All About You — Day 8: Class, Culture & Income
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[For “Day 7: Peers (Allies & Enemies),” click here.]
ALL ABOUT YOU — DAY 8:
CLASS, CULTURE AND INCOME
So far in this “All About You!” series, we’ve looked at how various influences since our earliest years helped shape who we are today.
Some of those influences have been internal, such as our unique biology giving rise eventually to our Big 5 Personality Traits. However, others have been largely external, such as our parents, siblings, and peers.
We also kicked off this first “Who are you?” part of this series with an overview of our own Top 10 Lists of the people, events, and goals we consider currently consider most influential from our past and most important to our futures. (Part Two is “What do you want?” and Part Three is “How will you get it?”) Our Top 10 Lists provided important clues about who we truly are because they point us to what we love most, as did our review of our childhood happiness and triumphs.
Now it’s time to consider the potential effects on our adult lives from having grown up in our own particular social class/status, culture/race/ethnicity/gender, and parents’ income levels. These influences are even less obvious to us than some of the others we’ve discussed in this series so far precisely because these were so pervasive and, hence, as common to us as the air we breathed. Even those of us who were very poor as kids usually didn’t know it till at least elementary school.
It wasn’t until we had moved several times in the U.S. and I was already attending my third elementary school that I finally realized we were considered “poor.” During our first year in that particular new city, our family was picked by the local school district as the family most in need of a little financial help over the Thanksgiving holiday. To our complete surprise, a group of strangers suddenly showed up on Thanksgiving Day with bags of groceries and used dolls for each of us girls. It’s true that we didn’t have any dolls that I can recall prior to that event. But, we always had plenty of food! I asked my dad why or how they could think that we were so poor. In one of his rare matter-of-fact, straight-to-the-point moods, he looked at me for a moment, shrugged his shoulders, and simply replied, “Because we are.”
LOW CLASS AND INCOME
As I have previously in this series, I quote once more from Abnormal Psychology: Core Concepts
In our society, the lower the socioeconomic class, the higher the incidence of mental disorder (e.g., Caracci & Mezzich, 2001); Kessler et al., 1994). The strength of this inverse correlation seems to vary with different types of mental disorder, however. For example, antisocial personality disorder is strongly related to socioeconomic status (SES), occurring about three times as often in the lowest income category as in the highest income category, whereas depressive disorders occur only about 1.5 times as often in the lowest income category (Kessler et al., 1994; see also Eaton & Muntaner, 1999; Kessler & Zhao, 1999).
There are many reasons for this general inverse relationship. There is evidence that some people with mental disorders slide down to the lower rungs of the economic ladder and remain there, sometimes because they do not have the economic or personal resources to climb back up (e.g., Gottesman, 1991) and sometimes because of prejudice and stigma against those with mental illnss (e.g., Caracci & Mezzich, 2001). At the same time, more affluent people are better able to get prompt help or to conceal their problems. However, it is also true that, on average, people who live in poverty encounter more, and more severe, stressors in their lives, including lower self-esteem, than do more affluent people, and they usually have fewer resources for dealing with them (e.g., Twenge & Campbell, 2002). Thus, lower socioeconomic groups may show increased prevalence of mental disorders due at least party to increased stress on the people at risk (Eaton & Muntaner, 1999; Gottesman, 1991; Hobfoll et al., 1995).
Children from lower-SES families also tend to have more problems. A number of studies have documented a strong relationship between the parents’ poverty and lower IQs in their children at least up to age 5. Persistent poverty has the most adverse effects (Duncan, Brooks-Gunn & Klebanov, 1994; McLoyd, 1998), including greater mental distress, as well as greater risk-taking and affiliating with deviant peers (Sampson, Morenoff & Gannon-Rowley, 2002). Children from low-SES families who were assessed when they were in preschool showed more acting-out and aggressive behaviors over the next 4 years (Dodge, Pettit & Bates, 1994). Nevertheless, many inner-city children from high-risk socioeconomic backgrounds do very well, especially those with higher IQs and those with adequate relationships at home, in school, and with peers (Felsman & Valliant, 1987; Masten & Coatsworth, 1995).
UNEMPLOYMENT
Other studies have examined the effects of unemployment per se on adults and children. Since the 1970s, there have been a number of severe economic recessions experienced worldwide, and significant rates of unemployment have accompanied each. Studies have repeatedly found unemployment—with its financial hardships, self-devaluation, and emotional distress—to be associated with enhanced vulnerability and elevated rates of psychopathology (e.g., Dooley & Catalano, 1980; Dooley, Prause & Ham-Rowbottom, 2000; Grzywacz & Dooley, 2003).
In particular, rates of depression, marital problems, and somatic complaints increase during periods of unemployment but usually normalize when employment rates recover (Dew, Penkower & Brumet, 1991; Jones, 1992; Murphy & Athanasou, 1999). It is not simply that people who are mentally unstable tend to lose their jobs. These effects occur even when mental health status before unemployment is taken into account. Not surprisingly, the wives of unemployed men are also adversely affected, exhibiting higher levels of anxiety, depression, and hostility, which seems to be at least partially caused by the distress of the unemployed husband (Dew, Bromet & Schulberg, 1987). Children too can be seriously affected. In the worst cases, unemployed fathers are much more likely to engage in child abuse (Cicchetti & Lynch, 1995; Dew et al., 1991).
RACE AND ETHNIC DISCRIMINATION
Vast numbers of people in our society have been subjected to demoralizing stereotypes, as well as both overt and covert discrimination in areas such as employment, education, and housing. We have made progress in race relations since the 1960s, but the lingering effects of mistrust and discomfort among various ethnic and racial groups can be clearly observed in many places (e.g., Eagly, 2004). For example, perceived discrimination seems to predict lower levels of well-being for women on dimensions relating to a sense of growth, autonomy, and self-acceptance (Ryff, Keyes & Hughes, 2003). Prejudice against minority groups may also explain why these groups sometimes show increased prevalence of certain mental disorders such as depression (Cohler, Stott & Musick, 1995; Kessler et al., 1994). One possible reason for this is that perceived discrimination may serve as a stressor that threatens self-esteem, which in turn increases psychological distress (e.g., Cassidy et al., 2004).
GENDER DISCRIMINATION
We have made progress in recognizing the demeaning and often disabling social roles our society has historically assigned to women. Again, though, much remains to be done. Many more women than men suffer from various emotional disorders, most notably depression and anxiety disorders, which are two of the three most common categories of disorders. This may be at least partly a consequence of the vulnerabilities (such as passivity and dependence) intrinsic to the traditional roles assigned to women and of the sexual discrimination that still occurs (Eagly & Karau, 2002; Helgeson, 2002). Sexual harassment in the workplace is another type of stress that women may experience. In addition, the special stressors with which many modern women must cope (being full-time mothers, full-time homemakers, and full-time employees) as their traditional roles rapidly change have also been implicated in higher rates of depression, anxiety, and marital dissatisfaction in women than in the past. This is especially true if a woman works long hours (over 40 hours a week), has a higher income than her husband, and has more children at home. However, it should also be noted that under at least some circumstances, working outside the home has also been shown to be a protective factor against depression and marital dissatisfaction (e.g., Brown & Harris, 1978; Helgeson, 2002).
SOCIAL CHANGE AND UNCERTAINTY
The rate and pervasiveness of change today are different from anything our ancestors ever experienced. All aspects of our lives are affected—our education, our jobs, our families, our leisure pursuits, our finances, and our beliefs and values. Constantly trying to keep up with the numerous adjustments demanded by these changes is a source of considerable stress. Simultaneously, we confront inevitable crises as the earth’s consumable natural resources dwindle and our environment becomes increasingly noxious with pollutants. No longer are Americans confident that the future will be better than the past or that technology will solve all our problems. On the contrary, our attempts to cope with existing problems seem increasingly to create new problems that are as bad or worse. The resulting despair, demoralization, and sense of helplessness are well-established predisposing conditions for abnormal reactions to stressful events (Dohrenwend et al., 1980; Seligman, 1990, 1998). This sense of helplessness was also exacerbated for Americans by the September 11, 2001, terrorist attacks on the World Trade Center in New York and the Pentagon, with many people now living under increased worry and uncertainty over the possibility of terrorist attacks. Yet, in other parts of the world, such as Israel and Palestine, people have lived with this uncertainty and worry over terrorist attacks for decades.
URBAN VIOLENCE
Every year, all over the world, vast numbers of people in big cities of both developed and developing countries are direct or secondhand victims of urban violence (Caracci & Mezzich, 2001). It has been estimated that at least 3.5 million people worldwide lose their lives to violence each year (World Health Organization, 1999). Domestic violence against women and children is especially widespread (e.g., Caracci, 2003). Such violence takes its toll on the victims not only in the areas of medical care and lost productivity but also in increased rates of anxiety, post-traumatic stress disorder, depression, and suicidality (e.g., Caracci & Mezzich, 2001).
HOMELESSNESS
Another severe stress in urban areas worldwide is homelessness, which has been rapidly growing for the past few decades. Estimates are that approximately one-third of homeless people are affected by severe mental illness, but many people who are not mentally ill also become homeless because they are victims of violence or poverty (e.g., Caracci & Mezzich, 2001). Needless to say, the major stressors experienced by being homeless create mental distress including anxiety, depression, suicidality, and physical illness, even in those who started out healthy.
DELINQUENCY
Broad social conditions may also tend to produce or support delinquency (Ward & Laughlin, 2003). Interrelated factors that appear to be of key importance include alienation and rebellion, social rejection, and the psychological support afforded by membership in a delinquent gang. A recent report by the Office of Juvenile Justice and Delinquency Prevention estimated that there are 23,388 youth gangs with 664,906 members in the United States. Every state and every large city has a gang problem, and gangs are cropping up in small rural towns across the United States as well. The gang experience is male-oriented; only about 3 percent of gang members are female. In 1995, there were 46,359 gang-related crimes and 1,072 gang-related murders reported (Office of Juvenile Justice and Delinquency Prevention, 1995). The problem of gang membership is most prevalent in lower-SES areas and more common among ethnic minority adolescents (48 percent are African-Americans; 43 percent are Hispanic Americans) than among Caucasians. Although young people join gangs for many reasons, most members appear to feel inadequate in and rejected by the larger society. One recent study (Yoder, Whitlock & Hoyt, 2003) found that a significant number of homeless youth (32 percent of the sample) become gang members. Gang membership gives them a sense of belonging and a means of gaining some measure of status and approval.
ALCOHOL ABUSE
Alcohol use is a pervasive component in the social life in Western civilization. Social events often revolve around alcohol use, and alcohol use before and during meals is commonplace. Alcohol is often seen as a “social lubricant” or tension reducer that enhances social events. Thus investigators have pointed to the role of sociocultural as well as physiological and psychological factors in the high rate of alcohol abuse and dependence among Americans (Vega et al., 1993).
The effect of cultural attitudes toward drinking is well illustrated by Muslims and Mormons, whose religious values prohibit the use of alcohol, and by orthodox Jews, who have traditionally limited its use largely to religious rituals. The incidence of alcoholism among these groups is minimal. In comparison, the incidence of alcoholism is high among Europeans. For example, one survey showed the highest alcohol-use rates among young people to be in Denmark and Malta, where one in five students reported having drunk alcohol ten times within the past 30 days (ESPAD, 2000). Interestingly, Europe and six countries that have been influenced by European culture—Argentina, Canada, Chile, Japan, the United States, and New Zealand—make up less than 20 percent of the world’s population yet consume 80 percent of the alcohol (Barry, 1982). Alcohol abuse continues to be a problem in Europe, and these problems greatly enhance accidents (Lehto, 1995), crime (Rittson, 1995), liver disease (Medical Council on Alcoholism, 1997), and the extent to which young people are becoming involved in substance-use problems (Anderson & Lehto, 1995). The French appear to have the highest rate of alcoholism in the world, approximately 15 percent of the population. France has both the highest per capita alcohol consumption and the highest death rate from cirrhosis of the liver (Noble, 1979). In addition, France shows the highest prevalence rates: In a broad survey of hospital patients, 18 percent (25 percent for men and 7 percent for women) were reported to have alcohol-use disorders, although only 6 percent of admissions were for alcohol problems (Reynaud, Leleu, et al., 1997). In Sweden, another country with high rates of alcoholism, 13.2 percent of men’s hospital admissions, and 1.1 percent of women’s, were attributed to alcohol (Andreasson & Brandt, 1997). Thus it appears that religious sanctions and social customs can influence whether alcohol is one of the coping methods commonly used in a given group on society.
The behavior that is manifested under the influence of alcohol seems to be influenced by cultural factors. Lindman and Lang (1994), in a study of alcohol-related behavior in eight countries, found that most people expressed the view that aggressive behavior frequently followed their drinking “many” drinks. However, the expectation that alcohol leads to aggression is related to cultural traditions and early exposure to violent or aggressive behavior.
In sum, we can identify many reasons why people drink—as well as many conditions that can predispose them to do so and reinforce drinking behavior—but the exact combination of factors that result in a person’s becoming an alcoholic are still unknown.
SUICIDE
Substantial differences in suicide rates occur among different ethnic/racial groups in the United States. For example, Whites have much higher rates of suicide than African-Americans, except among young males, where rates are similar between White and African-American men. Only young Native American men show a suicide rate similar to that of White American males.
Suicide rates also appear to vary considerably from one society to another. Hungary, with an annual incidence of more than 40 per 100,000, has the world’s highest rate (about four times that of the United States). Other Western countries with high suicide rates—20 per 100,000 or higher—are Switzerland, Finland, Austria, Sweden, Denmark, and Germany. Rates in Japan and China are also high (Hesketh, Ding & Jenkins, 2002). The United States has a rate of approximately 11 or 12 per 100,000. Countries with low rates (less than 9 per 100,000) include Greece, Italy, Spain, and the United Kingdom (Maris et al., 2000). Some have estimated the global mortality from suicide at 15 per 100,000 (WHO, International Suicide Statistics Resource Page, 2005).
Religious taboos concerning suicide and the attitudes of a society toward death are also apparently important determinants of suicide rates. Both Catholicism and Islam strongly condemn suicide, and suicide rates in Catholic and Islamic countries are correspondingly low. In fact, most societies have developed strong sanctions against suicide, and many still regard it as a crime as well as a sin.
Japan is one of the few societies in which suicide has been socially approved under certain circumstances—such as conditions that bring disgrace to an individual or group. During World War II, many Japanese villagers and Japanese military personnel were reported to have committed mass suicide when faced with defeat and imminent capture by Allied forces. There were also reports of group suicide by Japanese military personnel under threat of defeat. In the case of the kamikaze, approximately 1,000 young Japanese pilots deliberately crashed their explosive-laden planes into American warships during the war’s final stages as a way of demonstrating complete personal commitment to the national purpose. Comparable acts of self-destruction still occur today in the Middle East, where Muslim extremists and terrorists all too often commit suicide in order to ensure that a bomb explodes in a designated target area. In the case of the al Qaeda attacks on September 11, 2001, terrorists took over commercial jets and then flew them into the World Trade Center and the Pentagon, killing themselves and over 3,000 innocent people. More recently in Iraq, after the fall of Saddam Hussein, suicide bombers have formed a major part of the insurgency in Iraq against U.S. and other foreign soldiers, as well as against members of Iraq’s newly formed government forces.
There are also interesting cross-cultural gender differences in whether men or women are more likely to attempt and complete suicide. Although women are more likely to attempt and men to complete suicide in the United States, in India, Poland, and Finland, men are more likely than women to engage in nonfatal suicide attempts. In China, India, and Papua New Guinea, women are more likely to complete suicide attempts than men (Canetto, 1997; Jamison, 1999).
In a pioneering study of sociocultural factors in suicide, the French sociologist Emile Durkheim (1897 - 1951) attempted to relate differences in suicide rates to differences in group cohesiveness. Analyzing records of suicides in different countries and during different historical periods, Durkheim concluded that the greatest deterrent to committing suicide in times of personal stress is a sense of involvement and identity with other people. More contemporary studies tend to confirm this idea, showing, for example, that being marred and having children tends to protect one from suicide (Maris, 1997; Stolberg et al., 2002).
Durkheim’s views also seem relevant to understanding the higher incidence of suicide among individuals subjected to conditions of uncertainty and social disorganization in the absence of strong group ties. For example, there is a well-known association between unemployment and suicide (especially for men), which may well be related to the effects that unemployment has on mental health (Jamison, 1999; Maris, Berman & Silverman, 2000). Similarly, suicide rates have been found to be higher among groups subject to severe social pressures. For example, in 1932, at the height of the Great Depression in the United States, the suicide rate increased from less than 10 to 17.4 per 100,000.
Many investigators have emphasized the need for broad-based prevention programs aimed at alleviating the life problems of people who are in groups at high risk for suicide (Institute of Medicine, 2002; Maris et al., 2000). Few such programs have actually been initiated, but one approach has been to involve older men—a high-risk group—in social and interpersonal activities that help others. Playing such roles may lessen these men’s sense of isolation and meaninglessness, which often stems from forced retirement, financial problems, the death of loved ones, impaired physical health, and feeling unwanted. For adults who have already made at least one attempt, a recent study found that ten sessions of cognitive therapy focused on suicide prevention were beneficial in reducing further attempts (Brown, Have, et al., 2005). In the 18 months subsequent to receiving treatment, patients in the cognitive therapy group were 50 percent less likely to reattempt suicide than participants in the usual care group, and their depressive and hopelessness symptoms were also lower than in the usual care group. Other programs have been targeted at young adolescents who are at higher risk because of previous suicidal ideation and behavior, and/or mood or substance-use disorders (Zahl & Hawton, 2004).
TO BE CONTINUED …
This is going to be an adventurous journey into our past, present, and future lives. None of us can be prepared for what we might find along the way. So, just sit back and enjoy the ride! Also, I hope at least some of you brave souls will share your answers, insights, and revelations in the comments below for everyone’s benefit!
When you’re done, collect your answers and keep them in a safe place. I recommend a diary. It makes a precious gift to someone you love, especially you!
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August 6th, 2008 at 12:37 pm
Shanel,
I continue to enjoy your landmark series. I just wanted to clarify one thing on the history of my people: kamikaze, the suicide jet pilots, did not all willingly volunteer. Many did not want to die, but were forced to with military and social pressure. They threatened these young men that their cowardice bring shame and dishonor to their family and to the country. It may be hard to imagine from more individualistic cultures, but social pressure has an extremely strong hold on Japanese minds. We make many, many decisions based on whether it fits with our society/community/family/culture or not. But that does not make them a willing participant.
It is true that Japan has a history of view suicides as honorable death, a better alternative to the humiliation of defeat, capture, public embarrassment, and ostracism. However, modern Japan is trying to leave that value behind and is trying to encourage people to live.
ari
August 6th, 2008 at 1:55 pm
Hi Ari! Thank you for yet another though-provoking and insightful comment. However, I must disagree that “military and social pressure” alone — short of threats of torture or death to one’s persons or one’s loved ones — somehow sanctions an adult to seriously harm or kill others, or that such acts can somehow be interpreted as having been done against their will. Otherwise, are gangbangers who shoot and kill rival gangbangers not guilty of intentionally killing them because peer pressure made them do it? Our will is our own. We choose which influences we let sway us, short of torture — or threats of torture or death (which is just another form of torture). And, the law recognizes this and makes exceptions for it, even in instances of killing innocent persons. However, it’s my understanding that the kamikaze pilots were not under similar duress. If they were, I stand corrected.
I’m glad to hear that Japan is working on changing their public views about suicide to value life, regardless of fears of shame or ostracism. I suspect Korea also held similar harmful views about suicide. My parents were both from Korea (Dad originally from North Korea and Mom mostly from South Korea, but born and raised briefly in Japan); and, they both seemed to think that suicide was an acceptable — if not glorious — way to end all their troubles. I don’t know how else to interpret their constant theatrics about killing themselves, sometimes including the plot twist of killing the other first, sometimes not. No doubt my own suicidal tendencies were heavily influenced by all of that. But, when I finally did attempt suicide, I could not say that my actions were not my own, regardless of my “family pressure.”
Not every young man in Japan became a kamikaze pilot. There are always choices. Even if you choose to kill yourself, you can still choose whether or not to take any other lives with you. Do people have a right to die? Maybe. But, we never have the right to take the life of anyone who still wants to live! We are our choices!