SOCI 172: EXAM 2

What do 'social context' and 'spatial context' refer to in population health studies?

Social Context: The networks, norms, and relationships that influence behaviors and health outcomes. Spatial Context: The geographic and environmental factors—including places, institutions, and communities—that shape access to resources and overall well-being.

How do social and spatial contexts influence health outcomes?

They determine access to healthcare, education, and job opportunities; influence stress levels; and shape the distribution of risk factors and protective factors within communities.

How have U.S. income and wealth inequalities trended in recent decades?

Both income (annual earnings) and wealth (accumulated assets minus liabilities) inequalities have increased—with wealth inequality being even more pronounced—due to shifts in economic policies and market forces.

What distinguishes income inequality from wealth inequality?

Income Inequality: Differences in yearly earnings or wages. Wealth Inequality: Differences in the accumulation of assets (like property, stocks) minus liabilities over time.

What is a marginal tax rate, and why is it important?

It’s the rate applied to the last dollar earned. It matters because it influences incentives for additional earnings and is a key element of progressive tax systems designed to reduce inequality.

How is the Gini index used to measure inequality?

The Gini index quantifies inequality on a scale from 0 (perfect equality) to 1 (perfect inequality), for both income and wealth distributions.

What strategies are proposed to reduce income and wealth inequality?

Strategies include: Increasing the minimum wage, enhancing benefits (childcare, parental leave) for low-income families, strengthening labor unions, implementing a more progressive tax system (including higher taxes on high incomes and wealth).

What were the key components of the Tax Cuts & Jobs Act of 2017?

The Act reduced tax rates for both businesses and individuals, lowered the alternative minimum tax for individuals (and eliminated it for corporations), reduced the estate tax’s reach, and canceled the ACA individual mandate penalty.

How did the Affordable Care Act (ACA) aim to improve healthcare?

The ACA (Obamacare) expanded health insurance coverage, reformed insurance market practices, and provided for Medicaid Expansion (subject to state approval) to improve access for the uninsured.

What was the significance of President Reagan’s decision to fire air traffic controllers?

It delegitimized union power, set a precedent for weakening labor unions, and contributed to the decline in union membership and collective bargaining power.

What factors contribute to county-level disparities in population health?

Economic struggles, weak policy investments, corporate influences, and demographic shifts can lead to vast differences (up to 20 years) in life expectancy between counties.

What positive trend is observed regarding infant and child mortality rates in the U.S.?

Despite broader disparities, there has been slow, steady improvement in infant and child mortality rates across nearly all regions.

How have state-level disparities in life expectancy changed over time?

They have widened dramatically. For example, New York State’s advantage over Mississippi increased from 1.6 years in 1980 to about 7 years today.

Define devolution in the context of state policy.

Devolution is the transfer of federal oversight and fiscal responsibilities to state and local governments, often resulting in more localized decision-making and sometimes regressive policies.

What is pre-emption in state policy?

Pre-emption occurs when state laws restrict local governments from enacting their own policies on issues like anti-tobacco laws, gun control, minimum wage, and labor rights.

What does deregulation mean in economic and health policy contexts?

Deregulation is the removal or reduction of government regulations in industries (such as transportation, food, and pharmaceuticals), which can have mixed effects on economic efficiency and public health.

What did Montez et al. (2020) conclude about state policies and life expectancy?

They found that conservative state policies are associated with stagnant or worsening life expectancy, whereas liberal policies tend to correlate with improvements (e.g., higher cigarette taxes reduce smoking).

What was the outcome of the Sandy Hook parents vs. Remington gun maker case?

The case resulted in a $73 million settlement, underscoring the issue of corporate accountability in the realm of gun violence.

How does U.S. gun violence compare with other high-income countries?

The U.S. experiences the highest gun death rates among high-income nations, and these deaths are socially patterned; many American adults favor stricter gun laws.

What do recent reports reveal about U.S. COVID-19 mortality?

Reports indicate that U.S. COVID-19 mortality rates are the highest among high-income countries with reliable data, compounded by lower vaccination and booster coverage.

What did early research in the 1970s and 1980s find regarding religious denominational groups and mortality?

It demonstrated that social contexts, such as religious involvement, can provide social control and enhance social integration, thereby positively influencing population health.

Define 'social and spatial context.'

These contexts include the places, institutions, and groups that structure inequalities, norms, behaviors, and health outcomes in a population.

What is social regulation?

Social regulation comprises the formal (e.g., policies) and informal (e.g., cultural norms) controls on behavior derived from social and spatial contexts.

How is social integration defined?

Social integration is the process of forming social ties and participating in networks that provide support and enhance overall well-being.

What is social support?

Social support refers to the emotionally sustaining qualities of relationships that help individuals cope with stress and life challenges.

What does social isolation mean?

Social isolation is the relative absence of social networks and relationships, often leading to negative physical and mental health outcomes.

Define social networks.

Social networks are the structures of social interactions and relationships that allow ideas, norms, and health behaviors to spread—even among people who do not directly know one another.

What is social capital?

Social capital is the value or assets derived from the connections and relationships between people, which can enhance economic and health outcomes.

How is 'income' linked to population health?

Rising income inequality can contribute to declines in population health by affecting access to essential resources and opportunities.

Define 'wealth' in economic terms.

Wealth is the total value of assets owned by an individual or household minus liabilities, reflecting long-term financial security and disparity.

What impact did the Tax Cuts & Jobs Act have on marginal tax rates?

It reduced the alternative minimum tax for individuals and eliminated it for corporations, potentially contributing to increasing income and wealth inequality.

What are the key strategies for reducing income inequality in the U.S.?

Strategies include legislating a more progressive tax system (covering both income and net worth), increasing the minimum wage, strengthening labor unions, and providing more generous social benefits like the Child Tax Credit.

How does the U.S. compare internationally regarding income inequality and poverty?

The U.S. has the highest level of income inequality and the second highest rate of poverty among high-income countries, with trends worsening since 1980.

What has happened to U.S. union membership since the 1980s?

Union membership has decreased dramatically since the 1980s, which has contributed to growing income and wealth inequality.

How is the U.S. child poverty rate characterized compared to other high-income countries?

The U.S. child poverty rate is among the highest of selected high-income countries (per Smeeding and Thevenot study). None of the simplistic explanations (e.g., outdated definitions, school programs, or political agendas) fully capture its complexity (Answer: none of the above).

Which program’s support was sharply reduced on January 1, 2022, plunging millions of children into poverty?

The Child Tax Credit support was sharply reduced, which recently increased child poverty rates.

Which age group in the U.S. tends to be healthier than their peers in other high-income countries?

Adults aged 75 and older in the U.S. tend to have better health outcomes compared to their peers in other high-income countries.

What key provision does the Affordable Care Act (ACA) include regarding Medicaid Expansion?

The ACA provides for Medicaid Expansion, which requires approval by individual states—North Carolina, for example, is among the states that have not expanded Medicaid.

How has the life expectancy gap between New York State and Mississippi evolved?

In 1980, New York had a 1.6-year life expectancy advantage over Mississippi; today, that advantage has grown to about 7 years.

What is the current range of life expectancy differences across U.S. counties?

Over the past 40 years, differences have grown and can now be as wide as 20 years between the healthiest and the unhealthiest counties.

What were the key findings from Nicholas Christakis’ research on social networks?

His research demonstrated that even people who don’t directly know each other can influence one another’s health; social networks change over time; and people with similar characteristics tend to cluster together.

What does a recent New York Times report say about U.S. COVID-19 mortality?

It reports that the U.S. has the highest COVID-19 mortality rate among high-income countries with robust data—accompanied by lower vaccination and booster rates compared to peers.

What did early research reveal about mortality differences among religious denominational groups?

Findings showed that social contexts (like religious involvement) can exert social control and enhance social integration, positively affecting population health.

What are some possible explanations for international differences in population health?

Differences may stem from variations in healthcare systems, health behaviors, built environments, social and economic inequality, and policies (including corporate regulation).

What were the key findings of the 2013 NASEM Report on International Differences in Population Health?

The report found that the U.S. fares worse than comparison countries for ages 0–50 (with disadvantages emerging post-1980), with exceptions in cancer and self-rated health—while U.S. adults 75+ do relatively well.

How do trust levels impact COVID-19 vaccine coverage?

High levels of government and interpersonal trust—and lower corruption—are linked to higher COVID-19 vaccine coverage, emphasizing the need for accurate, timely public information.

Why does religious involvement increase life expectancy?

Religious involvement fosters social integration, lowers stress, and provides social regulation, all of which contribute to improved health outcomes and longer life expectancy, especially among African Americans.

What is illustrated by the 'Inequality Parade' lesson?

It emphasizes that wealth is disproportionately concentrated among a select few while most people remain in poverty, highlighting the stark disparities in economic distribution.

How do devolution, deregulation, and pre-emption affect population health?

Devolution shifts responsibilities to states, which may have more regressive tax systems. Deregulation reduces oversight in key industries, possibly impacting health safety. Pre-emption limits local policy-making, often restricting innovative health and social interventions.

What are the implications of Dr. Hummer’s research on religious context and population health?

Dr. Hummer’s findings highlight the critical role of religious institutions—especially the Black church—in fostering social integration and regulation. A lack of religious involvement is linked to higher mortality rates among African Americans, suggesting the importance of social contexts for health.