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Summary Theorizing Diversities
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Notes from the classes of Theorizing Diversities in Youth Care, to pass your exam with ease!
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Digital exam in Cirrus, combination of multiple choice and open questions based on lectures andliterature.
WC1: Which diversities and why do they matter?
What are diversities? Social groups differ on the basis of gender,
sex, sexuality, ethnicity, culture, religion, age and (dis)abilities.
Social groups are (un)equally treated in terms of mental (and
physical) health (care), education and policy. It’s important to
take these inequalities in account, clinical (protocols, individual
treatment, underlying larger/societal factors, stereotypes vs.
sensitivity) and policy-wise (equitability of schools, health care
system, society).
Which diversities are there?
- Sex/gender = the tools you were born with, biological.
o Gender identity = what do you feel like.
o Gender expression/behavior
o Sexual orientation/preference
o Queer and non-binary = you don’t feel
comfortable with the two boxes.
- Ethnicity, biological ‘race’, culture, language, religion:
o Feeling of belonging to a certain area or position in the world, in relation to a certain
community or place
o Member of ethnic minority group in NL: at least one of the parents born in another
country
o Differences depend on:
First/second/third generation migrant,
Level of acculturation
Migration reasons
Magnitude of cultural differences (how different are the norms compared to
the dominant group)
- Class, poverty, level of education/profession (SES)
How do diversities relate to identity? People often have multiple identities, and they can also
overlap. An identity is the reflective self-conception or self-image that we each derive from our
family, gender, cultural, ethnic and individual socialization process. You have two identities:
- Personal identity: what makes you unique?
- Social identity: to which groups do you belong? How do they behave? What are
their values?
Social identity: Identification with larger group(s) of people who share characteristics
(sense of self in terms of group membership). Belonging to a group is one of the basic
needs; humans need to feel connected to other people, have a sense of belonging,
receive social support. Social identities are also of importance regarding health and
(mental) health care:
- What health symptoms/behaviors are considered (ab)normal?
- How should one act upon these symptoms/behaviors?
- What coping mechanisms are used (e.g., asking for support, medication)
You can have multiple social identities, for example: the town you come from and you as
a student at RU.
,Disability spread: seeing only one aspect of someone’s identity (e.g., disability) and generalize that
aspect in such a way that it ‘becomes’ the entire person. Therefore: never reduce a person to (one
of) the group(s) that person belongs to. And do not simply generalize: have you ever met two
identical Belgian women?
Intersectionality
Intersectionality is an analytical framework for understanding how
various aspects of a person’s identity combine to create different
modes of discrimination and privilege.
So, diversities related to gender, sex, sexuality, ethnicity, culture, religion, age, and (dis)abilities may
result in inequalities, as social groups are treated differently because of them. On an individual level,
diversities have significance since they shape someone’s personal identity as well as social identity.
Diversities most often do not stand alone but overlap and can coexist: intersectionality. Moreover,
characteristics of individuals and their daily world have major influence on the success or failure of a
treatment or approach. It’s of great importance to pay attention to diversities as a future care
provider, education expert or policy maker.
WC2: Explanations for variations in (dis)abilities and problem behavior in individuals
We’re going to focus on differences between groups and explanations for those differences.
Examples of group differences:
- Sex: women are more often depressed, less autistic, less addiction in general (men do
experience more drug and alcohol abuse, women more often sleeping pills and pain killer
addiction), less in special education, more panic disorders (panic attacks)
- Homosexuals: more depressed, more suicide attempts, less good health, more addiction
- Class: people from lower “class” live about six years shorter, twenty years less in good health
- Ethnicity: one-year-old children of parents with Moroccan, Surinam-Hindustan or Turkish
background have lower score on health-related quality of life index and more emotional and
behavioral problems than those with parents with European and Surinam-Creole
background. Possible explanations: family factors (family functioning, ways of raising
children), social-economic factors, health of child
Explanations for diversities in care:
- Differences in occurrence of (mental health) problems
- Differences in getting access to health care
- Differences in remaining in the health care system
Schizophrenia is more often found among people from non-western countries, urban populations,
low IQ, hearing impaired or sexually abused. Explanations for the difference in occurrence could be:
- Competition/stress
- Feeling like a failure
, - Feeling like a social outcast/not belonging
But also: Moroccan-Dutch more than 5x prevalence of schizophrenia – but with culturally sensitive
questionnaire the difference disappeared (and depression was more often the case (Zandi et al
2010).
Explanations at client level
Ethnic groups/depression and anxiety:
- Article de Wit et al (2008): depressive and anxiety disorders in different ethnic groups – study
of sample of adult population in Amsterdam
- Prevalence depressive and/or anxiety disorder: 6,6% Dutch; 18,7% Turkish-Dutch (higher in
women); 9,8% Moroccan-Dutch (higher in men); 1,2% Surinamese/Antillean-Dutch (all data
are 1 month prevalence – for lifetime overall prevalence: 26,4%)
- Explanations:
o Social-economic status (income and education level); age; gender – did not explain
everything so:
o Selective migration; migration-history; migrant-status: perhaps an explanation is also
that this includes many second-generation migrants (more prone to these disorders)
for first generation immigrants is their choice to move away to have a better life,
for second generation it’s not
o Social support, acculturation, life events, discrimination, coping style
Ethnic: minorities access to health care
- Scheppers et al: Potential barriers to the use of health services among ethnic minorities
- Patient level barriers: demographic, social structure, health beliefs/attitudes, personal
enabling resources, community enabling resources, perceived illness and personal health
practice
Migrants/depression and anxiety:
- Lindert et al: depression and anxiety in labor migrants and refugees
- Prevalence rates for depression/anxiety 20/21% labor migrants; 44/40 % refugees
- Refugees: post/during and after migration stress factors
- Refugees: different from labor migrants in less selection of host country and in age, gender,
family bonds and education
- Explanations: better economic conditions in host country: better mental health for labor
migrants (not refugees) – more options for job
- ‘Healthy labor immigrant effect’ (self-selection of migrants, healthy people more easily
choose to migrate); see also Kennedy/Kidd 2015
Gender/depression:
- Hyde et al: The ABCs of Depression: Integrating Affective, Biological, and Cognitive Models to
Explain the Emergence of Gender Difference in Depression
- Depression about twice as common amongst women as amongst men (11 versus 21%) –
starting from adolescence
- Explanations:
o Biological vulnerability (genes and hormones)
o Affective vulnerability (temperament)
o Cognitive vulnerability (negative style; objectified body consciousness (OBC);
rumination)
o Negative life events (sexual abuse/harassment)
- Model (based on research) suggests these factors mutually influence each other – ‘multiple
pathways to depression
, Same-sex attraction/depression, school (Bos):
- Adolescent with same-sex attraction have poorer mental health: depression and lower levels
of self-esteem and lower school performance
- Same-sex attraction in –western- countries seen as first step, next steps could be e.g.,
naming same sex desire to oneself, make their feelings (‘sexual identity’) public, integrate it
as part of identity. So, first step, no experience yet with being stigmatized, but feelings of
being different. Feeling, self-labeling, behavior are different dimensions
- Same-sex attraction seems to lead to less (quality) social relationships with peers and fathers
(less disclosure to father) which (partially) explains poorer mental health
- Less quality relationships e.g., because of feeling different, higher levels of gender
nonconformity, worries over ‘never finding partner
Layer analysis of diversities
Structural (social context; resources; location in society):
- Who is situated where in society and has access to which resources?
- Social/economic and cultural capital
- Physical/institutional environment
Symbolical (cultural context; discursive; values):
- Stereotypes, discrimination, and self-fulfilling prophecies
- Which values dominate in society, in health care system, amongst health care takers and
with clients – and do these values collide?
Individual:
- Biological
- Events
- Effects of other layers on individual
Explanations for diversities in care? Look at all elements of the client:
- Individual elements: biological, life events
- Structural elements: social, economic and cultural capital
- Discourses (norms): discrimination/self-fulfilling prophecies and mismatch value systems
- And so: variations in risk/protective factors
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