Exam 6 Flashcards
What is meant by the term “life expectancy,” aka mortality or longevity? How has it varied over time? By sex? By race, ethnicity, or sexual orientation (why might this be)?
Life expectancy: length of time a person is expected to live, based on year of birth.
Marginalized group status induces unique stressors that can lower life expectancies (vs. dominant groups)
Black Americans: ~3.6 years less than Whites
Latino paradox: Latinos outlive Black people ~6.6 years, Whites 3 years
LGB: 12 years less in anti-gay (vs. welcoming) communities
As we live longer, “diseases of old age” outrank infectious diseases amongst leading causes of death
What is the morbidity-mortality paradox?
Morbidity-mortality paradox: women tend to have higher rates of morbidity (sickness) but older age of mortality (death) vs. men.
- Women self-report poorer health vs. men
- More doctor visits, use of health-related services, $ on healthcare, sick days
- Greater rates of debilitating conditions
- Men’s rates of death higher for all major causes
- Stronger immune systems and infant robustness in girls than boys
- Could gender norms play a role?
- Masculinity & weakness
- Women’s caretaking roles
What are sex-linked recessive diseases? How are they typically passed on, and why are men more likely to inherit them than women (e.g., why are men more likely to inherit hemophilia)?
Many sex-linked recessive diseases passed on by X chromosomes.
- If the disease’s gene is recessive, men have a higher chance of morbidity than women.
- Females (XX): Would need two copies to inherit genetically-recessive diseases
- Males (XY): only one; no “override” for these genes, making men more susceptible to such diseases.
- Note: for genetically dominant diseases, only one copy of gene is required to get sick—so this pattern may look different.
What are telomeres; what do they do? How might they help explain sex differences in longevity?
Telomeres: DNA sequences (“caps”) at ends of chromosome strands that protect genetic data and allow cells to divide.
- Shorten with each division; eventual cell death
- Telomere length: same for males and females at birth
- Male telomeres shorten faster than female ones ——–> greater mortality?
What role do sex hormones (testosterone; estrogen) play in longevity? Which is higher in men vs. women, and what consequences are associated with each? According to the evolutionary perspective, If testosterone can be bad for health, why would men evolve to have higher levels of it—what advantages might it confer (what’s the “tradeoff”)? What might be the evolutionary advantages of estrogen for females?
Sex hormones affect health and longevity.
Testosterone: higher in men
- Cholesterol issues higher cardiovascular (CV) risk
- Lowered immune functioning
Estrogen: higher in women
- Lower blood pressure lower CV risk
- Associated with expressing “longevity genes”
- However, also associated with risk of breast, uterine, ovarian cancers
Evolutionary explanation:
Sex differences in mating challenges
- Males: compete for access to mates prioritize procreation over immunity
- Higher testosterone facilitates aggression, risk-taking
- Tradeoff: increased mortality
- Females: invest time in gestation, raising offspring invest more energy into self-repair
- Mothers’ better immunity, cellular repair = better fetal, infant outcomes
How do health behaviors (accidents; risky sex; smoking; alcohol; poor diet; lack of exercise) differ between men and women? Know whether men or women are more prone to health risks in each area, if there is any difference.
How do behaviors contribute to sex differences in health?
Accidents and risky sex
- Men take more risks than women
- Higher rates of accidental death (workplace injury; leisure; home accidents; firearm; reckless driving; etc.)
- Risky sex generally related to poorer health, and is about equal in men and women
- Rates of HIV about equal by sex globally, but esp. high in marginalized communities (e.g., transwomen, Black/Latino US populations)
Globally, 5-8x as many men (vs. women) smoke cigarettes.
- Men and women both reduced smoking as we learned of health risks
- Mortality from smoking-related disease (e.g., lung cancer) becoming more gender-equal
- E-cig research shows men > women
Alcohol abuse greater in men.
- Decreasing but consistent sex difference
- More likely to die from alcohol-related causes
- More likely to binge drink
- More prone to dependence
Men eat less healthy diets vs. women.
- Associated w/ diabetes, cancer, cardiovascular disease
- Men more resistant to adopting a healthier diet
- Gender stereotypes: food, dieting
Women generally less active than men, although depends on region
- Activity also declines with age
- Sedentary lifestyle associated with chronic illness and obesity
- Obesity epidemic: over 36% of adults in the United States are obese (BMI > 30), and women more so than men
What is UA? UC? Which sex tends to be higher in each? How do these traits affect physical health?
Unmitigated agency (UA) and communion (UC)—extreme and dysfunctional versions of these traits—are bad for physical health
- UA=focus on the self to the exclusion of others; higher in men
- UC=focus on others to the neglect of the self; higher in women
- Being high in these traits are sometimes more predictive of health than sex alone
UA: rude behavior; mistrust and negative view of others; smoking, drinking, drug use; lack social skills (do not seek or accept help); depression, hostility, and tension.
UC: too much energy on nurturing (stressful; taxing); decreased immune functioning; taking on others’ worries; overly intrusive, concerned, and controlling, leading to conflict; do not seek or accept help
Sex differences in healthcare access and treatment: consider how gender role beliefs, racism, sex of the physician / patient, and egalitarianism affect healthcare.
- US women more likely to seek healthcare, increasing detection and treatment
- Gender norms discourage men’s help-seeking
- Men endorse traditional masculinity beliefs = put off seeking healthcare, less self-disclosure to doctors
- Black, Latino (vs. White) U.S. men less likely to have a regular doctor
- For Black men, may be rooted in historically-based mistrust (e.g., Tuskegee Syphilis Study)
- Sex of physician. Female (vs. male) PCPs* = longer visits, engage in more patient-centered communication
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Sex of patient. Doctors may (sometimes unknowingly) treat male and female patients differently, even when similar symptoms.
- Implicit physician biases (automatic, unconscious judgments and behaviors exhibited by doctors that are elicited by features of patient (e.g., sex, race, class)) based in stereotypes - Physicians less likely to test for or treat heart disease in women than men
Egalitarian communities reduce or eliminate sex differences in health.
- Kibbutzim: no sex differences in health status, illness behaviors (e.g., doc visits)
- Mortality sex difference reduced
- Religious communities emphasizing similar lifestyles across sex show smaller difference in mortality (e.g., Catholic nuns/monks)
How do race and gender intersect when observing average life expectancies?
On average, Black men have shorter average life expectancies than women or White men.
- Homicide (45% victims)
- Higher rates heart disease, cancer
- Higher HIV/AIDS mortality rates
Black (vs. White) babies more likely to be low birth weight, die in infancy
What factors contribute to racial minority individuals’ shorter life expectancies, on average?
Racial minority (vs. White) children have less regular access to healthcare
Black and Latino children more likely to live in food deserts
- May contribute to racial differences in obesity rates
How can SES contribute to morbidity and mortality rates? How does it intersect with race?
Socioeconomic status (SES) = total income, education, occupation.
Lower SES = greater morbidity and mortality
- Less access to insurance, healthcare
- Higher chance of living in a food desert (and therefore weight-related disease)
- Feminization of poverty: globally, women experience disproportionate rates of poverty
- Reproductive obstacles: contraceptive use, STI education, access to maternal services
- Can lead to early motherhood, making it harder to get out of poverty
What is minority stress theory? How can it explain worse health outcomes, and for whom?
Although SES is associated with race in USA, it doesn’t fully account for health disparities.
- Higher SES can lessen the gap, but it persists
- Minority stress theory: regardless of SES, belonging to a stigmatized group creates unique stressors that combine to increase minorities’ vulnerability to health problems
- Harassment; abuse; employment discrimination
[Ch 12 JE] What are the factors that contribute to worse health outcomes for Black mothers?
Black (vs. White) mothers 3-4x more likely to die during or after delivery
- Medical biases can lead to lower quality care for Black (vs. White) mothers in pregnancy, during delivery, and post-partum
- Weathering: overactive fight-or-flight response from stress decreases health and increases risky coping behaviors
- Telomeres shorten faster with allostatic load
What are the unique barriers LGBTQ+ individuals face in accessing quality healthcare?
Minority stress theory can also explain health disparities in the LGBTQ+ community.
- LGB = higher rates of disease (vs. heterosexuals)
- Transgender = poorer health, disability (vs. cisgender LGB)
- Chronic stress from stigmatized status, victimization can affect health 2 ways:
- Increased reliance on unhealthy coping strategies (e.g., risky sex, drug use)
- Overburdens stress response and immune system, reducing ability to fight illness
Barriers to quality healthcare also affect LGBTQ+
- Lower rates of health insurance (employment discrimination against same-sex couples)
- Lower quality of care (doctors lack understanding of LGBTQ+ needs; unknowledgeable about hormonal therapies; discomfort; fear of discrimination)
What are the major distinguishing factors that separate internalizing vs. externalizing disorders? Give examples of classes of disorders that fall under each umbrella, related symptoms, and the sex differences in diagnostic rates (d values).
Transdiagnostic approach: most psychological disorders fall into internalizing (“directed inward”) and externalizing (“directed outward”) patterns
Internalizing disorders:
- E.g., Depressive, anxiety disorders
- Experienced privately, blaming and punishing self, low self-esteem, withdrawal, self-injury
- d = -.23
Externalizing disorders:
- E.g., antisocial, conduct, substance use, impulsivity disorders
- Victimizing others, impaired judgment, inhibition, aggression, manipulation, drug use
- d = .52
Reexamine the four gender role factors we covered in class (gender intensification hypothesis; response styles theory; expansion hypothesis; devaluation of women’s domestic labor). What are the tenets of each prediction? What evidence is there for (or against) each?
1) Gender intensification hypothesis: pressure to adopt sex-typed traits intensifies in adolescence as children go through puberty & approach adulthood. Not well-supported.
- Sex differences in depression do arise around puberty
- But no evidence of intensification of sex-typed traits
- “Male-typed” agentic traits (e.g., confidence) are associated with less depression, but boys and girls do not differ much on these traits
2) Response styles theory: sex differences in rumination can explain higher rates of internalizing disorders in women. Supported.
- Women tend to ruminate more
- Men tend to use more active coping strategies (distraction; physical activity)
- Rumination correlates with depression, social phobia, PTSD, generalized anxiety disorder.
3) Expansion hypothesis: occupying multiple social roles buffers against distress by giving meaning and social connectedness
- Traditional domestic labor divisions restrict women to a smaller number of roles, increasing depression
- Partially supported. Doesn’t always replicate.
- Women are occupying more roles over time.
4) Widespread devaluation of women’s labor could contribute to women’s high rates of depression. Supported.
- Sex differences in depression are smaller in subcultures that honor the homemaker role (e.g., Orthodox Jews; Amish)
- Nation-level gender equality correlates with a smaller sex difference in depression rates
How does sexual abuse explain the sex difference in internalizing disorders?
Experiencing sexual abuse and violence: Supported
- Victimization associated with depression
- Girls and women more likely to experience sexual abuse, violence (18% vs. 7.6%)
- Serial victimization higher in women with disabilities
What is neuroticism and how does it contribute to this sex difference?
Neuroticism: chronic tendency to experience negative emotions. Supported
- Strongly correlated with internalizing disorders
- Women score higher on neuroticism than men across cultures
Biologically speaking, how do stress and hormones contribute to this sex difference?
Biology: Supported.
- Stress response: more extreme nervous system activity in women associated with depressive, anxious symptoms
- Estrogens: enhanced sensitivity of stress response increases vulnerability to long-term effects of stress
- Increases during puberty, as do internalizing disorders
- Estrogens: enhanced sensitivity of stress response increases vulnerability to long-term effects of stress
- Heritability: no sex difference in the presence of genes; may be more epigenetic
How are boys socialized early in life that increases their risk for externalizing disorders?
Gender role socialization: Supported.
- Taught to express negativity emotions through anger
rather than ”vulnerable” emotions (e.g., sadness) - Harsher, inconsistent discipline toward boys can
increase aggression, criminality, delinquency- However, a boy’s antisocial tendencies can also elicit these forms of parenting
- More likely to turn to alcohol or drugs
How do impulsivity, effortful control, and callous-unemotional traits contribute to the sex difference in externalizing disorders?
Impulsivity (sensation-seeking, novelty-seeking, risk-taking) and effortful control (”EC;” persistence, focus, inhibitory control). Supported.
- Sex differences:
- Risk-taking and sensation seeking: d = .36 to .41
- EC: d = -1.01
Callous-unemotional (CU) traits (low empathy, guilt, warmth). Supported.
- CU traits (d = .52) underlie aggression, criminality, lack of remorse
Consider the roles of the prefrontal cortex and dopamine. How could they explain the higher rates of externalizing disorders in men?
Prefrontal cortex (PFC) development: planning, emotion regulation, impulse control. Supported.
- Higher prenatal testosterone exposure = lower PFC volume
Dopamine (DA): neurotransmitter involved in reward and control of voluntary movement. Supported.
- Higher DA functioning in women than men
- DAT1 protein regulates use of DA in brain: men more likely to inherit a version that is linked to externalizing disorders