Social Inequality, Essay Example

Generalized Anxiety Disorder

Outline of Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) is a common mental illness of the 21^st Century. Patients with GAD experience worry and anxiety about everyday things without any real reasons, as well as physical symptoms associated with it. It also sometimes consists of multiple panic attacks, and that is why it is hard to tell the difference between GAD and other anxiety disorders. It is an illness that is thought to have several social elements. (Miech et al. 1999, p. 1103.). The assumption is that a low socioeconomic status is a trigger for mental illnesses. The author also concludes that the correlation between demographic data and the occurrence of GAD is proven. According to research, (Kessler et al. 2005, p. 1075) this mental illness is rarely found as a standalone condition. It is usually triggered by a life event or victimization, therefore, it is related to social status, situational stress occurrence and other mood disorders. It is therefore, evident that GAD is a mental illness that carries social aspects and cannot be examined solely on the clinical grounds of brain functioning. It is a dysfunction that affects one’s daily life; personal well-being and social status, relationships. Anxiety disorders affect around 10 percent of the population at least once in their lives and women are twice as likely to be affected as men. (Kessler et al. 2005, p. 1076) According to patient testimonials found on the Anxiety and Depression Association of America (online), Melanie Higgins experienced panic attacks and day-to-day worries as a side effect of hormonal treatment and a result of changes in her lifestyle or circumstances. She started worrying about members of her family becoming sick, without any real reason. “Because of the focus on evidence of inequality and structural explanations, the SDH approach to gender, race, and disability is mechanistic, and therefore not as sophisticated an analysis as we would get from Social Model of Health and Intersectionality approaches to health inequality.” (Dennis, p. 31.)

Social determinants perspective

There are different social determinants associated with health conditions, as well as mental illnesses. According to Dennis (2009), and Marmot (2005), namely: life expectancy, social wealth, income inequality, working conditions, education and the ageing of the population. As women are more likely to be affected by GAD, it is important to examine the social determinants leading to the mental illness. The increased workload and stress level of women in developed countries is proven to be a contributing element. (Olena, 2011. p. )However, on the sociological level, stress situations such as facing violence and danger on a regular basis, harassment at workplace are also important social determinants that can be examined when assessing generalized anxiety disorders. According to Silva (1999. p. 1115) the socio-economic status has a close relation with the severity of GAD. (Olena, 2011. p. )

Social constructionist perspective

The social constructionist perspective examines social interpersonal influences and their correlation to health inequalities. It focuses on the culture’s effect on one’s health. These effects can be assumptions and expectations the individual needs to face during their lifetime. In the case of generalized anxiety disorder, it can be a very effective way of examining reasons and trails leading to the occurrence of the illness. It focuses on personal interactions and their effect on one’s health. Considering socialization as the main aspect of personality development and health education, and often ignoring the genetic aspects or macro-economic factors, however, has its limitations. In the case of mental illnesses; namely generalized anxiety disorder, the effects of the smaller community as well as the social environment and approaches on a regional level should also be taken into consideration. As social constructivism says “social structure is provided as a catch-all for the organization of society and how it distributes access to actual material and social resources.” (p. 21.).As health inequalities are not only determined through personal socialization but also on a social group level, some of the inequalities might not be solved through this approach.

Intersectional perspective

Intersectional perspective of health inequalities examines the intersections between aspects of social difference and identity. (Dhamoon and Hankivsky, 2011. p. 16.) It examines both geological and demographic aspects of social groups and aspects of health. The theory concludes that there is a connection between location and demographic groups, therefore, they are interdependent and should be evaluated accordingly. Examining race, gender, socialization, status, as well as the macro level of health inequalities is an innovative combination of the two above theories. As identity and socialization occurs on demographic and sociological level, this can be also said for health inequalities. The treatment of GAD is a problem that carries demographic aspects of health inequalities, as minority groups might not have access to a treatment or the knowledge of the treatment options. In some cultures, however, GAD is not considered a serious illness and professionals are unable to differentiate between the different forms of anxiety disorders. The source of health inequality can lie both in the health policy of the country or regions, the culture and the personal socialization, such as people’s education, family relations and relationships between different groups. The categories of difference (Dhamoon and Hankivsky, 2011. p. 22.) are determined by religion, race, class, gender sexual orientation and nationality. The intersectional perspective of health inequalities model addresses the complexity of identity formation. (Dennis, 2009. p ) “As a theoretical approach, intersectionality forces researchers to deeply consider the diverse identities and subjectivities that exist among women, and how the se complexities inform the research process.” (p. 92.)

Evaluation of Approaches

After examining the above three approaches and evaluating their theoretical frameworks, determinants and their correlation with health inequalities, it is evident that the intersectional perspective would be the most relevant approach to study the problem of generalized anxiety disorder. As many of the socialization processes on health level are based on interdependent variables in the case of mental illnesses, and the studies concluded by Kessler et al. (2005. p.27) show that the prevalence of anxiety is determined by sex, social status, economic background and age, as well as victimization, exclusion by race or nationality. Examining the health inequalities on a national, regional health policy level, as well as the factors contributing towards personal socialization would result in a greater understanding of the health problem and its determinants.

References

Raphael, Dennis ed. (2009) Social Determinants of Health—Second Edition (Toronto: Canadian Scholars Press) 
Hankivsky, Olena, ed. (2011) Health Inequities in Canada: Intersectional Frameworks and Practices (Vancouver: UBC Press)

Miech, Richard A., Caspi, 2 Avshalom, Moffitt, Terrie E., Entner Wright, Bradley R.,

Phil A. Silva (1999) Low Socioeconomic Status and Mental Disorders: A Longitudinal Study of Selection and Causation during Young Adulthood. American Journal of Sociology, Vol. 104, No. 4 (January 1999), pp. 1096-1131 The University of Chicago Press Online. http://www.jstor.org/stable/10.1086/210137. Accessed: 17/05/2011 11:44

Kessler RC, Brandenburg N, Lane M, Roy-Byrne P, Stang PD, Stein DJ, Wittchen HU (2005) Rethinking the duration requirement for generalized anxiety disorder: evidence from the National Comorbidity Survey Replication. Psychol Med 35:1073–1082

Marmot, M. (2005) Social determinants of health inequalities. Public Health. Lancet 2005; 365: 1099–104