Chapter 4 The Social Demography of Health: Gender, Age, and Race Medical Sociology Twelfth Edition William C. Cockerham Chapter 4 The Social Demography of Health: Gender, Age, and Race

Gender: The Narrowing Gap in Longevity 2008 study revealed declines in life expectancy for some groups in the U.S. Between 1961 and 1983 no declines in life expectancy anywhere in the country Between 1983 and 1999 declines for 19% of women and 4% of men Declines sharpest among rural, low-income female populations in the South and lower Midwest

Gender: The Narrowing Gap in Longevity In preindustrial societies, life expectancy for men and women was similar Since 1850, women made greater gains in life expectancy and today outlive men in all but a few countries Changes in work and family circumstances in the 1970s and a convergence between men and women in lifestyles mean the gap between men and women is narrowing

Gender: The Narrowing Gap in Longevity

Gender: Male-Female Life Expectancy Male death rates still exceed those of females at all ages and for the leading causes of death such as heart disease, cancer, cerebrovascular diseases (stroke), accidents, and pneumonia Male inferiority in life expectancy has both biological and social components Higher mortality rates even at the prenatal and neonatal stages Higher rates of accidents, aggressive and risky behavior, and occupational stress

Gender: Male-Female Life Expectancy Men generally have a higher rate of mortality, but women appear to have a higher morbidity rate Women are more likely to have chronic conditions that are not a leading cause of death (except for diabetes) Men have more of the chronic health problems that end one’s life

Gender: Smoking Some 443,000 Americans die each year from smoking-related diseases The current trend in the United States is toward a decrease in smoking for both sexes Rate of male smokers began declining earlier and faster than women

Gender: Mental Health No consistent differences between men and women in clinically diagnosed cases of mental illness, except: Women have higher rates of mood and anxiety disorders Men have more personality disorders Marriage and employment carry mental health benefits for both men and women

Age The 20th century has seen the rapid growth of the aged population worldwide

Age Current cohort of elderly: Healthier, better educated, and more affluent than past cohorts Increased political power to influence relevant legislation (especially regarding Social Security and Medicare) Although healthier, will place greater demand on health care delivery systems as there are more of them

Age Most elderly rate their health as good despite the deterioration of health that accompanies old age Suggests two important points about self-rated health: It is a relative assessment People compare themselves to others who are similar in age and sex Shows how health is perceived in terms of ability to function Older adults generally have reduced daily activities compared to young adults, thus poor health is less likely to be viewed as disruptive

Race The convergence of biological factors with geographic origins, and multiple cultural, economic, political, and legal variables

Race: Black Americans Blacks are disadvantaged compared to whites in longevity

Race: Black Americans Significantly more blacks than whites have hypertension, a major contributor to black mortality Multiple reasons are suggested for this pattern: Genetic predisposition Physical exertion (more likely than whites to be engaged in manual labor) Associated disorders (more likely to have other diseases that cause hypertension) Psychological stress (from racial discrimination) Dietary patterns Poorer medical care

Race: Black Americans Health disparities between blacks and whites point to the importance of socioeconomic factors Poverty, marginal employment, low incomes, segregated living conditions, and inadequate education are more common among blacks than whites and are features of socioeconomic stratification known to cause poor health

Race: Black Americans The “intra-racial network effect” is offered as one explanation for why blacks have the highest rates of STDs Blacks are more segregated than other racial/ethnic groups in American society A high number of sexual contacts between an infected black core and its periphery of yet uninfected black sexual partners tends to contain the infection within the black population

Race: Hispanics “Hispanic paradox” Hispanics have lower mortality rates than non-Hispanic whites at most ages despite their lower socioeconomic status and levels of health insurance in the United States Population is younger than other racial groups and may explain the paradox Hispanics more likely to be without a regular source of health care

Race: Native Americans Have experienced a significant improvement in their overall level of health, but important problems remain. In particular, there are high rates of: Diabetes and mortality from diabetes Accidents Alcoholism and alcohol-related diseases Suicide

Race: Asian Americans Overall, Asians and Pacific Islanders are the healthiest racial group in American society when mortality rates are considered Again, demonstrates importance of socioeconomic status Asian Americans have the highest levels of income, education, and employment of any racial/ethnic minority in the U.S.

Race: Causes of Death

Race: Infant Mortality