The Impact of Inequality on Personal Life Chances

Roderick Graham

Fordham University

How does inequality effect…

1. Physical Health2. Psychological Health3. Food and Shelter

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

Physical HealthSubjective 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

Physical HealthHealth 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

Physical HealthHealth 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

Physical HealthUse 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

Physical HealthUse of Health Services

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

Class position creates mental distress

Mental Illness

OR?

Psychological HealthClass, 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

Psychological HealthClass, 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

Psychological HealthLabeling, 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)

A quick detour into labeling theoryLabeling 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…

Primary Deviance

Secondary

DevianceStigma Deviant

Career

Retrospective labeling

Projective Labeling

Psychological HealthSense 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

Food and ShelterHunger 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

Food and ShelterHomelessness 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)

END