The Impact of Inequality on Personal Life Chances

1. The Impact of Inequality on Personal Life Chances Roderick Graham Fordham University

2. How does inequality effect… • Physical Health • Psychological Health • Food and Shelter

3. Conceptual Clarification • Life expectancy – average age that one might be expected to live • Mortality rate – the chances that a person will die in a given time period or of a certain cause • Morbidity rates – rate of sickness for a given disease

4. Physical Health Subjective Health • Individuals rate their health lower if they have lower SES or are African-American Objective Health • Individuals low in SES or African-American tend to have greater rates of chronic illness, life expectancy, • Individuals low in SES or African-American also have higher mortality rates for major diseases and homicide

5. Physical Health Health Conditions • Minorities and lower-status individuals, especially African-Americans, tend to have higher morbidity rates • Obesity rates are higher • Rates of high blood pressure are higher • Smoking rates are higher • Overall health (subjective and objective) declines more dramatically with age • Middle aged-blacks have higher rates of fatal (hypertension, diabetes, stroke) and non-fatal (asthma, ulcers, depression) than comparable whites

6. Physical Health Health Conditions • The community that a person lives in also affects health. People living in lower income communities report higher rates of illness (controlling for SES) Differences by Gender? • Less is known about difference by gender • Women have higher rates of disability • Men have higher mortality rates • Women have higher nonfatal conditions, men have higher fatal conditions

7. Physical Health Use of Health Services • Significant differences between high income whites and poor/minorities in the quality of health care. Why? • Health care professionals treatment decisions were structured by the race of their patient • African-Americans (and to some degree Hispanics) believe they are treated differently than whites • Stereotypes about minorities and the poor may affect relationship with health care professional

8. Physical Health Use of Health Services

9. Psychological Health • There is a relationship between SES and poor mental health. But what is the direction of this relationship? Mental Illness Loss of job or loss of income OR? Class position creates mental distress Mental Illness

10. Psychological Health Class, Race, and Gender Distress • Poorer Americans report higher rates of mental distress (depression, anxiety) • Poorer Americans are less likely to be treated • Family poverty and living in a poor neighborhood also increases rates of mental distress • Higher rates of stress among African-Americans and Hispanics

11. Psychological Health Class, Race, and Gender Distress • Psychological distress experienced more by minorities. • Hispanic and Black students less likely to participate in school activities • Family stresses away from school (often being a part of low SES families) contribute to distress • At work, minorities who are in racially segmented occupations compare themselves to whites in more prestigious occupations, leading to more psychological distress

12. Psychological Health Labeling, Diagnosis, and Inequality • Expectations influence the diagnosis • Whites are labeled as bipolar • Blacks are labeled as schizophrenic (blacks seen as more violent and dangerous) • Male psychiatrists more inclined to see females as being depressed (women are seen as more emotional)

13. A quick detour into labeling theory Labeling theory • Deviance and conformity result not so much from what people do as from how others respond to those actions. • Deviance is relative, the same behavior may defined (labeled) in many different ways • The career of a deviant… Retrospective labeling Projective Labeling

14. Psychological Health Sense of Control, Choice, and Inequality • More control on the job leads to higher self-image • People in lower SES groups have a sense of vulnerability and powerlessness, leading to lower ratings of self-image

15. Food and Shelter Hunger • There is little agreement as to how to define hunger or “food insecurity” • 1% of households are seen as food insecure • Blacks and Hispanics are three times as likely to be food insecure Homelessness • Also problems with defining homelessness, is it: • “point-in-time” – estimates of 3.5 million • “period prevalence” – estimates of over 700,000 for one month of homelessness

16. Food and Shelter Homelessness • Population is heterogeneous • 51% single men, 30% families, 42% black, 39% white, 13% Hispanic • Being homelessness results in a powerful stigma (more than being poor)

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