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Chapter 11

SOC260 Chapter Notes - Chapter 11: Audre Lorde, Health Equity, European Canadian

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stephen speake

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CAGE(S) and Health
Audre Lorde
o Poet and equal-rights activist
o Black woman, feminist, and lesbian
o Grew up in Harlem in the 1930s-1940s
o Raised in a working-class household
o Due to prosperous economic times and equal rights movements at the time, she had
opportunities to get a job
o However, being a young, working-class black woman limited her opportunities
o Refused to take tell employers she could type when they gave her racist reasons for not
being able to hire her (used agency)
o Worked in a factory with bad working conditions
chemicals and equipment she worked around caused cancer but no one said
anything about that
all workers in the factory were either black or Puerto Rican
jobs were segregated by sex
o was unmarried (no access to family wage)
o not eligible for social assistance
o pressures of a woman to be nurturing resulted in her failing her 2 courses
o developed breast cancer and died at the age of 58
Inequality and Health
o mid-20th century: emphasis on a solely biomedical approach to health and illness
o lifestyle choices were thought to play a role in health
o if we are to understand health inequality, we have to have a theory that revolves around
macro-social factors as the main causes of disease risk.
factors like socio-economic status also play a role in health
o smoking, exercise, bad eating….
Psychosocial factors (1960s) (Exposure-resource framework)
o effects of stress on the body
o connection b/tween SES and physical & mental health reflects the:
different exposures to social stress over a lifetime based on social status
status-based differences in the distribution of personal and social resources that
could be used to buffer against stressors
o health=influenced by psychosocial risk factors like:
social support
psychological/personality dispositions

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Fundamental Cause Theory
resulted from House’s idea that in order to understand health inequality, we have to come up
with a theory that focuses on macro-social factors as the main cause of disease risk.
Leading social theory on health inequality
Investigations should focus on factors like socio-economic status or race/ethnicity
These factors shape exposure to psychosocial, environmental, and biomedical risk factors
Race, ethnicity, gender, socio-economic status
o Race, ethnicity and gender are thought to be mediated by socio-economic status (SES)
Ignores the importance of intersectionality (sees the above variables as completely separate from
each other)
Mortality, Morbidity, and Mental Health
Social Class and SES
Those who have more resources (income, education, etc.), often have longer and healthier lives
o Healthy education
o Awareness
o Access to prevention
o Capacity to avoid risk
(health advantage)
people living in highest income neighbourhoods = > life expectancy > those in lowest
women have a higher life expectancy than men
o as income rises, the life expectancy gap b/tween men and women disappears
people w/ low SES face more constraints on their ability to look after their health
geographic regions
o Life expectancy is higher in Ontario than in Nunavut
o Avg. life expectancy is increasing
But no increase for INuits
Inuit = hugely lower lifespan vs. non-Inuit
o Infant mortality in Nunavut = almost double the avg.
o Rural areas = higher mortality rates
o Northern Ontario has lower life-expectancy than southern Ontario
Health status declines when income declines
Low income areas have higher suicide rates
Infant mortality rates are higher in the territories than the provinces
Length of time people spend in economic advantage/disadvantage affects health trajectories
o Longer SES disadvantage = larger declines in health
o Long-term SES advantage = slower declines in health
Does low income, education, and bad jobs result in poor health and increase in death?
Or do those w/ poor and declining health consequently have lower income & education?
o What cause what?
o Low SES low health? Or low health low SES?
o Higher SES status lets people have more flexible resources for protecting their health
o Stronger relationships b/tween preventable causes of mortality and SES compared w/
less preventable forms of mortality

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o Those w/ higher SES are more able to avoid health risks
However, those w/ pre-existing health issues do struggle w securing stable employment and
o Ageism
Changes of being poor can be affected by
o Marital status
o Gender
o Age
o Race/ethnicity
Have to take all these factors into accountotherwise it can result in less effective/sometimes
harmful treatment and research
o Failure to take all these into account resulted in advocating hormone treatment as a
treatment against cardiovascular risk, but it happened to cause an increase in breast
cancer cases
o Can lead to generalized recommendations for treatment and research like this
Mental Illness
Poor, young, ethnic minorities, and black individuals have higher rates of mental illness
Lower income = lower mental health
1) Stress-process paradigm
Argue that stress affects physical and mental health
Most of the research has focused on its effect on mental health
Two main streams in current research:
o The extent to which diff. societal groups are exposed to chronic strains and stressful
events & documents the effect of inequality on mental health
o The other focuses on individual perceptions of stress and the resources/buffers they
can use to maintain/protect mental health
Psychosocial resources can be used to protect/buffer against stress:
o Self-esteem
o Mastery
o Perception of control over your environment
However, lower SES has less access to these resources b/c of structural barriers and
Childhood poverty higher levels of depression and antisocial behaviour
Psychiatric disorders are more prevalent among lower classes/disadvantaged classes
Neighborhoods w/ high levels of chronic stressors had higher rates of depression
o E.g. material deprivation; residential instability
Schizophrenia is linked to early exposure to “noisome” work conditions
o Noise, extreme temperatures, hazards, fumes….
o Class-linked stress may be a predisposition for the disorder
o higher rates among homeless population
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