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Race and ethnicity as a social determinant of health
Race and ethnicity as a social determinant of health
Race and ethnicity as a social determinant of health
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Currently, our aging population is living longer than any other generation due to improved medicine, stronger financial systems, and a larger emphasis on education and healthcare (Angel, 2009). Yet, literature shows that longevity is not a good indicator of successful aging, and we have to consider dimensions of health in cultural groups that are ignored but influence their aging. Consequently, mental health is a dimension that is severely overlooked in ethnic groups and it is critical that we consider positive mental health as a channel to assure successful aging. Every year, at least 50 million American adults suffer from mental illnesses. Furthermore, literature shows that depression has been identified as one of the most prevalent psychiatric diagnosis among the elderly, being linked to morbidity, disability, and suicide risk (Conner et. al, 2010; Liebowitz, et. al, 1997). Even more overwhelming, Black older adults suffer more psychological distress than their White counterparts due to their exposure and experiences with racism, discrimination, prejudice, poverty, and violence (Brown, 2003; Conner et. al, 2010; DHHS, 2001; Outlaw, 1993; Williams, Neighbors, & Jackson, 2003) and have fewer psychological, social, and financial resources than their White counterparts (Choi & Gonzales, 2005; Conner et. al, 2010). Even more disturbing, they are less likely to receive an appropriate diagnosis or treatment for depression, when compared to Whites. Prevalence estimates of depression among clinical samples of older Blacks range from 10% to 33% due to limited and varying research. Therefore, we will focus on some of the challenges aging Blacks face that can lead to depression and unsuccessful aging by looking at the following: Negativ... ... middle of paper ... ... T., Andresen, E., Wolinsky, F., Miller, J., Stamps, K., & Miller, D. (2007). Mortality Risk in Older Inner-City African Americans. Journal of American Geriatrics Society 55. 1049-1055. McMullen, C., & Luborsky, M. (2006). Self-rated health appraisal as cultural and identity process: African American elders' health and evaluative rationales. Gerontologist, 46(4), 431-438. Nairn, R. (2006). Media, racism and public health psychology. Journal of Health Psychology, 11, 183-196 Schroy, P., Glick, P., Robinson, P., Lydotes, M., Evans, S., & Emmons, K. (2008). Has the Surge in Media Attention Increased Public Awareness About Colorectal Cancer and Screening? Journal of Community Health 33: 1-9. Shiovitz-Ezra, S. & Litwin, H. (2012). Social network type and health-related behaviors: Evidence from an American national survey. Social Science & Medicine 75(5). 901-904
Mental health care disparities can be rooted in inequalities in access to good providers, differences in insurance coverage, or discrimination by health professionals in the clinical encounter (McGuire & Miranda, 2008). Surely, those who are affected by these disparities are minorities Blacks and Latinos compare to Whites. Due to higher rates of poverty and poor health among United States minorities compared with whites. Moreover, the fact that poverty and poor health are
Though social problems affect a wide variety of people from all races, classes, and cultures; minorities, specifically African Americans, encounter social problems on a multi-dimensional basis. Poverty, employment rates, discrimination, and other social problems strike African Americans in such a way that it is nearly impossible to separate them; each individual has different background, socially and physically, that would determine in which order his or her social problems need to be solved. Impoverished blacks in the inner city may have difficulty finding or keeping jobs, while others may have jobs, but face troubles with work discrimination that prevent them from moving upward .Underemployment, workplace inequalities, and unbalanced medical attention are three closely related social problems that, if ameliorated together, could increase upward mobility, decrease poverty levels, and tighten the lifespan gaps for not only blacks, but also other minority groups. The purpose of this paper is to show what effects these three problems have for blacks.
Decades of research has shown us that African Americans have been depressed for hundreds of years. Although the Declaration of Independence states “All men are created equal,” that rule did not apply to African Americans. By the end of the Civil War more than 180,000 black soldiers were in the United States Military. After the Civil War, many Africa...
"African American Communities and Mental Health." Mental Health America. N.p., n.d. Web. 18 May 2014. .
Willie, Charles V., Bernard M. Kramer, and Bertram S. Brown, eds. Racism Racism Racism and Mental Health. N.p.: Univerity of Pittsburgurgh Press, 1973. Print. Contemporary Community Health Series.
Souls of Black Men: African American Men Discuss Mental Health. (2003, July 21). Community Voices. Retrieved from http://communityvoices.org/Uploads/Souls_of_Black_Men_00108_00037.pdf
Thoits highlights how inequality results in differences of health outcomes among different groups of people. For example, African Americans and Hispanics generally have higher morbidity than whites. However, Thoits also focuses on the relationship between mental health and stress. Adolescents – who tend to be more stressed than older folks – more often suffer the onset of psychiatric disorders, a factor that becomes curbed with increased age (543). Thus, this shows how stress causes adverse mental health. In addition, Thoits also ties social status to stress levels in a way that is similar to the findings detailed in Stress: Portrait of a Killer. Highlighting previous studies, Thoits notes how there are cumulative stressors that particularly affect females, young adults, and members of racial-ethnic minorities (544). These “cumulative stressors closely paralleled inequalities in rate of physical and/or mental health problems by social status” (544). Once again, this shows how people who are disenfranchised or simply fall lower on social hierarchies are also those who experience more stress and, consequently, worse health outcomes. Finally, Thoits also argues that “stress can proliferate across generations” (545). In other words, the negative effects on health due to stress may be intergenerational.
Mental illness is an addition to all of the previously listed perceived disadvantages of Native Americans by those of other ethnicities. Many believe that Native Americans are at a higher risk for mental illness than those of European descent. Many also believe that Native Americans have more people suffer from depression than their white counterparts (Stark & Wilkins, American Indian Politics and the American Political System, 2011). There have been studies conducted to test whether or not this is the case, with mixed results. Some studies say that Natives are at a higher risk and others say they are not. This discrepancy makes the answer unclear. If Natives are actually at a higher risk for and have more people suffering from depression than individuals of European descent, the question to ask is, “why?” Several factors play into depression and other mental illness, including biology, social standing, history, family, and any preexisting/comorbid diseases that could contribute to or cause depression.
All minority groups experience discrimination which leads to increased levels of stress in those individuals. As the level of stress goes up, so does the risk for several health complications including those related to mental health. Wells, Klap, Koike, and Sherbourne (2001) conducted a study examining the disparities in mental health care among black, Hispanic, and white Americans. Of those Hispanics in the study (n=617), 16.6% of them had a probable mental disorder compared to 13.4% of whites (n=7,299). Hispanics also had a higher incidence of substance abuse problems with 9% of those surveyed meeting criteria compared to 7.6% of whites. Hispanics also had the least reported perceived need for treatment with 10.4% for mental health and only 1.3% for substance abuse. A clinician treating Antonio should keep in mind that he has a higher likelihood of having a mental illness or substance use disorder than a white client as well as the fact that if he does meet the criteria for either, that he probably does not believe he needs
Psychological distress, acculturation, and help-seeking attitudes were all measured using specific indexes and scales set for the point of interest. The hypotheses of this research was that even within the African American community, one would find disparities in the treatment of psychological issues – just based on the method of acculturation used, and their views on society. There are 4 basic modes of acculturation: traditionalist, assimilationist, integrationist, and marginalist. It is thought that the integrationist acculturation strategy is the best for optimizing and maximizing well-being. Although there is not a difference in the number of African Americans that have mental health problems when compared to European-Americans, the percentage of those who seek professional mental health services due to emotional distress is representatively lower. The rate at which African Americans receive psychological help services is half as much as that of European Americans – there is a need for an explanation of that statistic. The goal of this paper is to determine the reasoning behind the help-seeking disparities in African Americans and the field of psychological health. In order to make health services fair, we must first understand the reasoning behind why or why not one would seek out professional help in the first place. Understanding ethno cultural attitudes and other cultural variables will allow the health care field to better relate and help all people more uniformly and to the best of their needs.
During my research, I came across several articles that stated that generally people of color do not seek out mental health services. According to an article in Ebony Magazine by Nia Hamm, “African Americans are 20% more likely to report having serious psychological distress than non-Hispanic Whites, stated by the U.S Department of Health and Human Services, but yet young adult African Americans, especially those with higher levels of education, are less likely to seek mental health services than their White counterparts, according to a study published by the American Psychological Association.” The reason that a vast majority of people of color may choose to suppress their mental health conditions is because of their upbringing. From history, it has been stated that people of color were not allowed to seek aid and/or guidance when battling with dilemmas. As generations progressed, so did traditions, but some traditions that were instilled within ancestors, remained prevalent and passed on throughout future generations.
In recent years racial disparities in health status have received increasing attention. The relationship between race, poverty, and health is complex. Something to consider is that people suffering from mental illness and members of minority racial populations are disproportionately concentrated in high-poverty areas.(Chun-Chung Chow) Disparities in health status in these areas are believed to reflect a lack of access to care because of an absence of insurance coverage, a tendency to attribute certain health concerns to religious and culturally sanctioned belief systems, and a shortage of culturally compatible health care providers. (Chun-Chung Chow) Because of the lesser access to medical treatments Blacks and Hispanics ...
In our culture, money, status, and social power all play a part in how individuals think that others perceive them. There is growing evidence that shows the link between socioeconomic status and unhealthy psychological outcomes in mental health. When looking at higher levels of socioeconomic status for youth it shows a more positive and healthy psychological outcome for youth and their mental health. Studies have shown that there are higher rates of attempted suicide, cigarette smoking and engaging in episodic heavy drinking (“Pardon Our Interruption”). Other studies have shown that lower levels of socioeconomic status have been linked to emotional and behavioral difficulties, like anxiety, depression, attention-deficit-hyperactivity disorder and conduct disorders (“Pardon Our
Ulbrich, P. M., Warheit, G. J., & Zimmerman, R. S. (1989). Race, socioeconomic status, and psychological distress: An examination of differential vulnerability. Journal of Health and Social Behavior, 30, 131-146.
Aging is a fact of life. As the years progress, the amount of aging individuals in the United States has been projected to increase considerably. In fact, Wiener and Tilly (2002) expressed that, the number of aging individuals is estimated to increase by 135% between 2000 and 2050. Moreover, the number of aging minorities is expected to increase as well. By the turn of the next midcentury, they are projected to increase by 500% (Scharlach, Fuller-Thomson & Kramer 2002). With this substantial growth, I set out to uncover the underlying reasons to why the quality and longevity of life for those of the aging minority differ in comparison to their counterparts. Through critical analysis, theoretical perspectives, I intend to discover the societal views, strengths and differences that exists among minorities.