Lecture 11: Biosocial interaction and Health Disparities

mental health

spectrum encompassing a range of experiences, symptoms, and capacities and dynamic rather than as a fixed state

• all individuals fall somewhere on this spectrum

mental health experiences can be frames as forms of

disease - lack of balance or homeostasis rather than presence of a discrete illness

Mental health challenges can arise from

• recombination of novel human genes naturally selected for their influence on evolutionary adaptations of ancestral brains

• pressures and demands of contemporary social life

increased pop. density, broader social networks, and heightened social comparison

can make the stress of evolutionary mismatch worse

what major factors contributed to increased life expectancy in recent decades

• improvements in early life care

• clean water

• adequate nutrition

• vaccinations

• access to healthcare

income and wealth and life expectancy

higher income and wealth generally associated with longer life expectancy, especially when supported buy systems that distribute benefits broadly

does life expectancy continue to increase indefinitely with income

no - plateaus after a certain income level, meaning additional wealth has diminishing effects on lifespan

• suggests health is not just influenced by absolute wealth but also how income is distributed and levels of inequality

inequality and life expectancy

high inequality → larger class-based differences in life expectancy and lowers overall population health

countries, examples pf high inequality affecting life expectancy

the US and UK

what biological factors limit human longevity

• senescence (aging)

• cognitive decline

how is healthcare spending used in high-income countries regarding aging

large portion is spent on extending life in olde age, doesn’t always improve quality of life

quality of life cannot be

measured by income alone, includes social and environmental factors

social embeddedness

degree to which individuals are included connected, and supported within their society

• greater inclusion and support are linked to health and welling

forms of inequality that influence health and quality of life

racism, sexism, ageism, classism

• affects access to resources

• exposure to stress

• long-term wellbeing

life expectancy is not a perfect measure health of individual health because

it does not capture all aspects of individual health, but it still helps identify broad patterns of inequality and health disparities at the population level

health outcomes reflect how societies are

structured and how individuals are situated within those structures

each individual carries

• genetic histories

• lived experiences shaped by social and physical environments

• constraints and opportunities shaped by social position

race is not a valid biological category

scientific evidence shows human genetic variation is continuous (clinal) not categorical

• HOWEVER racial categories have real social consequences and map onto measurable health disparities

embodiment of stress

process by which chronic exposure to stress (ex. discrimination) becomes biologically incoroporated into the body over time

racial categories in research is controversial

helps measure inequality but also reinforces that idea that race is biologically real

racial health disparities should be understood as

persistent and unfair inequities that should be addressed as social injustices

Whitehall studies revelead

four fold difference in adult mortality rates across occupational classes, even with universal healthcare - cannot be explained by genetics or illness related mobility

key factors contributing to health inequalities in wealthy societies

• relative social status

• hierarchy awareness

• loss of control

• insecurity

• status anxiety

importance of sense of control

feeling in control of one’s life reduces stress and improves health

events that cause status loss

• divorce

• forced migration

• displacement

refugees particularly vulnerable to health issues

often experience sudden declines in social and economic status, leading to high stress

key factors leading to social inequality in high income countries

• relative social status

• chronic reminders of one’s position within social hierarchies

• loss of control, insecurity, and status anxiety

high levels of social cohesion (shared values, stable institutions, trust, equitable access to resources) →

lower stress and better pop health outcomes, tend to support collective investment in health and social programs

lifestyle incongruity

mismatch between educational attainment, occupation, income, and desired lifestyle can generate stress even among individuals with similar economic resources

adaptive prediction

• developing organisms respond to prenatal and early postnatal cues to anticipate fetus

• early life environments play a critical role in shaping lifelong health trajectories

nutritional stress and social stress experienced by mothers can elevate glucocorticoid exposure in fetus →

• anxiety and stress responses

• growth and maturation patterns

• social and emotional development

• *effects can last across generation → reinforce cycles of inequality

coping strategies can mitigate stress, but they do not

eliminate underlying structural causes

sex differences in stress and immunity reflect different lived experience by gender and hormonal influences

• androgens tend to suppress immune function

• estrogen enhances immunity but increases autoimmune risk

biocapital

commodification of human biological materials and processes, including:

• tissue and organ harvesting

• reproductive technologies (egg freezing, surrogacy, IVF)

• genetic testing and screening

• medical imaging and molecular technologies (ex. CRISPR, GLP1 medications)

biocapital technologies raise significant ethical concerns

• access and inequality

• surveillance and ownership of biological data

• profit motives shaping definitions of risk and health

humans increasingly exist using

technical enhancements placed inside bodies integrated with technologies that influence cognition, behavior, and self respect

boundaries between health, medicine, and consumer choice are shifting rapidly, raising questions about

• what constitutes legitimate treatment vs enhancement

• how risk is defined and managed by institutions

• how individual health depends on collective social health

MH emerges from

interactions between biological, cultural, social. and ecological systems

contemporary approaches to MH aim to move beyond

simplistic nature-nurture dichotomies

early psychiatry emphasized

hereditary, often with harmful consequences (ex. eugenics - forceful sterilizing, selective breeding)

mid20th century models of MH focused on

chemical imbalance

recent decades MH models focus on

neurobiological foundations alongside social context

MH diagnosis remain challenging due to

shifting definitions or normality, cultural variation, and the risk of u dissent or difference

culture-bound syndromes

MH conditions that do not fit neatly into Western diagnostic categories and are best understood within specific cultural contexts

examples

• Piboktoq - Inuit communities, involving sudden episodes of extreme agitation, screaming, disrobing, and sometimes amnesia afterward

• susto - Latin American cultures, caused by frightening event that leads to the soul leaving the body, resulting in symptoms like anxiety depression, and physical illness

• amok - SE Asia, suddenly enters violent, uncontrolled frenzy, often followed by exhaustion or amnesia

• latah - SE Asia, exaggerated startle responses, repeating words, imitating actions and automatic obedience

Culture bound syndromes show that MH is

shaped by cultural context and cannot be universally categorized

are common disorder like anxiety and depression the same across all cultures

no- their expression and interpretation vary across cultures

evolution of DSM indicates

diagnostic categories for MH change over time and are influenced by cultural and scientific developments

transient depressive systems may

facilitate reflection, social support, or recovery

in theory, having a range of genes that may have been selected to influence adaptation in various dimensions of human intelligence (heterozygosity) may

support creativity leadership, or social sensitivity in non extreme forms

genetic clustering from assortment and recombination may

contribute to disporders such as bipolar disorder or schizophrenia

symptoms like epigenetic

prove MH traits have adaptive roots - emerge from genotype x phenotype interactions

early brain development underscore importance of early intervention

• sensory development occurs early in life

• language capacity stabilized by adolescence

• higher cognitive functions continue into adulthood

promoting early wellbeing benefits not only individuals but society as a whole

healthier ops are better able to sustain social and economic systems