Topical Choices for Your Paper
TO: Soc364
FROM: Brent Berry
DATE:
RE: Topics for Literature Review Paper
Please choose to investigate one of the Topics about the effects of physical and social structure of places on health. You may use the cited references, but I EXPECT you to find and use further references. Please emphasize academic and scholarly articles published in leading journals. You may also cite chapters in scholarly books. Do not use magazine or newspaper articles.
The most general theoretical links between physical places and health involve the structure of places. Theories can be organized into those that link the physical structure of places to health, and those that link the social structure of places to health. Three types of mechanisms have been specified in theories about the relationship between place and health. First are mechanisms that directly link the physical or social structures of places to individual functioning or biology. Second are those that propose that effects of macro-level physical or social structures are mediated by other social factors, including other social structures. Third, there are theories that propose interactions between physical and social structures of places, or between those physical/social structures and individual characteristics of people.
I. Physical Structures of Places and Health.
Topic #1 Direct Links between Physical Aspects of Place and Health: Environmental Toxins:
Examples of the research in this group are studies of the effects of living near toxins on health. The theories about the effects of living in toxic areas on health are not sociological, but biological. Population health is studied in terms of aggregation of individuals, so the causal mechanisms link the environment directly to individual health. Studies in this literature focus on the health consequences of lead poisoning (1, 2), chemical compounds (3), molds (4, 5), bacteria and fungus (6), pesticides (7), and particulate matter and Cryptosporidium in drinking water (8, 9). It is generally recognized that individual differences (e.g. genetic makeup) are vulnerability factors and interact with toxins, but the interaction effects are usually not specified or studied, so most research on this type of topic implicitly assumes direct effects. Recent reviews of the literature on environmental toxicology include (7, 10). Several studies have focused on the environmental toxins of urban environments (11, 12).
Topic #2: Indirect Links between Physical Aspects of Place and Health: Mobilization of Communities in Areas of Environmental Toxins
Mobilization of people living in toxic areas is one theoretically important mediating mechanism that can have an effect on population health. This is the type of thing we refer to as community, as indicated by cooperative activity among neighbours. Thus community activities can mediate the effects of physical structures. That is, the mediating mechanisms are patterns of social interaction. Sociological research in this area focuses on selection into toxic areas, and on how people in those areas mobilize to understand or challenge health risks. For example, some communities were effective at implementing a public health surveillance system (13)
Topic #3: Indirect Links between Physical Aspects of Place and Health: The Role of Urban Planning and Design of the Built Environment
One very interesting area of research is on those aspects of physical space that make an area “defensible” – If people feel strongly attached to a place (dwelling, block, or neighborhood) and trust their neighbors; they are more likely to function territorially (14, 15). This may be exhibited in behaviors ranging from increased maintenance of their surroundings to assisting their neighbors and watching out for one another. Territorial functioning spills over into strong neighborhood ties. In communities where the neighborhood becomes a central behavioral space, community ties strengthen and the area becomes more capable of defending itself against outside threats. Certain ecological conditions can promote or reduce territorial functioning. These include spatial conditions that make neighborhoods defensible such as: opportunities for residential surveillance; attractive exteriors; real barriers that separate the residential area into manageable sectors; the absence of “spatial incivilities” such as litter, dilapidation, and graffiti; the presence of shrubs, trees and gardens (16). In addition to these physical characteristics, a high concentration of transients in an area is likely to reduce trust, leading to lower identification with neighbors and limited territorial functioning (17). When these features of defensibility are absent, ties to the larger metropolitan area and local community may be affected (15). For example, spaces that fail to promote defensibility discourage local social interaction. According to the research of Perkins, Brown and Taylor (16) “spatial incivilities, plantings, and barriers that create manageable spatial territories” are factors which are important in shaping local patterns of interaction. These simple, yet manageable aspects of local ecology can determine whether the spatial context promotes isolation, and whether the local area is actively engaged with the larger political context or inactive and ineffective.
II. Social Structures of Places and Health.
Topic #4: Direct Links between Social Aspects of Places and Health: Income and Wealth Inequality
A growing body of work suggests that income inequality per se influences health. Measures of income inequality in this body of work reflect income inequality of large aggregations (society-level of state-level) rather than community- or neighbourhood-level measures of income inequality. Theoretical mechanism: Kawachi et al (19) suggest that unequal income distribution creates a social environment with lower levels of social capital, and thus, higher rates of poor health. If social capital, which is features of social organization, such as networks, norms, and trust (20), is driven by broader levels of income inequality, then perhaps the social structural underpinnings of capitalism need to be addressed to reduce health disadvantage. However, it is unclear whether the advantages of neighbourhood income inequality (less economic segregation) outweigh the disadvantages the relative deprivation of that community’s disadvantaged residents.
Wilkinson (18) has argued that effects of social inequality on health are mediated through feelings of shame among those at the bottom. Although there is a mediating mechanism, all of the processes of mediation occur within the individual. There are many social psychological theories about how this type of thing occurs. These theories tend to specify how social structure in itself is stressful. For example, the group threat hypothesis is that the people in majority ethnic groups feel increasingly threatened as the proportion of minorities also occupying the space grows. Although group threat could be mediated by social processes (see below), the theory does not specify that this is necessary. Since perceived threat is one type of stress, and stress can have health effects, this type of theory is one variant of theories directly link social (ecological) structure to health.
Topics 5-7 Indirect Links between Social Aspects of Places and Health: Diffuse Mediators
There are a very wide range of theoretical processes that fall under this heading. We therefore divide those into processes that involve diffuse mediators typically involving informal social networks and those that involve more specific formalized institutions.
Topic 5: Indirect Links between Social Aspects of Places and Health: The Role of Subcultures, Peer Groups, and Role model Effects.
Theorists have argued that health related subcultures develop within places as a function of the social structure of those places. Specifically the segregation of places from each other has been thought to facilitate unique subcultures that can have unique effects on health. These effects are mediated by social networks within the group – Social psychology offers rich body of evidence on the importance of peer group or role model effects (21, 22). Individuals’ make decisions based not just on personal preferences but also on whether those decisions deviate from choices made by members of a reference group (23). Areas characterized by residents with limited life chances that are highly segregated tend to have dense local social networks and this localized social capital is likely to promote the development of subcultures. Individuals in such areas develop intense social bonds and have few links outside the social area-- creating what (23, 24) describes as a “critical mass” for subculture formation. A situation of high choice, local friendship occurring in densely populated areas, permits the critical mass that allows, “What would otherwise be a small group of individuals to become a vital, active subculture” (24). For a subculture to emerge, certain minimum numbers are necessary to support the institutions that give the group a unique identity. Individuals learn cultural norms and values from role models. If the choice of these role models is high, but their social diversity low, then a situation of high conformity to the local subculture is likely (Rytina and Morgan 1982). This conformity will be further intensified if people in the community also have limited resources to seek contacts outside the area, a condition occurring in inner-city areas where transportation is limited by low income and high rates of unemployment. Under these circumstances of limited life chances and highly concentrated social networks, conformity to the norms and values of the local area and limited individual autonomy will be the rule.
The degree to which the subculture deviates from the traditional culture will depend partially on how isolated the local group is from other communities within the metropolitan area. In areas with high local friendship choices, high levels of racial and class segregation, and low accessibility to other parts of the community, local social networks will be isolated. These spatial conditions promote a deviant subculture. Whether risky behaviors become part of this strong local subculture will depend on the presence of “illegitimate institutions” and “deviant role models” (25). Such conditions are most likely to emerge in places where the dominant culture’s goals (such as achievement, material acquisition, etc.) are difficult for the local group to attain-- a situation most common in areas with limited life chances (26). These ecological circumstances (high density, high segregation, low access, presence of illegitimate institutions, and deviant role models) may represent the spatial conditions that nurture high probabilities of health compromising behaviors and health beliefs. This health compromising subculture can further exacerbate the high-risks concentrated in such communities. Hence, local ecology often promotes a mosaic of distinct health challenges, combining unique subcultures with high amounts of hazard and risk. The most obvious and discussed of these subcultures are inner city areas where the “urban health penalty” is greatest (27).
Topic #6 Indirect Links between Social Aspects of Places and Health: The Role of Social Supports and Communalism
Personal contacts from an individual’s social network are an important resource that aid in securing a rewarding work or receiving advice and psychological support in times of stress (28). The combination of high density, high segregation, and limited access promotes communalism (29). Communalism is a situation where local social ties are strong but the community is cut off from other areas because of the absence of “weak ties” or bridging social capital to the remainder of the metropolis. Such local patterns of friendship, with dense networks that do not extend beyond the local area, make it difficult for any community to respond to threats from the outside. This may be particularly true in high-risk environments, such as the inner city, where ties to the local power structure clearly make a difference.
Topic #7 Indirect Links between Social Aspects of Places and Health: The Role of Racism and a Discriminatory Society
Some work has proposed that the well-known black-white differences in health outcomes are in part a product of a discriminatory society(31, 32). The social environment corollaries to discrimination are policies that discriminate based on race/ethnicity, leading to residential segregation or unequal distribution of one racial/ethnic group through institutions or corporations. Polednak has used the index of dissimilarity, measuring the degree of black-white segregation, to test hypotheses about the link between black infant mortality and the concentration of extreme poverty and “poorer neighbourhood quality (e.g. inadequate high-density housing, crime, noise, and psychosocial stresses). Leclere and colleagues (33) found that the mortality gap between blacks and whites was eliminated with the concentration of minority population, community SES variables, and individual SES variables were included in the model. In contrast, persons of Mexican origin were protected by concentrations of Hispanics and blacks, adjusting for individual SES. LaVeist (34)studies the relationship between black political power and post neonatal mortality, finding a an inverse relationship after adjusting for the poverty rate, level of segregation, percent of female high school graduates, birth rate to unwed mothers, percent of black population, and region of the country. Kennedy and colleagues (35) studied collective discrimination and mortality, defining collective discrimination as “a lack of respect one group displays toward another.” A lack of respect was inversely correlated with state median income level. They found that disrespect predicted age-adjusted black mortality rates and white mortality rates.
One relevant theory from this literature is the contact hypothesis. The idea is essentially that ethnic or racial composition of places has an effect on discrimination through opportunities to cooperative contact among equal status participant, but that contact among unequals can foster discrimination. Is proximity to other racial through desegregation necessarily good when proximity may open more avenues for discrimination?
Topics 8-9: Indirect Links between Social Aspects of Places and Health: Formal Social Institutions
The social networks and economic resources available to community residents impacts the political success at building and maintaining high-quality formal organizations that are important to health promotion -- clinics, schools, libraries, recreation, and law enforcement. A full range of formal institutional mediators that should be investigated include service agencies and the linkages among them. Some health education occurs in a diffuse way, through informal “transmission structures” associated with social networks in the community, but much also occurs through formal organizations.
Topic #8: Indirect Links between Social Aspects of Places and Health: The Role of Churches
LaViest has examined the role of the churches in black communities as mediators between disadvantaged social structural conditions and health (34, 36). Specifically, he studied the relationship between black political power via churches (as formal organizations) as critical in mobilizing communities to reduce post neonatal mortality. (37).
Topic #9: Indirect Links between Social Aspects of Places and Health: The Role of the Family
The family as an organization is another important mediator between social aspects of place and health (38, 39). Several scholars have tested Wilson’s (38) thesis that families in poor areas provides a “buffer” to the deleterious effects of poor neighborhoods on health and other developmental outcomes (40-42). The family structure and function as a mediator of some of the broader social structural processes(43). Some evidence suggests that parents in unsafe places control the activities of their kids more than in other places, and this increases their safety, and may translate into more control over health behaviors and environmental stress as well
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