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HLTHAGE 1AA3 (276)
Anju Joshi (12)
Lecture 8

HLTHAGE 1AA3 Lecture 8: Identity, Marginality, and Health

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Department
Health, Aging and Society
Course
HLTHAGE 1AA3
Professor
Anju Joshi
Semester
Fall

Description
March 8 Identity, Marginality, and Health Identity - Individual identity wrapped up with overarching structural forces - contributes both to how we behave and how others treat us - Both something that you have but also something is done to you - A performance you carry out but also depends on how others act towards you - Although we experience it as individuals, our identities also carry social meaning - Factors that shape identity? → race/ethnicity, class, gender, sexuality, and primary categories although others disabilities Identity and Health Identity shapes health in 2 ways - Social structures pose unequal health risk for some more so than others → Women more likely than men to experience domestic violence (and subsequent harm) → stress, leaving a city, out of job, social support, behaviours to deal with it - How we experience and respond to health problems → ex. Straight vs gay responses to HIV → choice/availability of health interventions - Individuals with marginalized identities prone to greater health risks Social Class - Also known as SES - refers to person’s position within economy - income, property, education, occupation - Class background also relevant - Identity does not necessarily change within a generation - In some countries class is extremely pronounced, less so in other places. Regardless, SES still structures health SES and Health - Class limits (or enables) access to resources like income, education, health care - all of which affect health - Recall the Whitehall Study → Put simply, more privileged members of society fare far better across a variety of health measures - SES gradient felt more severely over lifespan - Compared to most other developed countries, Canada’s health inequalities are greater (due to deeper inequalities in income) Case Study: Schizophrenia - Despite some evidence of genetic component, rates of schizophrenia far higher in lower SES. Why? - People with this mental illness tend to come from poorer backgrounds due to access to care → Less access to healthcare, complications during pregnancy or birth → Poorer housing, greater rates of prenatal infection → Insecurity creates more stress, life events → Socialization (less flexibility, greater conformity, feeling at the mercy of other forces) → Institutional bias against lower class (health care individuals have a bias towards lower class people and that is why these are the theories) → *these are just speculations* Race, Ethnicity, and Health March 8 Identity, Marginality, and Health Race and ethnicity, both of which imply a particular cultural heritage, are social constructs - Yet, race and ethnicity are very “real” in terms of creating inequalities. Health status affected by historical mistreatment and barriers in access to healthcare - In terms of mortality, morbidity, life expectancy and self-reported health, First Nations peoples fare worse than non-Aboriginal Canadians. Similar results reported for African-American population in US - Research on 1) genetic variations, 2) lifestyle 3) stress and 4) social inequalities found that genetic variations was insignificant - social inequalities (unemployment, housing, income, education) were most significant - Despite frequent overlap between ethnicity and SES, class alone does not account for differences - other factors (racism and stress it produces) are at play → Ex. people who report higher rates of racial discrimination had higher blood pressure, more respiratory illness, high rates of depression and psychosis - Ideas about race can also structure SES (ex. Redlining in the US) which further impacts health - Finally culture (tied to ethnicity) may shape management of health and response to illness - both protective and harmful. Exa
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