Categories
Economics Science

On Social Epidemiology, Healthcare Disparities, and Privitized Medicine

Social epidemiology is the study of causes and distribution of disease. Social epidemiology can show how social problems are connected to the health of different populations. These studies show that health problems of high-income nations differ greatly compared to those of low-income nations. Some diseases are universal, but others, like obesity, heart disease, and diabetes, are much more common in high-income countries and are a direct result of a sedentary lifestyle and poor diet.

Some theorists differentiate among three types of countries: core nations, semi-peripheral nations, and peripheral nations. Core nations are those that we think of as highly industrialized, semi-peripheral nations are those that are often called developing nations, and peripheral nations are those that are relatively underdeveloped.  While the biggest issue in the U.S. healthcare system is affordable access to healthcare services, other core countries have different issues, and semi-peripheral and peripheral nations face a host of additional concerns.

Health disparities based on gender include how women are affected adversely both by unequal access to, and institutionalized sexism in, the healthcare industry. Women experienced a decline in their ability to see needed specialists between 2001 and 2008, according to the Kaiser Family Foundation. Feminist sociologist Patricia Hill Collins developed intersection theory, which suggests that we cannot separate the effects of race, class, gender, sexual orientation, and other attributes. Further information derived from the Kaiser study found that women categorized as low income were more likely to express concerns about healthcare quality.

Many critics point to the medicalization (the process by which previously normal aspects of life are redefined as deviant and needing medical attention to remedy) of women’s issues as an example of institutionalized sexism. Historically and contemporarily, many aspects of women’s lives have been medicalized, including menstruation, PMS, pregnancy, childbirth, and menopause.

The concepts of socioeconomic status and health overlap in discussions of health with race and ethnicity, since the two are intertwined in the United States. Marilyn Winkleby and her research associates stated that “one of the strongest and most consistent predictors of a person’s morbidity (the incidence of disease) and mortality experience is that person’s socioeconomic status.” This finding persists across all diseases with few exceptions, continues throughout their lifespan, and extends across numerous risk factors of disease.

Research suggests that education also plays an important role in the socioeconomic status picture, not just economics. Some experts note that many behavior-influenced diseases like lung cancer, coronary artery disease, and AIDS initially were widespread across socioeconomic groups, however, once information linking habits to diseases was disseminated, these diseases decreased in high socioeconomic groups and increased in low socioeconomic groups, This shows the importance of education initiatives regarding disease, as well as possible inequalities in how these initiatives effectively reach different socioeconomic groups.

When looking at the social epidemiology of the United States, it’s hard to miss the disparities among races and ethnicities. In 2008, the average life expectancy for white males was approximately five years longer than for black males. An even stronger disparity was found in 2007: in infant mortality, which is the number of deaths in a given time or place, the rate for black people was nearly twice that of white people. Black Americans also have a higher incidence of several other diseases and causes of mortality.

Scoial Epidemiology of Mental Health

The treatment received by those defined as mentally ill or disabled varies greatly from country to country. People with mental disorders (a condition that makes it more difficult to cope with everyday life) and people with mental illness (a severe, lasting mental disorder that requires long-term treatment) experience a wide range of effects. According to the National Institute on Mental Health, the most common mental disorders in the United States are anxiety disorders. The second most common mental disorders are mood disorders; major mood disorders are depression, bipolar disorder, and dysthymic disorder. Another fairly commonly diagnosed mental disorder is Attention-Deficit Hyperactivity Disorder (ADHD), which statistics suggest affects 9 percent of children and 8 percent of adults on a lifetime basis.

Autism Spectrum Disorders (ASD) have gained a lot of attention in recent years. The term ASD encompasses a group of developmental brain disorders that are characterized by “deficits in social interaction, verbal and nonverbal communication, and engagement in repetitive behaviors or interests.” The National Institute of Mental Health distinguishes between serious mental illness and other disorders. The key feature of serious mental illness is that it results in “serious functional impairment, which substantially interferes with or limits one or more major life activities. Thus, the characterization of “serious” refers to the effect of the illness (functional impairment), not the illness itself.

Disability refers to a reduction in one’s ability to perform everyday tasks. The World Health Organization makes a distinction between the various terms used to describe handicaps that’s important to the sociological perspective. They use the term impairment to describe the physical limitations, while reserving the term disability to refer to the social limitation. Before the passage of the Americans with Disabilities Act in 1990, people in the United States with disabilities were often excluded from opportunities and social institutions many of us take for granted. This occurred through employment and other kinds of discrimination but also through casual acceptance by most people in a world designed for the convenience of the able-bodied. Ramps on sidewalks, Braille instructions, and more accessible door levers are all accommodations to help people with disabilities. According to the Bureau of Labor Statistics, people with a disability had a higher rate of unemployment than people without a disability in 2010.

Healthcare Systems and Access to Care

U.S. healthcare coverage can broadly be divided into two main categories: public healthcare (government-funded) and private healthcare (privately funded). The two main publicly funded healthcare programs are Medicare, which provides health services to people over sixty-five years old as well as people who meet other standards for disability, and Medicaid, which provides services to people with very low incomes who meet other eligibility requirements. The United States already has a significant problem with lack of healthcare coverage for many individuals. The U.S. Census Current Population Survey of 2013 showed that 18 percent of people in the United States had no health insurance at all. Skyrocketing healthcare costs are part of the issue. Many people cannot afford private health insurance, but their income level is not low enough to meet eligibility standards for government supported insurance. Furthermore, even for those who are eligible for Medicaid, the program is less than perfect. Many physicians refuse to accept Medicaid patients, citing low payments and extensive paperwork.

Many people in the United States are fond of saying that this country has the best healthcare in the world, and while it is true that the United States has a higher quality of care available than many peripheral or semi-peripheral nations, it is not necessarily the “best in the world.” Most peripheral or semi-peripheral and majority of developed countries rely on socialized medicine. Under a socialized medicine system, the government owns and runs the system. It employs the doctors, nurses, and other staff, and it owns and runs the hospitals. Germany, Singapore, and Canada all have universal healthcare. Universal healthcare is simply a system that guarantees healthcare coverage for everybody, as opposed to socialized medicine. People often look to Canada’s universal healthcare system, Medicare, as a model for the system. In Canada, healthcare is publicly funded and is administered by the separate provincial and territorial governments. However, the care itself comes from private providers. This is the main difference between universal healthcare and socialized medicine. Perhaps with recent progressive advances in establishing a Medicare For All program in the United States would aid in minimizing disparities in our healthcare systems. As of now, our current system has failed us, as many Americans lose their lives every year to preventable illness or disease simply due to lack of access to healthcare resources.

Categories
Philosophy & Politics Science

On Behavioral Ethics and the Burning of Notre Dame

A common misconception about the ideas of ethics and selfishness is that unethical behavior constitutes the behaviors of the wealthy upper-class that furthers these individuals’ wealth, power, and status at the cost of inhibiting the social and economic wealth, power, and status of the middle and lower classes.

According to definition, unethical behavior is actually behavior that is “illegal or morally unacceptable to the large community,” and selfishness refers to a heightened concern with one’s own personal profit or pleasure, both dictionary definitions respectively. According to David Dubois, Adam D. Galinsky, and Derek D. Rucker in their paper titled: “Social Class, Power, and Selfishness: When and Why Upper and Lower Class Individuals Behave Unethically,” empirical social and moral psychology research typically examines these phenomena in the context of unethical behavior and selfish behavior that benefits the perpetrator of these behaviors.

By extrapolating these concepts in light of new research regarding ethics and selfishness, particularly including variables such as power, social class, status, education level and income, we can conclude that all of these factors play a role in the ethics and selfishness of actions. For example, lower-class individuals are found to behave more unethically, however, they’re more selfless and the consequences of their behaviors tend to favor others in a more communal fashion rather than benefit themselves directly.

Considering this research, what is the influence of popularity, impression, and public opinion on whether or not an individual will behave ethically and selflessly? If power, social class, and selfishness among the multitude of other factors dictate the likelihood of an individual behaving in a manner that is deemed unethical, then why do individuals in these presumed psychologically and neurologically predisposed categories behave ethically and selflessly when public opinion favors it? Statistically, if every factor works against the likelihood of an individual behaving selflessly and ethically, then why did so many millionaires and billionaires donate so much money to the Notre Dame relief fund while the Amazon Rainforest burned?

Perhaps self-image plays a larger role in ethicality and selfishness than other factors. The importance of self-image to a person in conjunction with how they view their self-image likely has a positive correlation between whether an individual is likely to commit an unethical or selfish action if public opinion and privacy are factors. If the wealthy individuals who donated to Notre Dame, rather than the Amazon Forest relief fund to put out the fires that are burning up our earth’s oxygen supply, only had the option to donate anonymously, would Notre Dame receive the same funding as it actually received? If given the option to donate anonymously to Notre Dame, or donate publicly to the Amazon Forest relief, which option would individuals choose, and does that make the action ethical or unethical, selfish or selfless?

Considering the other factors that play a role in whether or not an individual is likely to commit an unethical act, be it out of selfishness or selflessness, what role does education level, socioeconomic status, and power play in the likelihood of an individual being unethical or selfish publicly versus privately? This is an important research topic because individuals act differently when others are watching versus how they act when they’re alone. For example, I may listen to one type of music when I’m with friends, another genre when I’m with coworkers or my supervisors, and an entirely different genre when I’m alone. I also may not even listen to music depending on the party I’m with (or not with). An example of how publicity versus privacy plays a role in ethicality and decision making would be supporting the LGBT community. If you’re a staunch supporter of individual rights, and believe that everybody should be able to get married regardless of gender, sexual orientation, and outward presentation of social traits, you would tend to behave in a manner that doesn’t necessarily imply or express that belief around your strict conservative family.

Presentation of beliefs and whether individuals choose to make a statement that could very well be deemed unethical depends entirely on the publicity or privacy of their statement. With this research in mind, we’re presented with newfound insight into the politics of ethics. By adopting Dubois, Rucker, and Galinskys’ research on this side of ethics, how can we change public economic policies regarding distribution of wealth and wealth inequality? Does benevolence play more of a role in the distribution of wealth towards programs that benefit the working class and the environment, or should we begin to shift away from the notion that human nature leans towards benevolence and instead adopt economic policies that redistribute wealth more effectively? The role that the publicity or privacy of behaviors and public statements plays in our society is expansive and complex- hopefully future research into the subject can provide intersectional context to the psychology of politics, as well as the politics of the discipline of psychology.

Citations:

Dubois, D., Rucker, D. D., & Galinsky, A. D. (2015, January 26). Social Class, Power, and
Selfishness: When and Why Upper and Lower Class Individuals Behave Unethically. Journal
of Personality and Social Psychology. Advance online publication.
http://dx.doi.org/10.1037/pspi0000008

Categories
Philosophy & Politics Science

On Androcentrism in Psychology Research

Yoder and Kahn’s research analysis thoroughly explored the concepts associated with differences in gender as we understand them in light of modern science. Their analysis acknowledges the physical differences between men and women (I found the relationship mentioned between even Soviet Russia and their inability to eradicate gender inequality to be interesting). (Yoder) Furthermore, Witkin’s et al. interpreted their research on visual-spacial perception in a manner that would only perpetuate gender roles in society- their research on the characterization of field dependence  and independence “fit neatly with the gender stereotypes of post-World War II America,” and was used to justify exclusion from the workforce and after the war. Eventually we’ve moved towards a less androcentric viewpoint on gender differences between field dependence and independence, focusing more on specific skills, and we now understand that such differences in variability in spacial abilities don’t exist across other countries. Ultimately, Linn and Petersen (1985) concluded that there are no reliable gender differences in performance of spatial visualization tasks, and their research was doubly validated by Voyer, Voyer, and Bryden ten years later in a meta-analysis.

I think Yoder and Kahn’s analysis of Diane Halpern’s research regarding cognitive psychology differences between genders to be a more nuanced comprehension of gender differences than the research emphasizing physical neurobiological differences and the way they manifest (or don’t) as behavior differences. In Halpern’s analysis of cognitive differences between genders (2000), she argues that “it seems likely that our abilities are influenced by age, birth order, cultural background, socioeconomic status, sex role orientation, learning histories, and so forth….” This digests more comfortably with me as an acceptable perspective on gender differences- there are an infinite number of factors that play into gender differences and the research that can and cannot be done, and I believe adopting a perspective that is more encompassing of complex sociopolitical and identity issues would be a more scientific approach to the subject. 

Yoder and Kahn concluded that cognitive performance does not and cannot occur nor be tested in a cultural vacuum, and that there is an undeniable impact of culture and social environment on cognition. An example is given of villagers in Uganda thinking of intelligence as manifested by being slow and careful (otherwise deliberate) while westernized groups in Uganda associate intelligence with speed. 

Cordelia Fine concluded in her lecture about gender differences in psychology that for the majority of psychological characteristics, an individual’s gender isn’t necessarily indicative of their masculinity or femininity. (Fine) The contingency principle concludes that cognitive gender differences within one population and one subject cannot be compared with another due to cultural and environmental differences. Fine also concluded in her analysis of psychology research that gender and masculinity and femininity exist on a spectrum- and that possession of one masculine or feminine traits are not indicative of an entirely masculine or feminine personality. In addition, gender is multidimensional, and masculine or feminine characteristics are poorly correlated with themselves. She also concludes that gender socialization experiences are captured within research in the field and cannot be disentangled from quantifiable gender differences research. In essence, the politics of psychology are important to understanding research on gender differences. 

Honestly, I think the reason there’s so much research focused on gender differences and sex differences is because historically, and contemporarily, psychology research has been largely androcentric. I believe the patriarchy perpetuates oppression against women through research with androcentric bias and shallow conclusions about how men are somehow better than women at valued tasks and skills, and women are only better than men at socialized gender role related topics. Toxic masculinity is fragile- it has to prove itself through twisted means and maintains itself in society through this kind of research that perpetuates gender roles and reaffirms binary, gender-associated traits in order to sustain oppressive social institutions. To clarify, I also acknowledge that issues like toxic masculinity affect men (male suicide rates). I only mention this because my dialog tends to not focus on that; I purposely don’t because it detracts from an important topic that is suppressed throughout our society, which is an issue that men don’t usually suffer from (basically, women don’t publish research to try to deliberately oppress men, women don’t interject/object when men speak out against institutions that affect them, women don’t actively possess political and social power over men, and men are already researching how these issues affect other men). Hopefully it wasn’t even necessary to touch on that. 

I do think of psychological theories of gender differences as being fluid, interacting concepts. I think in an evolutionary context, biological sex differences did make a difference in gender psychology over time, perhaps neurobiologically (exposure to different experiences for generations and generations), but largely sociologically. I think sociobiology theory of adaptive and maladaptive behaviors can function as a construtionist concept with the introduction of modern research, technology, medicine, and engineering). Essentially, I think as more women are empowered to combat oppression in our social and political institutions, and more men work to actively dismantle the systems they directly or indirectly benefit from, maladaptive behaviors (such as forcing your partner to stay home and raise kids) will be eradicated. This is because we have the technology and infrastructure to bypass these limitations based on sex differences- they’re called day-cares. The issue now is not the presence or absence of these institutions, but the socialized and institutionalized inequalities that deny access to these institutions to women (I’m thinking economically here). As we combat unequal access to institutions that can work to dismantle socialized gender roles, maladaptive behaviors such as stated above will become eradicated because nobody will stay home all day with the kids if they’re not forced to, and aren’t willing to. 

In Lips’s “Group Comparisons” section, she states that “it should be immediately obvious that such comparisons (regarding women vs men, middle-class women vs lower-class women, postmenopausal vs premenopausal) are fraught with difficulty. (Lips) This statement only furthers the notion of purposeful misinterpretation and framing of research questions and conclusions in order to perpetuate harmful gender stereotypes in psychology as consequences of androcentrism in the discipline. The research cited earlier further extrapolates this concept as it describes gender differences in psychology as being nonexistent outside of social, and cultural, context. The researchers propose idiographic and nomothetic approaches to research as methods of significantly realigning the discipline and further research with scientific principles of empirical analysis and appropriately framed, nuanced questions and conclusions regarding gender differences. The idiographic approach focuses on careful, in-depth case studies of individuals’ experiences, while the noothetic approach combines the responses of similar individuals in order to make summary statements about groups and/or compare groups. Both approaches are valuable for the detail they provide and their ability to discern patterns and evaluate beliefs and stereotypes about different specific groups. 

Prior to learning of androcentrism in psychology, I was unaware, although suspicious, of the lack of gender differences in psychology outside of a social and cultural context. This idea really gives me confidence that with deliberate redirection of cultural and social gender norms, we can accelerate research that dismantles the principles that gender roles are based upon. By this, I mean in a sort of domino effect, as research emerges disproving outdated androcentric theories of gender differences, science will be forced to acknowledge and further investigate the androcentrism in research, which will lead to more social change. It’s not that simple, but just like research on gender differences, neither is the politics.

Sources:

Lips, H. M. (2017). A new psychology of women: gender, culture and ethnicity (Fourth Edition). Long Grove, IL: Waveland Press Inc.

Yoder, J. D., & Kahn, A. S. (2003). Making Gender Comparisons More Meaningful: A Call for More Attention to Social Context. Psychology of Women Quarterly, 27(4), 281–290. https://doi.org/10.1111/1471-6402.00108

Fine, Cordelia. Questioning the Science of Gender Difference: A New Perspective. http://www.youtube.com/watch?v=mEX9Usqdurs.

Categories
Philosophy & Politics

On Law Enforcement, Prison/Military-Industrial Complex, and Institutionalized Disenfranchisement

It takes approximately half the time to be trained to become a law enforcement officer than it takes to become a licensed cosmetologist.

The people giving you haircuts and perms are better trained in their professions than the individuals assigned weapons and political power in order to protect the assets of the wealthy, including private property. NOT to protect the rights of an individual.

If your landlord doesn’t fix your shit, your boss doesn’t pay you on time, police can’t, and won’t, do anything about it. As enforcers of the directly and indirectly racist institutions & social stereotypes embedded in our code of law, law enforcement officers are the domestic enforcement arm of capitalist institutions and private property rights.

Source: https://mappingpoliceviolence.org/unarmed

The prison-industrial complex encoded in our legal institutions must be dismantled and redesigned in a fashion that protects the rights of the individual. Class struggle is intersectional- these issues disproportionately affect minorities & disenfranchised populations.

I dislike when people say they “hate politics” and don’t participate. Inequality and disenfranchisement is an intersectional issue, and affects everybody, including many individuals who directly benefit from these institutions at times as well (see: toxic masculinity and male suicide, for example).

The prison-industrial complex engraved in domestic policy is intertwined with American military-industrial complex. The big-money lobbyists whom advocate for wars that send our troops to their deaths in the name of imperialism are the same individuals and organizations that advocate for domestic law that pumps our working class into for-profit private prisons (at disproportionate rates by demographic). I firmly believe the resolution to this issue lies in grassroots movements to recapture political power from the establishment (which is enabled by, and supports, big-money corporate lobbying) in order to change domestic and foreign policy to protect disenfranchised groups from this form of institutionalized oppression.