Demographics Notes

Demographics

• Demographics are the statistics of populations and the mathematical applications of sociology.
• Demographic data can be gathered:
  • Informally (e.g., a professor asking about the distribution of students by year in a course).
  • Formally (e.g., the United States Census Bureau).

Common Demographic Categories

• Demographers classify individuals based on various criteria.
• Key demographic categories:
  • Age
  • Gender
  • Race and ethnicity
  • Sexual orientation
  • Immigration status

Age

• Aging is a universal process.
• Life Course Perspective (or Approach): Considering an individual's age and cumulative life experiences when analyzing their:
  • Personality
  • Social status
  • Health

Examples

• A psychiatrist considering a patient's early life events.
• A general practitioner conducting extra lung screenings on a patient who worked in a coal mine.
• Ageism: Prejudice or discrimination based on a person's age.
  • Examples:
    • Young professionals being viewed as inexperienced.
    • Older individuals being perceived as frail or less intelligent.
• Age Cohorts (or Generational Cohorts): Groupings of individuals based on age or birth year.

Utility of Age Cohorts

• Understanding individual life course differences.
• Analyzing a population at a macroscopic level to predict demographic shifts.

Examples of Demographic Shifts

• Aging population.
• Shift from developing to developed economy.
• Stable population.
• Baby Boomers: The generation born after World War II (1940s-1960s) that caused a spike in birth rates.
  • By 2030, over 70 million Americans will be 65 or older, representing nearly 20% of the population.
  • The fastest-growing age cohort in the U.S. is the 85 or older group.
  • Effects on healthcare: More than 40% of adult patients in acute care hospital beds are 65 or older.
  • Increased demand on government programs like Medicare and Social Security.
• Dependency Ratio: The ratio of the number of members of a population that are not in the workforce to the number of members that are in the workforce.
  • Formula:
    • $Dependency \ Ratio = \frac{\text{Number of dependents (under 15 and over 65)}}{\text{Number of people in the workforce (15-64)}}$
  • Youth Ratio: Number of people under 15 divided by the number of people aged 15 to 65.
    • $Youth \ Ratio = \frac{\text{Number of people under 15}}{\text{Number of people aged 15 to 65}}$
  • Age Dependency Ratio: Number of people 65 divided by the number of people aged 15 to 65.
    • $Age \ Dependency \ Ratio = \frac{\text{Number of people over 65}}{\text{Number of people aged 15 to 65}}$
    • Quantifies the economic burden on the working-age population to support those outside the workforce.

Contrast: United States vs. Uganda

• In Uganda, 48% of the population is under 15 years old (dependency ratio of 0.52), and 2% is 65 years and over.
• Explained by the drop in infant mortality rate.
• Forecasts predict a large proportion of the population entering the working-age cohort in the next 10-20 years, which could increase economic productivity if matched with job growth. If not, unemployment rates may increase, leading to civil unrest.
• Demographic Transition Theory: Explains the shift from developing to developed country.
• Stable Population: When a population's fertility rate and mortality rate remain relatively constant over a long period of time, the distribution of the population among the age cohorts remains fairly constant.

Gender

• Sex: Biologically determined (e.g., the biological female produces the larger gamete and carries offspring).
• Gender: Society's notions of femininity and masculinity (socially constructed).
• Gender Roles: Expected behavioral traits associated with each biological sex (also social constructs).
• Gender Identity: An individual's adoption of behaviors that project the gender that individual wishes to portray.
• Gender Segregation: Separation of individuals based on perceived gender.
  • Examples:
    • Male, female, and gender-neutral bathrooms.
    • Separate male and female sports teams.
• Gender Inequality: Intentional or unintentional empowerment of one gender to the detriment of others.
• Gender Stratification: Inequality in access to social resources based on gender.

Example

• Single-gender schools are an example of gender segregation, but gender stratification occurs if there is a systematic difference in resource allocation between such schools.

Race and Ethnicity

• The definition of race has changed through history and continues to change.
• The term originally referred to speakers of a common language and later indicated national origin.
• The term has also been used to denote shared phenotypic similarities between people.

U.S. Census Racial Categories

• White
• Black
• Asian
• American Indian or Alaskan Native
• Native Hawaiian/Pacific Islander
• Examples: white and black describe phenotypic similarities, while other categories like American Indian and Pacific Islander are based on national origin.

Race as a Social Construct

• No uniform agreement about racial categories.
• Each society generates its own racial labels.
• Racial labels materially affect people's lives through institutionalized practices, preference, and discrimination.

Sociological Definition of Race

• Socially constructed groupings of people based specifically on inherited phenotypic characteristics.

Ethnicity

• Societies also group people by shared language, cultural heritage, religion, or national origin.
• Ethnic labels and criteria for inclusion in an ethnic group change from society to society and over time.

Distinction between Race and Ethnicity

• African American individuals, African immigrants, and West Indian immigrants represent three different ethnicities but may be given the same racial label due to phenotypic similarities.
• Symbolic Ethnicity: A specific connection to one's ethnicity in which ethnic symbols and identity remain important even when ethnic identity does not play a significant role in everyday life.
  • Examples:
    • Celebrating Irishness only on Saint Patrick's Day.
    • Attending folk festivals or ethnic pride rallies.

Race, Ethnicity, and Healthcare

• Race and ethnicity influence a patient's chance of receiving specific procedures and treatments.
• Evidence suggests different races are not always offered the same level of care in medical emergencies due to conscious or unconscious bias.
• Public health outreach projects target at-risk racial or ethnic populations through education, screening, and treatment.
• Many clinics will staff Spanish-speaking doctors and medical students to cater to the Hispanic immigrant population.

Sexual Orientation

• Defined as the direction of one's sexual interest.

Categories

• Attraction to individuals of the opposite sex (heterosexual).
• Bisexual attraction to members of both sexes.
• Homosexual attraction to individuals of the same sex.
• Involves a person's sexual feelings and may or may not be a significant contributor to that person's sense of identity and may or may not be evident in the person's appearance or behavior.
• Coming Out: Disclosure of minority sexual orientations.
  • Associated with decreases in depressive and anxious symptoms linked to cortisol levels and stress.
  • Human sexuality is more fluid than previously believed.

Kinsey Scale

• Alfred Kinsey described sexuality on a 0 to 6 scale.
  • 0 representing exclusive heterosexuality.
  • 6 representing exclusive homosexuality.
  • Few people fell into the categories of 0 and 6, with many falling somewhere in between.
• LGBT: Lesbian, Gay, Bisexual, and Transgender.
  • Can be expanded to include queer or questioning (Q), intersex (I), or asexual (A).

Health Disparities in the LGBT Community

• HIV disproportionately affected gay men in urban environments during the early 1980s.
  • While the prevalence of HIV is still slightly higher in men who have sex with men (MSM), it exists in all populations.
  • Efforts to encourage safe sex and increase screening have helped to slow the epidemic of HIV as, as has increased awareness of these of those with HIV/AIDS with projects like the AIDS Memorial Quilt.
• Lesbians receive less screening for cervical cancer and may not be screened for other sexually transmitted infections.
• Transgender individuals may have multiple areas of increased risks including off-label or unsupervised use of street hormones without proper counseling on their side effects.
• Mental health disparities are also common.
  • LGBT youth are at higher risk for bullying, victimization, and violence and have higher rates of suicide.
  • Adults have a higher prevalence of depression and anxiety.
  • Gay men have an increased rate of eating disorders compared to heterosexual men.

Immigration Status

• The nation's total recent immigrant population is growing rapidly.
  • 40,400,000 in 2011 and expected to increase by roughly 20,000,000 in the next two decades.

Nativity and Generational Status

• The largest proportions of immigrants emigrated from Mexico, The Caribbean, and India.
• Generational Status: Refers to the place of birth of a specific person or that person's parents.

Definitions

• First generation: Someone who is born outside of their place of residence.
• Second generation: A person that has at least one parent that is foreign born.

Barriers Affecting Immigrants

• Complex organization of the U.S. health care system.
• Language barriers.
  • Telephone translation services.
• Racial and ethnic identity may be more pronounced in first-generation immigrants.
• Intersectionality: The interplay between multiple demographic factors, especially when it leads to discrimination or oppression.
• Undocumented status presents a major barrier for many immigrants to access healthcare due to fear of reporting and deportation.

Demographic Shifts and Social Change

• Demographic shifts are changes in the makeup of a population over time.
• The U.S. population has roughly doubled since 1950.
• The average age in the U.S. has increased, and the population is becoming more racially and ethnically diverse.
• Population Density: The number of people per square kilometer of land area.
• Population Projections: Attempt to predict changes in population size over time.
• Population Pyramids: Provide a histogram of the population size of various age cohorts.

Fertility, Mortality, and Migration

• The increased population of the U.S. is due to fertility, mortality, and migration.
• Fertility Rate: The average number of children born to a woman during her lifetime in a population.
  • In Africa, the average fertility rate is between four and eight children per woman.
  • In the U.S., fertility rates have trended downward over time, but in 2013 it was still above two, indicating continued population growth.
• Mortality Rates: The number of deaths in a population per unit time, usually measured in deaths per 1,000 people per year.
  • With advancements in health care and access, the mortality rate in the U.S. has dropped significantly over the past century.
  • Decreased mortality rate in the U.S. is one contributor to the increase in the average age of the population, as is a decreased fertility rate.
  • The aging of the baby boomer generation also increases this average age.
  • Birth and mortality rates can be reported in multiple forms: total rate for a population (crude rate), the crude rate adjusted to a certain population size over a specific period of time, and multiplied by a constant to give a whole number or age-specific rates.
• Migration:
  • Immigration is movement into a new geographic space.
  • Emigration is movement away from a geographic space.
  • The U.S. continues to have larger net immigration than emigration, driving an increase in population size.
  • Immigration also increases the racial and ethnic diversity of the U.S., as do increased mobility within the country and increases in intermarriage between different races and ethnicities.
  • Pull Factors: Positive attributes of the new location that attract the immigrant.
  • Push Factors: Negative attributes of the old location that encourage the immigrant to leave.

Demographic Transition Theory

• A specific example of a demographic shift that occurs as a country develops from a pre-industrial to an industrial economic system.
• Has been seen in the U.S. since the industrial revolution and is currently occurring in many developing countries.

Stages:

• Stage One: Pre-Industrial Society
  • Both birth and death rates are high, resulting in a stable population.
• Stage Two: Economic Progress
  • Economic progress leads to improvements in health care, nutrition, sanitation, and wages, causing a decrease in death rates, thus population increases.
• Stage Three:
  • Improvements in contraception, women's rights, and a shift from an agricultural to an industrial economy cause birth rates to drop.
  • As birth and death rates equalize, population growth hits an inflection point and begins to level off.
• Stage Four:
  • In industrialized society, birth and death rates are both low, resulting in a relative constant total population.
• Stage Five (Theorized):
  • Birth rates continue to drop and fall below the death rate, resulting in a decline of total population.
  • Japan and Germany are currently experiencing demographic shifts expected in this theorized fifth stage.
• Malthusian Theory This theory focuses on how the exponential growth of a population can outpace growth of the food supply and lead to social degradation and disorder.
  • Malthusian Catastrophe: Hypothetical mass starvation due to population growth outpacing the world's ability to generate food. The result is similar to the death phase of bacterial growth when resources in the environment have depleted.

Social Movements

• Organized either to promote or to resist social change.

Motivation

• Motivated by a group's perceived relative deprivation which is a decrease in resources representation or agency relative to the whole of society or relative to what the group is accustomed to from the past.

Types:

• Proactive: Promote social change.
  • Examples: civil rights movement, women's rights movement, gay rights movement, animal rights movement, and environmentalism movement.
• Reactive: Resist social change.
  • Examples: white supremacist movement, counterculture movement, anti-globalization movement, and anti-immigration movement.
• Establish coordinated organizations (e.g., NAACP, ACLU, HRC, Humane Society, and Greenpeace).
• May seek to share their message through the media and demonstrations.
• Political involvement is also common through lobbying and donations.

Globalization

• The process of merging the separate nations of the world into a single sociocultural entity.
• A relatively recent phenomenon spurred on by improvements in global communication, technology, and economic interdependence.
• Leads to a decrease in the geographical constraints on social and cultural exchanges and can lead to both positive and negative effects.

Positive Effects

• Availability of food, especially produce, from around the world during the entire calendar year.

Negative effects

• Worldwide unemployment, rising prices, increased pollution, civil unrest (particularly in unindustrialized or undemocratic nations), and global terrorism.
  Traditionally, the health sector has been organized at the national, state, or local level, but this is beginning to change. Groups such as the World Health Organization, WHO, the American Red Cross, and Doctors Without Borders supply aid to populations in need around the globe.
  Many medical schools are also increasing opportunities for medical students to complete rotations in other countries.

Urbanization

• Refers to dense areas of population creating a pull for migration.

Ancient Examples:

• Jerusalem, Athens, Timbuktu, etc.
• The economic opportunities offered in cities and creation of a large number of world cities has fueled an increase in urbanization during the last few decades.
• Currently, more than half of the world's population live in what are considered urban areas.
• Sociologists and other professionals have found links between urban societies and health, challenges related to water sanitation, air quality, environmental hazards, violence and injuries, infectious diseases, unhealthy diets, and physical inactivity.
• Cities are rarely homogeneous with respect to their population makeup.
• Ghettos: Areas where specific racial, ethnic, or religious minorities are concentrated, usually due to social or economic inequities.
• Slums: Extremely densely populated area of a city with low-quality, often informal housing and poor sanitation.

Conclusion

Trends Changing Healthcare Needs

• Increased diversity in the American population due to immigration, increased social and academic mobility, and interconnectedness through technology.
• Increased access to health care through reform legislation.
• Successes in medicine and public health have increased survival rates and enabled longer lives, leading to an aging population with multiple illnesses simultaneously.
• Medical schools are increasing coursework in interpersonal skills. Doctor-patient relationship, doctoring, or physician, patient, and society are such courses at various schools, as well as cultural sensitivity, the recognition and respect of differences between cultures and research ethics. This is part of the biopsychosocial model of medicine.
• Enhances the ability to counsel patients.
• Working with patients on their own terms to maintain and improve their health status and begin to correct health inequities.