Sociology 1020 Exam 2

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Generations

First generation: foreign-born living in the US 1.5 generation: individuals who immigrate before/during their teens Second generation: US-born children to at least one immigrant parent Note: more assimilation among 2nd+ generations

Similarities across articles

Focus on a restrictive law or the threat of restrictive laws as an environmental stressor that affects birth outcomes for a specific population ◦Prenatal period is highly sensitive to the environment Preterm births/low birth weight=long-term consequences for health The threat of punitive laws, even if not enforced Proposed explanations for unique stressor: physiological responses, distress/anxiety, health-care utilization, (unhealthy) behavioral responses Unable to focus just on undocumented mothers

Life Expectancy at Age 65

Foreign born hispanics have the highest life expectancy, even greater than U.S born hispanics

Educational Attainment, Females 65+

Foreign born hispanics have the most of their population with less than HS education, then US born hispanics, then blacks, and lastly whites

LGBT Mental Health

Proportion of adults who have committed suicide is much higher in lgbt populations, with trans people being the highest

4. Institutional Discrimination: Mass Incarceration

The lifetime cumulative risk (measured to age 34) of imprisonment for all African American men is over 20%. Among African American men without a high school diploma, the lifetime risk of incarceration is 59%. These estimates are at least five times higher than the rates of comparable Whites

What is Stress?

When environmental demands tax the adaptive capacity of a person In other words, stress is a biological and psychological response when encountering a threat we feel we do not have the resources to deal with

Infant Mortality Rate, 2000-2013

Lowest for hispanics currently, neck and neck with whites. the rate for black infants is much higher

Trans Health

"Association Between Gender Minority Stats and Self-Reported Physical and Mental Health in the United States" in JAMA Internal Medicine (2017) The study found that gender minority individuals (compared to cisgender individuals): ◦Had lower levels of education ◦Had lower household income ◦More likely to be unemployed ◦Less likely to have health insurance ◦More likely to have unmet health care needs due to the cost ◦More likely to be overweight ◦More likely to report diagnosed depression ◦More likely to drink alcohol ◦More likely to be an everyday current smoker ◦More likely to rate their health as poor/fair

1. Why do men live shorter lives despite having more power, status, SES?

"Constructions of masculinity" 1.Men adopt beliefs and behaviors that increase their mortality risk ◦High agreement in the US about typically feminine vs. masculine behaviors; men's beliefs/behaviors are way to demonstrate masculinity ◦For example, men may deny depression to demonstrate masculinity and distance themselves from women (for whom depression is more acceptable) 2.Men are less likely to engage in behaviors that promote health and longevity

Gender and Health Trends

"Women get sicker but men die quicker" ◦Women live longer, but have worse health overall throughout their life

Health & Society: Race

-Higher SES= Higher health outcome -SES affects health due to the fundamental cause theory -Example 1: Opioid Overdoses Rise when Automotive Assembly Plants Close -Russian Life expectancy is about 67, much less than other developed countries.

Types of stressors

-chronic -life events -daily hassles

Possible Explanations for the Hispanic Paradox?

1. Cultural/social factors that protect health ◦Family networks, food, smoking 2. Healthy immigrant selection ◦That is, must be healthy to leave home and travel 3. Salmon bias effect ◦Less healthy Hispanics return home, lowering mortality rates for those in the US 4. Data artifact Under-reporting of deaths, not great data, undocumented folks

Evidence?

1. Cultural/social factors that protect health ◦Some support for smoking - accounts for 50% of Hispanic advantage 2. Healthy immigrant selection ◦Not much support - 2nd generation still have advantage (although declines some) 3. Salmon bias effect ◦Not much support - Cubans have advantage (can't return); infant mortality advantage within first few days of birth 4. Data artifact Not much support - better data now and still see advantage

Two Concerning Patterns of Gender and Health

1. Men live shorter lives than women, despite being in an advantaged position (e.g., status, SES) 2. Women typically have worse mental and physical health throughout their lives

Reasons for Race Disparities in Health?

1.Income and education 2.Individual discrimination (e.g., internalized racism) 3.Interpersonal discrimination (e.g., everyday discrimination) 4.Institutional discrimination (e.g., residential segregation, mass incarceration)

Hispanic Population

2018 estimates: 18.3% of US population identifies as Hispanic or Latino ◦Approximately 60,000,000 people ◦Largest minority in the US Note: Most identify their race as "white"

Biological Activation: Weathering

An erosion of health by constant stress - stressors that are chronic and repeated throughout life ◦These stressors add up and have long-term consequences for health Focuses on lived experiences, not genetics or unhealthy behaviors One example: Black women experienced increasingly worse birth outcomes in their 20s compared to their late teen years (Geronimus 1992; Geronimus 1996) ◦In contrast to the idea that 20s and 30s are 'prime' childbearing years

LGBT Population

An estimated 4.5% of the adult population in the US identifies as LGBT (Over 11,000,000 adults)

Ancestry vs. Race

Ancestry ◦Inheritance of DNA from ancestors/descendants ◦Groups of people thought to share similar genetics Race ◦Sociocultural entities rather than genetically bounded categories

Race as a Social Construct

Biological differences in race do not exist ◦Race is not fixed or natural ◦Two people of different races may be more genetically similar than two people of the same race Definitions of race in the US change over time ◦Example: Irish used to be seen as non-white

Bisexual Population

Bisexuals are the largest group within the LGBT community The bisexual population is growing

Race & Health

Black Americans are also disadvantaged in: ◦Other measures of mortality (infant mortality, maternal mortality, homicide) ◦Other measures of health: heart disease, diabetes, many cancers, obesity, etc.

FYI, some reasons for race differences in incarceration

Blackness intertwined with notions of criminality Surveillance ◦Nonwhites singled out as potential criminals ◦For example, "stop and frisk" policy mostly applied to nonwhite Americans ◦Racial profiling results in more nonwhites being arrested ◦Target poor, nonwhite neighborhoods Unjust Sentencing ◦Life sentences and death penalty more likely given to nonwhites

Life Expectancy, 1970-2010

Blacks: started at a low age compared to others, but steady increase, gap seems to be decreasing All races: somewhat steady increase, kind of stagnant White: above all other races

3. Interpersonal Discrimination

Can be major experiences of discrimination (e.g., unfairly fired or stopped by police), as well as more minor, everyday experiences (e.g., treated with less courtesy, poorer service in stores)

1899 explanation for racial disparity in health

Common perception of the time: health differences due to innate biological differences between racial groups Du Bois: causes are social; "vastly different conditions" under which black and white folks lived

Bisexual Health

Compared to gay and lesbian people, bisexuals have: ◦More depression, anxiety, and mood disorders ◦More sexually transmitted infections ◦Higher rates of certain cancers ◦Higher rates of obesity Higher levels of stigma

Other Health Concerns

Compared to straight adults, LGBT adults are ◦More likely to smoke, drink alcohol, use drugs ◦Less likely to have access to health care ◦Have higher rates of stress ◦Think about the discussion of minority stress in your article for today "Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations"◦More likely to be overweight (especially lesbian and bisexual women) ◦More likely to have several cancers and other chronic conditions

Migration

Definition: the process by which individuals move from one place to another ◦Immigration and emigration (FYI) Foreign-born people in the US ◦Legal permanent residents ◦Foreign-born citizens ◦Legal temporary residents ◦Unauthorized immigrants ◦11 million in the US, most of whom have lived in US for 10+ years

Traditional Views of Masculinity and Femininity (some examples)

Femininity ◦Warm and expressive ◦Other-orientation: focus on needs of others instead of personal fulfillment ◦Caring and nurturing ◦Responsible for domestic sphere and nurturing Masculinity ◦Stoic/not emotional, denying weakness ◦Independent, competitive ◦Dismissal of need for help

Gender Identity & Transgender

Gender identity ◦One's concept of self as male or female (or neither) - how individuals perceive themselves ◦Gender identity can be the same or different from their sex assigned at birth Transgender ◦People whose gender identity is different from the sex they were assigned at birth ◦Does not imply any specific sexual orientation We often say "LGBT" without thinking about it, but sometimes we can't lump sexuality and gender identity together

Gendered Vulnerabilities

Gendered vulnerabilities: Vulnerabilities associated with social exposures that differ for men and women ◦Gendered behaviors and vulnerabilities are not a consequence of genetic sex Reasons: Gendered occupations and divisions of labor, as well as gendered leisure activities and ways of coping with stress ◦Also: health care experiences

FYI

In the second half of the video "Why women are paid less, explained", they talk about two countries with some of the smallest gender pay gaps in the world: Rwanda ◦Women had very little power in Rwanda, but after the country's genocide in 1994 (which predominantly affected men/boys), about 60-70% of the population was female. ◦The country had to give women more power to rebuild. Now women hold about 60% of parliament seats (for example), which is the highest in the world Iceland ◦Massive strikes promoting women's rights/equality in the 1970s led to the election of the first female president in the world in 1980 and policy changes in the 1980s ◦Implemented generous paid maternity in the 80s which shrunk the pay gap some, but the gap shrunk considerably once they also added paid paternity leave in 2000

The Gender Pay Gap & Motherhood

In the video from class (2/27), we learned about the gender pay gap, which primarily exists among women who are also mothers. Some more information about motherhood and work (for context): ◦Mothers are less likely to be hired than non-mothers with the same experience/qualifications ◦Stereotype that mothers are less committed to their careers ◦Mothers more likely than fathers to care for children ◦This curtails time and effort available to pursue careers ◦Mothers more likely than fathers to experience career interruptions to care for a child or family member (see next slide) Historically, most women would become mothers (~90%), so this motherhood penalty will apply to most women in the U.S.

Incarceration & Health

Incarceration is a strong predictor of long-term health ◦People who have been incarcerated report significantly worse health compared to people who have never been incarcerated ◦Incarcerated individuals also have limited access to housing, employment opportunities, voting rights, welfare programs, health services, and financial aid for higher education when they return to their communities Black Americans are disproportionately incarcerated, so this partly explains why black Americans (especially men) have worse health than white Americans

2. Intrapersonal (Individual) Discrimination

Internalized racism - internalized attitudes and beliefs about one's innate inferiority And stereotype threat -at risk of confirming a negative stereotype about one's group

Examples of Levels of Discrimination

Intra-individual ◦Own behaviors and beliefs (e.g., am I bossy or a leader?) Interpersonal ◦Doctor-patient interactions ◦Hiring/promotion ◦Gender-based harassment (e.g., street harassment) ◦Family interactions; interactions at school Institutional ◦No Equal Rights Amendment ◦No paid maternity/paternity leave ◦Glass ceiling

Gender as a Social Construct

Like race, gender is often considered a social construct because: 1. How to act like a man/woman is learned and can change over time ◦Learned at home, at school, with friends, etc. ◦Begins at birth and never ends 2. Gender can be different in other cultures

What is the Hispanic Paradox?

Life expectancy for hispanics are much higher than one would think, even higher than whites.

Evidence for Biological Explanations?

Male fetuses and infants have higher mortality rates in U.S. Female mortality advantage observed in all high-income countries ◦Protective effect of estrogen, for example

Big Points

Migration ◦Large number of foreign-born people in the US ◦Immigrants often have high levels of education, especially if from countries further from the US Generations: Assimilation ◦Assimilation tends to happen with more time in the US (and for 2nd, 3rd, etc. generations) ◦Health advantage tends to be reduced for 2nd, 3rd, etc. generations

Beliefs & Behavior: Ron Swanson's Masculinity

More masculine than a gladiator Eat lots of protein, preferably red meat Stoic/not emotional ◦Rage is the only acceptable emotion Small friend network Selfishness is key Importance of status/success ◦Capitalism separates smart from poor

2. Why Do Women Have Worse Health Overall?

Norms of femininity, especially "other-orientation" Socioeconomic gender stratification (i.e., SES disadvantage) Gender discrimination/bias/stereotypes *This fits our understanding of health inequalities better

Definitions of Race & Ethnicity

Race ◦Definition: A group of people who share a set of characteristics (usually physical characteristics) and are said to share a common bloodline ◦Main U.S. Race Categories: White, Black/African American, American Indian or Alaska Native, Asian, Native Hawaiian or Pacific Islander Ethnicity ◦Definition: One's ethnic quality or affiliation. A social group that has a common national or cultural tradition ◦Example: Hispanic, Irish, German

1. Income & Education

Race differences in SES (education, income, wealth, occupation) explain a large part of the disparity in health ◦African Americans and Hispanics have lower levels of education, income, and wealth than Whites ◦African Americans and Hispanics are more likely than whites to have unstable, low-paying, monotonous, unrewarding jobs, often with hazardous conditions Race & SES are tightly linked in the US HOWEVER, this is not the full story. College educated black adults still have worse health than college educated white adults, for example.

Racial Discrimination

Racism and discrimination can be ◦Individual: internalized racism ◦Interpersonal: major experiences of discrimination (e.g., being fired unfairly) and everyday discrimination (e.g., treated with less courtesy than others) ◦Cultural: representation, stereotypes ◦Institutional: residential segregation, mass incarceration

4. Institutional Discrimination: Residential Segregation

Residential segregation creates areas of concentrated poverty and social disorder Segregation contributes to health in multiple ways ◦SES attainment (e.g., quality of schools, job opportunities) ◦Access to food and exercise ◦Ads for tobacco and alcohol ◦Exposure to more stressors (financial and other) ◦Weakened community and less trust ◦Exposure to toxins and poor-quality housing ◦Crime and safety ◦Access to care

Generations and Health

Second generation usually has less of a health advantage compared to the first generation (foreign-born) ◦Somewhat paradoxical because SES tends to improve in the second generation Why? ◦Possible explanations: adapt unhealthy American behaviors, longer exposure to inadequate health care, experience discrimination in the US

Sex and gender

Sex ◦Typically describes biological differences that distinguish males from females ◦Examples: Chromosomes (XX (female) or XY (male)) or anatomy Gender ◦Social and cultural norms and roles associated with each sex ◦Not assigned by genetics ◦"Doing Gender:" Gender is the product of interactions with others ◦Examples? ◦ What is masculine or feminine? How should women dress? How should men act in the workplace?

Sex-Specific Vulnerabilities

Sex-specific vulnerabilities: differences in outcomes linked to an XX or XY chromosome ◦Note: Sex genotype does not cause these outcomes, but is a necessary precondition ◦May also be caused by environmental risk, poverty, etc.

Educational Attainment, Males 65+

Similar to females except black is switched with US born hispanics

Anti-Trans Violence

Some evidence suggests the life expectancy of trans women in America is between 30 and 35 years ◦Especially high mortality rates for trans women of color

Differences across articles

Specific law vs. general rhetoric around campaign #2 focused on all Latina mothers (not just foreign-born) - likely an underestimate #1 looked at awareness/concern by monitoring Google searches and newspaper references ◦Also looked at change in deportations

Gay & Bisexual Men: Mental Health

Suicide and HIV Related mortality rates have reached the same level HIV dipped, suicide steadily increased

One Caveat of the Hispanic Paradox

The Hispanic Paradox primarily applies to mortality. Hispanics are disadvantaged relative to whites for several health outcomes, including diabetes and disability ◦Hispanic adults could be living longer in worse health

Biopsychosocial & Behavioral Model

This is the overarching model for understanding how stress gets under the skin Responses to stress include: ◦Biological - Sympathetic nervous system (SNS) arousal & upregulation of the hypothalamic-pituitary-adrenocortical axis (HPA) ◦Cortisol (the "stress hormone") produced in the adrenal gland ◦Psychological - Depression, anxiety, PTSD ◦Social/SES - Relationship strain, isolation, adult SES opportunities ◦Behavioral - Smoking, overeating, alcohol use/abuse Note: These are just a few examples for each category

Human Sexuality

Three distinct domains: ◦Sexual attraction: Patterns of romantic or sexual feelings toward others ◦Sexual orientation is closely related term: sexual attractions to others based on their gender ◦Sexual behavior (e.g., sexual activity) ◦Sexual Identity (e.g., gay, lesbian, bisexual, heterosexual, plus many others)

Life Expectancy, 2017

White men: 76.4 Black men: 71.9 White women: 81.2 Black women: 78.5

Inequality in Wealth

Whites are the wealthiest, followed by asians, the hispanics, and lastly blacks

Inequality in Poverty

Whites have the least amount of people in poverty, followed by hispanics, then blacks

Behavior: The Role of Smoking

Why would women live longer despite having worse health? A lot of support for the idea that women's mortality advantage is due to women having less severe conditions related to smoking ◦Men with conditions associated with smoking are more likely than women with these conditions to die ◦Women are more likely to have lower-risk conditions ◦That is, women may suffer from conditions that affect quality of life (e.g., arthritis), but aren't as deadly as conditions affecting men (e.g., cardiovascular disease) ◦Most evidence for this explanation, but no complete explanation for the paradox With smoking ads were targeted towards men, when they started to reach out to women smoking rates decreased due to health concerns

1. Other Thoughts on Why Women Live Longer?

Women have larger social networks ◦Women "tend or befriend" in response to stress Some social norms might benefit women (discouraging smoking, excessive drinking, maybe less red meat) Women can/should express emotions and seek help Women as health experts - more frequent medical care

More Info on Gender & Occupation

Women outnumber men in undergraduate enrollments, but much less likely to major in STEM ◦Gendered ideas about who a scientist is are seen in small children ◦When kids are asked "draw a picture of a scientist," they are much more likely to draw a man ◦Boys more likely to be pushed toward STEM classes/majors/careers in K-12 ◦Gendered stereotypes affect employment prospects ◦This is seen in experimental studies when men and women score similarly on aptitude tests, but employers prefer male candidates Occupations with a high percentage of female workers have lower median earnings ◦This is especially true for professions related to caregiving

Evidence Against Biological Explanations?

Women's life expectancy rises with modernization ◦Declines in childbirth deaths; benefits of family planning ◦Access to care Social factors ◦Health-seeking behaviors among women ◦Risky behaviors among men ◦Occupational hazards among men Example of Israeli Kibbutz


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