for Health Statistics. (2011). Health, United States, 2010. Hyattsville, MD: Centers for Disease Control and Prevention.

[8] Haas, S. A., Glymour, M., & Berkman, L. F. (2011). Childhood health and labor market inequality over the life course. Journal of Health and Social Behavior, 52, 298–313; Kaplan, G. A. (2009). The poor pay more: Poverty’s high cost to health. Princeton, NJ: Robert Wood Johnson Foundation; Murphey, D., Mackintosh, B., & McCoy-Roth, M. (2011). Early childhood policy focus: Health eating and physical activity. Early Childhood Highlights, 2(3), 1–9; Robert Wood Johnson Foundation. (2008). America’s health starts with healthy children: How do states compare? Princeton, NJ: Author.

[9] Kaplan, G. A. (2009). The poor pay more: Poverty’s high cost to health. Princeton, NJ: Robert Wood Johnson Foundation.

[10] Pampel, F. C., Krueger, P. M., & Denney, J. T. (2010). Socioeconomic disparities in health behaviors. Annual Review of Sociology, 36, 349–370.

[11] Elo, I. T. (2009). Social class differentials in health and mortality: Patterns and explanations in comparative perspective. Annual Review of Sociology, 35, 553–572.

[12] Elo, I. T. (2009). Social class differentials in health and mortality: Patterns and explanations in comparative perspective. Annual Review of Sociology, 35, 553–572.

[13] Wray, L. A., Herzog, A. R., Willis, R. J., & Wallace, R. B. (1998). The impact of education and heart attack on smoking cessation among middle-aged adults. Journal of Health and Social Behavior, 39, 271–294.

[14] Pampel, F. C., Krueger, P. M., & Denney, J. T. (2010). Socioeconomic disparities in health behaviors. Annual Review of Sociology, 36, 349–370.

[15] Penn, N. E., Kramer, J., Skinner, J. F., Velasquez, R. J., Yee, B. W. K., Arellano, L. M., et al. (2000). Health practices and health-care systems among cultural groups. In R. M. Eisler & M. Hersen (Eds.), Handbook of gender, culture, and health (pp. 101–132). New York, NY: Routledge.

[16] Parra-Medina, D., Wilcox, S., Wilson, D. K., Addy, C. L., Felton, G., & Poston, M. B. (2010). Heart healthy and ethnically relevant (HHER) lifestyle trial for improving diet and physical activity in underserved African American women. Contemporary Clinical Trials, 31(1), 92–104.

[17] Pérez-Escamilla, R. (2009). Dietary quality among Latinos: Is acculturation making us sick? Journal of the American Dietetic Association, 109(6), 988–991.

[18] Bratter, J. L., & Gorman, B. K. (2011). Is discrimination an equal opportunity risk? Racial experiences, socioeconomic status, and health status among black and white adults. Journal of Health and Social Behavior, 52, 365–382.

[19] Lee, M.-A., & Ferraro, K. F. (2009). Perceived discrimination and health among Puerto Rican and Mexican Americans: Buffering effect of the lazo matrimonial? Social Science & Medicine, 68, 1966–1974.

[20] Meckler, L. (1998, November 27). Health gap between races persists. Ocala Star-Banner, p. 4A.

[21] Meckler, L. (1998, November 27). Health gap between races persists. Ocala Star-Banner, p. 4A; Ricker, P. P., & Bird, C. E. (2005). Rethinking gender differences in health: Why we need to integrate social and biological perspectives. Journals of Gerontology Series B, 60, S40–S47.

[22] Frank, R. (2007). What to make of it? The (Re)emergence of a biological conceptualization of race in health disparities research. Social Science & Medicine, 64(10), 1977–1983.

[23] Walker, A. K. (2011, November 20). Where you live can help determine your health, studies say. Bangor Daily News. Retrieved fromhttp://bangordailynews.com/2011/11/20/health/where-you-live-can-help-determine-your-health-studies-say.

[24] Michney, T. M. (2011). White civic visions versus black suburban aspirations: Cleveland’s Garden Valley urban renewal project. Journal of Planning History, 10(4), 282–309.

[25] Cernansky, R. (2011, February 8). Cancer alley: Big industry & bigger illness along Mississippi River. Retrieved from http://www.treehugger.com/corporate-responsibility/cancer-alley-big-industry-bigger-illness-along-mississippi-river.html.

[26] Gorman, B. K., & Read, J. G. (2006). Gender disparities in adult health: An examination of three measures of morbidity. Journal of Health and Social Behavior, 47(2), 95–110.

[27] Kuller, L. H. (2010). Cardiovascular disease is preventable among women. Expert Review of Cardiovascular Therapy, 8(2), 175–187.

[28] Guttman, M. (1999, June 11–13). Why more men are finally going to the doctor. USA Weekend, p. 10.

[29] Emmers-Sommer, T. M., Nebel, S., Allison, M.-L., Cannella, M. L., Cartmill, D., Ewing, S., et al. (2009). Patient-provider communication about sexual health: The relationship with gender, age, gender-stereotypical beliefs, and perceptions of communication inappropriateness. Sex Roles: A Journal of Research, 60, 9–10.

[30] Foreman, J. (1999, June 14). A vist most men would rather not make. The Boston Globe, p. C1.

[31] Guttman, M. (1999, June 11–13). Why more men are finally going to the doctor. USA Weekend, p. 10.

[32] Read, J. G., & Gorman, B. M. (2010). Gender and health inequality. Annual Review of Sociology, 36, 371–386.

[33] Read, J. G., & Gorman, B. M. (2010). Gender and health inequality. Annual Review of Sociology, 36, 371–386.

[34] Landry, L. J., & Mercurio, A. E. (2009). Discrimination and women’s mental health: The mediating role of control. Sex Roles: A Journal of Research, 61, 3–4.

[35] McNally, R. J. (2011). What is mental illness? Cambridge, MA: Belknap Press.

[36] Szasz, T. S. (2010). The myth of mental illness: Foundations of a theory of personal conduct. New York, NY: Harper Perennial.

[37] Cockerham, W. C. (2011). Sociology of mental disorder (8th ed.). Upper Saddle River, NJ: Prentice Hall.

[38] Warren, J. R. (2009). Socioeconomic status and health across the life course: A test of the social causation and health selection hypotheses. Social Forces, 87(4), 2125–2153.

[39] Mossakowski, K. N. (2008). Dissecting the influence of race, ethnicity, and socioeconomic status on mental health in young adulthood. Research on Aging, 30(6), 649–671.

[40] Jang, Y., Chiriboga, D. A., Kim, G., & Phillips, K. (2008). Depressive symptoms in four racial and ethnic groups: The survey of older Floridians (SOF). Research on Aging, 30(4), 488–502; Mossakowski, K. N. (2008). Dissecting the influence of race, ethnicity, and socioeconomic status on mental health in young adulthood. Research on Aging, 30(6), 649–671.

[41] Kort-Butler, L. A. (2009). Coping styles and sex differences in depressive symptoms and delinquent behavior. Journal of Youth and Adolescence, 38(1), 122–136.

[42] Read, J. G., & Gorman, B. M. (2010). Gender and health inequality. Annual Review of Sociology, 36, 371–386.


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