Tag Archives: health

It takes time to fight the effects of inequality

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A new sociology study suggests that the health effects of inequality in the United States aren’t felt immediately but rather take several years to develop:

Higher levels of U.S. income inequality lead to more deaths in the country long-term, an Ohio State University sociologist suggests.

Study author Hui Zheng said the findings suggested income inequality at any one point doesn’t work instantaneously — it begins to increase mortality rates five years later, and its influence peaks after seven years, before fading after 12 years.

Zheng used data from the U.S. National Health Interview Survey from 1986 to 2004 with mortality follow-up data from 1986 to 2006. His final sample involved more than 700,000 people age 30 and older…

The study, published in the journal Social Science and Medicine, found a 0.01 unit rise in the Gini coefficient increased the cumulative odds of death by 122 percent in the following 12 years.

“This finding is striking and it supports the argument that income inequality is a public health concern,” Zheng said in a statement. “For the first time, we can clearly capture the long-term effect of income inequality on health.”

While I don’t study health outcomes, I like a conceptual path a study like this offers: we need to think about and discuss the longer-term effects of inequality. In other words, decisions made now for better or worse will have extended effects down the road. In terms of all public policy, we don’t want to be at a place where one or several decades have passed and we haven’t thought through where public policies have led us.

On the flip side, it is common for critics of sociology to argue that certain changes can be made in public policy and magically two groups will be on equal footing. For example, housing discrimination was made illegal in the 1960s – doesn’t this mean that everyone is now on equal in the marketplace? Here is how I describe this in class: you have a graph with two upward curves, one with a steeper rise representing a more privileged (income, education, etc.) and one with a slower rise. If after fifty years there is a wide gap between the two groups but a policy is changed to help level the playing field, this does not mean that automatically that gap disappears. In terms of the housing example, there are still plenty of examples of disparities and discrimination even though certain actions are clearly illegal. It takes time to reverse social inequality and the social world is not easy to change. Thus, if inequality today leads to health disparities down the road, it will take more time to reverse that trend and get us back to the same starting point, let alone make things more equal in the long run.

Sociologist explains that one type of mass hysteria is behind cases in upstate New York

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A recent set of odd medical cases in one New York town has prompted news sources to look for explanations. One sociologist suggests the high school students are experiencing one type of mass hysteria:

Most doctors and experts believe that the students are suffering from mass sociogenic illness, also known as mass hysteria. In these cases, psychological symptoms manifest as physical conditions.

Sociologist Robert Bartholomew, author of several books on mass hysteria including The Martians Have Landed: A History of Media-Driven Panics and Hoaxes, explained to Discovery News that “there are two main types of contagious conversion disorder. The most common in Western countries is triggered by extreme, sudden stress; usually a bad smell. Symptoms typically include dizziness, headaches, fainting and over-breathing, and resolve within about a day.”

In contrast, Bartholomew said, “The LeRoy students are experiencing the rarer, more serious type affecting muscle motor function and commonly involves twitching, shaking, facial tics, difficulty communicating and trance states. Symptoms appear slowly over weeks or months under exposure to longstanding stress, and typically take weeks or months to subside.”

Mass hysteria cases are more common than people realize and have been reported all over the world for centuries.

Read the rest of the story for four more interesting stories of mass hysteria. These sorts of stories pop up every once in a while: a few people claim to be ill from smelling something but authorities can’t find any issue.

I’ve seen Bartholomew quoted in a few news stories about this mystery illness. I would be interested to hear how he thinks you can defuse this situation; how do you stop mass hysteria? Is it best to focus on reducing the stress of the people experiencing the illness or is it better to split up the group of those experiencing the illness to try to limit the “mass” part of the condition?

Also, do we have any studies of what takes place within a community that is experiencing this as opposed to studying the situations afterward? What is it like for the other students and their families in this high school?

Third, what kind of stress sets this off?

Fourth, is there something about the social networks between those who are ill that matter or the particular institutional setting that people are in (i.e., close quarters for long hours)?

63% of the elderly claim to have experienced discrimination

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Discrimination is typically associated with issues that arise involving race and ethnicity and gender. But a recent study suggests a majority of the elderly also say they have recently experienced discrimination:

A startling proportion of older people report that they’ve experienced discrimination: 63 percent, in a study recently published in Research on Aging. The most commonly cited cause? “Thirty percent report being mistreated because of their age,” said the lead author Ye Luo, a Clemson University sociologist. Perceived discrimination because of gender, race or ancestry, disabilities or appearance followed in smaller proportions…

Dr. Luo and her colleagues used national data from the federal Health and Retirement Study to measure what nearly 6,400 people — all older than age 53 when the study began in 2006 – thought about discriminatory behavior. Dr. Luo wasn’t surprised by the high proportion of people who said they had encountered it. That was consistent, she says, with previous studies.

As the researchers had expected, some people were more likely to report discrimination than others. Blacks, those who were separated or divorced or widowed, and those with fewer household assets had higher levels of perceived discrimination, as measured by questionnaires. It was less commonly perceived by whites, by the married or partnered, and by those with more assets…

Interestingly, the discrimination effect was stronger for everyday slights and suspicions (including whether people felt harassed or threatened, or whether they felt others were afraid of them) than for more dramatic events like being denied a job or promotion or being unfairly detained or questioned by police.

The study also suggests the experiences of discrimination are related to poorer health outcomes.

So if this is a common experience, what could society do differently to limit this? Public service announcements? Lessons in elementary school? How much of this is related to a youth-obsessed culture?

I wonder if these issues will only grow as Americans live longer. Also, what might happen if there is more generational conflict over debt, paying into social security, and the differences in wealth between the young and old?

Better educated people more able to adjust to new health research

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This finding from a study in the December issue of American Sociological Review has been getting a lot of attention: despite efforts to even out the effect more education has on health, higher levels of education still lead to better health outcomes. Here’s why:

Professor Richard Miech of the University of Colorado Denver and colleagues said data have showed for decades middle-aged adults with low education levels — high school or less — are twice as likely to die as those with higher education levels.

Miech’s study, published in the American Sociological Review, provides new understanding as to why death rates for less educated middle-aged adults are much higher than for their more educated peers, despite increased awareness and treatments aimed at reducing health disparities.

The researchers found as new causes of death emerge, people with lower education levels are slower to respond with behavioral changes, creating a moving target that often remains a step ahead of prevention efforts.

Despite efforts to reduce education-based mortality disparities, the gap remains because new health disparities counteract the efforts to reduce the death rates for those with less education — the causes of death have changed, rates have not, Miech said.

Translation: the world continues to change and certain groups are better positioned in society to take advantage.

Sociologist argues carers need more support

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In the high-stakes discussions taking place in a number of countries, a British sociologist argues countries should support one group more: carers.

Some 6.4 million people in the UK care for sick, disabled or frail friends and relatives – and they’re often punished for doing so. Many of them pay a “triple penalty”: damage to their health; a poorer financial situation; and restrictions in everyday life. The intrinsic unfairness of this situation is made all the more remarkable by the fact their work and effort saves the public purse £119bn a year – more than the whole budget of the NHS. But in the current climate of public sector cuts, how can we make their lives better without costing the earth, and support those who wish to care without giving up paid work?…

Our report New Approaches to Supporting Carers’ Health and Well-being: evidence from the National Carers’ Strategy Demonstrator Sites Programme highlights ideas that work to help carers stay well and healthy, to get a short break or chance to meet their own needs. For carers struggling to make ends meet, small investments in gym memberships, laptops or short holidays make a real difference, yet cost only a fraction of what needs to be spent if their care breaks down or cannot be sustained.

Special health and wellbeing checks spotted many physical and mental conditions, including diabetes, depression and cancer, which – as carers often put their own needs second to those of others – were previously undiagnosed. When GPs or hospitals work together with social services and voluntary agencies in their area, support for carers can really improve at a comparatively small cost…

Circle researchers have consistently made the case for better carer support. Our work has informed policy developments under both Labour and coalition governments. Unsupported, carers risk exhaustion, isolation and stress – yet when valued and offered flexible services, many see caring as among the most rewarding and important things they have ever done.

In the debates over health care costs in the United States, I haven’t heard much about carers. I wonder if some might argue that these caring duties shouldn’t be rewarded by the government but rather are familial or relational duties. But, if health care costs are a public problem, might it not make sense to invest here?

I wonder how millennials feel about this. Frankly, it probably hasn’t entered their minds much.

If sociologists have some interest in concepts like the sick role, do we have notable scholarly works addressing the role of carers?

In order to deal with issues like health, don’t focus on race but place and residential segregation

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Researchers examined health in two Baltimore neighborhoods and argue that it is not race that leads to different health outcomes but rather the places themselves:

LaVeist and several colleagues tested this idea by examining the counterfactual: If society weren’t segregated, would health disparities still exist? They identified a low-income community in Southwest Baltimore, spanning two census tracts, that is fairly equally divided between black and white residents (out of deference to the neighborhood, LaVeist doesn’t name it). The median household income in the area was less than $25,000 during the 2000 census. It has no pharmacy, no practicing physicians or dentists, no supermarkets, and no banks.

Within this integrated community, the researchers found that health disparities all but disappear. There was no significant difference in diabetes rates, or obesity rates among young women (a metric on which large gaps exist nationally). There did remain a difference in hypertension rates, albeit it a much narrower one than national data shows. The lone exception: Whites in this community smoked at a significantly higher rate than blacks.

This suggests that what the national statistics are really telling us is that minorities live in much higher numbers in unhealthy neighborhoods. And that means that in trying to address health disparities nationally, we’ve been looking for the answers to the wrong question. We should be asking what’s going on in these communities, not what’s going on within minority populations.

“Solutions to health disparities are likely to be found in broader societal policy and policy that is not necessarily what we would think of as health policy,” LaVeist says. “It’s housing policy, zoning policy, it’s policy that shapes the characteristics of communities.”

While this sounds like interesting research (though it only covers two neighborhoods?), haven’t sociologists been talking about this for years? In fact, Massey and Denton made just this point in American Apartheid back in the early 1990s:

Our research indicates that racial residential segregation is the principal structural feature of American society responsible for the perpetuation of urban poverty and represents a primary cause of racial inequality in the United States.

If as a country we really wanted to deal with disparities in education, jobs, opportunities, health, and more, then the problem of residential segregation is the one that needs to be tackled. Local decisions about zoning and resource allocation also matter. Simply dealing with the health concerns without addressing the whole neighborhood can only get us so far.

How a long commute harms you

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The Infrastructurist has a round-up of recent studies that show the negative effects of long commutes: higher rates of divorce plus “low happiness, high stress levels, and loneliness; they even makes us physically unhealthy.”

As they note, enough Americans seem willing to make the trade-off between a better house for a long commute. Is this because people simply don’t know or think about the social costs of long commutes? If not, what sort of organization would or could make this more known?

How being multiracial affects self-reported health

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It is only in the last 11 years or so that official forms (like the Census) have allowed individuals in America to identify as being from more than one race. A couple of sociologists argue that this multiracial identification impacts self-reported health:

Bratter and Bridget Gorman, associate professor of sociology at Rice, studied nearly 1.8 million cases, including data from more than 27,000 multiracial adults, from the Behavioral Risk Factor Surveillance System (BRFSS) questionnaire…

The new study found that only 13.5 percent of whites report their health as fair to poor, whereas most other single-race or multiracial groups were more likely to report those health conditions: 24 percent of American Indians, 19.9 percent of blacks and 18.4 percent of others. Single-race Asians were the least likely to report fair-to-poor health – only 8.7 percent did so.

While differences in self-rated health exist between single-race whites and multiracial whites, the percentage of single-race blacks who rated their health as fair to poor is nearly identical to that of multiracial blacks. The same is true for single-race and multiracial Asians.

“Our findings highlight the need for new approaches in understanding how race operates in a landscape where racial categories are no longer mutually exclusive yet racial inequality still exists,” said Bratter, director of Race Scholars at Rice, a program within the Kinder Institute for Urban Research. “This extends beyond health data to other measurements of well-being, income, poverty and so much else.”

The key question here seems to be whether multiracial individuals experience the same health outcomes as single race individuals.  From this description, it sounds like this study suggests that being multiracial and white has different health outcomes compared to whites while being black or multiracial black has the same health outcomes. This would make sense given what we know about health differentials by race (more than genetics and extending to areas like life expectancy).

(I searched the journal Demography for more information about the conclusions of this study but it must not be listed yet.)

The “science of shoveling”

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Reading an article like this about the “science of shoveling” makes me glad that someone out there is seriously concerned about the best way to shovel:

The science of shoveling was invented by the Progressive Era efficiency expert (and father of Taylorism) Frederick Winslow Taylor. Taylor observed laborers shoveling varying weights and concluded that the shovel load with which “a first class man would do his biggest day’s work” was about 21 pounds. That’s remarkably close to the current recommendation from Canada’s Center for Occupational Health and Safety (keep per-shovel snow loads below 24 pounds). At the Bethlehem Steel works in Pennsylvania, Taylor gave out shovels specifically designed to hold 21 pounds—small ones for shoveling iron ore, big ones for shoveling ash—and made “thousands of stop-watch observations” to calculate the most efficient shoveling method.

Taylor’s purpose was not to preserve workers’ health but to maximize output; by following his recommendations, Bethlehem was able to increase the daily weight shoveled by each laborer from 16 to 59 tons. But because physical endurance was a necessary component to maximizing output, Taylor’s shoveling method also reduced wear and tear on the human body…

The other change is that, even taking into account that Taylor’s subjects were all experienced manual laborers, people must have had much stronger backs back then.Today, ergonomists worry less about manual laborers’ arms than about their backs, because the lower back (specifically the lumbosacral junction) is now understood to be the weakest link in the “body segment chain.” The same goes for anyone in the general population who shovels snow. Various technological innovations have been attempted to protect the back and reduce muscle strain generally, thereby lowering the risk of heart failure. A shovel with a longer shaft makes the initial part of the job easier, but it makes the part where you actually lift the snow harder. Many stores sell a snow shovel with a bent shaft, which is widely recognized as the optimal ergonomic design. This type of shovel has the opposite problem. It makes the initial part of the job harder (you have to stoop, especially if you’re tall or fat), but makes the part where you actually lift the snow easier.

It makes sense that Taylor is behind some of these ideas, particularly since shoveling was tied to manufacturing. I have seen these ergonomic shovels and may just have to purchase one after reading this in order to protect “the weakest link in the body segment chain.” So why aren’t there more strenuous advertisements for the health benefits of these ergonomic shovels?

In my shoveling yesterday, my technique was generally to use a smaller shovel (actually the biggest one we have but still relatively smaller) and lift and throw snow more frequently. I imagine the throwing motions I was using are not optimal – however, they were necessary in order to clear the four foot snow drifts that were already there. It sounds like I would be better off with a slightly bigger shovel so that I don’t have to lift as often.

And a couple of links in this story are interesting:

-Harvard provides some guidelines about shoveling. Basically, you shoveling may be problematic if you are out of shape or don’t exercise often, shovel first thing in the morning, and are exposed to extreme cold. (This is part of a full page about health for older men. Are older men the primary shovelers or are they are the ones most at risk?)

-One might wonder about the relative risk of shoveling: is this more dangerous than other activities? On the whole, heart attacks while shoveling represent a small proportion of the total heart-related deaths in the US each year: “The absolute risk of death-while-shoveling is low. An often-quoted statistic holds that 1,200 American die from a heart attack or other cardiac event during or after a blizzard every year, and that snow-shoveling is frequently to blame. This figure is sometimes attributed to the Centers for Disease Control, although an agency spokeswoman could not verify its source. Even if this statistic were correct, it’s nothing in comparison to the total number of annual heart-related deaths. According to the American Heart Association, there are 425,425 deaths per year from coronary heart disease.” That comes out to 0.3%.

h/t Instapundit

How location, particularly living in the city, affects health

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Two sociologists argue that location, particularly living in poor neighborhoods in large cities, can lead to more negative health outcomes:

“When trying to understand a person’s health and well-being, we believe that their zip code may be just as important a number to their physical health as their blood pressure or glucose level,” Fitzpatrick says in a statement.

Fitzpatrick and Mark LaGory of the University of Alabama at Birmingham have authored, “In Unhealthy Cities: Poverty, Race, and Place in America,” about high-poverty urban neighborhoods and the health of Americans…

For example, there have been numerous studies on how a concentration of fast-food restaurants in poor, predominantly minority neighborhoods impacts the health of the residents, while other studies show many of these poor neighborhoods may not have a single grocery store offering fresh, nutritious food or safe places to exercise.

“Some parts of the city seemed to be designed to make people sick,” the authors say.

These conclusions are not surprising though they may contribute to the growing field of the sociology of wellness. I particularly like the last quote: “Some parts of the city seemed to be designed to make people sick.” This leads to a question: how could cities or neighborhoods be designed to make people healthy?

Reading about this reminded me about some of the rationale used by some of the first suburban residents in England and the United States. Among other factors, the suburbs were said to be healthier and have cleaner air. The big city, particularly by the late 1800s, was viewed as dirty and crowded. The single-family home allowed families to spread out and take in more of the country air.

I would be curious to see if this study, or other studies, could provide estimates of life expectancy for people with similar socio-economic status living in different locations.