Poverty, Discrimination, and Health/Mental Health Disparities

SW843, Section 001

This course examines social and environmental factors contributing to racial/ethnic and gender disparities in health and mental health, with an emphasis on the effects of poverty and discrimination. Using a lifecourse perspective that integrates biological and social risk and protective processes (Kuh et al., 2003), the etiology, course and outcome of specific health and mental health problems will be examined in depth. Examples include depression, post-traumatic stress disorder and substance abuse, HIV/AIDS, obesity and eating disorders, disparities in pregnancy outcome, and breast and prostate cancer. Current conceptual and methodological issues and controversies will be addressed. Examples include defining and measuring poverty and discrimination; ecosocial theory and biological expression or "embodiment" of poverty and discrimination (Krieger, 2002); accumulation of risk, critical and sensitive periods, transitions and turning points; psychoneuroendocrine processes; and gene-environment interactions. Racial/ethnic and gender differences in health/mental health care beyond those attributable to known access-related factors will also be explored, including patient-level factors such as mistrust and provider-level factors such as bias, stereotyping, and uncertainty (IOM, 2003). Implications for social work, social policy, and social justice will be addressed throughout.